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 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!

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?

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!

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

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?

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