Neurosurgery is a branch of medical science that deals with surgical aspects of the nervous system.
The nervous system includes the central and peripheral nervous systems. The brain and spinal cord constitute the central nervous system, while nerves and sensory receptors of end organs like skin, eyes, ears, etc. constitute the peripheral nervous system. Surgeons who perform neurosurgery are neurosurgeons, and they operate on the brain and spine.
What We Treat
Neurosurgical treatment encompasses a wide variety of brain and spine disorders. Like any other branch of medicine, the neurosurgical technique has evolved with the advent of microsurgical techniques and endovascular interventional techniques, and many pathologies which had dismal prognosis previously now have a better outcome.
We offer treatment for all brain and spine related diseases.
Brain pathologies like:
- Head injuries ( EDH, SDH, Depressed fracture, Diffuse Axonal Injury)
- Superficial and skull base brain tumors (Glioma, Meningioma, Acoustic schwannoma, Pituitary tumors, etc.)
- Hypertensive brain haemorrhage
- Aneurysm rupture(Clipping/Coiling)
- AVM/AVF bleed(Excision/Embolisation)
- Acute ischemic stroke(Mechanical thrombectomy for LVO/Intracranial stenting for ICAD)
- Hemifacial spasm
- Trigeminal neuralgia
Spine pathologiess like :
- Spine trauma
- Spinal tumor
- Degenerative spinal diseases (Disc prolapse, Spinal canal stenosis, Listhesis etc.)
- Cranio Vertebral Junction anomalies
- Congenital spinal malformations (Meningocele, Myelomeningocele, Lipomyelomeningocele, Tethered cord syndrome etc.)
How We Treat
- Surgery of the brain pathologies require opening of the skull vault- this procedure is known as CRANIOTOMY. It is usually done under General Anesthesia.
- Once the craniotomy is performed, coverings of the brain known as meninges or dura, the outer layer is opened. Depending on the location of the lesion (tumor, haemorrhage, etc.) i.e. on the surface, or within the brain substance, excision is done. The help of the operating microscope is taken for tumors and deeper lesions. Once the hemostasis is achieved, closure is done and the bone flap is put back.
- Decompressive craniectomy is a procedure similar to craniotomy, however, the difference being the skull vault is not put back into its place but is either kept in the abdomen or packed in a sterile package. It is usually done in cases in which the brain is too edematous. More often it is used in emergencies. Once the general condition of the patient improves and the edema subsides, around 6 to 8 weeks later, the bone flap is put back via another surgery called CRANIOPLASTY.
- Burr hole surgery is used to evacuate the chronic subdural hematoma. In this, instead of removing a large part of the skull vault, one or two burr holes are made into the vault and hematoma evacuated from it.
- Ventriculoperitoneal shunt (VP Shunt) – used for managing hydrocephalus (excess CSF accumulation within the brain). It involves placing a catheter in the ventricles of the brain and then passing the catheter through a subcutaneous tunnel and leaving the other end into the peritoneal cavity (abdomen), i.e. it is an internal CSF draining system. It is used for hydrocephalus due to tuberculosis, tumors or congenital conditions.
- External Ventricular Drain (EVD) – involves placing a silicon tube through the skull vault into the ventricle of the brain and the outer end is connected to a reservoir. It is an external CSF draining system. It is used in conditions like hydrocephalus due to pyogenic meningitis, or intraventricular haemorrhage or as a temporary measure during other surgery.
- Spine surgeries include laminectomy, discectomy and spine fixation procedures. Opening up of the spinal lamina is called a laminectomy. Removing the prolapsed disc along with a part of the lamina to gain access is called discectomy. Fixation of the spine by insertion of pedicle screws and rods is called a spinal fixation procedure. Placement of cage for interbody fusion may be done in conjunction with pedicle screw and rods. The above procedures can be done by open/convention method or by MISS (Minimally Invasive Spine Surgery Technique). MISS involves making a small incision and using a specialized dilator and retractor system and operating microscope/endoscope to perform the surgery.
- Endovascular procedures: Endovascular and interventional neurosurgical procedure involves accessing and treating brain conditions via a small femoral puncture and reaching the site of pathology via different types and sizes of catheters. For an aneurysm, coils are deployed via microcatheters into the aneurysm to occlude it. For AVM/AVF or tumors, embolization is done by injecting occlusive material(like EVOH/Glue/PVA particles). For acute ischemic stroke with large vessel occlusion, mechanical thrombectomy is done if a patient presents within the window period of the first 6 hours of symptoms.
At Aadicura, we are a team of two full-time neurosurgeons, who are available 24×7 for the management of patients. Also, we have a state-of-the-art operation theatre, with high end operating microscope, neuro drill, and other neuro instruments.
We have an in house rehabilitation and physiotherapy department to ensure early mobilization and faster recovery of our patients.
Our surgeons have a “patient first” approach and are committed to the safety and well-being of our patients.
The cath lab at Aadicura is the best in the region with 3-D rotational angiography/live fluoroscopy/smart mask facilities which are essential for giving the best result in neuro intervention cases.
We are the only center in central Gujarat which has CT perfusion imaging, which is very important in deciding the role of mechanical thrombectomy for delayed presenting stroke. For the best post-operative management of our patients, we have a state-of-the-art ICU with full-time intensivists, where other conditions apart from neurosurgery are also managed for the holistic treatment of the patient.