siliconindia | | December 20188By Dr. NK Venkataramana, Founder & Chief Neurosurgeon, Brains HospitalHeadquartered in Bangalore, Brains is one of India's leading neurology & neurosurgery hospital with its state-of-the-art infrastructure offering treatments in neurosurgery, neurology, neuro-oncology, neuro-radiology, pediatric-neuroscience, endovascular neurosurgery, and many more.N eurosurgery which was started as a process called trephination, centuries ago has evolved as one of the finest super-speciality branches over the years. According to the history, crude instruments made up of rough metals and stones were used to open the skull. During those days the problems were many like bleeding, visibility, illumination, localization and infection. The evolution of neuroscience over the last 100 years has been faster and more spectacular than any other medical spe-ciality, studded by a number of ground-breaking advances, which continue to throw open new windows of hope for a better life. The introduction of antibiotics, cautery systems, anaesthesia and imaging of the brain has brought neurosur-gery to a different platform. Operating microscopes has created illumination and magnifications so that there are no more any gloomy corners in the brain. This technology has made neurosurgery safe & fast and has also brought-in a transformation from macro neurosurgery to micro neurosurgery. The inven-tion of stereotactic and endoscopy has further made neurosurgery minimally invasive.Technologies like structural imaging, tractogra-phy and integrated navigation are reshaping the par-adigm of neurosurgery, enabling doctors to achieve unprecedented levels of precision with minimally in-vasive approaches. In the future, functional imaging promises to emerge as the potent important tool in the hands of doctors for minimizing mor-bidity and enhancing functional preser-vation during brain surgery. Smart instruments that provide the feel of tissue and sensory feedback to a surgeon's hands can make a qualitative difference.Modification of receptors, genes, neural proteins and transmitters will be the key therapeutic interventions in the future. Even as nano technology, new drug delivery systems and targeted therapies emerge as weapons of super-selective choice for precisely targeting neurological disease.Neurodegenerative conditions and tumors not only take a huge toll on human lives, but also wreck the quality of life of their countless victims, which extracts an enormous and for poorer nations, a crippling economic cost. Moreover, the phenomenon of ageing, memory and the fitness of the brain are areas of abiding and general human interest that extends beyond the medical fraternity.Most notably, work in stem cell research is advancing on top gear and promises to emerge as the greatest hope for dealing with degenerative neuro diseases ranging from Alzheim-er's to Parkinson's. Though em-bryonic cell research has been stalled by ethical and safety concerns, work involving Mes-enchymal (MSCs) and induced pluripotential stem cells (IPS) is progressing full steam. The hybrid operating theatre with the intra-operative imaging, as well as intra-operative angiog-raphy along with navigation system helps surgeons to get the real time feedback about the location and progression of the surgery. The advanced imag-ing techniques of white mat-ter tracts of the brain (diffusion ADVANCEMENT IN NEUROSURGERY & THE WAY FORWARDDr. NK VenkataramanaIn my opinion
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