Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

Migraine, the extreme headache that comes back to haunt its victims every chance it gets, can actually be managed with a controlled diet. Of course, medication is the solution, and so is surgery with botulinum toxin in extreme chronic cases. But let s try lifestyle changes before going for any of that.

Symptoms of Migraine:

Pain on the sides of the head is the characteristic symptoms of migraine, but there are others:

A throbbing sensation in the head.

Nausea from constant pain.

Photosensitivity.

More than the usual aversion to loud noises.

Sweating, stomachache, and diarrhea rarely come with the more common symptoms of migraines, as stated above.

Causes of Migraine:

Migraine is often genetic. Pain triggers include:

Hormonal changes, as in during menstruation or pregnancy or puberty.

Emotional disturbances like anxiety, depression, shock, or even excitement.

Poor posture that puts stress on the neck or head.

Tiredness or lack of sleep.

Side-effects of medication such as sleeping pills, some contraceptive pills, and medication for hormone replacement therapy.

External triggers like second-hand smoke, loud noises, very bright lights, lack of oxygen in a poorly ventilated room, dust, any strong smell.

Food Triggers

Foods that trigger migraines include:

Aged cheese with high tyramine: Blue cheese, cheddar, feta, mozzarella, brie, parmesan, gorgonzola, English stilton, Swiss cheese,

Alcohol: Red wine, scotch, champagne, beer, and vodka trigger migraine by dehydrating the body and/or due to the sulfite preservative in them.

Food preservatives: Nitrite or nitrate compounds in preserved foods like ham, sausages, hotdogs, bacon, pepperoni, and deli meat.

MSG: Monosodium glutamate in soy sauce or anything labeled  hydrolyzed  is a trigger.

Sourdough: Baked yeast products like bread, rolls, donuts, and cakes.

Nuts: Peanuts, peanut butter, dried fruits, and some seeds and nuts trigger migraine in not all but some people.

Smoked or Dried Fish

Tomatoes

Onions

Citrus Fruits: Like lemon, orange, grapefruit, Greek citron, etc.

Beans: Like lima, fava, pinto, snow peas, lentils, pole, and broad beans.

Caffeine: Anything more than 200mg of caffeine can trigger migraines.

Artificial sweeteners: Due to aspartame or sucralose content.

Chocolate: Due to beta-phenylethylamine

Avoiding these food items can alleviate symptoms of migraine. This is why one should avoid these foods in their diet. However, it is advisable to consult a Dietician or Nutritionist before avoiding or taking any food item.

Food Which Help to Cure Migraine

The elimination of diet tactics is not enough to manage migraines. There are foods that must be included in the diet. They are:

Salmon: For the vitamins, and omega 3 fatty acids that reduce inflammation and blood pressure.

Dark chocolate: Due to the magnesium content.

Fresh figs: Due to potassium and electrolytes. Avoid dried figs as they contain tyramine.

Shrimp: Due to astaxanthin and vitamins and minerals to help with inflammation.

Carrots: Beta-carotene helps.

Sweet potatoes: Vitamin C, niacin, pantothenic acid, phosphorus, Vitamin B group, manganese, copper, and potassium to the rescue.

Collard Greens

Kale

Quinoa

Ginger

Fresh fruits: Like bananas and apples.

Herbs: Like feverfew, butterbur.

Conclusion

Avoiding trigger foods, having migraines relieving foods, and having plenty of water along with enough sleep and some exercise can manage migraines well enough to not need medication.

All The Foods That Trigger Or Alleviate Migraine!

In today s stressful environment, more and more people are being diagnosed with psychological disorders such as insomnia and depression. Neither of the two are things which people feel lucky to possess. However, it is interesting to note that there is a link between the two conditions. Also, the problems are a lot more common than a person is likely to first think; 80% of depressed people suffer from chronic insomnia!

For a long time until recently, many people were of the opinion that most depressed people were insomniac. But that is not really correct. The two issues do overlap to a large extent, but they are different from each other. Again, that does not mean one cannot affect the other.

When a person has depression, one of the main things that he or she can experience is a lack of pleasure from the activities and happenings which occur in his or her daily life. Similarly, when a person does not get enough sleep or even just cannot sleep, he or she is quite likely to display a tendency to worry. Often, worrying sets the stage for depression to develop in the person. In fact, doctors have observed that people who do not sleep enough are more likely to undergo treatment for depression than the others.

Recent findings have concluded that when a person sleeps better, the case of depression also shows an uptick. In addition to this, the habit of sleeping well can also go quite a long way to make sure that a person does not relapse into depression. According to some sleep therapies, people who suffer from lack of sleep are advised to follow a systematic routine of getting to bed and getting out of bed. Activities including reading in bed or watching TV after going to bed must be avoided. While there are various means to help a person sleep better, the choice as to which one would suit a person in the best possible way is only best decided by the person s personal doctor. What is for sure is the fact that a person can effectively sleep to a better life!

So, it can be said that if a person wants to cure his/her depression and enjoy life being peppy, napping away is not such a bad idea after all. Having said that, everything is good only up to a certain limit!

Insomnia and Depression - Is There A Link Between Them?

Cerebral Palsy is a disorder related to the posture, movement or muscle tone, mostly due to immature development of the brain in a baby. This condition usually crops up, when the baby is already in the womb. The symptoms may surface when the baby is in its infancy or even later. Irregularities in the reflexes, posture, walking style, etc should ring a bell for the parents. Kids suffering from cerebral palsy may also suffer from muscle imbalance of the eye muscles, leading to problems focusing on an object. The range of motions becomes limited as well. There could be conditions such as deafness, epilepsy, impaired brain function and blindness associated with this disease. 

Whom to consult for cerebral palsy in kids? 
A kid suffering from Cerebral Palsy might have to work with a medical team for a very long time. Parents might need the help of a paediatrician, orthopaedic surgeon, paediatric neurologist, physical therapist, speech-language pathologist, mental health specialist, developmental therapist, recreation therapist and special education teacher. 

Treatments that are available for Cerebral Palsy in kids Medication: 

Medications: Medications are often used to improve the functional abilities of a kid. Certain spasticity related complications, treatment of pain, and other symptoms of Cerebral Palsy can be treated with medications. It is important to discuss with the doctor, the side-effects involved in taking the medication. There are two types of medications- for isolated spasticity and for generalized spasticity. In case of Isolated spasticity, doctors recommend Botox injections every 4-6 months to stabilize one muscle group. If the whole body is affected due to cerebral palsy, doctors recommend medications such as baclofen, diazepam and dantrolene to relax the contracted and stiff muscles. 

Therapies: While there are many therapy treatment, three types of therapies are the most important for treating a child suffering from cerebral palsy. They are physical therapy, occupational therapy and speech& language therapy. Physical therapy is necessary for the flexibility, mobility and motor development of the child. Occupational therapy helps a kid imbibe alternative strategies to participate in daily activities. From teaching a child to walk with a cane to help them operate a wheelchair, physical therapy makes a child self-sufficient as much as possible. Speech and language therapy helps child s ability to communicate either verbally or with sign-language. 

Surgery: Surgery may be necessary to loosen the muscles, correct abnormalities of the bone etc. An orthopaedic surgery is necessary in cases where a kid was born with several deformities. The correction can decrease pain and increase mobility. In severe cases when the normal treatments do not help, doctors cut the tendon of spastic muscle. It helps to relieve the pain and relax the muscle.

Cerebral Palsy In Kids - Treatments That Can Help!

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