An unusually large head, A rapid increase in the size of the head, A bulging or tense soft spot (fontanel) on the top of the head, Vomiting Sleepiness, Irritability, Poor feeding, Seizures, Eyes fixed downward (sunsetting of the eyes), Deficits in muscle.

Recurring episodes of excessive day time sleepiness, Sleep paralysis of limbs, Hallucinations, Dizziness, Fainting, Headache.

Apnea, Lethargy, Poor feeding, Tachypnea and Vomiting, Developmental delays, Birth defects, Abnormally small head, Seizures, Abnormal movements, Growth problems

Weakness of tongue and mouth muscles, Fasciculations and gradually increasing weakness of limb muscles with muscle wasting, Pre-mature muscle fatigue that begins in adolescence, Loss of sensation and numbness usually not noticeable, Hand tremor with volit

Altered movements, Awkward gait, Loss of speech, Lack of appetite, Impaired vision, Altered hearing, Slowdown in mental and physical development

Swollen lymph nodes in the neck, Armpits or groin, Abdominal pain or swelling, Chest pain, Coughing, Laboured breathing, Fatigue, Fever, Night sweats, Weight loss

Nausea, Vomiting, Sleepiness, Blurred vision, Loss of coordination, Slurred speech, Poor balance, Dizziness, Confusion

Fever, Headache, Nausea and vomiting Stiff neck, Photophobia (low tolerance to bright light), Confusion, Joint aches or pains, Drowsiness, Seizures, Fever, High-pitched cry, Pale and blotchy skin color, Not wanting to eat, Vomiting

Difficulty lifting the front part of your foot and toes (footdrop), Weakness in your leg, feet or ankles Hand weakness or clumsiness, Slurring of speech or trouble swallowing, Muscle cramps and twitching in your arms, shoulders and tongue

Bladder problems (frequent urination, urgency), Depression, Dizziness or vertigo, Impaired coordination (ataxia), Sensory symptoms (numbness, pain), Spasticity (muscle stiffness or spasms), Tremors, Trouble with short-term memory and concentration

Weakness of the eye muscles, Difficulty in swallowing, Slurred speech, Double vision, Altered speaking, Limited facial expressions, Problems chewing

Flat and light brown spots on the skin, Freckling in the armpits or groin area, Soft bumps on or under the skin, Bumps on the iris of the eye, Bone deformities, Learning disabilities, Impaired thinking skills (cognition) are common in children with NF1

Blindness in one or both eyes, Weakness or paralysis in the legs or arms, Painful spasms, Loss of sensation, Bladder or bowel dysfunction from spinal cord damage

Excessive daytime sleepiness, Loud snoring, Observed episodes of breathing cessation during sleep, Abrupt awakenings accompanied by shortness of breath, Awakening with a dry mouth or sore throat Awakening with chest pain, Morning headache

Headaches, Seizures, Personality changes, Weakness in the arms or legs, Numbness, Nausea and vomiting, Vision loss

Blurring of vision, Loss of vision, Loss of colour vision, Pain in the orbit

Pain, Vision loss, Loss of color vision, Flashing lights

Tremor, slowed movement, rigid muscles, impaired posture and balance, loss of automatic movements, speech changes, writing changes

Tiredness or fatigability, Difficulty in climbing stairs, Difficulty in getting up from squatting position, Difficulty in lifting arms, Difficulty in swallowing

Stiffness and weakness and spasticity in legs, Tripping, Difficulty with balance and clumsiness, Weakness and stiffness progressing to your trunk and arms/hands/tongue, Hoarseness, Reduced rate of speaking, Slurred speech and drooling as the facial muscle

Deterioration of language function in the form of difficulty in naming, Decreased fluency, Hesitancy in producing speech, Difficulty in understanding words

Back pain,Shooting pain along the back of the leg,Burning sensation along the back of the leg, Weakness of the toes, Inability to hold on to footwear, Numbness of the toes and foot, Difficulty to pass urine,Inability to appreciate bladder filling sensation

Back pain, Severe back pain on walking short distances that improves with rest, Weakness of feet on walking short distances that improves with rest, Burning sensation and pain in back and leg on prolonged standing or walking

Weakness of one side of the body, Difficulty in talking, Difficulty in swallowing, Visual disturbances, Imbalance, Double vision, Deviation of angle of mouth, Giddiness, Altered sensorium, Drowsiness, Unconsciousness

A. High-protein diet lowers stroke risk

Every year thousands of Indians die or are crippled by stroke. Here, however, is a simple way of reducing the risk. Eat lots of protein.

It is well known that fat-rich diets promote the build-up of plaques in the arteries, which can lead to atherosclerosis. Similarly, high blood pressure and diabetes are caused by overweight and obesity among other factors. However, the latest study published in the journal Neurology shows that dietary protein may reduce the risk of stroke by lowering blood pressure.

Researchers, who conducted this study, including Dr. Xinfeng Liu of Nanjing University School of Medicine in China, stated that their objective was to evaluate the link between protein intake and stroke risk by analysing all available research in the field.

The results of an analysis that involved 254,489 participants and seven studies showed that the risk of a stroke was 20% less among people with the highest dietary protein levels. All subjects were followed for an average of 14 years.

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The study points out that people on a diet full of proteins particularly from fish are 20% less likely to experience a stroke than those with the lowest protein intake. The team also found that stroke risk decreased by 26 per cent for every additional 20 g of protein consumed each day.

These findings remained even after taking other factors into account that may influence the risk of stroke, such as smoking and high cholesterol.

Dietary protein appears to reduce stroke risk partly because proteins have the effect of lowering blood pressure. In one study, the levels of triglyrcerides, total cholesterol and non-high-density lipoprotein cholesterol (bad cholesterol) was far lower among participants on a higher protein diet as compared to those who followed a high-carbohydrate diet. The researchers also noted that taking in lots of proteins reduces the risk of stroke by limiting our desire and capacity to consume other potentially harmful foods.

The benefits were appreciably more among participants who consumed a lot of animal (fish) protein rather than vegetable protein. However, since the number of participants on vegetable protein was small, this may not necessarily be the case.

Understanding which diets are most effective for reducing the risk of stroke "opens new avenues of research in stroke prevention with prospective, well-controlled clinical trials comparing major cardiovascular diets."

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B. Kids too can get a stroke

Bucking popular belief Dr. Ryan Felling at the Johns Hopkins University School of Medicine says that strokes are not purely a concern of the old. Sure, pediatric strokes are rare, not more than 11 per 100,000, but certainly not impossible. Be it adults or children the warning signs are the same corresponding to the abbreviation FAST:

FACE: One side of the face droop on smiling

ARMS: One arm drifts downward when a person is asked to raise both arms

SPEECH: The speech is slurred or strange?

TIME: Since fast response is key, you must consult a doctor if you observe any of these signs

When the brain receives insufficient oxygen a stroke occurs. If the oxygen deficiency is caused by a blood clot that has traveled from the heart the stroke is called ischemic. Or, if it is caused by a burst blood vessel in the brain, the stroke is classified as hemorrhagic. Strokes among children split about 50/50 between the two types.

Medical conditions like sickle cell disease and hemophilia increase the possibility of stroke. But doctors don't always know the reason for a stroke. "In 20 to 30 percent of childhood strokes, we may not find a specific cause. Oftentimes, we'll find one or more risk factors, but not all the time," said Dr Felling.

"Recognizing that it's rare but possible is important. People need to take signs and symptoms seriously and get them to medical attention." Family histories also can point to a predisposition. If a family has a medical history of vascular disease, the children are more susceptible to strokes.

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C. A breakthrough in battle against stroke

The risk of sustaining a serious disability from a stroke can be reduced with the use of peptides, researchers in West Australia have found. “It is an important development in stroke research,” said Professor David Blacker, medical director, West Australian Neuroscience Research Institute. Experimental peptides succeeded in reducing the volume of damage caused by stroke in rats.

If this can be applied to humans, critical bits of the brain could be protected from damage. Professor Blacker, who is also a neurologist at Perth's Sir Charles Gairdner Hospital, said most researchers had given up trying to find such a treatment. The peptides particularly target vulnerable tissue that may eventually become damaged. They aim to inhibit or suppress the brain damage that occurs after stroke.

This trial was done on rats and it is expected to be some years before the peptides are tested on humans in a clinical trial. But Professor Blacker said time is always of the essence when it comes to stroke research. "One in six people in the world will have a stroke," he said.

The team also hopes to secure funding to explore how the peptides could help people suffering from other conditions, including cardiac arrest and spinal injury.

D. Clot retrieval, a new ‘stroke’ of hope

A study involving patients in New Zealand has proved the efficacy of a treatment that removes blood clots from the brain. The procedure dramatically improves the recovery of stroke victims. Recently a young patient in Auckland affected a full recovery from a stroke which threatened to leave him with severe mobility issues.

Called clot retrieval the effectiveness of the treatment has been proved by studies in Holland, the US, Canada, Australia and New Zealand. Still, it could take up to five years before it is rolled out as standard practice in hospitals around the world.

The surgery is complex, resource intensive and involves inserting a thin tube known as a catheter through the groin and into the brain to draw out the clot. Stroke ranks third next only to heart disease and cancer as a cause for death and it occurs usually when a blood clot gets stuck in an artery supplying blood to brain. If the clot does not break up within a few hours, the brain stops working.

The standard treatment so far is to try and bust the clot with drugs and clear the artery. But this works only in one in three cases. Clot retrieval, on the other hand, is successful 80 per cent of the time.

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E. Tools help unlock brain mysteries

An advanced set of analytical tools is helping scientists unravel some of the brain’s deepest mysteries and open new horizons in stroke-related research. Developed by an international collaboration these tools provide a never-before look into cell types in the brain, says Associate Prof Ruth Empson, of the University of Otago physiology department who is part of the group. A part of the arsenal is a revolutionary $-1-million multi-photon "microscope", which uses infra-red light to see into living organs and cells with ""unparalleled detail and speed".

The powerful new tools are expected to deepen our understanding of how different parts of the brain connect and communicate during behaviour in more detail. In addition it would help researchers, understand ''the significance of connectivity changes'' among a specific group of motor neurons after a stroke.

Reported last week in Neuron the work of these scientists includes techniques that manipulate the genes of a small subset of cells and make them glow under fluorescent microscopes. The structure and function of different neurons types can be seen and studied by manipulating unique gene markers for each cell type into fluorescent labels or probe. Also cells are being made to fire a signal using a technique called optogenetics. Together, fluorescent imaging and optogenetic stimulation are helping reveal where specific cells were, when they were active and how they interacted with other cells.

F. A sense of purpose protects brains

If you are a senior citizen and lack a strong sense of purpose, then gets one, it may save your brain from tissue damage. New research involving autopsies of adults in their 80s showed far fewer "macroscopic infarcts" – dead tissue caused by blocked blood flow – among people who felt they were leading meaningful lives. Brain tissue damage of this kind is believed to increase the risk of dementia, movement problems, disability and/or death – many classic characteristics of old age.

"It is well known that negative emotions like feeling bad, alone or sad are linked to a great deal of negative health outcomes," said study co-author Patricia Boyle, a neuropsychologist at the Rush Alzheimer's Disease Centre in Chicago. Such outcomes can include early death, an increased likelihood for developing dementia and Alzheimer's, or a higher risk for disability, she noted.

"The new study is exciting because it is focused on the positive impact of having a purpose in life," Boyle added. "In other words, a feeling of well-being, a sense that your life is good and that you're doing something important with your time contribute to mental health." The team has found that having a positive mental state is somehow protective in old age, she said.

Autopsies were conducted on 453 seniors in their 80s. One in four of them were found to have experienced a stroke before death and nearly half of them showed signs of major and minor brain tissue damage. When their autopsy reports were seen alongside their annual psychological evaluations the research team determined that men and women characterized as having a strong sense of life purpose were 44 per cent less likely to have suffered major brain tissue damage.

The researchers said people can find meaning in their lives through volunteering, learning new things, or being part of your community. "You can find whatever it is that drives you to be helpful and positive and strive for that and doing that will make a difference to your physical health," Boyle said.

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G. Strokes affect women more than men

If you thought gender bias was a social problem think again. According to new study by researchers in Taiwan the after-effects of stroke are more pronounced in women than men. “Women appear to have more lasting and intense memory impairment issues over the long run following a concussion,” said the scientists who conducted the study. Also referred to as mild traumatic brain injury (MTBI), concussion is temporary loss of normal brain function, which often follows a head injury. Among its symptoms are headache, sleep impairment, fatigue, poor coordination, loss of memory, poor concentration and changes in mood. Most people recover from the condition in less than three months but 10-15 % of patients continue to experience complications.

The results of recent studies on the long-term effects of concussion are anything but reassuring. Increasingly, studies have found that concussion can lead to abnormal brain wave activity and poor memory even decades after injury. A study found that brain's gray matter continued to show signs of damage four months after injury. Underlining the presence of the gender bias studies on professional athletes engaged in contact sports show that concussion is more common among female than male athletes.

The lead author of the latest study, Dr. Chi-Jen Chen, of the Taipei Medical University Shuang-Ho Hospital and the Chia-Yi Hospital - both in Taiwan – says that women are also more likely to seek medical attention for persistent symptoms after concussion. Using functional magnetic resonance imaging (fMRI) Chen and his team analyze the activity of the brains of 15 men and 15 women with concussion while they performed working memory tasks. Since working memory impairment is a common complaint after concussion the team focused on this aspect.

H. Strokes age the brain by eight years in a single night

In one fell stroke, literally, your brain could age by eight years, according to the results of a new study carried out at the University of Michigan U-M Medical School and the School of Public Health and the VA Center for Clinical Management Research. The finding is based on the performance of a group of stroke patients on a 27-item memory test. The results of this test showed that the memory and speed of thought among these ‘stricken’ individuals had declined dramatically, as if they had aged 7.9 years overnight.

When supply of blood to a part of the brain is disrupted because of narrowing of arteries that carry blood to the brain, a clot or a rupture, it usually results in a stroke, which is a serious medical condition and could prove fatal in the absence of urgent and appropriate attention. The sooner a victim receives treatment the milder would be the after-effects of a stroke—that is the long-term damage caused by a stroke is directly related to the speed of adequate medical response. Many a time the treatment must begin inside the first few hours of the occurrence of symptoms.

The Michigan study was huge in size involving 4,900 black and white seniors. These 65 plus people had all suffered from stroke, an occurrence that had set their brains back by years. To arrive at their conclusion, the scientists co-related two large strands of information: the results of the performance tests conducted on a large number of individuals administered over a number of years and second, the medical care data of the same individuals.

From this huge mass of subjects the scientists selected a group of study participants who had not recently suffered from stroke or dementia, but whose records showed that they has been hit by a stroke inside of 12 years of their first survey and cognitive test in 1998. The results of the tests conducted on this group showed indubitably that the performance of the brain on counts like memory and speed of thinking declines dramatically after a stroke than it does before. The decline experienced in one night is as much as the brain’s performance would have declined in 8 years had it not been affected by stroke.

The findings of the Michigan researchers emphasise the importance of preventing a stroke. The lead author of the study Dr Deborah Levine says that the study had revealed the scale of cognitive aging that strokes cause. “It is, therefore, crucial,” she concludes for us to prevent stroke if we wish to prevent rapid decline in mental abilities”.

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I.Want to avoid stroke? Eat chocolates!

There is no feeling to beat falling in love. Wrong. Eating chocolates produces the same feeling in the brain. Plus, now it appears, it protects your heart and brain, from attacks and strokes! Wow. So, go ahead and dig into a juicy bar of rich dark chocolate with zero guilt.

For long, scientists (and most chocolate lovers) have known that it is intensely pleasurable to eat chocolates. Other than the taste, scientists have de-romanticized our affair with the sweet meat by proving that this ultimate comfort food produces the same chemical in the brain as love.

If that was not good enough, they have now shown in a recent study that noshing on up to two bars a day actually provides us protection from heart disease and stroke. For some time now the health benefits of dark chocolates have been evident; the recent study shows that the same holds true for milk chocolates as well. Chocolates are a source of precious nutrients that reduce the risk of strokes and heart problems.

Earlier studies had shown that chocolates lower cholesterol, reduce memory loss and stress, prevent diabetes and shield the skin from the harmful effects of sunrays. To check whether chocolates were indeed beneficial to the heart, researchers at the University of Aberdeen studied the snacking habits of 21,000 people over 12 years.

This is what they found: consuming as much as 100 grams of chocolate daily reduced the risk of people dying from heart disease by 25 per cent. Similarly, the probability of being hit by a stroke too fell by 23 per cent.

According to Professor Phyo Myint, at the Aberdeen University the weight of evidence gathered thus far indicates that a higher intake of chocolate is related to a reduced risk of cardiovascular events. "Flavonoids and other compounds like calcium and fatty acids, which constitute milk, may hold the key to this association." Also conducted was a review of accessible documentary evidence on the links between chocolate and cardiovascular conditions covering 158,000 people. In every single case the researchers found that people who regularly consumed chocolate had a significantly lower risk of stroke and heart disease.

Even sweeter is the finding that people who gorged on chocolate were slimmer, exercised more often and had lower blood pressure. However the authors caution that although evidence clearly links chocolate consumption with lower risk of future cardiovascular events, it’s not a prescription for over indulgence for, as Dr Tim Chico, Reader in Cardiovascular Medicine and Consultant Cardiologist at the University of Sheffield, says: “Although these studies indicate that there could be some health benefits from having chocolate, chocolate is also implicated with weight gain, which is unquestionably adverse for cardiovascular health”.

In other words, the latest findings are no prescription for gorging on chocolates (meaning it’s still not as good as fresh fruit, leafy greens and whole grains). But two bars of your favourite chocolate may do no harm at all and in fact help you keep strokes and heart problems at bay.

J.Even tiny brain lesions signal future stroke risk

A new study conducted by Dr Gwen Windham, an associate professor of geriatrics at the University of Mississippi in The US have revealed that the presence of small injured areas or lesions in the brain may suggest an elevated risk of stroke or stroke-related death among otherwise normal people.

Dr Windham observed that these findings indicate that even tiny lesions on brain imaging ought to be taken seriously as early pathology suggesting an increased risk of stroke even if there are no other symptoms.” Of course, individuals with both small and large lesions are at a clearly greater risk of being hit by a stroke.

"Although it would be necessary to replicate these findings across different populations, the study does imply that even miniscule lesions are relevant clinically. To understand what causes these little injuries and how to prevent them we would need to dig deeper," said the lead author of the study, which appeared in the July 7 edition of the Annals of Internal Medicine.

The report is based on an Atherosclerosis Risk in Communities Study that involved more than 1,800 adults aged 50 to 73. None of these subjects who were followed for an average of 14.5 years had any prior history of stroke. MRIs were used to spot lesions. The results showed that people with small lesions were three times more likely to have or die from strokes as compared to those who didn't. People with both small and large lesions are at seven to eight times higher risk.

The chairman of neurology at the University of Miami, Miller School of Medicine Dr Ralph Sacco, noted that the study contributes to the mounting evidence indicating that stroke and death may be implicit in silent changes that happen in the brain".

Quite often MRIs pick up silent strokes in older people. However, this study focused on a younger group of individuals. It is to be noted that silent stroke and other harmful alterations in the brain are more prevalent among smokers and people who suffer from hypertension and diabetes.

K.Brain stroke can be avoided with physical activity

Medical experts have said that brain stroke can be avoided by regular physical activity, not smoking and limiting the consumption of alcohol. This was among the observations made by leading neurologists at an event organized by Aayush hospital in the run up to the World Stroke Day, October 29 Know more