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Types Of Neurosurgery: Overview, Procedure & Costs

August 22, 2023

Neurosurgery is the branch of medicine that deals with surgery of the nervous system. The nervous system is made up of the central nervous nervous system and the peripheral nervous system. The brain and the spinal cord comprise the central nervous system while the peripheral nervous system is composed of the nerves and sensory receptors of the sense organs (such as the ears, eyes, skin etc.). Surgeons who perform neurosurgery are called neurosurgeons. A brain surgery is required to repair structural problems in your brain. They can either be due to birth defects, diseases, injuries, or any other problems. Some of the conditions that require neurosurgery are:

• Aneurysms
• Epilepsy
• Blood clots
• Parkinson’s disease
• Stroke
• Brain tumours
• Nerve damage

There Are Several Forms Of Brain Surgeries Such As:

• • Craniotomy - This type of surgery is done to remove brain tumours, an aneurysm, drain out blood or infection from an infection, or remove any abnormal brain tissue.
  • Biopsy - This is done to remove some brain tissues or tumours for inspecting them under a microscope.
  • Minimally invasive endonasal endoscopic surgery - This helps in removing any tumours or lesions from your nose and sinuses.
  • Minimally invasive neuroendoscopy - In this type of surgery, endoscopes are used to remove brain tumours.
  • Deep brain stimulation - In this type of surgery, an electrode is placed inside your brain for transmitting electrical signals

Types Of Neurosurgery

The types of neurosurgery can be broadly classified as follows: Neuro-oncology: This is a speciality that is focussed on tumours of the brain and the spinal cord Functional Neurosurgery: Surgery to treat problems such as movement disorders, cerebral palsy and epilepsy come under this speciality. Neurovascular Surgery: This speciality as the name indicates is focussed on the blood vessels that supply the nervous system and their related problems such as narrowing, aneurysms, etc. Paediatric Neurosurgery: Neurosurgery that is focussed on the neurological problems that occur in the developmental and childhood stages. This involves the treatment of congenital defects such a spina bifida, tumours and other anomalies. Traumatology: A neurosurgeon who specialises in traumatology treats injuries to the nervous system, such as head injuries, surgically. Spinal Surgery: This speciality is focussed on surgeries of the spinal cord. Skull-base surgery: Neurosurgeons in this field specialize in anomaly surgeries present at the skull base.

Diagnosis

A patient usually comes to a neurosurgeon after diagnosis by a neurologist. Most of the diagnostic tests would have been carried out by the neurologist, but a neurosurgeon may prescribe tests to study the problem more closely and confirm the need for neurosurgery. More detailed tests may be performed to analyse the problem more closely. The most commonly prescribed tests for neurological problems are- Imaging: Modern imaging techniques are able to obtain and study images of the tissues within the body closely. The imaging techniques used in Narayana Healthcare, the best neurosurgery hospital in India, are: Computed Tomography (CT): CT scans give two-dimensional images of the tissues within the body. The CT scan uses a contrast dye that is injected into the bloodstream of the patient to give better images. CT scans involve radiation and are not suitable for pregnant women as they may be harmful to the fetus. When a patient is not a suitable candidate for an MRI, a CT scan is the prefered option. Magnetic Resonance Imaging (MRI): MRI as the name indicates, uses a strong magnetic field and radio waves to obtain images of the internal structures of the body. In addition to images, MRI can also give valuable information about the blood flow and mineral deposits in the body. Since magnetic fields have an effect on the water molecules, MRIs can be used to analyse the water content of tissues. Sometimes, a contrast dye may be used to improve images. The strong magnetic field used makes this scan most unsuitable for a person who has implanted devices or infusion devices in their body. It is very important that anything metallic on the person’s body is removed prior to entering the MRI room. Functional MRI (fMRI): Since an MRI is an excellent tool to study the flow of blood it can be used to study the blood flow to areas of the brain. fMRI scans use these properties of the blood to study which areas of the brain are activated by stimulus and for how long. This is extremely useful for a neurosurgeon to study and localise the areas of the brain that govern different functions prior to surgery. Positron Emission Tomography (PET): PET scans are used by neurosurgeons when they need more detailed images than those that are obtained by CT and MRI scans. PET scans can produce two and three dimensional images of the patient. The PET scans use radioactive isotopes called tracers that are injected into the patient’s bloodstream to give very detailed and clear images of the brain and the rest of the nervous system. When more than one function of the brain has to be studied simultaneously, different tracers can be used for each function. Single Photon Emission Computed Tomography (SPECT): This scan is a nuclear imaging scan that also uses tracers similar to the PET scans. It is used as an additional scan to the other more commonly used scans. A Dopamine Transporter Imaging With Single-photon Emission Computed Tomography (DaT-SPECT) scan is a variation of the SPECT scan. Blood And Urine Tests Neurologists and neurosurgeons use urine and blood tests to look for the presence of toxins and protein disorders. Electroencephalogram (EEG) The nervous system can be studied through the electrical patterns that are generated in it. An EEG is a test that involves the placement of electrodes on the scalp that study and give readings of the electrical patterns generated. EEGs are also the tests that confirm brain death. Electromyogram (EMG) Sometimes, neurological symptoms involve the junction between the nerves and the muscles that they control. In an EMG test, electrodes are placed to detect the transmission of electrical signals and the level of communication between the nerve and the muscle it controls. Evoked Potentials Evoked potentials are tests that neurologists and neurosurgeons use to study the brain’s response to stimuli. The equipment that is used is very similar to that used in an EEG. Spinal Tap or Lumbar Puncture Cerebrospinal fluid is extracted through a lumbar puncture or a spinal tap to be studied in the laboratory. Nerve or Muscle Biopsy Biopsy involves the surgical extraction of a sample of nerve or muscle tissue for neuromuscular disorders. Brain tissue especially of tumors are biopsied to study them; a biopsy of nerve or muscle tissue is performed in patients with neuromuscular disorders. Muscle samples are usually removed surgically or through a thin hollow needle. Nerve samples are removed through an incision. Sometimes skin biopsies are required to test for metabolic disorders or for the measurement of the small nerve fibres present in the sample. Certain infections or tumours in the brain are tested through a biopsy where the sample is retrieved through a surgical procedure. Ultrasound Imaging / Ultrasonography Ultrasounds are especially useful when a neurosurgeon needs to measure the properties of blood flow to the brain. It is also the most commonly used test to study the nervous system of a fetus or a newborn baby. The study of the blood vessels in the neck region is done through carotid doppler scans while the study of the vessels in the brain are through the transcranial doppler ultrasound studies. Such scans are usually done in patients who have suffered or are at risk of a stroke. Treatment & Preventions Most neurological problems are not preventable. The basic guidelines to keeping oneself in good health apply to the health of the nervous system as well. Managing all chronic conditions such as diabetes and high blood pressure under medical supervision is important to prevent neurological problems.

Neurosurgery May Be A Treatment For Some Neurological Conditions Such As:

• Cerebrovascular problems such as aneurysms and blood clots
• Stroke
• Tumours
• Injuries
• Nerve damage
• Epilepsy
• Parkinson’s disease

Other General Classification Of Neurosurgeries Is:

• Base Of Skull Surgery: Specialised surgery performed at the base of the skull region.
• Spinal Surgery: Surgery of the spine in order to treat injuries or other neurological issues.
• Peripheral Nerve Surgery: surgery to treat neurological disorders that are present in the nerves outside of the brain and spine.