Neuroscience Center Virtualbook_EN

Bumrungrad International Hospital

Bumrungrad Neuroscience Center

Introduction

The renowned author Stephen King said, “The brain is a muscle that can move the world,”

to depict the importance of the human brain and its great potential. The brain or the nervous system is responsible for controlling and coordinating all bodily functions from movement, behavior, learning, to expressing emotions. It also regulates heartbeat and body temperature. In this way, a disorder of the nervous system or an injury to it following an accident could result in serious, long-term or permanent, and even life-threatening problems. Since the nervous system is extremely complex, it is necessary to rely on well-experienced and highly-skilled medical professionals in taking care of the system. Bumrungrad Neuroscience Center features a comprehensive team of neurological specialists encompassing all subspecialties as well as a multidisciplinary team with experience and expertise in treating patients with serious and complex neurological diseases. We provide the best possible and most appropriate personalized care based on the evidence-based best practice we have established. Also, with modern technology and medical equipment, patients and their families can rest assured that we are well-equipped and can provide accurate diagnosis and precise treatment as well as handle patients in complex emergencies in a timely manner.

Warning signs of neurological disorders

disrupted consciousness, confusion

chronic headaches

sudden weakness on one side of the body

sudden, unprecedented headaches

loss of balance

spasms

sudden vision problems, including double vision, half vision, and blindness in one or both eyes

speech problems, e.g. slurred speech and inability to speak

language problems

changes in personality and behavior

motor diculties, e.g. in walking

memory disorders, forgetfulness

mood changes

Nervous system disorders and conditions

02 acute ischemic stroke

intracranial or subarachnoid hemorrhage

cerebrovascular malformations

cerebral aneurysm

brain tumors

acute spine cord injury

traumatic brain injury

hydrocephalus

encephalopathy

dementia

parkinson’s disease

Treatment

02 03 04

surgery

counseling and cognitive behavior therapy

medications

dietary modications, exercise and stress management

06 07

physical, occupational, or speech therapy

interventional radiology treatment

targeted therapy or immunotherapy

Acute stroke occurs when blood ow to the brain decreases due to blockage or rupture of blood vessels, damaging brain tissues and disrupting brain function. Acute ischemic stroke

Treatment guidelines

Treatment depends on whether it is ischemic or hemorrhagic stroke as follows.

Several approaches are available for ischemic stroke. In some cases, thrombolytics may be prescribed to break up or dissolve clots.

For hemorrhagic stroke, surgery may be performed to prevent possible brain damage.

Prevention

Control risk factors for stroke, including diabetes, high cholesterol, smoking or lack of exercise.

Get annual health check-up to identify risk factors.

Avoid foods high in salt, fat and sugar.

Those found with risk factors should follow their doctors’ treatment plans, taking medications regularly and seeking medical advice immediately when facing unusual symptoms.

Maintain healthy blood pressure and cholesterol levels.

Exercise regularly, at least 30 minutes a day, 3 times a week.

Refrain from smoking and avoid alcoholic beverages.

Intracranial or subarachnoid hemorrhage

Considered in a group of cerebrovascular diseases, intracranial hemorrhage is the second most common. The main cause is the deterioration of the cerebral blood vessels, leading to rupture and brain damage, and then disability.

Treatment guidelines

Treatment for cerebral hemorrhage depends on the location and the cause. In general, the locations of hemorrhage may dictate dierent treatment approaches depending on the cause.

Prevention

Following these suggestions may help reduce the risk of cerebral hemorrhage.

Get an annual health check-up to screen for disorders and risk factors and deal with them.

Maintain healthy blood pressure and cholesterol levels.

Maintain a complete and balanced diet. Avoid foods high in salt, fat and sugar

Refrain from smoking and avoid alcoholic beverages.

Consult a doctor when experiencing unusual symptoms.

Cerebral aneurysm

A cerebral aneurysm is a ballooning arising from a weakened area in the wall of a blood vessel in the brain. High blood pressure against the vessel walls could cause the bulge to rupture anytime, seriously aecting the brain.

Treatment guidelines

Several approaches are available, including neurosurgical clipping – locating the aneurysm and sealing it shut with a tiny metal clip, and endovascular coiling – inserting a catheter into an artery in the leg and then passing coils into the aneurysm. Both techniques help prevent ruptures by stopping blood owing into the aneurysm. Doctors decide on proper treatment for each individual patient. Other treatments may also be used to control symptoms and reduce complications such as anticonvulsant medication, physical therapy, occupational therapy, and shunting - inserting a tube to drain the excess cerebrospinal uid into the abdomen cavity.

Prevention

Suggestions for reducing the risk of aneurysm are as follows:

Get an annual health check-up to screen for disorders and

Maintain healthy blood pressure and cholesterol levels.

Maintain a complete and balanced diet. Avoid foods high in salt, fat and sugar.

risk factors and deal with them.

Refrain from smoking and avoid alcoholic beverages.

Consult a doctor when experiencing unusual symptoms.

Cerebrovascular malformations result from irregular connections between your arteries and veins in the spinal cord and in the brain. Cerebrovascular malformations

Treatment guidelines

endovascular embolization

surgical removal

stereotactic radiosurgery - use of precisely focused radiation beams to destroy abnormal blood vessels

Prevention

Cerebrovascular malformations cannot be prevented as the causes are unknown. The conditions are mostly congenital but the following is suggested to reduce the risk of rupture.

Avoid blood pressure increasing activities

Avoid taking anticoagulants such as Warfarin.

Consult a doctor if you have any abnormal symptoms.

such as lifting heavy objects.

Acute spinal cord injury (SCI) is due to a traumatic injury that bruises, partially tears, or completely tears the spinal cord. SCI is a common cause of permanent disability and death. Acute spinal cord injury

Treatment guidelines

Acute spinal cord injury requires emergency medical attention on the scene of the accident or injury. The head and neck must be immobilized to prevent movement. Specic treatment for an acute spinal cord injury is based on several factors including age, severity and type of injury. Treatment may include the following:

mechanical ventilator

bladder catheter

tube feeding

surgery

medications

Prevention

While it cannot be surely prevented, the following is advised to lower the risk:

Take precautions to avoid falls.

Always wear a seat belt while in a vehicle.

Wear a helmet when playing sports or doing activities that may cause head injury, e.g. cycling, riding a motorcycle.

A brain tumor is a growth of abnormal cells in the brain. It can develop in any part of the brain. It can be benign or cancerous, and can be primary or metastatic. Brain tumors

Treatment guidelines

Taking into consideration such factors as the patient’s symptoms and the tumor’s location and size, doctors decide on treatment approaches including:

radiation therapy

observation, if the tumor is asymptomatic, very small, in the location not aecting the body functions

chemotherapy

targeted therapy or immunotherapy

surgery

Prevention

With no clear known cause, brain tumors are not preventable. They may be caused by heredity or environment or both together. However, the following measures may help reduce the risk.

Annual health check-ups for screening and management of risk factors

Avoiding exposure to UV rays, X-rays and gamma rays

Traumatic brain injury usually results from a violent blow or jolt to the head or body. It can be also caused by an object that goes through brain tissue, such as a bullet or shattered piece of skull. Traumatic brain injury

While mild traumatic brain injury may aect the brain cells temporarily, a more serious injury can result in long-term complications or death.

Treatment guidelines

Considering the severity of the injury, doctors decide on treatment approaches which include the following:

For mild injury, rest, pain relievers for headaches,

In moderate or severe cases, prescriptions of anti-seizure drugs, diuretics, and coma-inducing drugs, as a comatose brain needs less oxygen to function

and close monitoring of symptoms at home

Surgery, e.g. to repair the skull fractures or stop the bleeding in the brain

Rehabilitation including physical therapy, occupational therapy and speech therapy

Prevention

Prevent falls, e.g. with grab bars in the bathroom, non-slip mats, proper lighting and de-cluttering stairs.

Get an eye exam annually or regularly.

Exercise to strengthen muscles, which helps prevent falls.

Prevent falls in children by installing guards or railings on the deck.

Encephalopathy refers to damage or disease that aects the brain’s structure or function. It happens when there’s been a change in the way your brain works or when a change in the body aects the brain. Encephalopathy is not a single disease but a group of disorders with several causes. Encephalopathy

Treatment guidelines

Treatment depends on the cause of the conditions, generally including the following:

Medications to stop seizures or reduce ammonia levels

Pain management.

Changing the foods you eat

Nutritional supplements

Stopping the medication usually taken

Dialysis or transplant of problem organs such as liver or kidney

Prevention

Some types of encephalopathy such as hepatic encephalopathy can be prevented, while others are not preventable as they are hereditary. Meanwhile, certain lifestyle changes may reduce the risk of developing encephalopathy.

Refrain from smoking and excess alcohol consumption.

Reduce the risk of head trauma.

Reduce exposure to toxins.

Maintain a healthy weight.

Exercise regularly.

Follow a healthy diet.

Hydrocephalus

Hydrocephalus is a condition where uid builds up in the brain and the spinal column and causes brain swelling, leading further to a range of brain function problems.

Treatment guidelines

The most common treatment for hydrocephalus is the surgical insertion of a system, called a shunt, to drain the uid from the brain ventricles or spinal cavities to be safely reabsorbed in another location such as the peritoneum.

Prevention

Hydrocephalus cannot be prevented but the risk can be lowered in the following ways:

Get prenatal care during pregnancy to reduce the chance of going into premature labor, which can lead to hydrocephalus in the baby.

Wear safety helmets when playing sports or doing activities to prevent head injuries.

Get vaccinations against illnesses and infections as recommended by physicians.

Get regular health check-ups to ensure prompt treatment for illnesses.

Dementia

It is a condition in which the worsening brain functions aect daily life activities, as reected in various symptoms including forgetfulness, having diculties in calculating change or paying bills, getting items misplaced, getting lost in familiar places, and developing strange behavior, etc.

Treatment guidelines

Doctors decide on treatment considering the causes.

If found to have Alzheimer's disease, both palliative treatment with medication and non-medication therapies are important in enhancing the quality of life for both patients and their families. Discussion with doctors can also help caregivers cope with the patients’ symptoms appropriately.

Cognitive training is used to improve or maintain cognitive abilities in mild cases.

Prevention

Dementia cannot be prevented or cured but the following lifestyle choices may help reduce the risk.

Get enough sleep.

Follow a Mediterranean diet, which includes fresh vegetables and fruits, whole grains, olive oil, nuts, sh and occasionally red meat.

Drink enough water to meet the body’s needs.

Do moderate intensity exercise at least 3-4 times a week.

Do brain-stimulating activities like learning new things.

Socialize and meet with friends or relatives often.

Parkinson's disease Parkinson's disease is caused by a loss of nerve cells responsible for producing dopamine, leading to a reduction in dopamine, and then movement disorder.

Treatment guidelines

There is no cure for Parkinson's disease and no way to deter its progression. Treatments generally include the following.

Medication with drugs acting like dopamine

Deep brain stimulation surgery

Prevention

There’s no proven ways to prevent Parkinson’s disease but exercising regularly and maintaining a healthy diet may reduce the risk. Once diagnosed with Parkinson's disease, in addition to get medical treatment, exercises are recommended to slow down progression. These include balance training, strength training, aerobic exercise, and functional activities.

Bumrungrad’s neurological multidisciplinary team consists of a team of specialists in all branches of neurology and related systems as well as other well-trained multidisciplinary teams with expertise in diagnosing and handling serious and complex neurological disorders. Our teams are ready to provide compassionate tertiary care and quaternary care to the best of their abilities 24 hours a day. Here’s a list of people making up our teams: Neurological multidisciplinary team

Neurologists

Neurosurgeons

Neurointerventional radiologists

Specialists in critical neuropathy

having trained in critical care for neuropathy in the U.S.

Spine surgeons

Ear, Nose and Throat specialists

Rehabilitation medicine specialists

Nurses trained in neurological

Nutritionists

and cerebral critical care.

A team of physiotherapists and occupational therapists who specialize in the rehabilitation and treatment of patients with neurological and brain disorders

Speech therapists

Pharmacists who specialize in critical neurological disorders

Clinical nurse coordinators, neurology

Advanced medical technology and equipment

Transcranial Doppler (TCD) - to assess the risk of stroke and vasospasm

Electroencephalography (EEG)

Transcranial Magnetic Stimulation (TMS)

Magnetic resonance imaging (MRI)

Computed Tomography (CT Scan)

Operating rooms and the Neuro Critical Care Unit (NCCU)

The operating room with the biplane vascular X-ray system provides two sets of high denition X-ray images simultaneously, enabling surgeons to perform complex vascular surgery eectively.

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Neuro Critical Care Unit (NCCU), with an environmentally-focused design for maximum safety, features 10 individual rooms, each with a patient monitor linked to the central monitor, so the NCCU nurses can keep watch of all the critically ill patients.

Seamless care with facilities and working teams available 24/7 for critical conditions We realize that every millisecond counts

and we may reach a point of no return anytime. Our facilities and ecient teamwork enable us to be ready to handle critical patients 24 hours a day.

The Neuroscience Center works in close collaboration with the Emergency Department and the Neuro Critical Care Unit (NCCU) so they are all ready to handle patients in all critical conditions 24 hours a day.

In an emergency, neurologists and NCCU nurses can provide initial diagnosis and treatment at the emergency department

Our facilities allow seamless treatment coordination with the neurosurgical operating room, the bi-plane lab, and the NCCU are in the same area.

An aeromedical evacuation team trained by the National Defense College in medical evacuation procedures is ready to provide medevac services 24 hours a day, transporting patients both within the country and from overseas.

Emergency patients in need of an additional procedure such as clot retrieval can thus access treatment immediately.

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