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

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?

Surgery to remove abnormal growths of the brain, peripheral nervous system or the spine or any disorder can be tricky because the brain and the skull that shields it are complex areas. In the old days, open surgery was the only way to access the brain or spinal cord. But, with the invention of laparoscopy, keyhole surgery to treat neurological issues is gaining ground.

What is Neuroendoscopy? 
Neuroendoscopy is a surgical procedure that is favoured by doctors and patients alike because it is minimally invasive.
Before the surgery, you will be administered general anaesthesia so that you will be unconscious during the entire duration. During the surgery, the surgeon will drill a minute hole into your skull just above the eyebrows. You skull also has two natural openings. That is why the surgeon may make use of the nose or the mouth to access the region that needs to be operated upon.

Neuroendoscopy is useful because -

  It lets the surgeon reach regions that are not accessible with open surgery
  The tumour can be removed without any damage being done to surrounding tissues

An endoscope is a delicate device with a high-resolution camera mounted on it. There is an eyepiece on the other end. The device is also fitted with a light. When it is inserted into the brain, it lights up the passage and the eyepiece allows the surgeon to take a look inside. The camera sends a live feed of the path it is traversing and this guides the surgeon. When the tumour is reached, it is gently removed with other surgical instruments that too were inserted through the cavities or the drilled hole.

Benefits of Neuroscopy -
There are several advantages of relying on laparoscopy -

  The patient endures less pain
  Fewer chances of infection
  Faster recovery
  Very little scarring of tissues

Which Disorders call for Neuroendoscopy?
Any of the following disorders can be put to rights with a neuroendoscopic surgery -

  Pituitary tumours
  Rathke s cleft cysts
  Pineal area tumours
  Ventricular tumours
  Skull base tumours
  Brain inflammation triggered by an infection
  Chordomas
  Cerebrospinal fluid fistulas
  Trigeminal neuralgia
  Cerebral aneurysm

After Surgery-
Once you undergo the neuroendoscopic surgery, you will have to be rehabilitated so that your condition can be monitored round the clock. Neuroendoscopy is a state of the art clean and efficient surgery that is beneficial to both surgeons as well as the patients.

Know More About Neuroendoscopy And Its Uses!

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?

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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