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!

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 a neurologic condition that occurs in children, and is due to brain injury that develops before, during, or after childbirth. The condition presents with motor impairment, and therefore there is generalized physical and mental dysfunction. The brain continues to develop for the first two years of life, and so conditions like premature birth, asphyxia at birth, and postnatal meningitis and encephalitis.

The diagnosis could be trigged by the slow motor development, poor muscle tone, and delayed response of the baby. One of the main noticeable feature that becomes evident is the spasticity of the limbs. The child may not be able to voice it out, but pain is a significant disabling factor too. While doctors would advise that physical movement is required to keep the spasticity at bay, the pain keeps the child away from most activities. This further adds to the spasticity and worsening of the condition.

Pain control therefore assumes a significant role and the modes can range from physical therapy to pain killers to injections to surgery. The idea, in addition to pain control, is also to:

Improve range of motion
Improve motor response
Promote good motor development
Reduce and control contractures
Improve overall lifestyle
Improve muscle strength
Improve exercise tolerance
Reduce spasticity
Some of the non-medical ways to control pain are listed below. 

Of course, pain killers and injections are always used when immediate relief is required. A structured physical therapy program that includes medications and exercise is the best way to manage cerebral palsy pain. Though initially difficult, over a period of time, it improves range of motion and improves joint movement.

Acupuncture: Triggering specific points via needles is believed to stimulate the nerve endings and help in pain control
Alternating ice and heat therapy: This is also believed to improve pain control, blood circulation, and muscle movement.
Positioning in bed: A well-positioned child in bed may have less pain compared to another child who is not. Special equipment may be used also to keep the child in place, once the most comfortable situation is located.
Muscle massage: The affected muscles need to be massaged repeatedly so that blood flow improves, joint movement is better, and pain is controlled.
Botox is successfully used to pain control, as it paralyzes the specific muscles along with providing pain control.
Medications are used regularly, which are mainly anticholinergic and anti-spastic medications. They reduce stiffness, control pain, and help in pain control too.
Surgery is the last option and needs to be explored with the doctor.

Pain Management Of Spasticity With Cerebral Palsy!

Aging comes with many health problems including mild hearing loss. Usually, this mild hearing loss does not come alone. According to medical studies, adults, particularly males with hearing loss, mild or severe, are at a higher risk of developing Dementia and Alzheimer s disease. The risk increases as the hearing loss worsen. People with mild hearing loss are at twice the risk of developing dementia compared to people with normal hearing.

Dementia is a group of symptoms and diseases that affects the thinking, memory and social abilities that interfere with the daily functioning of an individual. However, memory loss alone does not mean that one has Dementia. Out of the many causes, Alzheimer s disease is usually the cause of Dementia. Alzheimer s disease is a progressive disease that affects the brain cells to degenerate and dies, destroying memory and other mental functions. 

How Hearing Loss Causes Alzheimer s?

According to medical studies, hearing loss causes several brain changes which increase the risk of developing Dementia. Hearing loss can lead to brain shrinkage, the process in which the section of the brain responsible for hearing becomes inactive. This condition leads to loss of tissues and alterations in the brain structure, developing as the first connection between hearing loss and Alzheimer s. Studies show that the brain of people shrinks more quickly who have hearing loss as compared to the brain of an individual with normal hearing. 

The second link created with an overwhelmed or overloaded brain. In hearing loss, the brain works overtime in understanding what others are saying. When the brain strains too much only for hearing every time and every day, it exhausts an individual s mental energy and snatches the brainpower required for other important mental functions, such as thinking, remembering and acting. This can further lead to Dementia, Alzheimer s and other mental disorders. 

Hearing Aids to prevent Dementia and Alzheimer s

According to various studies, hearing aids are not only helpful in improving one s hearing but they can also preserve an individual s mental and emotional health. Early diagnosis and treatment of a possible hearing loss help reduce risks later in life.

At times, the symptoms of undiagnosed hearing loss are mistaken with the symptoms of Alzheimer s. Hearing impairment makes it challenging for an individual to listen and respond to verbal signs. It increases the feeling of confusion, paranoia, and isolation. 

Hearing aids can relieve the symptoms of Alzheimer s. According to a study hearing aids slow down the rate of memory loss and improve an individual s quality of life.

Takeaway

Adults, especially males with hearing loss have a greater tendency of developing Dementia and Alzheimer s. Hearing loss causes brain to overwork leading to the loss of important mental functions. Hearing impairment can worsen the symptoms of Dementia and Alzheimer s. 

Hearing aids do help in improving the condition and symptoms of Alzheimer s and improve one s quality of life. A timely diagnosis can make a big difference.

Dementia And Alzheimer's Disease In Elderly - Could Hearing Loss A Reason?

Epilepsy is a neurological condition that leads to recurrent seizures. Seizures arise when electrical activity in the brain suddenly surges causing a temporary disturbance within the messaging systems located between the brain cells.

Epilepsy is more common in children below the age of two years and adults above the age of 65 years.

Seizure Types

Seizures are classified into two main categories depending on their area of impact. 

A focal seizure is one that affects only one part or area of the brain whereas a generalised seizure affects the whole brain. Further, both focal and generalised seizures have various sub-categories which are as follows-

Previous nomenclature- 

Partial Seizure

  Simple Partial Seizure
  Complex Partial Seizure
  Partial Seizure with Secondary Generalization

Generalized Seizure

  Absence Seizures
  Myoclonic Seizure
  Atonic Seizure
  Tonic Seizure
  Tonic-clonic Seizure
  Mixed Seizure
  Status Epilepticus

Latest nomenclature of seizure types:

Focal seizures-

  Focal aware seizures
  Focal impaired awareness seizures (previously called complex partial seizures)
. Bilateral tonic clonic seizures

Generalised onset seizures-

  Tonic clonic seizures.
  Atonic seizures (sometimes called drop attacks) and tonic seizure.
  Myoclonic seizures.
  Absence seizures.

Symptoms

The well know symptom of epilepsy is a convulsion/ fit, a few other symptoms include-

  Intermittent spells of fainting. When this happens the patient is likely to lose control of his/her bladder or bowel movements. Following this, the person is likely to suffer from extreme tiredness.
  Spells of a blackout with difficulty in remembering
  Becoming unresponsive to any instructions or questions asked during brief periods of time
  Bouts of continuous blinking without any known reason
  Inappropriate movements that keep on occurring
  Changes in sensory perceptions
  Sudden stiffness in the body

Reasons for Epilepsy

Messaging systems within the brain are responsible for every function that goes about in your body. A disruption to this system caused by defective electrical activity leads to epilepsy in a person. Many people inherit epilepsy while others may develop this condition as a result of-

  Head trauma sustained during an accident
  A stroke or a tumour that has affected the brain impairing its normal capabilities
  An injury to the brain before or during birth
  Associated with developmental issues
  Infections of the brain

Treatment for Epilepsy

Epilepsy in childhood can be treated by using medications and by adopting dietary changes in some cases. Medications for epilepsy mainly include-

  Anticonvulsants - Helps control seizures and manages the symptoms of epilepsy
  Medications for nerve pain - Reduce pain that is caused by the damaged nerves

These medications should be consumed as and when prescribed by the doctor. You must consult a paediatrician for this, as he/she will take your child s physical and mental in consideration before starting the treatment.

Seizures that occur in childhood may be benign. This means that it will not continue into one s adult life. Further, those children who have suffered from epilepsy in their childhood have been seen to have normal mental and intellectual development in their adulthood. However, some epilepsy syndromes in children can have a devastating effect on the child.

Seizure threshold is a term that is used to refer to the conditions that are important for the production of seizures. The threshold is lower for people who are more prone to having seizures whereas the threshold is higher for those who do not have a tendency to suffer from seizures.

A Complete Guide To Childhood Epilepsy!

Migraine is a very common form of a headache which strikes nearly 15 % of the population. Females are more prone to migraines. Science has not been able to find the real cause behind migraine attacks and the way it treats these massive headaches is also patchy at best. A migraine occurs for a definite period of time, usually, comes with a warning and paralysing pain.

Ayurvedic view
According to Ayurveda, migraine is a tri-dosha disorder. It occurs when vata or the wind element goes out of sync. Vata controls the nervous system and brain activity. Vata imbalances are linked to many diseases like joint problems, dizziness and it happens because of faulty metabolism, poor elimination, sleeplessness, etc. Pitta the fire element also has a role to play in migraines. It causes dilation of the blood vessels, which brings on a migraine attack.

Ayurvedic physicians can identify which dosha is causing a migraine. If the patient is constipated, has acute pain and has dry skin, his Vata is out of whack. If a patient has nosebleeds, is hypersensitive to light, has burning eyes and is irritable, pitta is out of balance. And if a patient has fatigue, is depressed and has a dull throbbing in the head, he is suffering a Kapha imbalance.

Ayurvedic therapies

Shirolepa: Application of herbal pastes to pacify pitta like sandalwood, camphor, Jatamansi.
Shiro Dhara: Medicated oils are poured on the scalp.
Taila dhara: Oils like ksheerabala taila, chandanadi taila are poured on scalp for calming higher vata imbalances. 
Ksheera dhara: Here cow milk is poured on the scalp to pacify pitta.
Takra dhara:  Also known as buttermilk is poured when there is obstruction to passage of vata.
Kavala graha: Oil pulling done with oils like chandanadi taila and mahanarayana taila.
Shirovasti: Medicated oils are retained on the scalp by wearing a leather cap.
Sneha nasya: Oils like Anu tailam are poured into nostrils.
Apart from there therapies herbs like Kumari or Aloe vera, Amalaki or amala and Bala or Sida cardifolia are very useful as migraine cures. Several Ayurvedic medicines are also very useful in migraine-like-

Pathyadi khada: It is used in the treatment of headaches, earaches, and migraine etc.
Shirashooladi vajra rasa: It is used in the treatment of headache, migraine, tension headache, vascular headache etc.
Bhoonimbadi khada: Used as a cure for fever, cold, sinusitis, headache.
Kamadugha rasa: Used to cure all high pitta conditions.
Godanti Bhasma: 250 mg of this medicine is also given twice a day for immediate relief from migraines.
Patients should also eat warm, nutritive foods like sesame, sweet fruits, cumin, garlic, jaggery and rice for balancing Vata. For balancing pitta, they should stay away from smoking and drinking at the very least.

Migraine - 8 Ayurvedic Remedies For Treating It!

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