Latest Techniques Used for Brain Tumour Surgery Prof Shahzad Shams

LATEST TECHNIQUES USED FOR  BRAIN TUMOUR SURGERY BY    PROF SHAHZAD SHAMS  

 

Prof. Shahzad Shams presently works as Chairman and Head of Neurosurgery Department at King Edward Medical University & Mayo Hospital, Lahore.

 

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. Computer Assisted Neuronavigation  Brain Tumor surgery used to precisely target the lesion and for complete removal.

4. Stereotactic Brain Tumor surgery a minimally invasive keyhole surgery technique for deep seated lesions with         1 mm accuracy

5. High Powered Microscopic Brain Tumor surgery are used to magnify the tumour for safe removal .

6. Endoscopic surgery ETV for Hydrocephalus attached to camera with images on monitor.

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.

About Stereotactic Brain Biopsy done through Keyhole surgery

Prof Shahzad Shams is the first Neurosurgeon in Punjab and KPK to start Stereotactic neurosurgery in the Private sector which involves mapping the brain in a three dimensional coordinate system. With the help of MRI and CT scans and 3D computer workstations, he is able to accurately target any area of the brain in stereotactic space (3D coordinate system). He uses RM frame system and Inomed IPS Planning software for this purpose. Stereotactic brain biopsy is a minimally invasive procedure that uses this most advanced and cutting edge technology to obtain samples of brain tissue for diagnostic purposes and for aspiration of cystic lesions.

Indications

This procedure is used to obtain tissue samples of areas within the brain that are suspicious for tumors or infections. The main indications for stereotactic biopsy are :-

  • Deep-seated lesions
  • Lesions in Eloquent areas of brain like Thalamus and Brain Stem.
  • Multiple lesions like Metastatic lesions
  • Diffuse Infiltrative lesions like Encephalitis and Diffuse Glioma
  • Lesions in patients who cannot tolerate anesthesia like old aged
  • For Aspiration of Brain abscess and cystic lesions
  • For Aspiration of hematomas

Technique

On the afternoon of surgery a head ring is placed on the patient. This involves giving local anaesthesia to the skin in four areas and placing the ring on the head with four pins. A CT scan is then performed.
In the operating room, the patient receives light sedation. An incision only a few millimeters long is made in the scalp and a small hole is drilled into the skull. A thin biopsy needle is inserted into the brain using the coordinates obtained by the computer workstation. The specimen is then sent to the pathologist for evaluation. Patients are monitored for several hours following the procedure and usually go home the same day.
Accuracy of the RM frame and IPS Planning system is of sub millimeter level and is considered to be the best system in the world giving 100% results to reach diagnosis.

 

 

 

Brain Tumor Surgery

BRAIN TUMORS OPERATED BY PROF. SHAHZAD SHAMS BY ENDOSCOPIC MINIMALLY INVASIVE KEY HOLE BRAIN SURGERY :-

 MENINGIOMAS , MALIGNANT Brain Tumour(Glioma, Astrocytoma, Metastatic)Cerebellopontine angle tumoursAcoustic Neuroma Schwannoma Tumor, Pituitary tumor, Prolactinoma, Colloid cysts, Craniopharyngioma, Rathke’s Cleft Cyst, Sellar and Parasellar tumors and Brain Tuberculomas

MALIGNANT BRAIN TUMORS

Malignant  brain tumors also called Gliomas and most aggressive in nature.

They need to be dealt as soon as possible basis as their growth rate which  is rapid and their local spread in the brain causes damaging effects.

Prof shahzad Shams has operated on more than 5000 Gliomas.

First step for him is diagnosis by MRI with contrast. Then planning about surgery and decision about safe approach to tumor and clean and safe removal so that no deficits are given so that patient has a good quality of life. Surgery is performed by using the Latest techniques and gadets like Endoscopes, microscopes, Stereotactic surgery and best microsurgical techniques. After surgery biopsy report reveals the grading of tumor which helps to make decision about Radiotherapy and chemotherapy. Biopsy also gives information about prognosis.

BENIGN BRAIN TUMORS

Meningiomas, Schwanomas, Neurofibromas, Tuberculomas and Fungal granulomas are few examples.

First step for him is diagnosis by MRI with contrast. Then planning about surgery and decision about safe approach to tumor and clean and safe removal so that no deficits are given so that patient has a good quality of life. Surgery is performed by using the Latest techniques and gadets like Endoscopes, microscopes, Stereotactic surgery and best microsurgical techniques. After surgery biopsy report reveals the type of tumor which helps to make decision about further treatment. Biopsy also gives information about prognosis.

 

Acoustic Neuroma

Acoustic neuroma is a benign tumor which lies in the region of brain where many important nerves and brain structures are present.

Acoustic neuroma surgery is one of the complicated surgeries and should be attempted by an experienced and trained neurosurgeon.

Prof Shahzad has operated on more than 2000 cases of Acoustic neuroma also called cerebellopontine schwanoma.

He suggests following options according to size and involvement of  adjacent structures:-

1. Gamma Radiosurgery

2. Sub occipital craniotomy

3. Translabyrinthine approach

He is one of the best neurosurgeon who has given excellent results and many patients operated for acoustic neuroma are livivng a normal life since decades.

Stereotactic Brain Tumor Surgery

STEREOTACTIC BRAIN TUMOR SURGERY (MINIMALLY INVASIVE KEYHOLE SURGERY)

Prof Shahzad Shams is the first Neurosurgeon in Pakistan to start Stereotactic brain tumor surgery and biopsy in Pakistan  He is also Pioneer and First to Perform in the Private sector Stereotactic Brain tumor surgery and biopsy in Lahore, which involves mapping the brain in a three dimensional coordinate system. With the help of MRI and CT scans and 3D computer workstations, he is able to accurately target any area of the brain in stereotactic space (3D coordinate system). He uses RM frame system and Inomed IPS Planning software for this purpose. Stereotactic brain biopsy is a minimally invasive procedure that uses this most advanced and cutting edge technology to obtain samples of brain tissue for diagnostic purposes and for aspiration of cystic lesions.

INDICATIONS

This procedure is used to obtain tissue samples of areas within the brain that are suspicious for tumors or infections. The main indications for stereotactic biopsy are :-

  • Deep-seated lesions like brain tumors in Pakistan
  • Lesions in Eloquent areas of brain like Thalamus and Brain Stem.
  • Multiple lesions like Metastatic lesions
  • Diffuse Infiltrative lesions like Encephalitis and Diffuse Glioma
  • Lesions in patients who cannot tolerate anesthesia like old aged
  • For Aspiration of Brain abscess and cystic lesions
  • For Aspiration of hematomas

TECHNIQUE

On the afternoon of surgery a head ring is placed on the patient. This involves giving local anaesthesia to the skin in four areas and placing the ring on the head with four pins. A CT scan is then performed.

In the operating room, the patient receives light sedation. An incision only a few millimeters long is made in the scalp and a small hole is drilled into the skull. A thin biopsy needle is inserted into the brain using the coordinates obtained by the computer workstation. The specimen is then sent to the pathologist for evaluation. Patients are monitored for several hours following the procedure and usually go home the same day.

Accuracy of the RM frame and IPS Planning system is of sub millimeter level and is considered to be the best system in the world giving 100% results to reach diagnosis.

Trigeminal Neuralgia Surgery

TRIGEMINAL NEURALGIA

This is a condition which may be treated by GP’s, Neurologists, Psychiatrists, Neurophysicians and Neurosurgeons. It is characterized by a severe spasmodic and lancinating pain which affects one side of the face. The pain is excruciating, severe and is triggered by actions like chewing, swallowing, drinking hot or cold liquids, brushing the teeth, or being exposed to cold wind. 

The cause of the symptoms is the pain which usually affects one branch of the trigeminal nerve which supplies sensation to the side of the face. In many cases symptoms seem to be related to a loop of a blood vessel within the brain itself pressing on the trigeminal nerve.

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

TREATMENT

MVD SURGERY

ENDOSCOPIC MICROVASCULAR DECOMPRESSION 

Endoscopic Microvasular decompression is a procedure in which a 2cm opening is made behind the ear and through this opening a endoscope of  4mm size is inserted to find the vessel which is offending oe pressing the trigeminal nerve which is then separated from the nerve using micosurgical instruments and a small teflon graft is placed in between the vessel and nerve. Patient is immediately relieved of the severe  pain on the face and is disharged within 24 hours from the hospital.

RESULTS

The results for ENDOSCOPIC Microvascular decompression (MVD) are excellent and the procedure once done the patient is relieved of the pain forever and permanently. Hospital stay is only for 24 hours.

 

 

 

 

 

 

Pituitary Tumour

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

PITUITARY TUMOURS/

SELLAR & PARASELLAR TUMORS

Professor Shahzad Shams is known world over for providing Quality care to Pakistani and patients from abroad for Nasal technique of removal of brain tumours like Pituitary adenoma, Prolactinoma, Craniopharyngioma, Rathke’s cleft cyst, Sellar and Parasellar tumors using Transnasal Transsphenoidal endoscopic pituitary surgery technique of removal of tumour through the nose also known as Transnasal endoscopic surgery of Pituitary tumours also called Transphenoidal surgery.  Patients come from countries like US United states of America USA , United Kingdom UK Britain England, Canada, Italy, Greece, Germany, Spain, Australia, Saudi Arabia, United Arab Emirates UAE, Dubai, Kuwait, Qatar, Bahrain and Afghanistan requiring Neuro, Neurological surgery or Neurosurgery management.

Brain Tuberculomas

 

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

Intracranial Tuberculomas

Best treatment of Brain Tuberculoma is Stereotactic biopsy which is Minimally invasive keyhole surgery which is safest surgery and done while patient is awake and stay in Hospital is only for 24 hours. On positive biopsy report of tuberculoma treatment with Anti tuberculous therapy completely cures the patient.

 

 

An intracranial tuberculoma originates by haematogenous spread from tuberculous lesions in other parts of the body, especially the lung. Tuberculomas are frequently multiple and are predominantly located in the posterior fossa in children and young adults, but may occur throughout the cerebral hemispheres.

The clinical presentation is similar to an intracranial tumour, with features of raised intracranial pressure, focal neurological signs and epileptic seizures, systemic symptoms of tumberculosis, such as fever, excessive perspiration and lethargy, occur in less than 50% of cases.

The MRI and CT scan appearance of a tuberculous granuloma is an area of low attenuation with a contrast-enhancing capsule. There is usually surrounding oedema and the lesions may be multiple. The tuborculoma is occasionally calcified.

LATEST ADVANCED TREATMENT OF INTRACRANIAL TUBERCULOMAS

 

Best treatment of Brain Tuberculoma is Stereotactic biopsy which is minimally invasive keyhole safest surgery and done while patient is awake and stay in Hospital is only for 24 hours. On positive biopsy report of tuberculoma treatment with Anti tuberculous therapy completely cures the patient.

CVA/ Stroke Brain Surgery

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

CVA / Stroke, Brain Surgery

The term “Stroke” is used to describe a sudden neurological deficit of vascular aetiology lasting more than 24 hours. A transient ischaemic attack (TIA) indicates a transient neurological deficit of vascular origin lasting lasting less than 24 hours, although many patients with TIAs have suffered minor strokes.

Stroke is categorized as cerebral infarction, signifying ischaemic brain damage or cerebral haemorrhage, where the primary pathology involves vascular rupture and estravasation of blood into the surrounding tissues or compartments. The term ‘haemorrhagic’ is used to describe an infarct into which there has been a secondary extravasation of blood.

Risk factors and associated disease

·         Age and sex

·         Hypertension

·         Heart disease

·         Diabetes

·         Smoking

·         Polycythaemia

·         Alcohol 

Pediatric Brain Tumours/ Chidhood brain tumours

 

 

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

 

 

CHILDHOOD BRAIN TUMOURS

Pediatric Neurosurgery

Pediatric Neurosurgery by prof.Shahzad provides individualized care for infants to young adults and encompasses the full range of neurosurgical disorders affecting a child’s brain or spinal cord. Prof.shahzad  leads the dedicated pediatric team consisting of neurosurgeons, anesthesiologists and specialized nurses. In 2010-11 Omar hospital was ranked as the best pediatric hospital in Lahore for neurosurgery and amongst the top institutions overall, nationally. Due to the neurosurgery team’s clinical expertise, integration with neuroscientists and professional support from an array of family centered specialists like pediatric therapists, on-site child education and recreation therapy, the Pediatric Neurosurgery program by Prof Shahzad has earned a national reputation for delivering the highest standard of family-focused care.

This centre has most advanced surgical facility in the country, designed exclusively for pediatrics, allowing the pediatric neurosurgical team to tackle even the most formidable of diseases and conditions.

PEDIATRIC ENDOSCOPIC BRAIN SURGERY

CRANIAL ENDOSCOPIC PROCEDURES

1. ENDOSCOPIC PITUITARY SURGERY AND CRANIOPHARYNGIOMA SURGERY

ENDOSCOPIC PITUITARY SURGERY

        Endoscopic pituitary surgery and Craniopharyngioma surgery also called as Transnasal Transphenoidal Endoscopic Pituitary Adenoma Surgery is performed through a natural nasal air pathway  through the nose without any incisions unlike the conventional microscopic surgery performed with an incision made under the upper lip or inner aspect of a nostril.  Endoscopic surgery does not require the use of a metallic transsphenoidal retractor that is used for conventional Microscopic Transnasal Transphenoidal Pituitary Tumour surgery.  A 4-mm endoscope is placed in front of the tumor in the sphenoidal sinus and the tumor is removed with specially designed surgical tools. Postoperative nasal packing is not necessary, and postoperative discomfort is minimal.  Most patients are able to go home the following day.  The optical advantages of an endoscope (such as a wide-angled panoramic view, an angled view by angled lens endoscopes, and a view in the tumor removal cavity) enhance tumor removal even in complex cases of bulky tumors.

 Advantages of Endoscopic Pituitary Surgery and Craniopharyngioma surgery

§  With this newly developed minimally invasive technique, pituitary tumors can be removed through the patient’s natural nose.

§  This procedure does not require sublabial or nostril incisions and eliminates the need for occlusive postoperative packing used with the conventional procedures.

§  This method is minimally invasive because it directly approaches the tumor through the patient’s nostril thus eliminating facial swelling, decreasing postoperative pain, and making recovery quicker.

§  The procedure is innovative because it utilizes endoscopic technology to improve visualization of the pituitary gland, the tumor, and other anatomical structures.

Most patients can go home the day following their surgery.

 TREATMENT :  ENDOSCOPIC MINIMALLY INVASIVE KEYHOLE TECHNIQUE FOR TUMOR EXCISION THROUGH THE NOSE WITHOUT ANY INCISION AND A HOSPITAL STAY 24 HOURS.

2. ENDOSCOPIC MINIMALLY INVASIVE KEYHOLE SURGERY FOR MANAGEMENT OF INTRAVENTRICULAR BRAIN TUMOURS

 

ENDOSCOPIC MANAGEMENT OF INTRAVENTRICULAR  

    BRAIN TUMORS

The cerebral ventricles are chambers within the brain that contain a clear-colorless fluid called cerebrospinal fluid (CSF). CSF serves as an excellent medium for endoscopy given the clarity and space. Since many varieties of brain tumors can occur in the ventricles, biopsy is commonly recommended in order to define the best type of therapy. Conventional procedures for tumor biopsy involve either a needle biopsy using a frame attached to the skull or an open surgical procedure. Brain tumors situated in the intraventricular compartment are amenable to an endoscopic biopsy or resection.

 

Endoscopic Tumor Surgery

The procedure is performed through a small incision (approximately 1 inch) behind the hairline. From this site, the endoscope is inserted into the ventricular compartment of the brain and then navigated toward the tumor. The tumor is readily identified due to the difference in appearance from the surrounding tissue. Biopsy forceps are then used to sample the tumor. Because direct vision is being used, samples can be selected avoiding any small blood vessels or other important structures within the ventricle, features that cannot be done with standard “closed” needle biopsies. The endoscope is then removed and the wound is closed. The procedure is performed in approximately 30 minutes and patients can return home the following day.

 

Endoscopic biopsy for intraventricular brain tumors avoids many of the inherent risks associated with conventional surgical approaches. Because these tumors are typically situated deep within the brain, the ability to approach these tumors with a minimally invasive technique offers a very significant advantage to the patient.

 TREATMENT :

 ENDOSCOPIC MINIMALLY INVASIVE KEYHOLE SURGERY FOR TUMOR EXCISION THROUGH A SMALL OPENING OF 2CM AND SHORT HOSPITAL STAY. 

 

 

 

 

 PEDIATRIC OR CHIDHOOD BRAIN TUMOURS

 

 

 

 

Brain tumours are among the most common childhood malignancies and they vary widely in their type, location, and growth rate.

 

Brain tumours are the most common solid tumours in children and account for 20% of all childhood malignancies,

 

 Symptoms

 

Brain tumours can cause a multiple symptoms depending on their location, its rate of growth, and the age of the child.

 

Tumours in any location can cause increased pressure within the skull causing the child to experience headaches, nausea, vomiting, and double vision. In infants, the increased pressure may cause excessive, rapid head growth. Tumours located in the back of the brain (posterior fossa) can also cause unsteadiness and difficulties with speech and swallowing. Tumours located in the top part of the brain (supratentorial) can cause seizures (involuntary convulsions with or without loss of consciousness) or weakness of the arms or legs. Tumours located near the base of the brain (suprasellar) can cause visual problems as well as hormonal imbalances that can lead to several conditions including growth disorders.

 

Diagnosis

 

When a child develops symptoms that are suggestive of a brain tumour, the mainstay of establishing the diagnosis is through imaging of the brain. This is done by either a CT scan or MRI Scan. While these types of images will demonstrate whether an abnormal mass is present in the brain, in only a few cases will this be enough to establish what type of a mass it is. Aside from brain tumour, abnormal masses in the brain could be caused by infection, bleeding, or a long-standing congenital abnormality. In most cases, some form of surgery is required in order to remove a sample of tissue. By analyzing the tissue, one can know for sure whether the mass is a tumour and, more importantly, exactly what type of tumour it is.

 

Treatment

The treatment of brain tumours varies greatly and is dependent by several factors including the size and location of the tumour, the age of the child, and the expected growth rate of the tumour. The main modalities of treatment are surgery, radiation therapy, and chemotherapy.

 SURGERY

 

LATEST TECHNIQUE IS ENDOSOCPIC SURGEY DONE THROUGH NOSE OR A ENDOSCOPIC MINIMALLY INVASIVE KEYHOLE  2CM OPENING WITH SHORT HOSPITAL STAY  

Surgery for brain tumours can be performed for different purposes, depending on the type, size and location of the tumour. The possible goals of surgery may be one of or any combination of the following:

1. To remove as much of the tumour as is safely possible. One of the great difficulties in removing brain tumours, as opposed to tumours in other locations in the body, is that extreme care must to be taken to try to prevent harm to the very delicate brain tissue. For most childhood tumours, the prognosis is generally better if the tumour can be either totally or near-totally removed. Therefore, surgery remains the mainstay of therapy for the majority of childhood tumours.

2. To remove enough of the tumour to improve the patient’s symptoms. For example, if a large tumour is causing increased pressure in the skull, or weakness of the arms or legs, or seizures, then surgery on the tumour may help relieve these symptoms.

3. To provide a tissue sample of the tumour. This tissue sample is analyzed by pathologists and this will tell the surgeon what type of tumour it is and, possibly, how aggressively it might be expected to behave. This will also help decide what type of treatment is needed.

Radiation Therapy

Radiation therapy involves passing high energy radiation through the body. Radiation slows rapidly growing tissue, like tumours. Radiation therapy is often used in conjunction with surgical therapy. The dose and timing of the radiation regimen depends on the type of tumour. In some cases, radiation might only be applied to the local area of the tumour, whereas in other cases, an additional radiation dose might be given to the entire brain and spinal cord to try to prevent the tumour from seeding via the spinal fluid. Because of the fear that radiation therapy may adversely effect the very young, developing brain, it is usually not performed in infants and very young children. Potential side-effects of radiation therapy include hair loss, nausea, vomiting, fatigue, and local skin irritation.

Chemotherapy

Chemotherapy involves giving very strong medications (directly into the bloodstream or occasionally as pills) that preferentially destroy tumour cells. There are numerous drugs that may be used for various types of brain tumours. Although some chemotherapy drugs can improve the survival of children with certain brain tumours, the drugs themselves can have substantial side-effects, including severe nausea, hair loss, and risk of infection.

 

Types of Brain Tumours

There are several different types of brain tumours that can affect children. Only some of the more common ones will be discussed here.

 

Craniopharyngioma

These tumours are located near the optic nerves and the pituitary gland, so they frequently cause visual problems and hormonal imbalances. The standard therapy for these tumours is surgery, attempting to remove as much of the tumour as is safely possible. Total removal of the tumour is very difficult and, because of its location, visual disturbances and hormonal imbalances are not uncommon after surgery. Radiation therapy is occasionally used if substantial tumour remains after surgery or if the tumour shows re-growth.

 

Astrocytoma

Astrocytomas are tumours that can either be low-grade or high-grade. The low-grade variety is commonly found in the back of the brain (posterior fossa) and these account for approximately 10% of all childhood brain tumours. They may, however, also be located in the top of the brain (supratentorial). Surgical removal of these tumours, especially in the posterior fossa, carries an excellent prognosis for complete cure.  The overall prognosis for these tumours is very good.

High-grade astrocytomas are most commonly located in the top of the brain (supratentorial). Treatment usually consists of a combination of surgery, chemotherapy, and radiation. These are quite aggressive tumours and the prognosis is much worse than for the low-grade variety.

Ependymoma

Ependymomas most commonly occur in the back of the brain (posterior fossa). Therapy consists of surgery, attempting to remove as much of the tumour as is safely possible, and radiation therapy.

Medulloblastoma

Medulloblastoma is another common tumour of the back of the brain (posterior fossa).Treatment initially consists of surgical removal. This is usually followed by radiation therapy, which frequently involves radiation to the entire brain and spinal cord to prevent the spread of the tumour to another location. Depending on the extent of the tumour, chemotherapy may also be considered.

Brainstem Glioma

The brainstem is the central area of the brain, where all the nerve fibers that travel between the brain and body meet. Tumours that arise in this delicate location are usually gliomas that can either be high-grade or low-grade

High-grade brainstem gliomas are very difficult to treat. They may be diagnosed based on brain imaging alone. Surgical removal is extremely difficult and so therapy is usually confined to radiation and, sometimes, chemotherapy.

Low-grade brainstem gliomas are quite different and sometimes need no urgent therapy. They can sometimes simply be watched with repeated brain imaging. It is not uncommon for these to remain unchanged for many years.

Tumours in the brainstem are particularly prone, due to their location, to obstruct the flow of the brain’s natural fluid. This causes a build-up of fluid in the brain (hydrocephalus) and increased pressure in the skull. The treatment for this can involve either placement of a silastic tube (shunt) to drain the fluid into the abdomen or the creation of a separate hole in the brain to divert the tumour obstruction (endoscopic third ventriculostomy).

 

 

 

 

 

 

 

 

 

 

 

 

 

Cerebral Brain Anuerysm

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

 

 

CEREBRAL BRAIN ANEURYSMS

ANTERIOR COMMUNICATING ARTERY ANEURYSMS ( Acom Aneurysm)

MIDDLE CEREBRAL ARTERY ANEURYSMS

 

Brain Haemorrhage/Aneurysms/AVM’s

The commonest type of brain haemorrhage requiring neurosurgical treatment is a subarachnoid haemorrhage which is due to rupture of  Brain aneurysms arising from Anterior communicating artery aneurysm , Acom aneurysm, Middle cerebral artery aneurysm, MCA aneurysm, Posterior communicating artery , Pcom aneurysm, Anterior cerebral artery aeurysm, ACA aneurysm, Internal Carotid artery aneurysm, ICA aneurysm or AVM .

Haemorrhages (bleeding) within the brain can also be related to high blood pressure (hypertension) blood thinning (anticoagulant) medicines and some types of stroke.

SAH Subarachnoid Haemorrhage

This type of haemorrhage usually occurs as the result of rupture of a small blister like abnormality (called an aneurysm) on one of the brain’s main arteries. Haemorrhage (bleeding) from one of these aneurysms is serious and potentially life threatening. It often presents with a very sudden and severe headache, which may be followed by loss of consciousness, nausea, vomiting or epileptic fits/seizures. The diagnosis is usually made with a CT scan or MRI Scan. Once referred to a neurosurgical unit the blood vessels of the brain are imaged by Cerebral Angiography to see if there is an aneurysm or other abnormality present. If there is, this may need to be treated by a neurosurgical operation to put a Titanium metal clip across the neck of the aneurysm and thereby prevent further bleeding permanently from the ruptured aneurysm. The commonest vessels involved are Anterior communicating artery aneurysm, Middle cerebral artery aneurysm , Posterior communicating artery aneurysm and Internal Carotid Artery aneurysm . The results of aneurysm surgery are excellent and total stay in hospital 2 days.

RESULTS

The Results of  Brain Aneurysm clipping arising from Anterior communicating artery aneurysm , Acom aneurysm, Middle cerebral artery aneurysm, MCA aneurysm, Posterior communicating artery , Pcom aneurysm, Anterior cerebral artery aeurysm, ACA aneurysm, Internal Carotid artery aneurysm, ICA aneurysm are EXCELLENT.

surgery are excellent.