Neurosurgery deals with the surgical management of brain and spinal disease as well as with peripheral nerve disease and surgical treatment thereof.

Brain Surgery

Skull and brain surgery quite often are opted for either in case of an emergency, when the patient’s life or vital organs are at stake, or they may be scheduled with a view to treating various types of disease. In the past two decades brain surgery has evolved greatly thanks to technology and surgical outcomes today are impressive compared to those of previous decades.

The use of an operating microscope for surgeons, intraoperative radioscopy, intraoperative angiography and computed tomography,navigation devices,  neurophysiological   monitoring during surgery to help check nerve route status, integrity and topography along with a wide range of specially-made tools allows surgeons to operate on serious cases which would have meant a host of post-op problems in the past. All this equipment is actually available in the Operating Rooms of Mediterraneo Hospital and helps neurosurgeons in their daily practice.
The acquisition of the first  portable CT Scan O-ARM by Medtronic in Greece, in conjunction with the Navigation module, allows the performance  of extremely delicate surgical interventions in parts of the brain that until now were out of reach.

The conditions being treated are:

Brain Tumors

Primary and secondary (metastatic) tumors:
Brain tumors may be either benign or malignant. They can be managed through microsurgery and navigation.
The objective is total tumor excision without post-op gaps.
There are cases of tumors, such as pituitary gland tumors or tumors in the ventricles of the brain, where surgeons opt for the use of an endoscopic technique and opt out of making incisions.
Wherever there is need for biopsy, for diagnosis purposes, the tissue block sample may be taken either through CT guidance or stereotactically without making major incisions and in absolute safety.

Brain Vessel Diseases

Vessels can be the cause of general morbidity problems such as cerebral and subarachnoid hemorrhage, cerebral ischemia and epileptic seizures or there may be vascular disorders and malformations which could possibly lead to aneurysms, arteriovenous dysplasias, stenosis and so on.
Depending on symptoms, these may be treated surgically or intra-vascularly (i. e. through the vessels themselves, without making incisions) in close cooperation with the Neuroradiology experts of our Hospital.
The fact there is a hybrid operating room available allows for neurosurgeons and neuroradiologists to work together at the same time, always in absolutely safe terms and conditions.

Diseases of the Extrapyramidal system & various types of tremor

Treating patients selectively by attaching electrodes stereotactically to deliver current to the appropriate brain centres is what DBS (Deep Brain Stimulation) does.

This innovative method is being tried on an experimental basis in famous centers abroad even in cases with various other symptoms and indications. The method is actually expected to provide solutions to dealing with other types of disease in the near future, and indeed some which so far had not been manageable such as depression, epilepsy, obsessive-compulsive disorders and Altzheimer’s disease.

Cerebrospinal Fluid (CSF) Disorders – Hydrocephalus

Cerebrospinal fluid disorders may be due to age and/or trauma and affect patient behavior. They may be treated either with the use of elastic flow-regulated valves or by means of endoscopic ventriculostomy.

Βrain Biopsies

Wherever there is need for diagnostic biopsies, a sample of tissue may be taken from the patient either through CT -guidance or stereotactically, without making any significantly-sized incisions and in absolutely safe terms.

Trigeminal Neuralgia

In cases of trigeminal neuralgia, when medication is not working, there are the following options and indeed in the order they are mentioned: percutaneous trigeminal ganglion balloon compression or infiltration, microsurgical trigeminal root decompression and neuromodulation (stimulating the motor cerebral cortex by attaching electrodes -Motor Cortex Stimulation).

Motor Cortex Stimulation is an innovative technique which was first described in 1991. It was used to treat facial pain of multiple hetiology including trigeminal neuralgias. In recent years technology allowed for proper implants (cortex electrodes and battery-powered devices) thus making the wider use of this method possible. Given the outcome was very good it is now considered a very reliable method and indeed the only treatment option for managing atypical trigeminal neuralgias, for example in case of multiple sclerosis or after a herpes-viral infection.

Bone Marrow and Spinal Nerve Surgery

Bone marrow surgery capitalizes on all the advantages brain surgery has to offer, the outcome being exceptional so far.

  • Bone marrow tumor surgery
    Tumors which are located in the sensitive bone marrow area may be removed with the use of microsurgery and laser; intraoperative neurophysiological monitoring and navigation devices are used
  • Disc herniation is dealt with through the use of microsurgical techniques and intraoperative radioscopy, without incisions and with the most limited hospital stay possible.
  • Bone marrow decompression is achieved thanks to the use of open or minimally invasive techniques and navigation devices.

Chronic Pain Resistant To Treatment

In cooperation with our Centre for Pain Management, when dealing with patients who are not responsive to other treatments, a spinal pump is used  to inject morphine. There is also a new technique, neuromodulation, in which case electrodes are attached either percutaneously or by means of surgery in the bone marrow or in the peripheral nerves depending on pain type and location. By conducting electrical current, thanks to battery powered devices, which are implanted  in most cases right below the skin of the abdomen, specific nerves are being stimulated thus replacing the sense of pain with another less unpleasant sense (hemodia).
Characteristic indications and symptoms making doctors opt for this technique include chronic back pain or/and leg pain after (normally many) spinal surgeries, various types of headache but also chest pain (angina) and vascular pain in the legs. This technique is moreover used to manage several forms of incontinence of the bladder and the intestines.



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