Epilepsy surgery in Germany

Neurosurgery is concerned with the diagnosis, prevention and treatment of diseases concerning the nervous system. It also deals with the rehabilitation of the disorders of the central nervous system, peripheral nerves and extra cranial cerebrovascular system.

Neurosurgery in Germany is practiced by specialized surgeons who have vast years of experience in the science of neurosurgery. There are several specialized neurosurgical clinics in Germany.

Epilepsy surgery: An Overview


In epilepsy surgery, the neurosurgeons either detach or remove part of the brain that is causing epileptic seizures. In instances, when the affected part of the brain is in the vital area and is risky to remove then the surgeon may make several incisions to make sure that the seizures do not spread to other parts of the brain.

Epilepsy surgery is suitable for individuals in whom the seizures always originate from the same part of the brain. In addition, anti-seizures drugs need to be tried prior to surgery; if two types of drug show no effect on the occurrence and severity of the seizures then surgery is the only option. Epilepsy surgery is in practice since the last decades. However there have been newer methods of performing the surgery, but epilepsy surgery generally is an well-developed field.

Treatment in Germany neurology has made vast advances and newer modes of surgeries are employed for effective management of epilepsy. Hospitals in Germany are equipped with the latest surgical instruments, which mean they are capable of handling complicated cases.

Types of epilepsy surgery


The main theory behind epilepsy surgery is removal of certain tissues from the brain that are responsible for carrying seizure. The following are the types of epilepsy surgery.
  • Lobectomy / cortical resection
  • Lobectomy also known as cortical resection is the most common type of epilepsy surgery. In this method, the entire or part of the affected lobe (either left or right) may be removed. These lobes of the brain give rise to simple and complex partial seizures.
  • Selective Amygdalohippocampectomy
  • Selective amygdalohippocampectomy is considered as an effective type of epilepsy surgery for individuals with temporal lobe epilepsy. In this procedure only selective or the affected parts of hippocamous and amygdala are removed.
  • Extra – temporal Lobectomy / Topectomy
  • This procedure involves surgical removal of frontal, parietal or occipital lobes. During the procedure detailed mapping of cortical functioning is carried out along with localization from subdural electrodes. The risk associated with such surgeries is pretty low as the part of lobe which is removed is non – functional and does not play role in functioning of the brain.
  • Multiple subpial transection
  • This surgical procedure is meant for those individuals in whom partial epileptic seizures occurs in those parts of the brain, which if removed would hamper the functioning of the brain. Therefore, in such cases, the neurosurgeon makes series of shallow cuts (medically known as transection) in the cerebral cortex region. These transections may in some way inhibit the fibers of the neighboring areas, but there has been no evidence suggesting that it causes long term damage to brain functioning.
  • Hemisherectomy
  • As the name suggests, this surgical procedure involves removal of either entire or part of the hemisphere. This operation is generally performed in children who suffer from Rasmussen’s encephalitis and those who are born with congenital defects in the brain. Children manage to function with half of the brain that fills with fluid over time and also gets weaker as they grow older.
  • Functional Hemispherectomy
  • In this type of brain surgery, the abnormal part of the hemisphere is disconnected from the brain and only a small part of the tissue is removed. Functional hemispherectomy is generally carried out in children below 13 years of age.
  • Corpus callosotomy
  • Anatomically, the corpus callosom connects the two hemispheres of the brain through nerve fibers. In the procedure of corpus callosotomy, the nerve fibers are disabled to prevent communication between the two parts of the brain for preventing the occurrence of epileptic seizures. This is a palliative procedure and sometimes also referred to as split – brain surgery. It is used in patients suffering from severe episodes of epileptic seizures and who are at an increased risk to serious injury or falls during the seizure episode.
  • Lesionectomy
  • In many instances, seizures occur due to formation of tumors or malformed blood vessels. In such cases, lesionectomy is performed to remove isolated brain lesions. This procedure effectively removes the tumors and corrects the malformation of the blood vessels. Following surgery, seizures do not occur.
  • Vagal nerve stimulation
  • This procedure involves implantation of pacemaker – like device in the neck. This sends electrical signals to the brain that is effective enough to prohibit occurrence of seizures. This method is suitable for those patients who are unable to undergo brain surgery.

Germany is a world leader in neurosciences and has high-class neurosurgical clinics that specialize in neurosurgery. With our vast experience and expertise in providing medical assistance, we can always help you to find a viable medical care facility for neurosurgery in Germany.

Neuro-oncology in Germany

Neuro-oncology: An Overview


The science of neuro–oncology deals with the studies of tumors in brain and spinal cord. Tumors that develop in the brain and spinal cord can turn dangerous and cause life threatening consequences. Some examples of these tumors include astrocytoma, glioma, glioblastoma multiforme, ependymoma and pontine glioma.

The efficacy of the treatment depends on several factors such as physical condition of the patient, immune system, type of the malignant neoplasm, stage at which the tumor was diagnosed and type of treatment used.

The neurosurgical clinics in Germany have specialized team of neurosurgeons that carry out various diagnostic procedures such as PET (Positron Emission Tomography) and MRI (Magnetic Resonance Imaging) scan for diagnosing benign, malignant and primary tumors of the brain and spinal cord. The German clinics also have expert team of doctors to carry out the diagnosis as well as the treatment procedures. This team includes medical oncologists, neurosurgeons, radiation oncologists, oncology nutritionists and nurses. With this specialized team of doctors you are sure to get the best of treatment in Germany.

Various treatment strategies are used for treating tumors of the brain. These include:
  • Surgery
  • This is usually the first line of treatment for brain tumors. Brain surgery that involves an opening in the skull is known as craniotomy. In this type of surgery the entire or part of the tumor is removed depending on its location. If the tumor is located in areas that carry out vital functions then neurosurgeons try their best to remove major part of the tumor. This reduces the pressure on brain to a great extent and a very small portion of the tumor is left to be removed with chemotherapy.

    In instances when the tumor is located in areas where surgery would not work then a small tissue of the tumor is removed for biopsy to study its nature. The nature of the tumor would decide the future course of treatment. Biopsy of the tumor is carried out through a specialized technique known as stereotaxis; wherein the neurosurgeons using MRI dig out the exact location of the tumor and make a small hole in the skull to extract the tumor tissue. The success rate of neurosurgery in Germany for treating benign as well as malignant neoplasms is increasing with each passing day. The neurosurgical clinics of Germany have also mastered several advanced techniques that are required for brain surgery. These include the technique of brain mapping during surgery that helps in locating functional pathways near the tumor. Other techniques include advanced frameless stereotaxic computer assisted tumor resections and intraoperative MRI scans.

    In many cases, patients may have certain secondary complains due to the tumor; which are addressed prior to the surgery. The doctors may put the patient on drugs containing steroids for reducing the inflammation due to edema. In case of seizures, the patients may also be given anti – seizure drugs to prevent the occurrence of seizures. In patients with hydrocephalus, the procedure of shunt is carried out and the excess liquid is drained into the abdomen.

  • Chemotherapy
  • In this method, one or combinations of drugs are used for killing or destroying the cancer cells. Chemotherapy is usually administered in cycles and each cycle is repeated after the recovery period. Drugs are often given orally or they can also be injected directly into the blood stream of the patient. Normally this method does not require a hospital stay, but sometimes the physical condition of the patient may demand a short stay. A more improved and advanced version of chemotherapy has now been introduced known as the convention enhanced delivery. In this method the drugs are directly placed into the tumor cavity for enhanced effect.

  • Radiation therapy
  • Radiation therapy makes use of high power radiation beam to destroy the cancer cells to prevent their recurrence. This method is used when surgery cannot be done to remove the tumor cells and also used in cases when a part of the tumor tissues remain even after surgery. In several cases, the radioactive material can be implanted directly in the brain for destroying the tumors. The implantation is done either temporarily for short periods or permanently. A newer method in radiation therapy has been developed that makes use of gamma knife. The technique has its qualities similar to its name. In this, a single finely focused high radiation beam is given to the tumor cells from various angles. In this manner, the tumor cells are destroyed and the brain functioning remains unaffected.

Treatment in Germany Neurology will offer you supreme quality services and has high class experienced neurosurgeons to carry out neurosurgeries. It has been carrying out advanced researches in the field of neuro – oncology to give you the latest and best possible treatment. With our vast experience and expertise in providing medical assistance, we can always help you to find a viable facility from among the best neurosurgery clinics in Germany.

Scull base surgery in Germany

Treatment of vascular lesions and removal of tumors occurring at the base of the skull pose a great amount of technical challenge even to the most efficient and expert of the neurosurgeons. Neurosurgery in Germany is performed by close knit group coordination; the group consists of expert neurosurgeons, plastic surgeons, ENT surgeons, medical and radiation oncologists, endocrinologists and ophthalmologists. An integrated team approach makes it sure that the patients always receive high-quality treatments and recover well as they undergo the least possible invasive endoscopic skull base techniques. The most innovative of the radiation and team treatments are employed in surgeries around the ear, temporal bone and for vestibular schwannomas.

  • CyberKnife treatments
  • Tumors that occur at the skull base, like pituitary tumors, sinus tumors, meningiomas, craniopharyngiomas and chordomas need a complex treatment. Such tumors are treated by the team of certified surgeons and radiation oncologists using a minimal invasive technique called as CyberKnife. This is an appropriate treatment for brain tumors and a larger surgery can be avoided in many patients.

    This form of radiosurgery involves targeting the affected area by pinpoint radiation beams without performing a larger surgery. Such treatments are generally outpatient and can be done within a day or two. Germany has many leading CyberKnife centers that have achieved expertise in treating sensitive skull base tumors by applying this complex technology.

  • Treatment for pituitary tumors
  • A multidisciplinary, integrated and holistic approach is employed while providing treatment in Germany neurology. Minimally invasive techniques are treating pituitary tumors instead of the conventional open approaches. Endoscopes are used for visualization through the nose and thus oral or facial incisions are avoided. Recovery is also fast in this technique. A technique called “Hydroscopy” is performed to check for any residual tumor once the procedure is successfully done. Cases of Cushing’s disease, prolactinoma, acromegaly and loss of normal pituitary functions due to tumors are treated using these minimally invasive treatment procedures.

  • Treatment for vestibular schwannomas
  • These are also referred to as acoustic tumors. They are benign growths that cause problems with hearing, balance and also cause tinnitus and chronic headaches. The reason for occurrence of these symptoms is because of a direct compression of the brainstem or the tumor pushing hard against the nerves alongside. Neurosurgical clinics in Germany employ excellent diagnosis techniques like MRI with a contrast application.

    Most of these tumors show a smaller growth tendency. However, in some rare cases they may grow at a faster rate up to 2 mm each year. It is possible that many smaller tumors are already present before you could begin with a treatment. Larger tumors may have to be managed with aggressive surgical procedures. Small and medium sized tumors can be treated by employing stereotactic radio-surgeries. Each of the cases may be typical on their own, expert skull base neurosurgeons in Germany will be watching all the factors and discuss thoroughly with you before making up a decision about your most viable treatment.

  • Neurosurgical treatment for endocrine ophthalmology
  • Also known as Graves’ ophthalmopathy, this is a form of immune disorder where inflammation and such other immune system reactions affect tissues and muscles around your eyes. The symptoms of this disease includes bulging eyes, dry and irritated eyes, excess tearing, puffy eyelids, intraocular pressure, pain and a gritty sensation in eyes, double vision, light sensitivity and a limited eye movement. In rare cases, a reduced or blurred vision may also occur and ulcers may occur on the cornea.

    The diagnosis is generally done by a clinical assessment. If the results are not clear, the doctor may resolve to have imaging tests like a CT scan or an MRI. The treatment procedures for Graves’ disease intend to limit the excess thyroid secretion and block the effects of thyroid hormones on your body. However, Graves’ ophthalmology needs its own typical treatments. Mild symptoms can be treated at day time by using artificial tears available over the counter and by using lubricating gels during night. Severe symptoms will have to be treated by:
    • Corticosteroids
    • A surgery known as orbital decompression
    • A surgery to the eye muscle
    • Using prisms with your glasses to correct double vision
    • Orbital radiotherapy
    After the successful completion of the treatment for Graves’ disease, you still need to take a better care of your eyes and make some life-style changes to avoid a relapse. The follow-up treatment tips will certainly help you in this regard.
    • By applying cool compresses to eyes, you can enhance the moisture that will soothe your eyes.
    • Because of the protrusion of eyes, there is a general tendency for bright light sensitivity and vulnerability to ultraviolet rays. Wearing sunglasses can help you to safeguard your eyes.
    • Using lubricating eye drops at night will help relieve the dryness.
    • To avoid fluid accumulation and a possible ocular pressure, you can elevate your head from the rest of your body while you sleep.
If you are considering a neurosurgery treatment, we are always able to recommend you a viable skull base neurosurgery facility center in Germany to suit your needs and the one that meets your preferences as well.

Spine surgery in Germany

When you hear that someone is about to undergo a neurosurgery, it is probably as a result of having a spinal disorder. Statistics reveal that spinal disorders are one of the leading causes of neurosurgery now a day. However, before we get ahead of ourselves and go on to explore the various spinal disorders that might require spinal surgery, it is vital that we understand what it is. As can be depicted from its name, spinal surgery is that performed on the spine. Spinal surgery is also usually referred to as back surgery. The decision to have spinal surgery is usually not an easy one, since the surgery has been known to have some serious effects on patients. If you have seen someone who has had back surgery, you have probably noticed that they do not heal completely. However, there have been a few people who have had the surgery and now have a better life than they had. Spinal surgery, therefore, though risky, could improve the quality of someone’s life.

The good news is that if you ever need some help, there are so many neurosurgical clinics in Germany that you could visit. Before getting spinal surgery or even making such a decision, it is vital that you are sure that the surgery is completely necessary. Research has shown that of all people suffering spinal disorders; only about two percent really need surgery. Therefore, before getting the surgery, it is recommended that you look into other options, since the surgery should be the last resort.

Common Spinal Disorders


The spectrum of neurological treatment usually includes a number of spinal disorders, some of which might be eligible for spinal surgery. For this reason, it is vital that we look at a few of the most common spinal disorders today.
  • Degenerative Spinal Disease
  • This is a common cause of disability among adults. Spinal degeneration is usually looked at as a normal stage of ageing. When people start getting older, they start to have problems with their backs. The fact that there might be so many causes of pain makes it difficult for doctors and patients to identify the exact cause of the pain, or to make diagnosis early. As a result, by the time the problem is properly diagnosed, it might be too late and disability might have already set in. Most degenerative spine disorders respond to conservative therapy, but in some instances, spinal surgery might be necessary, especially if there is need to correct a disability.
  • Inflammatory disease
  • Inflammation is part of a biological response to things like damaged cells and irritants among others. The symptoms of inflammation include pain, redness and swelling among others. Believe it or not, inflammation is usually the body’s way of trying to get rid of harmful or injurious stimuli. It is a way for the body to attempt to start healing itself. However, in some instances, inflammation does not do what the body wants, but instead it leads to a number of diseases.
  • Neoplastic Diseases of the Spine
  • There are so many neoplastic diseases that it is virtually impossible for me to talk about all of them here. The spinal axis can be divided into three different compartments. The compartments include extradural, intramedullary and intradural extramedullary. It is only if you identify the compartment affected that you will be able to properly diagnose the disease in question. This is because; different compartments of the spinal axis are affected by different neoplasms. Therefore, the earlier you identify the affected compartment, the earlier you will be able to diagnose the spinal disorder.
  • Lumbar, Thoracic and Cervical Disc Herniations
  • These are collectively referred to as spinal disc herniations. This is a disease where there is a tear in the outer or fibrous ring of the spine, which then allows the central portion or the softer part of the spine to bulge out. The biggest cause of this condition is straining of some cause. The condition could be caused by lifting excessive weights. The tear in the spine could cause a release of chemicals, which might then lead to severe pain.
  • Cervical and Lumbar Spinal Stenosis
  • This might be simply referred to as spinal stenosis and it is an unusual condition where spinal canal narrows causing a neurological deficit. The condition can occur at any region of the spine. Some of the symptoms of this condition include numbness, pain and loss in motor control among others.
  • Cervical and Lumbar Disc Degeneration (Disc Disease)
  • This is one of the commonest causes of pain in neck and it usually presents itself as a stiff neck. Also, essential to note is that cervical disc degeneration is more common than lumbar disc degeneration.
Apart from the treatments for above conditions, minimally invasive surgical interventions can be done for other spinal disorders like:
  • Segmental instabilities (primary and secondary) of the lumbar, cervical and thoracic spine
  • Inflammatory and neoplastic spine destruction
  • Osteoporotic spinal subsidence that show neurological symptoms
If you are considering treatment in Germany Neurology, we are always able to recommend you a viable healthcare facility for your neurosurgery in Germany to suit your needs and that meets your preferences as well.

Vascular neurosurgery in Germany

Vascular neurosurgery is a subspecialty in neurosurgery dealing with vascular disorders in the brain and spine areas. The vascular diseases treated under this category include aneurysms in brain, arteriovenous malformations or AVMs in the brain and spine, cavernoma, etc. The diagnosis and treatment of the vascular disorders of the central nervous system are carried out in reputable and best equipped neurosurgical clinics in Germany under close cooperation of experts from several disciplines like neurosurgery, radio-oncology and neuro-radiology.

Microsurgical techniques are employed to close aneurysms and remove AVMs; similarly bypass procedures can also be done to deal with blood vessels that are blocked. The procedures involved in the treatment include Extra-cranial and Intracranial Bypass (EC-IC Bypass), carotid endarterectomy, endovascular neurosurgery and radio-surgeries such as GammaKnife.

Vascular Neurosurgery in Germany


Germany has been a world leader in the field of vascular neurosurgery. The high-class neurosurgical treatments are available in Germany for the following neurovascular diseases:
  • Subarachnoid hemorrhage or SAH
  • This is an emergency and needs immediate medical attention. Specialized intensive care is necessary to treat this vasoconstriction, which may cause cerebral ischemia or even a stroke in severe cases. Early treatments include surgery and a procedure called endovascular coil embolisation. Multidisciplinary centers in Germany can diagnose and provide appropriate treatment immediately.
  • Aneurysms of the brain
  • A bulge in the vascular wall can lead to aneurysms. These can be visualized through CT Scans and MRI scans, a precise evaluation can also be done by using a CT angiography or a conventional angiography. An early treatment of such aneurysms is mandatory. Procedures like microsurgical clipping and endovascular coil embolisation are employed in treating this condition. Neurosurgery and neuroradiology departments carry out a coordinated treatment plan.
  • Arteriovenous malformations-AVMs
  • Angiomas or Malformations in arteries that supply blood to the brain can bypass oxygen exchange and make blood flow through a short-circuit (nidus). AVMs pose a high risk of bleeding and thus they have to be eliminated immediately. Treatment in Germany neurology includes endovascular embolisation, microsurgical resection and radio surgery.
  • Dural arteriovenous fistulas
  • This is a condition where there direct connection between arteries and veins occur within the layers of the meninges. This involves a risk of intracranial, subarachnoid or subdural bleeding. An appropriate treatment is provided by a coordinated team of neurosurgeons and neuroradiology.
  • Intracerebral hemorrhage
  • This is the serious form of stroke that causes bleeding within the brain. The area of puncture is evacuated with a surgery or by catheter puncture thrombolytic procedure to prevent further bleeding. A “Bedside” direct catheter puncture, followed by a thrombolytic procedure is a minimally invasive technique that is more effective and rapid mode of treatment can also be performed in Germany.
  • Cavernoma
  • Cavernous malformation is a clear circumscribed lesion made up of many loblues or small compartments. They may be small but can symptomatic leading to micro bleeds. The symptoms include epileptic seizures, paralysis, and such other neurological deficits. The treatment is performed by removing the lesion surgically. A deeply located lesion has to be performed gently using specialized instruments.
  • Vascular compression syndrome
  • The most common vascular compressions of the brain area include hemifacial spasm, trigeminal neuralgia and glossopharyngeal neuralgia. These conditions cause highly intolerable shooting facial pains and spasms, throat and tongue pain, etc. Surgical treatments for this condition include microsurgeries like microvascular decompression or the Jannetta Procedure, and transdermal procedures like glycerol injections, botox injections, electrc stimulations, radio therapy using stereotactic procedures and thermo coagulation.


Pituitary surgery


Treatments are available in Germany for most of the cases like pituitary adenoma, metastases, colloid cysts, chordomas, granulomas, meningiomas and craniopharyngiomas. The team of neurosurgeons and endocrinologists in Germany are experts in optimizing medical and surgical treatments for pituitary tumors.

Peripheral nerve surgery


Peripheral nerve surgery is a subspecialty within neurosurgery and deals with the diagnosis and surgical treatments of the nerve disorders and dysfunctions. After preliminary examinations of the symptoms, an additional assessment can be made by EMGs or electrodiagnostic studies. Imaging studies help in obtaining an assessment of the tumors and other problems in the spine area. Surgical interventions can be done in cases of nerve entrapment, nerve tumors and nerve injuries.

Pediatric neurosurgery


Pediatric neurosurgery deals with specific patterns of neurosurgical diseases in childhood. Cases of congenital deformities of the nervous system and developmental disorders are diagnosed and treated accordingly. Brain tumors, epilepsy, spasticity, etc. in children require a close attention and are treated in collaboration with many departments like neurosurgery, neuropediatrics, epilepsy center, pediatric oncology, neuroradiology and radiation therapy in Germany.

Neuro navigation


Neuro navigation enables the neurosurgeon to easily and quickly locate a brain tumor that could be located within the deeper layers of the grey matter. A CT or MRT imaging is obtained before beginning with the surgical processes. The operation is carried out using an infrared camera, an operation microscope and such other specialized instruments with continuous imaging and mapping of the patient’s brain. Similarly, neuro navigation technique is also used while performing spine surgeries.

Von Hippel-Lindau disease


VHL or Von Hippel-Lindau disease is a rarely occurring genetic disease that prompts the development of cysts and tumors in your body. These can grow in brain, spinal cord, pancreas, kidneys and even in the genital tracts in men. Symptoms occur as per the location of the tumors and include headaches, dizziness, problems with walk and balance, weakness in limbs, elevated blood pressure and vision problems. It is important to diagnose them while they are small and hence avoid a permanent damage. Treatments for these conditions involve surgery and in some cases radiation therapy.

Neurofibromatosis


This is also a genetic disorder of the vascular system of the brain and the spine area, which affects the general growth and formation of nerve cells. This can be hereditary or even occur in you as a result of gene mutations. The tumors are usually benign, but can be cancerous sometimes. There is no cure for this condition, but the treatment can help control the symptoms. Depending on the severity of the problem, the treatment procedures include surgical removal of tumors, medications and radiation therapies as well.

Syringomyelia


Syringomyelia is a rarely occurring disorder that causes cyst formation in the spinal cord. The cyst so formed can grow bigger with time and destroy a part of the spinal cord. The cyst also known as syrinx, can cause headaches, weakness and pain in arms, legs, shoulders and the back area and an inability to sense heat or cold. These can begin in the early adulthood and the symptoms often vary as per the size and location of the syrinx. Medicines can help relieve the pain; some people may need a syrinx drain. Surgery is an ideal treatment to treat this condition.

Well equipped neurosurgical clinics in Germany have high-class facilities for diagnosing and treating many types of vascular disorders and dysfunctions in the brain and spinal cord area. With our vast experience and an expertise in the filed of providing medical assistance, we are always able to help you select a viable treatment in Germany neurology for your particular health condition.