Most people think of neurosurgery as brain surgery but it is much more! It is the medical specialty concerned with the diagnosis and treatment of patients with injury to or diseases/disorders of the brain, spinal cord and spinal column, and peripheral nerves within all parts of the body. The specialty of neurosurgical care includes both adult and pediatric patients. Dependent upon the nature of the injury or disease a neurological surgeon may provide surgical and/or non-surgical care.
What is Neurosurgery?
Neurosurgery (or Neurological Surgery) is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. Neurosurgery is a branch of the surgery discipline which focuses on the brain and spinal cord. It is an extremely advanced form of surgery, requiring many years of training, and a high level of precision and experience on the part of the surgeon.
Amyotrophic Lateral Sclerosis
Encephalitis and Meningitis
Facial Nerve Problems
Cauda Equina Syndrome
Complex Regional Pain Syndrome
Thoracic Outlet Syndrome
Ramsay Hunt Syndrome
Restless Leg Syndrome
Seizures Symptoms and Types
Spinal Cord Injury
Progressive Supranuclear Palsy
Types of Neurosurgery procedures:
Deep Brain Stimulation
Vagal Nerve Stimulation
Sacral Nerve Stimulation
Cerebral Aneurysm Repair
Anterior Temporal Lobectomy
Human Leukocyte Antigen Test
Common Neurological Diagnostic methods:
Neurological diagnostic tests and procedures are designed to locate and diagnose nervous system issues and disorders. Some of the most common screening tests include:
Neurological examinations - these help determine function and status of speech, balance, coordination, reflexes, mental status as well as tumors or infections such as meningitis or encephalitis.
Fluoroscopy -a type of x-ray that utilizes pulsed low dose radiation beams to create continuous images of body parts. Pictures can be sent to a monitor for immediate viewing or videotaped. In some cases, contrast mediums or dyes may be used to provide specific focus to certain areas of the body.
Cerebral angiogram - often utilized to diagnose and pinpoint narrowing or obstruction of arteries or blood vessels in the brain or neck. They may also be used to determine size and location of brain aneurysms, tumors or vascular malformations.
Brain scans - include but are not limited to MRIs (magnetic resonance imaging), computed tomography (CT) and positron emission tomography (PET). Brain scans can diagnose location of brain hemorrhages, malformations in blood vessels, and be used to locate and diagnose tumor growth.
Electroencephalography - also known as an EEG, this test monitors brain activity. It's often used to diagnose brain damage caused by head injuries, seizure disorders, or inflammation in the spinal cord or brain caused by degenerative disorders, metabolic disorders and some psychiatric disorders.
Electromyography - also known as EMG, this test is utilized to diagnose muscle dysfunction, spinal cord disease processes and diagnose nerve damage or dysfunction. The test measures and records electrical activity from the spinal cord or brain to peripheral nerve roots located in the legs or arms.
Common Neurological procedures:
Laminectomy: A laminectomy is a surgical procedure in which the surgeon removes a portion of the bony arch, or lamina, on the dorsal surface of a vertebra, which is one of the bones that make up the human spinal column. It is done to relieve back pain that has not been helped by more conservative treatments. In most cases a laminectomy is an elective procedure rather than emergency surgery. A laminectomy for relief of pain in the lower back is called a lumbar laminectomy or an open decompression.
Craniotomy: A craniotomy is a procedure to remove a lesion in the brain through an opening in the skull (cranium). A craniotomy is a type of brain surgery. It is the most commonly performed surgery for brain tumor removal. It also may be done to remove a blood clot (hematoma), to control hemorrhage from a weak, leaking blood vessel (cerebral aneurysm), to repair arteriovenous malformations (abnormal connections of blood vessels), to drain a brain abscess, to relieve pressure inside the skull, to perform a biopsy, or to inspect the brain. Craniotomy is distinguished from craniotomy (in which the skull flap is not immediately replaced, allowing the brain to swell, thus reducing intracranial pressure) and from trepanation, the creation of a burr hole through the cranium in to the durra mater.
Rhizotomy: Rhizotomy is the cutting of nerve roots as they enter the spinal cord. Rhizotomy (also called dorsal Rhizotomy, selective dorsal Rhizotomy, and selective posterior Rhizotomy) is a treatment for spasticity that is unresponsive to less invasive procedures. Rhizotomy is performed under general anesthesia. The patient lies face down. An incision is made along the lower spine, exposing the sensory nerve roots at the center the spinal cord. Individual nerve rootlets are electrically stimulated. Since these are sensory nerves, they should not stimulate muscle movement. Those that do (and therefore cause spasticity) are cut. Typically, one quarter to one-half of nerve rootlets tested are cut.
Corpus Callosotomy: Corpus Callosotomy is a treatment for epilepsy, in which a group of fibers connecting the two sides of the brain, called the corpus callosum, is cut. It is used to treat epilepsy that is unresponsive to drug treatments. A person with epilepsy may be considered a good candidate for one type of epilepsy surgery or another if he or she has seizures that are not adequately controlled by drug therapy, and has tried at least two (perhaps more, depending on the treatment center's guidelines) different anti-epileptic drugs. The purpose of this treatment is to prevent spreading of seizure activity from one half of the brain to the other. The brain is divided into two halves, or hemispheres, that are connected by a thick bundle of nerve fibers, the corpus callosum. When these fibers are cut, a seizure that begins in one hemisphere is less likely to spread to the other. This can reduce the frequency of seizures significantly.
Stereotactic Radiosurgery: Stereotactic radiosurgery is the use of a precise beam of radiation to destroy tissue in the brain. This procedure is used to treat brain tumors, arteriovenous malformations in the brain and in some cases, benign eye tumors or other disorders within the brain. It works the same as all other forms of radiation treatment. It does not remove the tumor or lesion, but it distorts the DNA of the tumor cells. The cells then lose their ability to reproduce and retain fluids. The tumor reduction occurs at the rate of normal growth for the specific tumor cell. In lesions such as AVMs (a tangle of blood vessels in the brain), radiosurgery causes the blood vessels to thicken and close off. The shrinking of a tumor or closing off of a vessel occurs over a period of time. For benign tumors and vessels, this will usually be 18 months to two years. For malignant or metastatic tumors, results may be seen in a few months, because these cells are very fast-growing.
Meningocele repair: is surgery to repair birth defects of the spine and spinal membranes. Meningocele and myelomeningocele are types of spinal bifida. The surgery is necessary to close this abnormal opening to decrease the risk of infection and protect the integrity of the spina column and the tissue inside. A myelomeningocele is the most severe type of spina bifida because the spinal cord has herniated into the protruding sac. Neural tissue and nerves may be exposed. About 80% of myelomeningoceles occur at the lower back, where the lumbar and sacral regions join. Some people refer to myelomeningocele as spina bifida. Because of the exposed neural tissue, significant symptoms may be present.
The usual preoperative things that need to be done include bloodwork, heart function evaluation (e.g. EKG), medical clearance by your internist, a chest X-Ray, and possibly a localizing MRI or CT scan to help minimize the surgery. (A kind of "X marks the spot" idea). If you are undergoing stereotactic surgery, you may require an MRI with localization markers (usually felt-tip pen marks) on your scalp, or the placement of a sort of medieval "frame" that is literally screwed onto your skull, using local anesthetics.
Certain problems may require a cerebral angiogram to be performed, so that the surgeon has a "blood vessel" road map prior to surgery. Functional studies (special MRI, EEG, or magnetoencephalography) also might be necessary to guide the surgeon where not to go.
Cerebral blood flow studies (SPECT, Xenon studies or transcranial doppler studies) may be important to show the surgeon the state of your brain's blood supply reserves. You'll get an IV catheter the night before surgery; you'll be given various medications to prevent seizures, temporarily remove brain water (like medically squeezing a sponge), so the surgeon doesn't need to retract too much during surgery. You'll also be given antibiotics (to prevent infection). If you have an allergy to an antibiotic, make sure everyone knows it.
The night before surgery is usually full of anticipation. More often than not, you'll be the one comforting your family and friends. If you're afraid, thats only normal. Sometimes, sleep is difficult, so don't hesitate to ask for sleeping medication, if you want it.
The next twenty-four hours will be spent in either the recovery room or in an intensive care unit setting. Usually a postoperative CAT scan will also be performed during this time, and nurses will stand by you, repeating the neurologic examination every hour or so, while administering the usual post-operative medications. These usually include pain medications (not too much, because they all want to see you bright and alert), steroids, antibiotics and anticonvulsants. You will usually be allowed to drink after a few hours, and "advance" your diet with each subsequent meal. If all is well, you will return to a regular room the following morning. Depending upon circumstances, a physical therapist will visit you and begin to work with you. Over the next couple of days, you will increase your activity until you are ready to go home. During that time you may be seen by various ancillary physicians, such as interns, residents, psychiatrists, radiation oncologists, internists, neurologists, and possibly oncologists. They will all confer with your neurosurgeon and come up with some sort of game plan prior to your discharge.
Advance Neurological procedures:
Gamma Knife surgery: Patients with certain types of brain tumors and disorders no longer need to "go under the knife" or endure physically draining radiation therapy to find relief. With Gamma Knife technology, doctors are able to deliver over 200 beams of radiation with scalpel-like precision directly to tumors and lesions. Although many people have never heard of Gamma Knife, the procedure has been around for a long time. The Food and Drug Administration approved it nearly 30 years ago, and University of Maryland doctors have been administering Gamma Knife treatments for over a decade. Unlike traditional surgery, Gamma Knife procedures don't actually involve the use of a "knife" or scalpel. In fact, no incisions are made at all. The skull never has to be opened up.
Neurosurgery in India:
Of late, India has embarked by all its leaps and bounds in catering various Neurosurgery procedures. Every year we see thousands of international patients coming down to India from various parts of the world. The factor behind this haul is certainly the presence of rich medical infrastructure with state of the art hospitals unlike we find in developed nations of US and UK wherein, the patients get medical services through cutting edge technology and staffed by well-experienced, trained and qualified multinational team.
The Indian Neurosurgeons and the Neurological team are of highest quality and deliver state-of-art medical and surgical care in these highly specialized fields of neurosurgery. They are known to cater personalized care and attention with value added services besides results of world class standard at a very low cost affordable to all sections of society.
The various Neurological procedures in India are available at various hospitals in the following cities:
Cost of Neurosurgery in India:
A huge cost difference is evident in India when it comes to Neurosurgery in India. India is cheaper along with zero patient wait lists. Interestingly, the quality delivered at such a low cost doesn’t compromise the quality of treatment, as the foreign patients are accustomed to get in their respective country. This is due to the outburst of the private sector which is comprised of hospitals and clinics with the latest technology and best practitioners. The following cost comparison can give a right picture of the claim behind low cost treatment with quality:
Neurosurgery with Hypothermia
Brain tumor surgery
Some of the common countries from which patients travel to India for surgery are:
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.
Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.
Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.
Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,
Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra..
Kerala - Welcome to Kerala, state in India's southern tip and a state known as God's Own Country. Kerala is one of the ten 'Paradises Found' by the National Geographic Traveler, for its diverse geography and overwhelming greenery. It is a land much acclaimed for the contemporary nature of its cultural ethos, and much appreciated for the soothing, rejuvenating paradise that it is.
Delhi - Delhi, the capital of India is situated in the northern part of the country. Apart from being the capital of India, Delhi is also the travel hub of northern India. It serves as an excellent base for visiting the colorful state of Rajasthan, and Agra, the city of the Taj Mahal, is less than three hours away. Discover the many tales behind Delhi’s ancient, bewitching existence. Feel the excitement of stepping foot on a piece of the world’s oldest land!
Pune - Pune is the eighth largest city in the India state of Maharashtra. The city derives its name from Punya Nagari, which means 'the city of virtuous deeds.'Pune or the 'Queen of Deccan' is known for its educational, research and development institutions. This beautiful city has many exotic locales attracting innumerable tourists.
Jaipur – Jaipur is located in India and attracts a flurry of tourists from all over the world. Sited within eastern Rajasthan, North India, the city of Jaipur is famed for its hilltop fortresses, magnificent royal palaces and historic pink-painted sandstone architecture, earning it the affectionate nickname of the 'Pink City'.
Chennai - Chennai formerly known as Madras is the capital city of the Indian state of Tamil Nadu. It is famous for its culture and tradition. Chennai hosts a large cultural event, which includes performances by hundreds of artists. The city has a vibrant theatre scene and is an important centre for the Bharatanatyam, a classical dance form.
Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium City.' Gurgaon has recently emerged as the latest hub for Medical Tourism. Apart from being IT hub and a favorite haunt for MNC offices, the city has a number of world class hospitals that not only treat Indian citizens but also people from outside.
Chandigarh - Chandigarh is a rare epitome of modernization co-existing with nature's preservation. It is here that the trees and plants are as much a part of the construction plans as the buildings and the roads. India’s first planned city, Chandigarh is a rich, prosperous, spic and span, green city rightly called “THE CITY BEAUTIFUL”.
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