Services – Dr Siddharth Mistry

Trigeminal Neuralgia

sculpt — Thu, 09 Nov 2023 12:32:13 +0000

Trigeminal neuralgia is a condition that causes painful sensations similar to an electric shock on one side of the face.

Most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve.

It’s twice common in female than Male.

We offer treatment which include ablation of specific ganglion roots by needle and gold standard MVD surgery (Microvascular decompression of trigeminal nerve).MVD have the best results among all modality of treatment .

Spine Tumour Surgery

sculpt — Fri, 18 Aug 2023 12:12:40 +0000

Spine Tumour Surgery

Any spinal tumour required a biopsy which makes the diagnosis of the patient. Based on the biopsy of the specimen the future plan of management ( Radiation / Chemotherapy / Both ) will be decided. We do the removal of spinal tumours with the help of neuromonitoring ( IONM ), which allows us to do maximum safe removal of the tumour. Dr.Siddharth Mistry discuss with you the options and plans for the surgery. Every spine tumour should be evaluated as soon as possible to avoid permanent paralysis..

Spinal Fusion Surgery

sculpt — Fri, 18 Aug 2023 12:06:35 +0000

Spinal Fusion Surgery

Humans have gravitational weight distribution from head to toe through bone. When a patient will have a degenerative spine and spondylolisthesis, the gravitational weight from head to toe will not be distributed naturally. Those patients have severe back/neck pain due to bone misalignment. These patients will be benefited from spinal fusion surgery. The majority of the patients have spinal canal narrowing and root compression due to misalignment of the spine and they may also undergo spinal decompression of canal and roots to relieve pain permanently. We only use titanium fusion implants, which are considered as best implants in the world. Patients can have MRI of their body with the same implants lifetime.

Spine MISS ( Minimum Invasive Spine Surgery )

sculpt — Fri, 18 Aug 2023 11:52:29 +0000

Spine MISS ( Minimum Invasive Spine Surgery )

Minimum invasive spine surgery is a new modality of spine surgery for herniation disc, spondynolistbhesis and spinal fusion. where spine surgery is performed with a small incision using a tubular retractor system. It has faster recovery compared to conventional open surgery.

Microscopic Spine Surgery

sculpt — Fri, 18 Aug 2023 11:47:18 +0000

Microscopic Spine Surgery

when spine surgery is done with the help of an operating microscope with a small incision in a precise way is known as microscopic spine surgery.

Intra-Operative Neuro Monitoring

sculpt — Fri, 18 Aug 2023 11:44:38 +0000

Intra-Operative Neuro Monitoring

Real-time in-surgery monitoring for the brain and spine transmission of signals to avoid any damage to nerves at the time of surgery. IONM will give maximum surgical safety for brain and spine surgery.

Stroke

sculpt — Fri, 18 Aug 2023 10:05:43 +0000

Sudden onset of occlusion of brain vessel known as stroke.

Occur in 3 % of ischemic strokes in patients below 40 age. 10 in 1 lakh population between 35 to 44 years of age.

Over 10 % of ischemic strokes occur in patients below 55 age. 73 in 1 lakh population below 55 age. When the brain doesn’t get blood supply, the brain tissue will die which is known as ischemia of brain parenchyma. When a large ischemic event takes place, it’s known as an infarct.

When a patient has an infarct of part of the brain, that part of the brain stops its function. Patients who reach the hospital in time ( within 4 hours ) will have an Angiography of the brain, and they may be advised for thrombolysis or mechanical thrombectomy according to the patient’s angiographic findings. The majority of the patients who reach in time will recover very well due to fast intervention. Some of the patients who come lately may have haemorrhagic transformation ( bleeding ) at the impact area and they may require surgical removal of brain haemorrhage by endoscope or craniotomy. Some of the patients may develop malignant infarct and may require decompressive craniectomy to relieve brain pressure.

Congenital Malformation

sculpt — Fri, 18 Aug 2023 09:43:25 +0000

Arachnoid cyst

CSF contains cysts in the brain. If occur after trauma known as a growing skull fracture which is not related to infection. People who have arachnoid cyst has high susceptibility to developing brain subdural haemorrhage even with minor trauma.

Craniosynostosis

Early closure of scalp bone in a child. Abnormal Head shape. Patients with craniosynostosis will also develop retardation of brain development due to inadequate space for the brain to develop. Those patients with craniosynostosis will get correction of head shape and brain development after surgical correction.

Before

After

Dandy-Walker malformation

Enlarged Posterior fossa with partial or complete agenesis ( not formed) cerebellar vermis and cystic dilatation of the fourth ventricle. These patients may require shunting of the posterior fossa cyst and some may benefit from endoscopic third ventriculostomy.

Aqueductal Stenosis

Obstruction of CSF flow below 3rd ventricle at the region of aqueduct of Sylvius and dilatation of lateral and 3rd ventricle with normal size 4rth ventricle. These patients may have aqueduct stenosis due to different pathology and they will require Endoscopic third ventriculostomy or CSF diversion by shunt surgery.

Arnold Chiari Malformation

Herniation of cerebellar tonsils through foramen magnum which causes compression over the brain stem and syringomyelia formation. These are syndromic children and they will require foreman magnum decompression in the absence of tumours in the nervous system. Some may also have spinal cord tethering for which they will require separate surgery. They will have either difficulty walking, change in sensation over the face, snoring, difficulty in breathing, nasal intonation of voice etc.

Moya Moya Disease

Stenosis of internal cerebral arteries. The brain has blood supply anteriorly by two internal carotid arteries and posteriorly by two vertebral arteries. Patients with Moya Moya disease will have stenosis of both internal carotid arteries at the intracranial compartment. A typical presentation for the juvenile form is ischemic infarct and the adult form is haemorrhage at the basal ganglia region.

Tumour

sculpt — Fri, 18 Aug 2023 09:24:54 +0000

Tumour

Any space-occupying lesion SOL in the brain is termed a Brain Tumour. Brain tumours can be benign or malignant. To decide brain tumour as benign or malignant Biopsy will be required. Biopsy should be done either by removing the tumour or taking a small part of the tumour for analysis. Surgery can be planned endoscopically or microscopically. Patients with undiagnosed brain tumour/SOL should undergo a biopsy of the tumour as soon as possible. If the tumour comes out to be benign, the patient may not require any surgery in the future. If the tumour comes out to be malignant, the patient will require chemotherapy and radiotherapy. Only after a biopsy, a neuro radiation oncologist can give radiation therapy. The surgery should be planned as earliest as possible after the doctor’s direction to avoid brain damage due to the existing tumour. In certain circumstances, the patient who has a brain tumour may develop a haemorrhage in the side brain tumour or collection of fluid in the brain ( hydrocephalus ). These are the patients who may require surgery in an emergency.

The patient who has a Brain tumour may have symptoms of either of the following. They may present as headaches associated with vomiting/convulsion/paralysis/vision or hearing problems/difficulty in walking/speech problems/face sensation changes/vertigo..etc

It is very necessary for those who have such symptoms should contact to a Neurosurgeon as soon as possible to get evaluated.

Haemorrhage

sculpt — Fri, 18 Aug 2023 09:00:17 +0000

Brain Haemorrhage

A person can have brain haemorrhage by a variety of conditions which include Trauma, Age-related co-morbidity which includes high blood pressure, Diabetes, people who are on blood thinners, brain haemorrhage inside brain tumour, rupture of brain aneurysms or AVM/AVF, vascular malformation of blood vessels of brain .etc… Here are some examples of brain haemorrhage

EDH – Extradural Haemorrhage

EDH usually occurs due to the breakdown of the brain artery, these are very serious condition because haemorrhage will never stop due to high pressure in the artery. They may also have counter-coup injuries like the above image where the patient has a brain contusion on the other side of the brain haemorrhage as well. The patient may have a loss of consciousness at the time of injury, then the patient regains consciousness after a few minutes, and again patient will become unconscious. People who will reach late at the hospital may have death due to this haemorrhage.

SDH – Subdural Haemorrhage

There are 4 types, we called it as acute, early subacute, late subacute and chronic subdural haemorrhage. Subdural haemorrhage is a majority of the time due to injury of brain veins which we called as bridging veins. They directly compress brain parenchyma and by doing that it causes brain parenchymal injury. Subdural Haemorrhage has a very high chance of having a convulsion. Subdural haemorrhage which cause compression over brain parenchyma required surgery. Surgery can be performed by Burr hole endoscopic drainage or craniotomy.

Basal Ganglia Haemorrhage/ Thalamo-capsular Hemorrhage

The Basal Ganglia Haemorrhage usually happens in people who have high blood pressure. This haemorrhage usually occurs due to a sudden rise in blood pressure. It will cause paralysis on the opposite side of the body and the left side haemorrhage may have difficulty in speaking. If this haemorrhage gets larger in size, it will require removal by surgery. The brain will have swelling and may develop midline shift which also required removal of the haemorrhage by surgery. The patient may have active bleeding from the site of haemorrhage which is also required to stop. Surgery can be done Endoscopically or through Craniotomy.

Subarachnoid Haemorrhage

Subarachnoid haemorrhage occurs between Pia and the arachnoid space of the brain. Major arteries supplying the brain remain at the sub-arachnoid space and they have natural turns at certain areas of the brain where these arteries may have ballooning and they may burst which will cause SAH. It’s a very serious condition where the patient may have changes of sudden death due to a burst of the major artery of the brain. When these patients visit to the hospital in time, they undergo brain angiography which we call DSA. They will require post-angiography coiling or clipping of this Aneurysm. These patients have 2 options where they can choose to have surgery by craniotomy and clipping of aneurysm or endovascular coiling ( without craniotomy surgery, occlusion of the artery by coiling ). Some patients may have Arterio-venous malformation or Arterio-venous fistula which also present as subarachnoid haemorrhage.

Haemorrhage in Brain Tumour

Haemorrhage in the brain tumour may occur in those people who have neglected brain tumour surgery. Patients who have haemorrhage inside the brain tumour required removal of the brain tumour as well as a biopsy of the same tissue. They may require chemotherapy and radiation at a later date after the biopsy report.