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!

Surgery to remove abnormal growths of the brain, peripheral nervous system or the spine or any disorder can be tricky because the brain and the skull that shields it are complex areas. In the old days, open surgery was the only way to access the brain or spinal cord. But, with the invention of laparoscopy, keyhole surgery to treat neurological issues is gaining ground.

What is Neuroendoscopy? 
Neuroendoscopy is a surgical procedure that is favoured by doctors and patients alike because it is minimally invasive.
Before the surgery, you will be administered general anaesthesia so that you will be unconscious during the entire duration. During the surgery, the surgeon will drill a minute hole into your skull just above the eyebrows. You skull also has two natural openings. That is why the surgeon may make use of the nose or the mouth to access the region that needs to be operated upon.

Neuroendoscopy is useful because -

  It lets the surgeon reach regions that are not accessible with open surgery
  The tumour can be removed without any damage being done to surrounding tissues

An endoscope is a delicate device with a high-resolution camera mounted on it. There is an eyepiece on the other end. The device is also fitted with a light. When it is inserted into the brain, it lights up the passage and the eyepiece allows the surgeon to take a look inside. The camera sends a live feed of the path it is traversing and this guides the surgeon. When the tumour is reached, it is gently removed with other surgical instruments that too were inserted through the cavities or the drilled hole.

Benefits of Neuroscopy -
There are several advantages of relying on laparoscopy -

  The patient endures less pain
  Fewer chances of infection
  Faster recovery
  Very little scarring of tissues

Which Disorders call for Neuroendoscopy?
Any of the following disorders can be put to rights with a neuroendoscopic surgery -

  Pituitary tumours
  Rathke s cleft cysts
  Pineal area tumours
  Ventricular tumours
  Skull base tumours
  Brain inflammation triggered by an infection
  Chordomas
  Cerebrospinal fluid fistulas
  Trigeminal neuralgia
  Cerebral aneurysm

After Surgery-
Once you undergo the neuroendoscopic surgery, you will have to be rehabilitated so that your condition can be monitored round the clock. Neuroendoscopy is a state of the art clean and efficient surgery that is beneficial to both surgeons as well as the patients.

Know More About Neuroendoscopy And Its Uses!

Brain tumor refers to the development of unusual cells in the brain or around the nearby tissues and structures. Pediatric Brain Tumor means the development of these unusual cells in the brain of children. There are two types of brain tumors: Benign or non-cancerous and malignant or Cancerous. Tumors like ependymoma and medulloblastoma are quite common among children. The treatment of the tumor is determined by its severity, type, location, age, and overall health of the child. The treatment of Brain Tumor in children is different from the adult s treatment. One should ensure to consult with the pediatrician with the specialty in cancer and neurology. Brain Tumors in children are Primary Brain Tumors that develop in the brain or nearby tissues. This Primary Brain Tumor develops when the usual cells have DNA mutations or alterations. The alterations in the DNA permit the cells to develop and distribute or split with an increased rate and destroy the healthy cells. This leads to the development and collection of unusual cells forming a tumor. In most Primary Brain Tumor cases, the cause is not clear. Children with a family history of the genetic syndrome and Brain Tumor are more prone to the problem.

Symptoms-

The symptoms of the Pediatric Brain Tumor depend upon the severity, location, and type. There are a number of symptoms that are really common and are shared by other diseases. Other than this, there are symptoms which are possibly the signs of Brain Tumor among children. Adults and parents should consult a doctor if they find their children having the symptoms and signs for an unusual time.

Hearing issues

Frequent and severe headache

Fuller fontanel (soft spot) on the baby s skull

Vomiting or nausea

Behavior changes

Seizures

Sudden vision problems like double vision

Abnormal or strange eye movement

Increased heaviness or pressure in the head

Irritability

Slurred speech

Difficulty in swallowing

Weakness

Loss of appetite

Drooping on one side of the face

Difficulty feeding in babies

Loss of sensation on one side of the body

Imbalance or difficulty in balancing

Difficulty in walking

Diagnosis-

The diagnosis for the Pediatric Brain Tumor includes many lab tests. The doctor may initiate with some neurological examination like hearing, vision, reflexes, balance, and coordination. Any abnormality in these tests will lead to further examinations. There are some imaging tests that are used to determine the size and location of the tumor in the brain. These tests include MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), and CT (Computerized Tomography). After the confirmation of the presence of a Brain Tumor, the specialist will further move to the Biopsy. It includes the removal of a sample tissue for analysis or testing. The type of biopsy that will be performed on the patient depends upon the location of the tumor. Other than the biopsy, the tumor tissue can be examined for molecular basis and genetic mutations. After that, Drug therapy can be designed according to the individual s requirements. It is important for the doctor and the patient to know if the tumor has been spread through cancer in other parts of the body. If it is true, then the doctor will perform more tests and examinations to know the root and initial location of cancer for further treatment.

Treatment-

The treatment of the Pediatric Brain Tumor is determined by the severity, location, size of the tumor, and age and health of the child. There is a number of treatments available with modern technology but their usage depends upon the patient s requirement.

Surgery that is used when the location of the tumor is approachable via surgery. When the brain tumor is small, it can be completely removed by the surgery. But when the tumor tissues are located nearby sensitive areas of the brain, then the surgery becomes risky and maximum tumor tissues are tried to be removed through surgery. The risk of the surgery depends upon the location of the tumor. An example can be vision loss if it is anywhere near the nerves connected to the eyes.

Targeted Drug Therapy helps to destroy the abnormalities of the cancer cells resulting in the destruction of the cancer cells.

Radiation therapy is used to kill the tumor cells by using high-energy beams. Radiation therapy can either be given by an external machine (external beam radiation) or in exceptional cases, radiation is positioned within the body (brachytherapy) near the tumor.

Chemotherapy includes the consumption of drugs to destroy the tumor cells. These drugs can be consumed in tablet form but for children, the drugs are mostly injected (intravenous chemotherapy).

Stereotactic Radio Surgery includes various radiation beams to perform extremely focused radiation therapy to destroy the tumor cells located in a small part.

Proton Beam Therapy carries higher targeted radiation doses to the tumor cells with minimum exposure of radiation to the healthy cells and tissues. It decreases the chance of development of fresh cancer cells.

Take Away-

Pediatric Brain Tumor is the development of unusual cells in the brain or around it. Although this is a life-threatening problem, however, with advanced technology, it can be treated successfully. There are no specific causes discovered by specialists but genetic mutations and family history cause it. The symptoms can be really common like headache and nausea but can also be specific like difficulty in coordination, reflexes, speech, and many more. The timely diagnosis and treatment can give a new life to the child and reduces the chance of development of fresh tumor cells in the future.

Pediatric Brain Tumor - Know In Detail About It!

Neurodevelopmental disorders refer to any impairment and disorder of the brain and nervous system growth and development. Disorder in the brain and nervous system can affect the emotional, physiological, psychological ability and overall timely development of a child. With advanced technology and continuous study in the medical field, one can now assess the neurodevelopment of his/her children. Neurodevelopmental Assessment concentrates on the overall growth and development of a child including his/her weaknesses and strengths. A complete developmental profile is generated with the help of various tests and examinations. This assessment is used to analyse the various developmental factors including social and communication skills, functional and motor skills, cognition and learning abilities, and language and speech development. Neurodevelopmental Assessment involves a team of child s close people including parents, guardians, and family members who help to understand the medical history if any. It helps doctors to provide appropriate ways to assist the child in his/ her growth and development.

Tests and Examinations

Tests for the Neurodevelopmental Assessment may vary from child to child depending upon their condition. But, there are usually some tests that are done to understand the overall development of the child. These tests may include speech tests, hearing tests, blood tests, physical examinations, and questionnaires, which may be given before or during the assessment process.

Assessment

The assessment processes and sessions may vary depending upon the need of the child. However, usually, there are three major sessions that help the pediatrician understand the concerns of the family and parents. These sessions include consulting about the detailed medical history of the child, understanding the problem and its possible cause, and providing proper ways and treatment options for the patient. 

In the first session, parents and guardians are asked about any medical concern they have and the medical examination of the child is carried out accordingly. A standardized assessment with the child will be carried out by a clinical psychologist and the parents and guardians are asked to complete a questionnaire for the assessment. Depending upon the age, questionnaire may be sent to school for teacher/s to complete.

The next session is usually led by language and speech therapist to discuss and understand the current language and speech concerns of the child. Previous assessments and medical examinations are taken into account to carry out further assessments. An occupational therapist will assess the child s ability to perform self-care activities and other tasks according to his/her age. The session may include the assessment of a child s motor skills and abilities and reflection on any probable sensory-based problems that may be affecting the child s occupational performance.

The last session mainly includes the discussion with the parents and guardians to help them understand the problem, its causes, and treatment options. If the child requires any further assessment or/and recommendations, then the parents are told about that too.

Takeaway
Neurodevelopmental Assessment of children is often performed on kids who do not show the developmental signs according to their age. Parents and guardians should not hesitate to consult their children to clinical psychologist and therapist as the early intervention and assessment can help in the timely growth and development of the children.

Neurodevelopmental Assessment (0-5 Years)  - What Should You Know?

The term haemorrhage refers to the escape of blood from the vessels through which it runs and the discharge can be either into the internal cavities or in the external regions. Profuse as well as long drawn haemmorrhages can be dangerous and lead to serious outcomes. In some individuals there exists a predisposition which can either be acquired or hereditary and comprises defective contractility of affected arteries. The common haemorrhages can be of three types namely arterial, venous and capillary, and the special types are accidental, antepartum, cerebral, concealed, contrecoup, extradural and intradural haemorrhage. Regardless of the haemorrhage you are suffering from, homeopathy can offer you a solution to your ailment.

What are the symptoms of internal haemorrhage?
Internal bleeding is quite difficult to detect and in some cases it may not be identified for many hours after it starts. Symptoms may only take place when there is severe loss of blood and when the blood clot is big enough for compressing any organ, leading to its inability to function properly. Some people are affected with inborn and genetic errors of blood clotting and in such cases minor injuries can cause a heavy bleeding. Von 

Willebrand s disease and haemophilia are two instances of hereditary clotting disease.
There are several homeopathic medications, including secale, trilium, ipecac, hammelis and cinchona, along with various others that can be used for the treatment of haemorrage. However, it is best to consult an expert for availing medicines that are ideal to treat your individualistic health complication.

How can homeopathy treat haemorrahage?
Homeopathy aims to treat an individual as a whole instead of focusing on the affected area or the concerned ailment only. So when you are suffering from haemorrahage, your doctor will evaluate all the relevant aspects of your health that include assessment of the physical and mental conditions, present symptoms, underlying pathological conditions as well as possible causative factors. Some people have a tendency to choose medications on their own and administer them, but it is advisable to not take things into your own hands as a haemorrhage is a broad aspect and shouldn t be experimented with.

It is important to check whether you are susceptible to any kind of haemorrhage and get proper homeopathic medication. It is important to maintain a low blood pressure and stay away from all kinds of activities that can induce heavy gravitational force and stay as stress free as possible.




Haemorrhage - Can It Be Treated With Homeopathy?

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

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