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MANAGEMENT OF HEAD INJURY

Head injury is one of the common causes of death and disability in our society especially amongst young people. Preventive measure such as using helmets, seat belts, disciplined driving and avoidance of drunken driving help reduce the effects of head injury. Management of head injury patients requires a critical care unit with specially trained nurses, Intensive Care specialists and neurosurgeons. All types of head injuries can be caused by trauma. In adults such injuries commonly result from motor vehicle accidents, assaults, and falls. In children falls are the most common cause followed by recreational activities such as biking, climbing trees. A small but significant number of head injuries in children are from violence and abuse.

BRAIN TUMOUR

A brain tumor is an abnormal mass of tissue in which some cells grow and multiply uncontrollably, apparently unregulated by the mechanisms that control normal cells. The growth of a tumor takes up space within the skull and interferes with normal brain activity. A tumor can cause damage by increasing pressure in the brain, by shifting the brain or pushing against the skull, and by invading and damaging nerves and healthy brain tissue. The location of a brain tumor influences the type of symptoms that occur. This is because different functions are controlled by different parts of the brain. Brain tumors rarely metastasize (spread) to other parts of the body outside of the central nervous system (CNS).Some tumor types are more common in children than in adults. When childhood brain tumors occur in adults, they often occur in a different part of the brain than in children. Although most primary tumors attack member of both sexes with equal frequency, some, such as meningiomas occur more frequently in women, whereas others such as medulloblastomas more commonly affect boys and young men.

The most common symptoms include headaches which can be most severe in the morning, nausea or vomiting, seizures or convulsions, difficulty in thinking, speaking or finding words, personality changes, weakness or paralysis in one part or one side of the body, loss of balance, vision changes, confusion and disorientation and memory loss.

NEUROCYSTICERCOSIS

Neurocysticercosis is the result of accidental ingestion of eggs of pork tapeworm, usually due to contamination of food by people with taeniasis. In developing countries, neurocysticercosis is the most common parasitic disease of the nervous system and is the main cause of acquired epilepsy. Clinical manifestations of neurocysticercosis vary with the locations of the lesions, the number of parasites, and the host's immune response. Many patients are asymptomatic. Possible symptomatic presentations include: Epilepsy which is the most common presentation (70%), headache, dizziness, stroke, neuropsychiatric dysfunction. Treatment of neurocysticercosis depends upon the viability of the cyst and its complications. If the parasite is dead, the treatment is directed primarily against the symptoms. Anticonvulsants are used for management of seizures, monotherapy is usually sufficient. Duration of the treatment remains undefined.

HYDROCEPHALUS

Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain. Normally, this fluid cushions the brain. When it accumulates too much, it puts harmful pressure on brain. Hydrocephalus can be congenital or present at birth. Causes include genetic problems and problems with how the fetus develops. An unusually large head is the main sign of congenital hydrocephalus. Hydrocephalus can also happen after birth. This is called acquired hydrocephalus. It can occur at any age. Causes can include head injuries, strokes, infections, tumors, and bleeding in the brain. Symptoms include headache, vomiting and nausea, blurry vision, balance problems, bladder control problems, thinking and memory problems. Hydrocephalus can permanently damage the brain, causing problems with physical and mental development. If untreated, it is usually fatal. With treatment, many people lead normal lives with few limitations. Treatment usually involves surgery to insert a shunt. A shunt is a flexible but sturdy plastic tube. The shunt moves the cerebrospinal fluid to another area of the body where it can be absorbed.

GUILLAIN-BARRE SYNDROME

Guillain-Barre syndrome is a rare disorder in which body's immune system attacks its own nerves. Weakness and tingling in body’s extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a neurological emergency. Most people with the condition must be hospitalized to receive treatment. The exact cause of Guillain-Barre syndrome is unknown. But it is often preceded by an infectious illness such as a respiratory infection or the stomach flu. There's no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people recover from Guillain-Barre syndrome, though some may experience lingering effects from it, such as weakness, numbness or fatigue.