Neurosurgery (Brain Surgery)
Brain tumours are the second most common cause of death from malignant neoplasms in people over 35. Every year, a brain tumour is detected in one person out of 5,000 people of this age category.
The success and prognosis of treatment depend primarily on timely and correct diagnosis. But unfortunately, outdated equipment in most clinics in domestic countries does not allow for an accurate diagnosis. That is why patients cannot get rid of painful symptoms and decide to be treated abroad.
Thanks to recent advances in neurosurgery abroad, it has become possible to treat spinal, and brain tumours, neuro-oncological diseases, and many diseases and injuries of nervous tissue previously considered incurable. Today, neurosurgery is conditionally divided into three clinical areas: brain surgery (in particular vascular surgery), spine surgery (together with the spinal cord) and neuro-oncology (surgery of tumours of the central and peripheral nervous system).
There are the most common procedures possible with the help of neurosurgery abroad:
- Microsurgery of brain and skull base neoplasms;
- Treatment of all types of head and spinal cord injuries;
- Vascular surgery of aneurysms and vascular malformations;
- Intervention on the pituitary gland, using the transsphenoidal technique, only through one nasal passage;
- Operations of all segments of the spinal cord, anterior and posterior access for disc removal, spinal graft, implant and other techniques;
- Treatment of tumours and defects of the spinal cord and vertebral column;
- Endoscopic surgery of the brain, especially for tumours of the ventricles and treatment of hydrocephalus;
- Electrostimulation of the vagus nerve;
- Peripheral nerve and brachial plexus surgery;
- Pediatric neurosurgery.
Neurosurgery is one of the most demanded areas of medicine. However, brain interventions are one of the most challenging areas in surgery. Neurosurgical operations requires exceptional skill from the doctor since even minor damage to the nerve endings can lead to a violation of the body's vital functions.
Common signs of neurosurgical diseases
Among the symptoms of the disease, headache, nausea, dizziness, mental disorders, disturbances of tactile sensations, convulsions and vision problems are distinguished. Indications for a visit to the neurosurgery clinic are the following symptoms:
- Frequent headache;
- Fainting and dizziness;
- Impaired vision for an unknown reason;
- Poor concentration and memory;
- Numbness and tingling of the extremities;
- Paralysis of limbs;
- Osteochondrosis of the spine;
- Loss of balance;
- Hearing impairment;
- Frequent loss of consciousness.
Nevertheless, it is worth remembering that different brain and spinal cord lesions and numerous nerves throughout the body cause various manifestations. Each patient may have a different area of damage and other signs. Therefore, it is worth seeking medical help in case of unusual health changes. The doctor must examine the patient, find the reason for the disorder and suggest the proper treatment methods.
Diagnostic methods before a neurosurgical operation
Neurologists and neurosurgeons prescribe examinations that help to recognise diseases of the nervous system and their degree of severity.
Computed tomography (CT) is an imaging test that uses X-rays. A computer can create and process cross-sectional images by taking tomograms of specific body regions. For example, computed tomography of the skull plays a prominent role in acute stroke diagnosis. It can quickly decide whether the cause of the stroke is a cerebral haemorrhage or a cerebral infarction due to lack of blood.
CT angiography can be used to visualise blood vessels by injecting an X-ray contrast medium containing iodine into a vein. This procedure is used when there is a suspicion of a narrowing (stenosis) or blockage of an artery supplying the brain. It is also helpful for diagnosing vascular malformations (aneurysms, angiomas).
Magnetic resonance imaging (MRI) is a procedure that enables imaging of individual body sections using tomograms or cross-sectional images. In contrast to computed tomography, MRI does not work with X-rays but with a magnetic field. The most accurate and technically advanced test is emission tomography. With its help, a neurosurgeon can analyse lesions at the cellular level. It makes it possible to detect alarming changes early in their development.
MRI-supported neuronavigation is a computer-assisted surgical procedure that the neurosurgeon uses to orientate himself with millimetre precision during an operation on the brain or spinal cord. In combination with microsurgery, neuronavigation improves the accuracy of a neurosurgical procedure and increases patient safety.
In electroencephalography (EEG), the electrical activity of the cerebral cortex (so-called brain waves) is derived from the surface of the skull and recorded. The EEG is beneficial for diagnosing seizures in the brain (epilepsy). With the help of electromyography, the specialist can obtain electrical muscle activity from either the surface or the interior of a muscle. The EMG examination allows the doctor to determine whether, for example, the cause of paralysis (paresis) is due to damage to the power or to the nerve that supplies it. Electroneurography is used to measure the speed of nerve conduction. It is significant for the neurosurgeon in case of nerve damage.
Treatment options in modern neurosurgery
It is noteworthy that interventions on the brain were performed for a long time by opening the skull. Today, however, in most cases, such operations are performed without trepanation. Moreover, in countries such as Israel, Germany, Turkey, Spain and Poland, microsurgical endoscopic procedures have been practised for more than 15 years - they perform transsphenoidal interventions (through the nasal cavity).
Innovations most affected the technique of surgical interventions. Today, navigation systems are more actively used, and doctors perform computer-assisted operations.
One of the most promising areas in neurosurgery is stereotactic radiosurgery. It is especially popular in the treatment of brain tumours. To do this, surgeons use CyberKnife and GammaKnife, which are available in leading clinics abroad. The essence of stereotactic radiosurgery is that instead of a surgical scalpel, beams of radio waves are used, which are directed into the tumour at precisely specified coordinates. As a result, ionising radiation destroys the malignant neoplasm while not affecting healthy brain tissue.
The problem of preserving the function of the brain and the constant desire to minimise the amount of surgical intervention has always been one of the most important tasks in neurosurgery, which led to the emergence of entirely new directions in epilepsy surgery. Neurosurgeons began to use fundamentally different methods as an alternative to resection, one of which is DBS surgery (deep brain stimulation). It is based on the implantation of electrodes in specific brain structures, through which an electric current of low voltage and high frequency is supplied.
Neurosurgery does not stand still, and foreign doctors and scientists are constantly looking for new and effective methods for treating incurable diseases of the nervous system. And the achievements obtained at the moment testify to new technologies' great potential and progressiveness.
Why do patients prefer having brain and spine surgeries abroad?
High qualification of doctors - many years of training and internships in clinics worldwide allow the future neurosurgeon to gain great experience. As a result, doctors abroad master the latest achievements in neurosurgery that can be used in practice.
Accurate diagnosis - diagnosis is the most crucial step in the treatment of any disease. A successful treatment plan depends primarily on a correct diagnosis. Neurosurgical clinics abroad are equipped with the latest generation of diagnostic equipment, making it possible to detect pathologies early and apply effective therapy.
Modern operating rooms - neurosurgery treatment abroad is carried out in surgical rooms equipped with the latest technology. Interventions are carried out under the control of neuronavigation systems and other equipment that allows the doctor to perform actions with pinpoint precision.
Fast and effective rehabilitation - rehabilitation is the next critical step for adequate recovery after treating pathologies of the nervous system. Abroad, complex rehabilitation programs are used to resume lost functions in a short time and return to the usual rhythm of life.
What are the most common reasons for neurosurgery?
Neurosurgeons deal with the surgical treatment of skull, brain, spinal cord or nerve injuries, tumours, malformations of the head, brain, spinal cord or nerves, bleeding, intervertebral disc and vertebral diseases, and functional disorders (pain, spasticity, epilepsy or restricted mobility).
How safe is neurosurgery?
Qualified neurosurgeons use advanced methods of diagnosing and treating nervous system diseases. In addition, it allows for low-traumatic surgical interventions through micropunctures under complete visualisation with high accuracy. For patients, this is a guarantee of additional safety. Unfortunately, the mortality rates among all persons who underwent a neurosurgical procedure are about 10%, and 15% among those who did not undergo neurosurgery.
What are the main risks of brain surgery?
Thanks to modern technology, the risks of neurosurgery are minimal today, although a specific risk cannot be completely ruled out with every surgical intervention in the human organism. Possible dangers of brain surgery include problems with speech, memory, muscle weakness, balance, vision, and coordination. These problems may be short-lived or permanent.
Do you stay awake during brain surgery?
Neurosurgeons actively perform minimally invasive operations in treating brain aneurysms, shunting, and removing tumours and other nervous system pathologies. Doctors sometimes resort to a craniotomy (opening the skull), but they can do this without general anaesthesia. In this case, the patient remains fully conscious. This technique, called "awake craniotomy", controls the motor, speech, auditory and other human functions during surgery.
What is peripheral neurosurgery?
Peripheral neurosurgery improves function and minimises pain and disability in people with non-brain and spinal corn nerve disorders such as acute nerve injuries, entrapment neuropathies, brachial plexus injuries and nerve sheath tumours.
What are the leading countries for Neurosurgery (Brain Surgery)?
What are the best clinics for Neurosurgery (Brain Surgery)?
Who are the best doctors for Neurosurgery (Brain Surgery)?
Prof. Dr. med. Alexander Muacevic from European Radiosurgery Centre Munich
Prof. Dr. med Harald-Robert Bruch, MSc, PhD from Oncological and Haematological Praxis Clinic Bonn
Prof. Dr. med. Bettina Kuschel from University Hospital Rechts der Isar Munich
Prof. Dr. med. Bernhard Meyer from University Hospital Rechts der Isar Munich
Prof. Dr. med. Bernhard Hemmer from University Hospital Rechts der Isar Munich