Neurosurgery

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Neurosurgery offered at Best Reliable Hospital in India

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Neurosurgery offered at Best Hospital in India

Deep Brain Stimulation

Indian doctors with training in brain conditions (neurologists), brain surgeons (neurosurgeons), doctors with training in mental conditions (psychiatrists), pain specialists, specialized programming nurses and other specialists use an integrated team approach to treating people who have deep brain stimulation. Indian specialists have successfully used deep brain stimulation to treat hundreds of people who have essential tremor, Parkinson’s disease and dystonia. Recently, doctors have used DBS to treat people who have cluster headaches, Tourette syndrome, epilepsy and chronic pain that hasn’t responded to other treatment.

Neuro specialists in India use computer-assisted brain surgery, intraoperative MRI and awake brain surgery during deep brain stimulation.

Indian Neurologists are ranked among the Best surgeons for neurology and neurosurgery worldwide. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. This may cause more profound complications such as personality changes, but electrode misplacement is relatively easy to identify using CT.

After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.

What is Deep Brain Stimulation ?

Deep brain stimulation surgery technique involves implanting electrodes inside the deep nuclei of brain called as subthalamus under local anesthesia. These electrodes are then connected to IPG (Pacemaker) implanted underneath the skin below the clavicle through the connecting leads under general anesthesia. To perform any kind of activity, the patient has to switch on the device with the help of a patient programmer. This stimulates the deep brain nuclei, which results in improvement of all the symptoms of Parkinson disease.

With the progress of disease the parameters of stimulation are changed over a period of time so that patients can remain symptom free for long period. The patient himself can change the stimulation parameters with the help of patient programmer. Normally the life of the pacemaker is five years and after that a new pacemaker replaces it. The electrodes remain in position for life long.Rechargeble Pace makers are now available that can be recharged at home.The life of these pace makers are 15-20 years.The stimulation of subthalamic nucleus through this device leads to improvement in all the symptoms of advanced Parkinson disease.

DBS uses a surgically implanted medical device, similar to a cardiac pacemaker, to deliver electrical stimulation to precisely targeted areas within the brain. Stimulation of these areas blocks the signals that cause the disabling motor symptoms of Parkinson’s disease. The electrical stimulation can be noninvasively adjusted to maximize treatment benefits. As a result, many individuals may achieve greater control over their body movements.

DBS System consists of three implanted components :

  • Lead – A lead consists of four thin coiled insulated wires with four electrodes at the lead tip. The lead is implanted in the brain.
  • Extension – An extension connects to the lead and is threaded under the skin from the head, down the neck and into the upper chest.
  • Neurostimulator – The neurostimulator connects to the extension. This small, sealed device, similar to a cardiac pacemaker, contains a battery and electronics. The neurostimulator is usually implanted beneath the skin in the chest below the collarbone (depending on the patient, a surgeon may implant the neurostimulator in the abdomen). Sometimes called a “brain pacemaker,” it produces the electrical pulses needed for stimulation. These electrical pulses are delivered through the extension and lead to the targeted areas in the brain. The pulses can be adjusted wirelessly to check or change the neurostimulator settings.
  • The doctor may advise few antibiotics to prevent infection. The patient may need to visit the doctor several times after the surgery to adjust the stimulation with the help of programming. The doctor may prescribe a detailed medication plan to the patient. The patient should take some precautions after the surgery and follow the instructions given by the doctors. He/she should take care of the incisions and the surgical region on the head, by keeping it dry and covered. Heavy physical activities and lifting heavy weights should be avoided for few weeks after the surgery. Regular follow-up with the treating doctor should be done.

Deep Brain Stimulation Surgery Advantage:

  • In this surgery we do not injure the brain so it is relatively risk free.
  • Completely reversible and programmable
  • Parkinson medications are reduced which results in improvement of drug related side effects.
  • There is improvement of quality of life in both off and on stage of the disease.
Endovascular Surgery

Neurosurgery is a branch of surgery that treats conditions and diseases of the brain and nervous system. Radiology is a medical specialty that helps diagnose and treat conditions and diseases using various radiology techniques. Endovascular neurosurgery is a subspecialty within neurosurgery that uses catheters and radiology to diagnose and treat various conditions and diseases of the central nervous system. The central nervous system is made up of the brain and the spinal cord. This medical specialty is also called Neurointerventional Surgery.

Interventional neuroradiology is a subspecialty within radiology that also involves catheters and radiology to diagnose and treat neurological conditions and diseases. The term endovascular means “inside a blood vessel.” Endovascular neurosurgery uses tools that pass through the blood vessels to diagnose and treat diseases and conditions rather than using open surgery. The surgeon often uses radiology images to help him or her to see the part of the body involved in the procedure.

Doctors in these specialties may also diagnose and treat conditions of the spinal cord using similar techniques, although not through a blood vessel. These types of procedures are called “minimally invasive” because they generally require only a tiny incision instead of a larger incision necessary for open surgery.

Endovascular neurosurgery treats a variety of vascular diseases such as:

  • Stroke
  • Aneurysms
  • Arterio-venous malformations
  • IArterial stenosis
  • Dural arterio-venous fistulas
  • Vascular Tumours
  • Carotid Cavernous sinus fistulae
  • Cerebral revascularization after clotting
  • Vasospastic arteries

Neuro specialists in India use computer-assisted brain surgery, intraoperative MRI and awake brain surgery during deep brain stimulation.

Indian Neurologists are ranked among the Best surgeons for neurology and neurosurgery worldwide. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. This may cause more profound complications such as personality changes, but electrode misplacement is relatively easy to identify using CT.

After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.

Endovascular Neurosurgical procedures in India :

Thrombolytic therapy. This procedure uses “clot-busting” medication to dissolve a clot in a blood vessel in the brain or elsewhere in the body.

Endovascular coiling. A surgeon inserts a very thin metal wire that forms a coil inside a brain aneurysm to block blood flow. A brain aneurysm is a bulging, weakened area in the wall of an artery in the brain, resulting in an abnormal widening or ballooning. Because the artery wall has a weakened spot, the aneurysm is at risk for bursting if blood flow isn’t blocked.

Minimally invasive spine surgery. This procedure is used to treat spinal disorders such as fractures, tumors, compressed nerves, and other conditions that put pressure on the spinal cord.

Cerebral angiography. This is a radiology procedure that looks at how well blood is flowing in the brain.

Carotid artery angioplasty/stenting. This procedure uses a small balloon and/or a tiny metal scaffold called a stent to open a narrowed carotid artery. The carotid arteries supply blood to the brain.

Why Endovascular Neurosurgery at World’s Best Hospital in India

  • Indian doctors are known all over the world for their skill and knowledge and have the experience of studying and working at the best neuro surgery hospitals in the world.
  • Neurosurgery Hospitals in India are equipped with the latest and high end technology.
  • Advanced Dyna CT capability enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular areas like brain
  • Minimal incision similar to cardiac treatment, such as angioplasty or stent placement
  • Diagnostic (Cerebral or Spinal Angiography) or Therapeutic procedures for Intracranial Aneurysms, Arterial Stenosis, Stroke (Brain attack), Arteriovenous Malformations, Vertebroplasty and Percutaneous Sclerotherapy
Epilepsy Surgery

A disorder of the brain that also includes recurring seizures is termed as epilepsy. These seizures are due to chemical and electrical activity of the brain. Seizures can happen anywhere in the brain and involves multiple causes. A person has seizures when –

Doctors in these specialties may also diagnose and treat conditions of the spinal cord using similar techniques, although not through a blood vessel. These types of procedures are called “minimally invasive” because they generally require only a tiny incision instead of a larger incision necessary for open surgery.

Endovascular neurosurgery treats a variety of vascular diseases such as:

  • The causes of the seizures can be prevented.
  • There are 2 or more seizures.
Types of Epilepsy
  • Partial Epilepsy
    • Complex partial seizure
    • Simple partial seizure
  • Generalized Epilepsy
    • Absences
    • Generalized tonic clonic seizures
    • Myoclonic epilepsy
Why is Epilepsy surgery required?

Epilepsy surgery has proven to be successful in reducing and even eliminating seizures in patients who did not respond well to the epilepsy medications. It is important to get the treatment for epilepsy, repeated seizures may result in:

After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.

  • Irreparable Brain damage from repeated seizures
  • Sudden death, a rare complication
  • Injuries from falling / driving during various activities

Advanced Epilepsy Treatment Options Available at World’s Best Hospital in India

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet : This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

  • Anteromedial Temporal Lobectomy
  • Selective Amygdalohippocampectomy
  • Electrocorticography guided Resections
  • Multiple Subpial transections
  • Quadrantic Resections
  • Multilobar Resections
  • Functional Hemispherotomy
  • Vagal Nerve stimulation
  • Radiosurgery (selected cases)