Brain Tumour Surgery

Latest Techniques are used by Prof Shahzad Shams to remove brain tumours which are as following:
1. Endoscopic minimally invasive keyhole brain surgery
2. Endoscopic minimally invasive keyhole removal of brain tumours through nose.
3. Neuronavigation used to precisely target the lesion and for complete removal.
4. Stereotactic neurosurgery a minimally invasive keyhole surgery technique for deep seated lesions with 1mm accuracy
5. High Powered Microscopes are used to magnify the tumour for safe removal .
6. Telescopes attached to camera with images on monitor are used to treat Hydrocephalus.
7. Per operative neurophysiological monitoring is done to protect important nerves and areas of Brain.
8. Safest and best technique performed by only one Team of Prof Shahzad Shams in Pakistan called Translabyrinthine minimally invasive keyhole surgery and approach for Acoustic Neuroma surgery.
 All these methods help in safe and complete removal of tumors giving excellent results.

Spine Surgery

SLIPPED DISC or SCIATICA

Prof Shahzad Shams is one the best neurosurgeon to perform Endoscopic Disc surgery in Lahore, Pakistan. He has the largest experience and is master of the technique. Thousands of his patients are leading a normal and productive life in all fields.

SPINAL INJURY

Spinal fixation techniques have changed the mangement of spinal injuries in a radical manner. The use of these techniques and instrumentation has helped these patients to get back to normal lfe activites in a very short time and Omar hospital is one best place for the recovery of these patients.

SPINAL TUMOURS

Expert in Microsurgical techniques and experience are the the reasons why spinal tumor patients come to Prof Shahzad for surgery as he has operated on many comples and difficult cases safely bringing back patients to their normal life.

Parkinson’s Disease,Tremors and Dystonia

PARKINSON’S DISEASE, TREMORS AND DYSTONIA

Prof. Shahzad Shams worked as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore, Pakistan and presently works as Chairman Department of Neurosurgery King Edward Medical University and Mayo Hospital, Lahore, Pakistan.

 

Lahore General Hospital is known for last 50 years for the treatment of movement disorders. Lahore General Hospital is the first Hospital in Pakistan where movement disorder surgery was performed by Prof Bashir Ahmad in December 1964.  It excels in all kinds of treatments required for diseases like Parkinson’s disease, Essential tremors and Dystonia. Prof Shahzad Shams is the best Neurosurgeon for the treatment of movement disorders and considered the best among the Doctors, Neur ophysicians, Medical Specialists and General Physicians.

DBS DEEP BRAIN STIMULATION

SURGERY FOR MOVEMENT DISORDERS

 

Prof Shahzad Shams is the best Neurosurgeon for the treatment with most latest and Advanced techniques for Movement Disorders, Parkinson’s Disease, Essential Tremors, Dystonia, Writer’s cramp, Obsessive compulsive disorder OCD, Tourette’s Syndrome, Epilepsy, Major Depression and Coma with DBS Deep Brain Stimulation Surgery in Lahore, Pakistan.

Programming after deep brain stimulation is a very specialized process for which Prof Shahzad Shams is the best in Pakistan.

Best Neurosurgeon for treatment and  dbs deep brain stimulation surgery for Parkinson’s disease, Tremors and Dystonia in Lahore, Pakistan

Prof Shams MOVEMENT DISORDER CLINIC is the most comprehensive and has robust program for treatment of Parkinson’s disease , Tremors and Dystonia in Pakistan.

PARKINSON’S DISEASE

Parkinson’s disease symptoms, including tremor, stiffness of the limbs, gradual loss of spontaneous movement, decreased mental skills or reaction time, voice changes, decreased facial expression,gradual loss of automatic movement, decreased blinking, decreased frequency of swallowing, and drooling; a stooped, flexed posture, with bending at the elbows, knees and hips; an unsteady walk or balance; and memory loss with depresssion.

TREATMENT

  • MEDICAL
  • SURGERY
  • Thalamotomy
  • Pallidotomy
  • DBS- Deep Brain stimulation

ESSENTIAL TREMORS

An uncontrolled shaking or trembling, usually of one or both hands or arms, that worsens when basic movements are attempted.

TREATMENT

  • MEDICAL
  • SURGERY
  •  Thalamotomy
  •  Pallidotomy
  •  DBS- Deep Brain stimulation

DYSTONIA

This disorder is  characterized by involuntary muscle spasms. Patients with dystonia may experience uncontrollable twisting, repetitive movements or abnormal postures and positions. These can affect any part of the body, including the neck, hands, arms, legs, trunk, eyelids.

Treatment:

  • MEDICAL
  • BOTOX Injections
  • SURGERY
  • Thalamotomy
  • Pallidotomy
  • DBS- Deep Brain stimulation

 

Brain Injury

 

 

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

 

BRAIN  INJURY

 

Head injuries are a major cause of morbidity and mortality in the community.  Trauma is the third most common cause of death in the United States, exceeded only by cardiocerebral vascular disease and cancer.

Trauma is the leading cause of death in youth and early middle age and the death is often associated with major head trauma. Head injury contributes significantly to the outcome in over half of trauma related deaths. There are approximately 2.5 deaths from head injury per 10,000 population in Australia and neurotrauma causes approximately 3.5% of all deaths. Road traffic accidents are responsible for about 65% if all fatal head injuries in Australia.

There is a wide spectrum of head injury from mild concussion to serve brain injury resulting in death. The management of the patient following a head injury requires the identification of the pathological processes that have occurred.

Diseases Neurosurgeons Treat

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

Diseases Neurosurgeons Treat?

Neurosurgeons treat patients with tumors of the brain or spinal cord.

Accidents that lead to injuries of the head, spinal cord, or nerves require neurosurgical treatment.

Children born with a brain or spinal cord malformation at birth or with abnormal spinal fluid circulation require neurological surgery to help these children live a more normal life.

The most common condition that neurosurgeons treat is pain in the neck or lower back spreading to the arm or leg due to a ruptured disc. Slipped discs or pinched nerves may be treated non-surgically through bed rest, back braces, or physical therapy. Neurosurgery is performed to treat these patients when medicines fail to help or patients start to develop numbers or weakness of the affected limbs.

Neurosurgical Conditions

Acoustic neuroma tumor

 

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

 

ACOUSTIC NEUROMA TUMOR

Translabyrinthine approach or Translab approach and Minimally invasive Keyhole Technique for Acoustic Neuroma surgery

 

PROF SHAHZAD SHAMS AND HIS TEAM ARE THE FIRST TO START TRANSLABYRINTHINE SURGERY BY TRANSLAB TECHNIQUE AND APPROACH WHICH MAKES THE ACOUSTIC NEUROMA SURGERY SAFE WITH COMPLETE REMOVAL OF TUMOUR AND EXCELLENT RESULTS.

 

Prof Shahzad Shams and his team are the first and only team in Pakistan to start Translabyrinthine approach or Translab approach for Acoustic neuroma surgery which is the safest technique for complete removal of tumor. With the help of this technique complete excision with complete safety is now possible and after surgery patient is cured as it is a benign tumor.

 

Acoustic schwannomas arise from the 8th cranial nerve and account for 8% of intracranial tumours. Schwannomas occur less frequently on the 5th cranial nerve and rarely involve other cranial nerves. The acoustic schwannoma take origin from the vestibular component of the 8th cranial nerve near the internal auditory meatus, at the transition zone where the Schwann cells replace the oligodendroglia.

 

Clinical presentation:

The presenting features will depend on the size of the tumour at the time of diagnosis. The earlier symptoms are associated with 8th nerve involvement. Tinnitus and unilateral partial or complete sensorineural hearing loss are the earliest features. Episodes of vertigo may occur but these maybe difficult to distinguish from Meniere’s disease. Although the tumour causes compression of the facial nerve, the growth of the tumour is so slow that facial paresis is not evident until the tumour is large.

 

Treatment

Prof Shahzad Shams and his team are the first and only team in Pakistan to start Translabyrinthine approach and Translab approach for Acoustic neuroma surgery which is the safest technique for complete removal of tumor. With the help of this technique complete excision with complete safety is now possible and after surgery patient is cured as it is a benign tumor.

The total excision of a large acoustic neuroma remained one of the major operative challenges but with Translabyrinthine approach or Translab approach it is now possible to remove acoustic tumor completely and radically and safely by this minimally invasive keyhole surgery technique. 

 

Safest and best technique performed by only one Team of Prof Shahzad Shams in Pakistan called Translabyrinthine approach or Translab for Acoustic Neuroma surgery.

Latest Techniques of Spine Surgery

 

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

 

 

LATEST TECHNIQUES OF ENDOSCOPIC MINIMALLY INVASIVE KEYHOLE SPINE SURGERY

 

 

Trauma to the spinal column occurs at an incidence of approximately 2-5/100000 population. Although the majority of spinal injuries do not affect the cord or spinal roots, about 10% will result in quadriplegia.
Adolescent and young adult males are the most commonly affected group.

Most of the serious spinal cord injuries are a consequence of road traffic accidents although there are other, major causes of quadriplegia, for example water sports, especially diving into shallow water, and injuries following skiing accidents

.Few years back spine surgery was done only from the posterior side of the vertebral column but now anterior approaches have also made a huge difference in the results. 

CERVICAL SPINE

These days for cervical spine anterior titanium cage fixation ,anterior plate fixation are done. Anteriorly peek material and charite mobile discsa are placed.

THORACIC SPINE

For thoracic spine anterior thoracotomy is done to fix spine anteriorly by using expandable titanium cages , lateral body fixation with screws and rods or plates. Posterior transpedicular fixation and Posterior Hartshill fixation with wires and rectangles are used.

LUMBAR SPINE

For lumbosacral spine anterior retroperitoneal approaches are used and cage fixations can be done and  poserioriorly  transpedicular fixations are done . 

 

Treatments of Spine Injuries

 

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

 

Treatment of Spine Injuries

Early stabilization by fixation reduces the incidence of complications from bed rest, such as pressure sores, pneumonia and thrombophlebitis, the patient has less pain and can participate in rehabilitation and mobilization at an earlier stage, thus reducing hospital time and cost. Depending on the type of instability, fixation can be achieved using either an external orthosis such as a halo device or by internal means. The latter can be achieved in a variety of ways according to the type of injury. These include metal wire, clamps, pedicle screws or anterior vertebralplates, in combination with bone grafting.

Thoracolumbar fracture-dislocations are usually relatively stable compared with cervical injuries, and if the patient is moved with care, and nursed in slight hyperextension with a pillow in the small of the back, most remain reduced. When there is instability, and particularly if the lesion is incomplete and could therefore be made worse, decompression of the spinal canal followed by internal fixatin and bone grafting to restore the normal thoraco-lumbar curve is advised. Several effective methods are available for anterior, lateral or posterior fixation.

 

Types of Brain Injuries

 TYPES OF BRAIN INJURIES

 

Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.

 

Minor and Moderate Head Injury

The patient would be assessed as described above. Any patient who has suffered a head injury must be observed for at least 4 hours. The following are the minimum criteria for obligatory admission to hospital:

·         Loss of consciousness (post-traumatic amnesia) of greater than 10 minutes

·         Persistent drowsiness

·         Focal neurological deficits

·         Skull fracture

·         Persisting nausea or vomiting after 4 hours’ observation

·         If the patient does not have adequate care at home

The further management of these patients will be careful observation; the neurological observations should be recorded on a chart displaying the features of the Glasgow coma scale. If there has been a period of significant loss of consciousness, or if the patient is drowsy, then the following measures should be instituted to minimize the development of cerebral swelling:

·         Head of the bed elevated 200

·         Mild fluid restriction to 2-2.5 litres per day in an adult

Should the patient’s neurological state deteriorate an immediate CT scan is essential to re-evaluate the intracranial pathology; further treatment will depend on the outcome.

Severe head injury

The management of a patient following a severe head injury depends on the patient’s neurological state and the intracranial pathology resulting from the trauma. In general, the following apply:

1.       The patient has a clinical assessment and CT scan as described previously.

2.       If the CT scan shows an intracranial haematoma causing shift of the underlying brain structures then this should be evacuated immediately.

3.       If there is no surgical lesion, and following the operation, the management consists of:

a.       Careful observation suing a chart with the Glasgow coma scale.

b.      Measures to decrease brain swelling, these include:

                                                               i.      Careful management of the airway to ensure adequate oxygenation and ventilation. Hypercapnia will cause cerebral vasodilation and so exacerbate brain swelling.

                                                             ii.      Elevation of the head of the bed 200

                                                            iii.      Fluid and electrolyte balance