Neurosurgery. Epilepsy Surgery. Our Specialisations
Our range of services
Our Department for Neurosurgery and Epilepsy Surgery is specialised in the diagnosis and treatment of the following diseases:
- Brain tumours, cerebral haemorrhaging, brain infarcation (e.g. stroke)
- Craniocerebral injuries
- Epilepsy surgery
- Cerebrovascular malformations
- Cerebrospinal fluid circulation disorders
- Congenital deformities of the brain
- Spinal diseases
- Slipped discs
- Spinal cord tumours and tumours in the vertebral canal
- Deformities in the area of the lumbar spine
- Nerve compressions, injuries and tumours
- Pain surgery
Neurosurgery and Epilepsy Surgery. Our Treatment Concepts
Operations on the head and brain
Brain tumours cause headaches, seizures and personality changes, depending on the region of the brain. In terms of treatment, surgical removal is preferred to radiation therapy or chemotherapy. However the doctor must always assess whether an operation is possible and what risks there are.
In our Department we operate on brain tumours by making the smallest opening possible in the skull bone (trepanation). Precision planning is vital here. The most modern surgical microscopes and neuronavigation play a role here. They show the important centres of function and fibrous connections in the brain which must not be impaired if at all possible. Intraoperative neuromonitoring is standard with us.
We also surgically treat the consequences of cerebral haemorrhages, infarcts and traumatic brain injuries. Disturbances in the circulation of cerebro-spinal fluid lead to pathological widening of the cerebral ventricles. With the implantation of liquor shunt systems via a valve, the surplus cerebro-spinal fluid is either discharged into the bloodstream, the abdominal cavity or to the outside.
Patients with benign or malignant changes in the brain are in very good hands in our specialised centre.
Epilepsy surgery treatment concepts
In many cases epilepsy can be treated well with medication. In a few patients, however, even a combination of medications does not essentially reduce seizures. Quality of life is often severely limited. This is when surgical procedures are used. Our Clinic specialises in the diagnostics and therapy for the most complex types of epilepsy. We perform very many multiple flap resections and hemispherectomies. Our surgical equipment is among the most modern worldwide.
The aim of epilepsy surgery is to surgically remove parts of the brain where the focus of seizure is located. Moreover we also use the latest disconnective procedures. In our clinic therefore we perform the removal of half of the brain (hemispherectomy) using minimally invasive technology.
Before an intervention, intensive diagnostic procedures are carried out. We begin with a standard video EEG monitoring. If the focus of seizure remains unclear from this, our doctors rely on invasive monitoring procedures. These are then used if functional areas of the brain are being more closely evaluated. Our clinic uses special technology to do this – and this ranges from subdural electrodes to a stereo EEG.
Before the operation, the focus of the epileptic seizure will have already been localised using imaging procedures (MRI) and long-term video EEG monitoring. Fibre tracking, i.e. representation of the brain paths during the intervention allows greater precision during microsurgical operations. This means we are able to operate on epilepsy in areas of the brain, which up to now could only be treated under high risk conditions.
These very latest procedures have been established and developed further at our clinic by our Head of Department, Prof. Dr. Marting Staudt (Neuropaediatrics) and Head of Department Dr. Manfred Kudernatsch (Neurosurgery).
Operations on the spine.
Operative treatment of the following clinical pictures is provided in the Schön Klinik Vogtareuth for the following parts of the spine:
- Slipped discs in the area of the cervical spine
- Vertebral canal constriction of the cervical spine
- Vertebral canal constrictions and instabilities at the transition from head to neck
- Fractures in the area of the cervical spine
- Tumours in the area of the cervical spine
- Deformities in the area of the thoracic spine
- Tumours in the area of the thoracic spine
- Slipped discs in the lumbar spine area
- Vertebral canal constriction in the lumbar spine
Pain surgery treatment concepts.
In the event of severe pain conditions which cannot be controlled with drugs, special neurosurgical treatment methods are used, which rapidly lead to clear pain relief or stop it altogether. These methods are used for facial neuralgia, pain in the spine and legs and in case of isolated nerve pains in the arms. In the case of systematic pains or severe spasticity, the implantation of spinal cord stimulation (SCS) or analgesic pump, among other things, has prove its worth.
Treatment concepts for nerve disorders.
Neurosurgical treatment of peripheral nerve diseases includes nerve compressions, nerve injuries and nerve tumours. The most frequently occurring are nerve compressions due to bottlenecks in the hand (carpal tunnel syndrome, Loge de Guyon), the arm (e.g. sulcus ulnaris syndrome) and the leg (nervus peronaeus, tarsal tunnel syndrome). In the case of nerve injuries, micro-surgical nerve sutures or nerve replacement with the transfer of nerves from other parts of the body are necessary. Nerve tumours can occur in the skull (e.g. acoustic neurinoma) or in peripheral nerves. The art of removal lies in the most gentle, sparing procedure in order to avoid additional nerve damage.
Neuroradiology treatment concepts.
Neuroradiology includes the instrumental diagnosis of the central nervous system with brain and spinal cord, brain vessels, spine and invertebral discs. State-of-the-art computer-aided imaging techniques are used to examine the skull, brain, the individual sections of the spine and the vertebral discs to track down diseased processes. Navigational planning methods can be used to precisely localise tumours, haemorrhaging and other diseases. We use the following diagnostic methods:
- Computer tomography
- magnetic resonance tomography
- three-dimensional reconstructions of the brain, nerve and bone structures
- digital subtraction angiography (for illustrating the brain vessels)
- computer tomography in combination with contrast media (for examining the spinal canal for constrictions )
- Ultrasound and transcranial Doppler sonography
- Interventional Neuroradiology