Services:

International Neurosurgery Associates provide a comprehensive and holistic approach to the diagnosis and treatment of the entire range of neurological conditions.

Associated doctors from other specialities work with the primary doctors to cover all aspects of patient care, during the acute phase of the illness to the longer-term continuing care at home.

The range of conditions that we have the training and experience to treat include the following:

- Head and Spine Trauma

Emergency (24-hour) service available for the treatment of adult and paediatric head and spine injury, including simple and compound skull bone fractures, concussions and its sequelae, severe injuries requiring craniotomy for haematoma evacuation, intracranial pressure (ICP) monitoring and neuro-intensive care, chronic subdural haematoma, and spinal column and cord injury, causing paralysis.

Elective surgical treatment for reconstruction of skull defects (cranioplasty) using custom-made titanium mesh or polymer-biocompatible implants for adults and children.


- Stroke

Emergency (24-hour) service for the treatment of brain hemorrhage - acute haemorrhagic stroke (intracerebral haematoma, subarachnoid haemorrhage) - and ischaemic stroke (infarct).

Elective stroke risk assessment, by evaluating the carotid arteries and intracranial vasculature, using CT and MR angiogram techniques. Assessment and treatment of arteriovenous malformations, aneurysms and cerebral ischaemia.


- Brain and Spinal Cord Tumours

Surgical management of all primary and secondary brain and spinal cord tumours in adults and children, including:

Meningiomas:
Convexity, parafalcine, olfactory groove, suprasellar, petroclival, foramen magnum, spinal cord.

Gliomas:
Astrocytoma, grades 1- 4 (glioblastoma); oligodendroglioma, ependymoma.

Skull base tumours:
Acoustic neuroma, chordoma, pituitary tumours, brainstem tumours.

Spinal cord tumours:
Neurofibroma, intramedullary tumours.

Metastatic tumours:
Secondary tumours from breast, lung, colon, etc.

The operating theatres are fully-equipped with micro-neurosurgical equipment, intra-operative nerve stimulation and monitoring, stereotactic image-guidance system (IGS) equipment for biopsy and image-guided surgical resections. Treatment using adjuvant radiotherapy - (gamma-knife and LINAC), is available – chemotherapy and immunotherapy, will be recommended where appropriate.


- Paediatric Conditions

Management of children with congenital and developmental conditions, including:

Hydrocephalus:
Congenital aqueduct stenosis, Dandy-walker malformation, arachnoid cyst, acquired hydrocephalus, complex VP shunt problems.

Spinal cord malformations (Spinal dysraphism):
Spina bifida, tethered cord syndrome, spinal lipoma.

Chiari malformation and syringomyelia

Craniosynostosis and related cranio-facial syndromes

Paediatric brain and spinal cord tumours:
Craniopharyngioma, optic nerve glioma, brainstem glioma, medulloblastoma, benign neuroectodermal tumours, neurofibroma.

Together with pediatric oncologists and neurologists, children with neurological conditions can be treated surgically with the latest microinstruments and endoscopic equipment, in a minimally invasive manner.


- Spine Conditions

Emergency treatment of spinal trauma, fractures and acute prolapsed intervertebral discs, including surgical decompression and internal fixation.

Elective treatment of degenerative spine conditions, such as cervical spondylosis, disc prolapse, neural foraminal stenosis and spondylolisthesis. Surgical management includes nucleoplasty, microdiscectomy, minimally invasive neural foraminotomy, artificial disc replacement, pedicle screws and various fusion techniques, and vertebroplasty.


- Chronic Pain Management

The treatment team includes a certified pain specialist, neurologist and anaesthetist who will evaluate the patient together with the neurosurgeon. Apart from tailoring medication to the patient’s needs, the pain specialist is also able to administer injections, nerve blocks and acupuncture.

In certain cases, such as cancer patients with widespread disease, spinal cord pumps can be placed to administer pain-relief drugs (morphine) intra-thecally. In addition, implantable nerve stimulators can also be placed in the spinal cord or the brain for intractable neuropathic pain.

Trigeminal neuralgia is one condition that is treated by gamma-knife radiosurgery, or sometimes microvascular decompression. 80% of patients report good-to-excellent pain relief after gamma-knife treatment, with significant reduction in medication.


- Functional Neurosurgery

A range of conditions causing functional problems can be treated with surgical techniques, including:

Hyperhidrosis (sweaty palms):
Thoracoscopic sympathectomy is performed.

Spasticity:
Rhizotomy is performed or intra-thecal baclofen pumps are placed.

Parkinson's disease:
Deep brain stimulation or lesionectomy can be performed.

Epilepsy surgery:
Epileptogenic lesions can be excised; vagal nerve stimulator can be placed, and various other surgical options are available for intractable epilepsy.


Services Conditions




Contact Us: Feel free to call +65 6235 0945 / visit us @ Mount Elizabeth Hospital, #09-10, 3 Mount Elizabeth, Singapore (228510).

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