Neurosurgery

The term ‘cranial neurosurgery’ is used to describe a wide variety of different surgical procedures carried out either on the brain or on the nerves located within the skull.

These can be pre-planned procedures to tackle pain and other symptoms associated with chronic neurological conditions, or life-saving surgery to remove tumours or treat a traumatic brain injury.

“The aim of neurosurgery is to improve the quality of life of the patient, or in some instances, save the life of the patient, depending on their disease,” says Mr Shoakazemi.

As an extremely complex structure, the brain can be affected by countless different conditions and injuries.

However, there are some conditions that are particularly commonly treated by the neurosurgery team at The London Independent Hospital.

Brain tumours

“Brain tumours are one of the main reasons why patients are referred for neurosurgery,” says Mr Shoakazemi. “Some types of brain tumour can be treated, while others can only be managed using a combination of treatments”.

A diagnosis of a brain tumour can be extremely scary, but not all brain tumours are necessarily malignant. Non-cancerous (benign) brain tumours tend to grow relatively slowly and stay in one place, rather than spreading. If the tumour can be completely and surgically removed, it is unlikely to grow back. However, if some tumour cells remain, it could return in the future. In this instance, you’ll be monitored in the months and years after your surgery.

Unfortunately, some brain tumours are cancerous, and some patients who have cancer in other areas of their body may suffer from a condition called brain metastases. This is where the primary cancer has spread, leading to the formation of cancerous cells in the brain. These can also sometimes be treated with surgery, along with primary cancer brain tumours.

A craniotomy is the most common type of surgery used to treat a brain tumour.

Hydrocephalus

Hydrocephalus is the term used to describe a condition affecting the cerebrospinal fluid (CSF). The cerebrospinal fluid protects the brain from damage, removes waste products and provides the brain with the nutrients it needs to function properly.

In hydrocephalus, cerebrospinal fluid builds up in the brain, putting pressure on it that could lead to temporary or permanent brain damage. Without treatment, it can prove fatal.

Pituitary tumour removal

An endocrinologist may refer you to a neurosurgeon if you have a pituitary tumour that is pressing on the optic nerve, affecting your eyesight. It may also be recommended if your pituitary tumour is overproducing certain hormones.

Although some pituitary tumours can be removed via the nose, many require a craniotomy, particularly if the tumour is large or complex.

Traumatic brain injuries

A traumatic brain injury (TBI) is a disruption in the normal function of the brain caused by a bump, blow or other sudden impact to the head, or if something suddenly penetrates the skull and brain tissue.

TBIs can vary significantly, and can cause a wide range of cognitive symptoms — from headaches and confusion to paralysis and loss of bladder or bowel control.

Neurosurgery may be needed to remove a large haematoma (blood clot) or contusion that is compressing the brain and raising the pressure within the skull.

Pain problems/neuralgia

Everyone has 12 pairs of cranial nerves. These run from the brain to various parts of the head, neck and body and are responsible for either your senses, movement or, in some cases, both.

Nerve pain, or neuralgia, can occur in any of these nerves, but is most often associated with the trigeminal nerve. The trigeminal nerves run up each side of the side and are responsible for providing sensation to the face.

Trigeminal neuralgia is sometimes referred to as the “most excruciating pain known to humanity” and normally affects the lower half of the face and jaw. Surgery can be an effective treatment for patients who find that medications are no longer providing relief.

A wide variety of surgical procedures carried out either on the brain or on nerves within the skull are labelled under the umbrella term of ‘neurosurgery’.

Here are just a few types of neurosurgery we offer at The London Independent Hospital.

Craniotomy

A craniotomy is a common type of surgery used to treat a brain tumour.

Surgery can be used to remove all or part of the tumour (to try and cure or slow the growth of the tumour) or to make it easier to administer other treatments, such as chemotherapy.

Craniotomies are performed under general anaesthetic, meaning that you will be asleep, unaware and won’t feel anything. After removing all or part of the tumour, it may be sent off to the laboratory for biopsy.

Vascular neurosurgery

Vascular neurosurgery is a complex subspecialty that is often considered the very highest level of neurosurgery.

It involves treating patients who suffer from disorders of the blood vessels found in the brain, which may cause disruption to its normal function. Examples include aneurysms stroke and heart conditions, including carotid artery disease (CAD).

The aim of vascular neurosurgery is to treat the damaged or malformed blood vessels to reduce the risk of a cardiac event and reduce the symptoms that the patient has been experiencing.

Radiosurgery

Although radiosurgery isn’t actually a surgery at all, the seriousness and complexity of this important medical treatment means that it is carried out by highly trained and skilled neurosurgery teams at The London Independent Hospital.

Radiosurgery uses focused beams of radiation to treat cancerous tissues. It is a non-invasive treatment that destroys the DNA of tumour cells so that they aren’t able to reproduce or grow. Over time, they should shrink and even disappear altogether.

Referrals to a neurosurgical team almost never come directly from a private GP. Most patients will have already been receiving care from another medical department, such as oncology or ENT. Some referrals also come from ophthalmologists.

When you are referred to your neurosurgical team, you will still have a consultation appointment, which will be used to go over your medical history and the reason for your referral.

In some instances, it may be necessary for you to have further tests before your team explain the type of surgery you are being offered and how it will help you.

Conditions affecting the brain can be complex, making their treatment complicated and highly specialised.

When you choose The London Independent Hospital for neurosurgery, you will be able to benefit from a multidisciplinary approach to your care. This means that there will be a team of medical professionals involved in your surgery, not just your neurosurgeon.

Exactly who will be included in your multidisciplinary team (MDT) may vary, but will likely include:

• Neuro-oncologists, who will give advice and information on tumours and tumour treatments
• Neurologists, who will provide support with symptoms such as seizures
• Neuro-radiologists, whose job will be to interpret brain scans
• Neuro-pathologists, who will provide advice based on tissue sample biopsies
• Clinical neuropsychologists, who will be concerned with your mental health and the psychological aspects of your care, as well as the cognitive effects of your surgery
• Ophthalmologists, who will advise on all things related to your eyesight
• Clinical specialist nurses, before, during and after your treatment
• Allied health professionals, such as physiotherapists, occupational therapists, speech and language therapists and more

Don’t be fooled by the size of The London Independent Hospital. Despite being a small facility, the premises is home to a state-of-the-art theatre and the very latest and most advanced technology.

We’re also proud to have a highly specialised and dedicated theatre and nursing team who are able to perform even the most complex surgeries.

Every patient is unique, and your personal patient journey will depend on the type of neurosurgery you are having and how well you respond to treatment.

Your consultant will be able to give you specific information based on your circumstances. However, there is some general information relating to preparation and recovery that is applicable to nearly all neurosurgery patients.

The prospect of any sort of surgery can be daunting, but particularly so when you are having an operation on your brain.

The neurosurgery team at The London Independent Hospital understand how overwhelmed and anxious you may be feeling and will do everything possible to reassure you by answering any questions that you will almost certainly have.

Preparing for recovery at home

The best way to prepare for brain surgery is to understand what to expect from your recovery. This will help you to make any necessary adaptations to your home and to your daily routine.

This may be arranging for someone to come and look after your children, putting your pets into boarding or stocking the freezer with pre-cooked meals to make taking care of yourself easier when you are discharged.

Preparing for your procedure

Your neurosurgery team will also provide information that will help ensure that you are in good health ahead of your procedure.

This may involve stopping taking certain medications shortly before your surgery or switching to an alternative, fasting for 24 hours before surgery, and washing your hair with a special soap.

Following their guidance is essential to maximise your safety and minimise your risk of complications during or after your surgery.

Recovering from neurosurgery can be a complex process. It is normal to need additional support from loved ones, friends and colleagues in the days and weeks following your surgery.

They may need to help you with travelling to and from hospital, personal care once you return home, stepping in to support with childcare and chores, and making sure that you take any medications as directed.

Exactly how long you will take to recover will depend on the type of neurosurgery you are having. Your neurosurgery care team will be able to give you specific information relating to your personal recovery journey.

Your neurosurgery rehabilitation team

It’s not just family and friends you’ll need to rely on during your recovery. You may also have a team of dedicated professionals helping you to get back on your feet. They could include:

• Physiotherapists, who will be focused on restoring your strength, coordination, balance and movement
• Occupational therapists, who will evaluate your ability to think and perform day-to-day activities
• Speech & language therapists, whose job it is to help you with swallowing issues, as well as language, speech, pronunciation and even the connection between thinking and saying words

As with any recovery from surgery, it’s crucial that you follow the advice and guidance provided to you by your care team, including when to take pain medication, when to return to work and when you can return to your usual daily activities. Following this advice will help ensure that you minimise your risk of complications and recover as quickly as possible.

Your Circle Health Group specialist team will be happy to answer any questions that you have and to explain what you can expect from your recovery in greater detail.

Technology plays a vital role in many surgeries, and neurosurgery is no exception.

At The London Independent Hospital, patients can benefit from neurosurgery that is carried out using the very latest and most advanced technologies currently available. These include:

Intraoperative MRI (iMRI) scanning

iMRI scanning is used to produce images of the brain during the surgery itself. This ensures that your surgical team have current, highly accurate images of the brain that they can use for reference at any point during the surgery.

These images reduce the risks associated with all types of neurosurgeries.

Intraoperative computed tomography (iCT)

This cutting-edge technology uses advanced medical imaging to improve the accuracy and safety of the placement of electrodes in the brain. The CT scan provides improved clarity for surgeons to place electrodes during the surgery.

Stereotactic computer-assisted neurosurgery

Computer-assisted neurosurgery is sometimes known as ‘robotic surgery’.

It describes a revolutionary surgical technique in which your surgeon uses computer and software technology to control and move surgical instruments, which enter the body through several very small incisions.

The main benefit of computer-assisted neurosurgery is that it enables the surgeon to make smaller and more controlled movements. This enhances the precision and accuracy of the procedure, which in turn reduces the risks associated with it.

Being diagnosed with a brain condition or traumatic brain injury can be frightening.

But with the right support and care from the dedicated neurosurgery team at The London Independent Hospital, it may be possible to manage or cure your condition and restore your quality of life.

If you have been referred for brain surgery at a Circle Health Group Hospital, you can feel reassured that your treatment is in the most skilled and experienced hands.

If you have any questions about neurosurgery, or want to speak to us about scheduling an appointment, you can book your private consultation online today or phone us on 0203 9441784 to arrange your visit.

Based in Stepney Green, East London, The London Independent Hospital is easy to travel to by private or public transport. You can get directions here.