Neurosurgery is one of the youngest specialties of surgery. It deals with all diseases in which nerve tissue is pressed, degenerated or shows functional disorders. In addition, there are diseases of the vessels, which can have an effect on the nerve tissue. There is no other specialty that has such a rapid development as neurosurgery. Cushing received applause in the early 20th century because a patient survived surgery for a benign tumor (meningioma) for a few months. Rightly so, because in the course of his own career he succeeded in reducing the mortality rate for such operations from 90% to 7%.
Surgery to the point
With the introduction of the surgical microscope, especially in spinal surgery, as well as endoscopy, operations became increasingly minimally invasive and thus gentler and even more successful. With the help of stereotaxy and neuronavigation, probes can be placed with millimeter precision by a neurosurgeon. The future of neurosurgery lies in the modulation of brain and nerve functions. Examples are the treatment of tremor in Parkinson’s disease or nerve stimulation in therapy-resistant pain. In the meantime, there are probes that can be implanted without a stimulator, so that the important examinations in magnetic resonance imaging are still possible. However, more and more pain stimulators and pain pumps are also being designed in such a way that MRI examinations can still be performed.
Counteracting nerve pain with targeted impulses
Damaged nerves can lead to major health challenges for affected patients. If a nerve is permanently damaged, this often means chronic pain for the affected person. The daily accompanying symptoms are not to be underestimated – often the patients complain about strong pain impulses, which make normal lying or even sleeping impossible. The minimally invasive insertion of a neurostimulator can provide targeted relief for the aforementioned impairments. With this method, the pain at the nerve root is switched off or reprogrammed with the help of electrodes. The advantage of such an intervention, is the adaptable control and subsequent regulation by our specialist in neurosurgery.
Many neurological diseases develop very slowly. Therefore, the symptoms are often recognized much too late. One example of this is hydrocephalus, in which cerebrospinal fluid builds up in the skull. In children, this causes an enlargement of the skull because the bone sutures have not yet fully fused. A tube valve system (VP shunt or VA shunt) can be used to relieve the pressure. In the case of aqueductal stenosis, a small fenestration in the ventricular system is also sufficient to release the pressure. The operation in our clinic is performed endoscopically and is therefore hardly stressful for the patient. This technique is only performed in a few specialized clinics by experienced neurosurgeons. In adults, the skull can no longer give way, so that the brain tissue is increasingly exposed to pressure. Patients find it increasingly difficult to walk and develop symptoms similar to those of dementia. For this reason, older patients are very often misdiagnosed, although, if detected in time, a VP shunt can provide relief.