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!

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

Abnormal blood vessels
Aneurysm
Bleeding
Blood clots in the brain
When the protective tissue or dura is damaged
Epilepsy
Due to nerve damage
Parkinson's disease
Any kind of pressure after an injury
Abscesses
Skull fractures
In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Risks:
Brain surgeries may be associated with several risks. They may be:

Allergic reactions to anesthesia
Bleeding
Blood clot formations
Swelling of the brain
A state of coma
Impairment in speech, coordination and vision.
Problems in memory
Strokes and seizures
Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.

Brain Surgery - When It Is Required?

Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.

What are the common causes?

Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.

How can you control nerve pain?

Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:

Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.

Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.

Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.

Acupuncture: This time-honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.

Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.

Relaxation Techniques: In combination with the abovementioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.

Lifestyle Modifications: This one s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder.

How To Control Nerve Pain?

Epilepsy is a disorder in the central nervous system characterized by recurrent seizures. An unexpected rush of electrical activity inside the brain leads to a seizure. Brain activity becomes abnormal and leads to periods of unusual behaviour with loss of awareness at times.

Seizures do not always include unusual muscle movements or convulsions. Untreated seizures can seriously affect the lives of children having them. Epilepsy affects both men and women regardless of their ethnic background and age.

Signs of Epilepsy:

A staring spell
Momentary bewilderment
Loss of consciousness
Jerking movements of arms and legs.
Panic or anxiety
Kinds of Seizures:
Seizures are normally classified as focal or generalized depending on the commencement of abnormal brain activity.

Focal (partial) seizures result from abnormal activity in a particular area of the person's brain. Simple partial seizures may change emotions or the way things smell, appear, feel, sound or taste. It is characterized by tingling and dizziness.
Complex partial seizures or focal seizures with impaired awareness entail a modification of or loss of awareness and consciousness. Repetitive movements are performed during such seizures such as hand rubbing, walking in circles or swallowing.
Thorough testing is needed to differentiate epilepsy from other neurological disorders such as narcolepsy, migraine or mental illness.

Generalized seizures normally affect all areas of the brain and consist of:

Tonic seizures lead to muscle stiffness and normally affects muscles in the person's back, legs and arms.
Atonic seizures or drop seizures lead to a loss of muscle control which makes a person abruptly collapse or fall down.
Myoclonic seizures are visible as short jerks or twitches of a person's arms and legs.
Clonic seizures are characterized by repetitive or rhythmic jerking muscle movements.
Tonic-clonic seizures cause sudden loss of consciousness, quivering and body stiffening.
Absence seizures might take place in clusters and lead to momentary loss of awareness.
Symptoms of Epilepsy:
The main symptoms of epilepsy are seizures and it differs from one person to another.

Symptoms of Focal (partial) seizures include:

Dizziness
Change or modification in the sense of smell, taste, hearing, sight or touch.
Twitching and tingling of limbs.
Symptoms of Complex partial seizures include:

Unresponsiveness
Staring blankly
Performing repetitive movements
Loss of awareness or consciousness
Genetics may provide a person with a natural seizure threshold as a person who is susceptible to seizure triggers is said to have inherited a low seizure threshold. A higher threshold conversely makes a person less liable to have seizures.

Epilepsy is a comparatively common neurological disorder that affects innumerable people worldwide and treatments range from medication to surgery.

Epilepsy - Signs and Symptoms You Must Know!

Nerve compression is a condition caused by direct pressure on a nerve. It occurs when a nerve is squeezed or compacted. It is also known as compression neuropathy or entrapment neuropathy. 

It typically occurs at a single location. Nerves in the torso, limbs, and extremities may be affected. Common symptoms include pain, numbness, and muscle weakness at the site of the nerve.

Nerve compression syndrome is also known as:

nerve entrapment syndrome
compression neuropathy
entrapment neuropathy
trapped nerve
Types

Mentioned below are few of the most common types of nerve compression syndromes:

Carpal tunnel syndrome
Cubital tunnel syndrome
Suprascapular nerve compression syndrome
Guyon s canal syndrome
Meralgia paresthetica
Radial nerve compression syndrome
Causes

Prolonged or repeated external force, such as sitting with one's arm over the back of a chair (radial nerve), frequently resting one's elbows on a table (ulnar nerve), or an ill-fitting cast or brace on the leg (peroneal nerve).
Accidents such as sprains, fractures, and broken bones can also cause nerve compression syndrome
Diabetes
Autoimmune disorders, such as rheumatoid arthritis
Thyroid dysfunction
High blood pressure
Tumors and cysts
Pregnancy or menopause
Obesity
Neural disorders
Signs and Symptoms

Pain in the area of compressions, such as the neck or lower back
Radiating pain, such as sciatica or radicular pain
Numbness or tingling
Pins and needles or a burning sensation
Weakness
Symptoms worsen when you try specific movements, such as turning your head or straining your neck
Management

Lifestyle changes: Avoiding movements that cause pain.  Changing job duties may relieve symptoms. Losing weight can improve symptoms if obesity is the cause of nerve compression syndrome,
Physical therapy: Flexibility, strength, and range of motion in the affected area can be improved by working with a physical therapist. Physical therapy can also relieve symptoms, such as pain and numbness.
Medication: Drugs commonly prescribed to manage symptoms caused by nerve compression syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and aspirin. Corticosteroids, such as dexamethasone, are injected directly around the nerve.
Prosthetic devices: In few cases of nerve compression syndrome, a doctor or physical therapist may advise a splint or a brace to help avoid putting pressure on the nerve.
Surgery: The surgical procedure required depends on the type of nerve compression syndrome, the degree of compression, and the nerves and structures affected. Surgery also depends on several factors, which include the duration of the symptoms, the severity of symptoms, and any other underlying health conditions you might have. 
Home remedies: The following home remedies may stop or ameliorate symptoms of nerve compression syndrome:
Stop activities that cause pain
Apply icing on the affected area for 10 15 minutes
Taking regular breaks when doing repetitive tasks
Applying topical creams, such as menthol
Elevating the affected area
Keeping the affected area warmPerforming stretches and exercises to improve strength and flexibility
Using relaxation exercises

Pinched Nerve (Compressed Nerve) - How Can It Be Managed?

Cerebral palsy and occupational therapy

In order to recover the skills that are required for leading an independent and a satisfying life after any injury or disease, an occupational therapist is required. The word occupation refers to the tasks which one has to perform everyday not to one s profession. Muscle and joint coordination issues can be fixed with the help of occupational therapy in case if kids .These include the daily activities like eating, brushing using the toilet. With the help of OT your cognitive and social abilities and even your motor skills will improve at a very good rate.

How is this beneficial for children with cerebral palsy?

Occupational therapy will be helpful to the children who are specially suffering from cerebral palsy. These benefits includes:

- It will increase the chances of making your child more independent.
- It will boost their ability to play as well as to learn.
- The self esteem and the confidence of your child will readily increase.
- They ll have a sense of accomplishment.
- Their quality of life will improve as well.
- This is also beneficial for the parents as well. It will reduce your stress and will provide you with a sense of security.

What to expect?

Occupational therapy is different for different children who have cerebral palsy. It depends on one s physical, intellectual and social emotional abilities .The first session is basically done for evaluation where your child s fine motor and will be observed how your child responds to touch or any kind of movement. The parents are also interviewed in order to find out about the strengths and the weaknesses of your child. For children with cerebral palsy, a revaluation should be done in every 7-8 months in order to see the progress and change the treatment plan accordingly as per the improvement .The operational therapist will use some specific techniques which will help your child to improve very quickly and reach their destination.

These techniques are :

Paediatric constraint induced Movement therapy: This therapy helps your child to move the weaker parts of the body by restraining the stronger counterpart. If you child has a difficulty in moving one of the arms then the stronger arm will be restrained and the weaker arm will be trained in order to gain the strength.

Sensory integration therapy: This type of therapy will help your child to improve the ability bro receive , interpret and act on the information and situations that comes in your child s brain with the help of sensory receptors .

Occupational therapy has been a very important part in improving the physical and the mental discomfort faced by your child when he or she is suffering from cerebral palsy. The therapist may even provide your child with some gadgets in order to make his /her daily life easier and more independent. This helps your child to improve and gradually get better at it without any sort of negativity. While you re looking for a OT make sure the person has enough experience and knowledge, just to ensure that your child gets the right treatment.



Cerebral Palsy And Occupational Therapy

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