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!

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!

Neurodevelopmental disorders refer to any impairment and disorder of the brain and nervous system growth and development. Disorder in the brain and nervous system can affect the emotional, physiological, psychological ability and overall timely development of a child. With advanced technology and continuous study in the medical field, one can now assess the neurodevelopment of his/her children. Neurodevelopmental Assessment concentrates on the overall growth and development of a child including his/her weaknesses and strengths. A complete developmental profile is generated with the help of various tests and examinations. This assessment is used to analyse the various developmental factors including social and communication skills, functional and motor skills, cognition and learning abilities, and language and speech development. Neurodevelopmental Assessment involves a team of child s close people including parents, guardians, and family members who help to understand the medical history if any. It helps doctors to provide appropriate ways to assist the child in his/ her growth and development.

Tests and Examinations

Tests for the Neurodevelopmental Assessment may vary from child to child depending upon their condition. But, there are usually some tests that are done to understand the overall development of the child. These tests may include speech tests, hearing tests, blood tests, physical examinations, and questionnaires, which may be given before or during the assessment process.

Assessment

The assessment processes and sessions may vary depending upon the need of the child. However, usually, there are three major sessions that help the pediatrician understand the concerns of the family and parents. These sessions include consulting about the detailed medical history of the child, understanding the problem and its possible cause, and providing proper ways and treatment options for the patient. 

In the first session, parents and guardians are asked about any medical concern they have and the medical examination of the child is carried out accordingly. A standardized assessment with the child will be carried out by a clinical psychologist and the parents and guardians are asked to complete a questionnaire for the assessment. Depending upon the age, questionnaire may be sent to school for teacher/s to complete.

The next session is usually led by language and speech therapist to discuss and understand the current language and speech concerns of the child. Previous assessments and medical examinations are taken into account to carry out further assessments. An occupational therapist will assess the child s ability to perform self-care activities and other tasks according to his/her age. The session may include the assessment of a child s motor skills and abilities and reflection on any probable sensory-based problems that may be affecting the child s occupational performance.

The last session mainly includes the discussion with the parents and guardians to help them understand the problem, its causes, and treatment options. If the child requires any further assessment or/and recommendations, then the parents are told about that too.

Takeaway
Neurodevelopmental Assessment of children is often performed on kids who do not show the developmental signs according to their age. Parents and guardians should not hesitate to consult their children to clinical psychologist and therapist as the early intervention and assessment can help in the timely growth and development of the children.

Neurodevelopmental Assessment (0-5 Years)  - What Should You Know?

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

The relationship between intelligence and brain size, both among people and between various species, has never been precisely well defined. People often believe that their outstanding psychological capacities must mean that they are superior to all animals as far as brain size is concerned. However, it is not true since whales and elephants have much bigger brains than humans and humans have the same brain-to-body mass proportion as mice do.

Here are a number of ways by which the brain size can be determined:

Encephalization remainder: Since it would be against human instinct to admit loss and defeat, researchers have created a measure to determine the brain size called the encephalization remainder. It is the proportion of actual brain mass with respect to the anticipated cerebrum mass for the animal s size (based on the suspicion that bigger animals require somewhat less brain matter with respect to their size, compared to little animals). By this metric, human beings prove to be the best, with an EQ of 7.5 outperforming the dolphin's 5.3 and the mouse's 0.5.
IQ testing: Without a solitary and evident method for measuring intelligence, some improved tests like IQ (Intelligence Quotient) are by and large acknowledged as a moderately decent working device. IQ estimations are not without issues, and there is a great deal of criticism about their significance. IQ testing uses government sanctioned tests, for example, the WAIS III (Wechsler Adult Intelligence Scale). The normal IQ is somewhere around 90 and 110. The scores beneath the normal may demonstrate changing degrees of pathology, for example, marginal intellectual function, or mental hindrance of different severity. Over the normal range is regularly connected with knowledge, splendour, talent, or genius. However, as with computers of a few eras, size and intellect do not precisely relate. Present day portable computers weighing around one or two kilogrammes can store more data and perform a greater number of assignments than supercomputers from the 1980s that used to possess expansive structures. This is a contrast amongst quantity and quality. Numerous scientists now hold the view that it is not the whole brain, which is bigger in a human with a higher IQ, yet rather certain zones that are denser and might be bigger. A fascinating late revelation is that these ranges can be expanded in size and enhanced in usefulness during the course of our life.
NeuroplasticityIt refers to the dynamic procedure of repair and maintenance that our brains are continually experiencing. We are conceived with around hundred billion neurones, yet lose around two hundred thousand a day to a procedure called pruning. As we develop and grow, pathways in the brain that are not required are detached, and the neurones pass on. However, in a compensatory procedure, new neurones are delivered and more detailed associations are built up between neurones that are more dynamic. This is the procedure of de-cluttering, in which our brains develop to work at most extreme effectiveness. If you wish to discuss about any specific problem, you can consult a Neurologist.

Brain Size - How It Is Related With Intelligence?

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!

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