Acoustic vestibular schwannoma or the acoustic neuroma is a kind of tumour. But this tumour is benign which means it is non-cancerous. The vestibular nerve connects your ear to your brain, it is responsible for hearing and balancing. An acoustic neuroma develops on the vestibular nerve. And it can cause hearing impairment.

How does acoustic Vestibular Schwannoma occur? 
The vestibular nerve is lined with Schwann cells. Sometimes, these cells start to develop rapidly. This forms a mound on the nerve, it slowly becomes large enough to prod against the brain, and this adversely affects the actions of the brain.

What are the Symptoms?
In the early phases, the tumour does not trigger any symptoms. They begin to manifest once the tumour starts expanding. Here is a list of the symptoms of acoustic vestibular schwannoma-
  Gradual hearing loss
  Misalignment and losing balance
  Ringing in the ears.
  Regions of numbness in your face
Even though these tumours are benign, sometimes they enlarge to such an extent that they can be harmful to the brain. As soon as you witness the above-mentioned symptoms, book an appointment with a doctor.
With timely treatment and medication, doctors can reverse the growth of an acoustic vestibular schwannoma. 

What triggers this Disease?
The exact cause of this disease is not known. It could be any one of the following-
  A chromosomal anomaly or a malfunctioning gene
  Inhibition in the function of the protein suppressor that regulates the growth of Schwann cells

How is Acoustic Vestibular Schwannoma detected?
Your doctor will recommend these tests-

  Audiometry -
The audiologist will present sounds at different frequencies and you will have to make a gesture whenever you hear a sound. This will reveal the state of your hearing.

  Magnetic Resonance Imaging -
An MRI can detect the presence of a tumour that is 1-2 mms in diameter. If MRI causes pain or discomfort, a CT scan will be done.

Treatment -
If the tumour is tiny, your doctor won t prescribe medicines but your tumour will be monitored and imaged regularly so that the proper action can be taken as soon as it begins to enlarge.

  Surgery -
If the tumour is large, then you might have to undergo surgery. Not only will the tumour be removed, but also care will be taken to preserve the facial nerve so that facial paralysis does not set in.
You will be placed under general anaesthesia. The surgeon will drill a small hole in your skull near the ears and extract the tumour through your inner ears.

  Radiation -
If the tumour is small or if the patient is elderly and surgery can cause complications, doctors suggest radiation therapy. In this therapy, gamma rays are directed towards the tumour to shrink it.
Acoustic vestibular schwannoma can be treated if diagnosed on time. So, if you have noticed any symptoms, talk to a doctor right away.

Acoustic Vestibular Schwannoma - All You Must Know About It!

Brain tumours vary in shape and size and the same is the case with their symptoms. The location of the tumour affects the symptoms greatly. Just like in any other type of a malignant tumour, brain tumour has a rapid growth and proliferation of abnormal cells that may have its origin in affected site or areas adjacent to it. As per studies, every 2 in 1,00,000 people are said to be affected by brain tumour in India. However, it may come as a relief to some as not all brain tumors are cancerous or life threatening. Some are benign tumors and seldom pose any threat to the affected individual.

Types of Brain Tumor
Brain tumors may be primary or secondary.

Primary brain tumor: Here the abnormal mass of cells that originated in the brain do not metastasize to the other organs. Based on their location in the brain, the primary brain tumors may be of the following types.
Gliomas: One of the most common types of primary brain tumors, gliomas can have their origin in the spinal cord or the brain. Some of the common types of gliomas include Astrocytomas (originates in the cerebrum of the brain), Glioblastomas (these tumors form from the Astrocytes which form the supportive tissues of the brain), Ependymoma (these develop from the ependymal cells which are present within the CNS), Oligodendrogliomas (these tumors are found to arise from the oligodendrocytes).
Schwannomas: Also called as Acoustic neuromas, these primary brain tumors form on the nerves that play an important role in regulating the balance and hearing from the inner ear to the brain.
Meningiomas: These type of tumors are usually benign and have their origin in the meninges (membranes surrounding the spinal cord and the brain).
Primitive neuroectodermal tumors (PNETs): Primitive neuroectodermal tumors (PNETs) are rare malignant tumors that originate from the fetal (embryonic) cells in the brain.
Pituitary adenomas: As the name suggests, these tumors arise from the pituitary gland located at the base of the brain.
Medulloblastomas: Common among the children, these malignant primary tumors develop in the brain (lower back) and gradually spread via the spinal fluid.
Other types of primary brain tumors include Craniopharyngiomas and the Germ cell tumors.
Secondary brain tumors: Unlike the primary brain tumors, these tumors have their origin in the other body parts and organs (mostly in the lungs, skin, colon, breast, and kidney) and then gradually metastasize to the brain. The secondary brain tumors are found to be more common.
Symptoms or warning signs associated with brain tumors:
Some of the signs and symptoms that may be indicative of a brain tumor include

People with brain tumors often get seizures (due to the irritation caused by the tumors in the brain).
A headache (mild to severe depending on the part of the brain affected by the tumor).
A person experiences numbness or a tingling sensation in the legs and arms.
There may be difficulties in walking or balancing.
A person finds it difficult to concentrate.
There may be some problems with hearing, speech or even vision.
A person may experience weakness restricted to only one part of the body.
The symptoms may not necessarily indicate a brain tumor but it is always wise not to neglect the symptoms either.

Brain Tumor - What Are The Types?

Cancer has been regarded as one of the most deadly diseases. It is a non-communicable chronic disorder, caused by uncontrolled growth of cells in the human body. Every year over 7 million people succumb to this disease globally and over 12 million people are diagnosed with cancer. Indian Council of Medical Research (ICMR), estimated that India will observe over 8 lakh deaths and over 17 lakh new cancer cases annually by the year 2020. The survival expectancy of a cancer patient depends upon the stage of diagnosis.

There are some forms of cancer which show any noticeable symptoms only in the final stage while there are certain other subtle symptoms which if paid attention to might save a life.
Some common signs of cancer:

Unexplained weight loss: This is one of the earliest noticeable symptoms of cancer and is particularly common in patients of lung and breast cancer. Weight loss has been observed in over 40% of cancer patients at the time of diagnosis. Losing over 10% of body weight in a span of 6 months or less could be a cause of concern.
Wheezing: This is associated with lung cancer, which is also the most common form of cancer. When the airway in the lungs is pressed or narrowed by a tumor, it creates a wheezing sound while breathing.
Frequent infections: Frequent infections and fever may indicate that something is not right with the internal organs of the body. This could be because of cancerous conditions such as leukemia or lymphoma. 
Loss of appetite: Cancer impacts the metabolic process of the body, hence often leads to a loss of appetite. This is particularly a symptom of colon, stomach, ovaries and pancreatic cancer. 
Blood in stool/urine: Traces of blood while passing stool or urine could be a symptom of cancer. Though, this could be attributed to many other infections and conditions as well.
Chronic cough: Flu and cough along with symptoms like chest pain, hoarseness, weight loss and fatigue could be because of lung cancer.
Night sweats: Though night sweat could be attributed to many more reasons, it is also one of the many early warning signs of cancer.

Early Warning Signs Of Cancer That We Often Ignore!

If you have noticed your child to be restless and anxious all the time, it might look cute as the child is highly energetic, but it could be a cause for concern at the same time. It is not normal and the child could be having ADHD that is attention deficit hyperactivity disorder. As the name suggests, it is a disorder with deficiency of attention and in which the child is always hyperactive.

ADHD is a disorder in which the symptoms usually show up before the age of seven. It is characterized by a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. The impact of these symptoms is felt extensively where his overall self-esteem is affected, be it at home, preschool or school, academics or extracurricular activities and in interpersonal relationships.

The most common symptoms, which are almost diagnostic of ADHD are:

Inability to hold attention: The child's attention span is very short and it is very difficult to keep them engaged on one particular thing.
Increased restlessness: The child would be extremely restless and gets distracted easily.
Fidgeting: The child would be seen constantly fidgeting with his fingers.
The following are the less common ones:

Learning disability is rare, but can happen. However, the good news is that it does not affect the child's intelligence.
Sleep disorders
Difficulty in following directions
Poor executive functioning skills
Disorganization, which can lead to poor motor coordination and impaired movements
ADHD kids tend to forget things very easily and need help with coordinating movements
The child suffering from ADHD could easily tire and/or feel lethargic with very low energy levels. This can lead to the child procrastinating things and not wanting to do things on priority basis
These children also have difficulties with fine motor and cognitive skills and so there is delay in their overall participation in games.
While these are the pressing symptoms of ADHD, occupational therapy can play a significant role in managing the child in the following ways. As a first step, the caregiver should have a detailed discussion with the school staff and any other people with whom the child interacts significantly.

This will help identify areas that need support from an Occupational Therapy, which are the following:

Support with gross and/or fine motor skills
Support with improving handwriting
Support with engaging in playing sports and games
Support in engaging in social activities
Improving sensory processing difficulties
Improving visual perception
Support in adapting to the environment
Teaching strategies to participate in various social and academic activities
So, while an ADHD child is definitely a cause for concern, proper support from family can help manage the condition.

ADHD - Know The Symptoms

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!

Irrfan Khan's saddening revelation about his health and diagnosis of Neuroendocrine tumour (NET) has undoubtedly created a rage amongst his fans, which is now being followed by good wishes for speedy recovery from his supporters all across social media.  

The actor shared in an emotional Twitter post that he s been diagnosed with NET, a rare tumour that develops from cells of the neuroendocrine system and grows predominantly in the digestive or respiratory tract - lungs, appendix, small intestine, rectum, and pancreas - it can occur in any part of the body.

Here is more on Irrfan s disease:

What is NET?

A neuroendocrine tumor is characterized by a rapid and abnormal growth that happens in the nerve cells which produce hormones. Hormones control how different organs in the body work.

It is a condition wherein, endocrine cells, the hormone-producing cells of the body, develop a tumor in any part of the body - while it can can grow in lungs or the thymus, or more rarely, in the ovaries, kidneys, or testicles - the most common is lung, intestines, and pancreas.

What causes NET?

A neuroendocrine tumour is quite a rare disease, occurs in less than one per million cases. The exact cause is not known.

The Symptoms-

It can cause a myriad of symptoms, depending on where in the body the NET is.

If it is in your digestive system, it can cause pain or discomfort in the abdomen area that comes and goes. You may feel sick, nauseated, vomited, or there may be a change in how often you pass stools.
If the NET is in the lung, it can cause shortness of breath, chest infections, or you can even have a cough up blood.
Weight loss and loss of appetite may also be some common signs of a neuroendocrine tumour.
Some NETs may overproduce a hormone-like substance called serotonin. This causes a group of symptoms called carcinoid syndrome. Symptoms include wheezing (like asthma), flushing of the skin and diarrhoea.
Who can be affected with NET?

These tumours, depending on the type, are more common in certain age or sex. And few have very strong family history too.
People who have a rare condition called multiple endocrine neoplasia 1 have an increased risk of developing a NET.
Did You Know?

Apple founder  Steve Jobs  died from the same disease in 2011. The tumour affected his pancreas.

Know The Different Types of NET:

Based on the organ that is affected, NET can vary a lot. When the chromaffin cells that produce adrenaline are affected, it is called Pheochromocytoma, and it is related to the stress levels of the body.

When a cell is formed abnormally under the skin and the hair follicles, it is called Merkel cell cancer. This is also called neuroendocrine carcinoma of the skin and the condition can occur anywhere in the body. The commonly occurring places include lungs, gastrointestinal tract, and brain.

The status of the tumour, cancerous (malignant) or noncancerous (benign), decides the survival rate. Often slow-growing and noncancerous, they can invade surrounding parts of the body and at times, turn cancerous and spread across the body. However, you can still choose to live a good quality life with strict modifications in diet and lifestyle. The changes are made after taking into consideration the symptoms of the tumor. The organ where the tumor is formed also matters.

How Is It Treated?

Treatment depends on the location of the tumour, its type, how severe it is and whether it has spread to other parts of the body. Usually, the first treatment choice is surgery to remove the tumour. And, if the NET cannot be removed, your will prescribed with a treatment that will not only relieve the symptoms but will also improve the quality of your life.

How can a NET be prevented?

The first thing you need to do for the prevention of NET is to curb stress. Stress affects the entire body severely.

Lifestyle modifications:

A healthy lifestyle is what you need to stick to if you want to manage its symptoms during the treatment cycle. Your doctor will prescribe you to do exercises at least 4 days a week for a minimum of 30 minutes. You can also try a walk instead of strenuous exercises.

People with carcinoid syndrome may be advised to avoid food or activities that may trigger flushing, such as eating spicy food or drinking alcohol.

Indulge yourself in therapies that help in gaining more positive energy. If you are already affected by NET, eliminate all the sources of stress and get a good night's sleep every day. Join the support groups that make you grow strong and happy. After all, the mind is devised to do miracles when it is full of life and positive thoughts.

Is Irrfan Khan's tumour curable?

Dr Saumitra Rawat, HOD, Surgical Gastroenterology & Liver Transplant, Sri Ganga Ram Hospital, said, "NeuroEndocrine Tumour is an abnormal growth of Neuroendo cells which are present in bodies. When there is an abnormal growth, then it forms a tumor - Normally seen in intestine, pancreas, lung, thyroid and other parts of the body".

On commenting on Khan's case, he said, "It depends on the location of tumour, its size, and what is its mitotic index".

"Depending on where the tumour is localized, you can take it out surgically and the chances of cure are very high", Dr Rawat explained.

Actor Irrfan, who has been diagnosed with the disease is one of the most versatile actors in India, has also made a name for himself in the west, where he has been an important part of critically-acclaimed films such as  The Namesake ,  Jurassic World , and  Life of Pi . At home, the actor has delivered remarkable performances in films such as  Haasil ,  Paan Singh Tomar ,  Maqbool ,  Lunch Box ,  Piku , and the most recent  Hindi Medium .

Irrfan Khan is not just a disarmingly natural actor, but also an endearing human being -- honest and humble to the core. It s time to stand together and pray for him a speedy recovery!

Irrfan Khan - Battle Against Neuroendocrine Tumour!

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