Neurosurgery in India

Overview:

Most people think of neurosurgery as brain surgery but it is much more! It is the medical specialty concerned with the diagnosis and treatment of patients with injury to or diseases/disorders of the brain, spinal cord and spinal column, and peripheral nerves within all parts of the body. The specialty of neurosurgical care includes both adult and pediatric patients. Dependent upon the nature of the injury or disease a neurological surgeon may provide surgical and/or non-surgical care.

What is Neurosurgery?

Neurosurgery (or Neurological Surgery) is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. Neurosurgery is a branch of the surgery discipline which focuses on the brain and spinal cord. It is an extremely advanced form of surgery, requiring many years of training, and a high level of precision and experience on the part of the surgeon.

Neurological Disorders:

Types of Neurosurgery Procedures:

• Laminectomy
• Craniotomy
• Rhizotomy
• Corpus Callosotomy
• Stereotactic Radiosurgery
• Hemispherectomy
• Endotracheal Intubation
• Sympathectomy
• Vagal Nerve Stimulation
• Pallidotomy
• Sacral Nerve Stimulation
• Ventricular Shunt
• Cerebral Aneurysm Repair
• Anterior Temporal Lobectomy
• Human Leukocyte Antigen Test
• Meningocele Repair
• Deep Brain Stimulation

Common Neurological Diagnostic Methods:

Neurological diagnostic tests and procedures are designed to locate and diagnose nervous system issues and disorders. Some of the most common screening tests include:

• Neurological examinations: these help determine function and status of speech, balance, coordination, reflexes, mental status as well as tumors or infections such as meningitis or encephalitis.
• Fluoroscopy: a type of x-ray that utilizes pulsed low dose radiation beams to create continuous images of body parts. Pictures can be sent to a monitor for immediate viewing or videotaped. In some cases, contrast mediums or dyes may be used to provide specific focus to certain areas of the body.
• Cerebral angiogram: often utilized to diagnose and pinpoint narrowing or obstruction of arteries or blood vessels in the brain or neck. They may also be used to determine size and location of brain aneurysms, tumors or vascular malformations.
• Brain scans: include but are not limited to MRIs (magnetic resonance imaging), computed tomography (CT) and positron emission tomography (PET). Brain scans can diagnose location of brain hemorrhages, malformations in blood vessels, and be used to locate and diagnose tumor growth.
• Electroencephalography: also known as an EEG, this test monitors brain activity. It's often used to diagnose brain damage caused by head injuries, seizure disorders, or inflammation in the spinal cord or brain caused by degenerative disorders, metabolic disorders and some psychiatric disorders.
• Electromyography: also known as EMG, this test is utilized to diagnose muscle dysfunction, spinal cord disease processes and diagnose nerve damage or dysfunction. The test measures and records electrical activity from the spinal cord or brain to peripheral nerve roots located in the legs or arms.

Pre-operative Necessities of Neurosurgery:

• The usual preoperative things that need to be done include blood work, heart function evaluation (e.g. EKG), medical clearance by your internist, a chest X-Ray, and possibly a localizing MRI or CT scan to help minimize the surgery. (A kind of "X marks the spot" idea). If you are undergoing stereotactic surgery, you may require an MRI with localization markers (usually felt-tip pen marks) on your scalp, or the placement of a sort of medieval "frame" that is literally screwed onto your skull, using local anesthetics.
• Certain problems may require a cerebral angiogram to be performed, so that the surgeon has a "blood vessel" road map prior to surgery. Functional studies (special MRI, EEG, or magnetoencephalography) also might be necessary to guide the surgeon where not to go.
• Cerebral blood flow studies (SPECT, Xenon studies or transcranial Doppler studies) may be important to show the surgeon the state of your brain's blood supply reserves. You'll get an IV catheter the night before surgery; you'll be given various medications to prevent seizures, temporarily remove brain water (like medically squeezing a sponge), so the surgeon doesn't need to retract too much during surgery. You'll also be given antibiotics (to prevent infection). If you have an allergy to an antibiotic, make sure everyone knows it.
• The night before surgery is usually full of anticipation. More often than not, you'll be the one comforting your family and friends. If you're afraid, thats only normal. Sometimes, sleep is difficult, so don't hesitate to ask for sleeping medication, if you want it.

Common Procedures of Neurosurgery:

• Craniotomy: A craniotomy is a procedure to remove a lesion in the brain through an opening in the skull (cranium). A craniotomy is a type of brain surgery. It is the most commonly performed surgery for brain tumor removal. It also may be done to remove a blood clot (hematoma), to control hemorrhage from a weak, leaking blood vessel (cerebral aneurysm), to repair arteriovenous malformations (abnormal connections of blood vessels), to drain a brain abscess, to relieve pressure inside the skull, to perform a biopsy, or to inspect the brain. Craniotomy is distinguished from craniotomy (in which the skull flap is not immediately replaced, allowing the brain to swell, thus reducing intracranial pressure) and from trepanation, the creation of a burr hole through the cranium in to the durra mater.
• Rhizotomy: Rhizotomy is the cutting of nerve roots as they enter the spinal cord. Rhizotomy (also called dorsal Rhizotomy, selective dorsal Rhizotomy, and selective posterior Rhizotomy) is a treatment for spasticity that is unresponsive to less invasive procedures. Rhizotomy is performed under general anesthesia. The patient lies face down. An incision is made along the lower spine, exposing the sensory nerve roots at the center the spinal cord. Individual nerve rootlets are electrically stimulated. Since these are sensory nerves, they should not stimulate muscle movement. Those that do (and therefore cause spasticity) are cut. Typically, one quarter to one-half of nerve rootlets tested are cut.
• Corpus Callosotomy: Corpus Callosotomy is a treatment for epilepsy, in which a group of fibers connecting the two sides of the brain, called the corpus callosum, is cut. It is used to treat epilepsy that is unresponsive to drug treatments. A person with epilepsy may be considered a good candidate for one type of epilepsy surgery or another if he or she has seizures that are not adequately controlled by drug therapy, and has tried at least two (perhaps more, depending on the treatment center's guidelines) different anti-epileptic drugs. The purpose of this treatment is to prevent spreading of seizure activity from one half of the brain to the other. The brain is divided into two halves, or hemispheres, that are connected by a thick bundle of nerve fibers, the corpus callosum. When these fibers are cut, a seizure that begins in one hemisphere is less likely to spread to the other. This can reduce the frequency of seizures significantly.
• Stereotactic Radiosurgery: Stereotactic radiosurgery is the use of a precise beam of radiation to destroy tissue in the brain. This procedure is used to treat brain tumors, arteriovenous malformations in the brain and in some cases, benign eye tumors or other disorders within the brain. It works the same as all other forms of radiation treatment. It does not remove the tumor or lesion, but it distorts the DNA of the tumor cells. The cells then lose their ability to reproduce and retain fluids. The tumor reduction occurs at the rate of normal growth for the specific tumor cell. In lesions such as AVMs (a tangle of blood vessels in the brain), radiosurgery causes the blood vessels to thicken and close off. The shrinking of a tumor or closing off of a vessel occurs over a period of time. For benign tumors and vessels, this will usually be 18 months to two years. For malignant or metastatic tumors, results may be seen in a few months, because these cells are very fast-growing.
• Meningocele Repair: is surgery to repair birth defects of the spine and spinal membranes. Meningocele and myelomeningocele are types of spinal bifida. The surgery is necessary to close this abnormal opening to decrease the risk of infection and protect the integrity of the spina column and the tissue inside. A myelomeningocele is the most severe type of spina bifida because the spinal cord has herniated into the protruding sac. Neural tissue and nerves may be exposed. About 80% of myelomeningoceles occur at the lower back, where the lumbar and sacral regions join. Some people refer to myelomeningocele as spina bifida. Because of the exposed neural tissue, significant symptoms may be present.

Life after Neurosurgery:

The next twenty-four hours will be spent in either the recovery room or in an intensive care unit setting. Usually a postoperative CAT scan will also be performed during this time, and nurses will stand by you, repeating the neurologic examination every hour or so, while administering the usual post-operative medications. These usually include pain medications (not too much, because they all want to see you bright and alert), steroids, antibiotics and anticonvulsants. You will usually be allowed to drink after a few hours, and "advance" your diet with each subsequent meal. If all is well, you will return to a regular room the following morning. Depending upon circumstances, a physical therapist will visit you and begin to work with you. Over the next couple of days, you will increase your activity until you are ready to go home. During that time you may be seen by various ancillary physicians, such as interns, residents, psychiatrists, radiation oncologists, internists, neurologists, and possibly oncologists. They will all confer with your neurosurgeon and come up with some sort of game plan prior to your discharge.

The Cost of Neurosurgery in India:

A huge cost difference is evident in India when it comes to Neurosurgery in India. India is cheaper along with zero patient wait lists. Interestingly, the quality delivered at such a low cost doesn’t compromise the quality of treatment, as the foreign patients are accustomed to get in their respective country. The following cost comparison can give a right picture of the claim behind low cost treatment with quality:

Best Neurosurgeons in India:

• Neurosurgeons of India are nationally and internationally renowned experts in the diagnosis and surgical treatment of brain and spine disorders including brain tumors, trigeminal neuralgia and hemi facial spasms, neuro-vascular surgery, pediatric neurosurgery, pituitary surgery, Radiosurgery, spine and spinal cord surgery, epilepsy and movement disorders.
• Indian Neurosurgeons are also involved in Stereotactic Radiosurgery along with Radiation Oncologists for tumor and AVM treatment. Radio surgical methods such as Gamma knife and Cyber knife are used.
• They have begun to utilize endovascular image guided procedures for the treatment of aneurysms, AVMs, carotid stenosis, strokes, and spinal malformations, and vasospasms. Techniques such as angioplasty, stenting, clot retrieval, embolization, and diagnostic angiography are now being utilized.

Qualifications of a Neurosurgeon in India;

The Qualifications of Neurosurgeons in India are as follows:

• MS - General Surgery
• MCH - Neurosurgery
• DNB/FRCS/MRCS from International Colleges and Hospitals
• International Fellowship and Training Programs
• Publications and Paper Presentations in Reputed Scientific and Medical Journals
• Wide Clinical Experience

Top Neurosurgery Hospitals in India:

• Top Neurosurgery Hospitals in India are backed with team of highly qualified neurosurgeons who are fully equipped to perform procedures like Spine Surgery, Brain tumor surgery, Disk replacement surgery, Endovascular Neurosurgery and more.
• Indian Neurosurgery Hospitals and Centres are capable of providing 24/7 care for all neurological injuries and emergency Neuro-care. The added advantage lies in the fact that these centres and hospitals are fully equipped to deal with any type and kind of neurological emergencies round-the-clock. The neurological services extend to the very latest in diagnostic equipment such as EEG, ENMG and video monitoring.
• These Neurosurgery Hospitals and Centres in India are considered among the best in the world to have the most advanced microscope and Neuro-navigation facilities to conduct precision driven complex neurosurgeries. The highlights of some of the facilities available at these Neurosurgery Hospitals are:
  • World class Hospital Infrastructure
  • Dedicated Neurosurgical and Neuro Anesthesia Team
  • Diagnostics
  • Operating Rooms
  • The Intensive Care Unit
• Specialized Equipments e.g. Dedicated X-Knife, Computer Assisted Neurosurgery, Frame Based Stereotaxy, Interventional Neuro

Cities where top and world renowned Neurosurgical Hospitals and Centers are situated are as follows;

Plan your Neurosurgery in India with Tour2India4Health:

• Tour2India4Health Group came into existence with a mission to assimilate the finest in medical and surgical talent and technique, to bring them closer to our international patients providing quality treatment at an affordable and budgeted price.
• We believe in serving our patients not just good but the best giving the person the second chance to live a more better and normal life. All our patient medical investigations are conducted with the latest, technologically advanced diagnostic equipment. Stringent quality check is maintained by our company ensuring reliable and high quality services to our patients.
• Form the day Tour2India4Health Group has incepted it has looked forward in providing the best service to its patients by collaborating with the best and high quality hospitals and surgeons. Till date, we have established a huge network of renowned group of hospitals, doctors and surgeons in India establishing itself as the most trusted healthcare service providers in India.
• Our team serves the clientele most comfortable and convenient measures of healthcare services thus, making your medical tour to India a very fruitful experience. The list of services includes:
• Providing quick visa letters to our patients
• Airport pick up and drop facility
• Admitting the patient at the hospital
• Arranging meeting with the doctor or surgeon
• Providing medicines
• Providing food
• Stay arrangement for the accompanying person with the patient
• Language translators on requirement
• Good quality hotel arrangement
• Booking return air tickets etc

Neurosurgery and Medical Tourism in India:

• Medical Tourism or health tourism is a well-defined concept of patients seeking urgent or elective medical procedures in other parts of the world. Medical Tourism in India has the potential to welcome over a million medical tourists annually.
• Neurosurgery in India is not only cost effective but also it is healed and treated under best medical facilities. Price advantage being the major selling point, the cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West.
• And besides India being an emerging pioneer in healthcare sector, it is also known as tourist's paradise, so you can enjoy a good holiday following your medical procedure and more or less often plays an instrumental role in healing or recovering soon.

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