Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

With age, most body organs begin to deteriorate in their function. This happens to the brain also, thereby reducing the overall speed of functioning of most organs. While slowing of bodily movement is visible, the internal organs functioning also slows down, which is not that obvious. Memory loss or dementia is one of the main manifestations of this degeneration of the brain.

Alzheimer s is the most common form of dementia, and the associated symptoms includes reduced reasoning abilities and cognitive defects. Though it is seen only in the elderly, not all elderly people will have Alzheimer s. The overall quality of life of the affected person is reduced with difficulty remembering things that were recently learned. It is a progressive disease and as it gets more severe, a full-time caretaker may be required.

Causes: The brain cells are affected by protein masses known as plaques and tangles. These hamper the way communication between the brain cells happens as well as affect nutrition from reaching all parts of the brain. This leads to shrinking of the brain, eventually leading to memory loss and other problems. There is also a strong genetic linkage, as most people with Alzheimer s have the lipoprotein A gene.

Symptoms: Though memory loss is the most common symptom, there are other symptoms:

Being confused about places, people, and times
Inability to find the right words during conversations
Regular objects are misplaced
Becoming irritable, (in someone who was not so previously)
Mood swings
Personality changes
Inability to organise thoughts
Not able to make the right decisions
Repetitive talks and actions
Forgetfulness (not something the person always does)
Difficulty with numbers (again, not something calculations
Difficulty managing everyday tasks and minor problems
Suspicion of others (like immediate family members and friends)
Risk factors: While age is definitely a risk factor, the fact that not all aged people develop Alzheimer s is to be borne in mind. Other risk factors include the history of stroke, high cholesterol, high blood pressure, diabetes, smoking, obesity, and poor lifestyle choices.

Diagnosis: While there is no definitive way to diagnose Alzheimer s, symptoms along with brain scans and neuropsychological function testing are useful ways to confirm the diagnosis.

Treatment: This is aimed at two things reducing the rate of disease progression and treat (or reverse) symptoms if possible.

Cholinesterase inhibitors improve cellular communication in the brain and also manage depression and agitation. Memantine is used to slow the pace of disease progression.
In people with the disease, small changes are useful to help them with the symptoms. These include keeping essential things like keys and wallet in the same place, keep a daily diary to help them remember things, keep pictures of friends and family within visible distance.

Alzheimer's - An Overview!

A neurological disorder is characterized by sudden recurrent episodes of sensory disturbance, loss of consciousness, and convulsions associated with abnormal electrical activity in the brain.

Role of Physiotherapy in Epilepsy

It helps improve strength, mobility, and increases the range of motion and sphere of movement.
It helps improve sensory awareness, response, balance, and coordination.
It helps to improve quality of movement and physical performance.
The Goals of Physiotherapy

To develop strength enough to support one s head upright
To have balance and motor control to maintain their trunk at midline
To use many different muscle groups
To assist necessary motion in their trunk and extremities
The physiotherapists write short-term goals for each of the items on the problem list that need to be covered to help the patient achieve the long-term goals
To understand what the patient is good at and does well
To focus on what he or she capable of doing rather than on what they can t do
To educate and provide awareness with a view to prevent injury. For example, advice on special swimming equipment to prevent drowning if he/she gets seizures in the pool
Physiotherapy treatment for a healed fracture consists of strengthening muscles that have got weak from being immobilized and stretching muscles that are stiff owing to being in the cast for a long period of time.

Physical exercise improves fitness, energy, and mood and even relieves stress. Improving overall health and wellbeing in this way can help reduce seizures. It can also help people feel more in control of their health. It also helps release  feel good  hormones into the brain, helps keep the muscles active, reduces fat levels in the body, and increases oxygen flow to the brain. It can also increase the bone density. A research showed that regular sessions of aerobic exercise (for example running, walking, swimming, cycling) for 60 minutes, twice a week, for 15 weeks resulted in a significant reduction in the number of seizures they had.

Drink water, diluted fruit juice, or squash while exercising to help replace the fluids and body. Do not exercise straight after a meal.

Team sports or group activities such as walking or gardening groups can also be a good way of increasing self-confidence. Making new friends may help with any feelings of isolation. Most sports, including contact sports like football, hockey, basketball and rugby, have not shown to increase the chance of someone having a seizure, but contact sports come with an increased risk of head injuries, which could affect people with a history of epilepsy. Protective sports headgear helps to reduce this risk. 

Role Of Physiotherapy In Treating Epilepsy!

Depression is possibly regarded as the first sign of Alzheimer s disease. According to a research, the connection between Alzheimer s disease and depression is very interesting. It has been found that the life of people who are suffering from dementia is affected in 2 different ways. Individuals who have suffered from depression in their lives are at a greater risk of developing dementia. It has also been observed that people suffering from dementia also have depression. The health condition should be treated immediately because if it is ignored it can damage the quality of life and result in worst conditions like memory loss. Temperament, as well as behavioral changes, may precede memory problems in people with the disease.

Risk factor of dementia
The significant risk factor for dementia or common form of Alzheimer s is developing depression at a younger age. The other reasons for the link are not very clear, however, it has been speculated that the inflammation that occurs in depression is a contributing factor to the Alzheimer s disease. The risk of dementia also increases with certain proteins which spiral with depression. The common signs of Alzheimer s disease include lack of appetite, sadness, agitation, weight loss, and anxiety. People suffering from this condition are unable to tell if they are depressed, but their actions help in communicating a message. It is always better to seek the assistance of a physician as doctors can make use of tools to assess the neurological disorder.

Best way to treat patients with Alzheimer s
The best way to treat patients suffering from dementia and who are depressed is to engage them in activities. It is important that they step out and do some exercises. They should go out in the sunshine. It is necessary to engage them in activities and conversations and help them to lead a higher quality of life. Some of the symptoms of dementia and depression are alike but not all of them. The major symptoms of depression include feeling tired most of the times, feeling restless, irritable, feeling worthless/guilty, unplanned weight gain and trouble in focusing. These symptoms often occur for more than 2 weeks or longer.

Difficulties caused by Alzheimer s disease
In the case of Alzheimer s disease, it becomes very difficult for the individual to communicate, learn or remember mainly because the damage is caused to the brain. Due to the brain damage, there is a possibility of changes in the personality and moods of individuals suffering from this health condition. The quality of life is affected by depression as well as Alzheimer s disease. Hence, it is always better to treat the condition immediately. For that reason, it is very important to set up a pleasant environment around and help patients suffering from this condition by helping them do enjoyable tasks and make them feel positive about life.

Alzheimer's Disease & Depression - How They Are Related?

Cranial nerve palsy is one of the common culprits of causing double vision. This is all the more true for people above the age of 60. A person is more prone to cranial nerve palsy if he is suffering from high blood pressure and diabetes. This is the reason why this disease is more commonly known as diabetes palsy. Eventually, though they get better and the problem of double vision disappears.

Symptoms:

One weak cranial nerve leads to the weakness of other cranial nerves as well. In case the eyes fail to move together, chances are that the patient will have double or blurred vision. In case the sixth nerve gets affected, side to side double vision is encountered. For the 3rd and 4th nerve disturbance, there could be a vertical double vision. The lack of blood flow causes pain to the eye.

Possible Causes of Cranial Nerve Palsy?

Cranial nerve palsy can result from traumatic or congenital factors. They can also result from vascular diseases such as strokes, hypertension, diabetes, and aneurysms. It can also arise out of infections, increased intracranial pressure, migraines, and tumours. A patient's age and clinical findings help a doctor decide the right course of treatment.

Treatment:

There are no particular treatments which can speed up the recovery of cranial nerve palsy. In a case of pupil pain, doctors may prescribe anti-inflammatory drugs such as Motrin and Advil. They key to natural recovery is to ensure that the blood sugar and the blood pressure is diligently controlled. By patching the eyes, the problem of double vision can be resolved. They are typically worn over both the eyes. They are however known to slow down the process of recovery and strain the eye. There is no known exercise to fix this condition. Botulinum injections are sometimes used by doctors to straighten the eyes but the result of such a treatment greatly varies from person to person. Doctors mostly rely on watchful waiting until the phase passes within 6-8 weeks. Pain medications are recommended on a case to case basis.

Lifestyle Changes:

Managing cranial nerve palsy can be difficult for a working person. It involves many lifestyle changes till the condition fully cares. Some of the suggestions given by an ophthalmologist include resting the eye as long as one can. Reading or working on a computer should be eschewed since it puts great pressure on the eyes. The eye should not be contacted with forehands in case there is too much pain. Other basic hygiene issues include taking the medicine time to time, cleaning the eye with fresh water two to three times a day, putting the eye drops on time as prescribed by the doctor.

How To Treat And Manage Cranial Nerve Palsy?

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!

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