Neurosurgery is a unit that specializes in the diagnosis, management and rehabilitation of disorders that affect any part of the nervous system, including the brain, spinal cord, peripheral nerves and cranial cerebrovascular system.
The main diseases neurovascular system are:
♦ Arteriovenous malformation.
♦ Venous angioma, cavernous angioma.
♦ Capillary telangiectasia.
♦ Moyamoya disease.
♦ Brain tumors.
♦ Head trauma (brain hemorrhages, skull fractures, etc.)
♦ Traumas of peripheral nerves.
♦ Intravenous hemorrhage.
♦ Some kinds of drug-resistant epilepsy.
♦ Some movement disorders (progressive disease, chorea, Parkinson).
♦ Pains caused by cancer, injuries, pain of the cranial and peripheral nerves.
♦ Intractable psychiatric disorders.
♦ Meningitis and central nervous system infections, abscesses.
♦ Herniated disc.
♦ Spinal stenosis.
♦ Injuries and damage to the spine and spinal cord.
♦ Tumors of the spine, spinal cord and peripheral nerves.
In modern Israeli neurosurgical diagnosis and management are used neuroradiology, including image-guided computer tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), magnetoencephalography (MEG) and stereotactic surgery. Some neurosurgical procedures involve the use of MRI and functional MRI during surgery.
In many aspects of neurological surgery used microsurgery. These modern technologies allow to perform the most accurate setting of microvascular anastomosis aneurysm clipping with the least damage to the body. Such methods are used in minimally invasive spine surgery. Microsurgery based on such basic procedures as microdiscectomy, laminectomy and implantation of artificial discs.
Our neurosurgeons are increasingly using minimally invasive endoscopic surgery. For example, the endoscopic endonasal surgery is used to remove pituitary tumors, craniopharyngiomas, chords and correction of spinal fluid leakage. For the treatment of colloid cysts and neurocysticercosis used endoscopy ventricles. Endoscopic techniques may be used to assist in the removal of hematomas and trigeminal neuralgia.
Neurosurgeons also specialize in the correction of craniofacial disorders and disorders of the cerebrospinal fluid circulation, in cooperation with maxillofacial and plastic surgery. Problems such as the anomaly Chiari and syringomyelia craniosynostosis treated by cranioplasty.
Neurosurgeons are also involved in stereotactic radiosurgery in addition to radiation oncology in the treatment of tumors and treatment of arteriovenous malformations.
In neurosurgery and endovascular imaging techniques are used (diagnostic angiography) for the diagnosis and treatment of aneurysms, AVMs, carotid stenosis, stroke, spinal malformations and vascular spasm. In addition, such procedures are carried out as vertoplasty and kyphoplasty, and vascular – angioplasty, stenting, and the removal of thrombus embolization.
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Brain tumor or an intracranial tumor is a result of abnormal cell growth within the brain or central spinal canal.
Tumors formed by uncontrolled cell division expense not only in the brain but also in the lymphatic tissues, the blood vessels in the cranial nerves into the brain membranes, skull, pituitary or pineal gland. The cells involved in the formation may be neurons or glial cells (including astrocytes, oligodendrocytes and ependimotsity), hence the name of tumors.
Any brain tumor inherently serious and life-threatening because of its invasive and infiltrative in the confined space of an intracranial cavity. However, brain tumors (even malignant) are not always fatal. Severity depends on a combination of factors such as the type of tumor, its location, size and degree of aggressiveness. Because the brain is securely protected by the skull, the early detection of brain tumors occurs only when visual medical diagnostics.
If you or any of your relatives have put such diagnosis, please contact us. We accept applications for the treatment of patients with tumors of any type and any location.
We select the narrow section of each physician to treat a certain type of brain tumor that makes the most effective treatment and helps improve the quality of life of our patients.
Our neurosurgeons are among the leading Israeli experts with years of experience in the treatment of brain tumors as well as owning a unique surgical methods.
Types of brain tumors
Primary brain tumors are usually located in the posterior fossa in children and in front of the cerebral hemispheres in adults, although they may affect any part of the brain.
The most common primary brain tumors are:
♦ Glioma (astrocytoma, ependymoma, oligodendroglioma, oligodendrocytoma)
♦ Hypophyseal adenoma
♦ Tumor membranes of nerves
The most aggressive brain tumors are glioblastoma and olegodendroglioma.
Glioblastoma is the most common and most dangerous form of malignant brain tumor. For the treatment of these tumors with highest surgical resection followed by radiation therapy two to four weeks after surgery to remove the cancer, and the aggressive chemotherapy. Sometimes as in the experimental treatments applied stem cell therapy.
Oligodendroglioma is incurable, slowly progressive malignant brain tumor. It is also treated surgically, chemotherapy and radiotherapy. Sometimes low-grade tumor observation applies doctor accompanied symptomatic treatment.
Signs and symptoms
Symptoms of solid tumors of the brain (primary brain tumors and secondary tumor) is usually headaches, vomiting (sometimes without nausea), mydriasis on the affected side, altered state of consciousness (somnolence, coma), papilledema. Even small tumors in which hindered the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. In very young children, elevated intracranial pressure may lead to an increase in the diameter of the skull and the protrusion of the fontanelles.
In some cases there are in the form of cognitive dysfunction and behavioral disorders – loss of memory, spatial orientation disorders, emotional changes, hemiparesis, hypoesthesia, aphasia, ataxia, impaired sight, impaired sense of smell, hearing loss, facial paralysis, double vision, dizziness. More serious symptoms may occur too such as: paralysis on one side of the body or worsening swallow. Some patients found irritability, abnormal fatigue, and seizures.
Causes of brain tumors may be environmental factors – the impact of vinyl chloride or ionizing radiation, mutations and removal of so-called tumor suppressor genes, hereditary diseases (von Hippel Lindau syndrome), neurofibromatosis, multiple endocrine neoplasia.
Diagnosis of brain tumors
The main methods of diagnosis of brain tumors is magnetically resonance tomography (MRI) and computed tomography (CT) of the brain, the clinical picture and blood tests. In some circumstances, depending on the type of tumor, eye test, ENT, electrophysiological diagnosis, encephalography may be done.
Brain tumors management
Surgery – total or partial removal of the tumor, depending on its location, in order to improve a patient’s chances of survival and the preservation of all the necessary functions of the body. Surgery (resection) is the best way to remove the tumor. It carried through craniotomy. The operation can not be performed in cases of complex localization of the tumor, because of its inaccessibility or close proximity to vital areas of the brain.
Successful removal subject usually meningioma, except for some tumors located in the base of the skull. Lately becoming more common in operational practice received minimally invasive methods of removing pituitary adenomas small size:
trans – nasal, through the nose;
trans- wedge method, through the base of the skull.
Chemotherapy is used mainly in the presence of malignancy . This method is the least effective in the treatment of brain tumors, but is sometimes used in conjunction with other methods and improve the overall survival of patients.
Radiation therapy is the most commonly used method of treatment of brain tumors, radiation therapy as directed by selective elimination of tumor cells, leaving healthy brain tissue unharmed. Used beta- , X-rays or gamma rays, brachytherapy, stereotactic radiosurgery. Radiotherapy produced by multiple exposure procedures, from 10 to 30 fractional doses, while achieving the maximum effect of treatment with minimal damage to adjacent tissue.
Shunting – shunt installation aims to relieve symptoms. When there is a reduction of hydrocephalus shunt (accumulation of cerebrospinal fluid in the brain, due to its blockage)
Forecast of development of the disease depends on the type of tumor, as well as treatment. For example, medulloblastoma has a good prognosis with timely chemotherapy and radiation therapy, while even surgical resection of glioblastoma may not only be effective for a long time. Stem cell treatment for some types of gliomas can give positive results.
The right treatment can be determined only skilled, based on MRI images in three dimensions, with a contrast agent (gadolinium), and a physical inspection. With proper diagnosis and timely and properly prescribed treatment achieved the best results of brain tumors treatment.
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