Neurosurgery

Neurosurgery is one of the most advanced and delicate branches of medicine, dealing with the surgical treatment of diseases related to the central nervous system (brain and spinal cord), peripheral nerves, and the spine. Surgeries performed on the brain, the most complex organ of the human body, require high-level expertise, advanced technology, and multidisciplinary teamwork. The Neurosurgery department at Koru Hospital provides safe and effective treatment services to its patients with its experienced neurosurgeons and state-of-the-art surgical equipment.

What Does the Neurosurgery Department Do?

Neurosurgery deals with the surgical diagnosis and treatment of diseases of the brain, spinal cord, spine, peripheral nerves, and the blood vessels that supply these structures. The department's main areas of activity are:

• Brain tumor surgery: Surgical removal of benign and malignant brain tumors
• Spine surgery: Treatment of lumbar disc herniation, cervical disc herniation, spinal stenosis, scoliosis, and spinal fractures
• Cerebrovascular surgery: Treatment of brain aneurysms, arteriovenous malformations, and cavernous angiomas
• Neurotrauma: Emergency surgical treatment of head trauma, brain hemorrhage, skull fractures, and spinal cord injuries
• Pediatric neurosurgery: Surgical treatment of childhood brain and nervous system diseases
• Functional neurosurgery: Epilepsy surgery, deep brain stimulation for Parkinson's disease, treatment of trigeminal neuralgia
• Peripheral nerve surgery: Treatment of carpal tunnel syndrome, cubital tunnel syndrome, and peripheral nerve tumors
• Pituitary tumor surgery: Removal of pituitary adenomas via the transsphenoidal approach
• Hydrocephalus treatment: Surgical correction of cerebrospinal fluid circulation disorders

Common Diseases and Conditions

Lumbar Disc Herniation

Lumbar disc herniation occurs when the discs (cushions) between the vertebrae rupture, causing the nucleus pulposus inside to herniate toward the spinal canal or nerve root. It manifests with symptoms such as lower back pain, pain radiating to the leg (sciatica), numbness, tingling, and muscle weakness. The vast majority of cases improve with physical therapy, medication, and lifestyle changes. However, surgical intervention is required in cases that do not respond to conservative treatment, develop progressive neurological loss, or involve emergency conditions such as cauda equina syndrome (impairment in bladder/bowel control, numbness in the perineal region). Minimally invasive techniques such as microdiscectomy and endoscopic disc surgery allow patients to recover quickly and return to their daily lives.

Cervical Disc Herniation

Cervical disc herniation is the herniation of discs between the cervical vertebrae, putting pressure on the spinal cord or nerve roots. It presents with symptoms such as neck pain, pain radiating to the arm, numbness and weakness in the hand, gait disturbance, and a decrease in fine motor skills. Cervical myelopathy, which develops due to spinal cord compression, is characterized by difficulty walking and impaired hand dexterity, and is a condition requiring surgical treatment. Anterior cervical discectomy and fusion (ACDF), cervical disc replacement, and posterior decompression surgery are the primary surgical methods applied in the treatment of cervical disc herniation.

Brain Tumors

Brain tumors are divided into two main groups: primary tumors originating from brain tissue and metastatic tumors that spread to the brain from other parts of the body. Symptoms such as headache, seizures, personality changes, speech impairment, vision problems, weakness in the arm or leg, and balance disorders vary depending on the location and size of the brain tumor. Meningioma, glioma, pituitary adenoma, schwannoma, and medulloblastoma are the most common types of brain tumors. While surgical removal is the primary approach in treatment, radiotherapy and chemotherapy may also be included in the treatment plan depending on the type and stage of the tumor.

Cerebrovascular Diseases

Brain aneurysm is a balloon-like enlargement caused by weakness in the wall of brain blood vessels. Aneurysm rupture can cause life-threatening subarachnoid hemorrhage. Arteriovenous malformation (AVM) consists of abnormal connections between arteries and veins and carries a risk of bleeding. Advanced techniques such as microsurgical clipping, endovascular coiling, and stereotactic radiosurgery are used in the treatment of these diseases.

Spinal Stenosis

Spinal stenosis is the narrowing of the spinal canal, which puts pressure on the spinal cord or nerve roots. Advanced age, degenerative changes, disc diseases, and ligament thickening are the main causes of stenosis. Neurogenic claudication in the lower back (pain and weakness in the legs while walking, relief upon sitting and resting) is a characteristic finding. In cases that do not respond to conservative treatment, laminectomy, foraminotomy, and, when necessary, spinal fusion surgery are performed.

Head Trauma and Brain Hemorrhages

Head traumas caused by traffic accidents, falls, and assaults can lead to serious conditions such as epidural hematoma, subdural hematoma, intracerebral hemorrhage, and skull fractures. In these cases, emergency surgical intervention can be life-saving. Evacuation of hemorrhage via craniotomy, reduction of intracranial pressure, and repair of damaged tissues are the primary goals of surgical treatment.

Diagnostic Methods

In the field of neurosurgery, accurate diagnosis forms the basis of treatment planning. The main diagnostic methods used are:

• Magnetic resonance imaging (MRI): High-resolution imaging of the soft tissues of the brain, spinal cord, and spine
• Computed tomography (CT): Rapid assessment of bone structures, hemorrhages, and fractures
• Digital subtraction angiography (DSA): Detailed imaging of brain vessels, diagnosis of aneurysm and AVM
• CT angiography and MR angiography: Assessment of brain vascular structure using non-invasive methods
• Electroencephalography (EEG): Recording of brain electrical activity, a fundamental tool in the diagnosis of epilepsy
• Electromyography (EMG) and nerve conduction studies: Diagnosis of peripheral nerve and muscle diseases
• Neuropsychological tests: Assessment of cognitive functions
• Stereotactic biopsy: Taking tissue samples from brain lesions under imaging guidance

Modern Surgical Treatment Approaches

Technological developments in neurosurgery have significantly increased the safety and success of surgeries:

• Microsurgery: Precise surgeries performed under a surgical microscope with high magnification
• Neuronavigation: Digital guidance of surgical planning with brain mapping and real-time imaging during surgery
• Endoscopic brain surgery: Brain surgeries performed through small incisions using minimally invasive methods
• Minimally invasive spine surgery: Spine surgeries performed through small incisions using tubular retractor systems, endoscopic, and microscopic techniques
• Intraoperative neurophysiological monitoring: Prevention of nerve damage through continuous monitoring of nerve functions during surgery
• Awake craniotomy: A surgical technique where the patient is awake during surgery for tumors close to the brain's speech and movement centers
• Stereotactic radiosurgery (Gamma Knife, CyberKnife): Treatment of brain lesions with high-dose radiation without incisions
• Spinal instrumentation: Stabilization of the spine with titanium screw, rod, and cage systems

When to Consult Neurosurgery?

It is recommended to consult a neurosurgeon if you experience the following symptoms:

• Severe and persistent headache, especially accompanied by morning nausea and vomiting
• Pain, numbness, and weakness radiating to the arm or leg, accompanied by lower back or neck pain
• Progressive muscle weakness or signs of paralysis
• Seizures (epilepsy) or a first-time convulsion
• Gait and balance disorders
• Impairment in bladder or bowel control
• Speech, vision, or hearing impairments
• Personality and behavioral changes
• Loss of consciousness, vomiting, or blurred vision after head trauma
• Numbness in the hands, weakness, and decrease in fine motor skills
• Facial pain (trigeminal neuralgia), facial paralysis

Some of these symptoms may indicate conditions requiring emergency intervention. Especially in cases such as sudden onset of severe headache, loss of consciousness, and progressive weakness, a healthcare facility should be consulted without delay.

Neurosurgery Services at Koru Hospital

The Neurosurgery department at Koru Hospital offers comprehensive surgical services in all subfields of neurosurgery. The advantages of our department include:

• Experienced neurosurgery team: Surgeons specialized in brain tumors, spine surgery, and vascular neurosurgery
• Advanced technology operating room: Surgical microscope, neuronavigation system, endoscopic surgical equipment, and intraoperative monitoring devices
• Minimally invasive surgery options: Advanced surgical techniques that allow the patient to experience less pain, shorter hospital stays, and faster recovery
• Neurology collaboration: A holistic approach from diagnosis to treatment by working in coordination with neurology specialists
• Intensive care support: Expert care in a fully equipped intensive care unit during the critical postoperative period
• Rehabilitation coordination: Planning and management of the postoperative physical therapy and rehabilitation process
• Patient information: Detailed information provided to the patient and their family during the pre- and post-operative process

Surgical Safety and Patient Satisfaction

Neurosurgery involves surgeries performed on the most delicate and critical structures of the human body. Therefore, surgical success is directly related not only to technical skill but also to correct indication, comprehensive preoperative planning, use of advanced technology, and quality of postoperative care. At Koru Hospital, every surgical case is evaluated in multidisciplinary council meetings to create the most appropriate treatment plan.

In the Neurosurgery department at Koru Hospital, our specialist physicians offer their patients the safest and most effective surgical treatment by utilizing all the possibilities of modern neurosurgery. You can safely consult our department for your health problems related to the brain, spinal cord, and spine.