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TREATMENT, MANAGEMENT, AND REHABILITATION OF STROKE BY best spine surgeon in Gurgaon

The past decade has witnessed a dramatic change in the treatment of acute stroke, leaving the era of an indifferent approach firmly behind. Equally as important as the development of particular emergency treatments, however, is recognizing that the organization of stroke services per se plays a vital role in the provision of effective therapies and in improving the overall outcome after stroke.

A significant advance in stroke management is the advent and development of specialized stroke services (stroke units) by the best spine surgeon in Gurgaon.

These services are organized as specialized hospital units focusing exclusively on stroke treatment. Evidence favors all strokes to be treated in stroke units regardless of the age of the patient and the severity and subtype of the stroke. Evidence from randomized trials shows that treatment in stroke units is very effective, especially compared with therapy in general medical wards, geriatric wards, or any other kind of hospital department in which no beds or specialized staff are exclusively dedicated to stroke care.

The Stroke Unit Trialists Collaboration has shown that stroke units reduce early fatality (death within 12 weeks) by 28% and death by the end of one-year follow-up by 17% (relative risk reduction). Stroke units also decrease disability and result in more discharges to home, rather than having patients institutionalized. In most European countries, the elements of comprehensive stroke unit care outlined by the Stroke Unit Trialists’ Collaboration have been adopted. They include assessment and monitoring, physiological management, early mobilization, skilled nursing care, and short-term multidisciplinary team rehabilitation services.

Despite proven efficacy and cost–effectiveness, stroke unit care remains underused in almost all parts of the world. Ischaemic stroke is caused by interruption of the blood supply to a localized area of the brain. This results in cessation of oxygen and glucose supply to the brain with subsequent breakdown of the metabolic processes in the affected territory. The infarction process may take several hours to complete, creating a time window. It may be possible to facilitate the restoration of blood supply to the ischaemic area and interrupt or reverse the process. Achieving this has been shown to minimize subsequent neurological deficit, disability, and secondary complications.

Therefore the acute ischaemic stroke should be regarded as a treatable condition that requires urgent attention in the therapeutic window when the hypoxic tissue is still salvageable. Recent advances in the management of ischaemic stroke imply the implementation of thrombolytic therapy that restores circulation in zones of critical ischemia, thus allowing minimizing, or even reversing, the neurological deficit, and spine surgeons in Gurgaon decide it.

Thrombolysis is effective for strokes caused by acute cerebral ischemia when given within three hours of symptom onset. Intravenous thrombolysis has been approved by regulatory agencies in many parts of the world and has been established or is in the build-up phase in many areas.

The therapy is associated with a slight but definite increase in the risk of hemorrhagic intracerebral complications, emphasizing the need for careful patient selection. Currently, less than 5% of all patients with stroke are treated with thrombolysis in most areas where the therapy has been implemented. One half to two-thirds of all patients with stroke cannot even be considered for intravenous thrombolytic therapy within a three-hour window because of patient delays in seeking emergency care. Changing the patients’ behavior in the event of acute suspected stroke remains a significant challenge. Several studies are currently extending the current criteria for thrombolysis to larger patient groups including beyond the three-hour window. In acute stroke cases, aspirin is given as soon as CT or MRI has excluded intracranial hemorrhage. Several advances are noted with endovascular treatment of intracranial aneurysms by detachable coils. Recent evidence suggests that endovascular intervention is at least as effective as open surgery, with fewer complications.

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DEMENTIA

Dementia is a syndrome caused by a disease of the brain, usually of a chronic or progressive nature. There is a disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement. Consciousness is not clouded. Dementia mainly affects older people: only 2% of cases start before the age of 65 years. After This prevalence doubles with every five-year increment in age. Dementia is one of the significant causes of disability in later life which can be treated by consulting the best neurosurgeon in Gurgaon.

There are very many underlying causes of dementia. Alzheimer’s disease (AD), characterised by cortical amyloid plaques and neurofibrillary tangles, is the most common, accounting for one half to three-quarters of all cases. Vascular dementia (VaD) is diagnosed when the brain’s supply of oxygenated blood is repeatedly disrupted by strokes or other blood vessel pathology, leading to significant accumulated damage to brain tissue and function. The distinction between AD and VaD has been called into question, given that mixed pathologies are prevalent. Perhaps vascular damage is no more than a cofactor accelerating the onset of clinically significant symptoms in people with AD.

There are a few rare causes of dementia that may be treated effectively by timely medical or surgical intervention— these include hypercalcaemia, subdural haematoma, normal pressure hydrocephalus, and deficiencies of thyroid hormone, vitamin B12 and folic acid. For the most part, altering the aggressive pro- course of the disorder is unfortunately not possible. Symptomatic treatments and support can, however, transform the outcome for people with dementia and their caregivers.

Alzheimer and other dementias have been reliably identified in all countries, cultures and races in which systematic research has been carried out, though levels of awareness vary enormously. In India, for example, while the syndrome is widely recognised and named, it is not seen as a medical condition. Indeed, it is often regarded as part of normal ageing (1). The neurosurgeon in Gurgaon makes identification of these. To make a diagnosis, clinicians focus on their assessments upon impairment in memory and other cognitive functions and loss of independent living skills.

For carers and, arguably, for people with dementia, it is the behavioural and psychological symptoms of dementia (BPSD) that are most relevant. Nearly all studies indicate that BPSD is a fundamental cause of caregiver strain. They are a common reason for institutionalisation as the family’s coping reserves become exhausted. Problem behaviours may include agitation, aggression, calling out repeatedly, sleep disturbance (day-night reversal), wandering and apathy. Common psychological symptoms include anxiety, depression, delusions and hallucinations. BPSD occurs most commonly in the middle stage of dementia (see also the section on Course and outcome below). Despite their significance, there has been relatively little research into BPSD across cultures. One might anticipate that cultural and environmental factors could have a strong influence upon both the expression of BPSD and their perception by caregivers as problematic (2). Behavioural and psychological symptoms appear to be just as common in people living with dementia in developing countries (3). In some respects, the developing country caregivers were more disadvantaged. Given the generally low awareness about dementia as an organic brain condition, family members could not understand their relative’s behaviour. Others tended to blame the carers for the distress and disturbance of the person they were looking after.

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ACUTE MANAGEMENT OF TRAUMATIC BRAIN INJURY BY BEST SPINE SURGEON IN GURGAON

Treatment of mild head injuries

Many of the mild cases can be classified as “minor head injuries.” These patients can be dismissed after a short clinical examination and adequate information since their risk of further problems will be very low, i.e., <0.1%. Before dismissal, they deserve brief information, preferably written, about:

■ warning signs indicating possible complications; ■ how typical and mild symptoms are expected to develop; ■ how to resume normal daily activities. The remaining patients with mild TBI have a 1–6% risk of deterioration. Therefore, a closer examination may be required to identify the individuals with the highest risk of developing complications.

Patients who need special attention are those with:

■ decreasing level of consciousness; ■ neurological deficit; ■ epileptic seizure; ■ deficient blood coagulation; ■ age >60 years; ■ alcohol abuse. Patients at risk will need a CT examination and admission. ■ Observation should be maintained for 12–24 hours with repeated studies to detect a decreasing level of consciousness. ■ A CT scan gives excellent information about fractures and brain damage: ■ A skull X-ray should be performed if a CT scanner is not available. A fracture will indicate a higher risk of deterioration, and admission is necessary for a short observation time.

The clinical examination, a CT scan, and, in some cases, observation in a hospital ward will identify the very few patients in this group requiring treatment by the best spine surgeon in Gurgaon.

Treatment of moderate and severe injuries Patients with moderate or severe TBI represent less than 10% of all traumatic head injuries. In this category of TBIs, adequate health care can make a difference and substantially improve outcomes. Airway obstruction and falling blood pressure are acute threats to the vulnerable brain-injured patient. Pre-hospital care with skilled paramedics, early arrival at the accident scene, prompt stabilization of the patient’s condition following ABC guidelines.

Well-organized and updated hospital inpatient treatment is equally important. On admission, life-supporting measures should be continued, following Advanced Trauma Life Support recommendations.

The guidelines indicate how patients at risk should be identified and managed before progressive brain damage occurs. A study from the United States in patients with severe TBI showed improved outcomes after implementing evidence-based treatment guidelines. At the same time, reduced hospital costs were obtained through the shortened length of stay, from 21.2 days to an average of 15.8 days.

The research focused on identifying the ideal conditions for the highly vulnerable brain in severe TBIs has resulted in two different approaches in neurointensive care, the Lund model and the perfusion concept. Although they are different in many ways, both have improved outcomes in patients with severe TBI.

COSTS

Any information available about the economic consequences of TBI is mainly related to costs of hospitalization, which probably constitute only a relatively small part of the total costs. According to Berg and colleagues, TBI-associated costs can be subdivided as follows:

■ direct costs: hospitalization, outpatient care, rehabilitation; ■ indirect costs: lost productivity, in particular after moderate or severe injuries; ■ intangible costs to patients, families, and friends: related to death or reduced quality of life.

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TYPES OF HEADACHE DISORDERS

Migraine

Migraine is a primary headache disorder. It almost certainly has a genetic basis (4), but environmental factors play a significant role in how the disease affects those who suffer from it. Pathophysiology- call, activation of a mechanism deep in the brain causes the release of pain-producing inflammatory substances around the nerves and blood vessels of the head. Why this happens periodically and what brings the process to an end in spontaneous resolution of attacks are uncertain. These disorders may lead to a brain tumour, and that's is why consultation with the best brain tumour surgeon in Delhi is important

Usually starting at puberty, migraine is recurrent throughout life in many cases. Adults with migraine describe episodic disabling attacks in which headache and nausea are the most characteristic features; others are vomiting and dislike or intolerance of normal levels of light and sound. Headaches are typically moderate or severe in intensity, one-sided and pulsating, aggravated by routine physical activity; they usually last from several hours to 2–3 days. In children, attacks tend to be of shorter duration and abdominal symptoms more prominent. Attack frequency is typically once or twice a month. Still, it can be anywhere between once a year and once a week, often subject to lifestyle and environmental factors that suggest people with migraine react adversely to change in routine. Migraine is most disabling to people aged 35–45 years, but it can trouble much younger people, including children. Studies in Europe and the United States have shown that migraine affects 6–8% of men and 15–18% of women.

Similarly, in India, although major studies are still to be conducted, anecdotal evidence suggests migraine is prevalent. High temperatures and high light levels for more than eight months of the year, heavy noise pollution and the Indian habits of omitting breakfast, fasting frequently and eating rich, spicy and fermented food are thought to be common triggers. Migraine appears less prevalent but still familiar elsewhere in Asia (around 8%) and in Africa (3–7% in community-based studies). In these areas also, significant studies have yet to be carried out.

Tension-type headache

The mechanism of tension-type headache is poorly understood, though it has long been regarded as a headache with muscular origins. It may be stress-related or associated with musculoskeletal problems in the neck.

Tension-type headache has distinct subtypes. As experienced by vast numbers of people, an episodic tension-type headache occurs, like migraine, in attack-like episodes. These usually last no more than a few hours but can persist for several days. Chronic tension-type headache, one of the regular daily headache syndromes, is less common than episodic tension-type headache but is present most of the time: it can be unremitting over long periods. This variant is much more disabling. Dr Arun Saroha is the best neurosurgeon in Gurgaon.

Headache, in either case, is usually mild or moderate and generalised, though it can be one-sided. It is described as pressure or tightness, like a band around the head, sometimes spreading into or from the neck. It lacks the specific features and associated symptoms of migraine.

Tension-type headache pursues a highly variable course, often beginning during the teenage years and reaching peak levels around the age of 30–40 years. It affects three women to every two men. Episodic tension-type headache is the most common headache disorder, reported by over 70% of some populations, though its prevalence appears to vary considerably worldwide. In Japan, for example, Takeshima et al. found 22% of the people to be affected, while Abduljabbar et al. recorded only 3.1% with tension-type headache in a rural population of Saudi Arabia (though it was still the most common headache type). Lack of reporting and under-diagnosis were thought to be factors here. It may be that cultural attitudes to reporting a relatively minor complaint to explain at least part of the variation elsewhere. Chronic tension-type headache affects 1–3% of adults.

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Common brain tumors

Gliomas are seen to appear in both the benign and malignant groups of tumors. Astrocytomas are the most common glial tumor; tumors derived from oligodendrocytes, ependyma, neurons, primitive neuroectodermal, or other tissues are much rarer. Unless otherwise specified, the words ‘primary brain tumor’ or ‘glioma’ refers to an astrocytoma in clinical practice. Gliomas are classified histologically from grade 1 (benign) to grade 4 (the highly malignant glioblastoma multiforme). Benign gliomas are, unfortunately, much less common than malignant ones and tend to become more malignant with time. The best neurosurgeons in Delhi are there to investigate all types of brain tumors.

Meningiomas are nearly always benign. They may arise from any part of the meninges, over the brain's surface, from the falx, or the tentorium. There is a cleavage plane between tumor and brain tissue which makes total removal a definite possibility, so long as the cancer is reasonably accessible and unattached to dural venous sinuses, e.g., the sagittal sinus.

Pituitary adenomas produce two principal sets of symptoms: space-occupying effects and endocrine disturbance. When the pituitary gland enlarges in the pituitary fossa, it most commonly expands upwards (suprasellar extension) to compress optic nerves/chiasm/tracts. The classical bitemporal hemianopia resulting from chiasmal compression occurs when the optic chiasm is right above a pituitary extension directed upwards. The exact position of the optic chiasm, and the direction of pituitary expansion, do, however, vary from one case to another, so monocular blindness due to optic nerve compression and homonymous hemianopia from optic tract compression is not uncommon in patients with pituitary adenomas.

Acoustic neuromas are benign tumors of the Schwann cells along the hearing nerve, between the cerebellopontine angle and the internal auditory meatus in the petrous temporal bone. First and foremost, they produce progressive unilateral nerve deafness. Still, by the time of recognition, there may well be associated 5th and 7th nerve dysfunction, unilateral cerebellar signs, and evidence of raised intracranial pressure. Early diagnosis is highly desirable since a small tumor can be treated with radiotherapy or surgery with fewer complications than a large one which has caused the brainstem to displace and raised intracranial pressure.

Common malignant tumors in the brain are either gliomas or metastases, particularly malignant astrocytomas and metastatic carcinoma. Together these constitute well over 60% of all brain tumors. The history is usually short, of raised intracranial pressure, epilepsy, or neurological deficit. Not uncommonly, all three groups of symptoms are present by the time of diagnosis. It is not uncommon for a primary carcinoma elsewhere in the body to present with metastatic disease in the brain. If the metastases are multiple, the differentiation from malignant glioma is not tricky, but solitary cerebral metastases are common.

Differential diagnosis

The common presenting symptoms of brain tumors are: • raised intracranial pressure; • epilepsy;

Other mass lesions within the head may produce all three features. There may be difficulty in differentiating a malignant tumor from an intracerebral abscess when the history is a short one and from subdural hematoma when the past is a little longer.

Other causes of raised intracranial pressure include severe arterial hypertension, chronic meningitis, and benign intracranial hypertension (BIH). BIH is probably due to reduced venous drainage of the brain and mainly affects young obese women or patients with a predisposition to venous thrombosis. Epileptogenic scars from the previous intracranial disease more usually cause epilepsy and focal epilepsy. It is essential to consult the best neurosurgeon in Gurgaon when there is any symptom of a tumor.

The principal alternative cause of a progressive subacute focal neurological deficit is an ischaemic stroke, which occasionally, instead of developing with characteristic abruptness, comes on in a stuttering way.

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What is Vertebroplasty and Kyphoplasty? best spine surgeon in Gurgaon

Vertebroplasty and kyphoplasty are minimally invasive techniques used to treat painful vertebral compression fractures (VCF), which are fractures of the vertebral bodies that comprise the spinal column.schedule your appointment with Dr.Arun best spine surgeon in gurgaon. When a vertebral body fractures, the bone's normal rectangular form becomes compressed, causing pain. These stress fractures are a common complication of osteoporosis and may include the collapse of one or more vertebrae in the spine. Osteoporosis is a disorder that causes a loss of normal bone density, mass, and strength, resulting in a condition in which bones become increasingly fragile and brittle. Cancer can also weaken the vertebrae. In order to perform a vertebroplasty, physicians use image instruction, usually fluoroscopy, to inject a cement mixture into the broken bone via a hollow needle. During kyphoplasty, a balloon is first inserted through the hollow needle into the broken bone to create a cavity or void. After the balloon is removed, the cement is injected into the cavity.

What are some of the procedures' most popular applications? Vertebroplasty and kyphoplasty are procedures used to treat painful vertebral compression fractures in the spine, which are most often caused by osteoporosis. Vertebroplasty and kyphoplasty are typically prescribed when less aggressive procedures, such as bed rest, a back brace, or pain relief, have proven unsuccessful. Vertebroplasty and kyphoplasty may be done right away in patients with severe pain that need to be hospitalized, or for conditions that limit bed rest and pain medications. Vertebroplasty and kyphoplasty are also performed on patients who are elderly or weak and have a history of poor bone healing after a fracture. suffer from osteoporosis as a result of long-term steroid therapy or a metabolic disorder have vertebral compression caused by a malignant tumor Vertebroplasty and kyphoplasty should be performed within eight weeks of the acute fracture with the best chance of success.

What should I do to prepare? A clinical examination will be performed to confirm the existence of a compression fracture that may benefit from vertebroplasty or kyphoplasty care. Diagnostic imaging blood tests may be performed as part of the assessment. a physical examination X-rays of the spine bone scan with radioisotopes MRI stands for magnetic resonance imaging (MRI) computed tomography (CT) (CT) During care, you might be given bone-strengthening medicine. Inform your doctor about all of your drugs, including herbal supplements. Include any allergies, particularly to local anaesthetics, general anaesthesia, or contrast materials. Before your operation, your doctor can advise you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners. Inform your doctor about any recent diseases or medical problems. Prior to the treatment, you would need to get blood drawn for testing to decide whether the blood clots normally. You should be able to take your regular drugs with sips of water or clear liquid up to six hours before the operation. Juice, cream, and milk should be avoided. Follow the doctor's advice. In most cases, you should continue to take your regular medications, especially blood pressure medications. On the morning of your operation, take these with sips of water. Aside from drugs, your doctor may instruct you not to eat or drink anything for several hours prior to your procedure. Make arrangements for someone to bring you home after your treatment. During the operation, you will be given a gown to wear.

How does the equipment appear? X-ray devices, a hollow needle or tube called a trocar, orthopaedic cement, and a cement delivery system are used in vertebroplasty and kyphoplasty procedures. To make space for the balloon catheter during kyphoplasty, a system known as a balloon tamp is also used. A portable x-ray machine is a small piece of equipment that can be carried to a patient in a hospital bed or the emergency room. The x-ray tube is attached to a flexible arm, which is stretched over the patient, and an x-ray film holder or image recording plate is mounted under the patient. Polymethylmethacrylate is an ingredient in orthopaedic cement (PMMA). It has the appearance of toothpaste and hardens quickly after being placed in the body. An intravenous line (IV), ultrasound machine, and instruments to control the heart rate and blood pressure can also be used during the operation.Schedule your appointment with a spine surgeon in Gurgaon.

How is the operation carried out? Image-guided, minimally invasive procedures such as vertebroplasty and kyphoplasty are typically conducted in an interventional radiology or neuroradiology suite, or sometimes in the operating room, by a specially qualified interventional radiologist or neuroradiologist. This procedure is often performed as an outpatient procedure. However, certain patients may need to be admitted after the operation. Consult the doctor to see if you need to be admitted. Monitors that monitor your heart rate, blood pressure, oxygen level, and pulse may be attached to you. To administer a sedative, a nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm. Sedation can be used for this treatment. It does not necessitate the use of a breathing tube. Some patients, however, may need general anaesthesia. You may be given medications to alleviate nausea and pain, as well as antibiotics to avoid infection. For the treatment, you will be lying face down. The region in which the hollow needle, or trocar, will be inserted will be shaved, sterilised with a cleaning solution, and draped. The skin and deep tissues around the fracture are then treated with a local anaesthetic. At the location, a very small skin incision is made. The trocar is passed through the spinal muscles under x-ray guidance until its tip is precisely located inside the broken vertebra. The orthopaedic cement is then inserted during vertebroplasty. Medical-grade cement hardens rapidly, typically in less than 20 minutes. After the cement is injected, the trocar is extracted. The balloon tamp is inserted through the needle and then inflated to create a hole or hollow in the skin. The balloon is then removed, and bone cement is injected into the balloon's cavity. At the end of the operation, X-rays and/or a CT scan can be taken to verify the cement distribution. Pressure is applied to stop further bleeding, and the opening in the skin is bandaged. Sutures are not needed. This process is normally finished in an hour. If more than one vertebral body level is being handled, the procedure may take longer. Book your appointment with Dr.Arun top spine surgeon in Gurgaon.

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Caudal epidural and caudal nerve block injections by By neurosurgeon in Gurgaon

Caudal epidural and caudal nerve block injections are steroid injections administered in the coccyx (tailbone or caudal) area to relieve chronic lower back and leg pain. While both injections use a steroid solution to alleviate pain, they are administered in different ways. Book your appointment with the best neurosurgeon in Gurgaon.

An epidural is inserted into the epidural cavity, which covers the dura san, the nerve roots' protective tunnel. The acaudal nerve block is administered by injecting a substance into a particular nerve root in the tailbone area.

Why Are Caudal Epidural and Caudal Nerve Blocks Used? Numerous nerves run down our backs and out to the rest of the body through our spinal cords. The nerves that run through the legs and to the feet are located in the lower portion of the spinal cord. When one of these nerves is irritated and inflamed, it can cause lower back and leg pain. Spinal nerve inflammation can be caused by: Sciatica Disc herniation Spinal bone spurs Caudal epidural and caudal nerve blocks alleviate discomfort and inflammation in the lower back and legs.

What to Expect During a Caudal Epidural and Nerve Block Procedure Caudal epidural and nerve block injections are outpatient treatments, which means patients can go home right away. In most cases, the operation takes between 10 and 20 minutes to complete. To ensure that the drug is administered to the correct location, the pain control specialist employs real-time x-ray imaging. Patients are asked to lie face down on an x-ray table with a cushion beneath their abdomen before the operation. Until inserting a needle and injecting contrast dye into the caudal region, the pain specialist cleans and numbs the area of the lower back just above the buttocks with a topical anesthetic. The contrast dye can be used in the x-ray images, allowing the pain specialist to see precisely where the dye is being applied. The drug is then injected into the caudal cavity.

The Risks of Caudal Epidural and Caudal Nerve Block The risks of caudal epidural and nerve block are minimal, but they may include: Bleeding at the injection site Infection at the injection site Migraine

Caudal Epidural and Caudal Nerve Block Benefits Injections of the caudal epidural and nerve blocks offer pain relief without the need for surgery. Furthermore, caudal nerve block injections may assist physicians in determining the exact cause of pain to make a diagnosis. A local anesthetic is injected into a particular nerve root to accomplish this. After that, the patient is asked to explain any changes in pain symptoms. When the patient's pain level decreases, it means that the nerve causing the patient's symptoms has been found. Book your appointment with the best neurosurgeon in Gurgaon.

Preparing for a Caudal Epidural and a Caudal Nerve Block Patients should notify the pain doctor of their current drugs when scheduling a caudal epidural or caudal nerve block procedure. Certain drugs, such as blood thinners, will need to be stopped for some time before the operation to minimize the risk of bleeding or other complications.

Caudal Nerve Block and Post-Caudal Epidural Therapy Patients are usually recommended to avoid strenuous tasks and driving for at least 24 hours after the operation. The majority of patients will feel pain relief two or three days after the injection. It is not unusual for the area to be sore for a few days after the operation. Acaudal epidural or nerve block may have long-term effects, but they are not permanent. Periodic injections are needed to experience long-term pain relief. Call us and schedule your appointment with Dr. Arun who is the neurosurgeon in max Gurgaon.

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Degenerative Disc Disease (DDD) by  best disc replacement surgeon in Delhi

DDD is a common cause of back pain, especially as you age. The discs that cushion the vertebrae – your spine's long stack of bones – begin to dry out. Discs may also be damaged as a result of natural wear and tear or from an accident. Call us and schedule your appointment with Dr. Arun who is the best disc replacement surgeon in Delhi.

The magnitude of the breakdown, as well as how it affects people, varies. An individual may have serious disc breakdown but only moderate pain, while another person may have minimal disc damage and excruciating pain.

To better understand DDD, it is helpful to understand the basic structures of the spine and how they function:

Vertebrae The interlocking bones in your spine that sustain your entire body are known as vertebrae. They are divided into three sections: the cervical spine (neck), the thoracic spine (upper and mid-back), and the lumbar spine (lower back). DDD most often occurs in the neck or lower back, but it can occur anywhere along the spine. Disks Shock-absorbing discs, known as spinal discs or intervertebral discs, are located between each vertebra. They cushion your vertebrae and allow you to bend, flex, and twist your back. Since the outer portion of a disc is firm and includes nerves, a bulge or tear may be excruciatingly painful. If the jellylike interior leaks out, you will suffer even more pain. The stuff contains proteins that cause swelling and tenderness in any tissue it comes into contact with Call us and book your appointment for disc replacement surgery in Delhi.

Cartilage Cartilage surrounds each spinal joint, protecting and cushioning the spine. Wear and tear can cause the cartilage to deteriorate, worsening DDD. The regions of your spine are as follows: The back of the neck (cervical spine) Out in the center (thoracic spine) Back pain (lumbar spine) The sacrum and the coccyx, also known as the tailbone, are located at the lower end of your spine. Degenerative disc disease is most likely to affect the cervical or lumbar spine.

What Is the Cause of Degenerative Disc Disease?

Accidents. Any back injury that causes swelling or soreness, from a car accident to a bad swing on the golf course, will increase the risk of DDD. The genetic code. DDD runs in families, but scientists have yet to identify the genetic marker(s) known to increase risk. Call us and schedule your appointment with Dr. Arun who is the best spine surgeon in Delhi.

Spinal disorders Ankylosing spondylitis (an inflammatory spine disorder that causes vertebrae to fuse) and other back conditions may increase the risk of DDD.

Excessive weight Being overweight or obese raises the pressure on your back. The extra weight puts pressure on the spinal discs. Overweight and obese people are more likely to have severe disc degeneration than normal-weight people, according to a 2012 study published in Arthritis & Rheumatology.

Smoking Smoking Some research indicates that smoking leads to spinal disc degeneration. Again, spinal disc breakdown does not necessarily result in pain, but it is a significant factor.

What Are the Signs and Symptoms of Degenerative Disc Disease? Disc degeneration may also be the cause. Symptoms can range from mild to severe and may include: Feeling as if your back has "seized" or "locked up" Neck ache Your spine's range of motion has been reduced. Your back is tense. Pain that travels across your buttocks, thighs, arms, and hands Pain that worsens when sitting for long periods In extreme cases, there may be leg or foot weakness.

What Is the Diagnosis of Degenerative Disc Disease? While the past and physical would be your starting point, diagnosing DDD will necessitate more. Imaging studies will be required:

X-rays This may include a reduction in disc space, bone spurs (bony growths on the vertebrae), fractures, and other bone-related issues. Soft tissue is difficult to see on X-rays. MRI Soft tissue issues can be revealed by this scan. It may also reveal whether your discs have shrunk, your spinal canal has narrowed, or your spinal discs have been damaged.

What Non-Surgical Treatments Are Available for Degenerative Disc Disease? Treatments It is not always necessary to take drugs to feel better. Your symptoms will improve if you do the following: Acute back pain episodes should be treated with rest and ice. Exercising Physiotherapy Massage therapy Heat therapy includes the use of heating pads, bags, or warm showers and baths. Chiropractic treatment

Depending on where you fall on the pain scale, your doctor can advise you to take over-the-counter (OTC) or prescription medications. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen (Advil) and naproxen, are available over-the-counter or by prescription (Aleve) Opioid (narcotic) pain relievers are used to provide short-term relief from extreme pain. Muscle relaxants-Injections for medical purposes. Where oral drugs and non-drug treatments do not provide enough relief, injections are typically the next step. For DDD, these are as follows: Epidural corticosteroid injections, in which a potent anti-inflammatory drug (the corticosteroid) is injected into the fluid-filled cavity surrounding the spinal cord. Nerve blocks are procedures in which pain-relieving medicine is injected directly into a nerve. Trigger point injections, in which a pain reliever is injected into a nearby muscle

What Surgical Treatment Options Are Available for Degenerative Disc Disease? Your discomfort is worsening over time. Your suffering has lasted for at least 12 weeks with no relief. Your suffering is so intense that only opioids can alleviate it. Your suffering is so intense that you are unable to perform your daily activities. Your legs are deteriorating. Discectomy: This operation removes part or more of a damaged disc, which may be beneficial if the disc is rubbing on a nerve. spinal fusion.

spinal fusion. The surrounding vertebrae are fused (permanently joined) together to re-stabilize this portion of the spine.

Artificial disc replacement entails removing the defective disc and replacing it with an artificial, or prosthetic, disc. It may have fewer risks than spinal fusion in the neck, in particular. Call us and schedule your appointment with Dr. Arun who is the top disc replacement surgical doctor in Delhi.

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Central nervous system lymphoma by best brain tumor surgeon in Gurgaon

A primary central nervous system lymphoma (PCNSL) is a type of cancer that grows in the brain and/or spinal cord from immune cells known as lymphocytes (lymphoma) (central nervous system; CNS). Individuals over the age of 65 and those with a weakened immune system (immunocompromised), especially those living with HIV/AIDS, are at a higher risk of developing a primary CNS lymphoma. Schedule your appointment with best brain tumor surgeon in Gurgaon

Symptoms & Signs The possible signs of primary CNS lymphoma vary and are often determined by the tumor's anatomical location. Symptoms usually appear over weeks (subacute). The majority of patients have focal neurological deficits such as asymmetric upper and/or lower extremity weakness or impaired mobility (paresis). Many patients, especially those with AIDS-related PCNSL, experience neurocognitive deficits. Changes in personality, vocabulary, and actions are also possible. Incontinence can develop as a result of bladder and bowel dysfunction. Pressure from the surrounding mass and fluid (edema) may cause brain swelling and increased pressure inside the skull (intracranial pressure), resulting in symptoms such as headaches, vomiting (emesis), and vision changes (papilledema). Seizures can occur and are more common in AIDS-related PCNSL patients.

PCNSL may be associated with excessive eating (hyperphagia), reduced libido (hyposexuality), central diabetes insipidus, and syndrome of abnormal antidiuretic hormone production if particular brain structures (such as the pituitary gland and hypothalamus) are impaired (which leads to a decreased concentration of sodium in the blood, a condition known as hyponatremia). (To learn more about central diabetes insipidus, enter “central diabetes insipidus” into the Rare Disease Database.) Involvement of the brainstem, which connects the brain and the spinal cord, may result in gait imbalance (ataxia), vertigo, eye coordination disorder (dye conjugate gaze), and intractable vomiting.

PCNSL seldom involves the spinal cord. When a mass compresses and damages the spinal cord (myelopathy), affected individuals may experience weakness, loss of feeling, and bladder and bowel dysfunction. Other structures that may be affected by a primary CNS lymphoma include the brain's coverings (meninges) as well as the peripheral and cranial nerves (neurolymphomatosis). The above will result in nerve pain and deficits unique to the function of the affected cranial nerve (for instance, face droop if the facial nerve is affected). Since primary CNS lymphomas are malignant tumors, they have the potential to spread to other parts of the body. Eye (ocular) involvement is present in 20 to 40% of patients at presentation and in almost all patients later in the disease's path. The most common visual signs are blurred vision and floaters. Systemic transmission is uncommon, but it can have a significant impact on the prostate, skin, and gastrointestinal tract. Weight loss, fever, and night sweats may result from the systemic spread of a PCNSL. These are known as constitutional or B symptoms, and they are present in the majority of patients with AIDS-related PCNSL even though there is no systemic spread. Primary CNS lymphoma most frequently affects people over the age of 60, although rare cases have been reported in children. AIDS-related PCNSL usually develops around the age of 45 and is more aggressive. Primary CNS lymphoma regresses in about 85 percent of patients with adequate care. Relapse, on the other hand, happens in 50% of cases, most frequently within two years. After a PCNSL diagnosis, the estimated recovery time is 44 months. Overall, 30 percent of affected people live more than five years after diagnosis, with 15 to 20 percent achieving long-term survival. HIV infection and involvement of deep regions of the brain are associated with lower survival, while age under 60 years and a high degree of autonomy and functioning are associated with increased survival. Elevated blood levels of lactate dehydrogenase (LDH) and cerebrospinal fluid protein concentration, both of which are typically assessed during diagnostic workup, are also associated with decreased survival. Schedule your appointment with best brain tumor surgeon in Delhi

Causes Primary CNS lymphomas are most often caused by the uncontrolled proliferation of cells originating from B lymphocytes (also known as B cells), a form of immune cell. PCNSL can also arise from T lymphocytes (also known as T cells), but our understanding of prognosis and treatments for PCNSL is focused on patients with primary diffuse large B-cell lymphoma of the CNS. The precise mechanism by which malignant lymphocytes invade the brain is unknown, although two major theories exist: lymphocytes can be attracted to the CNS and then multiply, resulting in a malignant tumor. Alternatively, already malignant lymphocytes can be attracted to the CNS through the expression of unique adhesion molecules that mediate brain traffic. The prognosis The diagnosis of primary CNS lymphoma is complicated and necessitates a combination of patient history, physical examination, laboratory tests, diagnostic imaging, and microscopic, cellular, and genetic (cytogenetic) study of tumor cells. After obtaining tumor cells, they can be tested in a variety of ways to support the diagnosis of primary CNS lymphoma. Flow cytometry is a laboratory technique that identifies cells based on their scale, shape and the existence of unique markers. Immunohistochemistry can supplement microscopic examination by staining cells according to their origin. Tumor cell DNA may also be studied to determine the existence of complex alterations (mutations). Many such general examinations are usually conducted to assess the patient's baseline health and decide the appropriate care options. Blood checks to look for blood cells (complete blood count) and levels of various electrolytes (biochemical serum profile), cognitive function tests, renal function tests, liver (hepatic) function tests, and cardiac function tests are examples of these tests.

Treatment and Management of Standard Therapies Unlike most other types of brain tumors, primary central nervous system lymphoma is usually treated without surgery. Chemotherapy, especially high-dose methotrexate, is the mainstay of treatment (HD-MTX). To avoid systemic and bone marrow toxicity from MTX, leucovorin (folinic acid) is frequently added. HD-MTX can be paired with other chemotherapeutic medications such as alkylating agents, cytarabine, and rituximab, depending on the patient. Chemotherapy regimens often differ depending on the center where the patient is being treated since many new therapies are being studied. Whole-brain radiation may be used in some situations, but it should be used with caution due to an increased risk of neurocognitive deficits, especially in elderly patients. Corticosteroids, such as dexamethasone, can be used to reduce fluid retention (edema) around the tumor, although they are commonly only used after a definitive diagnosis because they can reduce diagnostic accuracy by altering the tumor. Anticonvulsants are prescribed to people who have seizures. In HIV-positive patients, highly active antiretroviral therapy (HAART) should be started or optimized. Treatment of Epstein-Barr virus (EBV) with ganciclovir or zidovudine may be effective, but this has yet to be proven, and clinical trials are needed. Schedule your appointment with the best brain tumor surgeon in Delhi.

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What is Parkinson's disease? by the best neurosurgeon in Delhi

Parkinson's disease is a nervous system disorder that impairs movement function. The disease usually begins slowly and worsens over time. You can shake, have muscle stiffness, and have difficulty walking and keeping your balance and coordination if you have Parkinson's disease. As the disease progresses, you can experience difficulty speaking and sleeping, mental and memory issues, behavioral changes, and other symptoms. Dr. Arun is the best neurosurgeon in Gurgaon, having vast experience in treating Parkinson's disease.

CAUSES AND SYMPTOMS

What is the cause of Parkinson's disease?

Parkinson's disease develops when nerve cells (neurons) in the substantia nigra region of the brain become damaged or die. These cells normally produce dopamine, a chemical (neurotransmitter) that aids brain cell communication (transmits signals, or "messages," between brain areas). Dopamine production decreases when these nerve cells become damaged or die. Dopamine is particularly essential for the functioning of another region of the brain known as the basal ganglia. This part of the brain is in charge of coordinating the brain's commands for movement. Parkinson's disease is characterized by movement symptoms caused by dopamine deficiency. People suffering from Parkinson's disease also experience a decrease in another neurotransmitter known as norepinephrine. This chemical is required for the sympathetic nervous system to work properly. Any of the body's autonomic functions are regulated by this mechanism, including digestion, heart rate, blood pressure, and breathing. Any of the non-movement-related signs of Parkinson's disease are caused by a lack of norepinephrine. Scientists aren't sure what kills the neurons that generate these neurotransmitter chemicals.

What are the signs and symptoms of Parkinson's? The symptoms of Parkinson's disease, as well as the rate of deterioration, differ greatly from person to person. The following are the most common symptoms: Tremor: This is a form of tremor. The shaking starts in your hands and arms. It can also happen to your jaw or foot. Typically, only one side of the body or one limb is affected in the early stages of the disease. Tremor can become more widespread as the disease progresses. It worsens as a result of stress. Tremor usually goes away when you sleep or shift your arm or leg. The slowness of movement (bradykinesia): This is a slowing of movement caused by your brain's slowness in transmitting required instructions to the appropriate parts of your body. This symptom is unpredictable and can easily become incapacitating. You might be able to move easily one minute and then need assistance moving and completing tasks such as dressing, bathing, or getting out of a chair the next. You could even stomp your feet as you walk. Muscle rigidity/stiff limbs: Rigidity refers to the muscles' failure to relax naturally. This rigidity is caused by uncontrolled tensing of your muscles, and it prevents you from moving freely. Aches and pains in the affected muscles may occur, and the range of motion may be impaired. Unsteady gait, as well as balance and coordination issues: You can develop a forward lean, making you more likely to fall when bumped. You may take short shuffling steps, have trouble starting and stopping, and you may not swing your arms naturally as you walk. When attempting to take a step, you can feel as though your feet are stuck to the floor. Twisting muscles, spasms, or cramps (dystonia). You can feel a painful cramp in your foot, as well as curled and clenched toes. Dystonia may occur in other areas of the body. A hunched stance. Your stance is “hunched over.” Some signs and symptoms include: Reduced facial expressions: As the disease progresses, you can find yourself not smiling or blinking as frequently; your face loses speech. Changes in speech/vocalization: Speech can become hurried, slurred, or soft in tone. You could pause before speaking. Your voice's pitch will remain constant (monotone). Changes in handwriting: The handwriting can become smaller and more difficult to read. Anxiety and depression Drooling, chewing, and swallowing difficulties Urinary issues Difficulties with mental "thinking"/memory. Delusions and hallucinations Constipation is a common ailment. Problems with the skin, such as dandruff. The loss of smell. Disrupted sleep, acting out dreams, and restless leg syndrome are all examples of sleep disturbances. Apathy, pain, weight gain, and vision changes are all symptoms of apathy. Blood pressure is low.

DIAGNOSTIC AND TESTING How is Parkinson's disease identified? Diagnosis of Parkinson's disease can be complicated at times because early symptoms can resemble those of other conditions and there are no clear blood or laboratory tests to diagnose the disease. CT (computed tomography) or MRI (magnetic resonance imaging) scans can be used to rule out other conditions that cause similar symptoms. To diagnose Parkinson's disease, your medical history and family history of neurologic conditions, as well as your current symptoms, medicines, and potential exposure to toxins will be asked. Your doctor will examine you for symptoms of tremor and muscle rigidity, as well as how you walk, posture, and balance, and slowness of movement. If you suspect you have Parkinson's disease, you should see a neurologist, preferably one who specializes in movement disorders. Treatment decisions made early in the disease may have a long-term impact on the treatment's effectiveness.

TREATMENT AND MANAGEMENT What is the treatment for Parkinson's disease? Parkinson's disease has no known cure. Medication and other therapies, on the other hand, may help alleviate some of your symptoms. Exercise will greatly improve your Parkinson's symptoms. Physical therapy, occupational therapy, and speech-language therapy can also assist with walking and balance issues, feeding and swallowing difficulties, and speech disorders. For certain patients, surgery is a choice. schedule your appointment with the best neurosurgeon in the world.

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Management of Chronic Back Pain

Chronic back pain, i.e. back pain lasting for over three months, is a very debilitating condition. The pain can be recurring, coming and going with short intervals of pain-free time bringing temporary relief but it can be quite frustrating, especially if the cause of the pain is not known.

Dr. Arun Saroha, the best back pain doctor in Gurgaon, has offered some insights here to help the patient understand the causes and the nonsurgical conservative management of said pain.

Some common causes for Chronic Back Pain are-

Spine arthritis, i.e. the gradual thinning of the cartilage in the spine

Disc problems like hernia

Myofascial pain syndrome, i.e. unexplained muscle pain and tenderness

Age

Previous spine injury

If your doctor or pain specialist is not unable to diagnose the correct problem for your pain, then seek a second opinion from a better and more experienced neurosurgeon or pain specialist. Do not rush into any treatment. Getting a treatment before a proper diagnosis can lead to the exacerbation of the problem, making the pain more severe.

If the source of the pain can not be detected or treated, then the best course of treatment is to manage the pain flare-ups by using conventional conservative nonsurgical treatments.

Nonsurgical Treatments for Chronic Back Pain are:-

Physical Therapy- the first treatment that you would be guided towards, by any neurosurgeon or pain doctor, is physical therapy. Exercise is considered to be the foundation of spine health and chronic back pain management. The physiotherapist tailors the exercises to the requirements of each person, depending on the nature of their pain, its location, etc. The same exercises do not apply to everyone. However, it is up to you to follow the exercise regimen at home.

Common physiotherapy exercises include Retraining of posture, Testing the limits of pain tolerance, Stretching and flexibility exercises, Aerobic exercises and Core strengthening.

Mindfulness and Meditation- To manage the frustration, anxiety, irritation, depression and all the other negative feelings developing due to chronic pain should be managed by meditation. This can be supplemented by yoga, tai chi and other cognitive and relaxation strategies.

Diet- It is very important to avoid inflammatory foods such as trans fats, refined sugars and processed foods during spine treatment. Losing a little weight can also be helpful as it would reduce the pressure on the spine.

Lifestyle modifications- If you have back pain, it is important to consider serious lifestyle modifications. For example, if you have a sedentary job attached to a computer, you should take breaks and be more active in those work breaks to keep your spine healthy. On the other hand, if you work continuously without any breaks, you should take a rest regularly in between your work. You should also give up any deleterious habit such as drinking or smoking as that may accentuate pain and delay your healing.

Pharmacologic treatments- Medicines such as analgesics, anti-inflammatory drugs, muscle relaxants and other medications can be used to manage chronic pain. Overuse of such medicines should be avoided as it can lead to addiction.

Alternative Treatments- Alternative treatments such as acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation, etc. have proven to be successful in many patients.

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Latest advancements in spine surgery

As time is advancing, advancements in medical technology, especially neurosurgery have made the outcomes of said surgeries to be much more positive than they used to be. The innovation of new imaging techniques has helped neurosurgeons to view and diagnose the problem much more accurately. Similarly, the innovation of more precise surgical tools has made neurosurgeons more capable to treat patients without leaving them diabled or disfigured.

Dr. Arun Saoha, the best spine surgeon in Gurgaon, is an expert at all the following advanced spine surgery procedures.

Some of the most recent advancements in spine surgery are:

Cervical artificial disc replacement- the procedure involves the insertion of an artificial disc in the spine for treatment of cervical disc pathology, as a much more successful alternative to the traditional approach of anterior cervical discectomy and fusion (ACDF). The treatment has proved to be capable of standing the test of time and is rapidly gaining popularity among patients and surgeons.

Spinal fusion- Over time the outcomes of spinal fusion surgeries have become much better, with better fusion rates and less postop pain and complications. The surgeries have improved so much thanks to the advancement in less invasive approaches, bone grafting options and innovation of implants or cages that hold or fix the spine while it is healing.

Minimally invasive sacroiliac (SI) joint fusion- With the innovation of minimally invasive surgery, sacroiliac joint fusion for SI joint pain dysfunction has become much more commonplace due to less complications and better recovery times in the surgery.

Vertebral augmentation- vertebral trauma such as fracture due to osteoporosis or traumatic accidents can now be easily treated surgically, thanks to so many different treatment options such as vertebroplasty and kyphoplasty, as minimally invasive surgery. Prior to this patients with osteoporosis compression fractures did not have any true treatment options and could only try to manage their pain, but the introduction of vertebral augmentation procedure, it has quickly become a popular option among patients and surgeons for providing true pain relief to the patient.

While vertebroplasty is done to stabilize the fractured vertebra and its segments using bone cement, kyphoplasty is a much more advanced treatment option that uses an inflatable balloon catheter to help restore the height of vertebra in severe fractures with a lot of segments before stabilizing those segments with bone cement.

Even with all these advancements, spine surgeries still have quite a few risks. The best way to avoid these risks is to keep two fundamentals of spine treatment in mind:

Get an accurate preoperative diagnosis. It might be difficult to arrive at the most accurate point of problem when it comes to neck or back pain, but do not rush to surgery without making an accurate diagnosis. Get a second or a third opinion if your surgeon is unable to pinpoint your problem. An accurate diagnosis is very necessary for a good surgery outcome.

Choose the right surgeon for you. Look up their specialty, their expertise, experience, patient reviews etc. before getting surgery. Don’t rush.

Dr. Arun Saroha is the best spine surgeon in Delhi, with all the prerequisites for treating you. He has over 20 years of experience in neurosurgery with over 8000 successful procedures under his belt.

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What is the right time to start considering spine surgery?

Chronic back pain, i.e. back pain lasting over 3 months, is a debilitating condition for many people, making even small tasks such as walking a luxury to them. As such there is no shortage of people online boasting about one cure or another, peddling their own brand of treatment and tooting their own horn, without any scientific backing at all, many of them scamming desperate people with miracle cures for back pain. 

Not just that, even well meaning friends and relatives can come to you with all sorts of home remedies that worked for them but might not work for you. People that are just starting to have back pain are willing to try anything while those who have tried everything can be weary, just resigned to living with pain. A lot of these people opt for surgery when it becomes hard to even live with the pain for them, maybe due to a disability, disfigurement, worsening pain or severe lifestyle accommodations. 

Dr. Arun Saroha is a top spine surgeon in Gurgaon, practicing neurosurgery at Max Super Specialty Hospital in Gurgaon. He has over 20 years of experience with spine surgery and is extremely adept in providing treatment for all sorts of complex neurosurgical cases.

Over time a lot of people have started to see spine surgery for chronic back pain as an easy way out of back pain, where the patient is trying to get pain relief without doing any actual work. Well, that is a bunch of ballcap. Spine surgery is not easy or risk-proof. And even after the patient has endured all the risks he can, the surgery may not provide any relief from pain.

Even still spine surgery has given a renewed sense of hope to many people who had previously given up by restoring their lives. Spine surgery is not for everyone. Careful deliberation must be done by both the patient and the surgeon to decide whether the person can undergo surgery and whether their condition is treatable. For example, spine surgery \has in the past, proven successful in people suffering with degenerative spinal diseases and traumatic spine injuries.

Spine surgery in people without trauma is only considered as an option when all the other conservative treatment avenues have either completely failed or not been able to provide adequate pain relief to the patient.

Conservative treatment options that should be considered before spine surgery are physical therapy, epidural steroid injections, chiropractic treatments and medication therapy, etc. If all else has failed and the patient’s condition is still worsening to the point that they have become wheelchair bound or have garnered a physical disfigurement such as scoliosis or kyphosis due to the pain, surgery becomes the only option left to treat the patient.

Dr. Arun Saroha, spine surgeon in Gurgaon, is an expert neurosurgeon in all kinds of spine surgeries, including minimally invasive spine surgeries.

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Complications and Risks Associated with Brain Surgery and Recovery from it

Brain surgery is any surgical procedure that involves the nervous system, the brain, the spine and any other neuromuscular junctions. Just like any other invasive procedure, brain surgery has a lot of risks associated with it, despite all the progress that has been made in the field.

This is even more pronounced in cases of nerves because unlike the rest of the human body nerves do not repair or regenerate. This means that any nerve damage occurring due to any reason is permanent.

Dr. Arun Saroha, the best neurosurgeon in Gurgaon, is an expert neurosurgeon completely capable of mitigating all these side effects to help with the patient's recovery.

Some of the worst risks associated with brain surgery are:-

Bleeding- Brain surgery can lead to spontaneous uncontrollable bleeding in the brain that can be resolved easily if it occurs when the patient is in medical observation.

Allergic reactions- Sometimes the patient might show an allergic reaction to the anaesthesia during the surgery leading to them going in anaphylactic shock.

Blood clots- Brain surgery can cause thrombosis, otherwise known as blood clots, which when left unattended can lead to a brain stroke.

Brain swelling- Brain swelling can occur as a result of the surgical trauma or fluid buildup after an operation.

Coma- In case of an unsuccessful brain surgery, if the brain damage is too much, the patient may end up in a permanently vegetive state known as a coma.

Infection- Infection around the surgical site is a very common side effect of any surgery and can cause further harm such as swelling, nerve damage, etc.

Amnesia- Nerve damage during brain surgery can result in short or long term memory damage.

Impairment of bodily functions- Since the nervous system controls the sensory and motor functions of our body, any brain damage can lead to permanent speech, vision and motor coordination dysfunction.

Seizures- Seizures are a common brain surgery side effect caused due to damage to the nerve centres.

Recovery from surgery can be aided by:-

Patients must remain for post-op monitoring under expert care at the hospital for at least a week, less for endoscopic surgeries, after a brain surgery. This is important to ensure that the patient does not have any side effects from the surgery and that their recovery is happening steadily.

The patient must make some active lifestyle changes to reduce their stress, such as reduced alcohol consumption and an easier workload, accompanied by light exercise and a balanced diet, to boost their immune system.

The patient must also undergo physiotherapy or speech therapy, with psychological therapy, if their surgeon feels that they need it.

Overall, it is very difficult to anticipate how somebody’s brain would react to a trauma and help them recover. Even with all the advancements in medicine such as precision tools and imaging techniques, surgeries have only become safer, but not completely risk-free. Anyone undergoing the surgery must be completely aware of the risks that are associated with the procedure, even if the best brain tumor surgeon in Gurgaon, Dr. Arun Saroha, is the person performing the procedure.

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The Basics of Brain Surgery

Neurosurgery or brain surgery is a surgical procedure that is conducted on the brain or the structures surrounding it to correct any abnormalities like tumors or aneurysms. It is a very complex procedure that is performed by expertly trained neurosurgeons in a very specialized environment. Although a very risky endeavor, brain surgery has become much more common after the technological advancements in medicine such as precision techniques, imaging techniques, etc. all this has made many disorders which were previously considered to be inoperable or untreatable due to structure and placement of the abnormality, the health of the patient vs the severity of the issue, etc. to be much more accessible and treatable .Dr. Arun Saroha is the best neurosurgeon in Gurgaon, for his excellent skills in diagnosing and treating all kinds of neurological conditions.

What are the indications for brain surgery?

Brain surgery is generally performed in case of:

Aneurysm so that the surgeon can prevent bleeding inside the brain

Brain tumor for partial or complete removal of any tumor inside the brain

Severe pain to relieve the pain that is being caused due to the pinching of a nerve

Trauma to relieve pressure from the brain being caused due to any abscess or blood that needs to be drained

What are the structural or congenital abnormalities that require brain surgery?

Structural anomalies that require brain surgery are:-

Congenital defects like malformation of blood vessels leading to cross-connection between veins and arteries in the brain

Rupture of an aneurysm causing bleeding in the brain

Blood clot formation in the brain as a result of trauma

Epidural or subdural hematomas

Brain edema due to fluid buildup causing swelling in the brain accompanied by severe recurring headaches

Brain tumors

Epilepsy being caused due to structural damage in the brain

Neuropathic pain due to stroke, tumor or accident

Abscess in the brain

Parkinson's disease

What are the different types of brain surgery?

Brain Biopsy- A biopsy is a procedure where a small tissue is removed from the brain to study it to diagnose the nature of the tumor or abnormality.

Craniotomy- A craniotomy is generally done in cases such as aneurysms, abscess, etc. where the surgeon is required to drain fluid from the brain by drilling a hole in the brain.

Neuroendoscopy- it is a minimally invasive procedure that  is performed to remove tumors that are easily accessible through small holes in the cranium, from which endoscopes can be inserted.

Deep brain stimulation- deep brain surgery involves the stimulation of nerve impulses in the patient’s brain with strategic electrode placement in neurodegenerative disorders such as Parkinson's disease, tremors and epilepsy.

Endonasal endoscopic surgery- in this surgery, an endoscope is inserted through the nose to remove tumors in the frontal regions of the brain.

Awake brain surgery- this procedure is carried out under local anesthesia while the patient is still awake to check the patient’s impulses in different areas of the brain during the surgery.

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How to Know When It’s Time for Spine Surgery by spine surgeon Gurgaon

Back pain can not be dismissed, as someone who has had it will tell you. It affects individuals differently, and it sometimes resolves on its own through non-surgical diagnosis and treatment. But what if it's a back injury that doesn't improve with rest and time? Is this a sign that you'll need spine surgery? How can you be sure in this case? Call us and schedule your appointment with Dr Arun who is the spine surgeon in Gurgaon.

Several Signs it’s Time to Consider Spine Surgery Your spine may be affected by a variety of illnesses, diseases, or accidents. Since the spine is linked to many of the muscle groups in the body, spinal disorders can affect almost every part of the body. Also mild spine issues can have a significant effect on your quality of life. If your spinal issues are serious, you can need surgery to fix them. Schedule your appointment for spine surgery with Dr Arun who is the top spine surgeon in Gurgaon.

When Do I Think About Surgery? Any surgery carries the risk of complications. You can only undergo surgery if the benefits outweigh the risks. In patients with serious spine injury, surgery may be the only, if not the only, viable choice for recovery.

You are unable to function normally. You should begin to lose some mobility as your body ages. However, if your spinal problems prevent you from working normally, this may be a sign of more serious issues. If this is the case, proper care will help to alleviate these issues.

Your Life Quality Is Affected Spinal problems can greatly limit the ability to engage in life by causing pain and decreased function. If your spinal issues are interfering with your quality of life, it is time to consult a professional.

Other Techniques Have Failed Few doctors would prescribe spinal surgery until all nonsurgical options had been exhausted. If you've tried nonsurgical therapies and your condition isn't improving, surgery might be necessary.

You've Sustained a Serious Injury Most of the time, you have enough time to assess your medical choices and make an educated decision about spinal surgery. Where possible, most physicians and patients would like to postpone surgery, although this is not always possible. In cases of serious injury, patients may undergo emergency spinal surgery.

Your condition is declining fast. Progressive spinal disorders, such as osteoporosis, deteriorate over time. If you have a progressive illness, you can see a doctor on a regular basis and have your condition monitored. Be sure to explore the potential care options, including surgery, during these appointments. When and if the condition suddenly deteriorates, you will be able to make an informed decision based on the facts.

You have a physical deformity.

Many spinal deformities, such as scoliosis and kyphosis, require excessive spine curvatures. Physical therapy and braces are often used to treat these disorders in their early stages. If the condition has progressed too far, surgery may be required.

You Experience Symptoms of Nerve Damage If your spinal problems cause nerve damage, you could end up permanently disabled. Common symptoms of nerve damage include tingling and numbness in the legs. If you are experiencing severe symptoms such as bladder or bowel incontinence, you should consult a specialist as soon as possible.

SOME OF BACK PAIN DOES NOT REQUIRE SURGERY. If you have back pain that does not go away after a few weeks, make an appointment with your family doctor or primary care physician for an examination. An x-ray and/or an MRI scan can also be used to test the spinal anatomy, including the bones or vertebrae for alignment, the intervertebral discs for degeneration and herniation, and the facet joints for arthritis. Non-surgical treatment is normally attempted first, based on clinical and imaging results, and can include medications, physical therapy, at-home workouts, and spinal injections.

SIGNS FOR BACK SURGERY

Some indicators that it is time to suggest spine surgery include:

Pain that is both chronic and progressive. If the pain from a back condition lasts more than a few months and/or appears to be getting worse.

Numbness, tingling, and fatigue are all symptoms of nerve damage. Compressed nerves in the spine are often the source of numbness, tingling, and/or weakness in areas such as the arms or legs. Nerve compression may occur for a variety of causes, including a herniated disc or bone spurs.

Problems with the bladder or bowels. Back pain may also be accompanied by bladder or bowel problems caused by pressure on the nerves that provide function to the bladder and bowel. This may be the result of a disc herniation or spinal stenosis.

A spinal degenerative disease. Degenerative conditions such as spinal stenosis or spinal arthritis may cause back pain. On imaging tests, this can appear as spinal deformity and/or spinal instability.

Reduced quality of life. Pain and lack of mobility can have a huge effect on how one performs on a daily basis, as well as one's overall quality of life. If your back issues are restricting your ability to participate in daily life, surgery could be an option to explore.

When do you contact a spine surgeon?

If the pain persists and your doctor has confirmed the diagnosis through imaging (X-ray or MRI), you can consult with a Spine Surgeon such as a Neurosurgeon. Speaking with a surgeon does not imply that you are agreeing to surgery. It's basically an opportunity to learn more about your choices for finding relief. Schedule your appointment for spine surgery with Dr Arun who is the top spine surgeon in Gurgaon.

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What is lumbar disc disease by neurosurgeon in gurgaon

The majority of disc herniations occur in the lower lumbar spine, especially between the fourth and fifth lumbar vertebrae and the fifth lumbar vertebra and the first sacral vertebra (the L4-5 and L5-S1 levels). Call us and schedule your appointment with Dr Arun who is the neurosurgeon in Gurgaon.

The vertebral column, also known as the backbone, is made up of 33 vertebrae separated by spongy discs. The spine is divided into four sections:

The cervical spine is made up of three parts: The first seven vertebrae of the neck

The thoracic spine: The following 12 vertebrae are found in the chest section.

Lumbar spine: The following five vertebrae are found in the lower back.

Sacral spine: The lowest five vertebrae, situated below the hip, also include the four vertebrae that comprise the tailbone.

The lumbar spine consists of 5 bony segments in the lower back area, which is where lumbar disk disease occurs.

Disk bulge. The intervertebral disc can lose fluid and become dried out as it ages. As a result, the spongy disc becomes compressed. This might cause the tough outer ring to fail. This allows the nucleus, or the inside of the ring, to protrude. This is known as a bulging disc.

Disk rupture or herniation The inner nucleus pulposus can rupture from the annulus as the disc continues to degrade or as the spine is subjected to further stress. This is a herniated or ruptured disc. The disc material fragments will then push on the nerve roots located just behind the disc space. This may result in discomfort, fatigue, numbness, or sensation changes.

What causes lumbar disk disease?

Lumbar disc disease is caused by a change in the normal disk's structure. The majority of the time, disc disease occurs as a result of age and the natural breakdown of the disc. A normal disc will herniate as a result of a serious injury. Injury can also aggravate an already herniated disc.

What are the effects of lumbar disc disease? While age is the most common risk factor, physical inactivity can lead to poor back and abdominal muscles, which may not properly support the spine. Back injuries are often more common when people who are not usually physically involved engage in strenuous activities. Back injuries can also be caused by jobs that involve hard lifting and twisting of the spine.

What do the signs of lumbar disc disease look like?

Symptoms of lumbar disc disease differ depending on where the disc has herniated and which nerve root it is pressing on. The following are the most common lumbar disc disease symptoms:

Back pain that comes and goes. Movement, coughing, sneezing, or standing for long periods of time will aggravate this.

Muscle spasms in the back

Sciatica is a form of pain that begins in the lower back or buttock and spreads down the leg to the calf or into the foot.

Leg muscle weakness

Numbness in the limbs or feet

Reflexes at the knee or ankle are impaired.

Changes in bowel or bladder function

The symptoms of lumbar disc disease may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.For appointment call us and get your appointment with Dr Arun who is the neurosurgeon in max gurgaon.

How is lumbar disk disease diagnosed?

In addition to a complete medical history and physical exam, you may have one or more of the following tests:

An X-ray is a form of radiography. A test that uses intangible electromagnetic energy beams to create images on film of internal tissues, bones, and organs.

MRI stands for magnetic resonance imaging (MRI). A technique that produces accurate images of organs and structures inside the body by combining large magnets, radiofrequencies, and a computer.

A myelogram is a form of electroencephalogram. A technique in which dye is pumped into the spinal canal to make the structure transparent on X-rays.

CT scan (computed tomography) (also called a CT or CAT scan). A medical imaging technique that employs X-rays and computer technology to create horizontal, or axial, images (often referred to as slices) of the body. A CT scan provides clear photographs of every portion of the body, such as the bones, muscles, fat, and organs. CT scans have more information than standard X-rays.

Electromyography is a form of electromyography (EMG). A test that tests muscle reaction or electrical activity as a result of nerve stimulation of the muscle.

What is the treatment for lumbar disc disease?

Conservative therapy is typically used as the first line of treatment for lumbar disc disease. This may involve a combination of the following:

Rest

Proper body mechanics education (to help decrease the chance of worsening pain or damage to the disk)

Ultrasound, massage, conditioning, and fitness plans are all examples of physical therapy.

Weight management

Utilization of a lumbosacral back assist

Pain relievers and muscle relaxants

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