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!

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?

There are various neurodegenerative disorders and Huntington Disease is one of them. It is characterized by loss of thinking ability, chorea or uncontrolled writhing and jerking movements, and psychiatric difficulties. 

Nerve cells in the brain are impaired in this disease. This leads to loss of coordination and involuntary movements. As the disease progresses, patients slowly fail to control their throat and mouth muscles and simple tasks like eating, swallowing, and speaking becomes challenging.

Huntington's Disease may also affect the reasoning and thinking abilities of an individual and makes communication and conversations more challenging. The problem of swallowing food can lead to choking as food can go down the wrong way or a lung infection in more severe cases. 

Speech-Language Pathologist or Speech Therapist helps the patients with speaking and swallowing problems with the help of various therapies.

Visiting a Speech-Language Pathologist in the initial stage of Huntington's Disease is advised. This helps in planning in advance about the ways to handle changes as the disease progresses. The therapist can help the patients when they begin showing an inability to speak or understand and swallowing problems. The symptoms showing swallowing difficulties may include choking, coughing and altered eating habits of the patient and loss of weight.

Symptoms

Dysarthria, in which the ability to remember words, understanding and forming a sentence is not lost but clear speech becomes difficult.

Stammering.

Slow or imprecise speech.

Aphasia, inability to understand what is being said and inability to remember grammar and vocabulary, and the pattern of losing a word in between the sentences.

Weak voice or low volume because of respiration issues.

Scanned Speech or unusual lengthy pauses between words.

Problem with pitch control and resonance.

Treatment

The progression of Huntington s disease varies from patient to patient and the therapy also varies as per the needs and challenges of the patients. The therapy usually starts with the discussion of problems and symptoms faced by the patients. 

For swallowing difficulties, patients may be recommended to maintain a journal of swallowing problems and fixing a time for meal intake every day. He/she may be recommended to eat soft food items, and eat slowly and chew the food properly.

As for speech therapy, one may be recommended breathing exercises. The therapist may demonstrate the patients how to overemphasize certain mouth movements to make the words easier to understand. The family of the patient is advised to reduce distraction while communicating with the patient. 

Assistive devices can also help with communication such as computers, smartphones or tablets. Other low-tech objects from everyday life, such as calendars, picture boards with a depiction of daily life activities, and object images and notebooks can also be helpful.

Take Away
Huntington Disease is a brain disorder where it becomes difficult for a person to control mouth muscles. In this, speaking, swallowing, and eating becomes a task for them. There are speech therapies that can help the patients to gather control over their words and communication problems.

 Huntington's Disease - How Effective Is Speech Therapy In It?

Sleep Apnea refers to sleep disorder which is characterized by irregular pauses or interruption in breathing during sleep. Every pause usually lasts for a few minutes or seconds and occurs several times at night. This may indicate that your brain as well as rest of your body is not getting sufficient supply of oxygen. Sleep apnea is of two types - Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA).

Obstructive Sleep Apnea- This occurs when the air passage gets blocked, generally when the throat muscles periodically relax and obstruct your air passage during sleep. It is the most common type of sleep apnea and is characterized by snoring.
Central Sleep Apnea- In this case, the airway does not get blocked, but the brain stops passing signals to the muscles that control your breathing.
Mostly people who are diagnosed with a number of underlying medical conditions such as obesity, diabetes, hypertension, chronic nasal congestion etc. are prone to Obstructive Sleep Apnea. Although Central Sleep Apnea is a less common type of sleep disorder, and does not lead to serious complications, various research studies show that Obstructive Sleep Apnea can pose adverse consequences if not treated at the right time.

One such fatal consequence is cardiovascular problems. Sudden drops in the levels of oxygen in blood that happens during Obstructive Sleep Apnea results can lead to increased blood pressure and damage of the cardiovascular system, which in turn increases the chance of a heart attack. Since men are more prone to heart ailments than women, men with sleep apnea are at a greater risk of heart ailments like stroke or heart failure, coronary artery disease and others.

Since Obstructive Sleep Apnea occurs due to interruption in the breathing procedure, it can lead to abnormal irregular heartbeats, known as arrhythmia. Arrhythmia can decrease the level of oxygen in blood and if there s an underlying heart condition, these repetitive encounters of low blood oxygen can even lead to a sudden cardiac arrest.

Most research studies have established a positive correlation between sleep apnea and heart ailment. According to researchers, the risk of untimely death increases as the acuteness of sleep apnea increases. However, there are ways of seeking treatment for this particular sleep disorder. You should consult a doctor immediately and get yourself proper medical assistance to prevent the condition from aggravating.

Can Sleep Apnea Be Fatal?

Sleep disorder is a serious problem which a large number of people are facing due to multiple reasons. Almost every other person complains of having some sort of sleep disorder, irrespective of his/her age. Sleep disorders may come across as something which can be overlooked, but this shouldn t be the case, as when the problem aggravates it can take quite a scary turn. You need to be aware of the different kinds of sleep disorders which affect a vast number of people, on a daily basis. Given below are some of the most common ones which affect the majority of the crowd.

1. Insomnia
Insomnia, a worldwide epidemic, is the most common type of sleep disorder today. A number of factors can cause insomnia and affect even the healthiest being. From stress, anxiety or depression, substance and alcohol abuse to certain types of medication, a lot of factors can cause this issue. People who have insomnia have difficulty in sleeping and then maintaining that sleep. A cognitive behavioral therapy can help people suffering from this disorder. Often medications are also prescribed.

2. Sleep Apnea
If you have a partial or complete blockage of the throat then, you might be suffering from sleep apnea. This disorder is the second most prevailing sleep disorder in the world today. People who suffer from this disorder hardly realize it until someone informs them about having the trouble. Some of the common symptoms of Sleep apnea are morning headaches, daytime sleepiness, and excessively loud snoring as well. People suffering from apnea may also face trouble breathing multiple times per night. Continuous Positive Airway Pressure machine is a common treatment for this disorder.

3. RLS or Restless Leg Syndrome
The real reason behind RLS is still not known by experts, however, most believe the real cause of the disorder is hereditary. Some medications can also be a cause of restless leg syndrome. In this disorder, an urge to move your legs and hands precedes the need to sleep. RLS usually occurs when the patient is resting. In order to treat the restless leg syndrome, one must reduce the consumption of alcohol and caffeine along with doing regular exercises. For more severe cases, often medications are prescribed. RLS is observed more in women than in men.

4. Narcolepsy
People with narcolepsy often complain about falling asleep during odd times and feeling weak quite often. An abnormality in the brain is usually the reason behind this sleep disorder. Patients of narcolepsy often develop cataplexy which is a condition where patients feel faintish as an emotional reaction to any situation. People suffering from narcolepsy are given medications as a treatment.


4 Most Common Sleep Disorders

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!

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