Key Procedures

Key Procedures at Neuro Foundation

Brain surgery is a critical and complicated process. The type of brain surgery done depends highly on the condition being treated. For example, a brain aneurysm can be repaired using a catheter that's introduced into an artery in the groin. If the aneurysm has ruptured, an open surgery called craniotomy may be used.

Surgery to open the skull is called a craniotomy. The surgeon makes an incision in your scalp and uses a special type of saw to remove a piece of bone from the skull. You may be awake when the surgeon removes part or all of the brain tumor. The surgeon removes as much tumor as possible.

There are 6 main steps during a craniotomy. Depending on the underlying problem being treated and complexity, the procedure can take 3 to 5 hours or longer. No food or drink is permitted past midnight the night before surgery. Patients are admitted to the hospital the morning of the craniotomy.

This is the most common way to remove pituitary tumors. Transsphenoidal means that the surgery is done through the sphenoid sinus, a hollow space in the skull behind the nasal passages and below the brain.

The Endoscopic Endonasal Approach (EEA) is an innovative surgical technique used to remove brain tumors and lesions—some as large as softballs—all through the nose.
With EEA, surgeons reach tumors and lesions of the skull base and top of the spine directly by operating through the nose and sinuses. A specially designed endoscope provides light and a lens for viewing and transmitting internal images. Highly crafted instruments are used alongside the endoscope for dissection and tumor removal.

Keyhole surgery is the concept of safely removing brain & skull base tumors through smaller, more precise openings that minimize collateral damage to surrounding scalp, brain, blood vessels & nerves.

The ideal surgical approach for each patient is determined by the specific tumor type and location. Regardless of the route chosen, our goals are to maximize tumor removal and minimize manipulation of critical structures, thereby avoiding complications and patient disfigurement, while promoting a more rapid, complete and less painful recovery.

The main types of Gliomas are:

Ependymomas: ependymal cells.

Astrocytomas: astrocytes (glioblastoma multiforme is a malignant astrocytoma and the most common primary brain tumor among adults).

Oligodendrogliomas: oligodendrocytes.

Brainstem glioma: develop in the brain stem.

A meningioma is a tumor that forms on membranes that cover the brain and spinal cord just inside the skull. Specifically, the tumor forms on the three layers of membranes that are called meninges. These tumors are often slow-growing. As many as 90% are benign (not cancerous). Most meningiomas occur in the brain.

Intraventricular tumors (also known as ventricular tumors) are generally benign tumors or lesions found within the ventricles of the brain. These tumors may arise from a variety of cells in the region and often obstruct the flow of cerebrospinal fluid and cause a buildup of pressure in the skull.

It occurs when a developing baby's spinal cord fails to develop or close properly while in the womb.

Symptoms can sometimes be seen on the skin above the spinal defect. They include an abnormal tuft of hair, a birthmark or protruding spinal cord tissue.

When treatment is necessary, it's carried out through surgery to close the defect. Other treatments focus on managing complications.

The extra fluid puts pressure on the brain and can cause brain damage. It's most common in infants and older adults.

Hydrocephalus is characterised by head enlargement in infants. Adults and older children experience headache, impaired vision, cognitive difficulties, loss of coordination and incontinence.

Treatment is often a tube (shunt) inserted surgically into a ventricle to drain excess fluid.

Tethered Cord (TC) is a disorder in which the spinal cord is "stuck" to a structure within the spine such as dura, scar tissue from a previous operation, a bony spicule or even a tumor.

Lipomas. A spinal cord lipoma is fat within the normally positioned spinal cord without any skin or bony abnormalities. Most commonly these rare lesions are located within the thoracic spinal cord. They may be symptomatic and appear most often in adults.

Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain or the tissue and structures that are near it. Many different types of pediatric brain tumors exist — some are noncancerous (benign) and some are cancerous (malignant).

Extradural tumors are the most common spinal tumors and are usually of metastatic origin. Intradural intramedullary lesions comprise 20 to 30% of all primary spinal cord tumors. The remaining 70 to 80% of primary intradural tumors are intradural extramedullary tumors.

Cerebrovascular surgery is the surgical repair of the blood vessels that supply the brain with oxygen. Our specialized team of cerebrovascular neurosurgeons diagnose and treat all adult and pediatric cerebrovascular conditions

Carotid endarterectomy is a surgical procedure used to reduce the risk of stroke by correcting stenosis in the common carotid artery or internal carotid artery. Endarterectomy is the removal of material on the inside of an artery.

Skull base surgery is a highly specialized, minimally invasive surgical technique for evaluating, diagnosing and treating benign or cancerous growths located on the underside of the brain, the base of the skull and the upper vertebrae of the spinal column.

Awake craniotomy is a neurosurgical technique and type of craniotomy that allows a surgeon to remove a brain tumor while the patient is awake to avoid brain damage.

Microsurgical clipping is a technique that cuts off the blood supply to a brain aneurysm to prevent it from rupturing or to control bleeding if a rupture has already occurred.

Arteriovenous malformations (AVMs) are abnormal, snarled tangles of blood vessels that cause multiple irregular connections between the arteries and veins. These malformations most often occur in the spinal cord and in any part of the brain or on its surface, but can develop elsewhere in the body.

Normally, arteries carry oxygen-rich blood away from the heart to the body’s cells, organs, and tissues; veins return blood with less oxygen to the lungs and heart. But in an AVM, the absence of capillaries—a network of small blood vessels that connect arteries to veins and deliver oxygen to cells—creates a shortcut for blood to pass directly from arteries to veins and bypass tissue, which can lead to tissue damage and the death of nerve cells and other cells. Over time, some AVMs get progressively larger as the amount of blood flow increases.

Arteriovenous malformations (AVMs) of the brain are rare, complex, vascular lesions that can result in significant morbidity and mortality.

Current therapeutic options include microsurgical resection, radiosurgery (focused radiation), and endovascular embolization. Endovascular embolization is primarily used as a preoperative adjuvant before microsurgery or radiosurgery. Palliative embolization has been used successfully to reduce the risk of hemorrhage, alleviate clinical symptoms, and preserve or improve neurological function in inoperable or nonradiosurgical AVMs.

A hemorrhagic stroke is either a brain aneurysm burst or a weakened blood vessel leak. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain.

High blood pressure and trauma are two leading causes. Taking blood-thinning drugs may also increase a person's risk.

Symptoms can vary based on the location of the haemorrhage in the brain, but may include numbness or weakness in part of the face, difficulty speaking or difficulty walking.

Emergency treatment is required for cerebral haemorrhage. It usually involves medication and close monitoring in an intensive care unit. In rare cases, surgery may be required to relieve pressure around the brain.

Stereotactic surgery or stereotaxy is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS), etc

The unique physiology of children and their medical needs means that the field of Paediatric Neurosurgery is highly specialised and requires significant resources.

Pediatric Neurosurgery is a subspecialty of neurosurgery; which includes surgical procedures that are related to the nervous system, brain and spinal cord; that treats human children with operable neurological disorders.

Our experts specialize in advanced movement disorder and epilepsy treatments such as:

Deep brain stimulation — An effective surgical procedure for involuntary movements and other symptoms associated with Parkinson’s disease and dystonia. UPMC is a leader in treating movement disorders with deep brain stimulation, and now offers both standard and MRI-guided "asleep" DBS, depending on your condition

Adult epilepsy surgery — A potential treatment option for people whose seizures continue after trying at least two different medications.

The trigeminal nerve carries sensation from the face to the brain. It's most common in women aged over 50.

Symptoms range from mild to severe facial pain, often triggered by chewing, speaking or brushing the teeth.

Deep brain stimulation (DBS) is a neurosurgical procedure involving the implantation of a medical device called a neurostimulator (sometimes referred to as a 'brain pacemaker'), which sends electrical impulses, through implanted electrodes, to specific targets in the brain (brain nuclei) for the treatment of movement and neuropsychiatric disorders.

DBS in select brain regions has provided therapeutic benefits for otherwise treatment-resistant disorders such as Parkinson's disease, essential tremor, dystonia, chronic pain, major depression, and obsessive–compulsive disorder.

In a needle biopsy, a small hole is drilled into the skull and a narrow, hollow needle is placed into the incision to extract a tiny portion of the tumor or tissue.

A stereotactic biopsy uses 3-D imaging technology, as well as data from CT and MRI scans, to examine a tumor or a piece of the brain.

Blood vessels abnormalities in the brain or elsewhere. If untreated, AVMs can rupture, causing life-threatening bleeding. Interventional radiologists can often treat these abnormalities without surgery by guiding thin catheters to the site and injecting a substance that blocks the supply of blood to the affected blood vessels.

Opening of blocked / narrow arteries and veins done by balloon catheter

Uses a stent (small metal tube) to open up blocked bile ducts and allow bile to drain from the liver done for Jaundice.

Internal bleeding of an artery can be stopped with a pin hole approach and without scar within a short time, prevening major surgery in life threatening situations. Done for any vessel in the body.

Delivery of cancer-fighting agents directly to the site of a cancer thereby increasing the drug load at the cancer site for better cure and early recovery. Done for liver cancers.

In some patients with high blood pressure, narrowing of the arteries in the kidneys can occur. The problem, called renal hypertension, can be treated with angioplasty and if necessary stenting.

Patients with a variety of illnesses may develop an area of persistent infection (abscess) in the body. The infection can be drained by inserting a catheter through a small nick in the skin and allowing continuously drainage there by avoiding surgery.

Needle Biopsy of almost all lesions can be done for accurate diagnosis and proper treatment.

Stent is a small flexible tube made of metallic wire mesh, when used in the body it improves blood supply by opening a narrow vessel.

Dissolving blood clots by injecting clot-busting drugs at the site of the solidified blood. Blood flow can be restored anywhere in the body from brain to foot with use of catheter and restore blood flow, preventing damage to the organs such as braing.

The ureter carries urine from the kidneys to the bladder. It can get blocked by kidney stones or other causes. The interventional radiologist inserts a catheter through a small nick in the skin into the blocked kidney to drain the urine.

An embolization procedure of uterine arteries to stop life threatening postpartum bleeding, potentially preventing hysterectomy. This procedure can help to shrink fibroids, preventing removal of uterus.

Patients who have blood in the sputum will benefit for blocking of the bleeding artery - a life saving procedure.

The occluded artery can be opened by percutaneous mechanical plaque extractor and restore blood flow, preventing amputation.

A tiny cage-like device that is inserted in a blood vessel to break up clots and prevent them from reaching the heart or lungs. Prevents pulmonary embolism.

A pain treatment for fractured vertebra in which medical grade bone cement is injected into the vertebra with immediate pain relief.

Removing the clot with thrombus removing device thereby restoring blood flow, reducing morbidity in comparison to IV/IA thrombolysis.

Treating the aneurysm with pin hole surgery, lusing coils and stents, completely occluding the aneurysm, preventing rebleed and assuring early recovery.

Angioplasty and stent placement to open the stenosed artery suppling the Brain.

Treating injured arteries with thrombus aspiration / stenting to restore blood supply artery.

Facet injection, celiac block, nerve block can provide good pain relief than oral medications.

Percutaneous embolisation of the tortuas veins in the legs.

Reduces the vascularity of the angioma reducing the blood loss during surgery and also pain.

Blocking blood supply to Injured spleen preventing open surgery, done in quick time with minimally invasive technique ensures early recovery.

Liver biopsy done through a vascular route avoiding third space bleed.

First time in Salem and neighbouring districts, Neuro Foundation introduces mechanical thromectomy, revascularistaion device, the only form of definitive treatment other than RTP approved by FDI. Mechanical thrombectomy removes the clot in the blood vessels and does not lise it thereby preventing distal embolisation of the clot reducing the morbidity and mortality. By mechanical thrombolysis the vessel is opened by passing a stent and removing the clot.

We are proud to introduce another device for people with limb ischemia and block of arteries. This is a peripheral plaque extractor which reopens the blocked peripheral arteries restoring blood flow and preventing amputation.

This is a special infusion catheter to breakup the thrombus in visceral and peripheral arteries thereby restoring the blood flow. Thrombolytic drugs are infusion for a long time through this catheter which is kept for a long duration in that specific artery.