Chapters authored
Intracerebral Hemorrhage: Issues in Rehabilitation By Ravi Dadlani and Amit Agrawal
While the advancements in the management of the spontaneous intracerebral hemorrhage (SICH) have resulted an increase in survival, this has also resulted in the number of survivors with significant functional morbidity that require long-term care and rehabilitation services. SICH can lead to various impairments, and the deficits related to SICH may include impairment in motor and sensory functions, emotional labiality, language dysfunctions, perception deficits and cognitive dysfunctions. In the present chapter, we present an overview of the issues in rehabilitation which are faced by medical personnel’s while managing the patients with SICH.
Part of the book: Hemorrhagic Stroke
Normal Pressure Hydrocephalus By Ravish Rajiv Keni, Harsh Deora and Amit Agrawal
Normal pressure hydrocephalus (NPH) is characterized by dilated ventricles and a combination of gait impairment, cognition impairment, and loss of urinary control (urgency and incontinence). The only effective treatment for NPH is a CSF shunt; however, only a small percentage of patients ever receive it. The features of gait impairment in patients with NPH are difficult to distinguish from patients of neurodegenerative disorders with motor involvement, such as parkinsonism or dementia with Lewy bodies. CT or MRI imaging is required for the diagnosis of idiopathic normal pressure hydrocephalus. An Evans ratio of more than 0.3 indicates large ventricles, and a ratio of more than 0.33 indicates very large ventricles, but is not specific for idiopathic normal pressure hydrocephalus. The international and Japanese guidelines support shunt surgery as effective treatment of idiopathic normal pressure hydrocephalus, as does the American Academy of Neurology practice guideline. There is a need to provide longitudinal care of patients with idiopathic normal pressure hydrocephalus after shunt surgery as all symptoms respond well to shunt surgery.
Part of the book: New Insight into Cerebrovascular Diseases
Primary Central Nervous System Neuroblastoma: An Enigmatic Entity By Rakesh Mishra and Amit Agrawal
Neuroblastoma is one of the most common solid tumour in the paediatric age group. Central nervous system (CNS) involvement in neuroblastoma is commonly due to metastasis from the extracranial primary. Primary CNS Neuroblastoma (PCNS-NB) is a rare entity and highlights errors in development of neural crest cells and CNS. A lot has been published since the first description of PCNS-NB four decades ago. Over the years, neuroscientists, geneticists, and clinicians have improved the understanding of PCNS-NB. PCNS-NB is an enigmatic entity with variable presentation, epidemiology, clinical features and outcomes. Recent update in knowledge is seen in 2016 WHO classification of CNS tumours with reclassification of CNS neuroblastoma. It further subclassified different histological variants of PCNS-NB and its molecular correlates. Most common histological subtype of PCNS-NB is neuroblastoma followed by ganglioneuroblastoma. Studies support the view that younger age group, less number of lesions, ganglioneuroblastoma histology subtype and surgical management are good prognostic indicators. This chapter provides an updated overview of epidemiology, clinical features, histological and molecular diagnosis, and outcomes of PCNS-NB in addition to the role of adjuvant therapy.
Part of the book: Pheochromocytoma, Paraganglioma and Neuroblastoma
Music Therapy and Its Role in Pain Control By Avinash Thakare, Anvesh Jallapally, Amit Agrawal and Pooja Salkar
Music has occupied our day-to-day life; as it is readily available, accessible and further technological advancement has made access to music a common norm. Music has been present since the very early part of human evolution and has helped in forming society and civilizations. It has served various purposes like social cohesion, emotional expressions, interpersonal communication as well as recreation. Due to its great bonding power; it is important in terms of social dynamics. Music therapy is convenient, inexpensive and user-controlled and seems to be influencing the physiological system positively if rightly used. Vast research is going on to find the right music that could be having a beneficial therapeutic effect. Music seems to affect the pain perception, modulation and also has the affective component to help positively in controlling the pain. This chapter is an attempt to evaluate the various pain modulating effects of music through a systematic music therapy intervention using the vast research work done in this field. This review is consistent to integrate the best scientific evidence for pain relief into practice, education, and research. Music being a non-pharmacologic, nontoxic intervention and is free from adverse effects and also is an inexpensive, low cost modality.
Part of the book: Music in Health and Diseases
Perspective Chapter: Glioblastoma of the Corpus Callosum By Daulat Singh Kunwar, Ved Prakash Maurya, Balachandar Deivasigamani, Rakesh Mishra and Amit Agrawal
Glioma is the most common malignant tumour of the brain, in which glioblastoma (GBM) is the most aggressive form which infiltrates through the white fibre tracts. Corpus callosum (CC) is most invaded by GBM, it carries poor prognosis as mostly these tumours are not touched upon due to the belief of post operative cognitive decline, or there is incomplete resection leading to tumour recurrence. However current advancement in technology, operative techniques and better understanding of nature of CC-GBM, maximal safe resection is being carried out with better outcomes in comparison with the GBM without infiltration of CC.
Part of the book: Glioblastoma
Spinal Shock: Clinical Pearls By Sri Rama Ananta Nagabhushanam Padala, Vaishali Waindeskar, Ved Prakash Maurya, Rakesh Mishra and Amit Agrawal
Spinal shock is a clinical manifestation following injury to the spinal cord resulting from multiple mechanisms. It is a complex phenomenon with flaccid paralysis, absent anal wink, and bulbocavernosus reflex. Management strategy for such patients includes rapid evaluation and treatment strategies to minimize the impact of secondary spinal cord injury. The advanced trauma life support (ATLS) guidelines provide the basis for rapid assessment and stabilization of A (Airway), B (Breathing), and C (Circulation) before dealing with the neurological deficits under the primary survey. The emergence of better radiological investigations has been pivotal in categorizing spinal syndromes and reaching a precise diagnosis. Early initiation of treatment measures results in better neurological and functional recovery with minimal residual deficits. The role of steroids in spinal shock has been a highly debated topic, and the timing of surgery is variable, intending to eliminate the secondary injury. Clinical differentiation between neurogenic and hypovolemic shock is vital, enhancing the quality of care with realistic outcome expectations.
Part of the book: Management of Shock
View all chapters