Treatments and surgeries we perform
• Aneurysm clipping
Aneurysm clipping is a surgical treatment for a brain aneurysm, a balloon-like bulge on a blood vessel wall that can enlarge over time and ultimately rupture, causing a life-threatening stroke. If the aneurysm has a narrow neck, neurosurgeons can clip it at its base, thereby isolating the aneurysm from the normal blood flow. Clipping an aneurysm requires a craniotomy, the surgical opening of the skull.
• Aneurysm coiling
Coiling is a minimally invasive, endovascular procedure used to neutralize a brain aneurysm, a balloon-like bulge on a blood vessel wall that can enlarge over time and ultimately rupture, causing a life-threatening stroke. A benefit of coiling is that it does not require invasive surgery or the opening of the skull (a craniotomy). During a coiling procedure, a surgeon threads a flexible catheter from the large femoral artery near the groin up to one of four arteries in the neck that lead to the brain. The surgeon then inserts platinum coils through small tubing into the aneurysm. The compacted coils are designed to block blood flow and prevent the aneurysm from bleeding.
• Aneurysm gluing
Gluing is a minimally invasive, endovascular procedure that fills a brain aneurysm with a glue-like material known as Onyx HD 500. An aneurysm is a balloon-like bulge on a blood vessel wall that can enlarge over time and ultimately rupture, causing a life-threatening stroke. While aneurysms that have a narrow neck can be surgically clipped at their base or filled with coils, aneurysms with wide necks are problematic because they cannot be clipped and because coils may not remain inside. During embolization with Onyx®, a flexible balloon catheter is threaded up from the large femoral artery in the upper leg (groin area) and advanced to an artery that leads to the brain The balloon catheter is placed over the aneurysm neck and inflated; a second flexible catheter then dispenses Onyx® into the aneurysm. After the glue has solidified, the balloon is deflated and removed. With the aneurysm now filled with solidified glue, blood can no longer enter the arterial bulge and pose a risk of stroke.
• Angioplasty & stenting
Angioplasty and stenting is a treatment for a narrowed or blocked artery in the brain (intracranial artery stenosis) or neck (carotid artery disease). The blockage is often caused by a buildup of plaque inside the artery wall that reduces blood flow to the brain. If left untreated, it could lead to stroke. During angioplasty, the physician inserts a catheter or tube into an artery in the groin and then threads the catheter through the arteries to the location of the plaque. A small balloon is slowly inflated within the narrowed artery to dilate it and compress the plaque against the wall. A self-expanding mesh-like tube called a stent is placed over the plaque, holding open the artery.
• AVM treatment (surgery, embolization, radiosurgery)
Treatment of an arteriovenous malformation (AVM), an abnormal tangle of blood vessels in the brain, can be accomplished in a variety of ways. Treatment options range from conservative watching to aggressive surgery, depending on the type, symptoms, and location of the AVM. Specialists treat some AVM’s with radiosurgery, aiming focused beams of radiation at the lesion and causing the blood vessels to gradually close off. Other AVM’s are treated with endovascular embolization, a minimally invasive procedure in which glue or another material is delivered into the AVM through a tiny catheter. After embolization, blood is no longer able to flow through the malformation. Still other AVM’s are treated surgically. A surgical opening, or craniotomy, is made in the skull, and the brain is gently retracted so that the AVM may be located. Using a variety of techniques such as laser and electrocautery, the AVM is shrunk and dissected from normal brain tissue.
Brachytherapy involves delivering radiation from inside the brain to help eradicate a tumor or reduce its size. A neurosurgeon places radioactive material that is sealed in seeds, about the size of grains of rice, directly into the tumor cavity during surgery.
• Brain tumor surgery
During a brain tumor resection, a neurosurgical team removes a tumor from inside the skull in one of a variety of ways. Often the resection involves a craniotomy, the opening of the skull, so that the surgeon can gain access to the tumor. Tumors located at the skull base (e.g., pituitary tumors) can increasingly be accessed through the nasal passages. Surgeons may use a microsurgical laser when eradicating tumors that have calcified or are entangled in areas of the central nervous system that are critical for speech, reasoning and movement.
• Brain biopsy
Biopsy is a procedure to remove a small amount of tumor to be examined by a pathologist under a microscope. A biopsy can be taken as part of an open surgical procedure to remove the tumor or as a separate diagnostic procedure, known as a needle biopsy via a small hole drilled in the skull . A hollow needle is guided into the tumor and a tissue sample is removed. A stereotactic biopsy is like a needle biopsy but is performed with the use of a stereotactic head frame and a computer to precisely locate the tumor and direct the needle.
• Carotid endarterectomy
A carotid endarterectomy is a treatment for carotid stenosis (a narrowing or blockage of the carotid artery), which is an important risk factor for stroke. The body’s two carotid arteries, one on the right side and one on the left, run through the neck and supply oxygen-rich blood to the brain. During an endarterectomy, a surgeon makes an incision in the neck and physically removes plaque from the inside of the artery.
• Cerebral artery bypass
A cerebral artery bypass is a surgical procedure performed to restore, or “revascularize,” blood flow to the brain. A cerebral bypass is the brain's equivalent of a coronary bypass in the heart. The surgery involves connecting a blood vessel from outside the brain to a vessel inside the brain to reroute blood flow around an artery that is narrowed, blocked, or damaged. The main goal of bypass surgery is to restore blood supply to the brain and prevent strokes. During the two-step surgical procedure, a vascular surgeon “harvests” an artery from another part of the body. A neurosurgeon then uses that artery to bypass the damaged artery in the neck or brain. The harvested artery is threaded under the skin and into the skull, where it is then attached to another healthy artery. This restores healthy blood flow to the patient’s brain.
• Chiari decompression
A Chiari decompression is a surgical procedure performed to alleviate symptoms of Chiari I malformation, a condition in which the lower part of the brain, called the cerebellar tonsil, herniates down through the skull and into the spinal canal. The herniated tissue presses against the brainstem and blocks the normal flow of cerebrospinal fluid (CSF), often causing headaches and pain at the base of the skull or neck. Surgery involves relieving the progression of symptoms and compression of the brainstem and cranial nerves. During the procedure, the neurosurgeon removes bone at the back of the skull and spine to widen the foramen magnum. The dura overlying the tonsils is opened and a dural patch is sewn to expand the space and restore normal CSF flow.
• Chemotherapy wafer
Chemotherapy is a treatment that uses chemical agents (drugs) to kill cancer cells. The drugs can be taken by pill or intravenous (IV). Wafers soaked in chemotherapy drug can be placed directly into the brain after a tumor has been removed. The wafers are about the size of a nickel and deliver BCNU, a standard form of chemotherapy, directly to the remaining tumor cells and brain.
• Cranial reconstruction / Cranioplasty
A cranial reconstruction, or cranioplasty, is an inpatient procedure in which neurosurgeons repair defects in the skull in order to protect the individual’s brain. Skull defects can be caused by physical trauma, a gunshot wound, or surgery. During a cranioplasty, neurosurgeons use a graft to repair a defect in the front of the skull. The graft can be made from the patient’s own bone, either adjacent to the defect or from somewhere else in the body, or from synthetic material. The surgeon affixes the graft, or implant, to the skull with small titanium plates and screws.
A craniotomy is a surgical cut that opens the skull, or cranium, which encases the brain. A craniotomy, which can be small or large, is used in the treatment of several conditions, including brain tumors, blood clots, aneurysms, arteriovenous malformations, or fractures to the skull. A craniotomy also may be performed so that surgeons can remove foreign objects, reduce swelling, or treat infection. During this surgical procedure, a section of the skull, called a bone flap, is removed to access the brain underneath. The bone flap is usually replaced after the procedure with tiny plates and screws.
• Deep Brain Stimulation (DBS)
Deep brain stimulation (DBS) surgery is a treatment for people with Parkinson’s disease, essential tremor, and dystonia. DBS is a minimally invasive procedure in which a neurosurgeon implants a medical device, similar to a pacemaker, into the brain to deliver electrical stimulation to precisely targeted areas. DBS is very effective at reducing dyskinesias, the uncontrolled wiggling movements caused by high doses of levadopa medication. Typically, DBS will help make your symptoms less severe so that lower medication doses may be used.
• Epilepsy / seizure surgery
Epilepsy surgery can be performed to eliminate or reduce seizures in patients who have medication-resistant or “intractable” seizures. Epilepsy surgery can performed in two different ways. In some situations, a neurosurgeon removes an area of the brain that is producing seizures. This is called a “curative” procedure, because the goal is stop the seizures entirely. In a second type of procedure, the neurosurgeon seeks to limit the spread of seizure activity or reduce the frequency of seizures by interrupting the seizure’s pathway. This procedure is considered “palliative,” because it is aimed at reducing physical harm caused by seizures. A candidate for epilepsy surgery undergoes rigorous testing to ensure that surgery can be performed safely and without negatively impacting brain structures responsible for movement, memory and cognition.
• Endoscopic endonasal for pituitary tumors
Endoscopic transsphenoidal surgery is a minimally invasive surgery performed to remove tumors from the pituitary gland, sellar region, and sphenoid sinus of the skull. The surgeon approaches the pituitary through the nose. A small incision is made at the back of the nasal cavity and causes little disruption of the nasal tissues. The ENT surgeon works through the nostrils with a tiny camera and light called an endoscope. Once the pituitary is exposed, the neurosurgeon removes the tumor.
• Hematoma aspiration
Hematoma aspiration is a minimally invasive procedure used to remove large blood clots (hematomas) caused by an intracerebral hemorrhage (a type of bleeding stroke) or trauma to the head. During the procedure, a stereotactic frame is attached to the head with four pins, or screws. A CT scan of the head helps the neurosurgeon pinpoint the exact coordinates of the hematoma. In the operating room, the neurosurgeon then drills a small hole about the size of quarter in the skull. With the aid of the stereotactic frame, a hollow needle is passed through the hole, through the brain tissue, and directly into the clot. The hollow needle is attached to a large syringe, which the surgeon uses to suction out the contents of the blood clot.
• Microvascular decompression
Microvascular decompression (MVD) surgery relieves abnormal compression of a cranial nerve. It is performed to treat trigeminal neuralgia, vagoglossopharyngeal neuralgia, and hemifacial spasm. These conditions can occur when an artery or vein compresses the nerve root as it leaves the brainstem. When compressed, normal nerve impulses can recruit nearby nerve fibers and send faulty messages, causing symptoms that include pain and muscle twitching. During an MVD, the neurosurgeon opens the skull (craniotomy), exposes the nerve, and inserts a tiny sponge between the compressing vessel and the nerve. This sponge isolates the nerve from the pulsating effect and pressure of the blood vessel, and painful symptoms are relieved.
• Needle biopsy
A stereotactic needle biopsy is a diagnostic test used to determine whether a brain tumor is benign or malignant. During the procedure, the neurosurgeon inserts a hollow cannula into the tumor. Small biting instruments remove bits of tumor. A pathologist will examine these samples and determine the exact tumor cell type. Peer-reviewed research conducted by Mayfield Clinic neurosurgeons has found that performing a stereotactic needle biopsy in an area of the brain associated with language or other important functions carries no greater risk than a similar biopsy in a less critical area of the brain.
• Percutaneous stereotactic radiofrequency (PSR)
Percutaneous stereotactic radiofrequency rhizotomy (PSR) is a minimally invasive procedure performed to relieve pain caused by trigeminal neuralgia, glossopharyngeal neuralgia, or cluster headaches. The treatment is an option when medications become ineffective in controlling pain or when they are causing serious side effects. During a PSR, a neurosurgeon destroys the part of the nerve that is causing pain by suppressing the pain signal to the brain. The surgeon passes a hollow needle through the cheek and into the selected nerve at the base of the skull. A heating current, which is passed through the electrode, destroys some of the nerve fibers, but not the entire nerve. A PSR is a one- to two-hour outpatient procedure that is performed in a radiology department or an operating room.
• Shunt for hydrocephalus
A shunt is hollow catheter inserted into the brain to drain or divert cerebrospinal fluid from inside the ventricles into another body cavity such as the abdomen. It is a treatment to relieve hydrocephalus - an abnormal build-up of cerebrospinal fluid usually caused by a blockage of the ventricular system of the brain. Increased intracranial pressure can compress and damage brain tissue. Also called “water on the brain.”
• Radiation seeds
Radiation seeds can be placed in a brain cavity after a tumor has been removed. Radiation seeds, about the size of grains of rice, consist of titanium casings containing low-radioactivity iodine 125. After a tumor’s removal, about 50 to 100 seeds are placed in the surgical cavity, where they remain permanently. By emitting radiation over a period of six months, they destroy microscopic tumor cells that may persist in the brain following surgery.
• Radiotherapy & radiosurgery
Stereotactic therapy, often referred to as “surgery without the knife,” involves the destruction of a lesion with multiple, precisely targeted doses of radiation. A lesion is an abnormality that can appear as a tumor or malformation. During radiotherapy, the head is immobilized with a special frame or mask, which also provides a frame of reference for targeting the lesion. Brain scans are taken while the patient is wearing the frame or mask and before each treatment, and special reflectors are placed on the mask to help align the patient. Radiation is delivered by a computerized machine known as a linear accelerator.
• Vagus nerve stimulation (VNS)
Vagus nerve stimulation (VNS) is a procedure used to treat epileptic seizures and depression. It is considered as a treatment option for seizures or depression that are “intractable,” or resistant to being treated effectively with medication. The human body’s two vagus nerves, one on each side, transmit signals into and out of the brain. During a VNS procedure, a neurosurgeon implants a pulse generator (which resembles a pacemaker) in the chest. An electrode from the generator is then threaded, under the skin, to the left vagus nerve in the neck. Electrical impulses generated by the stimulator have been shown to significantly reduce seizures and may be capable of reducing depression in some people.
Brain conditions we treat
• Acoustic neuroma
Acoustic neuroma is a tumor that grows from the nerves responsible for balance and hearing. More accurately called vestibular schwannoma, these tumors grow from the sheath covering the vestibulocochlear nerve. Acoustic neuromas are benign (not cancerous) and usually grow slowly. Over time the tumor can cause gradual hearing loss, ringing in the ear, and dizziness. Treatment options include observation, surgery, and radiation.
Aneurysm is a balloon-like bulge or weakening of an artery wall. As the bulge grows it becomes thinner and weaker. It can become so thin that the blood pressure within can cause it to burst or leak. A ruptured aneurysm releases blood into the spaces around the brain, called a subarachnoid hemorrhage (SAH) – a life-threatening type of stroke. Treatment focuses on stopping the bleeding and repairing the aneurysm with surgical clipping, coiling, or bypass.
• Arteriovenous fistula
An arteriovenous fistula (AVF) is an .... In an AVF there is a direct connection between one or more arteries and veins or sinuses. Dural AV fistulas and carotid-cavernous fistulas (CCF) are the most common AVFs.
• Arteriovenous malformation (AVM)
An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels in the brain or spine. Some AVMs have no specific symptoms and little or no risk to one's life or health, while others cause severe and devastating effects when they bleed. Treatment options range from conservative watching to aggressive surgery, depending on the type, symptoms, and location of the AVM.
Astrocytoma is a tumor arising from the supportive cells of the brain called astrocytes. These tumors are a type of glioma and range from slow growing and benign to fast growing and malignant. They are the most common primary CNS tumor, representing about half of all primary brain and spinal cord tumors.
• Brain tumors
A tumor (also called a neoplasm or lesion) is abnormal tissue that grows by uncontrolled cell division. Normal cells grow in a controlled manner as new cells replace old or damaged ones. For reasons not fully understood, tumor cells reproduce uncontrollably. Brain tumors are named after the cell type from which they grow. They may be primary (starting in the brain) or secondary (spreading to the brain from another area).
• Carotid artery disease (carotid stenosis)
Carotid stenosis is a narrowing of the carotid arteries, the two major arteries that carry oxygen-rich blood from the heart to the brain. Also called carotid artery disease, carotid stenosis is caused by a buildup of plaque inside the artery wall that reduces blood flow to the brain. The process of plaque buildup is called atherosclerosis. Carotid stenosis is a major risk factor for stroke and can lead to brain damage.
• Cavernous malformations
A cavernous malformation is an abnormal cluster of enlarged capillaries with no significant feeding arteries or veins; low pressure.
• Chiari malformation
Chiari I malformation is a condition in which the lower part of the brain, called the cerebellar tonsil, herniates down through the skull and into the spinal canal. The herniated tissue presses against the brainstem and blocks the normal flow of cerebrospinal fluid (CSF). Depending on the extent of herniation, these malformations cause a variety of symptoms that range from mild to severe.
Chordoma is a rare, bone tumor arising from primitive notochord cells; usually occurs at the base of the spine (sacrum) or at the skull base (clivus).
A concussion is a mild traumatic brain injury caused by a blow or “ding” to the head. Common in falls, sports, and car crashes, concussions can temporarily affect the brain causing confusion, memory, speech, vision, or balance problems. During the impact of an accident, the brain bounces back and forth inside the skull. This can cause bruising, bleeding, and tearing. Immediately after the accident, the person may be confused, not remember what happened, have nausea, blurry vision or dizziness. The person may appear fine at first, but may show symptoms hours or days later. A person does not have to lose consciousness to suffer a concussion.
craniopharyngioma: a benign tumor that grows from cells near the pituitary stalk.
• Cushing's disease
Cushing's disease is an endocrine problem caused by increased levels of cortisol in the body; often from an adrenocorticotropic hormone (ACTH)-secreting pituitary tumor. Hallmark signs include a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks on the skin. Also caused by excessive use of corticosteroid medication.
Dystonia is a movement disorder that causes sustained muscle contraction producing repetitive movements or abnormal postures. Spasms can often be controlled with sensory tricks to suppress the movement.
Ependymoma: a benign tumor that grows from the ependyma cells lining the ventricles.
Epilepsy is a disorder of the brain in which seizures occur repeatedly. A seizure is caused by an abnormal electrical discharge in the brain. This abnormal "short circuit" can cause a change in behavior without your being aware of what is happening. During a seizure you may fall down, stare off into space, or make jerking movements. Some people get a warning, called an aura that tells them when a seizure is about to happen. You cannot control what's happening while the seizure is occurring.
• Essential tremor
Essential tremor is an involuntary rhythmic tremors of the hands and arms occurring both at rest and during purposeful movement.
glioblastoma multiforme (GBM): these tumors, sometimes called high-grade or grade IV astrocytomas, grow rapidly, invade nearby tissue, and contain cells that are very malignant.
glioma: a large category of primary brain tumors that originate from glial cells. There are many types of gliomas; see astrocytoma, glioblastoma multiforme, mixed glioma, optic nerve glioma.
• Hemifacial spasm
Hemifacial spasm (also called tic convulsif) is an involuntary twitching of the facial muscles on one side of the face. The facial muscles are controlled by the facial nerve (seventh cranial nerve), which originates at the brainstem and exits the skull below the ear where it separates into five main branches (Fig. 1). The facial nerve is primarily a motor nerve, meaning it controls muscles that move the eyebrows, close the eyes, and move the mouth and lips.
hydrocephalus: an abnormal build-up of cerebrospinal fluid usually caused by a blockage of the ventricular system of the brain. Increased intracranial pressure can compress and damage brain tissue. Also called “water on the brain.”
• Normal pressure hydrocephalus
Normal Pressure Hydrocephalus (NPH) is a condition where excess fluid accumulates in the cavities (called “ventricles”) inside the brain causing some of the same symptoms as dementia, Alzheimer’s or Parkinson’s disease. Treatment involves placement of a shunt (hollow tube) to drain CSF fluid away from the brain thereby allowing the enlarged ventricles to return to a normal state.
A meningioma is a benign tumor that grows outside the brain and in the meninges, a thin layer of tissue covering the brain and spinal cord. Some meningiomas contain cysts or calcified mineral deposits; others, highly vascular, contain hundreds of tiny blood vessels. Because meningiomas tend to grow inward, they commonly cause pressure on the brain or spinal cord.
• Metastatic brain tumor
A metastatic brain tumor is one that has spread to the brain from a cancer that has originated elsewhere in the body. Metastatic brain tumors most often have spread from the breast or lung. As patients live longer with their primary cancer, they have a higher likelihood of developing metastatic tumors in the brain. About 170,000 cases are diagnosed each year.
• Moyamoya disease
Moyamoya disease is a disorder caused by blocked arteries at the base of the brain. The name "moyamoya" means "puff of smoke" in Japanese and describes the appearance of the tangle of tiny vessels that form to compensate for the blockage. As the normal blood vessels narrow and become blocked, a person may suffer a stroke – a life-threatening situation. No medication can stop or reverse the progression of moyamoya disease. Treatment focuses on reducing the risk of stroke and restoring blood flow to the brain.
• Parkinson's disease
Parkinson’s Disease (PD) is a chronic, progressive disorder that affects nerve cells deep in the brain responsible for planning and controlling body movement. Dopamine is a chemical used in body movement. When the dopamine-producing nerve cells die, symptoms such as tremor, slowness, stiffness, and balance problems begin to occur. The cause of Parkinson's is largely unknown, and the disease cannot be cured at this time. Treatments focus on reducing symptoms to enable a more active lifestyle.
• Pituitary tumor (adenoma)
A pituitary tumor is a benign growth that most often appears in the front portion of the pituitary gland, a small organ that sits at the base of the brain, behind the bridge of the nose. Pituitary tumors interfere with the gland’s ability to regulate the secretion of hormones.
• Skull base tumors
Skull base tumors develop at the base of the brain. They include acoustic neuromas, chordomas, meningiomas, pituitary tumors, tumors of the sino-nasal tract, and others. Increasingly, skull base tumors can be removed with minimally invasive techniques.
Stroke is a sudden interruption of the blood supply to the brain. Most strokes are caused by an abrupt blockage of an artery (ischemic stroke). Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke). The effects of a stroke depend on the severity and which area of the brain is injured. Strokes may cause sudden weakness, loss of sensation, or difficulty with speaking, seeing, or walking. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected. Hemorrhagic strokes have a much higher death rate than ischemic strokes.
Syringomyelia is a chronic progressive disease of the spinal cord caused by an obstruction of normal cerebrospinal fluid (CSF) flow that redirects the fluid into the spinal cord to form a syrinx. Syringomyelia affects about 65% of patients with Chiari malformation.
• Traumatic brain injury
Traumatic brain injury (TBI) is sudden damage to the brain caused by a blow or jolt to the head. Injuries can range from mild concussions to severe permanent brain damage. The consequences of a brain injury can affect all aspects of a person’s life, including physical and mental abilities as well as emotions and personality. While treatment for mild TBI may include rest and medication, severe TBI may require intensive care and life-saving emergency surgery.
• Trigeminal neuralgia
Trigeminal neuralgia is an inflammation of the trigeminal nerve causing extreme pain and muscle spasms in the face. Attacks of intense, electric shock-like facial pain can occur without warning or be triggered by touching specific areas of the face. Although the exact cause of trigeminal neuralgia is not fully understood, a blood vessel is often found compressing the nerve.
Diagnostic tests we use
An angiogram, also called an arteriogram, is an invasive diagnostic test that uses x-rays to take pictures of your blood vessels. A long flexible catheter is inserted through the blood stream to deliver dye (contrast agent) into the arteries making them visible on the x-ray. This test can help diagnose a stroke, aneurysm, arteriovenous malformation, tumor, clots, and arterial stenosis.
• Brain mapping
Three-dimensional brain mapping is a process in which surgeons use one or more types of brain scans to determine a tumor or lesion’s location in relation to important areas of the brain, such as electrical pathways, arteries, veins, and functional centers that play a role in memory, speech, and thinking. Up to four types of brain scans can be fused to create this detailed map of a patient’s brain. Using the map, doctors can determine the safest pathway to the tumor.
• CT angiogram
Computed tomography angiography (CTA) is an imaging technique that generates a map of blood vessels (arteries and veins) in the brain.
• CT scan
CT (computed tomography) is a painless, noninvasive diagnostic test that provides detailed images of bone, soft tissues, and blood vessels. It provides a rapid and effective way to look inside the body in an emergency. A CT machine uses x-rays and a computer to create cross-sectional images, taken in slices. The test is used in the diagnosis of brain damage in head injuries, blood clots, intracranial bleeding, fractures, hydrocephalus, spinal stenosis, herniated discs, and spinal cord damage.
• Diffusion Tensor Imaging (DTI)
Diffusion tensor imaging (DTI), or tractography, generates images of critical white-matter tracts in the brain that must be avoided and protected during surgery. White-matter tracts are electrical connectors between different parts of the brain.
• Electroencephalography (EEG)
EEG (electroencephalography) is a noninvasive test that records electrical patterns in your brain. The test is used to help diagnose conditions such as seizures, epilepsy, head injuries, dizziness, headaches, brain tumors and sleeping problems. It can also be used to confirm brain death.
Fluoroscopy (C-arm), which uses the same technology as an x-ray, is a painless, noninvasive procedure that can serve as a diagnostic test and can also provide image guidance to a surgeon, enabling the surgeon to track instruments inside the human body during an operation. Fluoroscopy directs radiation waves through the body and onto a fluorescent screen, enabling the surgeon to view images in real time. It helps the surgeon identify specific vertebral levels and place pedicle screws during surgery, and it helps pain specialists guide needle placement during injections.
• Functional MRI
Functional MRI (fMRI) creates a series of images that capture blood oxygen levels in parts of the brain that are responsible for movement, perception, and cognition. Functional MRI, which reveals the brain in action, differs from standard MRI, which provides a static image. The fMRI data, which pinpoint language, cognition, and mobility centers of the brain, allow neurosurgeons to remove tumors to the greatest extent possible without harming areas that are critical to the patient’s quality of life.
• MRI scan
MRI (magnetic resonance imaging) is a painless, noninvasive diagnostic test that provides a detailed view of the soft tissue of the spine or brain. An MRI machine creates images by using a powerful magnetic field, radio waves, and a computer. The images are taken in slices, from the side, front, or bottom. The test is most often used in the diagnosis of tumors, strokes, and disc herniations.
• PET scan
A positron emission tomography (PET) scan is a type of nuclear imaging test that shows the metabolic activities (energy usage) of your brain. A PET scan integrates two technologies to view your body: computed tomography (CT) and a radioactive material called a tracer. PET scanning allows doctors to measure a range of activity including blood flow, blood volume, oxygen usage, tissue pH (acidity), glucose (sugar) metabolism, and drug activity. PET is very useful in watching the activity of cancerous tumors.
• SPECT scan
A Single Photon Emission Computed Tomography (SPECT) scan is a type of nuclear imaging test that shows how blood flows to tissues and organs. A SPECT scan integrates two technologies to view your body: computed tomography (CT) and a radioactive material (tracer). The tracer is what allows doctors to see how blood flows to tissues and organs. A SPECT scan is primarily used to view how blood flows through arteries and veins in the brain.
X-ray imaging is a painless, noninvasive diagnostic test that provides pictures of bones, bone fractures, and foreign objects. An x-ray machine creates images by directing radiation waves through the body and onto sensitive film. The portion of the x-ray that is not absorbed exposes the film on the other side. The denser the tissue, the more x-rays it absorbs. X-rays are not highly effective at showing nerves or herniated discs. During an x-ray the patient is exposed to a small amount of radiation.