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!

How Physiotherapy Can Help with Neurological Disorders

Neurological disorders are problems with any one or a combination of the central nervous system or any of its peripheral systems such as cranial nerves, neuromuscular junctions, and the autonomic nervous systems among others.

Some extreme examples of neurological disorders are:

- Dementia
- Alzheimer's disease
- Parkinson's disease
- Epilepsy
- Disorders brought on by strokes
- Multiple sclerosis and others

What is physiotherapy and how can it help?

Physiotherapy is a form of treatment where practitioners use physical forms of treatment such as massages, exercises, heat treatment and other controlled forms of external stimuli to treat physical disorders.

This method of treatment can be very effective in correcting neurological disorders.

Some of the physiotherapy techniques, which can be implemented to help patients, are as follows:

Electrical Stimulation: This method is commonly used to treat muscular problems, especially incurred after an accident or any other form of injury. In this method, controlled electric stimulation is given to specific nerve areas over the skin to stimulate them.

Heat treatment: This method involves applying heat to parts of the body such as joints or muscles where there is nerve or muscular damage. This treatment is especially effective for muscle related problems.

Ice or cold treatment: Vertically opposite to the principle of heat treatment, ice or cold treatment is used to contract muscles within the body. This is especially effective where inflammation needs to be controlled.

Manual therapy: Possibly the most common form of physiotherapy, this method employs massages, pressure points, stretching and hands on strengthening exercises and helps regularize nerve impulses to areas where they have been affected.



How Physiotherapy Can Help with Neurological Disorders

Obesity is the new-age lifestyle disease with multiple ramifications. While its effects on the physical aspects are very evident, the damage it does to the brain are more severe, though not obvious. Read on to know some harmful effects of obesity on the emotional well-being.

Leads to binge eating: There is a certain pleasure in eating sugary and fatty food, and this is lost with depression. Therefore, to get that emotional satisfaction, people tend to eat more chocolates, cookies, milkshakes, and other weight-accumulating food items, which further add to obesity. Greater the weight gained by a person, lesser the response or happiness from such food products.
Increases impulsivity: The area of the brain known as orbitofrontal cortex, which is in charge of controlling impulsivity, shrinks in obese people. This results in people eating more impulsively.
Affects immunity: Obesity is a major cause of inflammation, leading to damage in certain parts of the brain. This impairs the immune system, making the affected person more prone to infections and tissue damage. This leads to increased chances of diabetes, heart disease, stroke, sleeping disorders, eating disorders, etc. The chemical known as C-reactive protein increases as seen on MRIs in obese people, and which is usually seen in patients with chronically increased inflammation.
Effects on memory: As the BMI increases, there is a decrease in scores of memory tests. This effect is more obvious in women after menopause. With increased fat accumulation, more hormones are released, which affects the memory. Increased inflammation also affects cognition and memory.
Increased risk of dementia: With more belly fat accumulating, there is extra stress on the body to burn the visceral fat. This reduces brain size and causes certain hormones to release, which further affects the body s ability to remember things. It has been proven that people with smaller brain size are at greater risk for developing dementia.
Weight loss stress adding to more stress: When obesity sets in and the BMI goes up, there is an added pressure to lose weight, which further ups the stress levels. During these dieting days, the brain is constantly alert and finds ways to eat more. This also leads to excess eating. Moreover, there are indications that there could be genetic changes during this phase, which may leave a permanent mark in the person s composition.
Depression: When a person is not happy with their reflection in the mirror, the chances of feeling good and happy are very less. In this age, where aesthetics plays a major morale booster, an obese image staring back does not help at all.
So, if you have a risk of obesity, watch out. It is not just how you look, but how you feel is also altered.

Obesity - How It Affects The Human Brain?

Antibiotics are something which have changed are lives for eternity as well as for the better, to say the very least. With each day that passes, there are greater strides of advancement which are made in the field. Of late, it is said that antibiotics also have the potential to stop new cells in the brain from growing, which is quite a risk when it comes to their usage among people are sick.

Research has found that if the brain of the person under treatment is subject to sustained use of antibiotics, it is true that the brain can lose its functionality for a quicker time than what one would consider to be normal. So it can be said, this usually is not the advisable way to go.

Like most testing practices when it comes to medication, antibiotics which were tested on the brains of the subjects i.e. those of mice had an effect of mitigating their high-level memory. How this happened to be is rather interesting, to say the very least.

How dangerous can antibiotics be?
It is often said that eating right does wonder for a person s brain. Well, the mice that were not treated with the antibiotics were seen to lose the healthy bacteria present in their stomachs. In addition to this, they lost new brain cells. This led on to them performing worse in mental tests than their peers who had had some antibiotics administered to them on a consistent basis.

Now a cynic may point out that what is seen to be true for mice may really not hold true when it comes to humans being considered. However, if it is taken into due account that a lot of path-breaking research is carried out on mice, there is quite some credence to the results of the study.

To supplement the evidence even further, it was also seen that for mice which were in possession of low levels of monocytes, which are a type of white blood cells. It was seen that there was a great dependency on monocytes for the generation of white blood cells. The part of the brain which is hindered by generating new cells on account of the sustained use of antibiotics is the hippocampus.

Antibiotics are the proverbial shot in the arm which can aid recovery by destroying the threat to a person s wellness. However, it is to be considered that they are not safe in general as there is collateral damage!

Antibiotics - Can They Stop The Growth Of Brain Cells?

Acoustic neuroma is a benign tumor that occurs in the primary nerve between the brain and the ear. The tumor progresses very slowly and can influence your balance and hearing. In certain cases, if the tumor becomes very large, then it may also impair vital functions of the body.
Symptoms-
The symptoms of acoustic neuroma tend to develop when the tumor starts to press on the nerve and its adjoining branches. The symptoms of this disorder are  
You may experience hearing loss on one side which might worsen gradually.
You may have problems in balancing yourself.
A continuous ringing sound in the ears.
Persistent dizziness.
If the tumor is large and presses on the nearby nerves, then you may experience numbness of the facial muscles.
In some cases, it may impair the vital functions of the body.
This disorder is caused by a malfunctioning gene. There is no documented reason as to why the gene malfunctions.
The treatment options for this disorder are  
Constant Monitoring: These tumors tend to grow very slowly but might spurt in some cases. In order to prevent damage to your body, they need to be monitored on a regular basis. Imaging tests are recommended on a periodic basis to determine the growth of the tumor.
Radiosurgery: Stereotactic radiosurgery is done to treat acoustic neuroma that is small in size. In this surgery, radiation is directed at the tumor without creating any incision. It is done to limit the growth of the tumor and preserve your hearing.
Surgery: The tumor can be removed by using surgical procedures. It involves administering general anesthesia, followed by removing the tumor through an incision on the skull or the inner ear. Surgery is used to remove the tumor and preserve your hearing abilities. 

Acoustic Neuroma - Everything You Need to Know

Cerebral palsy is the term for a group of neurological disorders that affects one s muscle movement and motor skills.

In most cases, the condition is caused due to a brain impairment that develops while the baby is still in the womb. Cerebral palsy may also occur shortly after or during birth.

Symptoms of Cerebral Palsy:

The signs and symptoms of the condition vary from one individual to another, ranging from mild to severe. The commonly observed ones in children are-

  Difficulty walking
  Difficulty holding on to objects
  Delay in developing motor skills- sitting up straight, rolling over, crawling
  Variation in the muscle tone- too stiff or too floppy
  Delay in development of speech
  Spasticity
  Lack of coordination of the muscles
  Difficulty swallowing and excessive drooling
  Functioning of only one side of the body
  Neurological ailments such as intellectual disabilities, seizures, and others

Types of Cerebral Palsy:

Cerebral palsy can occur in the following forms-

  Spastic cerebral palsy - Causes exaggerated reflexes and muscle stiffness. This is the most common type of cerebral palsy, affecting nearly 80% of the population.
  Dyskinetic cerebral palsy - Causes abnormal, involuntary movement of the legs, arms, and hands. It may also affect the movement of the tongue and face, thereby making it difficult to talk or swallow.
  Hypotonic cerebral palsy - Causes overly relaxed muscles and reduces muscle tone. The legs and arms are easily moveable and appear saggy.
  Ataxic cerebral palsy - This is the least common type. People living with this form of the condition have problems with coordination and balance.

Diagnosis and treatment of cerebral palsy

Cerebral palsy can be diagnosed with the help of the following-

  CT scan
  MRI
  Ultrasound
  Electroencephalogram

Treatment of the condition depends on its severity. Long-term treatment includes physiotherapy, medications and surgery.

  Physiotherapy and occupational therapy helps restore muscle strength and improves muscle tone. You can try stretching exercises to improve flexibility.
  Usually, the doctor prescribes medications in the form of muscle relaxants and sedatives. Muscle relaxants reduce muscle tension, helps relieve discomfort and muscle pain.
  You may need to undergo an orthopaedic surgery in case medications and therapy does not yield positive results. The surgery will aim to release tight muscles and repair bone abnormalities caused due to spasticity.

The specialist as a last resort may recommend SDR or Selective Dorsal Rhizotomy to reduce spasticity and chronic pain. This involves operating the nerves at the base of your spinal column.

There is no permanent cure for cerebral palsy. However, the condition is manageable with the help of drugs, therapy and surgery. The kind of treatment required depends on your overall condition. While some may be able to live with the condition without much assistance, others may require immediate medical intervention. Therefore, it is best to consult an orthopaedic and get help if the symptoms deteriorate over time.

Cerebral Palsy - Symptoms, Types & Treatment Of It!

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