Department Introduction

Neurosurgery | Our Speciality

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Excellence

Medical Services
Brain Strokes

There are 43 team physicians and specialists in the Center for Brain Stroke at China Medical University, of which 32 are stroke-specific physicians. The Brain Stroke Center of China Medical University is divided into five divisions (Brain Stroke, Radiology, Rehabilitation, Cerebrovascular Surgery and Traditional Chinese Medicine).

On average, about 1,300-1,500 new stroke patients are hospitalized each year, and that is 110 to 130 cases a month on average. The mortality rate from Brain Strokes was 2.9% before the Brain Stroke Center of China Medical University was established and merely 1.04% after its establishment.

With the endoscopic minimally invasive surgical removal, the complications of traditional surgery, surgical bleeding, and surgical time can be reduced by one year. The surgery can double the neurological prognosis (GOS) index, and about 3% of patients can receive thrombolytic therapy Within 3 hours after the stroke, and the rate is comparable to the standard rate around the world. The main reason is that the brain stroke center can actively collaborate with the team after its establishment within 25 minutes to complete  all brain tests, radiological tests and cerebrovascular tests.

In addition, the affiliated hospital of China Medical University has developed a unique brain stroke bleeding index that can be used to quickly and easily determine if the patient needs a surgery. And recently, the  brain stroke bleeding index has been accepted by the Medical Journal of “Critical Care Medicine” of the American Society of Intensive Care and has been reported to the American Association of Neurological Surgeons.

We offer a full range of cocktail-style stroke treatment tailored to meet the specific stroke types. Based on the time when the stroke occurs, we offer integrated  treatment to reduce the rate of mortality and disability. Our treatment include many features such as endoscopic minimally invasive hematoma removal, cerebral temperature and oxygen monitoring, hypothermia, cerebrovascular embolization, stem cells and Chinese medicine treatment.

Special type of brain strokes

Microsurgery can be adopted for removal, resection and embolism of ruptured cerebral aneurysms and cerebral arterial malformations. Even arteriovenous malformations can also be removed with the gamma knife. In order to reduce the damage after nerve infarction, Erythropoietin can be administered in the early stage to stimulate the body's stem cells to enter and repair the brain.

We purchased many advanced surgical microscopes, so that when we injected  indocyanion green, we could observe the removal of the  aneurysm under the microscope.

Brain endoscopic surgery

Endoscopic surgery is a minimally invasive surgery, which is different from the traditional craniotomy. In addition to reducing the surgical wound, shortening the operation time and reducing the complications of the operation, the endoscopic surgery also provides the opportunity for more neurological preservation and repair.

In 2002, the department began to use endoscopic treatment of hemorrhagic stroke patients. So far, there have been more than 200 cases in our clinical experience, and many papers have been published in foreign journals or international medical conferences to gain recognition from  international experts in neurosurgery.

In 2006, Dr. Zhou Deyang developed the minimally invasive spinal surgery (Marmot Surgery), which was published in the journal of American Society of Neurosurgeons (AANS) and annual conferences.

Spinal Fusion Surgery and Non-Fusion Spinal Surgery

The spinal surgery can be roughly divided into two categories: the fusion surgery and the non-fusion surgery.

The Fusion Surgery is a surgical procedure that involves implanting a fusion or bone plate fixation after all the discs have been removed. Such surgery is mainly done when the spine is unstable. With a strong and firm fusion, it can maintain the stability of the spine, and thus achieve the purpose of treatment.

The spinal fusion surgery is suitable for most cervical degenerative diseases, spinal scoliosis, spondylolisthesis or severe disc degeneration resulting in discogenic pain.

With advances in biomechanics and medical engineering, many devices have been developed. The basic idea of this type of surgery is to hope to maintain more vertebral activity angles and reduce premature degeneration of adjacent segments.

Our physicians will choose the appropriate surgery based on your conditions.

Minimally invasive cortical bone screws

Dr. Huang Xiang-Ming studied abroad and introduced the micro-incision lumbar fusion. After six months, more than 40 patients aged between 20 and 90 with lumbar degenerative diseases have received treatment. Besides, the micro-incision lumbar fusion is also suitable for obesity and osteoporosis patients. It can not only reduce pressure caused by the traditional spinal surgery, but also reduce the size of the wound to that of a 10-dollar coin, which is even smaller than that from the minimally invasive surgery. Plus, it also shortens the time required for full recovery.

Stubborn epilepsy surgery

According to statistics, the incidence of epilepsy accounted for about 0.5% -1% of the total population, and at least one in five patients cannot get good control with drugs. These patients may die owing to the whole-body seizures, and thus the epilepsy surgery has become the hope for patients with stubborn epilepsy.

The indications for the surgery are set out as follows: 1) The patient must not be able to effectively control the seizures under the appropriate medication and the seizure significantly affects the daily life. 2) It must be possible to find epilepsy lesions  in the patient's brain. 3) The surgical removal of the lesion does not cause serious neurological damage to the patient.

The success rate after surgery is closely related to the number and locations of the epileptic lesions. Taking the most common unilateral temporal lobe lesions as an example, the rate of complete absence of epilepsy after the temporal lobe resection can be as high as 80% or more. However, if the patient has other lesions besides the temporal lobe lesions, then the rate of complete absence of epilepsy may be only 50%.

In line with the establishment of the Neurology Medical Center in our hospital, the hospital has successively acquired a new brainwave monitoring system, a high-resolution MRI scanner and positron emission tomography equipment to develop the epilepsy surgery in hope of benefiting epilepsy patients in Taiwan.

3D stereotactic radiosurgery (Gamma Knife)

The so-called 3D space stereotactic radiosurgery (stereotactic radiosurgery) is the use of 3D spatial positioning system in a single high-dose radiotherapy for small intracranial lesions. This technology can give high doses to be the parts intended for treatment, and thus it can relatively reduce harm to the surrounding normal brain tissues.

Since 1970, the 3D stereotactic gamma knife surgery has proven effective in the treatment of arteriovenous malformations (AVMs).

The gamma knife can also be used in treatment of benign brain tumors (acoustic neuroma, craniopharyngioma, pineal tumor, meningioma and pituitary adenoma, etc.), primary or metastatic malignant brain tumors, neurological diseases (trigeminal nerve pain, epilepsy, uncontrolled movement, neuroticism with stubbornness in medicine) or even in the treatment of recurrent nasopharyngeal carcinoma after radical radiotherapy.

 

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