Stroke

A stroke happens when part of the brain is damaged because of either

1) the blockage of a blood vessel or
2) the rupture of a blood vessel in the brain

Types

Ischemic – 85%
(Thrombotic/ embolic)
Hemorrhagic – 15%

Things that increase the risk of having a stroke include

1) high blood pressure
2) high cholesterol
3) Diabetes
4) Smoking
5) an abnormal heart rhythm called atrial fibrillation
6) lack of physical activity
7) Therefore, maintaining a healthy lifestyle and taking medications for any of these other medical conditions will lower your risk of stroke

Treatment of ischaemic stroke

1) Aspirin
2) Atorvastatin/ Rosuvastatin
3) Management of B.P.
4) Anti-oedema measures (mannitol, diuretics etc.)
5) Medication to prevent stress ulcer
6) Prevention and treatment of infection
7) Physiotherapy
8) Speech therapy
9) Nutrition
10) Thrombolysis
11) Surgery for Ischemic stroke:
a) Decompressive hemicraniectomy
b) Carotid endarterectomy
c) Carotid artery stenting

Treatment of hemorrhagic stroke

1) Medicines to reduce oedema
2) Management of B.P.
3) Surgery

Prevention is better than cure

Many strokes can be prevented, though not all. You can greatly lower your chance of having a stroke by:
1) Taking your medicines exactly as directed. Medicines that are especially important in preventing strokes include:
a) Blood pressure medicines
b) Medicines called statins, which lower cholesterol
c) Medicines to prevent blood clots, such aspirin or blood thinners
2) Medicines that help to keep your blood sugar as close to normal as possible (if you have diabetes)
3) Stop smoking, if you smoke
4)Get regular exercise (if your doctor says it’s safe) for at least 30 minutes a day on most days of the week
5)Lose weight, if you are overweight
6)Eat a diet rich in fruits, vegetables, and low-fat dairy products, and low in meats, sweets, and refined grains (such as white bread or white rice)
7)Eat less salt (sodium)
9)Limit the amount of alcohol you drink

About Neurosurgery

Neurosurgery is a specialised branch of surgery. A neurosurgeon has to be meticulous and dedicated with an eye for details. Gone are the days when neurosurgery was associated with increased morbidity and mortality. Advances in diagnostic imaging, operating microscope and neurocritical care has made neurosurgery much safer and predictable. The key to success is proper case selection and timely intervention.

The various sub specialities include neuro-oncology, neurovascular( stroke, aneurysms, arteriovenous malformations), neurotrauma( head injury, spine injury), epilepsy surgery, functional neurosurgery(surgery for movement disorder, pain, spasticity).

My philosophy is – “ primum non nocere” i.e first do no harm. I firmly believe that even if I cannot alleviate the sufferings of my patients I must not make them worse.

Back Pain

Majority of back pain is caused by muscle strains Usually heals with conservative treatments and time Muscles in the lower back have an excellent blood supply bringing it the necessary nutrients for healing to occur.

Do’s & Don’ts

Maintain or achieve a healthy weight

Regular exercises

Eat healthily, drink plenty of water.

Practice good body mechanics.

Good quality sleep.

Avoid smoking.

Travel to work by walking or biking.

Get off public transport a stop earlier than normal or park your car further away from the office.

Stand instead of sitting when working as much as possible. Find as many excuses to get out of your chair as possible.

Spend time during breaks to go for a brisk walk or do some stretching to keep the muscles loose and strong.

My advice

Chances are you will experience back pain at some point in your life Expensive diagnostic tests cannot always identify the cause of your pain There is no quick fix Establish a healthy lifestyle

Remember – “The decision is more important than the incision.”