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!

Brain tumor refers to the development of unusual cells in the brain or around the nearby tissues and structures. Pediatric Brain Tumor means the development of these unusual cells in the brain of children. There are two types of brain tumors: Benign or non-cancerous and malignant or Cancerous. Tumors like ependymoma and medulloblastoma are quite common among children. The treatment of the tumor is determined by its severity, type, location, age, and overall health of the child. The treatment of Brain Tumor in children is different from the adult s treatment. One should ensure to consult with the pediatrician with the specialty in cancer and neurology. Brain Tumors in children are Primary Brain Tumors that develop in the brain or nearby tissues. This Primary Brain Tumor develops when the usual cells have DNA mutations or alterations. The alterations in the DNA permit the cells to develop and distribute or split with an increased rate and destroy the healthy cells. This leads to the development and collection of unusual cells forming a tumor. In most Primary Brain Tumor cases, the cause is not clear. Children with a family history of the genetic syndrome and Brain Tumor are more prone to the problem.

Symptoms-

The symptoms of the Pediatric Brain Tumor depend upon the severity, location, and type. There are a number of symptoms that are really common and are shared by other diseases. Other than this, there are symptoms which are possibly the signs of Brain Tumor among children. Adults and parents should consult a doctor if they find their children having the symptoms and signs for an unusual time.

Hearing issues

Frequent and severe headache

Fuller fontanel (soft spot) on the baby s skull

Vomiting or nausea

Behavior changes

Seizures

Sudden vision problems like double vision

Abnormal or strange eye movement

Increased heaviness or pressure in the head

Irritability

Slurred speech

Difficulty in swallowing

Weakness

Loss of appetite

Drooping on one side of the face

Difficulty feeding in babies

Loss of sensation on one side of the body

Imbalance or difficulty in balancing

Difficulty in walking

Diagnosis-

The diagnosis for the Pediatric Brain Tumor includes many lab tests. The doctor may initiate with some neurological examination like hearing, vision, reflexes, balance, and coordination. Any abnormality in these tests will lead to further examinations. There are some imaging tests that are used to determine the size and location of the tumor in the brain. These tests include MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), and CT (Computerized Tomography). After the confirmation of the presence of a Brain Tumor, the specialist will further move to the Biopsy. It includes the removal of a sample tissue for analysis or testing. The type of biopsy that will be performed on the patient depends upon the location of the tumor. Other than the biopsy, the tumor tissue can be examined for molecular basis and genetic mutations. After that, Drug therapy can be designed according to the individual s requirements. It is important for the doctor and the patient to know if the tumor has been spread through cancer in other parts of the body. If it is true, then the doctor will perform more tests and examinations to know the root and initial location of cancer for further treatment.

Treatment-

The treatment of the Pediatric Brain Tumor is determined by the severity, location, size of the tumor, and age and health of the child. There is a number of treatments available with modern technology but their usage depends upon the patient s requirement.

Surgery that is used when the location of the tumor is approachable via surgery. When the brain tumor is small, it can be completely removed by the surgery. But when the tumor tissues are located nearby sensitive areas of the brain, then the surgery becomes risky and maximum tumor tissues are tried to be removed through surgery. The risk of the surgery depends upon the location of the tumor. An example can be vision loss if it is anywhere near the nerves connected to the eyes.

Targeted Drug Therapy helps to destroy the abnormalities of the cancer cells resulting in the destruction of the cancer cells.

Radiation therapy is used to kill the tumor cells by using high-energy beams. Radiation therapy can either be given by an external machine (external beam radiation) or in exceptional cases, radiation is positioned within the body (brachytherapy) near the tumor.

Chemotherapy includes the consumption of drugs to destroy the tumor cells. These drugs can be consumed in tablet form but for children, the drugs are mostly injected (intravenous chemotherapy).

Stereotactic Radio Surgery includes various radiation beams to perform extremely focused radiation therapy to destroy the tumor cells located in a small part.

Proton Beam Therapy carries higher targeted radiation doses to the tumor cells with minimum exposure of radiation to the healthy cells and tissues. It decreases the chance of development of fresh cancer cells.

Take Away-

Pediatric Brain Tumor is the development of unusual cells in the brain or around it. Although this is a life-threatening problem, however, with advanced technology, it can be treated successfully. There are no specific causes discovered by specialists but genetic mutations and family history cause it. The symptoms can be really common like headache and nausea but can also be specific like difficulty in coordination, reflexes, speech, and many more. The timely diagnosis and treatment can give a new life to the child and reduces the chance of development of fresh tumor cells in the future.

Pediatric Brain Tumor - Know In Detail About It!

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?

Your mother has often yelled at you for playing video games for long hours, but obviously you haven t paid heed to it. Such is the obsession with video games that they don t let you rest unless you have championed all the levels in the virtual interface. Here is the source of all problems. Studies have revealed that video games have a direct relation to neuropsychiatric problems. As a result, many health experts across the world consider video game as a kind of health abuse.

People who play action-oriented video games are at higher risks. The more you indulge in these kinds of games, the more they are going to affect the hippocampus section of your brain. It is that part of the brain which is considered to be the centre of your nervous system, memory and emotion. Reduced hippocampus volume may make person vulnerable to multiple neuropsychiatric complications. Let us see some of the signs, which may indicate the onset of certain complications arising from an over indulgence in these games.

1. You spend hours on the computer or related gaming devices and devote lesser hours for your family and friends

2. You get agitated when someone stops you midway through the game

3. You become socially isolated and show signs of occasional mood swings

4. You are unable to keep a track of time once you start playing

5. You repeatedly neglect your studies, resulting in a dip in performance at school

Why does this happen?

All of the above signs indicate that sooner or later you might develop neurological problems. When you spend an excessive number of hours on playing and navigating through the games, the  hippocampus  portion of your brain shows signs of decreased gray matter. As a result, the volume of the hippocampus shrinks, causing severe nerve related disorders such as schizophrenia, Alzheimer s disease, dementia, depression, and overall general stress.

One of the biggest reasons behind this is a lack of self-control. Most of the video games will encourage you to steal cars, run away after a theft and kill your enemies. Moreover, if you succeed, you are rewarded. This naturally unleashes a blatant urge for the gratification of all these awkward desires in your real life too. Hence, once you are encountered with the reality, you tend to show violent behavior.

Can Playing Video Games Cause Neurological Problems?

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?

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?

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