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?

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!

Whether it's a child or a grown-up, difficulty in concentrating is often experienced by many people. While, people tend to brush off this particular problem to be nothing worth being concerned about, but sometimes, there may be a more serious underlying issue for which concentration problem is only a mere symptom. Yes, difficulty in concentrating can be a sign of a neurological disorder. Keep on reading to know more about neurological disorder, its symptoms, and treatment.

Reasons behind difficulty in concentrating
Inability to focus properly is a periodic and normal occurrence for many. While sometimes it is the emotional stress or physical tiredness that is responsible for it, at times it is the outcome of hormonal changes in the body, such as during pregnancy or menopause that causes it. However, when experienced in severe degrees, it may be a characteristic of a serious psychological condition called neurological disorder. Affecting both adults and the children, the neurological disorder can be a serious threat if not treated at the right time.

Neurological disorder
Neurological disorder refers to any condition that happens due to the dysfunction of the nervous system or the parts of the brain. Depending on the location of the damage to the nerve or in the spinal column or the brain, different areas controlling the vision, movement, thinking or hearing can be severely affected. The decreased ability to focus on something or loss of concentration power being one of the many symptoms of neurological disorders among the various complications it causes.

Causes behind neurological disorder
Many reasons lead to neurological disorder or its associated symptoms like difficulty in focusing. From lifestyle-related issues to nutrition related causes, physical injuries to some infections, complications during childbirth, and genetics to environmental influences, numerous factors can be responsible for such disorder. Depending on the type of neurological disorder, the symptoms can vary from to another, while for some difficulty concentrating can be a symptom, for some, the symptoms can be more of physical difficulties such as problems in walking or difficulty speaking or seeing, etc.

Dealing with difficulty concentrating
Once the cause of the neurological disorder is determined, there are various treatment options, offered by the doctors. To deal with the neurological disorder as the cause of difficulty concentrating one may need medications and treatment provided by the medical professionals. However, there are a few tips that one can keep in mind, such as minimizing multitasking and focusing on one single thing or thought at one time or dividing tasks into small steps, etc.

Difficulty in concentrating means the ability to focus on thoughts or action decreasing. In case one experience this issue on a long term basis or excessively, visiting the neurologist as soon as possible should be the best thing to do.

Problem In Concentrating Could Be A Sign Of Neurological Disorder!

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?

Leading a life with peripheral neuropathy is quite similar to riding a roller coaster. Managing the pain can be frustrating at one time and overwhelming on the other as patients can experience alternating symptoms with debilitating pain. So you should learn about the various treatment options as they can help you go a long way in managing the pain.

The peripheral nerves are considered the longest in the body which extend from the hands to feet. When these nerves are damaged, you may feel some sort of pain, tingling in the hands and feet and even numbness, and these symptoms can even get worse and you may experience stabbing pain with increasing weakness. 

There are many things that you should know about peripheral neuropathy as they would help you to manage the condition much more effectively.

Diabetes is the leading cause of neuropathy: More than 70% of diabetics develop symptoms of peripheral neuropathy. So you should keep your blood sugar within optimum levels as a means of reversing diabetic neuropathy.
A melange of causes behind neuropathy: Though diabetes is the number 1 cause of peripheral neuropathy, other causes include deficiency of vitamin B12, alcoholism, traumatic injury, chemotherapy and exposure to toxic substances. Physicians may find it difficult to pin-point the cause and when this happens. This is often termed as  idiopathic neuropathy .
Medications causing neuropathy: If you are suffering from diabetes and being treated with the drug named metformin, you may develop peripheral neuropathy.
Preventing neuropathy is the most recommended way: While it is the fact that some nerves may potentially get damaged from certain surgeries or injury, peripheral neuropathy can be potentially prevented or sometimes stopped from spreading. As diabetes is a major cause of diabetes, being watchful about your diet and exercising regularly can help you go a long way to prevent diabetes as well as neuropathy.
Pain is not simply confined to a tingling sensation: Though pain and a tingling sensation is the commonest and easiest way of recognising the symptoms of peripheral neuropathy, each of your sensory, motor and autonomic nerves can show different set of symptoms that you should be watchful of.
A diet may make the symptoms even worse: You can either help or hurt your nerves with your choice of foods. For improving symptoms, you should avoid food with excessive sugar, refined grains and artificial sweeteners as they may strain your nerves and irritate them further.
Whether you are recently diagnosed with peripheral neuropathy or living with it for many years, understanding a few conditions would help you make informed decisions about your well-being.

Peripheral Neuropathy - 6 Things You Should Know!

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