NEUROSURGERY is a highly specialized surgical subspecialty that involves i) medical treatments ii) physical treatments iii) interventional or endovascular procedures and iv) minimally invasive microsurgeries for treating a very wide spectrum of clinical conditions and diseases that happen at our BRAIN and SPINE. Among all, treating STROKE and PAIN are the basics of Neurosurgery daily practices.
In the other words, NEUROSURGEONs, with their knowledges and trainings, together with their sophisticated micro-instruments, utilize their operative skills under the microscope, they treat wide spectrum of clinical conditions and diseases that happen along human nervous systems and its surrounding tissues; skull, spinal column, vessels and related tissues.
The followings are the summary of the common routines in Neurosurgical Practices:
with numbness, pain, weakness at arms or legs, sciatica pain at legs.
with spinal cord or cauda equina nerves compressions, causing pain, numbness, weakness at arms or legs, disturbed gait, disturbed urinary habit and bowel habits, disturbed sexual function.
with back pain, nerves compressions, spinal instability or scoliosis:
Minimally Invasive Spine Fusion Surgery under Microscope:Among all Neurosurgeries, minimally invasive spine surgery (MIS Spine Surgery) are the microsurgeries that Neurosurgeons most commonly perform among their routines.
For all spine surgeries, Neurosurgeons apply their knowledges of nervous system and spinal column, and also their microsurgical skills and techniques, together with their micro-instruments of brain surgeries. Sometimes, Neurosurgeons may also add the technique of Continuous Intra-Operative Neural Monitoring (IOM) to monitor the nerve signal transmission function along brain, spinal cord and nerves during surgery, so as to assure patients’ good neurological outcome in spine surgeries.
With the ever-advancing Medical Technology, seeking a second medical opinion is now the standard practice for all kinds of medical diagnoses. Getting a second medical opinion from another Medical Expert is a decision-support tool for ratification or modification of the medical suggestions from other doctors.
Second medical opinion may have critical impacts on the disease outcome by influencing the followings, namely 5Cs:
Brain tumors can be subdivided into non-cancerous benign tumor and malignant cancerous tumor. If a tumor is originated within brain compartment ......
Tumors can develop in the vertebrae, nerves, and other tissue throughout your spine. Some spine tumors, such as astrocytomas, occur more commonly in children and adolescents......
Given the disease burden of strokes, prevention is an important public health concern. As stroke neurosurgeons, we do not want to treat stroke unless we are forced to do so for acute stroke ......
Brain tumors grow and compress normal brain tissue. Both benign and malignant tumors can cause swelling of the brain and raised intracranial pressure. Headache, dizziness....
Yes, only if stroke being treated within right time within Golden-Hours before permanent brain damage occurs. All neurological deficits may be reverted normal if stroke patient being treated within right time (within Golden Hours) at right hospital (equipped with stroke services & instruments) by right person (Stroke Specialists).
Type of emergency treatments: An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"), and some hemorrhagic strokes benefit from neurosurgery
Intra-venous i.v. thrombolysis with recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke, when given before three to four and a half hours of symptom onset, in long term improves the rate of functional independence among stroke survivors. However most of the stroke patients are not eligible or cannot receive the treatments within 3-4.5 hours. Besides, there are many contraindications (such as abnormal lab values, high blood pressure, or recent surgery) to be considered before the drug is administered. Moreover, the treatments regimen based on a plain CT brain image for clinical decision, with or without a detailed angiogram mapping of neck and brain vessels to look for the exact cause of stroke, rtPA thus carries 6.4% risk of causing substantial brain hemorrhage leading to severe morbidity and mortality.
Under X ray control, a stroke neurosurgeon can pass a very fine catheter up to carotid artery at neck or into the brain arteries. The procedure allows removing obstructing blood clot and offer an option for those who either are not eligible for or do not improve with intravenous thrombolytics of Golden 3-4.5 hours treatments. Our clinical experience observed complete reversible of all neurological deficits for some patients if early artery unblockage were performed within 8 hours after symptom onset. Some patients with good collateral blood supply to brain may allow their brain to withstand or tolerate an even longer golden hours of therapeutic window. Similar to Golden 3-4.5 Hours Treatments, medical literatures reviewed that significant complications occur in about 7% of cases.