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

Migraine is the most severe forms of headaches. Migraine attacks usually include nausea, vomiting, and sensitivity to light along with the severe headaches, which are sometimes unbearable. If faced with this condition, there is only one way out to suffer through it, though pain medications do help manage the pain.

Being such a common condition, there is constant research being done about how to help people deal with migraines. In addition to popping pain killers, there is more than what a person can do to reduce the pain.

Identify the triggers: Those who have had migraine for a while would know what triggers the attack. Whether it is chocolates or eggs, get to know what can induce an attack, and if possible, stay away from it.
Stick to a schedule: Whether it is in terms of food or sleep, try and develop a routine and follow it.
Physical workout: Develop an exercise regime to cover at least 30 minutes of physical exercise. Most people see a dramatic difference with a regular exercise routine.
Bid goodbye to smoking: If you are a smoker, work at quitting this habit. It is one of the known triggers and also aggravates regular headaches.
Stress management: Whether you are going through physical or emotional stress, migraine attacks can become more frequent and severe. Manage physical stress by not sitting at the same location for prolonged periods and by doing small exercises to relax the shoulders, knees, and jaws. For emotional stress, identify what helps you relax and follow it. While deep breathing works for some, for others, it could be music. Whatever your relaxation technique may be, ensure that you follow it. Work on improving relationships that stress you out. A regular exercise routine and sleep pattern also helps in reducing physical stress.
Despite these methods, migraine attacks do happen. Follow the next few steps when you know you are getting an attack.

Stop your regular activities and find a calm environment for yourself. Let this place have less of light and sound as they can aggravate migraines.
Sleep if you are able to.
Go for a warm bath if possible.
Try hot or cold compresses, which can numb the senses and reduce the pain.
Have a caffeinated beverage as this will provides relief. Do not have it in excess as you will have hangover effects from the caffeine.
Use only those medications that were prescribed by your doctor. Do not experiment.
Lifestyle changes including exercise, diet, and stress management play a vital role in dealing with migraines.

Migraine - How To Deal With It?

Sleep apnea is a sleeping disorder in which you experience frequent breathing pauses while sleeping. In case of some, the pauses may last for just a few seconds, while for others, it may continue for a few minutes. Sleep apnea is generally chronic in nature. There are three types of sleep apnea, namely Central, Obstructive and Complex sleep apnea. Central sleep apnea occurs if the brain fails to transmit signals to the muscles responsible for your breathing functions. Obstructive sleep apnea occurs due to relaxation of your throat muscles. Complex sleep apnea refers to a combined condition of both central and obstructive sleep apnea.

Some of the possible causes of sleep apnea are as follows: 
1. Blockage of airway during sleep can cause sleep apnea
2. Putting on weight can cause obstructive sleep apnea
3. In some cases, large tonsil tissues can lead to obstructive sleep apnea in small children
4. Intake of certain medicines like Oxycontin or MS Contin can cause central sleep apnea
5. Male people are more prone to sleep apnea
6. Smoking is also a potent trigger for sleep apnea
7. At times, high blood pressure can induce sleep apnea
8. Suffering from sinus can also lead to sleep apnea
9. Large neck size (more than 16 inches) may cause sleep apnea
In case of some people, sleep apnea might be an inherited condition.

The most common symptoms of sleep apnea are mentioned below:
a. Sometimes, obstructive sleep apnea is accompanied by choking or snorting sounds.
b. You may encounter breathing trouble while sleeping, leading to a disruption of your sleep.
c. Maximum times, sleep apnea is accompanied by snoring.
d. Sleep apnea leads to a dry mouth, which can disturb your sleep.
e. You may feel dizzy during daytime.

Causes and Symptoms of Sleep Apnea

A migraine is one of the worst form of headache. It is reported that over 90 percent of people who suffers from a migraine are unable to work. The intense pain totally makes them vulnerable. A mammoth 113 million workdays are wasted globally due to this problem. This being said, if the pain is slowly starting to set in, it is possible to manage it at the workspace.

Here is a convenient guide to do just that:

1. Pain Medication: If you are a migraine patient, it is likely that you have your migraine medication with you. The first step is to try the medication. If on the other hand, the medication is not available basic painkillers can be given a shot to manage the pain. Basic pain medications, such as ibuprofen are easily available over the counter and are capable of providing temporary relief.

2. Educate co-workers: Despite awareness about migraine pain, many organisations continue to turn a deaf ear about the problem. Instead of fighting with the whole organisations, it makes sense to educate your immediate colleague about a migraine. All you require is 1-2 people who have your back.

3. Control the environment: With the onset of the pain, it becomes more and more difficult to resume work. Few environmental changes such as adjusting the monitor to the eye level, using a sachet of odour neutralizer and switching off the nearest light will help you to manage the pain for few hours.

4. Staying hydrated: Migraine tends to increase multifold if the body is not hydrated. It is, therefore, essential to drink as much water as you can. Apart from the water, a few other drinks such as lime juice and green tea can be of great assistance to hold the pain back for quite some time. The best time to drink green tea is in the morning as it helps in improving mental alertness.



5. Small snacks: Although eating during a migraine can be tough because of the buzzing pain it is a good idea to have small snacks throughout the working hours. An empty stomach creates acidity and further aggravates the pain. Small time snacks such cookies and chocolate bar can come really handy at this time.

6. Get enough air: A centralized workplace can be claustrophobic and intensify the pain for many. Get out of the workspace to get some fresh air. A sudden gush of oxygen can be a welcome relief from the monotonous and crowded office floor.

7. Apply water on the skull: While this might sound like a crazy idea, applying a small amount of water in the middle of the skull can give temporary relief from the throbbing effect of a migraine. If ice is available in the office pantry, make no hesitation in applying it on the migraine side of the forehead. Ice is capable of spreading a cooling effect throughout the forehead and the skull. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Migraine - 7 Ways You Can Deal With at Workplace

Asperger's Syndrome or Asperger's Disorder is a neurotypical condition that affects the development of the child the effects of which continue into adulthood. This condition typically shows up as difficulties faced by the patient when it comes to social interactions as well as other nonverbal means of communication. It should not be confused with autism as the patient has no speech and cognitive development delay. 

Asperger's syndrome can show up as restricted and repetitive patterns in the behaviour of the patient. It lies at the higher end of the autism spectrum and the signs are usually less obvious. Here are a few ways with which you can effectively deal with someone who is suffering from this disorder.

1. Routine: The patient suffering from this condition will need a certain kind of stability as it is very difficult to predict what will happen in the near future or to even plan for it. The best way to tackle this scenario is with the help of a proper routine that can help the patient achieve some kind of control over the situation surrounding him or her so that he or she is better equipped and more capable of handling normal functioning and social situations as well.

2. Information: It is also a good idea to help these patients in looking at and in processing information. While normal people may easily be able to discard insignificant or unimportant information, the brain of the patient suffering from asperger's syndrome does not allow him or her to do so. In many cases, the patient is not able to filter the important and the unimportant information. This can debilitate many functions. So, it is important to be present to help the patient in making decisions and processing information that is actually relevant to his or her functioning.

3. Learning: One of the most crucial things to remember with the Asperger's patient is that they tend to understand and process things when they have a visual presentation rather than being told verbally. So showing them things practically in the proper manner is the right way to help them learn and process situations in a correct way. This will prevent them from doing things in the same old way even when their brains tell them that it will lead to wrong results.

4. Physical Abilities: Poor motor skills as well as lack of proper organisation skills are traits that usually characterise these patients. It is important to make them aware of this during games and activities that require management as well as use of social skills. For example, football and other such activities can be introduced in the routine. This will promote interaction with the team in order to play and enjoy the game.

How to Deal With a Patient Suffering From Asperger's Syndrome?

Migraine headache is characterized by a severe headache usually affecting one side of the head. There are other symptoms along with headache like nausea/vomiting, sensitivity to light and sound. Some patients experience neurological phenomena like changes in vision, temporary loss of sensation and altered sensation, a phenomenon known as an aura (flashes of light, zigzag patterns, bright spots, tingling in the arms and the legs). Migraine headache can last for 2 to 3 days. 

Symptoms: The symptoms depend on the stage of a migraine attack. The stages of a migraine attack can be: 

Prodrome, Aura, Headache or attack, and Postdrome. 
Prodorme: One to two days prior to the migraine attack, patient may experience; 
Mood swings. 
Cravings for food. 
Increased yawning. 
Stiff neck. 
Constipation and frequent thirst and urination. 
In case of an aura (during or before a migraine), there may be visual, motor, speech, and sensory illusions and disturbances such as, 

Loss of vision. 
A strange sensation of needles pricking an arm or a leg. 
One side of the body becomes weak and numb. 
There are visual illusions such as the appearance of flashes of light, zigzag patterns, bright spots. 
There is a problem in hearing and speaking. 
In some cases, there may be a hemiplegic migraine (the limb becomes weak). 
During a Migraine Attack (lasts for 4 to 72 hours), there may be 

A throbbing pain on either one or both sides of the head 
Blurred vision, light-headedness. 
Nausea and vomiting 
Sensitivity to light and sound 
Sensitivity to touch and smell (though rare) 
In Postdrome (after a migraine), there can be 

Mood swings. 
A person may be sensitive to light and sound. 
Dizziness and weakness 
Confusion 
Extreme fatigue 
An amalgamation of environmental and genetic factors may be responsible for a migraine. Trigger varies for each patient: 

Stress and extreme physical exertion 
Obesity 
Alcohol and caffeinated drinks and beverages 
Salty and processed foods 
Altered sleeping habits 
Hormonal alterations in women (Constant fluctuation in the level of oestrogen) 
Oral contraceptives and certain vasodilators (nitroglycerin) 
Preservatives like MSG (monosodium glutamate) and Aspartame (sweetener) 
Sunshine, certain odours, travel, etc can trigger migraine. 
Treatment and Prevention: 

Medicines under supervision to abort an attack of migraine and special drugs to stop attacks. 
Lifestyle changes are helpful to decrease attacks: 
Avoid your trigger for migraine. 
Follow regular sleep -wake cycle. 
Regular exercise, meditation. 
Avoidance of alcohol, caffeine containing beverages. 
Other treatment options that can be availed from pain specialist: 
Transcutaneous supraorbital nerve stimulation 
Intramuscular stimulation. 
Botulinum toxin injection. 
Occipital nerve block.

Migraine Pain - Facts About It!

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