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!

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

How Physiotherapy Can Help with Neurological Disorders

Neurological disorders are problems with any one or a combination of the central nervous system or any of its peripheral systems such as cranial nerves, neuromuscular junctions, and the autonomic nervous systems among others.

Some extreme examples of neurological disorders are:

- Dementia
- Alzheimer's disease
- Parkinson's disease
- Epilepsy
- Disorders brought on by strokes
- Multiple sclerosis and others

What is physiotherapy and how can it help?

Physiotherapy is a form of treatment where practitioners use physical forms of treatment such as massages, exercises, heat treatment and other controlled forms of external stimuli to treat physical disorders.

This method of treatment can be very effective in correcting neurological disorders.

Some of the physiotherapy techniques, which can be implemented to help patients, are as follows:

Electrical Stimulation: This method is commonly used to treat muscular problems, especially incurred after an accident or any other form of injury. In this method, controlled electric stimulation is given to specific nerve areas over the skin to stimulate them.

Heat treatment: This method involves applying heat to parts of the body such as joints or muscles where there is nerve or muscular damage. This treatment is especially effective for muscle related problems.

Ice or cold treatment: Vertically opposite to the principle of heat treatment, ice or cold treatment is used to contract muscles within the body. This is especially effective where inflammation needs to be controlled.

Manual therapy: Possibly the most common form of physiotherapy, this method employs massages, pressure points, stretching and hands on strengthening exercises and helps regularize nerve impulses to areas where they have been affected.



How Physiotherapy Can Help with Neurological Disorders

The neurones in the brain are constantly reorganising their connections both functionally and physically according to the environment, your thinking and behaviour. This ability is known as neuroplasticity. Through neuroplasticity the nerve cells of brain can compensate for injury to some parts of the brain and enable a person to recover from stroke, birth abnormalities. It is also beneficial in treating autism, ADD, learning disabilities and helps manage obsessive compulsive disorders.

Here are seven things you should know about neuroplasticity.

Change depends on the attentiveness of the brain: Neuroplasticity changes can only happen if the brain is alert and active. When the brain is active it releases neurochemicals that are necessary for the neurone connections to change. If a person is distracted to inattentive, these changes cannot happen.
The more the effort; the bigger the change: Neuroplasticity changes depend on how motivated the person is to change or learn new tasks. For this reason, when it comes to using neuroplasticity for physiotherapy, it is essential to first deal with any depression or anxiety issues the patient might be having before attempting to rehabilitate them.
It helps strengthen neural connections: Repetition of actions is one of the key elements of neuroplasticity in physiotherapy. Through this, the strength of neurone connections is strengthened to include sensory information, movement and cognitive patterns.
It improves cell to cell connections: This is crucial to a patient s rehabilitation as it increases reliability and makes a person more independent. In turn, this makes behaviour patterns more reliable.
It helps predict actions: A task can usually be broken down into a series of smaller tasks. For example, feeding oneself can be broken down into steps that begin with lifting a spoon and filling it with food to finally putting the spoon into your mouth. Hence, along with completing an action, the brain must also know what to do next. Neuroplasticity helps improve this associative flow and allows the brain to predict the next step.
Changes can be temporary or permanent: Initial changes due to neuroplasticity are temporary ad only if the brain determines the experience to be desired is this change made permanent. This is why when treating mobility issues, patients are not always able to repeat tasks in the same way.
Memory guides the learning: When making new neural connections through neuroplasticity, the brain is taught to discard unsuccessful attempts and only remember the experience of the successful attempts. From here, adjustments are made to improve the connection.

Neuroplasticity - 7 Things You Must Know About it!

Polio is a virus that has the potential to infect any parts of the body including, but not limited to nerves and muscles. Primarily there are 3 types of polio namely, non-paralytic, spinal paralytic and bulbar. This disease shows minimal to no symptoms in more than 90 percent of the cases. 5 percent of the cases can show symptoms such as nausea, diarrhea, vomiting, sore throat and abdominal pain. Polio is a communicable disease and can cause massive damage if a proper dosage is not taken. It can spread through air, physical contact with an infected person, coughs etc.

Polio can cause paralysis: Polio has a far-reaching permanent effect on the body. It can cause paralysis on any of the limbs leading to permanent disability. This severely alters a child s life. The far-reaching consequences of the virus can only be negated through vaccination.
Weak muscle: Polio can result in weak muscles, respiratory problems and loss of reflex. If the breathing muscle collapses, it can result in the death of a person. Any of the above-mentioned symptoms can lead to weak body development altering the fate of a child.
It can spread fast and quick: Polio spreads very fast through the air, physical contact, saliva and water. It not only affects a single life but put millions at risk of the disease. A 1916 outbreak of the disease killed 6000 people in the United States and left several thousands of people disabled.
It reduces the risk of infection: 3 dosages Polio vaccination under the age of 6 can save a baby from getting polio in future. The body successfully creates polio antibodies from the vaccines and gets enough ammunition to fight it if the virus attacks it in future.
Social responsibility: Massive amount of awareness campaigns have been run by countries all over the world to permanently eradicate polio from the face of the earth. As per the latest reports, only 3 countries are reported to have babies affected with polio; Afghanistan, Pakistan and Congo. It is, therefore, a social responsibility to take part in the mission of removing polio from the face of the earth once and for all.
Save future generation: Although polio is not known to be a disease which passes through heredity, there still lies a chance for the future generation to get this disease. In order to negate that from happening, it makes sense to get the vaccines on time.
Give your kid a head start: Every kid deserves to have an equal amount of privileges like others. One small mistake on part of the parents can heavily cost a child s future. In order to make sure your kids grow up with any apprehension of polio, it is very important to treat them with polio vaccines.

Polio Vaccination - Why Is It so Important?

Acoustic vestibular schwannoma or the acoustic neuroma is a kind of tumour. But this tumour is benign which means it is non-cancerous. The vestibular nerve connects your ear to your brain, it is responsible for hearing and balancing. An acoustic neuroma develops on the vestibular nerve. And it can cause hearing impairment.

How does acoustic Vestibular Schwannoma occur? 
The vestibular nerve is lined with Schwann cells. Sometimes, these cells start to develop rapidly. This forms a mound on the nerve, it slowly becomes large enough to prod against the brain, and this adversely affects the actions of the brain.

What are the Symptoms?
In the early phases, the tumour does not trigger any symptoms. They begin to manifest once the tumour starts expanding. Here is a list of the symptoms of acoustic vestibular schwannoma-
  Gradual hearing loss
  Misalignment and losing balance
  Ringing in the ears.
  Regions of numbness in your face
Even though these tumours are benign, sometimes they enlarge to such an extent that they can be harmful to the brain. As soon as you witness the above-mentioned symptoms, book an appointment with a doctor.
With timely treatment and medication, doctors can reverse the growth of an acoustic vestibular schwannoma. 

What triggers this Disease?
The exact cause of this disease is not known. It could be any one of the following-
  A chromosomal anomaly or a malfunctioning gene
  Inhibition in the function of the protein suppressor that regulates the growth of Schwann cells

How is Acoustic Vestibular Schwannoma detected?
Your doctor will recommend these tests-

  Audiometry -
The audiologist will present sounds at different frequencies and you will have to make a gesture whenever you hear a sound. This will reveal the state of your hearing.

  Magnetic Resonance Imaging -
An MRI can detect the presence of a tumour that is 1-2 mms in diameter. If MRI causes pain or discomfort, a CT scan will be done.

Treatment -
If the tumour is tiny, your doctor won t prescribe medicines but your tumour will be monitored and imaged regularly so that the proper action can be taken as soon as it begins to enlarge.

  Surgery -
If the tumour is large, then you might have to undergo surgery. Not only will the tumour be removed, but also care will be taken to preserve the facial nerve so that facial paralysis does not set in.
You will be placed under general anaesthesia. The surgeon will drill a small hole in your skull near the ears and extract the tumour through your inner ears.

  Radiation -
If the tumour is small or if the patient is elderly and surgery can cause complications, doctors suggest radiation therapy. In this therapy, gamma rays are directed towards the tumour to shrink it.
Acoustic vestibular schwannoma can be treated if diagnosed on time. So, if you have noticed any symptoms, talk to a doctor right away.

Acoustic Vestibular Schwannoma - All You Must Know About It!

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