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Frequently Asked Questiones

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Everybody Needs Help in

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Advances Care

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Pediatric Care

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What we do

We Provide Awesome Services

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Cardiology

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Pediatric

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Ophthalmology

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Neurology

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Gastroenterology

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Immunology

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Our Specialist Doctor

The Best Medics, Doctors & Physicians For A Healing Touch

Reputed Neurologist

Dr. Ashok Hande

Dr. Hande is practising neurosurgery for the past 25 years. Having worked with reputed hospitals in Mumbai like K.E.M. Hospital, Jaslok Hospital and Lilavati Hospital in the past, I am currently working as a senior consultant with Fortis Hospital (Vashi & Mulund), Sayadri Hospital and Ruby Hall Clinic (Pune).

Practice Area

Dr. Ashok Hande is specialized in,

BRAIN STROKE

A stroke is a medical emergency. Symptoms of stroke include trouble walking, speaking and understanding, as well as paralysis or numbness of the face, arm or leg.

COMPLEX SKULL BASE TUMOUR

What are symptoms of skull base tumors? These tumors can grow slowly or rapidly. Symptoms of chondrosarcomas depend on their location in the skull base and may include headache, ringing in the ears, and problems with vision, hearing, or balance.

RADIO SURGERY

Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy, it is usually used to treat cancer.

VASCULAR SURGERY

VASCULAR SURGERY

EDAS
STA-MCA
PET IN TIA

BRAIN TUMORS

MENINGIOMA
GIANT SPHENOID WING MENINGIOMA
SPH MENINGIOMA

3RD V COLLOID CYST

Epidermoid cyst

SCHWANOMAS

TRIGEMINAL (5th nerve) SCHWANNOMA
5TH SCHWANOMA
ACOUSTIC /VESTIBULAR (8th nerve) SCHWANOMA

 GLOSOPHYRYNGEAL ( 9th nerve) SCHWANOMA

MALIGNANT BRAIN TUMOR

ELOQUENT AREA TUMOUR-NAVIGATION CORTICAL STIMULATION
MOTOR STRIP-TRANS-SULACAL-AWAKE TRANS-SULACAL

MVD for NEURALGIAS

TRIGEMINAL NEURALGIA
SURGERY FOR TINNITUS

HYDROCEPHALUS

4TH V TUMOR
NPH
AQUEDUCT STENOSIS-ETV
TRAPPED 4TH V

ENDOSCOPIC SURGERY

PITUITARY SURGERY
CSF RHINORRHOEA
3RD V COLLOID CYST
ETV

ENDOSCOPICALLY ASSISTED SURGERIES

ACOUSTIC
ANEURYSM
MVD
TEMPORAL HORN FENESTRATION

VENTRICULOSCOPY

3RD V COLLOID CYST

SPINAL INTRAMEDULLARY TUMOUR

TETHERED CORD

BRAIN HEMORRHAGE- uncontrolled HT

COMBINING SPECIALITIES

Intervention Neuro-radiology

stereotactic radiosurgery

Neuro-oncology

Neuropathology

Hormone therapy for pituitary

Technological support

4TH V TUMOR

NPH

AQUEDUCT STENOSIS-ETV

TRAPPED 4TH V

BRAIN TUMORS

BENIGN TUMORE

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MENINGIOMA
06
SPH MENINGIOMA
06
3RD V COLLOID CYST
06
Epidermoid cyst

SCHWANOMAS

06
TRIGEMINAL
(5th nerve) SCHWANNOMA
06
ACOUSTIC /VESTIBULAR
(8th nerve) SCHWANOMA
06
GLOSOPHYRYNGEAL
( 9th nerve) SCHWANOMA

Our Services

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Do You Have any Query?

Frequently Asked Questiones in Brain Surgery

Neurosurgery is not to be taken lightly. While some procedures are riskier than others, even the most “routine” of surgeries are not going to feel routine to you. Knowledge is power, so before agreeing to undergo any surgery, you are entitled to obtain as much information about the procedure as possible. This includes the preparation, the risks, recovery, prognosis — whatever you need in order to feel comfortable with it.

A neurologist and a neurosurgeon are similar to a cardiologist and a cardiac surgeon: the neurosurgeon can offer a surgical solution to neurologic disorders, while the neurologist identifies neurological disorders through diagnostic testing and uses non-surgical treatment options.

It’s important to consider what your life might be like without undergoing the surgery. Would you stay the same, get worse, or is there a chance for recovery without the procedure?

Generally, in cases of brain tumours and brain haemorrhage, surgery is necessary if they are large and causing pressure on the brain. Thus, it becomes a life saving procedure. But, it differs from patient to patient. In cases of brain haemorrhage due to high blood pressure, surgery may not be indicated if the haemorrhage is extensive (spread all over the brain) or if it is too small.

Again, it differs from patient to patient. In general, it is not advisable to wait as delaying the surgery may cause permanent deficits and delay the recovery. Brain tissue does not regenerate, once destroyed.

Surgery on brain and spinal cord is not without risks. They are specific to the underlying problem. Some of the risks that can arise during a brain surgery are:

  1. Reaction to anaesthetic medicines
  2. Breathing problems
  3. Blood clots and infections
  4. Speech and memory problems, weakness in muscles. These may last for some time and go away after that
  5. Bleeding in the brain
  6. Stroke
  7. Seizures
  8. Brain infection
  9. Brain swelling

High blood pressure and diabetes affect the entire body (including the heart, kidneys), mainly the blood supply to the organs. It can create problems for any surgery.

Many a times, the primary disease (like say brain tumour, trauma or brain haemorrhage) itself destroys the neural tissue, which can cause permanent deficits.

Every tissue has its own healing power. For example, skin stitches are removed on 7th day, whilst plaster (applied for fractures) is removed after 6 weeks. Brain healing is still longer, anywhere between 3 months to a year.

Neurosurgery, like heart surgery can not be done in small setup. These specialities require extensive back up and facilities both during surgery and post-operatively. They require team work of skilled and trained personnel.

There are few diseases, which have genetic expression and can get transmitted to the next generation, like neurofibromatosis 2. Brain tumours generally don’t get transmitted to the next kins, except few exceptions like

Brain stroke is an emergency. The patient must reach the hospital within 3 hours of starting the symptoms, preferably within 60 minutes (called as ‘door to needle time’) for best possible outcome.

Yes, brain surgery is expensive in private hospitals.

Of course, yes. The General hospitals can be well equipped too.

 With the advent of technology, Endoscopic brain surgery is becoming famous now. It is possible to use endoscopes, where the brain tumours could be accessed through the nose, like pituitary tumours, particularly if they are small. In general, large tumours which are causing severe pressure and involvement of multiple brain structures are operated by removing a part of the skull (craniotomy).  

This technology is not available everywhere. It is very helpful for both benign and malignant brain and spinal tumours, those are deep inside the brain or hard to reach with open surgery.

 

Stereotactic laser ablation is a treatment option for brain tumors. It is also called “Laser Interstitial Thermal Therapy,” abbreviated LITT. LITT uses focused light from a laser to heat and destroy tumors. A specially-trained neurosurgeon performs this procedure within an MRI scanner. LITT may be used on smaller brain tumors, for side effects of radiation therapy, and/or on tumors that grow despite radiation and chemotherapy.

Biopsy is a small representative piece of tumour which is sent for histology. Generally, it is a part of single procedure, where the tumour is excised.

There are various reasons why the tumour is or can not be removed completely during first surgery. Common reason is  when it is adherent or infiltrated into the vital structures of the brain or spinal cord. Such residual tumours either can be watched carefully for regrowth or treated with other adjuvant therapies like radiotherapy and or chemotherapy, depending upon the histological type.

All the investigations are done prior to surgery. The risk factors for anaesthesia and surgery are discussed with the patient.

The blood thinners like aspirin is stopped for 5 days before planned surgery. Antihypertensives and anticonvulsants should not be stopped under any circumstances.

On the night before surgery, detailed instructions are usually given on the pre-anaesthesia visit, but as a general rule you should not eat or drink after midnight. You may have a light snack before midnight so you will be less hungry on the morning of surgery.

Immediately after the surgery, you’ll be monitored closely to ensure everything is working properly and that there are no complications. You’ll mostly be made to sit in an upright posture to prevent swelling of your face and brain. The recovery from the surgery depends on the type of surgery done. How long you stay in the hospital will depend on the success of your recovery. You may have to take pain medications during this time. Before leaving the hospital, your doctor will tell you how to take care of your wounds.

If you experience any of the symptoms below, please call your doctor immediately:

  1. Any fever greater than 101.5
  2. Any new weakness in arms or legs
  3. Change of mental status
  4. Any seizure activity
  5. Any drainage coming out of the incision
  6. Worsening headache unrelieved by any medication
  7. Increased swelling/redness at incision site
  8. Pain/redness in leg(s)
  9. New confusion or increase in confusion

Usual length of stay for patients who undergo a craniotomy for a brain tumor, with no complications, is generally for 5 days. Patients who have postoperative difficulties may be required to stay longer. Complicated brain tumours or those who come in an emergency situations (like brain hemorrhage or brain trauma) may need hospitalisation for much longer time. You may need to stay in the hospital for about 3-10 days after the surgery is complete. However, the length of your stay in the hospital also depends on your operation and how long you take to recover.

A majority of patients who undergo brain tumor surgery feel surprisingly well afterward. However, you will be restricted to 4 weeks of non-strenuous activity. This includes:

  1. No heavy lifting >1-2 kgs for 4 weeks
  2. No pushing while moving bowels for 4 weeks
  3. No strenuous activities such as working out or running

Pain is usually minimal since there are only a small number of pain nerve endings in the head. Nevertheless, you may experience headaches and other tenderness in the area that was affected. This can be treated with non-narcotic medications. 

Brain surgeries are often complex and sometimes risky, and sometimes areas of the brain do not work as well for a while afterwards. This can be due to local swelling of the tissues, as occurs in any type of surgery. Most often, any post-operative problems are temporary and settle fairly quickly. However, the risk of permanent impairment of function from a surgical procedure does need to be carefully assessed pre-operatively. The risk of intervention versus the risk from the disease process is a critical consideration in deciding whether or not surgery is appropriate, but your surgeon will take you through this decision-making process carefully.

Usually, your doctors would give you some idea about your recovery journey. Since brain surgery differs from person to person, your specialists are the best people to speak to for information.

With advances made by medical technologies, brain surgeries are able to be performed with a greater margin of safety than ever.

Awake surgery can indeed be performed on the brain but it is only very rarely required.

Awake surgery of your brain may have a role when the surgery is carried out in parts of your brain that control speech or movement. Your surgeon would determine if it is necessary to consider monitoring these functions of your brain while performing surgery.

Awake surgery can potentially lower the risk of side effects post-surgery and can be performed without pain. It is however a daunting prospect for the patient, and fortunately is only rarely necessary.

Brain surgery is a major event in a person’s life, and it can be a while before you recover from it. It is common for patients to notice side-effects like confusion, mood swings, or issues with speech. However, the impact of brain surgery on personality differs from person to person.

There are many factors that contribute to the changes in your behavior like the type and size of the tumour, effects of other treatments like chemotherapy and radiotherapy, or overall fitness of the patients. Occasionally personality change can result from the presence of a tumour within a part of the brain that regulates aspects of personality (typically the frontal lobes of the brain), or from surgery to treat it.

The vast majority of surgeries can be performed safely and effectively, with minimum risk.

The risk to one’s life from an operation on the brain is very small, but it does vary from one procedure to another, depending on the structures that are involved in the disease process for which the surgery is being performed.

In general, one should only elect to have brain surgery when the alternative to the operation (ie the risk or degree of incapacity from the disease) is of higher risk than the operation itself.

The vast majority of surgeries can be performed safely and effectively, with minimum risk. However, no intervention is without risk and the pros and cons of any surgical procedure need to be carefully considered and discussed before proceeding.

Brain surgery doesn’t cause dementia. A dementia – like process can sometimes result in the long term after radiotherapy to the brain for treatment of some tumours, but not from surgery itself.

There is no evidence that brain surgery plays any role in the treatment of autistic spectrum disorder.

Brain surgery is a major event in someone’s life. It is not unusual for a patient to feel mood swings, sudden emotional responses etc. Occasionally some people can develop depression after surgery, although it is usually temporary and treatable. This is most commonly seen after some surgical procedures to cure epilepsy.

The recovery journey post brain surgery can be challenging with people suffering from some kind of emotional issues within weeks lasting shorter durations and some might find it difficult to control their emotions for a period of time.

No, being stressed doesn’t directly increase the risk of cancer. The best quality studies have followed up many people for several years. They have found no evidence that those who are more stressed are more likely to get cancer.

Unfortunately, many brain tumors can recur even after successful surgery and standard treatments. You need to be aware that tumor recurrence is a potential reality during the brain tumor path. If a meningioma tumor is not removed completely, it is likely to regrow within 10 to 20 years

How do I know if my brain tumour has come back?

If your brain tumour comes back after treatment or starts to grow again, you are likely to have similar symptoms to when you were diagnosed.

The cause for backache needs to be determined by X-rays, CT scan and or MRI. Just backache can not be an indication for surgery, unless it is because of fracture, instability, severe stenosis or tumour.

Back surgery might be an option if conservative treatments haven’t worked and  pain is persistent and disabling. Back surgery often more predictably relieves associated pain or numbness that goes down one or both arms or legs. These symptoms often are caused by compressed nerves in your spine.

Both specialities are trained for such surgeries. Each of these surgical specialists has their own areas of expertise however, their skill and expertise overlap in the area of spinal surgery. Generally, when spinal cord is involved, the neurosurgeons are preferred.

Only if there is neurophysiological monitoring during surgery.

Brain surgery survival rates depend mainly on type of  tumour, extent of removal, and the age and health of the patient. On average, brain surgery long-term survival rate can be between 50-70% except in cases of malignant tumors where chances are lowered.

It differs from case to case.  Working out involving heavy lifting and strenuous running is to be strictly avoided after a brain operation. Any activity that may cause sudden internal movements and strain, such as pushing or swimming, is also not recommended.
It is necessary to consult with your doctor after a brain surgery before starting any intense physical activity and get a complete follow-up assessment performed.

Generally, a good rest for 6 weeks is recommended after spine surgery, though complete bed rest is not necessary.

No. Driving is a complex activity that requires several cognitive and behavioural skills and a decent amount of coordination. It’s possible that you retain part of your driving abilities and can go back to driving later.

You may go for it, if you have any doubts about the indication for surgery or if your symptoms persist or aggrevate even after surgery. SECOND OPINION SHOULD BE TAKEN ONLY FROM SENIOR  OR EXPERIENCED SPECIALIST FROM THE SAME FIELD.

If your brain tumour comes back after treatment or starts to grow again, you are likely to have similar symptoms to when you were diagnosed.

Symptoms

  1. headaches
  2. seizures (fits)
  3. feeling or being sick.
  4. drowsiness or loss of consciousness.
  5. problems with your eyes.
  6. Does brain surgery change your personality?
  7. Neurosurgical resection of a brain tumour is a major life event that changes patients’ subjective experiences of different emotions, and leads to observer-rated changes in personality. In this study, these changes were not accompanied by increases in anxiety or depression.
  8. Can stress lead to brain tumors?
  9. No, being stressed doesn’t directly increase the risk of cancer. The best quality studies have followed up many people for several years. They have found no evidence that those who are more stressed are more likely to get cancer.

Survival for patients with benign tumors is usually much better but, in general, survival rates for all types of brain cancers, benign and malignant, are: About 70% in children. For adults, survival is related to age.

If a meningioma tumor is not removed completely, it is likely to regrow within 10 to 20 years.

Some people recover well after brain surgery, but this can take some time. Other people have some problems, or long term difficulties. The problems you may have depends on the area of the brain where the tumour was (or still is if you only had part of the tumour removed).

If you have been diagnosed with a brain tumor and are meeting with a neurosurgeon for a consultation, please bring any and all brain images with report.

If you had prior surgery and are meeting with a neurosurgeon, please bring pre-op MRI along with most recent MRI and pathology report (including slides, if possible). 

If you had chemotherapy or radiation and are meeting with a neurosurgeon, please bring notes from the oncologist and the radiation planning MRI on a disc.

Yes, all the investigations are done prior to surgery. The risk factors for anaesthesia and surgery are discussed.

The blood thinners like aspirin is stopped for 5 days before planned surgery. Antihypertensives and anticonvulsants should not be stopped under any circumstances.

Detailed instructions are usually given on the pre-anesthesia visit, but as a general rule you should not eat or drink after midnight. You may have a light snack before midnight so you will be less hungry on the morning of surgery. You may drink water up until 2 hours before the scheduled arrival time on the day of the surgery.

Pain is usually minimal since there are only a small number of pain nerve endings in the head. Nevertheless, you may experience headaches and other tenderness in the area that was affected. This can be treated with non-narcotic medications. 

Usual length of stay for patients who undergo a craniotomy for a brain tumor, with no complications, is generally for 5 days. Patients who have postoperative difficulties may be required to stay longer. Complicated brain tumours or those who come in an emergency situations (like brain hemorrhage or brain trauma) may need hospitalisation for much longer time.

Post-Surgery

A majority of patients who undergo brain tumor surgery feel surprisingly well afterward. However, you will be restricted to 4 weeks of non-strenuous activity. This includes:

  • No heavy lifting >5-10 lbs for 4 weeks
  • No pushing while moving bowels for 4 weeks
  • No strenuous activities such as working out or running
  1. This depends on the primary diagnosis. In most cases, a return to normal life with improved energy and activity levels, and removal of any impairments resulting from brain damage are expected after brain surgery. Depending on the specific concern and the brain surgery type, as well as overall health, you can expect to live a healthier life with a prolonged lifespan. In some cases, major life changes, such as changing a job, may become necessary. Diet and exercise plans may also be different from what was followed before the surgery. You can expect some tiredness in the initial weeks following brain operation.
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