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The Department of Neurosciences is well equipped with all modern equipments like state-of-the-art Carl Zeiss Operative Microscope, Kapalin Drill System, Neuro Endoscopy, Siemens C-arm machine, EEG, EMG and NCV to perform all types of procedures related to Neurology and Neuro Surgery. Our highly qualified Neurologists, Neurosurgeons, Critical care specialists, Neuro Radiology Interventional Specialists, Neuro Recovery Intensive Care assistants, physiotherapist as well as Medical and Radiation Oncologist at Capitol Hospital collaborate seamlessly like a single entity.
The Department offers wide range of services which are as following:
- Microneurosurgery: This involves the use of operating microscopes during surgery, for enhanced precision in brain and spine operations like:
- Brain tumours (Supra Tentorial and Infra Tentorial)
- Skull base tumours
- Spine tumours
- Anterior Cervical Micro Discectomy
- Lumbar Micro Discectomy
- Head injuries (Evacuation of haematomas and de-compressive craniotomy)
- Spine injuries (Stabilization of fracture spine)
- Paediatric Neurosurgery:
- VP shunt surgery
- Congenital anomaly correction
- Brain & spine tumours excision
- Spinal dysraphism anomaly correction
- Spine Surgery
- Stabilization of fracture spine
- Spinal tumors
- Stroke surgery due a blood clot or an infraction
- Medical management of Neurological disorders:
- Seizure disorders
- Movement disorders
- Parkinson's disease
We have a dedicated Neurosurgical ICU adjoining the OR suite, where operated patients can recover from the surgery. This facility is staffed by dedicated nurses who are trained to look after neurosurgical patients. Trained physiotherapists work on rehabilitating patients with neurologic dysfunctions.
The Department of Neurosciences at CAPITOL hospital performs the following procedures on routine basis:
What is Brain Tumour?
A brain tumour is an abnormal growth of cells within the brain, which can be cancerous or non-cancerous (benign). It is defined as any intracranial tumour created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumours).
What are the types of Brain Tumour?
Brain tumours are either primary which form and grow from the structures of the brain or those that are tumours from other parts of the body which enter brain and grow there. Also Brain tumours are gradedas grade I, grade II, or grade III, or grade IV depending on their ability to grow rapidly and infiltrate into adjacent structures or spread to other parts of the brain or body. There most common type of primary brain tumours among adults are astrocytoma, meningioma, and oligodendroglioma. The most common type of primary brain tumours in children are medulloblastoma, grade I or II astrocytoma, ependymoma, and brain stem glioma.
Meningioma: The tumour arises in the meninges. It can be grade I, II, or III. It's usually benign (grade I) and grows slowly.
ligodendroglioma: The tumour arises from cells that make the fatty substance that covers and protects nerves. It usually occurs in the cerebrum. It's most common in middle-aged adults. It can be grade II or III.
Medulloblastoma: The tumour usually arises in the cerebellum. It's sometimes called a primitive neuroectodermaltumor. It is grade IV.
Brain stem glioma: The tumour occurs in the lowest part of the brain. It can be a low-grade or high-grade tumour. The most common type is diffuse intrinsic pontineglioma.
What are the treatments / surgery for Brain Tumour?
Treatment of brain tumours aims at removing the tumour by doing Surgery and in those which can be melted by using radiation called radiotherapy or using anti cancer drugs called chemotherapy. Depending upon the type and nature of the tumour a combination of the above will be required. With advances in imaging, earlier diagnosis, sophisticated planning, preoperative, anaesthetic management, special microscopes and surgical instruments, it is possible to remove significant amounts of brain tumour through brain tumour by doing surgery safely without damage to the normal brain tissue and producing deficits. The advent of PET CT, IGRT and Gamma knife surgery (stereotactic radio surgery) is revolutionizing the treatment of various problems in the brain, including benign brain tumours in treacherous locations, like the brain stem or near the optic nerve.
What are the symptoms of Brain Tumour?
Different parts of the brain control different functions, so symptoms will vary depending on the tumour’s location. The tumour's size and how fast it is growing also determine which symptoms a person will have.
In general, the most common symptoms of a brain tumour include:
- Seizures or convulsions
- Difficulty thinking, speaking, or finding words
- Personality or behavior changes
- Weakness or paralysis in one part or one side of the body,
- Loss of balance or dizziness
- Loss of hearing
- Vision changes
- Confusion and disorientation
- Memory loss
It should be understood that all the above symptoms by themselves are not indicators of Brain Tumours but can be commonly found in brain tumour patient.
What is an Aneurysm?
An aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood vessel of the brain, it is called a cerebral aneurysm.An aneurysm may be present from birth (congenital) or it may develop later in life, such as after a blood vessel is injured.
What are the treatment options available in India for Cerebral Aneurysm?
There are two main types of treatment for a brain aneurysm:
Preventive Treatment: where an aneurysm is treated to prevent it from rupturing
Emergency Treatment: where an aneurysm is repaired after it ruptures
What are the surgical treatments available in India for Cerebral Aneurysms?
Neurosurgical clipping is a procedure carried out under general anaesthetic (you're asleep throughout). A cut is made in your scalp and a small flap of bone is removed to reveal your brain underneath.When the aneurysm is located, the neurosurgeon (an expert in surgery of the brain and nervous system) will seal it shut using a tiny metal clip. After the bone flap has been replaced, the scalp is stitched together.
Endovascular coiling involves inserting a catheter into an artery in your leg or groin. The tube is guided through the network of blood vessels into your head and finally into the aneurysm. Tiny platinum coils are then passed through the tube into the aneurysm. The coils block the flow of blood into the aneurysm. Over time this should seal the aneurysm off from the main artery to prevent it from rupturing.
What is Traumatic Brain or Head Injury?
A traumatic head or brain injury is defined as a blow to the head or a penetrating head injury that disrupts the normal function of the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of damage to the brain. Mild cases may result in a brief change in mental state or consciousness, while severe cases may result in extended periods of unconsciousness, coma, or even death.
What are the surgical lesions in case of head injury?
This refers to an area of localized injury that may cause pressure within the brain. The most common mass lesions related to TBI are hematomas and contusions.
Epidural Hematoma Due to Head Injury:
An epidural hematoma is a collection of blood between the dura mater (the protective covering of the brain) and the inside of the skull.
Subdural Hematoma Due to Head Injury:
A subdural hematoma is a collection of blood between the dura mater and the arachnoid layer, which sits directly on the surface of the brain.
Cereberal Contusions Due to Head Injury:
A cerebral contusion is bruising of brain tissue. When examined under a microscope, cerebral contusions are comparable to bruises in other parts of the body. They consist of areas of injured or swollen brain mixed with blood that has leaked out of arteries, veins, or capillaries. Contusions are seen most commonly at the base of the front parts of the brain, but they may occur anywhere.
Intracereberal Hemorrhage Due to Head Injury:
This describes bleeding within the brain tissue, which may be related to other brain injuries, especially contusions. The size and location of the hemorrhage helps determine whether it can be removed surgically.
Subarachnoid Hemorrhage Due to Head Injury:
This type of Hemorrhage is caused by bleeding into the subarachnoid space. It appears as diffuse blood spread thinly over the surface of the brain, and is seen commonly after TBI. Most cases of SAH associated with head trauma are mild. Hydrocephalus may result from severe traumatic SAH.
What are the Surgical Treatments Available in Head Injury Cases?
In case of some head injuries surgery is performed to remove a large hematoma or contusion that is significantly compressing the brain or raising the pressure within the skull.
What is the measuring tool for success in Head Injury Cases?
One of the most widely used systems to classify outcome from head injury is the Glasgow Outcome Scale (GOS).
Patients with mild head injury (usually defined as GCS score on admission of 13-15) tend to do well. They may experience headaches, dizziness, irritability, or similar symptoms, but these gradually improve in most cases.
What is Disc in spinal cord?
The disc is the soft cushioning structure located between the individual bones of the spine, called “vertebra.” It is made of cartilage-like tissue and consists of an outer portion, called the annulus, and an inner portion, called the nucleus. In most cases, the disc is flexible enough to allow the spine to bend.
What is an Artificial Disc ?
An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a device that is implanted into the spine to imitate the functions of a normal disc (carry load and allow motion).
Who needs an artificial disc replacement?
The indications for disc replacement varies for each patient. During the aging process, discs can weaken and develop tears or cracks in the outer portion, resulting in degenerative disc disease. Additionally, the inner portion may bulge out and press against the outer portion, resulting in pain.The purpose of artificial disc replacement is to replace the worn out disc while also preserving the spine’s motion. The result is reduced back pain and no increased risk of problems developing at an adjacent level of the spine.
What are various types of surgeries done in India for affected disc?
Disc Replacement Surgery
A lumbar disk replacement is a type of back surgery. It involves replacing a worn or degenerated disk in the lower part of your spine with an artificial replacement made of medical-grade metal or a combination of medical-grade metal and medical-grade plastic. Lumbar disk replacement is a relatively new procedure to relieve back pain. It gained FDA approval in 2004. It is generally seen as an alternative to the more common spinal fusion surgery that joins two vertebrae together. Lumbar disk replacement is a major surgery that requires general anesthesia and a two- to four-day hospital stay.
Spinal Fusion Surgery
A spinal fusion surgery is designed to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. There are many approaches to lumbar spinal fusion surgery, and all involve adding bone graft to an area of the spine to set up a biological response that causes the bone graft to grow between the two vertebral elements and create a fusion, thereby stopping the motion at that segment.