Neuroimaging & Interventions:
Diagnostic imaging and interpretation of disorders of brain, spine, head and neck in adult and children using the conventional and advanced imaging techniques. Advanced imaging techniques available include perfusion imaging (T1 and T2* perfusion), noncontract perfusion imaging (Arterial spin labelling), Magnetic resonance spectroscopy, intracranial vessel wall imaging and functional MRI.
- Multiparametric tumor imaging is performed using various advanced imaging techniques in diagnosis and post treatment follow up of brain tumors.
- Intracranial vessel wall imaging is high resolution imaging of the blood vessels of the brain to diagnose the diseases involving these vessels like inflammation, infection, atherosclerotic disease, dissection and vasculopathy
- Functional MRI: Imaging technique used prior to surgery in patients with brain tumors and epilepsy to localize and lateralize functional areas of the brain and its relation to the tumor or site of surgery.
- Dynamic CT myelography/ MR Myelography: Investigation performed to localize the site of spinal CSF leak in patients with intracranial hypotension.
- CT Cisternogram: Investigation performed to localize the site of intracranial CSF leak in patients with intracranial hypotension.
Interventional Neuroradiology (Endovascular Neurosurgery):
Overview: Minimally-invasive endovascular procedures performed through a small hole in the groin (femoral vessels) or wrist (radial artery) to diagnose and treat a wide range of cerebrovascular disorders (involving the brain, head, neck, spine and spinal cord regions). Enlisted below are the range of diagnostic and interventional procedures which we perform.
- Cerebral angiogram is a technique where in x- ray images of the brain are obtained after injection of contrast in the arteries supplying the brain to diagnose cerebrovascular diseases like block, narrowing or tear in the blood vessels, arterial aneurysms and vascular malformations.
- Spinal angiogram is similar to the cerebral angiogram, here the images of the spinal cord are obtained after injection of the contrast to diagnose vascular diseases of the spinal column and spinal cord.
- Stroke therapy includes emergency endovascular mechanical thrombectomy preformed in patients presenting with acute stroke or weakness of one half of the body due to clot blocking the blood vessels supplying the brain. Here using various endovascular devices the clot can be pulled out and the blood flow to the brain can be established.
- Endovascular Aneurysm management: Aneurysms are focal bulge in the wall of the artery. Patients with aneurysm can present with severe head ache and loss of consciousness, when it ruptures and bleeds intracranially or can present with symptoms caused by compression on the important structures in the brain due to the size. These can be treated endovascularly using coils and stent achieving completely obliteration of these aneurysms and preventing further events of bleeding.
- Angioplasty and stenting of neck and intracranial vessels involves restoring the caliber of the narrowed blood vessels supplying the brain using stents or balloons to improve the blood supply to the brain.
- Arteriovenous malformation Embolisation of brain and spine. Arteriovenous malformations are abnormal connections between the arteries and veins which can presents with various symptoms due to bleeding, increased pressure in the blood vessels and compression of the adjacent structures. These can be treated endovascularly by blocking the connections using embolic agents.
- Thrombectomy in cerebral venous sinus thrombosis involves mechanical aspiration or chemical lysis of the thrombus in the veins of the brain.
- Tumor Embolisation: Pre-operative tumor embolization is performed in tumors of the head, neck, brain and spine to reduce the bleeding from these tumor during surgery.
- Embolisation of bleeders: Endovascular treatment of bleeders in head, neck and spine caused by tear or damage to the blood vessels dur to trauma, infection or tumor.
- Digital subtraction myelography(DSM): Diagnostic test to detect CSF leak in patients with intracranial hypotension.
- Venous sampling from inferior petrosal sinus – for pituitary diseases
Image guided intervention in head neck and spine:
- Biopsies of soft tissue/bone tumors and lymphnodes in the skull base, neck and face
- Biopsies of vertebral lesions, intervertebral disc lesions and paravertebral soft tissue lesions.
- Pain management:
- Transforaminal nerve block, intercostal nerve block and epidural steroid injections. These are minimally invasive techniques for reduction of pain caused by irritation of the nerves due to degenerative disease or tumors.
- Facet joint steroid injection: Pain relief measure in patients with severe degenerative facet joint arthropathy.
- Radiofrequency Ablation for Trigeminal Neuralgia: Percutaneous day care procedure performed to relieve pain in patients with trigeminal neuralgia
- Epidural blood patch: Treatment for patient with intracranial hypotension caused due to CSF leak in the spinal cord.
- Vertebroplasty for benign and pathological compression fractures: Procedure performed to strengthen the vertebral body with cements in patient with fracture of the vertebral body.
- Alcohol ablation of vertebral hemangioma