臨床神経学および脳神経外科ジャーナル

Near-infrared spectroscopy is used to measure cerebral oximetry, which offers continuous and non-invasive information on the oxygen saturation of haemoglobin in the central nervous system. This is particularly critical in the case of individuals who have suffered catastrophic brain injuries. Brain oximetry monitoring in these individuals may enable for the identification of insufficient cerebral oxygenation caused by cerebral blood flow abnormalities. It could be able to detect hypoxia and cerebral ischemia events. Continuous bedside monitoring might aid in the early detection of cerebral haemorrhage and cerebrovascular autoregulation problems, as well as therapy implementation. However, it is important to realise that using near-infrared spectroscopy to monitor cerebral oximetry has a number of drawbacks, which are mostly due to its physical characteristics. TBIs are one of the leading causes of death in patients who have been wounded in traffic accidents, falls from great heights, battery, or a firearm attack. TBIs are categorised in a variety of ways. Mild, moderate, and severe injuries are classified according to the severity of the injury. They are divided into two categories: focal injuries and primary diffuse brain injuries, depending on the mechanism of damage. They can occur on their own or as part of a multi-organ injury. A Traumatic Brain Injury (TBI) causes a primary brain damage.

Many people with idiopathic Normal Pressure Hydrocephalus (iNPH) have been reported to have fallen before being diagnosed. There have been no previous studies on the prevalence of iNPH among the elderly with a history of falls. The efficacy of screening for iNPH in older patients who present after a fall was examined in this research. The clinical trial of gait disturbance, cognitive impairment, and urine incontinence, as well as ventricular enlargement on neurological imaging, describe idiopathic normal pressure hydrocephalus (iNPH). Clinical care for iNPH is becoming increasingly important in a rapidly ageing population, as the condition is more frequent in the elderly. Among dementing diseases, iNPH is one of the few that can be treated; a Cerebrospinal Fluid (CSF) shunt has proven to be successful, with clinical improvement reported in 60%-80% of patients. Despite the growing significance of identifying this condition, it is still underdiagnosed, owing to its non-specific symptoms and predominance among the elderly, who are more likely to have other diseases that are similar, leading to diagnostic confusion.

COVID 19 is new to humanity; its impact and severity on general health have yet to be determined, although those with chronic illnesses such as asthma, renal diseases, cardiac problems, and the geriatric population have been advised to take extra care. COVID-19 has resulted in both internal and foreign battle for mankind [1]. On the one hand, external forces and the government are addressing individuals in order to preserve social distance, isolation, and other hygienic conditions. On the other side, some segments of society, particularly elderly people, children, and the sick, are grappling inwardly with the prospect of a worsening scenario as a result of the COVID-19 epidemic.

Motor Neuron Disease (MND) or Amyotrophic lateral sclerosis (ALS) is a slow fatal neurodegenerative disease characterized by selective and gradual motor neuronal death with unknown aetiology. The insufficient clearance of glutamate through the glutamate transporter, and the specific distribution of Ca2+-permeable AMPA receptors in spinal motor neurons, indicates that glutamate-induced neurotoxicity is involved in its pathogenesis. NO is generated by nitric oxide synthase (NOS) which acts via 10000-fold effect to reverse the neuronal death. NO is destructive within 5 to 7 days as noted in earlier study by various authors. We have used intrathecal sodium nitroprusside to activate the 10000-fold effect to modulate the retrograde neuroregulation in MND.

In tetanus patients Levodopa and Carbidopa combination (which is usually used to relieve the signs of extrapyramidal) causes respiratory muscles spasm relief thereby the need for sedatives is decreased and patient saved later on via central nervous system mechanism, by providing the inhibitory neurotransmitters at Anterior Horn cells. The tetanus toxin initially binds to peripheral nerve terminals then it retrogradely goes to CNS attaches with gangliosides at presynaptic inhibitory motor nerve endings, blocks glycine and gamma amino butyric acid (GABA) across the synaptic cleft.