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!

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!

With age, just like other body functions, the mind too begins to slow down. This could lead to problems in communication, focus, recall, reasoning, and thinking. So with dementia, the person faces problems which are a combination of above-mentioned activities. Dementia is a symptom associated with many diseases and is not a disease on its own.

Alzheimer s is the main cause of dementia, followed by stroke or brain injury, Huntington s disease, and Lewy body disease. However, there are some symptoms that can be indicative that a person is gradually progressing into dementia. Watching out for these symptoms can help one seek help at an early stage, thereby helping the affected person, and slowing down its progress.

Short term memory loss: With age, people tend to forget what happened recently, and this can even be something as recent as the previous day. However, they can very clearly recollect events from the past. They might forget things like where they have placed their glasses, where the television remote control is, etc. They may also ask for the same information repeatedly, even after it is answered.
Mood changes: Rapid mood swings is observed in a person suffering from dementia. Their emotions keep changing within a matter of seconds, and they may show also less emotion than what they used to show previously.
Personality changes: Since dementia affects reasoning and judgment, someone who was earlier shy could suddenly become outgoing. Their inhibitions which led to a shy personality are lost, making them more outgoing.
Difficulty in performing regular tasks: Be it forgetting things like laying out tables, keeping things back in their places, or organising medical kits, with dementia setting in, these tasks slowly become more difficult to do. Also, learning new tasks, even simple ones, seem tough and are often not accomplished.
Losing storylines: The elderly would usually be good with telling and appreciating stories like telling tales to their grandchildren or following television soaps and stories. However, as dementia begins to set in, they tend to lose storylines, both when observing and telling.
Repeating actions: As they are not able to register things, they tend to repeat things, both in words and in actions.
Feeling lost: Things like heading out to a store to buy something and then wondering why they came there are common. Short-term memory loss can cause such situations. This confusion, especially with regard to time and things, is very common.
Spatial and time orientation: There could be problems relating to space and time, seasons, and they may often ask questions like what time it is, etc. Routine tasks like paying bills, cooking using recipe books, which were easily managed, suddenly begin to look difficult.
Apathy: Losing interest in people, hobbies, or other things like puzzles, which they once enjoyed, become boring and unenjoyable.

9 Early Symptoms of Dementia!

Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

Autism spectrum disorders are a group of severe neurological and developmental disorders which begin in early childhood and can last throughout a person s life. It affects the ability to interact with others and also hinders communication and well as learning ability. A proper health center can diagnose the presence of autism spectrum disorder early on. Many tests are available for evaluation and diagnosis as it is a range of disorders which can have a variety of symptoms. The environment and genetics also play a role in the development of autism spectrum disorder but the exact cause of autism spectrum disorder is not yet known.

Symptoms of autism spectrum disorder:

Your child may not be able to respond when called by his or her name by 12 months age.
Will avoid eye contact and also have the desire to stay alone.
Have trouble understanding or relating to other people or talk about their own feelings.
Delayed speech and language skills which would affect the ability to speak.
Show unusual reaction to sound, smell, taste or feelings.
Answering questions with unrelated answers that have no meaning or link.
Prefer to play alone and would avoid physical contact.

Diagnosis of Autism Spectrum Disorder:

Comprehensive Diagnostic Evaluation   The behavior of your child and development is first studied by the doctor in detail. The tests include genetic testing, neurological testing, hearing and vision testing among others. Doctors may also suggest other specialized tests in certain cases.
Developmental Screening   The development of your child s basic learning skills with respect to the age is checked. The doctor checks for some delays in the progress and will also monitor movement, behavior and speaking progress of the child. Some additional checks are also done for low birth weight, premature birth among other things.
Treatment:

Applied behavioral analysis   This is a notable treatment and widely accepted by doctors all over the world. ABA is known to encourage positive behaviors and improves a variety of skills in a child.
Occupational Therapy   Teaches the skills to live independently like eating, dressing and social skills. This can help people afflicted by autism spectrum disorders to lead a normal life within the society and thus relate to as well as interact with other people.
Speech therapy   It improves and focuses primarily on communication skills and also uses picture boards and gestures to improve the abilities and induce learning skills.

Autism Spectrum Disorder - How To Diagnose It?

Are you aware of behavioral and emotional disorders in children? During the developmental years of a child, constant growth and change are signified. This fact should be strictly kept in mind while dealing with behavioral and emotional disorders in children. Brain disorders like bipolar disorder, depression and anxiety disorders may affect any child during early childhood. The assistance of a mental health professional should be taken while dealing with these problems. On a global scale, almost 15% of children suffer from behavioral disorders. Among the different forms of behavioral disorders, Attention Deficit Hyperactivity Disorder (ADHD) accounts for being one of the most common ones.

Here is a list of the different forms of behavioral and emotional disorders, which are observed in children:

ADHD- This common mental disorder in children is more common in boys than in girls. Commonly, children affected with this disorder are unable to finish familiar tasks, plan or sit still. They may even lose awareness about what goes around them. ADHD-affected children may seem fine on some days, but on other days, they may experience disorganized and frenzied activities. This disorder may continue into adolescence and adulthood as well. There are several treatment options for ADHD, which may include medications, therapy and educational options.

Autism- Children affected with autism seem to become indifferent, remote and isolated in a world of their own. They are unable to form emotional ties with other people or their peers. Autism is more likely to occur in boys than in girls. The condition may result in language delays, mental retardation, and in some cases, a child may suffer high functioning and usual speech and intelligence. This is because the brain of such children functions differently than others. Consistency is very important for managing autism in children.

Bipolar Disorder- This disorder is most likely to begin in early childhood and it continues into adulthood. It is featured by extreme mood swings in the patient. A child may have extremely high or euphoric feelings, but his mood may turn into depression and sadness all of a sudden. This condition is a genetic illness, and it is often mistaken or misdiagnosed as ADHD.

Anxiety- Anxiety disorders make children feel uneasy, distressed and unusually scared for no appropriate reason. Panic disorders, featured, by intense episodes of fear, which occur without any kind of provocation or signal are a common type of anxiety disorder. OCD or obsessive compulsive disorder, which is repetitive and compulsive in nature, is another type of anxiety disorder.

It is very important to treat and deal with children s behavioral and emotional disorders at an early stage. Early diagnosis enables an early start of treatment, which prevents further degradation of the condition.

Types Of Behavioral And Emotional Disorders In Children

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