A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements. 

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a  Clot Buster  drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 
Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try  removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

High blood pressure,
Cigarette smoking,
Diabetes
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 
Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Brain Stroke - Things You Must Know!

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?

Grading of brain cancer is entirely different as compared to the staging of other cancers in the body. Cancer in the breast, lung, colon etc. are staged depending on the possible spread, location of a tumor and lymph node involvement etc. However, brain tumors are graded based on the aggressiveness of the tumor cells under a microscope. The resect ability and the grade of the tumor cells guide a doctor on the treatment decisions. The decision of a brain surgery depends on factors such as the location, spread of a tumour and the general health of the patient.

Types of Brain Tumor Grading:

Grade 1 tumor- These sets of tumors are medically known as the juvenile pilocytic astrocytoma and subependymoma. They are slow growing and non-invasive. There is a likelihood of the patient getting cured with surgery.
Grade 2 tumor- These are brain tumors that do not possess dead cells as part of the tumour. But, they do portray a lot of abnormal cells. Tumors of this type can be categorized under oligodendroglioma, astrocytoma, and ependymoma.
Grade 3 tumor- Tumors of this type are graded based on the cell type of the cancer cells. For instance, an anaplastic astrocytoma is a grade 3 tumor that has no dead cells but possesses dividing cells. In contrast, anaplastic ependymoma and anaplastic oligodendroglioma are grade 3 tumor cells that have dead cells in them.
Grade 4 tumor- Tumors of this type are referred to as glioblastoma. The tumor cells are actively dividing, the growth of blood vessels is witnessed and areas of dead tissue keep expanding.

Treatment options:
Surgery- If the location of a brain tumor is such that it is accessible to a surgeon, the latter goes ahead and removes most of the tumor if not the whole. If, however, the brain tumor cells are placed very near to the surrounding very sensitive brain tissues, a doctor might remove a small portion of the tumor to curb its growth.
Radiation Therapy- This mode of treatment uses high energy X-ray beams to kill targeted cells of the brain. External beam radiation usually targets a small area of the brain. A whole brain radiation, on the other hand, is usually employed when a tumor has spread to most parts of the brain. Radiotherapy is now so evolved that it is highly targeted to tutor cells that kills cancer and spares normal brain .
Chemotherapy- Chemotherapy employs drugs to kill cancer cells. Chemotherapy can either be taken in the form of an IV or in the form of pills. The dosage of chemotherapy is decided based on the concentration of cancer cells, spread frequency, platelet count of the patient etc. The most common chemotherapy drug that is prescribed by doctors to fight cancer cells is temozolomide.

Brain Tumor - Stages and Treatment!

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

Hypopituitarism is defined as a condition in which the pituitary gland is unable to produce enough hormones. Under-secretion of pituitary hormones affects reproduction, body growth and blood pressure. It also results in pre-mature aging.

The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.

In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and reproduction.

Few Causes:

Head injury

Tuberculosis

Radiation treatment

Stroke

Brain tumors

Brain surgery

Meningitis (brain infection)

Hypophysitis (autoimmune inflammatory disorder)

Sarcoidosis is an infiltrative (accumulation of cells and tissues in excess of the normal amount) disease which occurs in various organs.

Impaired hormone secretion by the pituitary gland is caused by genetic mutations.

Sheehan s syndrome: It is a condition in which the pituitary gland gets damaged due to severe blood loss during childbirth.

Hypothalamus (a part of the brain which is located above the pituitary gland) diseases wherein the pituitary activities are directly affected by the hypothalamus.

Symptoms:

Fatigue

Reduced sex drive

Decreased appetite

Anemia

Irregular menstruation, pubic hair loss, hot flashes (feverish heat), and inability to breast-feed properly because of low breast milk production).

Dwarfism in children

Weight loss

Increased sensitivity to cold temperature

Infertility

Facial puffiness

Reduction in body hair or facial hair

Treatment Options:

Hormone replacement drugs include:

Corticosteroids: Adrenocorticotropic hormone deficiency leads to low production of adrenal hormones (different kinds of hormones such as cortisol and adrenalin, produced in the endocrine glands). These drugs act as a replacement of adrenal hormones.

Growth hormone: Growth hormone, also known as somatropin, is injected beneath the skin. This treatment method promotes growth, which balances the height in children. Growth hormone deficiency in adults is also cured by these medications to some extent.

Surgery: Surgical procedure is needed if the condition of hypopituitarism is the result of a tumor. The doctor will remove the tumor through surgery, thus resulting in normal growth.

Radiation: Radiation therapy helps in reducing the size of the tumor which causes stunted growth or pre-mature aging.

Hypopituitarism: Causes, Symptoms and Treatment

Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

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