Neurosurgery in India's Best Hospitals

1. Endovascular Neurosurgery in India

2. What is Endovascular Neurosurgery? Endovascular Neurosurgery or Interventional Neuroradiology is a medical specialty in which minimally invasive diagnostic and therapeutic procedures for cerebrovascular disorders are performed under radiological guidance. It is somewhat similar to the treatment carried out in the heart by cardiologists, such as angioplasty or stent placement. In these procedures, very thin catheters or wires are placed through blood vessels in groin and navigated in the blood vessels to the site of the abnormal vessels.

3. How is the Interventional Neuroradiology/Endovascular Neurosurgery is performed? • Cerebral or Spinal Angiography : DSA (Digital Subtraction Angiography) is considered as the 'gold standard' investigation to diagnose diseases of blood vessels and is performed when a vascular disease is suspected. • Intracranial Aneurysms : Introcranial Aneurysm is a weakness and ballooning of a blood vessel within the head which if left untreated, may get burst and causes its complications. Treatment is the passage of thread like platinum coils through blood vessels to the site of the aneurysm thus avoiding open surgery.

4. Arteriovenous Malformation : An autriovenous malformation is a complex mass of abnormal arteries and veins located in the brain or spinal cord. During open surgery, it is often difficult to control bleeding from an arteriovenous malformation Endovascular treatment can be used to block blood flow to certain portions of the malformation that cannot be reached surgically. In such cases, patients may no longer need conventional surgery. • Tumour Embolisation : One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional Neuroradiologist can help the surgeon by preoperative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery.

5. Vertebroplasty and Kyphoplasty : With age, bones become weak and collapse of bones (vertebrae) in the spine is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.  • Percutaneous Sclerotherapy :  Many superficial vascular malformations such as Haemangioma (malformation of the blood vessels) or Lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of 'Sclerosant Material' which causes obliteration of the malformation.

6. Advantages of Endovascular Neurosurgery/ Interventional Neuroradiology • The endovascular approach ensures minimal injury to normal brain. • It has fewer complications, better outcome and ensures shorter hospital stay. • Enables treatment of diseases, which could be treated in the past. • Acute stroke patients can be treated even many hours after the stroke.

7. Why Endovascular NeuroSurgery at Top Hospital in India • Use of Bi-plane technology - visualization in 2 planes simultaneously and 3D imaging of blood vessels • Advanced Dyna CT capability enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular areas like brain • Minimal incision similar to cardiac treatment, such as angioplasty or stent placement • Very thin catheters or wires placed through groin are navigated in to the blood vessels of the brain • Diagnostic (Cerebral or Spinal Angiography) or Therapeutic procedures for Intracranial Aneurysms, Arterial Stenosis, Stroke (Brain attack), Arteriovenous Malformations, Vertebroplasty and Percutaneous Sclerotherapy • Tumour Embolisation is done to reduce bleeding during surgery

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