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!

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

Remove the brain tissues that are grown abnormally
Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
Biopsy purpose or to remove the tumour
Make a nerve free
Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
To implant artificial electronic device as a treatment for conditions like Parkinson's disease
Types:

Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.
Risks:

Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

Brain Surgery - Know The Purpose Behind It!

A Brain Tumour can be defined as an abnormal growth of the tissues in the brain, which can disrupt the proper brain functions. Generally, the cells in the human body die and are replaced by new cells, while in the case of a tumour, the old cells do not die and form an accumulation and continues to grow to form a mass as more and more cells are added to it.

Symptoms of Brain Tumour:

Headache: Having headache on regular basis, without any history of having such frequent headaches in past, which becomes worse because of other pressure related activities, such as sneezing, coughing, exercising might be a possible symptom of brain tumour and issues related to such sudden and frequent headaches should be taken up with the doctor without any further delay.
Seizures: Seizures (fits) are amongst the most common symptoms of brain tumour, which might be limited to a particular body part or the whole body. Seizures might even continue after the treatment of brain tumour because of the left scar tissues in the brain.
Numbness in arms/legs: Numbness in any body part, especially arms and legs should also be get evaluated timely, so that, if the possible reason behind them is a brain tumour, then the same could be treated well on time.
Balancing problems: Poor coordination and balancing problems also arise as the most prominent symptom for the brain tumour and hence such small changes must be evaluated and the person suffering should be taken to a doctor immediately to get treated without any delay.
Memory problems: Lack of concentration, poor memory and short term memory loss are few of the possible symptoms that indicate the presence of tumour.
Nausea or vomiting: Nausea or vomiting might be the symptoms of many other possible health issues, but a headache supported by nausea and/or vomiting is one of the many symptoms of a brain tumour and hence should not be ignored.
Facial paralysis: The inability to keep the facial activities under control also indicates the presence of a possible brain tumour and the same should also be diagnosed as soon as one experiences it.
Change in vision: A person suffering from brain tumour might also experience changes in the vision, dizziness, blurry vision, among other sight related issues.
Change in speech: The inability to speak properly and changes in the speech of a person may also indicate a possible presence of a tumour.
Hearing problems: Sudden occurrence of hearing problems and other hearing related disorders might have the brain tumour as a possible reason.
Diagnosing a brain tumour may include one or more of many tests, including CT scan, Magnetic Resonance Imaging (MRI), Angiogram and biopsy. One should never ignore the symptoms of the brain tumour and should get himself/herself checked since the brain tumours might result into permanent damages to the brain; hence such issues should never be ignored.

Do You Think You are Suffering from Brain Tumor? 10 Signs You Must Take Seriously

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

British head injury statistics report that about one million people are required to go through emergency care every year. Although many of these accidents are minor, one out of five victims is required to be admitted in the hospital for emergency care. Head injuries amount to about 1 percent of all deaths and about 15 to 20 percent death in people aged between 5 and 35 years. This is the most common form of death in abused children.

Symptoms of a concussion
Head injuries are also known as concussions or traumatic brain injuries, which may range from mild to severe. Most mild injuries cause no harm over time but in rare cases, these may trigger a host of problems. You must seek medical help in case you observe any of the following symptoms:

Nausea, drowsiness and headache are persistent for a long time and get worse every day.
Difficulty in waking up from sleep; this problem is very common with children.
Unusual and incomprehensible behavior like getting annoyed or losing temper and being confused.
Amnesia or forgetfulness.
Change in the size of eye pupil especially dilated pupil.
Difficulty in explaining anything, speaking and even walking.
Drainage of blood-like or clear fluids from nose or ears.
Weakness or numbness in different parts of the body, particularly in arms and legs.
Seizures
Vomiting more than twice or thrice in a day.
Such symptoms should never be overlooked and they may take place separately or in combination in people affected with mild head injuries. These symptoms are collectively called post concussional syndrome causing irritability, depression, fatigue, tiredness, insomnia together with the above mentioned problems.

Homeopathic treatment to alleviate the symptoms
Initial hours right after the head injury are very crucial. A proper treatment at this point of time can prevent further worsening of the condition. Arnica and NatrumSulph are very effective in treating head injuries or concussion. Though most people regard Arnica as a small remedy in petty injuries, in truth, Arnica plays a vital role in preventing immediate as well as remote effects culminating from a head injury. It can control internal hemorrhages or bleeding, which may lead to critical problems in the future.

Another important homeopathic medicine is NatrumSulph that is known for its ability to treat epilepsy, sightlessness, vertigo and memory loss, which can arise from an immediate or distant head injury. It can also lead to swelling in the optic channel through which the optic nerve goes that can cause acute visual disturbances. Therefore, it is important to consult a responsive healthcare provider without further delay.

Concussion - 10 Signs that Indicate it!

Cancer today is not as rare as it once was. Today, cancer affects the young and old alike. One of the reasons for this is the pollution in particular air and water pollution that we are exposed to on daily basis.
The air we breathe in today is a mixture of smoke, particulate matter and noxious gases that causes great harm to our bodies. Amongst these, particulate matter that is smaller than 2.5 millionths of a metre is the worst.

These particle matters are emitted into the air from car exhausts, industrial exhausts, coal fires, wood stoves etc. While the body s natural defences help keep larger particle matter out of the system by sneezing or coughing it out, smaller particle matter enters the body easily. These then get trapped in the lungs and enter the bloodstream. Particle matter has in particular been linked to increasing number of lung cancer cases. Apart from lung cancer, coal tar particle matter has been linked to bladder cancer, soot to oesophageal cancer and benzene and other pesticides to leukaemia.

Radon is another source of air pollution that is emitted from the ground. In some cases, radon can also be emitted through the water. As this gas decays, it releases tiny particles that when inhaled bombard the lung cells with radiation that can cause radiation. Smoking can worsen this effect and increase a person s risk of suffering from lung cancer. Both first-hand and second-hand smoking have also been linked to breast cancer. Apart from trying to reduce emissions to lower air pollution, it is also important to clean filets of air conditions, etc. regularly to lower indoor air pollution. Preventing the smoking of tobacco in public spaces can also help improve air quality.

All pollutants emitted by us eventually find their way into the water we drink. Even if you are not drinking contaminated water, merely, showering or swimming in contaminated water can make your body more vulnerable to the carcinogens in it. Common water pollutants include arsenic, hazardous waste, animal waste, radon, chemicals and asbestos. Drinking water with concentrated amounts of arsenic has been linked to cancer of the lungs, liver, kidney and bladder while the chlorine used to treat drinking water increases the risk of bladder and rectal cancer.

To reduce the risks of cancer caused by polluted water, it is essential to reduce disinfectant by products by keeping water treatment facilities updated and promote green chemistry and alternative assessments to reduce pollution as a whole.

Pollution - How It Has Increased the Risk Of Cancer?

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