Neurosurgery

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The department of neurosurgery at DHMC handles all cases of brain, spine and peripheral nerves. There is a close collaboration with neurology, orthopaedics and spinal departments.The neurosurgery is a specialty which deals with injuries, tumours, strokes, and infections in the regions of brain, spine and peripheral nerves.

Services

Head injury is a devasting event. Usually young people are involved. Initial few hours of management are essential. At DHMC there is 24 hours cover so that no patient with head injury suffers from delay in medical treatment. Not all the patients require operation. Those who do require surgery would get surgery in the most advanced international level operating theatre in the country.
Strokes may be bleeding from a ruptured artery or a blood clot blocking an artery. Both these situations lead to damage to an area of brain. Timely treatment would help in early recovery of the patient. In some cases, the point of bleeding is like a balloon and it has to be blocked in any case otherwise it would cause death of the patient. These tiny balloons called aneurysms may be blocked by clips or through springs from inside the arteries by angiography.
When the stroke is due to blockage from blood clot around cholesterol deposit it has to be corrected surgically through carotid endarterectomy.
Brain tumours are seen in infants till old age. The brain tumours may be of benign(mild ) or malignant(dangerous) type. These are treated by a combination of surgery, radiotherapy and chemotherapy. Similarly rehabilitation and physiotherapy have important role. In the start brain tumours may persent with headache, fits, vomiting, poor vision, weakness or abnormal feeling over a part of the body. Some brain tumours may affect body hormones leading to arrested or rapid growth, infertility or obesity.
Different types of infections may involve the brain and spinal cord. Tuberculosis is one of them. Timely detection and treatment is essential. All the medical and surgical options are available at the DHMC. In case of infection rest of the family needs to be screened for hidden source of infection.
The spine may be affected by injury, tumour, infections, since birth, abnormal growth , or overuse.
Young children during growth period may develop angled or abnormally curved spine. It may be due to nutrition deficiency, bad posture or lack of physical activity. In extreme cases there may be leg weaknesses. In such cases spine is straightened and corrected by operation.
Spinal tumours present as pain or weakness in the arm or leg. Since it is a very delicate structure the surgery is done under microscope. Tumours and prolapsed discs are removed and replaced. Surgery is done with microscope and endoscope where needed.
With injury, spine may become weak and unstable. There may be damage to spinal cord leading to paralysis of arms and legs. In such cases the paralysis may be temporary or permanat. To save the patient spine is fixed and supported by metallic implants to help in the recovery.
In new borns there may be different swellings of brain or spine called encephaloceles, myelomeningocele, and craniosynostosis.
There may be blockage of brain water (CSF) called hydrocephalus. The disease affects the growth and finally may become life threatening. It is corrected by surgery. The surgery is done either by putting a shunt or tube from the brain to abdomen or by using endoscope to open the water passages inside the brain.
After brain surgery skull bone defects are cosmetically unacceptable. In such cases artificial bone is used to make the head shape normal this is reconstructive cranioplasty.
Stereotaxic procedures are done as minimally invasive procedures.
Peripheral nerves may be damaged during birth. These patients would have deformed short arms and disability for the rest of life. The treatment is use of medicines, physiotherapy and surgical correction.
Nerves are injured while playing sports, roadside accidents or workplace trauma.When the nerves are divided or cut the operations are done to remove the scar and reconnect and repair the nerves.
Nerves may be damaged by injections given by unqualified persons at the wrong points. In such cases early exploration and removal of the material is performed.
Sometimes nerves are entrapped on their route along bones. Carpal tunnel and ulnar nerve entrapment are common examples. In these cases operations are performed to remove the pressure from the nerves.
In peripheral nerve cases operations are performed to relieve the pressure, graft and rejoin the nerves. peripheral nerve surgery and regeneration of injured spine.
I run a pain clinic for patients with intractable disorders.
In extreme cases of epilepsy or in some psychiatric disorders highly selective surgical operations may be beneficial.
In tumour cases chemotherapy has beneficial value. DHMC has an active cancer center to help such cases.