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Details of surgery with different Neurological  conditions
& surgical Techniques

    Dr. Aadil Shaukat Chagla has Performed over 3000 neurosurgical Operations

    Microsurgical technique has been used where indicated.

    The surgeries performed have been classified as follows:

    Cranial :

    Supra-tentorial

    Tumours:

    Gliomas - lobar as well as deep seated (e.g. Thalamic)

    Meningiomas - Para-Sagittal, Convexity, Falx, Olfactory groove/ Planum Sphenoidal.

    Tuberculum sella, anterior and post clinoidal [97 cases]

    Intra-ventricular - Ependymomas, Choroid Plexus Papillomas

    Others - Metastasis, PNET, Lymphomas,

    Infections:

    Tuberculomas - lobar as well as deep seated (e.g. Thalamic)

    Abscess - otogenic, traumatic, systemic

    Subdural Empyema - inter-hemispheric, surface

    Hematomas:

    Spontaneous - hypertensive, AVM, tumors

    Traumatic - EDH,SDH, Intracerebral

    Brain biopsies

    Sellar/Supra-sellar

    Pituitary Adenoma:

    Transsphenoidal, Pterional approaches

    Craniopharyngioma [no. of cases 66]

    Pterional approach

    Hypothalamic/ Opto-Chiasmatic Glioma

    Pterional, Inter-hemispheric Transcallosal approaches


    Pineal Region

    Pineocytoma/Pineoblastoma

    Infra-tentorial supra-cerebellar approach

    Sub-occipital Trans-tentorial


    Infra-tentorial

    Cerebello-pontine Angle [over 200 cases]

    Acoustic Neurinomas - Retro-sigmoid approach [75 cases]

    Trigerninal Neurinomas - Retro-mastoid, Sub-temporal Trans-tentorial

    & combined ( Malis) approaches

    Meningiomas – Petrous, Petro clival, Retro-mastoid, Sub-temporal Trans-tentorial & combined approaches

    9th/ 10th Neurinomas - Retro-mastoid approach (included in CPangle)

    Others - Epidermoid, Hemangioblastoma,Exophitic Brainstern

    Midline and Retro-sigmoid approach


    Midline Posterior Fossa (Midline Sub-occipital Trans vermian approach)

    Medulloblastoma

    Cerebellar Astrocytoma

    Ependymoma

    Brainstem Glioma


    Lateral Cerebellar / Hemispheric lesions (Lateral Sub-occipital approach)

    Astrocytomas

    Metastasis

    Tuberculomas

    Abscess

    Hematomas


    Skull Base Surgery

    Foramen Magnum tumors (Far Lateral Transcondylar approach)

    Meningiomas

    Chordomas

    Neurofibromas


    Spheno-Petro-Clival Meningiomas / Glomus Jugulare

    Post auricular Infra temporal approach


    External Ear Malignancies

    Lateral Temporal bone resections


    Nasopharangeal Malignancies / Angiofibromas

    Pre auricular Infra temporal approach

    Anterior & Antero-lateral Craniolacial Resections

    Transsphenoidal / Transoral Transpalatal approaches


    Vascular Lesions

    Aneurysms (Clipping of Aneurysms) [ 250 cases]

    Anterior Circulation: A. Com., P. Com.; (Pterional), MCA (Pterional) ICA including Carotico-ophtalmic, Doral ICA, ICA bifurcation (Pteriona), (Orbitozygomatic), (drilling anterior clinoid) ,Pericallosal (Parasagittal )

    Posterior Circulation: PCA, (Orbitozygomatic)Basilar (Sub-temporal) ( Pterional), SCA, (Sub-temporal)
    (Pterional), (drilling posterior clinoid), PICA (Retrosigmoid)

    Arteriovenous Malformation (Excision) [ 40cases]

    Supra tentorial:

    Motor strip / Lateral and medial paratrigonal / perisylvian / Corpus Callosal / basifrontal, Parieto-occipital

    Infratentorial:

    Cerebellar: Hemisphric

    Vermian

    Dural Fistulae (assisted)


    Craniovertebral Anomalies

    Atlanto-axial Dislocation

    Posterior approach - wiring / graft, Hartshill / graft with or without excising posterior arch of Atlas

    Anterior approach - odontoid excision (assisted)

    Basilar Invagination

    Posterior approach - wiring / graft, Hartshill / graft with Foramen Magnum Decompression & excision of post. arch of Atlas

    Anterior approach - odontoid excision (assisted)

    Chiari Malformation / Syringohdromyelia

    Foramen Magnum Decompression / Duraplasty

    Syringo-peritoneal Shunt

    Miscellaneous

    CSF Rhinnorhea

    Anterior Fossa Floor Repair

    Transsphenoidal (assisted)

    Hydrocephalus

    Venticulo-peritoneal / Atrial Shun

    Theco-peritoneal Shunt

    Third Ventriculostomy (endoscopic)

    Arachnoid Cyst

    Excision

    Cysto-peritoneal Shunt

    Colloid Cysts

    Excision (transcallosal)

    Orbital tumors

    Lateral Orbitotomy / Anterior Orbitotomy

    SubFrontal approach (Dandy)

    Fronto Zygomatic Approach- Supero-lateral Orbitotomy (Maroon)


    Peripheral/ Crainal nerve surgery:

    Facial to hypoglossal anastomosis

    Cable grafting (sural graft)

    End to end/side repair (assisted)

    Brachial Plexus surgery (assisted)

    SPINAL:

    Tumours / Granulomas

    lntramedullary (midline Myelotomy)

    Astrocytomas

    Ependymomas

    Epidermoids/Dermoids

    Aspergilloma

    Lipoma

    Intradural

    Neurofibroma

    Meningioma

    Tuberculoma

    Arachnoid cysts (included)

    Lipoma

    Extradural

    Metastasis

    Tubercular Abscess / Granuloma

    Neurofibroma

    Hemangioma

    Lipoma


    Developmental Anomalies

    Meningomyeloceole / Meningoceole / Diastomatomyelia / Tethered cord

    Repair/Duraplasty, Detethering,cutting Filum Terminal,

    Excising bony spur

    Syringohydromyelia

    Syringoperitoneal Shunt

    Foramen Magnum Decompression with Duraplasty


    Degenerative disorders

    Disc

    Anterior Cervical Fusion - Smith Robinson, Cloward

    Trans-thoracic

    Microlumbar

    Laminectomy with discoidectomy

    Canal Stenosis

    Laminectomy

    Corpectomy (Cervical)

    Internal Decompression For Spinal Stenosis (IDSS)

    Instability

    cervical

    Anterior - Fusion with plating

    Posterior - Hartshill / Lateral mass screws (Roy Camille)

    Dorsal

    Anterior - Fusion with Plating

    Posterior - Hartshill / Steffi screws & plates

    Lumbar

    Anterior - ALIF with plating

    Posterior - PLIF with Steffi screws & plates / Hartshill



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