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Second Opinion in Neuro Surgery and Spine surgery in India

What is Neuro Surgery?

Neurological Surgery is a discipline of medicine, and that specialty of surgery which provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the Central, Peripheral, and Autonomic Nervous Systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the Nervous System, including the Pituitary Gland; and the operative and non-operative management of Pain.
second opinion in neuro surgery india
We all know how distressing and frightening it can be, when we get a diagnosis that requires brain surgery.  Getting a second opinion is always a good idea as there are many advanced imaging techniques and minimally invasive procedures available today, and any patient would be benefitted to get a second opinion from another neurosurgeon.It saves a lot of heartache and headache later on.
Our Neuro surgeons are trained and working in reputed training centres and hospitals in India and abroad. They bring together years of reputation in this field. Taking a second opinion never offends your first surgeon and it is always for your own benefit in order to take a well informed decision before embarking on a surgical journey.
Resources available with  Second Opinion programme for remote consultation include: Online top neurologists, online neurosurgical consultation and online neuro-oncology consultation. Now you can speak to top neurologists & top neurosurgeons online and get neurologist or neuro surgeon consultation from the comfort of your home and in complete privacy.
Regardless of your condition, you can now access renowned super-specialists at Surgery second opinion  for online Second Opinion consultation from anywhere in the world. We have an excellent pool of  trusted expert neuro surgeons with advanced technology to deliver Gold Standard neuro and spine care 24/7. Our  Second Opinion programme gives you easy online access to its eminent doctors, helping you take the best possible decisions for your illness. So, if you have been diagnosed with a serious brain disease and wish to consult a world leading expert before deciding on a difficult course of treatment, including surgery, then consider our Second Opinion programme. It assures you valuable guidance and peace of mind.
SECOND OPINION IN NEURO SURGERY MEDANTA DR ANIRBAN DEEP BANERJEE

Dr. Anirban Deep Banerjee

MBBS, MCh - Neuro Surgery, Fellowship in skull base neuro surgery
Senior Consultant Neurosurgeon, Dept of Neurosurgery and spine -Medanta Medicity Hospital- Delhi -NCR
Dr.-Manish-Vaish

Dr. Manish Vaish

MBBS, DNB - Neuro Surgery, Fellow of American Association of Neurological Surgeons
Director Neuro surgical sciences at Max Super Specialty HospitaL
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Dr. Pranav Kumar

MBBS, MS, MCh - Neuro Surgery,
Senior Consultant Neurosurgeon at Apollo Hospital, Delhi -NCR
dr-rahul-gupta-neurosurgeon

Dr. Rahul Gupta

MBBS, MS - General Surgery, MCh - Neuro Surgery
Senior Consultant Neurosurgeon - Brain and Spine surgeon at Fortis hospital, Noida
dr-ajay-nanda-jha-neurology-neurosurgery-medanta

Dr A N JHA

MBBS, MS , Surgical Neurology (UK), FRCS from Royal College of Surgeons, Edinburgh
Chairman at Institute of Neurosciences Medanta Hospital, Gurgaon/Gurugram

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46811565006639

Dr Joy Varghese

MBBS, MS, MCh., FMVS., FSS., FINR.
Senior Consultant Neurosurgeon in Apollo Hospital, Chennai
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Dr.Krishna Prabhu

MBBS, MCh - Neuro Surgery, Fellowship (Seoul) spine surgery
Professor of Neurosurgery and spine surgery, CMC Vellore
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Srinivasan Paramasivam

MBBS, MCh - Neuro Surgery,MRCS, Fellowship
Senior Consultant Neurosurgeon at Apollo Hospital, Chennai
second opinion in neuro surgery dr vijay iyer

Dr. Vijay Iyer

MBBS, MS - General Surgery, MCh - Neuro Surgery
Senior Consultant Neurosurgeon, Fortis Hospitals, Chennai
second opinion in neuro surgery aiims Dr Deepak Agrawal

Dr Deepak Agarwal

MBBS,MS,MCH Neurosurgery
Additional Prof. Neurosurgery and Gamma -Knife, JPNATC ALL INDIA INSTITUTE OF MEDICAL SCIENCES, , NEW DELHI.
What is Neurological Surgery?

Neurological Surgery is a discipline of medicine, and that specialty of surgery which provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the Central, Peripheral, and Autonomic Nervous Systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the Nervous System, including the Pituitary Gland; and the operative and non-operative management of Pain.
 
Neurological Surgery encompasses the treatment of adult and pediatric patients with disorders of the entire Nervous System. This includes disorders of the Brain, Meninges (the covering of the brain and spinal cord); disorders of the Skull; disorders of the Blood Supply to the Brain (including the Extracranial Carotid and Vertebral Arteries); disorders of the Pituitary Gland; disorders of the Spinal Cord and Vertebral Column (including those which may require treatment by spinal fusion or instrumentation) and disorders of the Cranial and Spinal Nerves throughout their distribution.
A Neurosurgeon is a medical doctor who has received extensive training in the surgical and medical management of neurological diseases. The field of Neurosurgery is one of the most sophisticated surgical specialties and encompasses advanced surgical, imaging (CT and MRI scanning) and interventional technologies.

Not all Neurosurgeons are engaged in every aspect of the broad field that encompasses Neurological Surgery. There are different levels of expertise required for some special interest areas such as is involved with Skull Base Tumor Surgery, Minimally Invasive and Microendoscopic Surgery, the surgical treatment of Pituitary Tumors and Acoustic Neuromas, Intracranial Vascular conditions requiring Microvascular Neurosurgical techniques, Pediatric Neurosurgery, Radiosurgery and several others.for Coronary Arteries). In other circumstances reconstruction of the blood supply to the Brain may be appropriate either by creating an entirely “new” vessel using a “bypass” technique (commonly referred to as Extracranial-Intracranial Bypass Graft (or EC-IC-) or more rarely by directly removing a focal stenosis from within an intracranial vessel ( a procedure called “endarterectomy”.)

The incidence of Subarachnoid Hemorrhage (bleeding covering the surface of the brain) is 10 per 100,000 persons per year. The most frequent cause of spontaneous Subarachnoid Hemorrhage is rupture of an Intracranial Aneurysm. The symptoms of Subarachnoid Hemorrhage are characterized by a sudden onset of severe headache that worsens over time, and includes nausea, loss of consciousness (with or without seizure) and vomiting. Depending on the extent of the bleed, symptoms of Subarachnoid Hemorrhage can also include visual sensitivity to light (photophobia), a stiff neck, and low grade fever. Symptoms before rupture of the Aneurysm occur in 40% of persons and are usually due to minor subarachnoid hemorrhage. These symptoms can also include headache or dizziness, and tend to go unnoticed. Sudden onset of double vision may occur as an aneurysm expands and injures a nerve inside the skull that controls eye muscles.
Due to its size and location, the symptoms and neurological signs can include visual impairment and/or double vision and epilepsy.

Approximately 30% of Subarachnoid Hemorrhages occur during sleep. Smoking is a major factor in increasing the odds of sustaining a Subarachnoid Hemorrhage. After a Subarachnoid Hemorrhage, most patients are hypertensive and experience changes in cardiac rate and rhythm. CT scans are the best initial diagnostic tool for evaluating patients suspected of having suffered a Subarachnoid Hemorrhage. CT scans can be positive in 90% of patients within the first 24 hours and in more than 50% in the first week after the hemorrhage has occurred. Spinal taps to sample the Cerebrospinal Fluid (CSF) may be required to evaluate some patients who are suspected of having had a Subarachnoid Hemorrhage.A spontaneous, Intracerebral (ICH) Hemorrhage is a blood clot within the substance of the Brain tissue that usually occurs abruptly. It is strongly correlated with hypertension. There are approximately 40,000 new cases in the United States annually. Stroke is the third leading cause of death in the United States, and ICH accounts for 10% of all stroke cases. Advancing age is a major predisposing factor for ICH: The incidence of ICH is two per 1,000 persons per year by age 45 and 350 per 100,000 persons per year for those aged 80 years or more. Hypertensive Intracerebral Hemorrhage can occur in different areas within the Brain with damage to some areas being associated with a very high death rate.

Tumors of the Nervous System: There are disease processes which, if left untreated, can threaten the Brain, its ability to function and life itself. These conditions include mass lesions such as Brain Tumors and Brain Abscess which exert undue pressure on the Brain causing damage as the pressure inside the skull rises.

Tumors that affect the Central Nervous System (CNS-Brain & Spinal Cord) include Benign (non-cancerous) and Malignant varieties; Primary Tumors (those which arise from Brain or Spinal Cord cells); Secondary or Metastatic Tumors (those cancers which spread from some other region to the Brain and/or Spinal Cord); Tumors of the Skull and/or Spine (Primary or Secondary Tumors involving the Bone that surrounds and protects the CNS); Tumors of the Peripheral Nervous System (nerves that lie outside the Brain and Spinal Cord which course throughout the body); and tumors of the Autonomic Nervous System (nerves that help control basic bodily functions).

The incidence of Primary Intracranial Tumors is 11.5 per 100,000 accounting for approximately 35,000 persons per year in the USA. One of the most common types of tumors is the Glioma, which accounts for 50% of all Primary Brain Tumors.Approximately 250,000 persons in the USA are affected by secondary (also called Metastatic) intracranial tumors each year.
A tumor in the Brain can become apparent when there is an increase in the pressure inside the skull (known as intracranial pressure or ICP) or when the tumor grows and compresses particular parts of the Brain. Slowly growing Brain Tumors may not become apparent clinically for many years since the Brain is compressible and may tolerate that compression quite well. Once the Brain can no longer tolerate any added mass, symptoms begin to appear. Once this happens it is actually quite late in the course of this disease process. Common symptoms associated with compression of the Brain can include nausea, vomiting, headache that is worse in the morning, blurred or double vision, drowsiness and a reduced level of consciousness. Tumors causing focal compression on or irritation of the Brain may cause seizures (epilepsy) and/or result in impairment of some neurological function (such as becoming weak in a hand, arm foot or leg.) Other symptoms of progressive loss of neurological function can manifest as diminished hearing and ringing in the ears (tinnitus), difficulty with language (aphasia) or balance problems (dysequilibrium).

Technical improvements combined with medical and anesthetic advancements have made surgical removal of Brain tumors much safer and more effective. Perhaps some of the most remarkable examples have occurred in the treatment of Skull Base Tumors.
There are some malignant tumors that are very sensitive to chemotherapy or radiation therapy such as Lymphoma and Germinoma. In these cases, surgery may not be warranted.

Degenerative Diseases of the Spine: Degenerative and Herniated Disc disease, Spinal Stenosis (narrowing of the Spinal Canal) and instability of the Spinal Column may cause compression and injury to the Spinal Cord and/or spinal nerves resulting in neurological deficits and pain. All of these are treated by Neurological Surgeons.Degenerative disorders of the spine are a common problem. Between 50% and 90% of the population will experience back pain at some point in their lifetime. Most of these back pain symptoms subside on their own within a few weeks. However, the cost to our society in decreased productivity and lost wages constitutes a significant public health problem. Lower back pain (in the lumbar spine) is one of the most common reason adults seek medical attention and is among the most frequent reasons for referral to a Neurosurgeon. The lumbar spine, in particular, withstands a considerable load as it supports the weight of the entire Spinal Column.

The discs that lie between the vertebral bones act as shock absorbers. Cervical (neck) and Lumbar (lower back) discs are very prone to herniation and drying out (desiccation) as a result of the load they bear and the motion to which they are subjected. Degeneration of the discs may change bony structures in a way that results in the formation of bone spurs (osteophytes) which then causes nerve compression as those nerves leave the spinal canal. Typically, individuals with degenerative disorders of the spine experience pain, numbness, tingling (paresthesia), weakness in an extremity and restriction of movement of the Lumbar or Cervical regions.

Congenital Abnormalities: Failures during Embryonic development can result in the abnormal formation of the Brain, Skull, Spinal Cord and Spinal Column either alone or in combination. Important changes in growth and chemistry occur during the second week of gestation of the human embryo which contributes to the development of the nervous system. Several different types of cells proliferate as they move together or separate into other structures according to an orchestrated, natural time clock. Errors that result in Developmental Defects can occur at different stages of embryonic development. These conditions may be severe and obvious at or before birth, or quite subtle and not manifest themselves until later in life.

Pain: There are Nervous System Diseases that cause severe and debilitating pain. Among these are Trigeminal and GlossopharyngealNeuralgias. Pain conditions of this magnitude are often first treated with medications such as anticonvulsant drugs. For many patients this may require life-long drug therapy. Oftentimes the medication either fails to continue to be effective or creates disagreeable or intolerable side effects. In these latter circumstances there are Neurosurgical procedures that can be very effective in relieving these conditions.
There are many other pain conditions that may be successfully managed by Neurosurgical procedures among which a considerable number are related to Spine Disease.

Traumatic Head or Spine Injury: These are conditions caused by accidents or assaults. Accidents that result in head injury are a major public health problem. Trauma causes approximately 150,000 deaths annually in the United States; approximately half of these deaths are caused by fatal head trauma. Additionally, there are 10,000 new Spinal Cord injuries annually. The cost of disability (e.g., chronic long-term care, lost wages and work) is very high. Approximately 200,000 persons in the United States are living with disabilities consequent to Head and Spinal Cord trauma.

  • Spine Trauma: Injuries to the Cervical, Thoracic and/or Lumbar Spine may result in injury to the Spinal Cord and/or Nerve Roots or could be related ONLY TO THE STRUCTURAL SUPPORT MECHANISM. In any of these cases, Neurosurgical consultation is appropriate.
  • Head Trauma: Severe head injury is defined as an injury that produces coma.

These patients will not open their eyes even to painful stimulus, are incapable of following simple commands and are unable to speak. These clinical criteria are defined within a system known as the Glasgow Coma Scale (GCS). A neurological assessment by a trained physician and Brain scan imaging (CT scan) is necessary for the initial evaluation. Neurosurgeons are often involved in the managementof these patients either directly or as consultants. There are times when surgical intervention is required such as when the skull bones have been fractured and driven into the brain (a depressed skull fracture), when there is a large blood clot that can cause progressive Brain injury or when a special catheter to monitor intracranial pressure (due to Brain swelling) is inserted.

Functional and Stereotactic Neurosurgery: This special interest area involves the surgical treatments for Movement Disorders (such as occurs with Parkinsonism); Epilepsy; some Pain conditions; and Radiosurgery (the special field of radiation therapy using stereotactic radiation equipment.)
Stereotactic Neurosurgery makes use of a coordinate system that provides accurate “navigation” to a specific point or region in the Brain. There are two main types of these systems. One involves placing a frame onto the head (using four threaded pins that penetrate the outer skull to stabilize the frame in position) under local anesthesia. Once the frame is in position, a special box and stereotactic arc are placed to precisely determine X, Y, and Z coordinates of any point within the frame.
The other technique, called “Frameless Stereotactic Surgery”, uses different technology that is based upon concepts similar to a “Global Positioning System”, except in this case the systems are either optically or magnetically based rather than using “satellites in the sky”.

Epilepsy (seizures) is a serious health problem for which approximately 70 per 100,000 people in the United States take antiepileptic medications. The risk of developing epilepsy over a lifetime is 3%, and there are 100,000 new cases per year. The majority of cases (approximately 60,000) involve the Temporal Lobe portion of the Brain. Approximately 25% of patients prescribed antiepileptic drugs for Temporal Lobe seizures are not adequately controlled or the side effects of the drug are far too great and outweigh the therapeutic benefits. It is estimated that 5,000 new cases of epilepsy per year require epilepsy surgery. In the case of Temporal Lobe Epilepsy this consists of removing the front part of the Temporal Lobe (a Partial Anterior Temporal Lobectomy.) Surgery may be appropriate if frequent seizures cause injuries due to repeated falls; driving restrictions; limitation of social interactions; problems related to education and learning; and employment limitations.

SECOND OPINION ONLINE DOCTOR
Medical Second Opinion surgery India online
contact us for second opinion

Our Expert Surgeons can provide second opinions on a wide range of brain conditions, including but not limited to –

Surgical consultation and Medical second opinion for Acoustic neuromas

Surgical consultation and Medical second opinion for Trigeminal Neuralgia .

Surgical consultation and Medical second opinion for Aneurysms

Surgical consultation and second opinions for Brain tumours .

Surgical consultation and Medical second opinion for Colloid cysts .

Surgical consultation and Medical second opinion for Epilepsy .

Surgical consultation and Medical second opinion for hemiplegia .

Surgical consultation and Medical second opinion for AVMs .

Surgical consultation and Medical second opinion for Hemi facial spasms .

Surgical consultation and Medical second opinion for Parkinson’s Disease .

Surgical consultation and Medical second opinion for spine , disc prolapse ,backache neck pain, Acoustic neuroma, Brain Aneurysm, Arteriovenous malformations (AVMs), Brain tumour, Cerebrovascular surgery/vascular problems, Carotid artery disease/stenosis, Deep brain stimulation (DBS), Neurologic ailment (dizziness, headaches, vertigo, etc), Pituitary tumours, Seizures/Epilepsy, Spine conditions, Spinal cord tumours, Spine tumour.

01. Organization !

We are a group of surgeons from different surgical specialities and not a intermediate/ middleman medical website company just in the business of giving second opinion.

02. Our principles !

We want to re-establish the dwindling lack of trust between the doctors and patients with our honest second opinion.

03. No financial expectation bias !

For your second opinion, We choose surgeons who practice in a city away from your place, so they won’t have any expectation that you would be coming to them for surgery – so no bias of financial expectation

04. We are not a Hospital !

Lot of Hospitals give second opinion. Their opinion cannot be unbiased as they would definitely be benefited if they advise surgery and they would expect you to be coming to them as patients. Whereas we are not a hospital.

05. Surgeons preferred by other doctors !

We choose the surgical panel team very carefully –after taking suggestion from other fellow doctors as to whom they would prefer if someone of their own family requires a surgery.

When is it necessary to take a second opinion in neurosurgery ?

  • Second opinion in neuro surgery is important when your doctor doesn’t have the required specialist knowledge for your condition.
  • Second opinion in neuro surgery is important when different surgeons have given you different recommendations and you are not able to make a decision.
  • Second opinion in neuro surgery is important when you haven’t received a clear diagnosis or therapy recommendation.
  • Second opinion in neuro surgery is important when your doctor has recommended a major operation .
  • Second opinion in neuro surgery is important when you feel that you haven’t been given enough information about your planned treatment.
  • Second opinion in neuro surgery is important when the suggested treatment promises no significant improvement to your condition.
  • Second opinion in neuro surgery is important when you want to find out if there are other treatment options you can pursue.
Some common Neurosurgical second opinions are sought for :
  • Acoustic neuromas
  • Aneurysms
  • Arteriovenous malformations (AVMs)
  • Brain tumors
  • Carotid artery stenosis and surgical options
  • Cerebrovascular surgery
  • Deep brain stimulation (DBS)
  • Hydrocephalus
  • Neurocognitive conditions
  • Pediatric neurologic conditions
  • Peripheral nerve conditions and neurostimulators
  • Pituitary tumors
  • Skull Base Tumors
  • Stroke (hemorrhagic or ischemic)
  • Spine surgery and other spine conditions (acute or chronic)
  • Spinal tumors
  • Traumatic injuries (to the brain or spine)
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