Study of the brain has fascinated specialists all over the globe since time immemorial. The brain being the most vital organ for survival and coordination is perhaps the most complex of them all too. This has led to a limited understanding of its working in spite of the available advanced technology. However, with the advent of techniques for diagnosis and treatment, therapeutic strategies are evolving. This is a major step towards rendering Neurosurgery safer than ever in the history of mankind.

Neurosurgery through the 20th Century-

During the beginning of the 20th century, Neurosurgery was considered as a specialty. The clinical-neurologist would draw conclusions related to lesions in the brain through neurological examination and clinical history. It enabled diagnosis of vascular lesions, spinal disorders, and brain tumors. During the second and third decades of the 20th century, vascular pathologies and brain tumors could be diagnosed indirectly through techniques like angiography, ventriculography, and pneumoencephalography. But since the operative techniques were too crude and the lack of skilled professionals were rampant, there were high rates of morbidity and mortality due to neurological conditions. Generally, after diagnosing the nature of brain lesion and its site, surgery was performed with inadequate maintenance and control of intracranial pressure and through not too sophisticated surgical instruments.

During the fifth and sixth decades of the 20th century, chemotherapy and radiation treatment came into the picture for treating malignant brain tumors, thereby reducing mortality to a good extent.

During the seventh decade of the 20th century, Computed Tomography (CT) scan provided a better understanding of the location of lesions in the brain which slightly substantiated the earlier techniques. Then, the procedures for cerebrospinal fluid diversion significantly improved management of intracranial pressure during surgery.

It was only during the last decade of the 20th century that the Neurology saw a giant progressive leap through the introduction of Magnetic Resonance Imaging (MRI) and powerful high magnification microscopes. Combined with Neuroanesthesia and Intracranial Pressure Management, this aided surgeons to work on a relaxed brain. This promoted safe removal of the brain tumor and better management of vascular lesions. Moreover, the understanding of micro-surgical anatomy improved drastically, leading to a boost in confidence levels of the micro-neurosurgeons performing the operation.

Neurosurgery in the 21st Century-

The 21st century is actually a revolutionary era that uses powerful computers in almost all the fields possible. Computer-based applications such as Neuro-imaging, Neuronavigation, Intra-operative Neuro-monitoring, and Neuro-modulation are now used in standard neurosurgical practice as a part of the routine. Extremely powerful CT scans and MRIs are used for diagnosis before surgery. The advent of nanotechnology and its application in Neurosurgery is doing great and has a promising future ahead based on the current study of scenarios. Moreover, there is a possibility of most of the Neurosurgical procedures becoming minimally invasive. Frameless Stereotaxy is another technique that helps in locating the exact position of the tumor, which further helps the neurosurgeon in navigating with great precision the very sensitive, high-risk areas of the brain. Such techniques, to a great extent, have lowered mortality and morbidity, lessened the rate of recovery, and chances of infection related to Neurosurgery.

Take Away-

A number of techniques for diagnosis and precise location of the tumor in the brain have made Neurosurgery much safer today, due to advancement in science and technology, than it ever had been in the history of mankind.

Advancements In Neurosurgery - Know How Safe It Is!

Cerebral palsy is a neurologic condition that occurs in children, and is due to brain injury that develops before, during, or after childbirth. The condition presents with motor impairment, and therefore there is generalized physical and mental dysfunction. The brain continues to develop for the first two years of life, and so conditions like premature birth, asphyxia at birth, and postnatal meningitis and encephalitis.

The diagnosis could be trigged by the slow motor development, poor muscle tone, and delayed response of the baby. One of the main noticeable feature that becomes evident is the spasticity of the limbs. The child may not be able to voice it out, but pain is a significant disabling factor too. While doctors would advise that physical movement is required to keep the spasticity at bay, the pain keeps the child away from most activities. This further adds to the spasticity and worsening of the condition.

Pain control therefore assumes a significant role and the modes can range from physical therapy to pain killers to injections to surgery. The idea, in addition to pain control, is also to:

Improve range of motion
Improve motor response
Promote good motor development
Reduce and control contractures
Improve overall lifestyle
Improve muscle strength
Improve exercise tolerance
Reduce spasticity
Some of the non-medical ways to control pain are listed below. 

Of course, pain killers and injections are always used when immediate relief is required. A structured physical therapy program that includes medications and exercise is the best way to manage cerebral palsy pain. Though initially difficult, over a period of time, it improves range of motion and improves joint movement.

Acupuncture: Triggering specific points via needles is believed to stimulate the nerve endings and help in pain control
Alternating ice and heat therapy: This is also believed to improve pain control, blood circulation, and muscle movement.
Positioning in bed: A well-positioned child in bed may have less pain compared to another child who is not. Special equipment may be used also to keep the child in place, once the most comfortable situation is located.
Muscle massage: The affected muscles need to be massaged repeatedly so that blood flow improves, joint movement is better, and pain is controlled.
Botox is successfully used to pain control, as it paralyzes the specific muscles along with providing pain control.
Medications are used regularly, which are mainly anticholinergic and anti-spastic medications. They reduce stiffness, control pain, and help in pain control too.
Surgery is the last option and needs to be explored with the doctor.

Pain Management Of Spasticity With Cerebral Palsy!

Multiple sclerosis or MS is an autoimmune disease where the protective cover around the nerves is lost. This affects the communication between the brain and the rest of the body. Symptoms commonly experienced by patients suffering from this condition include partial or complete loss of vision, weakness or numbness in one or more limbs, double vision, tremors, slurred speech, tiredness and lack of energy, and issues with bladder and bowel movements. In the early stages of this disease, these symptoms come and go. Allopathy has no cure for this disease but can help patients manage the symptoms and slow the speed at which the disease progresses.

What causes MS?
Damaged nerve signals can cause debilitating symptoms, including:

muscle weakness
walking problems
fatigue
vision problems
MS affects everyone differently. The severity of the disease and the types of symptoms vary from person to person. The exact cause of MS is still unknown. However, it is belived that the aforementioned factors may play a role in the development of the disease.

Symptoms-

Numbness or weakness in one or more limbs 
Partial or complete loss of vision
Prolonged double vision
Tingling or pain in parts of your body
Electric-shock sensations that occur with certain neck movements 
Tremor, lack of coordination or unsteady gait
Slurred speech
Fatigue
Dizziness
How Homeopathy Can Help?

Homeopathy is also a very effective way of managing the symptoms of this disease. This is a constitutional form of medication that takes into account the patient s overall physical and mental health, emotional state and symptoms being seen to prescribe a remedy. Unlike allopathic remedies, homeopathy not only addresses the symptoms being presented but it also addresses the root cause of the disease. It has negligible side effects and can be prescribed to children and adults of all ages. The goal of a homeopathic treatment for multiple sclerosis is to reduce the severity and number of flare-ups and slow down the disease s progression rate. It also seeks to improve the patient s outlook, attitude, and energy levels thereby improving his or her quality of life.

There is no standard homeopathic remedy for this condition. As mentioned earlier, a homeopathic doctor takes into account many different factors to prescribe a remedy. Thus, two MS patients may be given different remedies if they have different physiques, personalities etc. For this reason, it is not advisable to self-medicate with homeopathy. Homeopathic treatment also requires patience as it takes a while for the body s immune system to adapt. That said, it is important to note that homeopathy cannot be considered a miracle cure for patients suffering from advanced stages of multiple sclerosis. As with allopathic medication, the earlier a homeopathic remedy is prescribed, the more effective it will be.

In addition to following a homeopathic prescription or MS, the patient is also usually advised to make a few lifestyle changes. Stress is one of the biggest triggers for an MS episode. Hence, it becomes important for MS patients to de-stress and avoid high-stress events. A healthy diet and vitamin supplements can also help to strengthen the body.

Multiple Sclerosis And Homeopathy - How Does It Help?

Multiple sclerosis refers to disabling disease of the central nervous system, where the body s immune system eats away the protective layer sheathing the nerve fibres and disrupts communication between the brain and the rest of your body. 

Often, multiple sclerosis is associated with impaired cognitive functioning. Cognitive changes have direct functional consequences on your quality of life, ranging from occupational activities to professional career and personal life. In addition to it, a complex interplay between cognitive impairment and mental disorders like anxiety and depression, which negatively affect the normal course of life.

Rehabilitation Psychology works through various techniques and aims to ease the impact of cognitive changes on everyday life rather than simply defining their severity and nature.

Rehabilitation Psychology Approach to Multiple Sclerosis

The goal of Psychological Rehabilitation programs is to improve and preserve mental and physical abilities, as well as help patients adapt to changes in functioning. 

A team of specialists   consisting of a psychologist, physician, physiotherapist, speech-language pathologist, and an occupational therapist   works together in order to offer you well-rounded support and care. These specialists have years of experience and expertise in the management of symptoms of multiple sclerosis.

The rehabilitation program helps you address the following problems related to multiple sclerosis  

Spasticity

Fatigue

Sleep disorders

Chronic pain

Walking difficulties

Bladder and bowel issues

Changes in movement

Difficulty swallowing food

Mood disorders, like depression

Speech problems

Cognitive changes

Anxiety and uncertainty about the disorder

How Rehabilitation Programs Can be Helpful?

Since multiple sclerosis affects each person differently, Rehabilitation Psychology provides tailor-made treatment to patients.

The team of specialists work closely with the patients to evaluate their health needs, track progress, address pain, and teach them strategies essential to cope with the chronic disease.

Occupational therapy is directed toward patients with mobility problems. The therapy helps you with daily tasks, such as dressing, cooking, and learning ways to manage personal hygiene. 

Rehabilitation strategies for speech-language problems help maximize your abilities to cope with cognitive functions.

Multiple sclerosis is a lifelong condition and can be challenging as it progresses. Many people require constant support, care and motivation to get through the tough phase. Rehabilitation Psychology is just the way to combat the psychological effects of multiple sclerosis. You should communicate your concerns to a doctor, and learn all you can about the disease. 



 Rehabilitation Psychology In Management Of Multiple Sclerosis!

Coping with Parkinson s disease is not an easy task. Whether you or your loved one is suffering from it, the effect of the disease takes a toll. Other than the fact that it is a degenerative disease and the neurological condition deteriorates over time, the mental trauma that Parkinson s brings; not only to the patient but to the caregiver as well, is a whole chapter on its own. When you are taking care of someone who is suffering from 

Parkinson s disease, it is natural that the emotional upheaval that you may go through will take a huge toll on your health and your mind. It is imperative that you prepare yourself thoroughly, whether you are the patient or the caregiver, about the disease and its treatments.

There is hardly any cure and treatment for the disease. It is still in its research stage and hence, often there is a strong sense of despair that sets in the mind of the patient and their loved ones. It is for this reason you have to prepare yourself to face and fight this disease. 

Here are some tips that may help you to cope with the treatments of Parkinson s disease:

Educate Yourself: Educate yourself about every detail of the disease, specific to the type of Parkinson s that has affected you or your loved one. Ask questions, whether to your doctor or the nurses. Search through the internet, you will get plenty of genuine information. This is necessary as it will prepare you to face the future head-on. You will understand what you are dealing with and how much worse it can get.
Stay Active: If you are the one who is suffering from Parkinson s, then write it down as the golden rule   I will have to stay physically active. Staying active will keep your muscles active and there will be a steady functioning of the nervous system. Staying active gives you the benefit of keeping the muscles at work, ultimately fighting the main symptom of Parkinson s disease. Being physically active is also essential to have a good mental health, both for the patient and the caregiver.
Connect With People: Talk to people, your friends, family members, children, grandchildren and anyone you feel like. If you have any estranged relative, it could be a good time to reconnect. Have wholesome conversations that will influence happy thoughts and encourage you to think and ponder on happy memories. This is crucial as Parkinson s invites depression and you will have to tackle it vehemently.
Talk to a Mental Health Professional: If you feel that you are losing a complete hold of your life and your depression seems uncontrollable, it is time to visit a professional psychiatrist and seek his/her advice in dealing with your troubled mental condition.

Impact Of Parkinson's Treatment - How Can It Be Managed?

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements. 

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a  Clot Buster  drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 
Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try  removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

High blood pressure,
Cigarette smoking,
Diabetes
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 
Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Brain Stroke - Things You Must Know!

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