Brain and Nerve Surgery, Neurooncological Surgery (Brain Tumor surgeries), Neurovascular Surgery (Surgeries for cerebrovascular diseases), Spinal Surgery (Spine and Spinal Cord Surgery), Pediatric Neurosurgery (Pediatric Brain and Nerve Surgery), Epilepsy Surgery (Surgery for Epilepsy), Stereotactic and Functional Neurosurgery, Peripheral Nerve Surgery, Neurotrauma and General Neurosurgery and Radiosurgery.
Brain and nerve surgery, also known as neurosurgery, is the branch of medicine that provides surgical treatment of diseases involving the brain, spinal cord and nerves in the body. Physicians who perform these operations are called neurosurgeons.
Neurosurgery operations are procedures that require a high level of attention and precision, usually involve very detailed interventions, and are more risky than other surgeries. In addition, it is the surgical branch that is most intertwined with technological developments. While many diseases that required surgical operation in the brain and nervous system were considered fatal or incurable in the past, they have become treatable today in parallel with the technological advances and the medical developments every year. Especially in the field of Neurosurgery, neurosurgeons of our country have pioneered many developments at the international level and have a well-respected and leading position in the world.
Neurooncological surgery is the surgical removal of brain tumors. Today, the diagnosis and evaluation of brain tumors can be made at an advanced level thanks to advances in radiological imaging techniques such as high-resolution MR, tomography, PET, and functional imaging. The surgeries are performed with high success and low risk with the help of advanced surgical microscopes, endoscopes and sensitive microsurgical instruments that assist the surgeon. Techniques such as neuronavigation, intraoperative ultrasound, intraoperative MRI, brain mapping, neuromonitoring are available that show the location and boundaries of the tumor and provide a high level of protection of normal brain tissues in surgeries. Thanks to advanced technology, it is possible to distinguish the tumor from normal tissues by staining it with special tissue dyes during surgery.
Examples of diseases and methods that can be treated surgically;
Tumors of the brain itself or metastatic tumors
Meningioma (brain lining tumors)
Skull base tumors
Pituitary gland tumors
Cerebellum and brain stem tumors
Corner tumors – schwannoma
It is the field that includes the surgical treatment of cerebrovascular diseases. Work of an experienced team is required for the diagnosis and treatment of these diseases, which often present themselves with cerebral hemorrhage or stroke. Imaging tests such as CT-angiography, MR-angiography and cerebral angiography are of great importance in the diagnosis and evaluation of these diseases. Examples of diseases and surgical methods evaluated in the field of neurovascular surgery are;
Aneurysm (vascular bubble)
AVM (arteriovenous malformation) (brain vein ball)
Cerebral by-pass surgeries
Carotid endarterectomy (surgical opening of carotid artery stenosis)
Decompressive craniectomy (opening of the skull in stroke disease)
Spinal surgery is the field that deals with the surgical treatment of diseases in the neck, back, waist and coccyx region. It includes the surgical treatment of diseases such as spinal cord hernias, spinal canal stenosis, spinal misalignment, traumas, spinal fractures and dislocations, spine and spinal cord tumors, congenital curvatures or structural abnormalities of the spine. Specially designed technological means such as spinal surgery table, intraoperative tomography, C-arm scopy, neuronavigation, neuromonitorization, are used in such surgeries. Examples of diseases and operations in spinal surgery are given below.
Lumbar disc herniation (lumbar hernia) (microdiscectomy, screw surgeries)
Cervical disc herniation (neck hernia)
Thoracic disc herniation (back hernia)
Spondylolisthesis, spondylolysis (waist shift)
Spondylosis, narrow canal (spinal canal narrowing)
Spine and spinal cord tumors
Craniocervical junction diseases (Chiari disease – cerebellum prolapse, congenital deformities)
Kyphoplasty, vertebroplasty (Spine bone filling surgeries)
Scoliosis surgeries (Spine curvature correction surgeries)
Since the body structures and functioning of infant and pediatric patients are different from adults, their surgeries require different approaches. The field of neurosurgery that focuses on patients under the age of 18 is called Pediatric Neurosurgery. These patients are evaluated in the categories of premature, newborn, infant, child and adolescent according to their age. Each group has its own common diseases and surgical treatment approaches. In addition, close cooperation with the Neonatology and Pediatrics departments is required in the treatment of pediatric patients.
Examples of diseases and methods that are frequently treated surgically in the field of pediatric neurosurgery are;
Craniosynostosis (head deformity) surgeries
Spina bifida, meningocele, myelomeningocele surgeries (split spinal cord, congenital spinal cord, congenital external spinal cord)
Childhood brain and spinal cord tumors
Hydrocephalus (accumulation of cerebrospinal fluid in the brain)
Endoscopic ventriculostomy and tumor surgeries
Childhood spine diseases
Epilepsy is a group of diseases that affect a significant part of the population and can seriously limit daily functioning. Although there are different types, very good results can be obtained with surgical methods in suitable patients who do not respond to medical treatment. Deciding on which surgical treatment to follow in epilepsy usually takes place at the end of a long and detailed evaluation process, and in this process, advanced imaging techniques are used and the opinions of experienced neuroradiology specialists, evaluations of adult and pediatric neurologists specializing in epilepsy (Epileptology), evaluation of neuropsychiatric and social factors are obtained.
Examples of surgical methods and diseases applied in the field of epilepsy surgery:
Temporal lobe epilepsy surgery (amygdalohippocampectomy, temporal lobectomy)
Lesionectomy (DNET, Cortical dysplasia, low-grade glioma)
Hemispherotomy, functional hemispherectomy
Vagal nerve stimulation (Pulse generator)
Invasive deep and cortical EEG monitoring
Stereotactic surgery is a method that makes it possible to reach deep and sensitive structures in the brain with advanced geometric spatial calculation methods with minimal damage. In functional neurosurgery, surgical treatment of movement disorders such as Parkinson's Disease, tremor, dystonia, pain surgery, surgical treatment of some psychiatric diseases, spasticity surgery and surgical procedures to restore bodily functions are performed. It requires teamwork with departments such as Neurology, Physiotherapy and Rehabilitation, and Psychiatry. Some surgical methods and diseases applied in the field of Stereotactic and Functional Neurosurgery;
Brain Battery surgeries (Parkinson's disease, Dystonia, Tremor)
Trigeminal neuralgia surgeries (Radiofrequency, injections, microvascular decompression, Gamma Knife)
Baclofen pump implantation (Spasticity surgery)
Cordotomy, DREZ surgery (Reducing cancer pain)
Spinal cord stimulation (Pain pacemaker – Spinal cord pacemaker)
Percutaneous pain interventions (Epidural injection, denervation, RF)
Peripheral nerve surgery is the field of neurosurgery that deals with the diseases of the nerves in body parts other than the central nervous system that require surgical treatment. It includes surgical treatment of conditions such as various nerve compressions, nerve sheath tumors, nerve traumas. For example;
Carpal tunnel syndrome (Nerve compression in the wrist)
Ulnar nerve entrapment (Cubital tunnel syndrome) (Nerve compression at the elbow)
Malignant peripheral nerve sheath tumor
Brachial plexus injury
Nerve gunshot injury
The head and spine are frequently affected areas in accidents and other traumas. It is aimed to minimize risk of death and permanent damage with rapid and effective evaluation and intervention in trauma patients. Examples of this are as follows;
Epidural, subdural, intraparenchymal, intraventricular hematoma (Brain hemorrhages)
Spinal cord hemorrhages, injury
Increased intracranial pressure
Radiosurgery is a method of treating tumors or some non-tumor diseases by applying high-dose radiation to a certain point in the head, one or several times, without creating an operation scar. It is generally preferred in the treatment of lesions that do not exceed certain dimensions and are considered risky for open surgery. Diseases that can be treated with radiosurgery;
Vestibular schwannoma (Corner tumor)
AVM (Arteriovenous malformation) (Glomerulus)
The emphasis on prominent changes to the aesthetics of the body alone is not enough to define this specialty. Its full definition will be plastic and reconstructive surgery. It is the surgery to correct all congenital or acquired deformities and dysfunctions including facial deformities, asymmetries, congenital masses, rare facial clefts, cleft lip and palate, popularly known as rabbit lip, wolf mouth, mouth, face and jaw surgery, deformities of jaw and facial bones, nasal defects (tumors, ruptures), salivary gland problems, all congenital tumors, moles, vascular diseases, bone and soft tissue injuries of the face and their resulting disorders, head and neck tumors, absence of the breast, asymmetry or excess breasts, replacing the lost breast after cancer, congenital anomalies of the breast and genital organs, repairs of genital organs, suturing of ruptured organs, chest and abdominal wall defects, hand surgery, deficiencies in the hand and foot, deformities and nerve problems in the arm and leg, tumors of the skin and soft tissue, treatment of all defects and disorders that occur during and after the treatment of burns, radiation-related wounds or wounds in the skin and subcutaneous region due to other effects, non-healing pressure sores or venous insufficiency, and foot wounds due to diabetes fall into the field of this expertise.