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Wockhardt Brain And Spine Hospital

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Home > Wockhardt Hospital, Mumbai > Centers of Excellence > Brain And Spine Hospital

Wockhardt Brain and Spine Care


Wockhardt Brain & Spine specialties in Bangalore and Mumbai provides advanced micro-surgical techniques to treat complex Brain & Spine disorders. This super specialty center is amongst the few in Asia equipped with most advanced Neuro-navigation and Endoscopic facilities to perform complex brain and spine neurosurgeries.

Wockhardt Brain & Spine Care has a vastly experienced team of Neurosurgeons and Neurologists, backed by the most comprehensive neuro-diagnostic and imaging facilities, positions the hospital among the best in the region. Neurological services extend to the very latest in diagnostic equipment such as EEG, ENMG, and Video-monitoring, 1.5 Tesla MRI and 64-Slice CT Scan.

Spine Surgery Wockhardt Hospital, Spine Care Wockhardt Hospital, Spine Surgery Mumbai Our dedicated state-of-the-art Neurosurgery operation theaters have semi-robotic microscopes, the neuro-navigation facility, cranial and spinal endoscopy, MRI and CT compatible stereotaxy for functional neurosurgery assist our doctors in attaining precision while conducting complex neurosurgeries.. Minimal invasive techniques, being developed for complex brain and spine


Q. Why choose Wockhardt for Brain & Spine surgical Services ?

Most of the doctors / surgeons at Wockhardt specialties have trained or worked for significant amount of time in some of the best medical institutions in US, Europe or other advanced countries. All doctors and nurses speak good English.

Top of the line medical / diagnostic equipment is available at Wockhardt specialties from globalized international conglomerates like GE, Toshiba, Medtronic, Philips . Same technology / medical equipment / computer diagnostic / imaging equipment is available as in Hospitals in New York, London or Sydney. Highest Quality medical and nursing care for a fraction of the cost in the US or UK. High quality medications are available in India at a fraction of European or American prices. Please see indicative package costs of some surgeries below


Patient Experiences

Spine Surgery Mumbai Mr. Larry Tullos - Minimally Invasive Spine Surgery
I have been in a hospital for more than a dozen times in my life, good hospitals in the United States, but the difference you have in Bangalore, we didn't expect that when we got here.
Spine Care Wockhardt Hospital, Spine Surgery Mumbai, Spine Wockhardt Hospital India Mr. John Mattos - Endoscopic Micro Discectomy
Spine Surgery Wockhardt Hospital, Spine Wockhardt Hospital India, Spine Care Wockhardt Hospital India Mr. Paul Opel - Multilevel decompression & Spine Tumor complex
We got here and were picked up at the airport and then had 3 days of tests in the hospital before the surgery.
Spine Wockhardt Hospital India, Spine Surgery Hospital India Ms. Gillian Harrington - Spinal Decompression & Fusion Surgery
My stay at Wockhardt specialties has been very different as compared to stay in an English hospital.Overall it has been very positive.


International Patient Services

Spine Surgery Wockhardt Hospital, Spine Care Wockhardt Hospital, Spine Surgery Mumbai, Spine Surgery Hospital India We look after the special needs of International Patients with services like Visa, Travel Assistance, Airport Pick ups, accommodation for the companion,shopping, interpreters, currency exchange..


Spine Surgery Wockhardt Hospital, Spine Care Wockhardt Hospital, Spine Surgery Hospital India Spine Surgery Hospital India, Spine Care Wockhardt Hospital India

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Innovative Technology

EEG - 32 channel digital video EEG Polysonography with features of selectable 21 channels and 24 hours sleep lab. Detailed EP studies can also be conducted in the dept. EMG - with evoke potential system has 8 channel EMG & EP amplifier with VEP to conduct bone, nerve, tendon conduction studies with oscilloscopes. It also has the MER for movement disorders.

Complete DSA unit with CARE package - For neurovascular studies and neurovascular angiography useful to treat aneurysms and carry out neuro-interventions Sensation 10 CT Scanner - It's the first of its kind in India, having a multi slice technology, true isotropic resolution feature and requires low radiation dose to the patient and use. The patient is at ease and the clinical does not miss out on small lesions because of the single breath-hold imaging.

Symphony is the first MRI in Asia with dedicated 8 channel head coil for advanced neuro-imaging. The dedicated cardiac coils are the first in Mumbai providing superior cardiac imaging. The patient will be benefitted with unmatched resolution and shorter exam-ination time. The combination coil concept results in shorter time and examination of the whole system without patient repositioning.

OPMI Multivision - It's a new generation micro-scope for neuro navigation. It has a facility of image injection, auto-focus based on laser principle and Contraves Counterbalance Technology. The surgeon can connect neuroendoscope with this microscope and superimpose live image with CT and MR.

Dedicated Neuro Intensive Care Unit and Physiotherapy & Rehabilitation department provide excellent post operative support for a faster recovery.


Brain & Spine Services

  • Microscopic lumbar discectomy or decompression
  • Microscopic anterior cervical discectomy
  • Endoscopic discectomy
  • Spinal decompression with or without fusion
  • Endoscopic fusion of spine
  • Percutaneous Endoscopic Lumbar Discectomy

Spinal Surgeries : -


  • Degenerative Disc Disease : -
    • Minimally-invasive spinal fusion and advanced instrumentation
    • Total disc replacement surgery
    • Spinal deformity correction and stabilization
    • Endoscopic fusion of spine
    • Percutaneous Endoscopic Lumbar Discectomy
  • Osteoporosis Of The Spine : -
    • Vertebroplasty
    • Kyphoplasty
    • Spondylolisthesis
    • Posterior spinal instrumentation
  • Abnormal Curvature Within The Spine-Scoliosis / Kyphosis : -
    • Thoracoscopic deformity correction
    • Posterior correction of Scoliosis or Kyphosis with instrumentation
  • Other Spine Surgeries : -
    • Tuberculosis of Spine - Thoracoscopic Spinal Surgery with Para spinal abscess drainage
    • Spine Tumor Surgery
    • Spine Trauma
  • Brain Surgeries : -
    • Microsurgery for Brain Tumors
    • Endoscopic Brain Surgery
    • Trans Nasal Endoscopic Brain Tumor Removal
    • Skull Base Surgery
    • Brain Trauma Surgery
    • Congenital Cranial Deformity
    • Stereotactic Brain Surgery for Tumor and Functional Neurosurgery
    • Craniofacial Surgery with FMS (Facio-Maxillary Surgery)
    • Brain Surgery for Abnormal Blood Vessels
    • Brain Surgery for Epilepsy
    • Brain Surgery for Removal of Blood Clots
    • Interventional/ Neuro-endovascular Therapy for Cerebro-vascular Diseases and Tumor
    • Interventional/ Neuro-endovascular Therapy for Cerebro-vascular Diseases and Tumor


Spinal Surgeries

Narrowing of the spinal canal, a condition called spinal stenosis can cause chronic pain, numbness, and muscle weakness in your arms or legs .The condition primarily afflicts elderly people and is caused by degenerative changes that result in enlargement of the facet joints and thickening of the ligaments.

Constriction of the spinal cord and nerves may be effectively relieved with a spinal decompression procedure if your symptoms have not improved with physical therapy or medications. This surgery requires a hospital stay from 1 to 3 days and recovery takes between 4 to 6 weeks.

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Q. What is spinal decompression ?

Spinal decompression can be performed anywhere along the spine from the neck (cervical) to the lower back (lumbar). The procedure is performed through a surgical incision in the back (posterior).The lamina is the bone that forms the backside of the spinal canal and makes a roof over the spinal cord. Removing the lamina and other soft tissues gives more room for the nerves and allows for removal of bone spurs. Depending on the extent of stenosis, one vertebra (single-level) or more (multi-level) may be involved.

There are several types of decompression surgery : -


  • Laminectomy is the removal of the entire bony lamina, a portion of the enlarged facet joints, and the thickened ligaments overlying the spinal cord and nerves.
  • Laminotomy is the removal of a small portion of the lamina and ligaments, usually on one side. Using this method the natural support of the lamina is left in place, decreasing the chance of postoperative spinal instability. Sometimes an endoscope may be used, allowing for a smaller, less invasive incision.
  • Foraminotomy is the removal of bone around the neural foramen - the space between vertebrae where the nerve root exits the spinal canal. This method is used when disc degeneration has caused the height of the foramen to collapse, resulting in a pinched nerve. It can be performed with a laminectomy or laminotomy.
  • Laminaplasty is the expansion of the spinal canal by cutting the laminae on one side and swinging them open like a door. It is used only in the cervical area.

In some cases, spinal fusion may be done at the same time to help stabilize sections of the spine treated with laminectomy. Fusion uses a combination of bone graft, screws, and rods to connect two separate vertebrae together into one new piece of bone. Fusing the joint prevents the spinal stenosis from recurring and can help eliminate pain from an unstable spine.


Degenerative Disc Disease

Degenerative disc disease (DDD) is a condition in which the spinal discs start to dehydrate and shrink. DDD causes loss of disc height and less room between the vertebrae. This condition is usually found in the neck (cervical) and lower back (lumbar) regions of the spine. DDD is also called spinal degeneration or simply disc disease.

DDD sounds like a horrible condition, but really it is just a NORMAL part of aging. The majority of people have mild to moderate disc degeneration in one or more lumbar discs by the age of 30. Almost as many have equal degeneration in one or more of their cervical discs by the same age. Although degenerative disc disease is common in most people, only a small percentage actually experience ANY symptoms from this condition.


Q. What is an artificial disc replacement ?

An artificial disc is a device that is implanted into the spine to replace a degenerative disc, whose regular function is to carry weight and allow motion. A disc is the soft cushioning structure between the individual bones of the spine, (called vertebra). Artificial discs are usually made of metal and plastic-like (biopolymer) materials, or a combination of the two. These materials have been used in the body for many years. Total disc replacements have been used in Europe since the late 1980s.


Pre-Surgery Preparations

Once you and your surgeon have agreed about the need for disc replacement surgery, some preparations are normally required:

  • You should stop smoking as soon as possible before surgery, as it will increase your chances of a successful result
  • Discussions with your family and other people who may be assisting you once you return from the hospital.
  • You may need to visit your primary care physician or internal medicine specialist to obtain medical clearance for surgery.


Surgery

After the anesthesia has taken effect, the patient is laid on their back in order for the surgeon to get access to the spine through the front of the body-a pillow is normally placed under the low back. One surgeon is either a general or vascular surgeon while the other is a spine surgeon. The surgeon makes a small incision near your belly button.

Working through the abdomen, the organs are carefully moved to one side. This makes it easier to see the front of the spine. An X-ray is taken at this time to get a clearer picture of disc to be replaced. The disc is then removed, the area prepared, and the replacement inserted. A second X-ray may be taken to double check the location and fit of the new disc.

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Q. How long is the recovery after artificial disc replacement surgery ?

Most people spend three to four nights in the hospital. You may require an extra day or two if for some reason you're having extra pain or unexpected difficulty. Patients generally recover quickly after an artificial disc replacement. You should be able to get out of bed and walk within a few days. Some people wear a corset or brace for support. As you recover in the hospital, a physical therapist may see you to start you on a few gentle exercises.

You'll also start a walking program that you are encouraged to continue when you get back home. When you leave the hospital, you should be safe to sit, and walk. Your surgeon will see you within a month to do an X-ray to make sure the disc is in place and holding steady. However, you should avoid lifting things for at least four weeks. You can often return to work after your surgeon has evaluated you, as long as your job does not include heavy lifting.


Spinal fusion (arthrodesis)

Spinal fusion (arthrodesis) is a surgical procedure that joins, or fuses, two or more vertebrae. Spinal fusion is major surgery, usually lasting several hours.

There are different methods of spinal fusion.


  • Bone is taken from the pelvic bone or obtained from a bone bank. The bone is used to make a bridge between adjacent vertebrae. This bone graft stimulates the growth of new bone.
  • Metal implants are secured to the vertebrae to hold them together until new bone grows between them.


Q. What To Expect After Surgery

You will need to be watched in the hospital for a few days after spinal fusion surgery. Bed rest is not usually necessary during your recovery period at home. Your doctor may recommend that you wear a back brace during recovery. Rehabilitation can be a prolonged process and includes walking, riding a stationary bike, swimming, and similar activities.


Q. Why It Is Done

Spinal fusion may be done by itself or in combination with decompression to treat painful symptoms caused by misalignment or instability of the vertebrae, such as spondylolisthesis. Spinal fusion may also be done as a follow-up to decompression and debridement procedures done to treat spinal stenosis, herniated discs, spinal injuries, infection, tumors, and deformities.


Q. How Well It Works

This surgery was originally developed as a way to stabilize the spine and treat deformity caused by tuberculosis, scoliosis, and traumatic injury. Its use has now spread to treatment of degenerative bone or disc changes and spinal stenosis. Spinal fusion is often necessary to stabilize the spine after a traumatic injury, infection, or tumor.

There is no solid body of research supporting the effectiveness of spinal fusion for various other spinal conditions. A recent study showed no clear difference between spinal fusion surgery and intensive rehabilitation for treating chronic low back pain


Osteosporosis of the Spine

Osteoporosis, a disease that gradually weakens bones, causing them to become brittle, affects more than 28 million Americans. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. Along with hip and wrist fractures, severe osteoporosis can cause compression fractures in the spine. This occurs when the bony block, or vertebral body, in the spine collapses causing severe pain, deformity and loss of height.

Compression fractures occur in more than 700,000 patients per year in the United States, are more frequent than hip fractures, and often result in prolonged disability. Until recently, doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing or invasive spinal surgery were the only options available. Today there are two promising therapeutic and preventive treatments for compression fractures. They are called vertebroplasty and kyphoplasty.


Vertebroplasty

Vertebroplasty is a minimally invasive, non-surgical procedure that is designed to relieve the pain of compression fractures. Vertebroplasty literally means fixing the vertebral body. In addition to relieving pain, those vertebral bodies that are weakened but not yet fractured can be strengthened, thus preventing future problems.

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Q. How is Vertebroplasty Performed ?

Under general anesthesia, a special bone needle is passed slowly through the soft tissues of the back. Image guided x-ray, along with a small amount of x-ray dye, allows the position of the needle to be seen at all times. A small amount of orthopedic cement, called polymethylmethacrylate (PMMA), is pushed through the needle into the vertebral body.

PMMA is a medical grade substance that has been used for many years in a variety of orthopedic procedures. The cement is mixed with an antibiotic to reduce the risk of infection, and a powder containing barium or tantalum, which allows it to be seen on the X-ray. When the cement is injected it is like a thick paste, but hardens rapidly. Usually each vertebral body is injected on both the right and left sides, just off the midline of the back. Within a few hours, patients are up and moving around. Most go home the same day.


Kyphoplasty

Kyphoplasty is a newer treatment for patients immobilized by the painful vertebral body compression fractures associated with osteoporosis. Like vertebroplasty, kyphoplasty is a minimally invasive procedure that can alleviate up to 90 percent of the pain caused by compression fractures. In addition to relieving pain, kyphoplasty can also stabilize the fracture, restore height and reduce deformity.


Q. How is Kyphoplasty Performed ?

Kyphoplasty is performed under local or general anesthesia. Using image guidance x-rays, two small incisions are made and a probe is placed into the vertebral space where the fracture is located. The bone is drilled and a balloon, called a bone tamp, is inserted on each side.

These balloons are then inflated with contrast medium (to be seen using image guidance x-rays) until they expand to the desired height and removed. The spaces created by the balloons are then filled with PMMA, the same orthopedic cement used in vertebroplasty, binding the fracture. The cement hardens quickly, providing strength and stability to the vertebra, restoring height and relieving pain.


Benefits of Vertebroplasty and Kyphoplasty

Limitations in the traditional treatments of vertebral compression fractures have led to the refinement of such procedures as vertebroplasty and kyphoplasty. These procedures provide new options for compression fractures and are designed to relieve pain, reduce and stabilize fractures, reduce spinal deformity and stop the "downward spiral" of untreated osteoporosis.

Both vertebroplasty and kyphoplasty utilize a cement-like material that is injected directly into the fractured bone. This stabilizes the fracture and provides immediate pain relief in many cases. Kyphoplasty has the additional advantage of being able to restore height to the spine thus reducing deformity.

After either procedure, most patients quickly return to their normal daily activities. While vertebroplasty and kyphoplasty are encouraging developments, it remains essential that osteoporosis sufferers seek medical help and learn about ways to treat their condition as well as ways to prevent future problems.


Spondylolisthesis

spondylolisthesis happens when one of the spine's vertebrae (bones) slips forward over the vertebra beneath it. Spondylolisthesis occurs most often in the lumbar spine (low back).

Some people never know they have a spondylolisthesis because they have no symptoms. When symptoms exist, they typically include one or more of the following:

  • Pain in the low back, thighs and legs
  • Weakness in the thighs or legs
  • Tight hamstring muscles (back of the thighs)
  • Loss of, or difficulty with, bowel or bladder control

Spondylolisthesis can alter your appearance.

Some noticeable physical differences are : -


  • Stomach sticks out
  • Torso looks shorter
  • Swayback (low back curves too far inward)
  • Waddle when walking

Doctors describe the severity of a spondylolisthesis using a grading scale from 1 to 5. Grade 1 indicates that 25% of a vertebra has slipped forwards over the vertebra below. A Grade 2 indicates a 50% slip, all the way up to a Grade 5, which represents a 100% slip, (known as spondyloptosis).

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Curvature Of The Spine-Kyphosis - Scoliosis


Q. What is Curvature of the Spine ?

When looked at from behind, the spine is normally straight. A SCOLIOSIS is present when there is a curve of the spine to one side. Sometimes two curves in opposite directions may be present. There is often abnormal rotation of the spine as well as the curve. This means that either the ribs or the muscles of the lower back form a hump to one side.

The hump is more obvious when the patient bends over. If the curve is in the lower back, then one hip may stick out. A curve in the upper part of the spine causes the shoulders to be at different levels. In some cases, the scoliosis will disappear when the patient sits or bends. When seen from the side, the upper part of the spine normally curves outwards: the lower spine curves inwards. A KYPHOSIS is present when there is abnormal outward curvature of the spine.

In the lower spine this curvature is actually opposite to the normal inward curve. In both scoliosis and kyphosis, the symptoms depend on the cause of the curve. The majority of scolioses are painless: it is usually the odd shape of the spine which is noticed first. Pain is more often a problem when a kyphosis is present. Again, the pain depends on the cause of the curvature.


Q. How does Curvature of the Spine occur ?

In some patients a scoliosis is present because the legs are different lengths. This type of curve will disappear on sitting. Some children normally stand with a slight curve which disappears when they bend. The cause of the most common type of scoliosis in teenage girls is unknown. Younger children are occasionally affected too.

This type of curve is more obvious when the patient bends over. Weakness of the back muscles may also cause scoliosis. This is seen in polio, muscular dystrophy and cerebral palsy. Abnormal bones in the spine or growths can also cause scoliosis. In older people, a curve may be caused by wear and tear changes in the bones. The commonest type of kyphosis occurs in older people due to collapse of several bones in the spine as a result of thinning of the bones (osteoporosis).

Arthritis, particularly a variety called anklyosing spondylitis, can cause a kyphosis. Rarely, infection, a fracture, or a growth within the bones of the spine may cause a sharply angled kyphosis.


Q. Why does Curvature of the Spine occur ?

Scoliosis does tend to run in families, particularly the type that occurs in young girls. It may also be part of a disease which is passed on from parents to children.


During Treatment for Curvature of the Spine

When surgery is not needed, patients are normally seen about every 6 months. Seek advice if there is any sudden change in the curve, or if there is pain. After an operation, any pain, problems with the wound, or a change in the shape of the curve should be reported to the doctor. Sometimes a plaster or plastic jacket may rub on the skin underneath. This causes discomfort, and advice should be sought: the part of the jacket which is causing pressure can be cut out and replaced.

If Curvature of the Spine is Left Untreated As mentioned, many curves do not need treatment. If a bad curve is not treated, then this may get much worse as a child grows. The result may be a very deformed spine. This may cause problems with breathing and produce spinal arthritis in later life. Growths and infection in the spine must be treated; otherwise damage to the spinal nerves is likely to occur. Early medical examination is very important in any child with a possible curvature of the spine.


Brain surgery

The brain controls and coordinates conscious and unconscious body functions, as well as 'higher' functions such as memory, learning and thinking. Like any other part of the body, it is susceptible to bleeding, infection, trauma and other forms of damage. This damage or alteration in brain function sometimes requires brain surgery (neurosurgery) to diagnose or treat these problems.


Symptoms

The symptoms of conditions requiring brain surgery may vary, depending on the type and severity of the condition.

General symptoms include : -


  • Headache
  • Nausea
  • Vomiting
  • Drowsiness
  • Seizures.

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Brain conditions may require brain surgery

The main types of brain conditions that may require brain surgery include : -


  • Alterations of the brain tissue : - such as brain cancer, infections and swelling (oedema).
  • Alterations in brain blood flow : - such as subdural haematoma, subarachnoid haemorrhage and intraventricular bleed.
  • Alteration in cerebrospinal fluid : - such as infection or hydrocephalus.


Brain cancer: Some of the different types of brain cancer that may require brain surgery include:

  • Gliomas : - glial cells make up the supportive tissue of the brain, and don't conduct electrical impulses. Glioma is a broad term used to describe brain tumours associated with the three types of glial cell, which include the astrocyte, oligodendrocyte and the ependymal cell.
  • Pituitary tumour : - cancer of the pituitary gland, such as craniopharyngioma.
  • Acoustic neuroma or schwannoma : - a type of benign tumour that grows in the canal connecting the brain to the inner ear.
  • Medulloblastoma : - a type of cancer that originates in the brain and can migrate down the spinal cord.
  • Dysembryoplastic neuroepithelial tumour (DNET) : - an abnormal tissue growth in the brain that may or may not be cancerous.
  • Primitive neuroectodermal tumour (PNET) : - a general term referring to abnormal tissue growths of the brain.
  • Lymphomas : - cancers of the lymphatic system.
  • Chordomas : - tumours that originate in particular parts of the skeleton including the skull.
  • Metastases or secondary tumours : - metastasis means cells (usually cancer), which have moved from one part of the body to another.


Alterations in brain blood flow

Some of the causes of altered blood flow in the brain include : -


  • Subdural haematoma : - the build-up of blood beneath the thickest membrane (meninges) that covers the brain, called the dura mater. A subdural haematoma can be classified as acute, acute on chronic or chronic. The most common cause is head injury.
  • Stroke : - occurs when a blood vessel supplying the brain either blocks or bursts. A stroke produces sudden and unexpected brain injury and can sometimes be fatal.
  • Subarachnoid haemorrhage : - bleeding between the arachnoid membrane and the delicate membrane that covers the brain (pia mater). Common causes include head injury and aneurysms.
  • Intraventricular bleed : - an increase in blood flow may cause the small blood vessels of the brain (periventricular capillary network) to burst. Premature babies are at increased risk.


Alteration in cerebrospinal fluid

Some of the causes of alteration in cerebrospinal fluid include : -


  • Hydrocephalus : - the abnormal build-up of cerebrospinal fluid within the skull. In babies, this can cause the head to enlarge.
  • Infection : - various infections of the brain can cause alterations to cerebrospinal fluid.

If left untreated, any condition requiring brain surgery can cause further damage to the brain. Pressure on the brain can be harmful as it forces the brain against the skull, causing damage to the brain and hampering the brain's ability to function properly. This drop in function can lead to long-lasting brain damage and, if left untreated, death.


Diagnosis methods

The range of diagnostic tests can include : -


  • Physical examination
  • Medical history
  • CT scan
  • MRI scan.


Craniotomy explained

A craniotomy is an operation to open the skull in order to access the brain for surgical repair. The patient is put under general anaesthesia. The hair on the scalp is shaved. A neurosurgeon performs the craniotomy by first cutting through the scalp over the area where the brain injury is thought to lie.

A hole is then cut into the skull in order to access the brain. This is needed to repair any ruptured blood vessels and to remove the blood clot or growth. After the operation is finished, the piece of bone that was removed is replaced, the muscle and skin are stitched up and a drain is placed inside the brain to remove any excess blood left from the surgery.


Branches of Wockhardt Hospitals in India : -


Wockhardt Hospital Bangalore Wockhardt Hospital, Bangalore
Wockhardt Hospital hyderabad Wockhardt Hospital, hyderabad
Wockhardt Hospital Mumbai Wockhardt Hospital, Mumbai
Fortis La Femme Womens Hospital Delhi Wockhardt Hospital, Kolkata


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