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Ailmemts & Remedies

Haemospermia (Blood in the Semen)

Definition:
When semen changes from its usual cream-white colour to white with ‘a hint of pink’, or is bloodstained, it’s called haemospermia, which simply means blood in the semen. The semen can also appear brownish-red in colour. Whatever the shade, it isn’t normal and means something is not right and should be checked out.

One problem with haemospermia is that it invariably causes men great anxiety. Another problem is that the cause often remains unknown.

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Hematospermia (haematospermia), (or Hemospermia, haemospermia) or the presence of blood in semen, is most often a benign and idiopathic symptom, but can sometimes result from medical problems such as a urethral stricture, infection of the prostate, or a congenital bleeding disorder, and can occur transiently after surgical procedures such as a prostate biopsy. It is present in less than 2% of urology referrals, although prevalence in the overall population is unknown.

Patients with hematospermia should be evaluated by a urologist to identify or rule out medical causes. Idiopathic hematospermia is sometimes treated with tetracycline and prostatic massage.

Causes/Risk Factors
Haemospermia most commonly affects men in their 30s, although it’s by no means exclusive to this age group.

It’s not always possible to prevent it from occurring, but if the cause can be found then taking care to avoid such triggers can result in fewer sleepless nights.

Most commonly, haemospermia is a consequence of non-specific inflammation of the urethra (the tube urine passes through), prostate and/or seminal vesicles. That is, inflammation anywhere along the path semen follows when leaving the body.

Other possible causes include:
•Minor trauma – the result of vigorous sexual activity, for example, or a trouser-zip accident.
•Infections of the genital tract ­ this is usually accompanied by other symptoms, including pain on urination, scrotal tenderness or swelling, groin tenderness or aching, pain on ejaculation, low back pain, fever or chills.
•Biopsy of the prostate gland, where seminal fluid is manufactured.
•In rare instances, haemospermia is secondary to cancer.
For most men, haemospermia is a one-off event. For some, though, the problem is a recurrent one for which a cause cannot be identified, despite full and thorough investigation.

Diagnosis:
This disease generally affects men after their 30s though it can not be confirmed that men of other age group are not at risk. It cannot be prevented from happening always but if the cause is detected  preventive measures can be taken easily.

If the underline cause is found by the doctor,such as an inflamation or an infection,he can prescribe proper medicine

Treatment/Recovery
It may necessary to refer a man with haemospermia to the local hospital urology service where a number of tests such as laboratory examination of urine and semen, ultrasound or CT scans, or even a cystourethroscopy (a telescopic examination of the inside of the urinary tract under anaesthetic) may be recommended in order to check the diagnosis.

Fortunately, in the majority of cases haemospermia is benign and self-limiting, so no specific treatment is required other than a large dose of reassurance and advice about safer practices.

Where an underlying cause is identified – for example, infection or inflammation – specific treatment can be provided. This may involve a course of antibiotics or anti-inflammatory medication.

Advice :
The treatment is not always gaurantee  that the condition will not reappear.If the ailment is caused by some blood related problems then treating that may give better results. It is always advicible for men who have suffered from this disease  to monitor their semen  for any further occurance of bleeding.They should remember various factors as time of blood appear in their semen and they should keep count of times  they had sex  recently. They also need to be cautioned about STD and make their urine routine check.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:

http://en.wikipedia.org/wiki/Hematospermia
http://www.ayushveda.com/healthcare/haemospermia-blood-in-the-semen.htm
http://www.bbc.co.uk/health/physical_health/conditions/haemospermia1.shtml

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Ailmemts & Remedies Pediatric

Concussion

Alternative Names :Mild brain injury, Mild traumatic brain injury (MTBI), mild head injury (MHI), minor head trauma

Definition:
A concussion is a traumatic brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally.Effects are usually temporary, but can include problems with headache, concentration, memory, judgment, balance and coordination.

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Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. These injuries can cause a loss of consciousness, but most concussions do not. Because of this, some people have concussions and don’t realize it.

Concussions are common, particularly if you play a contact sport, such as football, boxing etc. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Luckily, most concussive traumatic brain injuries are mild, and with rest, most people fully recover from concussions within a few hours to a few weeks.

On rare occasions, concussions cause more serious problems. Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of permanent brain problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

Symptoms:
It is not always easy to know if someone has a concussion. Not everyone who has a concussion passes out. A person who might have a concussion should immediately stop any kind of activity or sport. Becoming active again before the brain returns to normal functioning increases the person’s risk of having a more serious brain injury.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion include:
*Passing out.
*Not being able to remember what happened after the injury.
*Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
*Feeling lightheaded, seeing “stars,” having blurry vision, or experiencing ringing in the ears.
*Not being able to stand or walk; or having coordination and balance problems.
*Feeling nauseous or throwing up.

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can’t readily communicate how they feel. Nonverbal clues of a concussion may include:
*Listlessness, tiring easily
*Irritability, crankiness
*Change in eating or sleeping patterns
*Lack of interest in favorite toys
*Loss of balance, unsteady walking

Occasionally a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:

*Changes in your ability to think, concentrate, or remember.
*Headaches or blurry vision.
*Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
*Changes in your personality such as becoming angry or anxious for no clear reason.
*Lack of interest in your usual activities.
*Changes in your sex drive.
*Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

Causes:
Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit unexpectedly hard, your brain can suddenly crash into your skull and temporarily stop working normally.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen while participating in rough or high-speed sports such as football, boxing, hockey, soccer, skiing, or snowboarding.

Risk Factors:
Factors that may increase your risk of a concussion include:

*Participating in a high risk sport, such as football, hockey, soccer or other contact sport; the risk is further increased if there’s a lack of proper safety equipment and supervision
*Being involved in a motor vehicle collision
*Being a soldier involved in combat
*Being a victim of physical abuse
*Falling, especially in young children and older adults
*Having had a previous concussion

Complications:
Potential complications of concussion include:

*Epilepsy. People who have had a concussion double their risk of developing epilepsy within the first five years after the injury.

*Cumulative effects of multiple brain injuries. Evidence exists indicating that people who have had multiple concussive brain injuries over the course of their lives may acquire lasting, and even progressive, cognitive impairment that limits functional ability.

*Second impact syndrome. Sometimes, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and typically fatal brain swelling. After a concussion, the levels of brain chemicals are altered. It usually takes about a week for these levels to stabilize again. However, the time it takes to recover from a concussion is variable, and it is important for athletes never to return to sports while they’re still experiencing signs and symptoms of concussion.
Diagnosis:
Diagnosis of Concussion is based on physical and neurological exams, duration of unconsciousness (usually less than 30 minutes) and post-traumatic amnesia (PTA; usually less than 24 hours), and the Glasgow Coma Scale (MTBI sufferers have scores of 13 to 15). Neuropsychological tests exist to measure cognitive function. The tests may be administered hours, days, or weeks after the injury, or at different times to determine whether there is a trend in the patient’s condition. Athletes may be tested before a sports season begins to provide a baseline comparison in the event of an injury.

Health care providers examine head trauma survivors to ensure that the injury is not a more severe medical emergency such as an intracranial hemorrhage. Indications that screening for more serious injury is needed include worsening of symptoms such as headache, persistent vomiting, increasing disorientation or a deteriorating level of consciousness,   seizures, and unequal pupil size. People with such symptoms, or who are at higher risk for a more serious brain injury, are CT scanned to detect brain lesions and are frequently observed for 24 – 48 hours.

If the Glasgow Coma Scale is less than 15 at two hours or less than 14 at any time a CT recommended.[8] In addition, they may be more likely to perform a CT scan on people who would be difficult to observe after discharge or those who are intoxicated, at risk for bleeding, older than 60, or younger than 16. Most concussions cannot be detected with MRI or CT scans.   However, changes have been reported to show up on MRI and SPECT imaging in concussed people with normal CT scans, and post-concussion syndrome may be associated with abnormalities visible on SPECT and PET scans. Mild head injury may or may not produce abnormal EEG readings.

Concussion may be under-diagnosed. The lack of the highly noticeable signs and symptoms that are frequently present in other forms of head injury could lead clinicians to miss the injury, and athletes may cover up their injuries to remain in the competition. A retrospective survey in 2005 found that more than 88% of concussions go unrecognized;.

Diagnosis of concussion can be complicated because it shares symptoms with other conditions. For example, post-concussion symptoms such as cognitive problems may be misattributed to brain injury when they are in fact due to post-traumatic stress disorder (PTSD).

Treatment:
Usually concussion symptoms go away without treatment, and no specific treatment exists. About one percent of people who receive treatment for MTBI need surgery for a brain injury. Traditionally, concussion sufferers are prescribed rest, including plenty of sleep at night plus rest during the day. Health care providers recommend a gradual return to normal activities at a pace that does not cause symptoms to worsen. Education about symptoms, how to manage them, and their normal time course can lead to an improved outcome.

Medications may be prescribed to treat symptoms such as sleep problems and depression. Analgesics such as ibuprofen can be taken for the headaches that frequently occur after concussion, but paracetamol (acetaminophen) is preferred to minimize the risk for complications such as intracranial hemorrhage. Concussed individuals are advised not to drink alcohol or take drugs that have not been approved by a doctor, as they could impede healing.

Observation to monitor for worsening condition is an important part of treatment. Health care providers recommend that those suffering from concussion return for further medical care and evaluation 24 to 72 hours after the concussive event if the symptoms worsen. Athletes, especially intercollegiate or professional athletes, are typically followed closely by team trainers during this period. But others may not have access to this level of health care and may be sent home with no medical person monitoring them unless the situation gets worse. Patients may be released from the hospital to the care of a trusted person with orders to return if they display worsening symptoms or those that might indicate an emergent condition, like unconsciousness or altered mental status; convulsions; severe, persistent headache; extremity weakness; vomiting; or new bleeding or deafness in either or both ears. Repeated observation for the first 24 hours after concussion is recommended; however it is not known whether it is necessary to wake the patient up every few hours.

Prognosis:
Concussion has a mortality rate of almost zero. The symptoms of most concussions resolve within weeks, but problems may persist. Problems are seldom permanent, and outcome is usually excellent. People over age 55 may take longer to heal from MTBI or may heal incompletely. Similarly, factors such as a previous head injury or a coexisting medical condition have been found to predict longer-lasting post-concussion symptoms. Other factors that may lengthen recovery time after MTBI include psychological problems such as substance abuse or clinical depression, poor health before the injury or additional injuries sustained during it, and life stress.  Longer periods of amnesia or loss of consciousness immediately after the injury may indicate longer recovery times from residual symptoms. For unknown reasons, having had one concussion significantly increases a person’s risk of having another. Having previously sustained a sports concussion has been found to be a strong factor increasing the likelihood of a concussion in the future. Other strong factors include participation in a contact sport and body mass size. The prognosis may differ between concussed adults and children; little research has been done on concussion in the pediatric population, but concern exists that severe concussions could interfere with brain development in children.

A 2009 study published in Brain found that individuals with a history of concussions might demonstrate a decline in both physical and mental performance for longer than 30 years. Compared to their peers with no history of brain trauma, sufferers of concussion exhibited effects including loss of episodic memory and reduced muscle speed.

Prevention:
The following tips may help you to prevent or minimize your risk of head injury:

*Wear appropriate protective gear during sports and other recreational activities. Always use the appropriate protective gear for any sport you or your child undertakes. Make sure the equipment fits properly, is well maintained and worn correctly. Follow the rules of the game and practice good sportsmanship. When bicycling, motorcycling, snowboarding or engaging in any recreational activity that may result in head injury, wear protective headgear.

*Buckle your seat belt. Wearing a seat belt may prevent serious injury, including an injury to your head, during a traffic accident.

*Make your home safe. Keep your home well lit and your floors free of clutter — meaning anything that might cause you to trip and fall. Falls around the home are the leading cause of head injury for infants, toddlers and older adults.

*Protect your children. To help lessen the risk of head injuries to your children, pad countertops and edges of tables, block off stairways and install window guards. Don’t let your children play sports that aren’t suitable for their ages.

*Use caution in and around swimming areas. Don’t dive into water less than 9 feet (3 meters) deep. Read and follow posted safety rules at water parks and swimming pools.

*Wear sensible shoes. If you’re older, wear shoes that are easy to walk and maneuver in. Avoid wearing high heels, sandals with thin straps, or shoes that are either too slippery or too sticky.

Prevention of  Concussion  involves taking general measures to prevent traumatic brain injury, such as wearing seat belts and using airbags in cars. Older people are encouraged to try to prevent falls, for example by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance.

Use of protective equipment such as headgear has been found to reduce the number of concussions in athletes. Improvements in the design of protective athletic gear such as helmets may decrease the number and severity of such injuries. New “Head Impact Telemetry System” technology is being placed in helmets to study injury mechanisms and potentially help reduce the risk of concussions among American Football players. Changes to the rules or the practices of enforcing existing rules in sports, such as those against “head-down tackling”, or “spearing,” which is associated with a high injury rate, may also prevent concussions.

Post-concussion syndrome:
In post-concussion syndrome, symptoms do not resolve for weeks, months, or years after a concussion, and may occasionally be permanent. Symptoms may include headaches, dizziness, fatigue, anxiety, memory and attention problems, sleep problems, and irritability. There is no scientifically established treatment, and rest, a recommended recovery technique, has limited effectiveness. Symptoms usually go away on their own within months. The question of whether the syndrome is due to structural damage or other factors such as psychological ones, or a combination of these, has long been the subject of debate.

Cumulative effects:
Cumulative effects of concussions are poorly understood. The severity of concussions and their symptoms may worsen with successive injuries, even if a subsequent injury occurs months or years after an initial one. Symptoms may be more severe and changes in neurophysiology can occur with the third and subsequent concussions. Studies have had conflicting findings on whether athletes have longer recovery times after repeat concussions and whether cumulative effects such as impairment in cognition and memory occur.

Cumulative effects may include psychiatric disorders and loss of long-term memory. For example, the risk of developing clinical depression has been found to be significantly greater for retired American football players with a history of three or more concussions than for those with no concussion history.[74] Three or more concussions is also associated with a fivefold greater chance of developing Alzheimer’s disease earlier and a threefold greater chance of developing memory deficits.

Dementia pugilistica:
Chronic encephalopathy is an example of the cumulative damage that can occur as the result of multiple concussions or less severe blows to the head. The condition called dementia pugilistica, or “punch drunk” syndrome, which is associated with boxers, can result in cognitive and physical deficits such as parkinsonism, speech and memory problems, slowed mental processing, tremor, and inappropriate behavior. It shares features with Alzheimer’s disease.

Second-impact syndrome:
Second-impact syndrome, in which the brain swells dangerously after a minor blow, may occur in very rare cases. The condition may develop in people who receive a second blow days or weeks after an initial concussion, before its symptoms have gone away. No one is certain of the cause of this often fatal complication, but it is commonly thought that the swelling occurs because the brain’s arterioles lose the ability to regulate their diameter, causing a loss of control over cerebral blood flow.  As the brain swells, intracranial pressure rapidly rises. The brain can herniate, and the brain stem can fail within five minutes. Except in boxing, all cases have occurred in athletes under age 20. Due to the very small number of documented cases, the diagnosis is controversial, and doubt exists about its validity.

Epidemiology:
Most cases of traumatic brain injury are concussions. A World Health Organization (WHO) study estimated that between 70 and 90% of head injuries that receive treatment are mild. However, due to underreporting and to the widely varying definitions of concussion and MTBI, it is difficult to estimate how common the condition is. Estimates of the incidence of concussion may be artificially low, for example due to underreporting. At least 25% of MTBI sufferers fail to get assessed by a medical professional. The WHO group reviewed studies on the epidemiology of MTBI and found a hospital treatment rate of 1–3 per 1000 people, but since not all concussions are treated in hospitals, they estimated that the rate per year in the general population is over 6 per 1000 people.

Young children have the highest concussion rate among all age groups. However, most people who suffer concussion are young adults. A Canadian study found that the yearly incidence of MTBI is lower in older age groups (graph at right). Studies suggest males suffer MTBI at about twice the rate of their female counterparts. However, female athletes may be at a higher risk for suffering concussion than their male counterparts.

Up to five percent of sports injuries are concussions. The U.S. Centers for Disease Control and Prevention estimates that 300,000 sports-related concussions occur yearly in the U.S., but that number includes only athletes who lost consciousness.  Since loss of consciousness is thought to occur in less than 10% of concussions, the CDC estimate is likely lower than the real number. Sports in which concussion is particularly common include football and boxing (a boxer aims to “knock out”, i.e. give a mild traumatic brain injury to, the opponent). The injury is so common in the latter that several medical groups have called for a ban on the sport, including the American Academy of Neurology, the World Medical Association, and the medical associations of the UK, the U.S., Australia, and Canada.

Due to the lack of a consistent definition, the economic costs of MTBI are not known, but they are estimated to be very high. These high costs are due in part to the large percentage of hospital admissions for head injury that are due to mild head trauma, but indirect costs such as lost work time and early retirement account for the bulk of the costs. These direct and indirect costs cause the expense of mild brain trauma to rival that of moderate and severe head injuries.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/concussion1.shtml
http://en.wikipedia.org/wiki/Concussion
http://www.mayoclinic.com/health/concussion/DS00320
http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview?page=2

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Brain Cancer

Animation of an MRI brain scan, starting at th...
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Alternative Names:Glioma, Meningioma

Definition:
Brain cancer is a disease of the brain in which cancer cells (malignant) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions.

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There are more than 100 different types of brain tumour, depending on which cells within the brain are involved. The most common (about 50 per cent of brain cancers) is called a glioma, and it is formed not from the nerve cells of the brain but from the glial cells, which support those nerves. The most aggressive form of glioma is known as a glioblastoma multiforme – these tumours form branches like a tree reaching out through the brain and may be impossible to completely remove.

Other tumours include:
*Meningiomas – account for about a quarter of brain cancers and are formed from cells in the membranes, or meninges, that cover the brain

*Pituitary adenomas – tumours of the hormone-producing pituitary gland

*Acoustic neuromas – typically slow-growing tumours of the hearing nerve often found in older people

*Craniopharyngioma and ependymomas – often found in younger people

The treatment and outlook for these different brain tumours varies hugely. Some, such as meningiomas and pituitary tumours, are usually (but not always) benign, which means they don’t spread through the brain or elsewhere in the body. However, they can still cause problems as they expand within the skull, compressing vital parts of the brain. Other types of brain cancer are malignant, spreading through the tissues and returning after treatment.

Brain tumours are also graded in terms of how aggressive, abnormal or fast-growing the cells are. Exactly where the tumour forms is also critical, as some areas of the brain are much easier to operate on than others, where important structures are packed closely together.

Causes:
The cause of brain cancer  remains a mystery, but some risk factors are known. These include:

*Age – different tumours tend to occur at different ages. About 300 children are diagnosed with brain tumours every year, and these are often a type called primitive neuroectodermal tumours (PNETs), which form from very basic cells left behind by the developing embryo. PNETs usually develop at the back of the brain in the cerebellum

*Genetics – as many as five per cent of brain tumours occur as part of an inherited condition, such as neurofibromatosis

*Exposure to ionising radiation – such as radiotherapy treatment at a young age

*Altered immunity – a weakened immunity has been linked to a type of tumour called a lymphoma, while autoimmune disease and allergy seem to slightly reduce the risk of brain tumours

*Environmental pollutants – many people worry that chemicals in the environment (such as from rubber, petrol and many manufacturing industries) can increase the risk of brain cancers, but research has so far failed to prove a link with any degree of certainty. Neither is there clear and irrefutable evidence for risk from mobile phones, electricity power lines or viral infections, although research is ongoing.

Symptoms:
The symptoms and signs of a brain tumour fall into two categories.

Those caused by damage or disruption of particular nerves or areas of the brain. Symptoms will depend on the location of the tumour and may include:

*Weakness or tremor of certain parts of the body

*Difficulty writing, drawing or walking

*Changes in vision or other senses

*Changes in mood, behaviour or mental abilities

Those caused by increased pressure within the skull – these are general to many types of tumour and may include:

*Headache (typically occurring on waking or getting up)

*Irritability

*Nausea and vomiting

*Seizures

*Drowsiness

*Coma

*Changes in your ability to talk, hear or see

*Problems with balance or walking

*Problems with thinking or memory

*Muscle jerking or twitching

*Numbness or tingling in arms or legs

Diagnosis:
The initial test is an interview that includes a medical history and physical examination of the person by a health-care provider.If he or she  suspects a brain tumour, you should be referred to a specialist within two weeks. Tests are likely to include blood tests and the most frequently used test to detect brain cancer is a CT scan (computerized tomography). This test resembles a series of X-rays and is not painful, although sometimes a dye needs to be injected into a vein for better images of some internal brain structures.

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Another test that is gaining popularity because of its high sensitivity for detecting anatomic changes in the brain is MRI (magnetic resonance imaging). This test also resembles a series of X-rays and shows the brain structures in detail better than CT. MRI is not as widely available as CT scanning. If the tests show evidence (tumors or abnormalities in the brain tissue) of brain cancer, then other doctors such as neurosurgeons and neurologists that specialize in treating brain ailments will be consulted to help determine what should be done to treat the patient. Occasionally, a tissue sample (biopsy) may be obtained by surgery or insertion of a needle to help determine the diagnosis. Other tests (white blood cell counts, electrolytes, or examination of cerebrospinal fluid to detect abnormal cells or increased intracranial pressure) may be ordered by the health-care practitioner to help determine the patient’s state of health or to detect other health problems.

Treatment:
The type of treatment offered and the likely response depends on the type, grade and location of the tumour. Unlike many other organs, it’s very difficult to remove parts of the brain without causing massive disruption to the control of body functions, so a cancer near a vital part of the brain may be particularly difficult to remove.

The main treatments for brain tumours include:

*Surgery – to remove all or part of the tumour, or to reduce pressure within the skull

*Radiotherapy – some brain cancers are sensitive to radiotherapy. Newer treatments (stereotactic radiotherapy and radiosurgery) carefully target maximum doses to small areas of the tumour, avoiding healthy brain tissue.

*Chemotherapy – these treatments are limited by the fact that many drugs cannot pass from the bloodstream into brain tissue because of the ‘blood-brain barrier’, but may be useful when tumours are difficult to operate on, or have advanced or returned.

*Biological’ therapies – for example, drugs that block the chemicals that stimulate growth of tumour cells

*Steroids – can help to reduce swelling of the brain and decrease pressure in the skull
Often a combination of treatments will be recommended.

While, as a general rule, brain tumours are difficult to treat and tend to have a limited response, it can be very misleading to give overall survival figures because some brain cancers are easily removed with little long term damage, while others are rapidly progressive and respond poorly to any treatment.

While only about 14 per cent of people diagnosed with a brain tumour are still alive more than five years later, this sombre statistic could be unnecessarily worrying for a person with a small benign brain tumour. What a person diagnosed with brain cancer needs to know will be the outlook for their individual situation, which only their own doctor can tell them.

Treatments do continue to improve – for example, survival rates for young children have doubled over the past few decades, and many new developments are being tested.

Other treatments may include hyperthermia (heat treatments), immunotherapy (immune cells directed to kill certain cancer cell types), or steroids to reduce inflammation and brain swelling. These may be added on to other treatment plans.

Clinical trials (treatment plans designed by scientists to try new chemicals or treatment methods on patients) can be another way for patients to obtain treatment specifically for their cancer cell type. Clinical trials are part of the research efforts to produce better treatments for all disease types. The best treatment for brain cancer is designed by the team of cancer specialists in conjunction with the wishes of the patient.

Prognosis:
Survival of treated brain cancer varies with the cancer type, location, and overall age and general health of the patient. In general, most treatment plans seldom result in a cure. Reports of survival greater that five years (which is considered to be long-term survival), vary from less than 10% to a high of 32%, no matter what treatment plan is used.

So, why use any treatment plan? Without treatment, brain cancers are usually aggressive and result in death within a short time span. Treatment plans can prolong survival and can improve the patient’s quality of life for some time. Again, the patient and caregivers should discuss the prognosis when deciding on treatment plans.

Living with Brain Cancer:
Discuss your concerns openly with your doctors and family members. It is common for brain cancer patients to be concerned about how they can continue to lead their lives as normally as possible; it is also common for them to become anxious, depressed, and angry. Most people cope better when they discuss their concerns and feelings. Although some patients can do this with friends and relatives, others find solace in support groups (people who have brain cancer and are willing to discuss their experiences with other patients) composed of people who have experienced similar situations and feelings. The patient’s treatment team of doctors should be able to connect patients with support groups. In addition, information about local support groups is available from the American Cancer Society at http://www.cancer.org/docroot/home/index.asp.

Prevention:
Although there is no way to prevent brain cancers, early diagnosis and treatment of tumors that tend to metastasize to the brain may reduce the risk of metastatic brain tumors. The following factors have been suggested as possible risk factors for primary brain tumors: radiation to the head, HIV infection, and environmental toxins. However, no one knows the exact causes that initiate brain cancer, especially primary brain cancer, so specific preventive measures are not known. Although Web sites and popular press articles suggest that macrobiotic diets, not using cell phones, and other methods will help prevent brain cancer, there is no reliable data to support these claims.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/brain_cancer/page5.htm
http://www.nlm.nih.gov/medlineplus/braincancer.html
http://commons.wikimedia.org/wiki/File:MRI_head_side.jpg

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Brain aneurysm

Definition:
Brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.Brain aneurysms are like tiny blisters or balloons on the surface of the arteries running through the brain. The outer wall of the vessel has a weakness, and the inner lining (like the inner tube of a tyre) bulges out. In 15 per cent of cases there are multiple aneurysms on different arteries around the brain.

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A common location of brain aneurysms is on the arteries at the base of the brain, known as the Circle of Willis. Approximately 85% of cerebral aneurysms develop in the anterior part of the Circle of Willis, and involve the internal carotid arteries and their major branches that supply the anterior and middle sections of the brain. The most common sites include the anterior cerebral artery and anterior communicating artery (30-35%), the bifurcation, division of two branches, of the internal carotid and posterior communicating artery (30-35%), the bifurcation of the middle cerebral artery (20%), the bifurcation of the basilar artery, and the remaining posterior circulation arteries (5%).

The main worry with an aneurysm is that it will burst under the pressure of blood pulsing through the artery, causing a brain haemorrhage, which may be fatal.

Each year, many thousands of people around the world, often young or middle-aged, die or are left disabled because of brain aneurysms.

Symptoms:
Most brain aneurysms cause no symptoms and may only be discovered during tests for another, usually unrelated, condition. In other cases, an unruptured aneurysm will cause problems by pressing on areas within the brain. When this happens, the person may suffer from severe headaches, blurred vision, changes in speech, and neck pain, depending on the areas of the brain that are affected and the severity of the aneurysm.

Onset is usually sudden and without warning. Rupture of a cerebral aneurysm is dangerous and usually results in bleeding into the meninges or the brain itself, leading to a subarachnoid hemorrhage (SAH) or intracranial hematoma (ICH), either of which constitutes a stroke. Rebleeding, hydrocephalus (the excessive accumulation of cerebrospinal fluid), vasospasm (spasm, or narrowing, of the blood vessels), or multiple aneurysms may also occur. The risk of rupture from an unruptured cerebral aneurysm varies according to the size of an aneurysm, with the risk rising as the aneurysm size increases. The overall rate of aneurysm rupture is estimated at 1.3% per year, resulting in approximately 27,000 new cases of SAH in the United States per year. Screening for aneurysms with annual imaging is possible, but not viewed as cost effective. The risk of short term re-rupture decreases dramatically after an aneurysm has bled in about 3 days, though after approximately 6 weeks the risk returns to baseline.

Symptoms of a ruptured brain aneurysm often when come on suddenly. They may include:

*Sudden, severe headache (sometimes described as a “thunderclap” headache that is very different from any normal headache).
*Neck pain.
*Nausea and vomiting.
*Sensitivity to light.
*Fainting or loss of consciousness.
*Seizures.

If a brain aneurysm presses on nerves in your brain, it can cause signs and symptoms. These can include:

*A droopy eyelid
*Double vision or other changes in vision
*Pain above or behind the eye
*A dilated pupil
*Numbness or weakness on one side of the face or body

Causes:
Aneurysms may result from congenital defects, preexisting conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma. Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age.

A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging. Some risk factors that can lead to brain aneurysms can be controlled, and others can’t. The following risk factors may increase your risk of developing an aneurysm or, if you already have an aneurysm, may increase your risk of it rupturing:1

*Family history. People who have a family history of brain aneurysms are twice as likely to have an aneurysm as those who don’t.

*Previous aneurysm. About 20% of patients with brain aneurysms have more than one.

*Gender. Women are twice as likely to develop a brain aneurysm or to suffer a subarachnoid hemorrhage as men.

*Race. African Americans have twice as many subarachnoid hemorrhages as whites.

*Hypertension. The risk of subarachnoid hemorrhage is greater in people with a history of high blood pressure (hypertension).

*Smoking. In addition to being a cause of hypertension, the use of cigarettes may greatly increase the chances of a brain aneurysm rupturing.

Diagnosis:
Because unruptured brain aneurysms often do not cause any symptoms, many are discovered in people who are being treated for a different condition.

These images show exactly how blood flows into the brain arteries.

If your health professional believes you have a brain aneurysm, you may have the following tests:

*Computed tomography (CT) scan. A CT scan can help identify bleeding in the brain.

*Computed tomography angiogram (CTA) scan. CTA is a more precise method of evaluating blood vessels than a standard CT scan. CTA uses a combination of CT scanning, special computer techniques, and contrast material (dye) injected into the blood to produce images of blood vessels.

*Magnetic resonance angiography (MRA). Similar to a CTA, MRA uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. As with CTA and cerebral angiography, a dye is often used during MRA to make blood vessels show up more clearly.

*Cerebral angiogram. During this X-ray test, a catheter is inserted through a blood vessel in the groin or arm and moved up through the vessel into the brain. A dye is then injected into the cerebral artery. As with the above tests, the dye allows any problems in the artery, including aneurysms, to be seen on the X-ray. Although this test is more invasive and carries more risk than the above tests, it is the best way to locate small (less than 5 mm) brain aneurysms.

Sometimes a lumbar puncture may be used if your health professional suspects that you have a ruptured cerebral aneurysm with a subarachnoid hemorrhage.

Treatment:
Emergency treatment for individuals with a ruptured cerebral aneurysm generally includes restoring deteriorating respiration and reducing intracranial pressure. Currently there are three treatment options for brain aneurysms: medical hypotensive therapy; surgical clipping or endovascular coiling. If possible, either surgical clipping or endovascular coiling is usually performed within the first 24 hours after bleeding to occlude the ruptured aneurysm and reduce the risk of rebleeding.

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Medical Hypotensive Therapy:
Medical—hypotensive therapy for ruptured intracranial aneurysms was introduced by Paul Slosberg MD (1926 – ; currently in practice) at the Mount Sinai Hospital in 1956 and was shown superior to surgery and other treatments in the largest randomized controlled study (multinational—15 institutions) ever conducted. This was reported in the major neurologic journal Stroke years ago but was underpublicized. More recently, with modifications for unruptured brain aneurysms and review of 50 years’ results it has again been found superior to surgical and now also to endovascular treatment. The method has the extreme cost-benefit advantage of completely eliminating the need for hospitalization itself, thereby eliminating surgical costs, endovascular costs, operating room costs and recovery room costs. In addition, it enables patients to completely avoid life-threatening nosocomial i.e. hospital-based, infections especially the frequently fatal MRSA infections along with other fatal hospital-based infections now being reported. This entirely medical treatment is performed by the neurologist both early and in long-term follow-up, in a private office or outpatient hospital facility. Aneurysms have been treated successfully regardless of size(e.g. giant aneurysms are included), location, complicating medical illnesses etc. These long term clinical results are buttressed by long-term MRA and CTA radiographic results showing that instead of the expected increase in size, the aneurysms either remain the same size, decrease in size or are no longer even visualized. This entirely medical method has now been endorsed by least two aneurysm surgical groups in England, as reported in both the Journal of Neurosurgery and Lancet Neurology.

Surgical clipping:..
Surgical clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937. It consists of performing a craniotomy, exposing the aneurysm, and closing the base of the aneurysm with a clip chosen specifically for the site. The surgical technique has been modified and improved over the years. Surgical clipping has a lower rate of aneurysm recurrence after treatment.

In January 2009, a team of doctors at UNC Hospital in Chapel Hill, North Carolina pioneered a new approach for aneurysm treatment – clipping aneurysms through an endoscopic endonasal approach. The team was led by UNC neurosurgeon, Dr. Anand Germanwala. This procedure may be groundbreaking for patients with aneurysms near the skull base, as an approach through the nose is less invasive than traditional approaches. Two videos related to this procedure can be seen on the UNC Neurosurgery website: http://www.med.unc.edu/neurosurgery/news/germanwala-presents-first-aneurysm-patient-treated-through-nose and http://www.med.unc.edu/neurosurgery/news/video-it-takes-two-or-more.

Endovascular coiling:.……
Endovascular coiling was introduced by Guido Guglielmi at UCLA in 1991. It consists of passing a catheter into the femoral artery in the groin, through the aorta, into the brain arteries, and finally into the aneurysm itself. Once the catheter is in the aneurysm, platinum coils are pushed into the aneurysm and released. These coils initiate a clotting or thrombotic reaction within the aneurysm that, if successful, will eliminate the aneurysm. These procedures require a small incision, through which a catheter is inserted. In the case of broad-based aneurysms, a stent may be passed first into the parent artery to serve as a scaffold for the coils (“stent-assisted coiling”), although the long-term studies of patients with intracranial stents have not yet been done.

Benefits & Risk:-
At this point it appears that the risks associated with surgical clipping and endovascular coiling, in terms of stroke or death from the procedure, are the same. The ISAT trials have shown, however, that patients who have experienced aneurysmal rupture have a 7% lower mortality rate when treated by coiling than patients treated by clipping, when all other factors are equal. Coiled aneurysms, however, do have a higher recurrence rate as demonstrated by angiography. For instance, the 2007 study by Jacques Moret and colleagues from Paris, France, (a group with one of the largest experiences in endovascular coiling) indicates that 28.6% of aneurysms recurred within one year of coiling, and that the recurrence rate increased with time. These results are similar to those previously reported by other endovascular groups. For instance Jean Raymond and colleagues from Montreal, Canada, (another group with a large experience in endovascular coiling) reported that 33.6% of aneurysms recurred within one year of coiling. The most recent data from Moret’s group reveals even higher aneurysm recurrence rates, namely a 36.5% recurrence rate at 9 months (which breaks down as 31.1% for small aneurysms less than 10 mm, and 56.0% for aneurysms 10 mm or larger). However, no studies to date have shown that the higher angiographic recurrence rate equals a higher rate of rebleeding. Thus far, the ISAT trials listed above show no increase in the rate of rebleeding, and show a persistent 7% lower mortality rate in subarachnoid hemorrhage patients who have been treated with coiling. In ISAT, the need for late retreatment of aneurysms was 6.9 times more likely for endovascular coiling as compared to surgical clipping. Furthermore, data from the ISAT group in March 2008 indicates that the higher aneurysm rate of recurrence is associated with a higher rebleeding rate, given that the rebleed rate of coiled aneurysms appears to be 8 times higher than that of surgically treated aneurysms in the ISAT study.

Therefore it appears that although endovascular coiling is associated with a shorter recovery period as compared to surgical clipping, it is also associated with a significantly higher recurrence rate after treatment. The long-term data for unruptured aneurysms are still being gathered.

Patients who undergo endovascular coiling need to have several serial studies (such as MRI/MRA, CTA, or angiography) to detect early recurrences. If a recurrence is identified, the aneurysm may need to be retreated with either surgery or further coiling. The risks associated with surgical clipping of previously-coiled aneurysms are very high. Ultimately, the decision to treat with surgical clipping versus endovascular coiling should be made by a cerebrovascular team with extensive experience in both modalities.

Prognosis:
The prognosis for a patient with a ruptured cerebral aneurysm depends on the extent and location of the aneurysm, the person’s age, general health, and neurological condition. Some individuals with a ruptured cerebral aneurysm die from the initial bleeding. Other individuals with cerebral aneurysm recover with little or no neurological deficit. The most significant factors in determining outcome are grade (see Hunt and Hess grade above) and age. Generally patients with Hunt and Hess grade I and II hemorrhage on admission to the emergency room and patients who are younger within the typical age range of vulnerability can anticipate a good outcome, without death or permanent disability. Older patients and those with poorer Hunt and Hess grades on admission have a poor prognosis. Generally, about two thirds of patients have a poor outcome, death, or permanent disability.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.webmd.com/brain/tc/brain-aneurysm-topic-overview
http://www.nlm.nih.gov/medlineplus/brainaneurysm.html
http://en.wikipedia.org/wiki/Cerebral_aneurysm
http://www.bbc.co.uk/health/physical_health/conditions/brainaneurysm.shtml
http://www.nlm.nih.gov/medlineplus/ency/imagepages/17031.htm

http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW029076

Categories
Ailmemts & Remedies

Binswanger’s Disease

Alternative Name: Subcortical vascular dementia.

Definition:
Binswanger’s disease is a form of small vessel vascular dementia caused by damage to the white brain matter. White matter atrophy can be caused by many circumstances including chronic hypertension as well as old age. This disease is characterized by loss of memory and intellectual function and by changes in mood. These changes encompass what are known as executive functions of the brain. It usually presents itself in 54 and 66 years of age, and the first symptoms are usually mental deterioration or stroke.

Click to learn more & see the picture

Click for picture………..(1.)………(2)…………….

A  form of multi-infarct dementia caused by damage to the white brain matter.

Binswanger’s disease is a particular type of atherosclerosis-related dementia, in which there are widespread, microscopic areas of damage to the white matter below the outer layer or cortex of the brain. This is called subcortical dementia and produces a particular pattern of symptoms which is somewhat different to other types of dementia.

The disease may develop gradually or seem to be triggered or rapidly aggravated by a stroke or other event that leads to brain damage.

It was described by Otto Binswanger in 1894, and Alois Alzheimer first used the phrase “Binswanger’s disease” in 1902.  However, Olszewski is credited with much of the modern-day investigation of this disease which began in 1962

Symptoms:
Binswanger’s disease affects the speed at which the brain can process information and this typically causes problems with higher brain functions such as:

•Organisation
•Planning
•Decision making
•Attention
•Concentration (all of which impinge on intellectual function)
•Mood (typically apathy, irritability, and depression)
•Behaviour
Memory loss can occur but is not usually as bad as in other forms of dementia such as Alzheimer’s, while a feature known as psychomotor slowness (where a person takes longer than normal to turn a thought into an action) is common in Binswanger’s disease.

click & see

There may also be changes in speech, an unsteady gait, shaking similar to that seen in Parkinson’s disease, clumsiness or frequent falls and loss of bladder control. These symptoms are not always present in all patients and may sometimes appear only as a passing phase. Seizures may also occur.

Patients usually show other signs of atherosclerosis and cardiovascular disease such as:

•Raised blood pressure
•Stroke
•Blood abnormalities
•Disease of the large blood vessels in the neck
•Disease of the heart valves
Brain scans such as CT scans or magnetic resonance imaging (MRI) show a characteristic pattern in Binswanger’s disease.

Causes:

Atherosclerosis, a disease process that narrows the blood vessels and cuts off the blood supply to the neurons or nerve cells of the brain, causing death of those cells, is a common cause of dementia.

Binswanger’s disease is a particular type of atherosclerosis-related dementia, in which there are widespread, microscopic areas of damage to the white matter below the outer layer or cortex of the brain. This is called subcortical dementia and produces a particular pattern of symptoms which is somewhat different to other types of dementia.

Diagnosis:

Binswanger’s disease can usually be diagnosed through a CT scan, MRI, and a proton MR spectrography. Indications include infarctions, lesions, or loss of intensity of central white matter and enlargement of ventricles, and leukoaraiosis or white matter atrophy. click & see

Click to see the picture

CT Brain Scan showing active NCC (left) and lacunar infarction on the head of the caudate nucleus (right) and lecoara.

Presentation:

Leukoaraiosis (LA) are white matter changes that are common in Binswanger’s Disease. However, LA can be found in many different diseases and even in the general population, especially in people older than 65 years of age.

There is controversy whether LA and mental deterioration actually have a cause and effect relationship. Recent research is showing that different types of LA can affect the brain differently, and that proton MR spectroscopy would be able to distinguish the different types more effectively and better diagnosis and treat the issue.[8] Because of this information, white matter changes indicated by a MRI or CT cannot alone diagnose Binswanger’s disease, but can aid to a bigger picture in the diagnosis process. There are many diseases similar to Binswanger’s disease including CADASIL syndrome and Alzheimer’s disease which makes this specific type of white matter damage hard to diagnose.Binswanger’s disease is best when diagnosed of a team by experts including a neurologist and psychiatrist to rule out other psychological or neurological problems. Because doctors must successfully detect enough white matter alterations to accompany dementia as well as an appropriate level of dementia, two separate technological systems are needed in the diagnosing process.

Technology:

Much of the major research today is done on finding better and more efficient ways to diagnose this disease. Many researchers have divided the MRIs of the brain into different sections or quadrants. A score is given to each section depending on how severe the white matter atrophy or leukoaraiosis is. Research has shown that the higher these scores, the more of a decrease in processing speed, executive functions, and motor learning tasks. Other researchers have begun using computers to calculate the percentage of white matter atrophy by counting the hyper-intense pixels of the MRI. These and similar reports show a correlation between the amount of white matter alterations and the decline of psychomotor functions, reduced performance on attention and executive control. One recent type of technology is called susceptibility weighted imaging (SWI) which is a magnetic resonance technique which has an unusually high degree of sensitivity and can better detect white matter alternations.

Recently a Mini Mental Test (MMT) has been created to accurately and quickly assess cognitive impairment due to vascular dementia across different cultures. Binswanger’s disease has been shown to be the most severe impairment of all of the vascular dementia.


Treatment:

There is no specific treatment for Binswanger’s disease. What treatment there is consists of keeping associated symptoms under control and supporting the patient with their activities of daily living such as dressing, washing and preparing meals.

Medications may be used to treat symptoms such as depression, or generally treat arterial disease and its effects throughout the body (so helping to preserve blood flow to the brain and delay the progression of Binswanger’s).

Specific drugs called “cognitive enhancers” used generally in dementia may be given but the results with them are variable and many people get little benefit.

It has been shown that current Alzheimer’s medication, Aricept, may help Binswanger’s Disease patients as well. Aricept increases the acetocholine in the brain through a choline esterase inhibitor which deactivates the enzyme that breaks down acetocholine. Alzheimer as well as Binswanger patients have low levels of acetocholine and this helps to restore the normal levels of neurotransmitters in the brain. This drug may improve memory, awareness, and the ability to function. If no medical interception of the disease is performed then the disease will continue to worsen as the patient ages due to the continuing atrophy of the white matter from whatever was its original cause.

You may click to see :Homoeopathy and  Binswanger’s disease

Prognosis:
Binswanger’s disease has no cure and patients with the disorder usually die within five years of its onset.
The best way to manage the vascular risk factors that contribute to poor perfusion in the brain is to treat the cause, such as chronic hypertension or diabetes.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:

http://en.wikipedia.org/wiki/Binswanger’s_disease
http://www.bbc.co.uk/health/physical_health/conditions/binswangers_disease.shtml

Binswanger’s disease or Binswager’s Dementia

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijn/vol2n1/bins.xml

http://www.walgreens.com/marketing/library/contents.html?docid=000002&doctype=10

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