Dr Anurag Saxena

A stroke may be called a brain attack. It may happen to any person at any time. A stroke occurs when blood supply to the brain is cut off. The brain cells become oxygen deprived due to the stroke and eventually die. Dead brain cells result in brain dysfunction due to which patients lose control over muscle and memory.

Strokes can be mild to life threatening and requires immediate medical attention. Stroke requires advanced care and should be treated by extensively qualified and experienced medical experts. 

Neurosurgery satisfies all the required clauses for treatment of stroke and accounts for being one of the best ways for management of stroke. Renowned hospitals have a dedicated neurosurgical wing and a team of neurological specialists who know how to deal with stroke the best.

Vascular Neurology
This form of neurology focuses on patients who have undergone a stroke or have experienced symptoms of stroke. A multidisciplinary approach is taken for the prevention of recurrent cerebrovascular conditions.

Types of stroke

1. Ischemic stroke: This kind of stroke occurs when there is a blockage in a blood vessel, which supplies blood to the brain. This form of stroke is the more common. The underlying cause of this stroke is known as atherosclerosis, which is a condition where fatty deposits occur in the walls of the blood vessels and cause blockage in them.
2. Hemorrhagic stroke: This type of stroke occurs when a blood vessel gets weak and ruptures into the brain. This is caused by two types of weak blood vessels known as aneurysm and arteriovenous malformation.
3. Transient ischemic attack: This type of stroke is also known as a mini stroke. These attacks occur because of blood clots. The blockage caused is temporary or transient in nature.

Treatment of Ischemic stroke

1. Tissue Plasminogen Activator: This is one of the best ways to treat ischemic strokes. This medicine is given to the patient intravenously. It dissolves the blood clot and improves blood flow to the area of the brain which is affected. The medicine should be given within three to four hours after stroke symptoms appear.
2. Endovascular procedure: This is a process by which the blood clot is removed using a catheter, which gets inserted into the area of the blocked blood vessel. It helps in restoring blood flow to that area. 

Treatment of Hemorrhagic stroke

1. Endovascular procedure: Several endovascular techniques and methods are used so that the weakening of blood vessels is reduced and less bleeding is caused.
2. Surgical treatment: Different modes of neurosurgery may be undertaken to stop bleeding and for relieving pressure within the skull.

The medical term ‘spina bifida’ or spinal bifida refers to a congenital defect in the spine. In simpler terms, spina bifida is a defect in the neural tube. Based on the severity of this disease, spina bifida can be divided into three different types:

• Myelomeningocele
• Meningocele
• Occulta

The symptoms of spina bifida vary depending on each of these three types. Let's take a closer look at its symptoms here:

Myelomeningocele

Myelomeningocele is the most severe form of spina bifida. In this type of neural defect, spinal canal of the baby remains open in the middle or lower back along a few vertebrae. Due to this opening, a sac is formed at the back of the baby at birth, which exposes the baby to several life-threatening infections.

Some of the common symptoms of this type of spina bifida are:

1. Presence of uneven hips
2. Deformed feet
3. Curved spine or scoliosis
4. Bladder and bowel problems
5. Muscle weakness
6. Paralyzed leg muscles.

Physical deformities from moderate to severe levels are also very common in this type of spina bifida.

Meningocele

Meningocele is a ratherrare form of spinal bifida in which a sack of fluid stays in open at the back of the baby. Here the protective membranes that usually stay around the spinal cord push out through the vertebrae’s opening. Though this sack contains no part of the spinal cord, it may cause minor disabilities.

Some common symptoms of this kind of spina bifida are:

1. Membranes forming a visible sack on the back at birth
2. Presence of a small opening in the baby's back

The good news is that this sack can be removed through surgery without hampering the normal development of the spinal cord.

Occulta
Spina bifida occulta is the mildest form of spina bifida, which, in majority of the cases, often stays hidden as its symptoms are rarely visible. As it doesn’t even cause any form of disabilities, it generally goes unnoticed. It doesn’t cause any damages to the nerves or the spinal cord.

Some common symptoms of occulta are:

1. Presence of a gap between the vertebrae
2. An area on the back formed with extra fat
3. Acluster or small group of hair on the back
4. A dimple or birthmark on the back.

In this kind of spina bifida, neither any sack of fluid is formed, nor are there any visible opening in the back. Sometimes, people who have spina bifida are not aware of it due to its minimal symptoms.
Spina bifida usually affects a child before birth, when the brain or the cord or the protective covering over them fails to develop completely. Knowing about the symptoms can be one of the best ways to identify and diagnose this disease and opt for proper treatment solutions.

A Brain Tumour can be defined as an abnormal growth of the tissues in the brain, which can disrupt the proper brain functions. Generally, the cells in the human body die and are replaced by new cells, while in the case of a tumour, the old cells do not die and form an accumulation and continues to grow to form a mass as more and more cells are added to it.

Symptoms of Brain Tumour:

1. Headache: Having headache on regular basis, without any history of having such frequent headaches in past, which becomes worse because of other pressure related activities, such as sneezing, coughing, exercising might be a possible symptom of brain tumour and issues related to such sudden and frequent headaches should be taken up with the doctor without any further delay.
2. Seizures: Seizures (fits) are amongst the most common symptoms of brain tumour, which might be limited to a particular body part or the whole body. Seizures might even continue after the treatment of brain tumour because of the left scar tissues in the brain.
3. Numbness in arms/legs: Numbness in any body part, especially arms and legs should also be get evaluated timely, so that, if the possible reason behind them is a brain tumour, then the same could be treated well on time.
4. Balancing problems: Poor coordination and balancing problems also arise as the most prominent symptom for the brain tumour and hence such small changes must be evaluated and the person suffering should be taken to a doctor immediately to get treated without any delay.
5. Memory problems: Lack of concentration, poor memory and short term memory loss are few of the possible symptoms that indicate the presence of tumour.
6. Nausea or vomiting: Nausea or vomiting might be the symptoms of many other possible health issues, but a headache supported by nausea and/or vomiting is one of the many symptoms of a brain tumour and hence should not be ignored.
7. Facial paralysis: The inability to keep the facial activities under control also indicates the presence of a possible brain tumour and the same should also be diagnosed as soon as one experiences it.
8. Change in vision: A person suffering from brain tumour might also experience changes in the vision, dizziness, blurry vision, among other sight related issues.
9. Change in speech: The inability to speak properly and changes in the speech of a person may also indicate a possible presence of a tumour.
10. Hearing problems: Sudden occurrence of hearing problems and other hearing related disorders might have the brain tumour as a possible reason.

Diagnosing a brain tumour may include one or more of many tests, including CT scan, Magnetic Resonance Imaging (MRI), Angiogram and biopsy. One should never ignore the symptoms of the brain tumour and should get himself/herself checked since the brain tumours might result into permanent damages to the brain; hence such issues should never be ignored.

A stroke may be called a brain attack. It may happen to any person at any time. A stroke occurs when blood supply to the brain is cut off. The brain cells become oxygen deprived due to the stroke and eventually die. Dead brain cells result in brain dysfunction due to which patients lose control over muscle and memory.

Strokes can be mild to life threatening and requires immediate medical attention. Stroke requires advanced care and should be treated by extensively qualified and experienced medical experts. 

Neurosurgery satisfies all the required clauses for treatment of stroke and accounts for being one of the best ways for management of stroke. Renowned hospitals have a dedicated neurosurgical wing and a team of neurological specialists who know how to deal with stroke the best.

Vascular Neurology
This form of neurology focuses on patients who have undergone a stroke or have experienced symptoms of stroke. A multidisciplinary approach is taken for the prevention of recurrent cerebrovascular conditions.

Types of stroke

1. Ischemic stroke: This kind of stroke occurs when there is a blockage in a blood vessel, which supplies blood to the brain. This form of stroke is the more common. The underlying cause of this stroke is known as atherosclerosis, which is a condition where fatty deposits occur in the walls of the blood vessels and cause blockage in them.
2. Hemorrhagic stroke: This type of stroke occurs when a blood vessel gets weak and ruptures into the brain. This is caused by two types of weak blood vessels known as aneurysm and arteriovenous malformation.
3. Transient ischemic attack: This type of stroke is also known as a mini stroke. These attacks occur because of blood clots. The blockage caused is temporary or transient in nature.

Treatment of Ischemic stroke

1. Tissue Plasminogen Activator: This is one of the best ways to treat ischemic strokes. This medicine is given to the patient intravenously. It dissolves the blood clot and improves blood flow to the area of the brain which is affected. The medicine should be given within three to four hours after stroke symptoms appear.
2. Endovascular procedure: This is a process by which the blood clot is removed using a catheter, which gets inserted into the area of the blocked blood vessel. It helps in restoring blood flow to that area. 

Treatment of Hemorrhagic stroke

1. Endovascular procedure: Several endovascular techniques and methods are used so that the weakening of blood vessels is reduced and less bleeding is caused.
2. Surgical treatment: Different modes of neurosurgery may be undertaken to stop bleeding and for relieving pressure within the skull.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

1. Remove the brain tissues that are grown abnormally
2. Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
3. Biopsy purpose or to remove the tumour
4. Make a nerve free
5. Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
6. To implant artificial electronic device as a treatment for conditions like Parkinson's disease

Types:

1. Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
2. Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
3. Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
4. Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.

Risks:

1. Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
2. Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
3. General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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.

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. Surgical risks are very low, however one should be aware of them namely infection, bleeding or nerve damage. Emergency surgery is also required in cases where patient starts developing bladder or bowel control problems.

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

1. Abnormal blood vessels
2. Aneurysm
3. Bleeding
4. Blood clots in the brain
5. When the protective tissue or dura is damaged
6. Epilepsy
7. Due to nerve damage
8. Parkinson's disease
9. Any kind of pressure after an injury
10. Abscesses
11. Skull fractures
12. In case of stroke and tumors

A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

1. Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
2. Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
3. Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
4. Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.

Risks:
Brain surgeries may be associated with several risks. They may be:

1. Allergic reactions to anesthesia
2. Bleeding
3. Blood clot formations
4. Swelling of the brain
5. A state of coma
6. Impairment in speech, coordination and vision.
7. Problems in memory
8. Strokes and seizures
9. Infections in the brain

Brain surgeries are now much safer with advancements in medical science. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

As the famous quote says, 'prevention is better than cure', let us take you through some preventive measures to keep you and your loved ones away from the dreadful brain stroke. Brain stroke occurs due to an interruption in the regular blood flow to the brain or bursting of a blood vessel or due to the bursting of blocked artery, which reduces the supply of oxygen and nutrients, leading the brain cells to die.

Top 8 things that will reduce the likelihood of having a brain stroke:

1. Eat well: Having good eating habits are not just good for a healthy outlook of the body, but also benefits the body in many other ways. Eating a plenty of fresh fruits and vegetables, fibre rich diet, reducing salt and fat content can prevent stroke.
2. Stay Active: Regular exercising not just makes you feel and look good, but also reduces the odds of developing a brain stroke. Exercising regularly or keeping the physical activities regularly will keep you away from suffering a stroke. Pick any physical activity, but do work out to stay away from the brain stroke.
3. Say no to Smoking and drugs: Yes! The more you smoke, the more are the chances of you of suffering the deadly brain stroke.
4. Control your blood pressure: Normal range varies with age of patient. Regular check-up of blood pressure is advisable to control the chances of suffering a stroke as high blood pressure can result into damage of arteries, which causes brain stroke.
5. Drink in limits: Limit the amount of alcohol you consume, as alcohol increases the blood pressure, which is one of the main reasons behind the stroke. The high amount of alcohol can increase the blood pressure to a higher level very quickly. Consulting a doctor is the best option in case you are not able to control your alcohol intake.
6. Cholesterol: People suffering from high cholesterol are at higher risk of strokes as the cholesterol can travel to the arteries in the body making the arteries narrow and the body more prone to suffer a stroke. Choosing healthy lifestyle helps in reducing the cholesterol level.
7. Diabetes: High level of diabetes is one of the most prominent reasons behind stroke. One should get his diabetes level checked and keep it under control since the arteries might get blocked because of fatty deposits because of higher sugar levels.
8. Depression/Stress: Any kind of depression or stress, generally leads to avoidance of all or some of the points discussed above and hence becomes a reason for an unhealthy body, which is more prone to strokes. Consultation with a doctor and/or psychiatrist is advisable in case a person if suffering from depression.

Improving your health and taking charge of your life should be the top most priority and should never be ignored. Regular health checkups can pick these diseases early and are encouraged. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.