Brain, Nerve and Spinal Surgery
A well-equipped center, team approach and understanding of multidisciplinary treatment are crucial
for success in the common brain diseases. Brain, Spinal Cord and Neural Surgery are rapidly
developing with innovations in medical technology, and in parallel, more successful results can be
obtained in diagnosis and treatment.
Cerebrovascular Diseases
There are endovascular, interventional neuroradiology and surgery (microsurgical) work groups for
the treatment of cerebrovascular diseases. Treatment methods can be applied separately or together
according to the condition of the patient.
• Brainstem Aneurysms: Brain vascular disease that can occur as a bubble in the brain’s veins,
causing sudden deterioration with bleeding and vital loss.
• Arterio-Venous Malformation: A vascular disease that is prone to bleeding, where the arteries and
veins are seen as a ball in the brain.
• Carotid Stenosis: Shrinkage and clogging of the parts of the jugular vein in the neck or brain. With
clot formation, stroke (paralysis) occurs and treatment needs to be done within hours.
• Brain Hemorrhages: There is blood leakage into brain membranes or brain tissue.
• Brain Vein Occlusion: The blood flow to the brain is suddenly interrupted due to brain vessel
occlusion. This picture is known as stroke or paralysis and should be treated quickly. It is possible to
open the injured vessels with endovascular methods, to re-establish brain blood flow by
microsurgery, or to relieve the trapped brain tissue.
Brain and Spinal Tumors
Surgical interventions are performed with microsurgery and endoscopic techniques in both adults
and childhood brain and nerve tumors. The patients are assessed by the brain and neurosurgeon, the
radiation oncollar, the medical oncologist and the council of neuroradiologists. In some tumors, long-
term chemotherapy (drug therapy) and / or radiotherapy (radiation therapy) planning is done.
Especially in papillary tumors, especially head and scalp tumors, operations are performed with the
participation of ENT specialist in the surgical team.
Spine Diseases
The spine; Traumatic injuries such as accidents and injuries, narrowing of the spinal canal and
slippage of the elderly, as well as surgical interventions for congenital diseases. And also; Diseases
such as back and neck cancers are treated by the brain and neurosurgeons. The “Minimally invasive
spine center” where microsurgical and endoscopic surgical procedures are applied to the sternum,
cervical spine and vertebral strengthening (instrumentation) operations is planned together with
rehabilitation services, physical therapy and rehabilitation department. Minimally invasive pain
interventions, ie non-operative interventional treatments for pain, are also maintained within this
Childhood Brain and Neurological Disorders (Pediatric Neurosurgery)
Surgical intervention is performed for congenital and acquired head and spinal diseases. These
include tumors, vascular diseases, hydrocephalus, which is defined as the accumulation of brain
water in the head, and “spinal dysraphism” that is more common in the neonatal period.
Traumas (injury or accidental brain injury)
Emergency interventions are performed without losing time to head trauma patients. Patients are
treated with intensive care unit. They are also directed to physical therapy and rehabilitation
programs simultaneously. The aim is to lift the vital risk and raise the quality of life. Rapid diagnosis,
diagnosis and care of all kinds of traumas (head trauma, spinal trauma, etc.) that can develop due to
various accidents can be performed by a team of brain, spinal cord and neurosurgeon who are
coordinated with emergency service and intensive care unit for 24 hours.
Treatment of Functional Diseases
In diseases that lower the quality of life, such as Parkinson’s and other involuntary movements,
brainstem practice is particularly prevalent. Treatment of spasticity resulting from congenital or post-
traumatic severe head trauma is performed with “selective dorsal rhizotomy” or “placement of the
baclofen pump”. Epilepsy surgeries are planned in case of epilepsy which is not successful with drug
treatment. For all functional diseases, the study group formed by the participation of neurologist,
psychiatrist and physical therapist decides whether the necessity of surgical treatment is necessary
or not by making necessary evaluations.
Operational risks are minimized thanks to advanced technology systems
Neuronavigation: The neuronavigation system that enables 3D imaging of the brain, spinal cord and
neuron surgeries is performed. This method is used in brain tumors, brain tumor biopsy, spine and
spinal surgery and Parkinson’s surgery. In this system, the images taken before or during the surgery
of the patient are called “neuronavigation” for use during surgery. In this method, the MR of the
patient is withdrawn before the operation and transferred to the neuronavigation device. The
anatomical or physiological image obtained from the patient’s MR can be used during surgery. Thus,
during the operation, various risk zones in the patient’s brain or spinal cord can be seen with real-
time neuronavigation and planning accordingly. This technology provides a high degree of accuracy
to the targeted area of the brain and spinal cord, reducing the most possible damage to the healthy
tissue during operation.
Neuromonitorisation: After neurological surgeons in neurological surgeons such as aneurysms or
AVM surgeries, spinal cord tumors and scoliosis, the neuromonitoris is signaled during the operation
from electrodes placed on the patient’s face, arms and legs before surgery. When the signal falls, the
surgeon is informed by warning that it is in the sensitive area. In this case, the risk of facial, arm or
leg paralysis that may occur after surgery is greatly reduced.
Intraoperative ultrasonography: During the operation, the surgeon’s specialist examines the location
and extent of the brain or spinal tumor using an ultrasonic device. It allows the complete removal of
tumors that are particularly difficult to distinguish from brain and spinal cord tissue.
Endoscopy: Provides a wide field of view in a small area, especially in narrow corridors where
pituitary, intraventricular tumors, and hydrocephalus surgery are used. In addition, microsurgery is
an alternative treatment option for common spinal problems such as spinal cord.
Gliolan Staining Technique: The patient is given gliolan material which allows the tumor to appear in
a different color before surgery. Surgical microscopy special filter in surgery, tumor tissue with
normal brain tissue is seen in different colors. With this method, normal brain tissue damage is
minimized, tumor removal is at the maximum level, and the risk of neurological loss of the patient is
Awakening craniotomy: The surgery is performed by keeping the patient awake in the sensitive
surgeon’s area of tumors, which is responsible for the movement of the limbs and the speech center
or the “motor area”. The speech and arm-leg movements of this person are controlled during surgery
to prevent damage. With this method, the operative success is increased.
Intraoperative CT (O-Arm): Computed tomography can be performed during the operation, and the
situation in the operation can be visualized. Especially used in spine screwing operations. It is seen
that there is no error margin in screwing operations performed with O-Arm technology, which can
obtain a 3D tomography image. At every stage of surgery, surraha gives critical information and the
risk of recurrence of the disease is zeroed. The patient is exposed to less radiation on this count. The
method allows surgery to be performed with smaller incisions. It provides these advantages and
reduces the risk of infection.


  • 11 November 2019

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