RARE BRAIN DISEASE TREATED BY NEUROSURGERY AT KOLKATA

Institute of Neurosciences Kolkata: An institute dedicated towards quality treatment of brain and nerve diseases had recently successfully operated upon a 4-year-old girl with Moya-Moya Disease of the brain.

Described first time in Japan in 1957, Moya-Moya is a progressive disease of the brain with an incidence of one per million populations. The cause of Moya-Moya disease in unknown but in 10% cases there is a chance of genetic predisposition. Children presenting with this disease land up having ischemic strokes, seizures or involuntary movements of the limbs.

A team of dedicated Neurosurgeons of national & international repute with support from paediatric neurologists and Neuro-radiologists performed a rare surgery EDGAMS to relieve the congestion in blood vessels within the child’s brain. In spite of the surgery being complex, the child was fit to be discharged in 5 days time.

A 37-year-old driver was brought to the hospital with history of sudden onset severe headache which was probably the worst headache of his life. CT-angio revealed a blister in one of the main artery of his brain which was sitting like a bomb ready to burst anybody’s guess (Basilar Artery Aneurysm)!

A brain angiography (DSA) was performed following which the patient finally underwent a highly complicated brain surgery and was discharged a week later with a new lease of life.

Management of Basilar Artery Aneurysm is one of the most challenging areas in neurosurgery. Through Endovascular modality in management of such cases is gaining popularity, the cost remains a major hurdle for the poor and unaffordable. Multidisciplinary approach, quick decision and management along with low cost is the need of the hour for such patients.

About Institute of Neurosciences Kolkata
(I-NK)
Institute if Neuroscience Kolkata (I-NK) brain child of the “Neurosurgeon of the Millennium” - Dr. (Prof). R. P. Sengupta, with support from the State Government, the KMC, the neuroscience foundation of Bengal and philanthropic organizations/individuals across the globe today stands high in the heart of the city as a pride of Bengal.

Founded on a mission ‘to serve is to worship’ I-NK is already delivering world class quality care in areas of Neuro surgery, Neurology, Neuro-ICU, Neuro-psychiatry, Neuro-pathology, Neuro-radiology & Neuro-rehabilitation, near to the door-steps of people of Eastern India, North Eastern India, Nepal, Bhutan & Bangladesh.

Complex surgeries like epilepsy surgery, aneurysm surgery and stroke surgery together with complex spinal and peripheral nerve surgeries are being regularly done here.

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For more information, call Rakesh Agrawal +91 98310 35500 Email: inkrakesh@gmail.com Visit: http://www.neurokolkata.org/ 185/1 AJC Bose Road, Kolkata 700 017 India
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Moyamoya Disease...

'EDAMS' (encephaloduroarteriomyosynangiosis) a major surgery has taken place here at Institute of Neurosciences Kolkata (I-NK) on 29th April 2010 (morning) was very successful.

Age of the patient: 4 years

Doctors involved in the surgery:
Drs. - RP Sengupta, Martin Lahecka, Rajib Samanta, Amit Chakraborty, Sucharita Chakraborty and Paivi Tanskanen.

Background:
Moyamoya disease (MMD) is a rare disorder of the blood vessels of the brain typically seen in children less than 10 years old. It is characterized by a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the feeding arteries. The name Moyamoya is Japanese for "puff of smoke". This distinctive name describes the angiographic appearance of the abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The changes may affect the major blood vessels of the brain including the anterior, middle, and posterior cerebral arteries.

The symptoms and clinical course vary and depend upon the location and severity of the hemorrhage or stroke. Thus symptoms may be mild or in its worst form, severe neurologic deficits.

The exact etiology of MMD is unknown but several familial cases have been reported. Several other diseases have been associated with the disease.

Aim of this surgery:

To improve blood flow to the brain so that ischemic stroke and hemorrhage will be less likely in the future. Most of these procedures use the blood vessels in the scalp to improve the circulation of the brain. In an encephaloduroarteriosynagniosis (EDAS) or encephaloduroarteriomyosynangiosis (EDAMS) the scalp blood vessel, called the superficial temporal artery (STA), with or without muscle, is isolated and laid onto the surface of the brain. The goal is that over time the brain will recruit new growth of blood vessels in from this large blood vessel, improving the circulation of the brain.

There are several different techniques but some are more effective than the other.

However, we chose the most advanced and the recommended technique which at the moment is considered state-of-the-art in treating children with Moyamoya disease.

After the surgery on 29th April 2010 morning, the patient is recovering very well in the neurological ward at I-NK surrounded by very pleased family members.

Readers, you are kindly requested to circulate this very IMPORTANT NEWS among your network as this 'EDAMS' surgery is probably the first successful, one of its kind surgery that has taken place in Eastern India. Public must be aware of I-NK's achievements / milestones and the kind of advanced surgeries it can perform successfully.

Should you need more information on the above case, please contact me directly on my cell.
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INSTITUTE OF NEUROSCIENCES KOLKATA (I-NK)
Eastern India's only Super Specialty Neuro Hospital for Brain, Spine & Nerve Disorders; in the heart of Kolkata. Make a difference to the lives of people you love and care. By creating awareness about I-NK you may cover your loved ones against the worries of finding the right doctor, treatment cost, etc! At I-NK a dedicated team are at hand to guide you to recovery with facilities that equal international standards. Come team up ...with I-NK. Show your loved ones that you care...
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185/1 AJC Bose Road, Kolkata - 700 017
Rakesh: +91 98310 35500 / +91 33 2286 7094 / 95 / 96
Email: inkrakesh@gmail.com Visit: www.neurokolkata.org
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Epilepsy - A Common Neurological Disorder in Infancy & Childhood

• Children with epilepsy needs

- proper specialist’s healthcare

- support for children’s

> growth & neurological development

> intellectual progress

> psycho-social development

Complete Epilepsy Care Package offered in Institute of Neurosciences Kolkata

• Co-ordinated by Child’s Neurologist

- Detailed Discussion about

> Diagnostic tests & Treatment

> Planning & Implications for future

- High quality MRI scan

- Video Telemetry (24 hrs) in difficult epilepsy

- Support from Therapists

- Guidance from Psychologist

- Discussion about alternative treatments

Seek advice at Institute of Neurosciences Kolkata (I-NK)

Please Contact: Dr. Rajib Samanta, FRCPCh (UK), MRCP, DCH, CCST (UK), Paediatric (Child) Neurologist, Monday - Saturday 10:00 AM - 5:00 PM), For Appointments Call: + 91 98310 35500 / +91 98 36 16 46 26 / +91 33 2286 7094 / 95 / 96 Email: inkrakesh@gmail.com Visit: www.neurokolkata.org

!!! MENTAL ILLNESS ARE TREATABLE !!! (in Bengali)

!!! MENTAL ILLNESS ARE TREATABLE !!!

Have You Reviewed Your Hospital Bill?

I've heard about people finding big errors on their medical bills. In fact, I recently learned that at least 8 of 10 hospital bills contain errors. A "small" error might be a few hundred dollars. More likely the errors run in the thousands.

What kinds of errors? A great example of just how outrageous these charges can get to be was demonstrated on Good Morning America. A woman who had surgery for breast cancer was told beforehand that her bill would probably run around $5000. When she received the bill, it totaled $12,700.

Holly Wallack, a medical billing advocate, worked with the patient and the hospital to question charges and review the possible errors. She found problems such as:

· Misplaced decimals -- a charge for $887 that should have been $87.
· Fat finger errors -- the billing clerk repeated a charge for a pain killer 7 times when, in fact, the drug was administered only 4 times
· A charge for a post surgery bra for $192. An identical bra was found on the internet for $19.
· The bill for the "first hour post surgery" was billed -- twice! How do you repeat a "first hour?"

Bottom line - Holly was able to reduce the bill from $12,700 to $5,800. That's almost $7,000.

Those errors do cost US big time, however. The GMA piece first suggested that it would be "free" to have the work done, but that's not true. And the conclusion suggested that it's inexpensive because you don't pay unless they find errors.

That's not exactly true either. It does get expensive.

While some billing advocates do charge by the hour, others charge a commission on total of errors they find, ranging from 15% to 35%. Billing advocates do the work on your behalf and yes, it's very fair that they get paid to do so. Thanks heavens they are around to figure it out!

However -- if you are overbilled by a hospital to the tune of $7,000, then you are, in effect, paying (an average of) $1750 to get a bill fixed that never should have been sent to you to begin with. In this woman's case, she will pay around $7,550 in total, even though her hospital bill, if put together correctly to begin with, would have been only $5,800.

That would be like going to the supermarket, the clerk tells you your bill is $100, you take a look and realize you were over charged by $50, you ask a supermarket advocate to prove that to the supermarket, you pay that advocate $12.50 for her trouble, so in effect, your $50 worth of groceries just cost you $62.50. What's right about that?

The FAIREST way for this to happen would be for the hospital to pay that advocate, not the patient! Why should the patient have to pay extra because the hospital didn't do its job?

Oh! wait! I forgot. This is America. Healthcare is always about money! And never to the benefit of the patient. Once again, we must follow the money.

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NOTE:– At I-NK we follow a principle i.e. ‘benefit of the patient first’. Institute of Neurosciences Kolkata (I-NK) an institution founded on the mission of ‘to serve is to worship’, providing the best treatment, yet with transparent cost parameters. An institution where the team would dedicate themselves to care for the patient, helping them along the road to recovery. A comprehensive treatment package provided by an integrated multidisciplinary team skilled in their knowledge of latest technologies. Using innovative surgical and non surgical methods for specialized segments.

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For more information, Contact:

Rakesh Agrawal CMO +91 98310 35500

Institute of Neurosciences Kolkata

185/1 AJC Bose Road, Kolkata - 700 017 India

Tel: +91 33 2286 7094 / 95 / 96 +91 98 36 16 46 26

Email: inkrakesh@gmail.com visit: www.neurokolkata.org

!!! MENTAL ILLNESS ARE TREATABLE !!!

!!! MENTAL ILLNESS ARE TREATABLE !!!


“IT ALL HAPPENS IN THE BRAIN”


Some hard facts;
(1) Psychiatric disorders are treatable
(2) They require early recognition and treatment
(3) Medications has to be taken regularly
(4) Medications seldom produce dependence and most of them are quite safe
(5) Electro-Consulsive Therapy (ECT) is a safe mode of treatment for difficult to treat Psychiatric disorders contrary to the popular belief
(6) Family support and regular visit to doctor is utmost importance
(7) Do not have any stigma in mind, these disorders are like any other medical conditions


Seek advice at Institute of Neurosciences Kolkata (I-NK).
Please Contact:
Dr. Kaustav Chakraborty, Consultant Neuropsychiatrist (Mon - Sat 9:00 AM - 2:00 PM)
Dr. Nilotpal Das, COnsultant, Consultant Neuropsychiatrist (Mon & Fri 11:00 to 1:00 PM)
For Appointments Call: +91 33 2286 7094 / 95 / 96 Helpline: +91 98 36 16 46 26
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Stroke is a “Brain Attack”

STROKE IS A “BRAIN ATTACK”

What is stroke?
Stroke, also called a brain attack, happens when the arteries leading to the brain are blocked or rupture. When the brain does not receive the needed oxygen supply, the brain cells begin to die. A stroke can cause paralysis, inability to talk, inability to understand, and other conditions brought on by brain damage. Strokes kill nearly 150,000 Americans each year and are the leading cause of adult disability.

What are the different types of stroke?
Strokes can be classified into two main categories:
88 percent are ischemic strokes - strokes caused by blockage of an artery.
12 percent are hemorrhagic strokes - strokes caused by bleeding.
What are the most common symptoms of stroke?

Symptoms may be sudden and include:
- weakness or numbness of the face, arm, or leg, especially on one side of the body
- confusion or difficulty speaking or understanding
- problems with vision such as dimness or loss of vision in one or both eyes
- dizziness or problems with balance or coordination
- problems with movement or walking
- severe headaches with no other known cause

All of the above warning signs may not occur with each stroke. Do not ignore any of the warning signs, even if they go away - take action immediately. The symptoms of stroke may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

STROKE IS PREVENTABLE

1. Know your blood pressure. Have it checked at least annually. If it is elevated, work with your doctor to control it.
2. Find out if you have atrial fibrillation (also called AF). If you have AF work with your doctor to manage it.
3. If you smoke, stop.
4. If you drink alcohol, do so only in moderation.
5. Know your cholesterol number. If it is high, work with your doctor to control it.
6. If you are diabetic, follow your doctor’s recommendations carefully to control your diabetes.
7. Include exercise in the activities you enjoy in your daily routine.
8. Enjoy a lower sodium (salt), lower fat diet.
9. Ask your doctor if you have circulation problems which increase your risk for stroke. If so, work with your doctor to control them.
10. If you have any stroke symptoms, seek immediate medical attention.

Stroke Prevention Guidelines for the Public:

1. Know your blood pressure. Have it checked at least annually. If it is elevated, work with your doctor to keep it under control.
• High blood pressure (hypertension) is a leading cause of stroke.
• Have your blood pressure checked at least once each year – more often if you have a history of high blood pressure.
• If the higher number (your systolic blood pressure) is consistently above 130 or if the lower number (your diastolic blood pressure) is consistently over 85, consult your doctor.
• If your doctor confirms that you have high blood pressure, he/she may recommend changes in your diet, regular exercise, and possibly medication.

2. Find out if you have atrial fibrillation (AF). If you have AF, work with your doctor to manage it.
• Atrial fibrillation (AF) can cause blood to collect in the chambers of your heart. This blood can form clots and cause a stroke.
• Your doctor can diagnose AF by carefully checking your pulse. AF can be confirmed with an ECG (electrocardiogram).
• If you have AF, your doctor may choose to lower your risk for stroke by prescribing medications such as warfarin or aspirin.

3. If you smoke, stop.
• Smoking doubles the risk for stroke.
• If you stop smoking today, your risk for stroke will immediately begin to drop.
• Within five years, your stroke risk may be the same as that of a non-smoker.

4. If you drink alcohol, do so in moderation.
• Drinking up to two glasses of wine, or the alcohol equivalent, each day may actually lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol).
• Heavy drinking increases your risk for stroke.
• Remember that alcohol is a drug — it can interact with other drugs you are taking, and alcohol is harmful if taken in large doses.

5. Know your cholesterol number. If it is high, work with your doctor to control it.
• Lowering your cholesterol may reduce your risk for stroke. Having high cholesterol can indirectly increase stroke risk by putting you at greater risk of heart disease – another important stroke risk factor.
• Some cholesterol-lowering medications have been shown to lower the risk of stroke in some high-risk individuals.
• High cholesterol can be controlled in many individuals with diet and exercise; some individuals may require medication.
• Recent studies show that some individuals with normal cholesterol may lower their risk for stroke by taking specific medications for cholesterol.

6. If you are diabetic, follow your doctor’s recommendations carefully to control your diabetes.
• Having diabetes puts you at an increased risk for stroke.
• Often, diabetes may be controlled through careful attention to what you eat.
• Your doctor can prescribe a nutrition program, lifestyle changes and medicine that can help control your diabetes.

7. Include exercise in the activities you enjoy in your daily routine.
• A brisk walk or other activity for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
• Try walking with a friend; this will make it more likely that you’ll make it a habit.
• If you don’t enjoy walking, choose another exercise activity that suits your lifestyle; bicycle, golf, swim, dance, play tennis or take an aerobics class.

8. Enjoy a lower sodium (salt), lower fat diet.
• By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.

9. Ask your doctor if you have circulation problems which increase your risk for stroke. If so, work with your doctor to control them.
• Fatty deposits - caused by atherosclerosis or other diseases - can block the arteries which carry blood from your heart to your brain. This kind of blockage, if left untreated, can cause stroke.
• You can be tested for this problem by your doctor.
• If you have blood problems such as sickle cell disease, severe anemia or other diseases, work with your doctor to manage these problems. Left untreated, these can cause stroke.
• Circulation problems can usually be treated with medications.
• Occasionally surgery is necessary to remove the blockage.

10. If you see or have any stroke symptoms, seek immediate medical attention.
• Sudden numbness or weakness of face, arm or leg— especially on one side of the body
• Sudden trouble seeing in one or both eyes
• Sudden confusion, trouble speaking or understanding
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause
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Seek advice at Institute of Neurosciences Kolkata (I-NK).
Please Contact: Prof. (Dr.) Dipes Mandal, (Head – Neurology Dept. Sr. Consultant)
(Monday - Friday 10:00 AM - 1:00 PM & Saturday 10:00 – 12:00 PM)
For Appointments Call: +91 33 2286 7094 / 95 / 96 Helpline: +91 98 36 16 46 26

Remember: We may be rich, we may be famous but we are nobody when we have severe head injury, stroke, severe depression or dementia. Only an Institution in our doorstep can help us with immediate care. I-NK a 150 bedded Super Specialty Hospital for Brain, Spine & Nerve Disorders is now fully OPEN.

Call: +91 98 36 16 46 26 / +91 33 2286 7094-96 Email: inkrakesh@gmail.com Visit: www.neurokolkata.org.

Source: NSA’s Complete Guide to Stroke
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Brain Attack !!!

BRAIN ATTACK !!!
Stroke is a “Brain Attack”
Stroke happens in the brain rather than the heart
Stroke is an emergency
“Time is Brain”

Stroke, also called a brain attack, happens when the arteries leading to the brain are blocked or rupture. When the brain does not receive the needed oxygen supply, the brain cells begin to die. A stroke can cause paralysis, inability to talk, inability to understand, and other conditions brought on by brain damage. Strokes kill nearly 150,000 Americans each year and are the leading cause of adult disability.

Patients experiencing brain attack can be affected in a number of ways, including paralysis, loss of speech, loss of memory - and even death. The term "brain attack" is being used today so that people will see that it is an emergency.

The term "brain attack" sounds serious, and that's exactly how it should sound. In other words, think of a brain attack, or stroke, in the same way you think of a heart attack. In both situations, immediate action can improve the odds of survival and restoration of your good health. That really is good news!

CHANGING THE PERCEPTION OF STROKE:
MYTH
Stroke is not preventable
Stroke cannot be treated
Strokes only strike the elderly
Stroke happens to the heart
Stroke recovery happens for a few months post-stroke
REALITY
Almost 80% of strokes are preventable
Stroke requires emergency treatment
Strokes can happen to anyone of any age
Stroke occurs in the brain
Stroke recovery can continue throughout life

What are the different types of stroke?
Strokes can be classified into two main categories:
• 88 percent are ischemic strokes - strokes caused by blockage of an artery.
• 12 percent are hemorrhagic strokes - strokes caused by bleeding.

What are the most common symptoms of stroke?
Symptoms may be sudden and include:
• weakness or numbness of the face, arm, or leg, especially on one side of the body
• confusion or difficulty speaking or understanding
• problems with vision such as dimness or loss of vision in one or both eyes
• dizziness or problems with balance or coordination
• problems with movement or walking
• severe headaches with no other known cause

All of the above warning signs may not occur with each stroke. Do not ignore any of the warning signs, even if they go away - take action immediately. The symptoms of stroke may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
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Seek advice at Institute of Neurosciences Kolkata (I-NK).
Please Contact: Prof. (Dr.) Dipes Mandal, Head – Neurology Dept. Sr. Consultant
(Monday - Friday 10:00 AM - 1:00 PM & Saturday 10:00 – 12:00 PM)
For Appointments Call: +91 33 2286 7094 / 95 / 96 Helpline: +91 98 36 16 46 26
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