A fully equipped Center, team approach and understanding of multidisciplinary treatment are crucial for success in brain diseases that are common in society. Brain, spinal cord and neurosurgery are developing rapidly with innovations in medical technology every day, and in parallel, more successful results can be obtained in diagnosis and treatment.
Vascular Diseases Of The Brain
There is a working group on endovascular, i.e. interventional neuroradiology and surgery (microshirurgical) for the treatment of vascular diseases of the brain. Treatment methods can be applied separately or together depending on the patient’s condition.
Brain vessel aneurysms: a disease of the brain vessels that occurs in the form of bubbles in the brain vessels, which can cause sudden worsening with bleeding and vital losses.
Arterio-venous malformation: a vascular disease in which the arteries and veins are monitored in the form of a ball in the brain, prone to bleeding.
Carotid stenosis: a narrowing and blockage of the parts of the carotid artery in the neck or brain. Stroke (stroke) occurs with the formation of clots, and treatment should be performed within hours.
Brain hemorrhage: a condition in which blood leaks into the brain membranes or brain tissue.
Brain vascular Obstruction: This is a sudden interruption of blood flow to the brain due to brain vascular obstruction. This table is known as stroke or stroke and should be treated quickly. It is possible to open the blocked vein by endovascular methods, restore brain blood with microsurgery, or relieve the trapped brain tissue.
Brain and spinal cord tumors
Surgical intervention with microsurgery and endoscopic techniques is performed in both adult and childhood brain and nerve tumors. Patients are evaluated by the council, which consists of a brain and neurosurgeon, Radiation Oncologist, Medical Oncologist and neuroradiologist. In some tumors, long-term chemotherapy (drug therapy) and/or radiation therapy (radiation therapy) are planned. Operations are performed with the participation of an ENT specialist in the surgical team, especially in pituitary tumors, as well as in head pedestal tumors.
Surgical intervention is applied in traumatic diseases of the spine, such as accidents and injuries, narrowing of the spinal canal and shifting of the waist, as well as in congenital diseases that occur in the Old Age process. In addition, diseases such as lower back and neck hernia are treated by brain and neurosurgeons. Herniated disc, neck pain, and spine stabilization (instrumentation) mikrosirurjikal of surgery and endoscopic surgical methods are applied, where “minimally invasive ” spine center”and also rehabilitation services, in conjunction with the Department of physical therapy and rehabilitation are planned. Minimally invasive pain interventions, i.e. non-surgical interventional treatments for pain, are also carried out within this discipline.
Childhood brain and Nervous Diseases (Pediatric Neurosurgery)
Surgical intervention is applied to congenital and subsequently acquired head and spine diseases. These include tumors, vascular diseases, hydrocephalus, defined as brain water collection in the head, and “spinal dysraphism”, which is more common, especially in the neonatal period, i.e. waist opening.
Traumas (brain injury as a result of being beaten or accidental)
Emergency interventions are applied to patients with head injuries without wasting time. Patients are treated together with the intensive care unit. They are also simultaneously referred to physical therapy and rehabilitation programs. The aim is to eliminate vital risk and improve the quality of life. All kinds of injuries that can develop due to various accidents (head trauma, spine trauma, etc.) rapid diagnosis, diagnosis and care can be carried out by the brain, spinal cord and neurosurgery team, which works in coordination with the emergency department and intensive care unit for 24 hours.
Treatment Of Functional Diseases
In diseases that reduce quality of life, such as Parkinson’s and similar involuntary movement disorders, in particular, the application of a brain battery is made. “Selective dorsal Rhizotomy” or “baclofen pump placement” operations are performed to treat spasticity that occurs later due to congenital reasons or severe head trauma. Epilepsy surgery operations are planned in cases of epilepsy, that is, epilepsy, which cannot be achieved with medication. A working group formed with the participation of neurologists, psychiatrists and physical therapists decides whether surgical treatment is necessary or beneficial for all functional diseases.
Surgery risks are minimized thanks to advanced technology systems
Neuronavigation: operations in brain, spinal cord and nerve surgery are performed using a neuronavigation system that provides 3-dimensional imaging. This method is used in brain tumors, brain tumor biopsy, spine and spinal cord surgery, and Parkinson’s surgery. In this system, the use of images of the patient taken before or during surgery during surgery is called “neuronavigation”. In this method, an MRI of the patient is taken before surgery and transferred to a neuronavigation device. An anatomical or physiological image obtained from the patient’s MRI can be used during surgery. In this way, with real-time neuronavigation during surgery, various risk areas in the patient’s brain or spinal cord can be seen and planning is done accordingly. This technology, which provides a high accuracy approach to the targeted area of the brain and spine, minimizes the damage that can occur in healthy tissue during the operation.
Neuromonitorization: in tumors located in the sensitive area of the brain, in aneurysm or AVM surgery, in spinal cord tumors, and in sensitive spine surgery such as scoliosis, signals are received throughout the operation from electrodes placed on the patient’s face, arms and legs before surgery after the patient is put to sleep by a neurologist. If the signal falls, the surgeon is informed by warning that it is in the sensitive area. In this way, the risk of facial, arm or leg paralysis that may occur after surgery is greatly reduced.
Intraoperative ultrasonography: during surgery, the location of the brain or spinal cord tumor and how much it has been removed are checked by a radiology specialist using an ultrasound device. It allows the removal of all tumors that are difficult to distinguish, especially from brain and spinal cord tissue.
Endoscopy: provides a wide viewing angle from a small area, especially in areas where narrow corridors are used as a path in pituitary, intra-ventricular tumors and hydrocephalus operations. In addition, microsurgery is an alternative treatment option for common spinal problems such as herniated disc.
Gliolan staining technique: the patient is given a gliolan substance that allows the tumor to appear in a different color before surgery. In surgery, with a special filter of a surgical microscope, normal brain tissue and tumor tissue appear in different colors. With this method, normal brain tissue damage is minimized, tumor removal is at the maximum level, and the patient’s risk of neurological loss is reduced.
Awake craniotomy: in sensitive surgery of tumors of the region responsible for ARM and leg movements, called the speech center or “motor area”, the patient is operated by keeping him awake. In this way, the person’s speech and arm-leg movements are controlled during the operation and damage is prevented. With this method, the success of surgery increases.
Intraoperative CT (O-Arm): computed tomography can be performed during the operation and the condition that occurred during the operation can be displayed. It is mainly used in spinal screw operations. It is observed that there is no margin of error in screw operations performed with O – Arm technology, which can take a 3-D tomography image. At each stage of the operation, it gives critical information to the surgeon, and the risk of recurrence of the disease is reset. In this way, the patient is exposed to less radiation. The method allows surgery to be performed with smaller incisions. In addition to these advantages, it allows you to reduce the risk of infection.