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!

Leading a life with peripheral neuropathy is quite similar to riding a roller coaster. Managing the pain can be frustrating at one time and overwhelming on the other as patients can experience alternating symptoms with debilitating pain. So you should learn about the various treatment options as they can help you go a long way in managing the pain.

The peripheral nerves are considered the longest in the body which extend from the hands to feet. When these nerves are damaged, you may feel some sort of pain, tingling in the hands and feet and even numbness, and these symptoms can even get worse and you may experience stabbing pain with increasing weakness. 

There are many things that you should know about peripheral neuropathy as they would help you to manage the condition much more effectively.

Diabetes is the leading cause of neuropathy: More than 70% of diabetics develop symptoms of peripheral neuropathy. So you should keep your blood sugar within optimum levels as a means of reversing diabetic neuropathy.
A melange of causes behind neuropathy: Though diabetes is the number 1 cause of peripheral neuropathy, other causes include deficiency of vitamin B12, alcoholism, traumatic injury, chemotherapy and exposure to toxic substances. Physicians may find it difficult to pin-point the cause and when this happens. This is often termed as  idiopathic neuropathy .
Medications causing neuropathy: If you are suffering from diabetes and being treated with the drug named metformin, you may develop peripheral neuropathy.
Preventing neuropathy is the most recommended way: While it is the fact that some nerves may potentially get damaged from certain surgeries or injury, peripheral neuropathy can be potentially prevented or sometimes stopped from spreading. As diabetes is a major cause of diabetes, being watchful about your diet and exercising regularly can help you go a long way to prevent diabetes as well as neuropathy.
Pain is not simply confined to a tingling sensation: Though pain and a tingling sensation is the commonest and easiest way of recognising the symptoms of peripheral neuropathy, each of your sensory, motor and autonomic nerves can show different set of symptoms that you should be watchful of.
A diet may make the symptoms even worse: You can either help or hurt your nerves with your choice of foods. For improving symptoms, you should avoid food with excessive sugar, refined grains and artificial sweeteners as they may strain your nerves and irritate them further.
Whether you are recently diagnosed with peripheral neuropathy or living with it for many years, understanding a few conditions would help you make informed decisions about your well-being.

Peripheral Neuropathy - 6 Things You Should 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!

Your mother has often yelled at you for playing video games for long hours, but obviously you haven t paid heed to it. Such is the obsession with video games that they don t let you rest unless you have championed all the levels in the virtual interface. Here is the source of all problems. Studies have revealed that video games have a direct relation to neuropsychiatric problems. As a result, many health experts across the world consider video game as a kind of health abuse.

People who play action-oriented video games are at higher risks. The more you indulge in these kinds of games, the more they are going to affect the hippocampus section of your brain. It is that part of the brain which is considered to be the centre of your nervous system, memory and emotion. Reduced hippocampus volume may make person vulnerable to multiple neuropsychiatric complications. Let us see some of the signs, which may indicate the onset of certain complications arising from an over indulgence in these games.

1. You spend hours on the computer or related gaming devices and devote lesser hours for your family and friends

2. You get agitated when someone stops you midway through the game

3. You become socially isolated and show signs of occasional mood swings

4. You are unable to keep a track of time once you start playing

5. You repeatedly neglect your studies, resulting in a dip in performance at school

Why does this happen?

All of the above signs indicate that sooner or later you might develop neurological problems. When you spend an excessive number of hours on playing and navigating through the games, the  hippocampus  portion of your brain shows signs of decreased gray matter. As a result, the volume of the hippocampus shrinks, causing severe nerve related disorders such as schizophrenia, Alzheimer s disease, dementia, depression, and overall general stress.

One of the biggest reasons behind this is a lack of self-control. Most of the video games will encourage you to steal cars, run away after a theft and kill your enemies. Moreover, if you succeed, you are rewarded. This naturally unleashes a blatant urge for the gratification of all these awkward desires in your real life too. Hence, once you are encountered with the reality, you tend to show violent behavior.

Can Playing Video Games Cause Neurological Problems?

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!

Whether it's a child or a grown-up, difficulty in concentrating is often experienced by many people. While, people tend to brush off this particular problem to be nothing worth being concerned about, but sometimes, there may be a more serious underlying issue for which concentration problem is only a mere symptom. Yes, difficulty in concentrating can be a sign of a neurological disorder. Keep on reading to know more about neurological disorder, its symptoms, and treatment.

Reasons behind difficulty in concentrating
Inability to focus properly is a periodic and normal occurrence for many. While sometimes it is the emotional stress or physical tiredness that is responsible for it, at times it is the outcome of hormonal changes in the body, such as during pregnancy or menopause that causes it. However, when experienced in severe degrees, it may be a characteristic of a serious psychological condition called neurological disorder. Affecting both adults and the children, the neurological disorder can be a serious threat if not treated at the right time.

Neurological disorder
Neurological disorder refers to any condition that happens due to the dysfunction of the nervous system or the parts of the brain. Depending on the location of the damage to the nerve or in the spinal column or the brain, different areas controlling the vision, movement, thinking or hearing can be severely affected. The decreased ability to focus on something or loss of concentration power being one of the many symptoms of neurological disorders among the various complications it causes.

Causes behind neurological disorder
Many reasons lead to neurological disorder or its associated symptoms like difficulty in focusing. From lifestyle-related issues to nutrition related causes, physical injuries to some infections, complications during childbirth, and genetics to environmental influences, numerous factors can be responsible for such disorder. Depending on the type of neurological disorder, the symptoms can vary from to another, while for some difficulty concentrating can be a symptom, for some, the symptoms can be more of physical difficulties such as problems in walking or difficulty speaking or seeing, etc.

Dealing with difficulty concentrating
Once the cause of the neurological disorder is determined, there are various treatment options, offered by the doctors. To deal with the neurological disorder as the cause of difficulty concentrating one may need medications and treatment provided by the medical professionals. However, there are a few tips that one can keep in mind, such as minimizing multitasking and focusing on one single thing or thought at one time or dividing tasks into small steps, etc.

Difficulty in concentrating means the ability to focus on thoughts or action decreasing. In case one experience this issue on a long term basis or excessively, visiting the neurologist as soon as possible should be the best thing to do.

Problem In Concentrating Could Be A Sign Of Neurological Disorder!

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