Neurosurgery is a branch of surgery which develops the methods of diagnostics and operative treatment of the nervous systemdiseases and damages.
From year to year neurosurgery is developing thanks to the improvement of equipment and techniques for successful operative intervention.
The spheres of neurosurgery services in our clinics include the following specializations:
- Emergency life saving surgeryfor head and spinal cord injuries
- Hypophysis surgery, with the use of transsphenoidal techniques, only through one nasal passage.
- Microsurgery of tumors of brain and skullcap.
- Treatment of tumors and defects of spinal cord and backbone.
- Endoscopic surgery of brain, especially in the case of tumors of brain ventricles, and hydrocephaly treatment.
- Treatment of hernias of waist and neck.
- Vascular surgery of aneurysms and vascular malformations.
- Treatment of hydrocephaly with the use of shunts and other equipment.
- Implantation of electrodes for stimulation of vagus nerve in the treatment of heavy epilepsy.
- Surgery of peripheral nerves andbrachiplex.
- Functional neurosurgery, especially for epilepsy treatment.
- All kinds of children's neurosurgery.
Thanks to the latest achievements in the sphere of neurosurgery and neurotraumatology it became possible to treat back and brain tumors, neurooncological diseases,as well as many illnesses and damages of nervous tissue which used to be considered incurable. Neurosurgeons from the Turkish clinics successfully treat such diseases as skull trauma, high intracranial pressure, spinal cord compression, tumors, brain blood circulation disturbance, intracranial bleeding. Our professional teams serve patients according to the international standards, with the use of the advanced equipment, technology and research.
The brain vessels surgery includes the treatment of aneurysms,angiomas and cavernomas.Embolization of cerebral aneurysms, arteriovenous malformations and fistulas is used, thrombolysis in case of acute stroke and stenting of carotid and vertebral arteries. In case of such diseases as aneurysms of brain vessels the problem of the choice of treatment method is solved individually for each patient (either neurosurgical treatment (clippung-method) or endovascular method of treatment (coiling-method). Operative therapy is carried out with the help of intraoperative ultrasonography and intraoperative neuromonitoring intended for dynamic monitoring of the indicators of the functional condition of brain. For the treatment of cavernomas and angiomasneuronavigation is used in order to make it possible to findthe exact location of tumor in the brain tissue. It means that the access to the centers of disease is reached with the minimum impact on healthy tissues.
Microsurgery of brain and skullcap tumors.
Thanks to the close cooperation of colleagues inneurooncology, neuroradiology, neuropathology and radial oncology there exists the service of diagnostics and treatment of patients with brain tumors. This service is equipped with the cutting edge technology, including intraoperative navigation, intraoperative mapping and intraoperative МRТ. The method of choice in the treatment of most brain tumors and metastatic brain tumors is microsurgical operations which are made with the help of intraoperative neuronavigation. To localize a tumor located close to especially important centers of brain, first intraoperative brain cartography (intraoperative brain mapping) is made. For microsurgical treatment of inherent brain tumors (gliomas) we use additionally intraoperative fluorescent navigation with the use of ALA (5-aminolaevulinic acid). The treatment of patients with tumors and vascular lesions of the skullbase is made by a special highly skilled team consisting of neurosurgeons, ear nose throat surgeons and cosmetic surgeons. The above-mentioned specialists have alarge experience, the operations they made demonstrate good results. Meningiomas of the skull base, acoustic neurinomas, adenomas ofhypophysis and aneurysms of the front and back circle of brain blood circulation are of particular interest. Hypophysis tumors lead to hormonal dysfunctions and sight disturbances. There are hormone-producing tumors (prolactinomas) which can often be successfully treated by means of medications. In case of other tumors of thehypophysis area (hormonally active tumors) operation is the only method of treatment. The decision as to what treatment method is optimal and justifiedin each specific case, is made together with endocrinologists specializing in the area of hormonal therapy.
Stereotaxic and functional neurosurgery.
Stereotaxy is a set of methods and calculations which enable one toaccess with a big degree of accuracy a certain structure of brain with the medical purpose,by means of special devices and methods of visualization and functional control. This method is used for carrying out of certain neurosurgical manipulations (tumors biopsy), cystic lesion drainage, brachytherapy, surgery of functional disorders. The purpose of activity of this specialization is aimed at surgical improvement of the quality of life of the patients who suffer from motor defects, chronic pain syndromes, spasticity, peripheral diseases of nervous system and epilepsy. The availability of new equipment and cooperation with related experts in each of these spheres enables the doctor teams toprovide the advanced service in this promptly developing sphere. Surgical treatment of initial tremor and Parkinson disease by means of deep brain stimulation or radio-frequency ablation is of particular interest. One of the perspective directions of neurosurgery is radio surgery — stereotaxic operations made by means of the gamma knife device.
Our specialists carry out the treatment of degenerate diseases of cervical andthoracic section and lumbar spine, discalhernias at cervical, thoracic and lumbar levels, spinal canal arctation (spinal stenoses). Stabilizing operations in the area of head and neck, as well as prosthetic repair operations on intervertebral disks are performed. Spinal surgery includes minimum-intrusive operations of compression syndromes of spinal cord and nervous roots in cervical, thoracic and lumbar sections of spine. The reasons of these diseases occurrence are prolapse of intervertebral disks and other degenerative backbone diseases. The therapeutic aimis carrying out of operations in a sparing way, prompt recovery, preservation of normal stability and biomechanics of backbone, and the fastest possible return of the patient to thelabor activity. Endoscopic and microscopic operative techniques provide the achievement of these aims. Endoscopic operative technics make it possible to restore the destroyed vertebrae by injecting special cement (vertebroplasty) thanks to which in certain cases it is possible to avoid open operations. In certain cases an alternative and optimum treatment is implantation ofintervetrebral disk prosthesis.
For treatment of patients with dysfunctions of spinal fluid circulation (hydrocephaly) there are endoscopic methods of treatment, as well as shunting operations. Patients who suffer from sylvian canal stenosis (the canal connecting the 3rd and 4th brain ventricles) almost always undergo endoscopic perforation of the third ventricle bottom – thus operative intervention is carried out through a small window, and no alien shunting systems are implanted in the organism. If endoscopic perforation is impossible, special shunting systems are implanted, which by means of valves and silicone tubes discharge superfluous spinal liquid into abdominal (less often pleural) cavity. Special programmed valves are used, which allow, depending on the clinical picture and the results of computer or magnetic and resonant tomography, to regulate throughput of the shunt (and hence, intracranial pressure). Reprogramming is carried out without repeated operative intervention.
We devote special attention to recognition and treatment of normotensive hydrocephaly. It is a syndrome characterized by the combination of mental deficiency, walking dysfunctions and uroclepsia when there is expressed expansion of ventricular system and normal pressure of cerebrospinal fluid (CSF). To reveal NTH dysfunctions, neuropsychological tests are used. Neuropsychological tests at early stages of the disease have especially important differential and diagnostic value. NTH treatment is made by means of shunting operations with the use of ventriculoperitoneal and lumboperitonealshunts. For preventive maintenance of complications individual selection of a shunt is recommended. Neural disorders which take place in the case of NTH can completely or substantially regress after a shunting operation if it was performed in due time. If the diagnosis is made correctly and the treatment(shunt placement) is timely, the condition of the patient’s health and the quality of his/her life improves essentially.
Our clinics are a unique combination of complex treatment and individual approach to patients; they provide not only complete diagnostics, operative and conservative treatment, but alsospecialized rehabilitation of patients.