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NEUROSURGERY
 
The neurosurgical diseases include diseases of the brain, spine and nerves. In the brain this involves treatment for brain injury due to accident, stroke due to bleeding, rupture of blood vessel and tumour. In the spine it involves illnesses like fracture of the spine, compression of the spinal cord or nerve due to disc prolapse or bony spur. Occasionally there can also be tumour in the spinal cord causing pain or weakness in the limb.

Neurosurgery photo
Operating microscope
Treatment of the neurosurgical diseases has improved a lot with a better knowledge of neurosurgical diseases and the availability of advanced diagnostic and treatment facilities in this era.

The most common complaint when neural structures are compressed is pain. This can lead to headache, neck pain, pain in the arm and the leg. One of the important clues as to the seriousness of the headache is when the headache is severe and sudden. This indicates something serious such as a bleed in the brain. Secondly if the headache is continuous and is associated with drowsiness and vomiting it is usually of a more serious nature.

Pain in the neck and arm can indicate problem at the cervical spine (the neck part of the spine). Most frequently it is due to arthritis in the joints in the neck. If there is arm pain associated with numbness and/or weakness then it can mean there is also compression of the nerve that supplies the arm. Difficulty in walking or urination indicates a more serious situation where the spinal cord is compressed.
 
Neurosurgery photo
Clipping of aneurysm
 
Neurosurgery photo
Position during operation at the back of head
 

Lower back pain is a frequent complaint. This can be due to arthritis and degeneration of the disc in the lower back or the lumbar spine. Most people do not need operation. However if it compresses the nerve and affects the function of the leg and bladder then an operation is warranted.

Finding a cause for a neurosurgical disease involves taking a detailed history from the patient and doing a thorough examination of the neurological system. This usually gives a likely cause of the illness. Depending on the likely diagnosis, blood test, a scan or a combination of them can be done to define the disease and its location. This can be simple blood test to look for infection or inflammation. More often an imaging study is needed like an X-ray, CT scan, MRI scan or an angiogram.

Operation in the brain is called craniotomy while an operation to remove a disc from the spine is called discectomy. Operation in the brain and the spine is very safe in this day and age. This is achieved due to the availability of the state of the art facilities like the operating microscope, ultrasonic aspiration device, stereotactic equipment, nerve monitoring facility and fine instrumentation which are all a normal part of a neurosurgical service. This is further enhanced due to the improvement in neuroanaethesiolgy and neuroradiology. With the availability of all these facilities, patients can now undergo the operation safely, despite operating sometimes in the most critical parts of the human body namely the brain, the spine and the nerves coming out from these structures.
 
 
Dr Albert Wong
Consultant Neurosurgeon
 
 
Timberland Medical Centre @ 2007