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 a benign tumor that occurs in the primary nerve between the brain and the ear. The tumor progresses very slowly and can influence your balance and hearing. In certain cases, if the tumor becomes very large, then it may also impair vital functions of the body.
Symptoms-
The symptoms of acoustic neuroma tend to develop when the tumor starts to press on the nerve and its adjoining branches. The symptoms of this disorder are  
You may experience hearing loss on one side which might worsen gradually.
You may have problems in balancing yourself.
A continuous ringing sound in the ears.
Persistent dizziness.
If the tumor is large and presses on the nearby nerves, then you may experience numbness of the facial muscles.
In some cases, it may impair the vital functions of the body.
This disorder is caused by a malfunctioning gene. There is no documented reason as to why the gene malfunctions.
The treatment options for this disorder are  
Constant Monitoring: These tumors tend to grow very slowly but might spurt in some cases. In order to prevent damage to your body, they need to be monitored on a regular basis. Imaging tests are recommended on a periodic basis to determine the growth of the tumor.
Radiosurgery: Stereotactic radiosurgery is done to treat acoustic neuroma that is small in size. In this surgery, radiation is directed at the tumor without creating any incision. It is done to limit the growth of the tumor and preserve your hearing.
Surgery: The tumor can be removed by using surgical procedures. It involves administering general anesthesia, followed by removing the tumor through an incision on the skull or the inner ear. Surgery is used to remove the tumor and preserve your hearing abilities. 

Acoustic Neuroma - Everything You Need to Know

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!

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!

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!

Polio is a virus that has the potential to infect any parts of the body including, but not limited to nerves and muscles. Primarily there are 3 types of polio namely, non-paralytic, spinal paralytic and bulbar. This disease shows minimal to no symptoms in more than 90 percent of the cases. 5 percent of the cases can show symptoms such as nausea, diarrhea, vomiting, sore throat and abdominal pain. Polio is a communicable disease and can cause massive damage if a proper dosage is not taken. It can spread through air, physical contact with an infected person, coughs etc.

Polio can cause paralysis: Polio has a far-reaching permanent effect on the body. It can cause paralysis on any of the limbs leading to permanent disability. This severely alters a child s life. The far-reaching consequences of the virus can only be negated through vaccination.
Weak muscle: Polio can result in weak muscles, respiratory problems and loss of reflex. If the breathing muscle collapses, it can result in the death of a person. Any of the above-mentioned symptoms can lead to weak body development altering the fate of a child.
It can spread fast and quick: Polio spreads very fast through the air, physical contact, saliva and water. It not only affects a single life but put millions at risk of the disease. A 1916 outbreak of the disease killed 6000 people in the United States and left several thousands of people disabled.
It reduces the risk of infection: 3 dosages Polio vaccination under the age of 6 can save a baby from getting polio in future. The body successfully creates polio antibodies from the vaccines and gets enough ammunition to fight it if the virus attacks it in future.
Social responsibility: Massive amount of awareness campaigns have been run by countries all over the world to permanently eradicate polio from the face of the earth. As per the latest reports, only 3 countries are reported to have babies affected with polio; Afghanistan, Pakistan and Congo. It is, therefore, a social responsibility to take part in the mission of removing polio from the face of the earth once and for all.
Save future generation: Although polio is not known to be a disease which passes through heredity, there still lies a chance for the future generation to get this disease. In order to negate that from happening, it makes sense to get the vaccines on time.
Give your kid a head start: Every kid deserves to have an equal amount of privileges like others. One small mistake on part of the parents can heavily cost a child s future. In order to make sure your kids grow up with any apprehension of polio, it is very important to treat them with polio vaccines.

Polio Vaccination - Why Is It so Important?

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