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!

Acoustic neuroma is the development of noncancerous and slow-growing tumors on the main, vestibular nerve that travels from the inner ear to the brain, connecting the two organs. They are also known as vestibular schwannoma, as it arises from Schwann cells covering the vestibular nerve. It rarely grows rapidly or attains a large enough size that can press against the brain and interfere with the vital functions of the brain. Since the tumor is benign, the patient can be assured that it won t spread to the other parts of the body; however, they can grow large enough to disrupt the normal function of the body.

The pressure from the acoustic neuroma on the main nerve can cause loss of hearing, a constant ringing in the ear and unsteadiness. As per a report published by the Acoustic Neuroma Association, 1 out of every 50,000 people suffers from this condition.

Risk factors for acoustic neuroma
Acoustic neuroma does not have quite as many risk factors. The only established risk factor for acoustic neuroma is having a parent who suffers from the rare genetic disorder neurofibromatosis 2 (NF2). However, having said that, neurofibromatosis 2 (NF2) accounts for only 5 percent of the reported cases. In most of the cases, it has been found that the tumors appear spontaneously without any indication of a family member having this disease or any medical history of the same.

The development of noncancerous tumors on the ear nerves as well as other nerves in the body is scientifically supported as a characteristic indication of neurofibromatosis 2 (NF2). Neurofibromatosis 2 (NF2) is also termed as an autosomal dominant disorder, which indicates that the mutated gene can pass from just one parent. Each of the children has a fifty-fifty chance of inheriting the disease.

However, scientists and doctors have failed to identify why specific people get these tumors. They have reached a generic conclusion about the risk factors, which may include:

Loud noises near the ear.
A parathyroid neuroma, which is a similar benign tumor of the thyroid.
A chance of exposure to low levels of radiation in the childhood.
How to diagnose the risk factors for acoustic neuroma?
If you are experiencing loss of hearing or other neurological symptoms, try to keep track of them. Later on, mention them to your doctor for a proper diagnosis. A detailed history of the symptoms will help your doctor. Your doctor will perform a hearing test to check whether you have an acoustic neuroma. Then the doctor may perform a brainstem auditory evoked response tests along with an electronystagmography to detect any changes in eye movement, caused due to the inner ear. MRI and CT scans are also quite common diagnoses methods for acoustic neuroma.

Acoustic Neuroma - What Are The Risk Factors?

Neurological disorders are the diseases of the brain and spine, and the nerves which connect the brain and spine.

Some of the most common types of Neurological disorders are:

Alzheimer s Disease (AD)

Multiple Sclerosis

Epilepsy

Migraines

Parkinson s Disease

Ayurvedic Approach of Neurological Disorders

Ayurveda is an ancient system of medicine which originated in India, having a holistic approach to focus on treating the entire being. Ayurveda treatments are based on vata, pitta, and kapha doshas, whose balance leads to harmony and whose imbalance leads to toxic accumulations inside the body. Ayurveda aims to maintain an equilibrium among the three. It has effective solutions for a number of Neurological Disorders, also called  Vatavyadhi .

Eighty types of Vatavyadhi are described in Ayurvedic texts which can be placed under four categories: Kevala vata (Vata alone), Samsarga (Vata in association with Pitta and Kapha), Avarana (due to entrapment by other Dosha/Dhatu/Mala), and Dhatu Kshaya Janya (neurodegenerative). 

Ayurvedic Treatment

Ayurveda is plant-based systems of medicine. Because of being natural and harmless, it is very popular in treating various diseases. Several herbs have excellent properties to treat panic and anxiety affecting the central nervous system. Nature s gift of herbs and minerals not only alleviates symptoms but ensures cure by regulating neural biokinesis, thus preventing recurrence, relapse, and adversity.

Ayurveda can cure a number of Neurological Disorders like migraine, sinus, Parkinson s disease, anxiety, stress, insomnia, epilepsy, hysteria, cerebral palsy, stroke, etc. For treating these Neurological Disorders Panchakarma therapy is adopted which focuses on holistic treatment for long-lasting results.

Some of the common remedies under Panchakarma therapy are:

Chamomile tea, roots of kava, passion flower, ginseng, Cannabis sativa are all prescribed for anxiety.

Valerian is used as a natural sedative and for treating insomnia and panic attacks.

Ginkgo biloba and Hypericum perforatum have neuroprotective properties and are useful in treating learning dysfunction and improving memory.

Inhaling powder of seeds of Achyranthes aspera or Prickly chaff flower relieves from stiffness and migraine.

Bark powder of Acorus calamus or Sweet flag root enhances memory by curing forgetfulness. When consumed with honey, it is beneficial for anxiety and epilepsy. Equal weights of this powder with ginger powder is recommended for facial paralysis.

Powder of Malabar nut with honey cures epilepsy.

Seed powder of Siris tree is used for treating insanity, psychosis, anxiety, and hysteria.

Coriander extract relieves vertigo and headache.

Juice of Dodder plant or Amarbel is taken in water to improve brain disorders.

Extract of branches of peepal tree cures madness.

Decoction of roots of drumstick plant is given for epilepsy and hysteria.

Velvet bean is effective in treating Parkinson s disease.

Poppy is beneficial in sleeplessness, delirium, convulsion, etc.

Decoction of leaves of guava is used to cure physical and mental deformities.

Leaves of pomegranate, when concentrated in boiling water and given in warm milk, cures fatigue and insomnia.

Leaves of pomegranate and rose petals when concentrated in boiling water and given in ghee, cure madness.

Cloves paste in water is applied on earlobes to cure migraine.

Almonds improve memory, especially when taken at an early age.

Yoga and meditation help in improving mental health by incorporating discipline and relaxation.

Take Away

For reliable cure with minimal side effects, Ayurveda is very well developed for treating many brain-related disorders with an approach of maintaining equilibrium among the three doshas and towards holistic, long-term treatment.

Neurological Disorders - How Ayurveda Can Assist?

Cerebral palsy is the term for a group of neurological disorders that affects one s muscle movement and motor skills.

In most cases, the condition is caused due to a brain impairment that develops while the baby is still in the womb. Cerebral palsy may also occur shortly after or during birth.

Symptoms of Cerebral Palsy:

The signs and symptoms of the condition vary from one individual to another, ranging from mild to severe. The commonly observed ones in children are-

  Difficulty walking
  Difficulty holding on to objects
  Delay in developing motor skills- sitting up straight, rolling over, crawling
  Variation in the muscle tone- too stiff or too floppy
  Delay in development of speech
  Spasticity
  Lack of coordination of the muscles
  Difficulty swallowing and excessive drooling
  Functioning of only one side of the body
  Neurological ailments such as intellectual disabilities, seizures, and others

Types of Cerebral Palsy:

Cerebral palsy can occur in the following forms-

  Spastic cerebral palsy - Causes exaggerated reflexes and muscle stiffness. This is the most common type of cerebral palsy, affecting nearly 80% of the population.
  Dyskinetic cerebral palsy - Causes abnormal, involuntary movement of the legs, arms, and hands. It may also affect the movement of the tongue and face, thereby making it difficult to talk or swallow.
  Hypotonic cerebral palsy - Causes overly relaxed muscles and reduces muscle tone. The legs and arms are easily moveable and appear saggy.
  Ataxic cerebral palsy - This is the least common type. People living with this form of the condition have problems with coordination and balance.

Diagnosis and treatment of cerebral palsy

Cerebral palsy can be diagnosed with the help of the following-

  CT scan
  MRI
  Ultrasound
  Electroencephalogram

Treatment of the condition depends on its severity. Long-term treatment includes physiotherapy, medications and surgery.

  Physiotherapy and occupational therapy helps restore muscle strength and improves muscle tone. You can try stretching exercises to improve flexibility.
  Usually, the doctor prescribes medications in the form of muscle relaxants and sedatives. Muscle relaxants reduce muscle tension, helps relieve discomfort and muscle pain.
  You may need to undergo an orthopaedic surgery in case medications and therapy does not yield positive results. The surgery will aim to release tight muscles and repair bone abnormalities caused due to spasticity.

The specialist as a last resort may recommend SDR or Selective Dorsal Rhizotomy to reduce spasticity and chronic pain. This involves operating the nerves at the base of your spinal column.

There is no permanent cure for cerebral palsy. However, the condition is manageable with the help of drugs, therapy and surgery. The kind of treatment required depends on your overall condition. While some may be able to live with the condition without much assistance, others may require immediate medical intervention. Therefore, it is best to consult an orthopaedic and get help if the symptoms deteriorate over time.

Cerebral Palsy - Symptoms, Types & Treatment Of It!

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!

Some diseases like Bell s Palsy have a sudden onset. One moment everything is fine and the next, half your face feels paralysed. Bell s Palsy is a viral infection that causes temporary paralysis of one side of the face. The exact cause is unknown but this virus is said to be related to the herpes virus. The sudden onset of this condition can make a person believe that they have suffered a stroke and this condition can last for several months. Many people do not completely recover from this condition. A numb sensation, lack of control over the lips and eyelids, drooping of one side of the face and an inability to smile or blink are some of the symptoms of this condition.

Homeopathy has been used to treat a number of Bell s Palsy cases successfully. However, the results vary from person to person and the extent of nerve damage done. This form of treatment does not address only the visible symptoms but addresses the physical, mental and emotional health of a person as a whole. Since homeopathy has negligible side effects, it can be prescribed to children and adults alike. Some common homeopathic remedies for Bell s Palsy are:

Aconite and Causticum: Aconite is prescribed in the initial stages of this condition especially is paralysis seems to have set in after exposure to a cold draft. Patients who can benefit from aconite often also complain of a tingling sensation on the affected side of the face. On the other hand, causticum is prescribed to treat chronic cases of facial paralysis.
Hypericum: This is the most preferred homoeopathic remedy in cases of paralysis caused due to injury to a nerve. In addition to the symptoms of Bell s Palsy, the patient may also complain of tingling or numbing sensations and burning sensations on the affected side of the face.
Ignatia: Bell s Palsy can also be triggered by grief. In such cases, Ignatia has been proven to be quite effective. It also resolves excessive saliva production and frequent biting of cheeks of the tongue while talking and swallowing.
Cadmium Sulph: Bell s Palsy that develops as a result of a sudden haemorrhagic condition can be treated with Cadmium Sulph. In such cases, the patient may have a distorted face and may face difficulties swallowing food and speaking properly. He or she may also be unable to close the eye on the affected side of the face.
Bacillinum and Causticum: The medicines are prescribed in cases of Bell s Palsy triggered by the suppression of facial eruptions.


5 Natural Homeopathic Medicines For Bell's Palsy

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