Treatment of Neurological Problems
Treatment of Nerve And Muscle Disorders
Treatment of Paralysis
Joint Dislocation Treatment
Hepatitis B Treatment
Treatment of Spondylosis
Treatment Of Disk Slip
Treatment Of Herniated Disc
Treatment of Spine Injuries
Brain Tumor Surgery
Treatment of Disc Prolapse
Spinal Cord Injury Medicine
Accident Injuries Treatment
Hepatitis C Treatment
Submit a review for Max Super Specialty HospitalYour feedback matters!
Patient Review Highlights
Dr. Manish Vaish or as I call him Manish sir has been a godly figure to me. We came to him seeking his help to treat my mother who met with a severe neck accident (medically labeled as post trauma atlanto co-axial dislocation). This was a life threatening situation for her but with expert hands of Dr. Manish and his assurance we went ahead with the treatment and a critical surgery which lasted for 12 hours. It's been over 3 years now and my mother is living a healthy second life. Dr. Manish has always been more than welcoming to help us for post surgery treatment. To him any patient treated by him becomes his responsibility and he treats them with such humility. Thank you sir. I would never have surplus of words to express my gratitude for you.
He is a great doctor and a good soul. He is very passionate about his work. He always goes out of his ways to look after his patients. He does charity work as well for poor patients. His years of experience and hard work makes him stand out of the crowd. A very genuine and sincere doctor, hard to find these days!
Dr Manish protrays a very high level of competence in terms of quick & precise diagnosis of the ailment. An extremely compassionate doctor with a wide range of experience in neuro related issues.
Dr. Vivek Patel
Excellent surgical skills Vast experience in brain and spine surgery A fine endoscopic neurosurgeon Amazing teacher and a wonderful person
Ca Manish Aggarwal
Excellent, very cooperating
The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.
Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.
Brain surgeries are performed to:
- Remove the brain tissues that are grown abnormally
- Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
- Biopsy purpose or to remove the tumour
- Make a nerve free
- Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
- To implant artificial electronic device as a treatment for conditions like Parkinson’s disease
- Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
- Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
- Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
- Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.
- Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
- Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
- General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain. If you wish to discuss about any specific problem, you can consult a neurosurgeon.
Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.
Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain that forms a tumor in the brain.Tumours can be either benign or malignant.
Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.
Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.
There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.
Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:
Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.
Difficulty walking or clumsiness.
Changes in alertness.
Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.
What are the risk factors for brain cancer?
Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome
Personal history of cancer or family history of brain cancer
Impaired immune system
Radiation therapy of the head
Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.
Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
There is no trustworthy evidence regarding what causes brain tumors, but there are a few risk factors that have been substantiated through research. Children and young people who receive radiation around the head are susceptible to developing tumors in the brain once they grow up. Also, people with a certain kind of rare genetic condition like neurofibromatosis may develop a brain tumor though such cases are very few in number. Age is also an important factor as people aged over 65 years are diagnosed with brain tumors at quadruple times higher than children and younger people.
Types of Brain Tumours:
A primary brain tumor originates in the brain, and they may or may not be cancerous. Some tumors can be benign, which do not spread in the surrounding tissues and are not very malicious. However, that does not signify that they will not cause any harm over time. Sometimes these tumors can be severe and cause a threat to the life of the sufferer. The National Cancer Institute reports that approximately there were 23, 380 fresh cases of brain tumors in 2014.
Identifying the Symptoms of Brain Tumors:
The symptoms of the brain tumor are dependent on various factors such as the size, type as well as the exact location of the tumor. These symptoms are triggered when any tumor is pressed or clashed against a nerve or disturbs a part of the brain. Symptoms are also felt when any tumor particle blocks the fluid flowing around the brain or when there is a swelling in the brain owing to the build-up of fluid.
Common symptoms include: headaches that get worse in the morning, nausea along with vomiting, an alteration in the speech, hearing and imbalances in walking and movement, mood swings, change in personality and ability to concentrate or remember things and seizures or convulsions.
Treatment for Brain Tumor:
Surgery is normally the most usual treatment for brain tumors, and the patient is given anesthesia, and the scalp is shaved before the surgery. Then, craniotomy is performed to open the skull, and the surgeon removes a bone piece out of the skull. Then the tumor is removed as much as possible. The bone is then restored back, and the incision on the scalp is closed. Sometimes surgery is not viable in case the tumor has developed in the brain stem or some other complex parts.
Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it (called partial removal). Even partial removals can relieve symptoms and facilitate or increase the effectiveness of other treatments.
The role of surgery in treating brain tumors:
Surgery can provide:
- The complete removal of some brain tumors
- A sample to enable doctors to diagnosis the tumor and recommend the most appropriate treatment
- Better quality of life:
- Reduced symptoms and improved ability to function (e.g., to think, speak or see better)
- Less pressure within the skull from the tumor
- A longer life
In case you or any of your near ones is affected with brain tumor, you should visit the doctor to know the possible treatments other than surgery and other important questions related to brain tumor.
Regardless of whether the cause is a tumor, trauma, stroke or any other illness, any injury which inflicts damage on your brain cells is considered to be a brain damage.
There are two types of brain damage, both of which interfere with the standard functioning of the brain.
- Acquired brain injury (ABI): Either resulting from a tumor or a neurological illness, for instance a stroke, this type of brain injury originates from the cellular level and is commonly linked with brain pressure.
- Traumatic brain injury (TBI): It results from any damage imparted to the skull usually from an external and physical force like a blow to the head or a head accident, which in turn damages the brain.
How severe the brain damage is depends largely on the type of brain injury. Mild brain injuries are temporary, causing headaches, memory lapses, nausea and confusion. On the other hand, severe brain injuries cause cognitive, physical and behavioral impairments which are often life-changing and permanent.
Acquired brain injuries may be caused by:
- Being exposed to toxic substances
- Choking, strangulation or drowning
- Heart attacks
- Neurological illnesses
- Illegal drug abuse
Traumatic brain injuries are usually caused by:
- Car accidents
- Sports injuries
- Physical violence
- Head blows
- Falls and other mishaps
Whether acquired or traumatic, symptoms of brain damage can be classified under four major groups:
1. Cognitive symptoms generally include
- Having a hard time processing information or expressing thoughts
- Difficulty in understanding others or abstract concepts
- Memory loss
- Short attention spans
2. Physical symptoms generally include
- Excessive physical fatigue
- Extreme mental fatigue
- Persistent and frequent migraines or headaches
- Sleep disorders
- Light sensitivity
- Loss of consciousness
- Slurred speech
3. Perceptual symptoms generally include
- Spatial disorientation
- Smell and taste disorders
- Heightened pain sensitivity
- Changes in hearing, seeing, or touch sensations
- Unable to perceive time
- Balance problems
4. Emotional or behavioral symptoms generally include
- Decreased stress tolerance
- Heightened or flattened reactions or emotions
- Impatience and irritability
Parkinson's disease is a neurodegenerative condition that affects your brain cells which produce dopamine and thus hampering all kinds of motor functioning and other emotional responses. After the disease is diagnosed, medication and therapy can help to provide relief from the symptoms to a large extent but a permanent cure is not possible.
The disorder does not have a definite set of causes. A small percentage of the cases have been related to hereditary factors and others have a range of environmental causes associated with them.
1. Genetic factors:
Specific gene mutations and gene variations have been proved to cause Parkinson's, such as SNCA, PARK2, PARK7, PINK1 and LRRK2. These make or recycle proteins which are linked to the disease.
Research shows that men are at a 1.75 times greater risk of developing the condition than women are. Also, age plays a role with most cases occurring after the age of 60.
2. Environmental factors:
Regular exposure to inorganic insecticides, pesticides, herbicides and heavy metals or other toxins may cause the disorder. In rare cases, Parkinson's disease occurs in the aftermath of a severe head injury or immune disorders.
The symptoms can be classified into two broad categories-
1. Motor symptoms:
- The hand tremors when in resting position
- The grip loosens
- Walking slows down
- Facial muscles freeze partially
- Speech is slurred
- Balance is disturbed
- Swallowing is painful
- Urination is abnormally frequent
- Dementia-like symptoms are seen
- There is involuntary twitching of the fingers and toes
- Repetition of the same movement in quick succession is nearly impossible
2. Non-motor symptoms:
- Dental problems
- Vision impairment
- Skin disorders
- Panic attacks
- Excessive secretion of saliva
- Extreme weight loss or gain
- Sexual problems
- Loss of sense of smell
- Lowering of the pitch of the voice
Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.
Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures
Types of Brain Tumor Surgery: The different types of surgery that are performed in cases of brain tumor include the following:
Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy
Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.
Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.
Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.
Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.
Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring
Sciatica refers to the pain one experiences due to the irritation or compression of nerve roots contributing to formation of Sciatic nerve. The sciatic nerve is the longest and widest nerve in the body, running from the lower back, down to the back of each leg. The pain can occur in the lower back and spread to the hips, buttocks and leg. Sciatica generally affects one side of the body. There are numerous causes of irritation of the sciatic nerve and sciatica.
Some of them are:
- Spinal Stenosis: The narrowing of the spinal canal caused by natural wear and tear of the vertebrae (individual bones in the spine protecting underlying nerves) of the spine is known as spinal stenosis. The narrowing may put pressure on the roots of the sciatic nerve, causing pain.
- Herniated Disc: A disc is made up of cartilage and acts as a cushion between vertebrae, allowing flexibility of the spine. A herniated or slipped disc occurs when a disc is temporarily pushed out of place, putting pressure on the sciatic nerve.
- Spondylolisthesis: It is a condition where one of the lower vertebrae slips forward over another. This also causes a collapse of the disc space between both, causing the nerve to get pinched. This may cause sciatica.
- Piriformis Syndrome: Piriformis is a muscle found deep inside the buttocks, which connects the lower spine to the upper thighbone, running directly over the sciatic nerve. Spasming of this muscle can pressurize the sciatic nerve, triggering symptoms of sciatica.
- Sacroilitis: Sacroillac joints are the place where the lower spine meets the pelvis and inflammation of one or both of these joints causes sacroilitis. This can give rise to symptoms of sciatica as it causes pain in the lower back, buttocks and legs.
- Spinal tumors: Very rarely, tumors growing inside or along the spine may put pressure on the sciatic nerve.
- Infection or injury: Muscle inflammation, infections, fractures or any other spinal injury may lead to irritation or compression of the sciatic nerve.
- Pregnancy: Pregnant women may suffer from sciatica due to weight gain, expansion of the uterus or increased fluid retention or other changes occurring in the body, which put pressure on the sciatic nerve.
- Other causes: Osteoarthritis and fractures caused by osteoporosis may also affect the sciatic nerve, producing symptoms of sciatica.