In diagnosing a stroke, the doctor will usually start by asking the patient what happened and when the symptoms began. Then the doctor will ask the patient some questions to see if she or he is thinking clearly. The doctor also will test the patient’s reflexes to see if she or he may have had any physical damage. This helps the doctor find out which tests are needed.

The doctor may order one or more of the following tests. These include imaging tests that give a picture of the brain. These include CT, computed tomography, scanning, sometimes called CAT scans and MRI, magnetic resonance imaging, scanning. CT scans are useful for finding out if a stroke is caused by a blockage or by bleeding in the brain. Another is the electrical tests such as EEG or electroencephalogram and an evoked response test to record the electrical impulses and sensory processes of the brain. The effect of stroke depends on the type of stroke attack, the area of the brain where the stroke occurs, and the extent of brain injury. A mild stroke can cause little or no brain damage. However, a major stroke can cause severe brain damage and even death.Experts think that up to 80 percent of strokes can be prevented. Some stroke risk factors cannot be controlled, such as age, family history, and ethnicity. But you can reduce your chances of having a stroke by taking these steps. Know your blood pressure, do not smoke, do not drink alcohol or if not, put a limit to your drinking, get tested for diabetes, get your cholesterol and triglyceride levels tested, maintain a healthy weight, and also find ways to cope with stress. Original text here:

http://www.4woman.gov/faq/stroke.htm

For patients who are not responsive to medications for Parkinsons, brain surgery is sometimes suggested and used. Usually, surgery is done in the late stages of Parkinsons disease. One of the neurosurgical procedures done by doctors on Parkinsons disease patients is called Deep Brain Stimulation. Deep Brain Stimulation or DBS is used to treat disabling neurological symptoms associated with Parkinsons, most commonly the debilitating symptoms, such as tremor, rigidity, stiffness, walking and movement problems. Deep Brain Stimulation uses a surgically implanted and battery-operated medical device called a neurostimulator. This neurostimulator acts similarly to a heart pacemaker. Its primary use is to deliver electrical stimulation to target areas in the brain, usually the thalamus, subthalamic nucleus, and globus pallidus, responsible for controlling movement. It also blocks the abnormal nerve signals that cause tremor and other symptoms of Parkinson disease. MRI or Magnetic Resonance Imaging or Computed Tomography or CT scanning is commonly done before the procedure to specifically locate the brain areas where the electrical nerve signals cause symptoms of Parkinsons disease. A more specific procedure, called microelectrode recording, is at times done by other doctors to specifically monitor microscopic nerve cells and their activity in the brain target area.

Once the device is surgically set in place, electrical impulses are sent by the neurostimulator to the brain, and thus blocking the nerve signals causing the Parkinsons disease symptoms. Deep Brain Stimulation is not the same as with other previous surgical treatments for Parkinsons that destroying microscopic nerve cells. DBS works without damaging healthy brain tissues. After DBS, the patients are still to continue their anti-Parkinsonian medications. It has been observed for most patients after DBS surgery however that there is a considerable drop in their Parkinsons disease symptoms and they are able to reduce their medications dramatically. This reduction in dosage of medications for most patients result in decreased medication side effects too, like dyskinesia or difficulty of movement associated to some very common anti-Parkinsons drugs. As of the present, many scientists study the specific sites of the brain where to surgically place the DBS that could lead to the best results in reducing Parkinsons disease symptoms. Deep Brain Stimulation as a procedure is also currently being researched and studied to determine its safety, effectivity and reliability.

Tremors refer to rhythmic movements or shaking, usually in the patients hands, especially when at rest. This is likewise called fine hand tremors or resting tremors. The patients with Parkinsons disease also experience stiffness, weakness, tenseness and sometimes aching of muscles. They are also slow in moving, like in walking. Since they have poor coordination of movements and balance, Parkinsons patients are also prone to accidents and falls. Their characteristic walking is called shuffling gait. Parkinsons, over time, also leads to other symptoms including speech problems and changes, swallowing problems, urination and defecation problems. Depression is also very common. Symptoms of Parkinsons vary from one patient to another.

DIAGNOSIS OF PARKINSONS Diagnosing Parkinsons disease is done by assessing the signs and symptoms of the disorder on the patient. Patients usually initially seek help because of tremors. Aside from that, the doctor usually assesses for other signs and symptoms of the disorder particular to Parkinsons disease. There is no specific diagnostic test that can diagnose Parkinson disease. However, upon assessment of the suggestive signs and symptoms of Parkinsons, MRI or magnetic resonance imaging test help in confirming that the cause of these signs and symptoms are not caused by any other disorder or disease. There is no specific cure for Parkinsons disease. However, there are medications given to provide relief for its many symptoms. The palliative treatment would depend on what symptom each Parkinson patient experiences. Medications for Parkinsons patients act to increase the dopamine levels of the brain, even if the microscopic cells are no longer able to do so. Some medications also act to copy the effects of the chemical dopamine in the brain, thereby transmitting information to the brain and commanding the body to move. This causes improvements in the patients movements. The other anti-Parkinsonian medications extend the effect of dopamine already in the brain. This will maximize the ability of the chemical in helping with motor activities. It is important to know however that medications given to Parkinsons patients can neither cure the disease, nor keep it from progressing. The medications only serve to provide momentary relief for its symptoms.

In treating an epileptic patient, the key is to determine the type of seizure that he has. Once the diagnosis of an epilepsy has been established, current treatment options can be offered to the patient. These treatment include medications with antiepileptic drugs, vagus nerve stimulation for epilepsy that is not responsive to medications and ketogenic diet which is low in sugar and proteins and high in fat, and lastly neurosurgery. Neurosurgery is an option for seizures that don’t respond to medication therapy. Usually, surgery is not considered until the patient has tried two or three different antiepileptic drugs for a period of time without success. The surgical procedures could be lesionectomy, lobectomy, corpus callosotomy, or hemispherectomy.

Lesionectomy is the surgery most frequently used for seizure patients. It aims to remove a seizure focus in the brain where there is an abnormality, believed to be causing the seizure activity. This areas, or lesions, are removed. This type of surgery is most appropriate for partial type of seizures. Lobectomy takes away a larger focus area of the brain. Temporal lobectomy is most often performed. The temporal lobe of the brain is removed and this usually stops up to about 90 percent occurrence of epileptic seizures.

With corpus callosotomy, the connection between the left hemisphere and the right hemisphere of the brain is done. The connection is surgically cut. This type of surgery is ideal for children whose seizure activiy starts on one side or hemisphere of the brain and spreads on the other. This is helpful in treating generalized and atonic seizures. The last neurosurgical procedure is called hemispherectomy. This procedure involves the removal of half the cortex or outer layer of the brain. This procedure is used as last resort.

Epilepsy can be triggered by imbalances of chemicals in the brain. These chemicals are called neurotransmitters. They are responsible for transmitting electrical impulses to the brain. Some patients are believed to have too much neurotransmitters and others have too little. Sometimes, the chemical imbalance of microscopic neurotransmitters in the brain is genetically predisposed by nature. Sometimes it can be caused by injury or other possible diseases. Numerous epilepsy cases are linked to genetics. Some families are believed to possess a specific abnormal gene. It causes an abnormal way of the body in processing body chemicals such as potassium, calcium, and sodium. Genes are likewise able to influence the way we can metabolize drugs. It can cause abnormally formed neurons, visible with a microscope, in the brain. Other disorders can trigger epilepsy. Some of these disorders are brain tumors, Alzheimers disease, alcoholism, heart attacks and strokes, infectious diseases like meningitis, AIDs and encephalitis, cerebral palsy and autism.

Environmental exposure to carbon monoxide, lead and other chemicals too can trigger an epileptic seizure. Some drugs, alcohol, stress, hormonal changes, and lack of sleep may all trigger epilepsy. Withrawal from antidepressants and anxiolytics can also cause the same problem. Epilepsy can be dangerous especially if the seizure lasts more than five minutes at a time. In this condition, called status epilepticus, permanent brain damage, microscopically small or even larger, could be caused.

To diagnose epilepsy, the neurosurgeon first takes the medical history of the patient. With the patients medical history, the doctor will then have clues as to the patients family having seizures history or not, and as to what the patients seizure looked like which would help classify the type of seizure. The doctor will also have a chance to find out what the patient experienced before the seizure and what he was doing that could have probably triggered the attack. He will also have an opportunity to ask relevant questions such as possible alcohol withdrawal, drug withdrawal, drug abuse, infections, or injury. Tests to help confirm the diagnosis of epilepsy include electroencephalography, brain imaging such as computerized tomography scan and magnetic resonance imaging, and positron emission tomography scan. Blood tests are also done along with other neurological, developmental and behavioral tests related to seizure diagnosis.

The care of a neurological patient is very individualized depending on the patients needs. Also involved in the neurological team are neuropsychologists, neuroradiologists, neurosurgeons, neurodiagnostic technicians, rehab specialists, neuroscience nurses, physical therapists, occupational therapists and speech pathologists. The care of a neurologic patient has different areas. It may involve inpatient and outpatient care and services. Because of diverse care needs, the care of patients includes intensive care, acute care, sub-acute care, acute rehab, outpatient therapies and outpatient clinics.

Neurosurgery is the surgical treatment and procedures of the structural abnormalities in the brain that cause neurologic diseases. It involves the nervous system and its coverings. This includes the brain, the spinal cord, the scalp and the skull, and the bony vertebral column. Neurosurgery includes many types of disorders such as epilepsy, spine and brain tumors and vascular disorders such as aneurysms. The neurosurgeon does the surgical procedure on the patient as means to treat neurologic disorders. It is the neurologists job however, not the neurosurgeons job, to identify and diagnose the presence of these neurologic disorders through diagnostic testing, example microscopic blood testing, before one undergoes the surgery.

Neurosurgical instruments are considered to be high precision instruments. Some are considered as diagnostic instruments, and others are surgical instruments. The most commonly used neurosurgical instruments are the neuropinwheels, the scissors and the surgical saws and the retractors. The neuropinwheels are instruments used for measuring the reflex and the subluxation of a person. It has a rolling head that is generally made of plastic or steel and it has a handle with proper grip. It is also called the Wartenberg Pinwheel after its inventor.

Scissors are used and require in all types of surgeries. A specific scissors is usually designed for a specific procedure. Scissors may be straight, curved, or angular in shape and they may have different sizes, cutting tips and grips. Under the surgical sharps category are the surgical scissors. Surgical scissors are used for cutting and dissecting the tissues, cutting sutures and bandages. Scissors with serrated blades help surgeons prevent tissue slippage in their surgical operations. There are numerous types of scissors. There are curved scissors for dissecting. They provide a better field of vision for the surgeon. Straight scissors are used when a straight cut is desired, like in sutures, nerves, and blood vessels. Smaller scissors are used for cutting surfaces and larger ones for the deep cuts. Other scissors are the bandage scissors, dissecting scissors, iris scissors, operating scissors, stitch scissors, tenotomy scissors and plastic surgery scissors.

Surgical saws are steel instruments for bone amputation purposes. The most commonly used types are the Satterlee and Gigli saw, both having specific blades. Surgical retractors hold back the tissues at the operative site during surgery. There are different kinds of retractors, but the purpose of it all is basically the same. There are hand held retractors and self retaining ones. Retractors are commonly classified as self retaining retractors, tissue retractors and cheek retractors.