WhatsAppSpecialist Treatment of the Brain, Spinal Cord and Peripheral Nerves
Neurosurgery is the medical specialty that covers the surgical treatment of the central and peripheral nervous system. Surgical intervention is planned and performed across a wide range, from brain tumours to spinal disorders and from the treatment of hydrocephalus to deep brain stimulation. The Academic Hospital Neurosurgery clinic provides comprehensive microsurgical care with an experienced team working in an integrated way with the neuroanaesthesia and neuroradiology units, and with an operating theatre supported by neuronavigation. Tumour cases are assessed at a multidisciplinary board together with neurology and radiation oncology; where systemic treatment is required, the work is coordinated with the medical oncology department.
Contents
What Is Neurosurgery?
Neurosurgery is the specialty in which diseases affecting the brain, spinal cord, spine and peripheral nerves are treated by surgical methods. The neurosurgeon performs operations such as tumour resection, surgery for vascular anomalies, spinal stabilisation and surgery for nerve compression. The department also works within a multidisciplinary approach together with branches such as neurology, orthopaedics and radiation oncology.
Which Diseases and Conditions Are Treated Surgically?
Neurosurgery undertakes the surgical treatment of a large number of diseases directly related to the nervous system.
- Brain tumours: Glioma, meningioma, pituitary adenoma, metastatic brain tumours
- Hydrocephalus: Raised pressure caused by the accumulation of cerebrospinal fluid (CSF)
- Trigeminal neuralgia: A nerve disorder that runs with attacks of severe facial pain
- Cervical and lumbar disc herniation: Disc displacement in the neck or lower back that compresses a nerve root
- Spinal instability and degenerative spinal disease: Narrowing of the space between the vertebrae, listhesis, spinal curvature
- Arteriovenous malformation (AVM): Abnormal vascular formation within the brain and spinal cord
- Intracranial haemorrhage: Hypertensive and trauma-related brain haemorrhage and subarachnoid haemorrhage
- Parkinson's disease (advanced stage): Surgical management with deep brain stimulation (DBS)
- Nerve entrapment syndromes: Carpal tunnel syndrome and other peripheral nerve compressions
- Spinal cord tumours and intradural lesions
When Should You Consult Us?
Consult the neurosurgery outpatient clinic if the following symptoms and conditions are present.
- Severe or progressively increasing headache, particularly one that begins at night or in the morning
- Numbness, tingling or loss of strength in the hands, arms or legs
- Difficulty walking, impaired balance or problems with coordination
- Blurred vision, double vision, sudden loss of vision
- Neck or lower back pain together with pain radiating into the leg or arm (radiculopathy)
- Difficulty speaking or a sudden change in consciousness (an emergency: go to the emergency department immediately)
- Loss of bladder or bowel control (this may be related to a spinal disorder)
- Severe, electric-shock-like attacks of facial pain (trigeminal neuralgia)
- Conditions for which surgical assessment has been recommended by neurology or another clinic
Preoperative Assessment and Diagnostic Methods
The preoperative assessment process involves comprehensive examinations in order to prepare the safest and most effective surgical plan.
| Assessment | What is done |
|---|---|
| Brain and spinal MRI (magnetic resonance imaging), CT (computed tomography) and, in vascular lesions, digital subtraction angiography (DSA) | |
| Neuropsychometric tests, visual field assessment and EEG (in cases where it is required) | |
| Full blood count, coagulation panel, biochemistry and infection markers | |
| Preoperative 3D image mapping in complex tumour and vascular cases | |
| Preoperative risk assessment with the neuroanaesthesia team | |
| In tumour cases, a joint decision with neurology, radiation oncology and medical oncology |
Operations and Surgical Procedures Performed
The Academic Hospital Neurosurgery clinic performs the surgical procedures listed below.
| Procedure | Description |
|---|---|
| The surgical removal of gliomas, meningiomas, pituitary tumours and metastatic lesions using neuronavigation, intraoperative ultrasound, neuromonitoring and ultrasonic aspiration. The aim is to clear the tumour to the maximum extent while preserving functional brain tissue. | |
| An adjustable ventriculoperitoneal (VP) shunt is a surgical procedure that drains the pressure caused by fluid accumulation within the brain through a tube system directing it into the abdominal cavity. Endoscopic third ventriculostomy (ETV) is performed as an alternative to a shunt in suitable cases. | |
| Skull base surgery in which the vessel compressing the facial nerve (the trigeminal nerve) is moved away from the nerve under the microscope. It provides long-lasting success in cases of trigeminal neuralgia that do not respond to drug therapy. | |
| This covers discectomy performed from the front or from behind, and spinal fusion where required, in order to relieve the pressure on the nerve root. Minimally invasive methods are preferred, shortening the recovery time. | |
| Fixation operations with screw and rod systems in spinal instability caused by listhesis, traumatic spinal fractures, degenerative instability and tumour infiltration. | |
| Microsurgical resection of the abnormal tangle of vessels within the brain; it is performed in AVM cases with a high risk of bleeding or with symptoms. Where necessary, combined treatment with stereotactic radiosurgery or endovascular embolisation is planned. | |
| A surgical method in which the symptoms of tremor, rigidity and dyskinesia are brought under control in advanced Parkinson's disease through electrodes placed in specific nuclei of the brain. The operation is planned through the joint assessment of the neurology, neurosurgery and neuropsychiatry team. | |
| Decompression surgery is performed in carpal tunnel syndrome, ulnar nerve compression (cubital tunnel) and other peripheral nerve compressions. It can be carried out by an open or an endoscopic method. |
The Postoperative Process
The postoperative recovery process varies according to the type of intervention performed and the patient's general state of health.
| Type of operation | What to expect |
|---|---|
| Follow-up of 1-2 days in intensive care and 3-5 days on the ward; a return to daily activities is planned within 4-6 weeks after discharge. | |
| Mostly a one-day hospital stay; a return to light activity is possible within 1 week. | |
| The physiotherapy programme is started in the early postoperative period; full recovery is completed in 2-4 months. | |
| Close follow-up together with neurology is carried out during the device programming process. |
In all cases, postoperative neurological examination, follow-up imaging and, where necessary, a physical therapy consultation are planned.
Routine follow-up visits take place at 1 month, 3 months and 1 year.
You can request an appointment for an assessment at the Neurosurgery clinic.
Book an AppointmentNeurosurgery at Academic Hospital
The Academic Hospital Neurosurgery clinic manages both planned and emergency neurosurgical cases with an operating theatre supported by neuronavigation and with the neuroanaesthesia team. The surgical decision is taken after a joint assessment with the following departments:
- Neurology: preoperative neurological assessment, DBS patient selection and postoperative follow-up
- Radiology: surgical planning with brain and spinal MRI, CT and angiography
- Anesthesiology and Reanimation: neuroanaesthesia and preoperative risk assessment
- General Intensive Care: early postoperative monitoring and supportive care after craniotomy
- Medical Oncology: decisions on postoperative systemic treatment in brain tumours
- Physical Medicine and Rehabilitation: physiotherapy programme after spinal and brain surgery
- Scoliosis and Spine Center: joint assessment in spinal curvature and degenerative spinal disease
Frequently Asked Questions
The answers to the questions most frequently asked about neurosurgery are given below.
References
The general information given on this page about brain, spinal and peripheral nerve surgery is supported by the reliable health sources listed below.
- American Academy of Neurology (Brain & Life), "Brain Tumor: Symptoms, Risk Factors, and Treatments", brainandlife.org
- National Institutes of Health, "Recent Updates on Minimally Invasive Spine Surgery: Techniques, Technologies, and Indications", ncbi.nlm.nih.gov
- Mayo Clinic, "Trigeminal Neuralgia: Symptoms and Causes", mayoclinic.org
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
