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

A tumor is an uncontrolled and abnormal growth of cells. A brain tumor is thus an abnormal growth and multiplication of cells in the brain. The cell growth can also be in areas adjacent to the brain. The brain tumor may

Have its origin in the brain (Primary brain tumor), or
Its origin may be in some other parts or organs of the body, which gradually spreads to the brain (Secondary/metastatic brain tumor).
Not all brain tumors are harmful and life threatening.

Brain tumors that exist as noncancerous cell growths are known as Benign brain tumors. Benign brain tumors seldom pose any threat to life.

Brain tumors that are cancerous and, thus, harmful, are known as Malignant brain tumors.

Do not neglect any brain tumors (malignant or not). It is better to be safe than to be sorry.

Types of Primary brain tumors:

Based on its cell of origin, primary brain tumors (benign as well as malignant) may be of the following types:

Meningiomas: Brain tumors that originate from the meninges (the membranes that cover the brain and the spinal cord). Meningiomas are seldom malignant.
Acoustic Neuromas: A noncancerous cell growth that has its origin in the vestibulocochlear nerve (the eighth cranial nerve). This nerve connects the brain with the inner ear.
Gliomas: Here, the tumor has its origin in the brain and the spinal cord (glial cells). This type of brain tumors, in most cases (~80%), are malignant.
Primitive Neuroectodermal Tumors (PNETs): Extremely rare, PNETs are malignant tumors that develop in the embryonic cells in the brain.
Medulloblastomas: Medulloblastomas is a malignant brain tumor that mostly affects children. It originates in the cerebellum (lower part of the brain).
Craniopharyngiomas: A benign brain tumor that has its origin near the pituitary gland (base of the brain). Craniopharyngiomas are common in children.
Probability of a secondary brain tumor are more in people who have had;

Kidney cancer
Breast cancer
Lung cancer
Colon cancer
Melanoma
Symptoms:

The symptoms of brain tumor include:

Chronic and regular headaches.
A change in the headache pattern.
Seizures.
A person may experience vision problems (Peripheral vision may be affected, double or blurred vision).
There may be difficulty in hearing.
Nausea and vomiting.
Behavioral and speech problems.
An arm or a leg may lose sensation.
A person has difficulty with balance.
Diagnosis and Treatment:
Though brain tumor can affect anyone and everyone, its chances are higher in

People who are more exposed to ionizing radiation. People having undergone a radiation therapy are equally vulnerable.
Children as well as older people.
People having a family history of brain tumors.
The diagnosis includes;

An imaging test like the MRI, CT scan and PET (Positron Emission Tomography).
Biopsy, whereby samples of the abnormal tissue is collected and examined.
Neurological examination.
Treatment:

Surgery is an effective treatment for brain tumors.
One can also opt for:

Radiations, whereby the abnormal tumor cells are destroyed using protons and x-rays (high-energy beams).
Chemotherapy: In this treatment, the tumor cells are destroyed using strong drugs (taken orally or intravenously).
Radiosurgery.
Targeted drug therapy: This treatment blocks the abnormalities that are characteristically present only in the cancer cells.

Brain Tumors: Types, Symptoms, Diagnosis, and Treatment

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!

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

The relationship between intelligence and brain size, both among people and between various species, has never been precisely well defined. People often believe that their outstanding psychological capacities must mean that they are superior to all animals as far as brain size is concerned. However, it is not true since whales and elephants have much bigger brains than humans and humans have the same brain-to-body mass proportion as mice do.

Here are a number of ways by which the brain size can be determined:

Encephalization remainder: Since it would be against human instinct to admit loss and defeat, researchers have created a measure to determine the brain size called the encephalization remainder. It is the proportion of actual brain mass with respect to the anticipated cerebrum mass for the animal s size (based on the suspicion that bigger animals require somewhat less brain matter with respect to their size, compared to little animals). By this metric, human beings prove to be the best, with an EQ of 7.5 outperforming the dolphin's 5.3 and the mouse's 0.5.
IQ testing: Without a solitary and evident method for measuring intelligence, some improved tests like IQ (Intelligence Quotient) are by and large acknowledged as a moderately decent working device. IQ estimations are not without issues, and there is a great deal of criticism about their significance. IQ testing uses government sanctioned tests, for example, the WAIS III (Wechsler Adult Intelligence Scale). The normal IQ is somewhere around 90 and 110. The scores beneath the normal may demonstrate changing degrees of pathology, for example, marginal intellectual function, or mental hindrance of different severity. Over the normal range is regularly connected with knowledge, splendour, talent, or genius. However, as with computers of a few eras, size and intellect do not precisely relate. Present day portable computers weighing around one or two kilogrammes can store more data and perform a greater number of assignments than supercomputers from the 1980s that used to possess expansive structures. This is a contrast amongst quantity and quality. Numerous scientists now hold the view that it is not the whole brain, which is bigger in a human with a higher IQ, yet rather certain zones that are denser and might be bigger. A fascinating late revelation is that these ranges can be expanded in size and enhanced in usefulness during the course of our life.
NeuroplasticityIt refers to the dynamic procedure of repair and maintenance that our brains are continually experiencing. We are conceived with around hundred billion neurones, yet lose around two hundred thousand a day to a procedure called pruning. As we develop and grow, pathways in the brain that are not required are detached, and the neurones pass on. However, in a compensatory procedure, new neurones are delivered and more detailed associations are built up between neurones that are more dynamic. This is the procedure of de-cluttering, in which our brains develop to work at most extreme effectiveness. If you wish to discuss about any specific problem, you can consult a Neurologist.

Brain Size - How It Is Related With Intelligence?

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

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