• Dr. Ashuvi Kunjan Agay M.B.B.S.,MS.M.ch(Neurosurgery) 9772860125

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NEUROSURGERY IN MANAGEMENT OF STROKE!

Neurosurgery mainly deals with treating of functional disorders that affect the nerves, brain and muscles through major or minor surgery. The field of neurosurgery makes use of advanced surgical procedures. The different techniques are used to treat brain tumors, trauma to the head, cerebral hemorrhages, spinal disc herniation, brain aneurysms and peripheral neuropathy.

Neurosurgery Treatment

The main aim of neurosurgery treatment in patients suffering from stoke is to prevent neurologic deterioration as well as the recurrence of stroke. The advancement in medical treatment has increased to a great extent, however the mortality and morbidity in stroke patients is very high. The second leading cause of death all over the world is stroke, and hence, through neurosurgery stroke can be managed. Each year in the U.S there are about 800,000 people who suffer from stroke which causes disability.

Symptoms of Stroke and its Effects

The main symptoms of stroke are not identified easily by people. However, the symptoms that are caused on delay of treatment include difficulty in speaking, weakness on one side of the body, drooping on one side of the face and difficulty in walking. Stroke at times is life threatening and it is also referred to as brain attack and can occur at any time to an individual. It is caused when the flow of blood supply to the brain is cut off and oxygen is deprived to the brain cells. Brain dysfunction occurs due to the dead brain cells and hence some patients lose their memory and control over their muscle movement. The treatment of stroke in such cases includes a neurosurgery by a neurological specialist.

Types of Stroke

The abrupt interruption to the flow of blood that causes hindrance in the neurological function can be best treated if detected early and by accurate diagnosis by a neurosurgeon. There are 3 different types of stroke that can occur and these include Hemorrhagic stroke, Ischemic stroke and Transient ischemic attack. The Ischemic stroke mainly occurs when blood vessels that supply blood to the brain are blocked. It is a common form of stroke and its underlying cause is known as atherosclerosis. The main procedures that are used for treating ischemic stroke include tissue plasminogen activator and endovascular procedure. In the tissue plasminogen activator procedure, the patient is given medicine intravenously. The blood flow to the affected area of the brain is improved when the blood clot dissolves through this method. The medication is given immediately after 3-4 hours on occurrence of the stroke symptoms. In the second procedure, a catheter is used, which is injected in the area of the obstructed blood vessel. The blood flow to the area is restored by the endovascular procedure. Even anticoagulants are given to thin the blood and prevent clogging. In case you have a concern or query you can always consult an expert & get answers to your questions!

ADOPTING DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE

One of the common ailments in elderly people is Parkinson’s. A progressive disorder, when left untreated, worsens the symptoms. Hence, it is essential to understand the treatment options available to manage the condition effectively. You may be suggested surgical therapies if medication is not effective enough to treat the symptoms. Surgical treatment options can be beneficial for patients who are suffering from symptoms, but they do not help with treating the disease. In the past, surgical methods like Thalamotomy and Pallidotomy were used to destroy brain cells that contributed to the symptoms. While these methods are still used, they are very rare and situational. Deep Brain Stimulation (DBS), an FDA-approved procedure, has become much more popular as it is much safer and does not involve invasive surgery. Instead of destroying brain cells like traditional methods, DBS involves sending electric pulses to the affected brain cells to reduce the symptoms. It is not a treatment procedure, but a means of bringing down the severity of Parkinson’s to allow better and more comfortable treatment.

Deep Brain Simulation – Who are the right candidates?

Deep Brain Simulation is commonly used for Parkinson’s disease, but it is not recommended for everyone. It is a preferred method of treatment for people who have had Parkinson’s for at least four years but have complications which include long periods of time where medications do not work, symptoms return, uncontrolled and involuntary movements or the freezing/stiffness in the body Deep Brain Simulation is not recommended for those who have Dementia as it can lead to memory problems. The general rule of thumb that neurosurgeons follow is that Deep Brain Simulation can help with symptoms that do not get better with medication. DBS can help reduce medication requirements for patients as well as reduce the side effects that may occur due to medication. Disorder specialists and neurosurgeons can conduct tests to determine if DBS will be effective for a patient before proceeding with such a procedure. An extensive assessment is necessary to understand the symptoms, the effect of Parkinson's drugs, and also brain imaging is done. All of the expected benefits are then evaluated for the patients, and if the procedure can help alleviate the symptoms, DBS is given a green signal by neurosurgeons and patients can undergo the procedure.

How Does Deep Brain Simulation Work?

Deep Brain Simulation is a very complex procedure. Brain cells communicate with the rest of the body through electric signals, and these become irregular and do not work properly when affected by Parkinson's. DBS smoothens the functioning of these brain cells and reduces symptoms through electric pulses through the implantation of a medical device known as a neurostimulator which is also referred to as a brain pacemaker. But, as with any treatment procedure, DBS has potential risks and side effects, hence discuss with the neurosurgeon thoroughly to assess the suitability.

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ADOPTING DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE

One of the common ailments in elderly people is Parkinson’s. A progressive disorder, when left untreated, worsens the symptoms. Hence, it is essential to understand the treatment options available to manage the condition effectively. You may be suggested surgical therapies if medication is not effective enough to treat the symptoms.

Surgical treatment options can be beneficial for patients who are suffering from symptoms, but they do not help with treating the disease. In the past, surgical methods like Thalamotomy and Pallidotomy were used to destroy brain cells that contributed to the symptoms. While these methods are still used, they are very rare and situational.

Deep Brain Stimulation (DBS), an FDA-approved procedure, has become much more popular as it is much safer and does not involve invasive surgery. Instead of destroying brain cells like traditional methods, DBS involves sending electric pulses to the affected brain cells to reduce the symptoms. It is not a treatment procedure, but a means of bringing down the severity of Parkinson’s to allow better and more comfortable treatment.

Deep Brain Simulation – Who are the right candidates?

Deep Brain Simulation is commonly used for Parkinson’s disease, but it is not recommended for everyone. It is a preferred method of treatment for people who have had Parkinson’s for at least four years but have complications which include long periods of time where medications do not work, symptoms return, uncontrolled and involuntary movements or the freezing/stiffness in the body

Deep Brain Simulation is not recommended for those who have Dementia as it can lead to memory problems. The general rule of thumb that neurosurgeons follow is that Deep Brain Simulation can help with symptoms that do not get better with medication. DBS can help reduce medication requirements for patients as well as reduce the side effects that may occur due to medication.

How Does Deep Brain Simulation Work?

Deep Brain Simulation is a very complex procedure. Brain cells communicate with the rest of the body through electric signals, and these become irregular and do not work properly when affected by Parkinson's. DBS smoothens the functioning of these brain cells and reduces symptoms through electric pulses through the implantation of a medical device known as a neurostimulator which is also referred to as a brain pacemaker. But, as with any treatment procedure, DBS has potential risks and side effects, hence discuss with the neurosurgeon thoroughly to assess the suitability.

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SPLIT SPINE: KNOW THE SIGNS THAT INDICATE IT!

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

Myelomeningocele

Myelomeningocele is the most severe form of spinal bifida. In this type of neural defect, the 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.

  • Seizures
  • Presence of uneven hips
  • Deformed feet
  • Curved spine or scoliosis
  • Bladder and bowel problems
  • Muscle weakness
  • Paralyzed leg muscles.

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.

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:

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

In this kind of spinal bifida, neither any sack of fluid is formed, nor are there any visible opening in the back. Sometimes, people who have spinal bifida are not aware of it due to its minimal symptoms. Spinal 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