Neurosurgery

What’s Neurosurgery?

Our department has been dealing with the surgical diseases (which requires surgery) of this system attached to supporting structure and relations of brain, spinal cord and nerves, the brain and spinal cord tumors, vascular diseases of brain and spinal cord, diseases of pituitary gland, neurosurgical diseases of infants and children, back and neck hernia, spinal canal stenosis spine tumors, surgery of Parkinson’s disease, and movement disorders, epilepsy surgery, and gamma knife radiosurgery are within this group.

What Are The Diagnosis and Symptoms In Neurosurgical Patients?

Headache: is the common symptom of many diseases developing in the head. Sudden severe and unusual headache can be a symptom of an emergency such as a cerebral hemorrhage. Prolonged and severe pain may be due to increased pressure in the head. Therefore patients having sudden or long-term severe headaches should contact neurological or neurosurgical units.
Vomiting: is accompanied by vomiting in most of the intracranial events. When recurrent vomiting occurs with headache, it may indicate increased intracranial pressure.

Back and neck pain: pain is a major symptom in many diseases associated with the spine and spinal cord. Physician should be contacted in the presence of pains permeating to the arm and leg or when the neck/ low back pains don’t recover with simple precautions.

Visual impairment: intracranial events associated with visual pathways may cause decreased vision and constriction in the visual field. Eye examination is important in the diagnosis of many brain diseases.

Arm and leg weakness, sensory loss: nerves from the central nervous system extending to the arms and legs may be affected not only in diseases of the brain but also in spinal cord and spinal disorders. When such symptoms develop, detailed examination and examinations are required for diagnosis.
Dizziness and imbalance: diagnosis should be made by the detailed examination and examinations not only in the disorders of cerebellum and brainstem regions but also in the symptoms which develop in the inner ear balance system diseases .

Preparation and Postop Process

Emergency surgeries can be performed 24 hours a day AT neurosurgery unit.

Other elective surgical patients are prepared by being hospitalized usually one day before the surgery or performing preoperative tests as an outpatient. These tests are usually carried out under pre-anesthetic blood tests, chest radiography and electrocardiography. These examinations are varied in making consultations by related branches (cardiology, pulmonology, etc.) in referred patients.

On the day of surgery, patients are taken to the operating room from the ward by performing sedation by anesthetics. In this process, patients’ relatives can wait in the waiting room of the operating room or at the patient’s room. Patients’ relatives often are informed about the situation and surgery of the patient. At the end of surgery, a detailed conversation about the performed operation and the disease is made by the surgical team via face to face with relatives of patients who underwent surgery.

Postoperatively, the patient is taken toward or intensive care unit according to the patient’s condition after being kept at PACU for a while.

Our Treatment and Surgery In Neurosurgical Patients

• Brain and Spinal Cord Tumors – Neurooncological
• Neurovascular Diseases
• Spinal Surgery
• Pituitary Surgery
• Pediatric Neurosurgery
• Functional Neurosurgery and Stereotaxy
• Gamma Knife Radiosurgery

Brain and Spinal Cord Tumors – neurooncology: In recent years, more early diagnosis of the brain and spinal cord tumors with developing diagnostic and treatment methods, are operated with special equipment minimally invasive and microscopic / endoscopic / stereotactic intervention methods in our center. Treatment plan is arranged by performing MR, MRI spectroscopy / functional MRI / MRI tractography, computed tomography, SPECT, and PET-CT with 1.5 and 3 Tesla MRI device by neuroradiology unit before the surgery. 5-ALA method for safe and definite removal of high-grade brain tumors by staining during the surgery is successfully used through our special surgical microscope. Neuronavigation system which provides finding direction in the brain and spinal cord and enable removal of the tumors by easily determining their locations is used in all surgeries. Brain surgeries can be performed in the awake state and with motor-sensorial stimulation in brain tumors which are located in specific regions. spinal cord functions are instantly recorded with neuro-monitorization in all surgeries of spinal cord tumors. Postoperative treatment and follow-up of the patients having brain and spinal cord tumor are determined by discussing the cases at neuro-oncology council held with physicians from radiation and medical oncology units and neuroradiology.

Neurovascular Diseases: Florence Nightingale Hospital in Istanbul, offer any kind of modern surgical interventions in the operating room, intensive care and diagnostic facilities for all types of vascular diseases of the brain and spinal cord. Aneurysms (bubbles vessels), arteriovenous malformations (vascular tangles), arteriovenous fistulas and blockages are successfully treated at our unit. All operations are performed by using completely microsurgical techniques, neuronavigation and minimally invasive interventional procedures in our operating room equipped with the latest technology Modern surgical microscope we use during the surgery provide performing ICG (Indocyanine Green) angiography and this method makes surgeries safer. All of our neurovascular patients are discussed in neuroradiology in terms of the diagnosis and treatment of their diseases.

Surgery of and Peripheral Nervous System: Surgical interventions for the variety of surgical diseases of the spinal cord which extends within the spine by being preserved and peripheral nerves distributing to the body are performed at Florence Nightingale Hospital in Istanbul. Spinal cord injury, spinal cord tumors, peripheral nerve injuries, tumors, carpal tunnel syndrome, ulnar groove syndrome are within this group. Hernia of the back and the neck which is the common and very frequent diseases of the spine are treated with microsurgery and endoscopic methods by neurosurgery. Also, current treatment methods are also used in the shifting and stenosis of the waist and the neck.

Pituitary Surgery: All surgical diseases of Pituitary and sella diseases (tumors, cysts, bleeding, etc.) are operated with microscopic and endoscopic methods at Florence Nightingale Hospital in Istanbul. In general, neuro navigation system is used for direction finding during intranasal (transsphenoidal) surgeries. Treatment and follow-ups of all patients are determined after being discussed at the neuroendocrinology council.

Pediatric Neurosurgery: Diseases of congenital malformations (spina bifida, Chiari, etc.), childhood brain and spinal cord tumors, hydrocephalus, epilepsy, and head deformities (craniosynostosis-craniostenosis) special in this age group can be treated at Istanbul Florence Nightingale Hospital. patients in the neonatal period are followed up at special neonatal intensive care and services of the pediatric team and some patients which are diagnosed with prenatal anomalies are monitored at the perinatology unit. Treatment and follow-ups of the pediatric patients are made with a multidisciplinary approach by pediatrics, pediatric surgery and plastic surgery departments.

Functional and stereotactic neurosurgery: Lesions in the brain and selected foci are millimetrically reached with Lexell G stereotactic system at our department İn Istanbul Florence Nightingale Hospital. Obtaining biopsy from the tumor and non-tumor lesions, cyst puncture, inserting catheter, and stimulator are accurately performed with this method. All operations of surgical treatment of the patients with trigeminal neuralgia are performed with the procedure of inserting a pump within pain surgery and other pain surgery procedures. Deep brain stimulation (placing battery into the brain) and other applications of movement disorders which are often applied in Parkinson patients in recent years are within the surgical interventions we perform at our hospital.

Gamma Knife Radiosurgery: High-intensity focused beam for tumoral, vascular, functional and ocular diseases is performed at Advanced Gamma Knife Perfexion Radiosurgery Unit at Gayrettepe Florance Nightingale Hospital Oncology Center. Gamma Knife surgery is within further radiosurgical methods and used for many years in the treatment of cerebral diseases. Leksell Gamma Knife Perfexion device, Elekta company has developed over the years is still in widespread use around the World and is a device of choice for advanced medical centers and developed countries. Latest Gamma Knife Perfexion is equipped with features far beyond the renewal or updating of previous models. Higher therapeutic efficacy and minimal side effects can be provided with Perfexion.