Neurosurgery

 

Neurological surgery embraces surgery of the head, spine and peripheral nerves. Traditionally neurosurgery incorporates the following:

  • The removal of lumps (i.e. tumours, blood clots, pus, disc prolapse)
  • The relief of a blockage of blood vessels (causing a stroke) or in the head (producing hydrocephalus)
  • The repair of blood vessels (i.e. removing an aneurysm or arteriovenous malformation)
  • The elimination of pain (by cutting a nerve)
  • The improvement of function of the brain (i.e. epilepsy or movement disorder surgery).

However these days Neurosurgery involves sophisticated methods of tumour removal using computer directed radiation called the “Gamma Knife”. Despite its name no cutting is involved, the term gamma knife being used to denote that it is a “one off” treatment unlike conventional radiotherapy. The Gamma Knife is also used to treat arteriovenous malformation, pain (trigeminal neuralgia) and sometimes epilepsy. Movement disorder surgery has become extremely sophisticated, safer and more successful. Stimulation of the brain is also being increasingly used for treatment of otherwise intractable pain.

The introduction of micro neurosurgery in the late 1960s markedly improved the scope and safety of neurosurgery. Improvements in microsurgery continue and for instance transsphenoidal surgery for pituitary tumours (through the nose rather than through the head) produces strikingly good results. Neuroradiology, especially with the introduction of MRI scanning has revolutionised the investigation of patients. Further more angiography - (a method of introducing dye to outline blood vessels via a small tube (catheter) introduced in the groin) now allow many, if not most, aneurysms and arteriovenous malformations to be treated without recourse to a cutting operation. This is know as “interventional neuroradiology”.

Despite the emphasis on brain surgery about 70% of most neurosurgical operations involve spinal surgery. Spinal surgery involves operations to remove lumps pressing on nerves or the spinal cord, usually in the neck of lower (lumbar) spine. Common lumps that require removal are disc prolapses, boney spurs (called osteophytes), and tumours. Spinal neurosurgery is also involved in stabilizing the spine by fusing the bones in the neck (cervical fusion) or lumbar spine.

Increasingly, and rightly, neurosurgeons are sub specializing in various areas of neurosurgery. This is necessary in order to achieve the knowledge, experience and expertise in various aspects of complex and sometimes difficult surgery that constitutes the body of neurosurgery. Thus the Neurosurgical Consultants that work at Bupa Cromwell Hospital specialise in specific areas, as described in their profiles below.