Neurology and Neurosurgery

Departments of Neurology and Neurosurgery at ACIBADEM Hospitals in Turkey provide advanced treatment options for brain, spine, and nervous system disorders.

What is Neurology?

Neurology is a medical branch dealing with various disorders of the nervous system. These may affect the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves extending to all body parts). It is considered that 1 in 6 people are affected by neurologic disorders. A doctor specialized in neurological diseases is called a neurologist. Neurologic specialists are trained to diagnose and treat conditions such as migraine, stroke, epilepsy, nerve injuries, hydrocephalus, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, brain tumors, spinal cord tumors, and many others. Diagnosis and treatment of neurological disorders often require the expertise of various medical specialists. Comprehensive neurology centers like ACIBADEM can offer a multidisciplinary approach, with specialists in neurology, radiology, interventional radiology, oncology, orthopedics, physical therapy, and neurosurgery, all in one place.

What is Neurosurgery?

Neurological surgery, or neurosurgery for short, involves the operative treatment of neurologic conditions. While neurology specialists can use medicines and non-operative procedures, neurosurgeons can provide both surgical and nonsurgical solutions. İn advanced neurology clinics, neurosurgeons are often supported by hi-tech devices for intraoperative visualization and neuroimaging to improve success rates and patient safety.

Symptoms of neurologic disorders

There are more than 600 neurological disorders that may present with various signs and symptoms. Speech, movements, breathing, or mental abilities might be affected, depending on the particular condition and the body parts it involves. However, the most common symptoms of nervous system diseases include:

• Persistent or severe headache
• Unprovoked seizures or tremors
• Language impairment or slurred speech
• Movement disorder, slow or clumsy movements, ataxia
• Muscle rigidity, weakness, or loss of strength
• Back pain radiating to the feet, toes, or other body parts
• Lost, blurred, or double vision
• Numbness or tingling in any body part
• Unexplained nausea or vomiting
• Memory loss, confusion, and impaired cognitive abilities

• Balance problem or lack of coordination
• Changes in behavior, having difficulties with daily activities

These symptoms could also indicate other conditions but if you experience any of them, consult a doctor without delay. A neurological exam and further tests can help for timely diagnosis. 

Neurological Conditions

Neurologic disorders may be caused by various reasons, such as brain injury or spine injury, faulty genes (Huntington’s disease), infections (meningitis), or degenerative changes (Alzheimer’s disease). Some of them are common (migraine), while others are rare (Guillain-Barre syndrome). Here are some conditions often treated at ACIBADEM:

Brain Tumors

They can begin in the brain itself (primary brain tumor) or migrate from cancer located elsewhere in the body (secondary brain tumor). Primary brain tumors are usually named after the type of cells involved: gliomas, meningiomas, acoustic neuromas, pituitary adenomas, etc. There are over 120 brain tumor types, and not all of them are cancerous. They are classified in 1-4 grades, depending on how much the tumor cells differ from the normal ones. Grade 1 and 2 are noncancerous, while grade 3 and 4 tumors are malignant.

• Benign brain tumors. They usually grow slowly and do not spread to other areas. However, benign brain tumors can also cause symptoms by pressing surrounding tissues. Meningioma is the most common type of brain tumor and it is benign in most cases. Craniopharyngiomas, schwannomas, craniopharyngiomas, hemangioblastomas, and low-grade gliomas are other examples of noncancerous tumors. Though rarely, some benign tumors can turn into malignant.
• Malignant brain tumors. They are likely to grow rapidly and spread. Astrocytomas, oligodendrogliomas, glioblastomas are common types of malignant brain tumors. Glioblastoma multiforme is a fast-growing and aggressive type that infiltrates surrounding areas. 
• Pituitary tumors. They originate from the pituitary gland which is responsible for releasing hormones into the body. Pituitary tumors are classified as benign pituitary adenomas and malignant pituitary carcinomas.

Brain tumor symptoms are similar in all types. The most common symptom is a headache caused by increased intracranial pressure. Vomiting or seizures can be observed in some patients. Depending on the size and location of the tumor, some localized symptoms can be seen, such as hemiparesis, one-sided weakness, visual disturbances, balance problems, mental and behavioral changes. If brain cancer is suspected, a neurological exam and various imaging methods help diagnose the condition. MRI scan allows the experienced physicians not only to see the tumor but also to evaluate its type and whether it is benign or malignant with 92-93% accuracy.

Epilepsy and Seizures

Epilepsy is a neurological disorder characterized by abnormal brain activity causing unprovoked seizures. There are different types of epilepsy seizures, varying from blank stare for a few seconds to spasm and jerky movements in the entire body. They can be classified as focal or generalized, depending on whether they originate from one or more brain areas. A reliable diagnosis is based on a detailed medical history of the patient, the seizures and their patterns of occurrence, followed by various diagnostic tests. These may include EEG (Electroencephalography), Cranial MRI (Magnetic Resonance Imaging), PET, SPECT, and neuropsychological evaluation.

Parkinson’s Disease

Parkinson’s disease (PD) is a progressive degenerative disorder of the central nervous system. It is caused by the loss of brain nerve cells producing the neurotransmitter called dopamine. Parkinson’s symptoms may include tremors, slow movements, rigid muscles, problems with balance, coordination, and posture. Patients may also experience sleeping and speech disorders, changes in handwriting, eating difficulties, cognitive and mental impairment. Parkinson’s symptoms have adverse effects on the quality of life. At an advanced stage, the patients may need full-time help in their daily life.

Cerebrovascular Diseases

Cerebrovascular diseases include a wide range of disorders related to the blood vessels and blood flow in the brain. Circulation of blood may be impeded by narrowing of the vessels (stenosis) or blocked by blood clots. When the oxygen supply to the brain is interrupted, it may cause brain damage and stroke. ACIBADEM Neurology and Neurosurgery Department treats all kinds of cerebrovascular diseases, including:

• Cerebral aneurysms. An aneurysm is a weak, thin spot in a blood vessel within the brain. A rupture may cause life-threatening bleeding (hemorrhage). 
• Arteriovenous malformations (AVMs). AVM is a group of abnormal tangled vessels in the brain. İf left untreated, they can enlarge and tear.
• Cavernous malformations. A cerebral cavernous malformation is a formation of abnormal blood vessels in the brain that may leak or bleed.

Herniated Disc

Spinal discs serve as cushions absorbing the pressure between the vertebrae that form the spine. Composed of cartilage and connective tissue, healthy discs between vertebrae can lose their flexibility, wear and tear. Degeneration may be caused by aging, a sedentary lifestyle, lifting heavy weights, or traumas and accidents. Subsequently, spinal disks may protrude or bulge out, resulting in herniated disc or bulging disc. Moreover, the herniated disc may irritate or compress some nerve roots, causing back pain or pain starting in the neck and extending down to the arms or legs. The person begins to experience numbness, weakness, loss of sensation, and impaired motor skills in body parts related to the affected nerves. A hernia may occur in any part of the spine. Most often, it develops in the neck (cervical disk hernia) or the lower back (lumbar disk hernia).

MRI is the most commonly used method for diagnosing a herniated disc, along with a CT scan for better image quality. The definitive diagnosis on whether the nerves are affected or not is made with Electromyography (EMG).

Trigeminal Neuralgia

Trigeminal neuralgia presents with episodes of sudden and severe facial pain. Patients often compare it with an electric shock. It occurs due to compression of the trigeminal nerve and can be felt in different face areas. Trigeminal neuralgia pain can last seconds and grow in duration over time. Painkillers usually do not help. The treatment options may involve medicines, surgery, and Gamma Knife radiosurgery.

Neurosurgical Procedures

Spine and brain neurosurgery requires the highest level of accuracy. Therefore, the patients should be referred to medical centers with proven success records, experienced medical teams, and high-end technology for the best outcome. At ACIBADEM, we have some of the best neurosurgeons in Turkey, specialized in subdisciplines such as spine surgery, neurooncology, neurovascular surgery, and functional neurosurgery. They are aided by the latest technology, including an intraoperative MRI device for real-time images during surgery, neuronavigation system for prevention of nerve damage, and Gamma Knife ICON for radiosurgery. Skull base surgery is successfully performed for brain tumors such as meningiomas, chordomas, schwannomas, and skull-base vascular malformations like aneurysms, arteriovenous and cavernous malformations.

Some of the most common types of neurosurgical procedures performed at ACIBADEM are listed below:

Brain Tumor Surgery

Surgery is the main option for brain tumor treatment. The goal is either to remove the tumor completely or, if it is located in a sensitive area, to resect as much as possible without affecting vital functions. Depending on the case, the surgery may involve a craniotomy or less invasive procedures such as neuroendoscopy. Since the gross total resection of the tumor is crucial for survival, brain cancer patients need to choose a skilled surgeon and an experienced neurosurgical center. Today, advanced technology supports neurosurgeons to ensure higher success rates and improve safety. We have thousands of successful brain tumor patient stories with people coming to ACIBADEM from all over the world.

Epilepsy Surgery

Approximately 20-30% of the patients have drug-resistant or refractory epilepsy. It means that they cannot control the seizures by medications. For some of these patients, surgery can be an alternative. There are different types of epilepsy surgery performed at ACIBADEM:

• Focal resection: the excision of a small area in the brain where the seizures occur
• Corpus callosotomy: cutting the nerve fibers between the two hemispheres of the brain to prevent seizures from spreading between them
• Hemispherectomy: the disconnection of a single hemisphere of the brain with the other in cases when one side of the brain is damaged
• Vagus nerve stimulation: attaching an electrode to the vagus nerve

Depending on the case, the purpose of epilepsy surgery is to eliminate the seizures, reduce their frequency, or decrease the severity of seizures.

Parkinson Surgery (Deep Brain Stimulation)

Deep brain stimulation (DBS) is a surgery performed to control the symptoms of Parkinson’s disease when medications are not effective. The operation involves the implantation of electrodes in a particular area of the brain to regulate the electrical activity disrupted by the disease. The area is precisely determined through brain tomography and MR images. DBS surgery is a viable option for people in an advanced stage of Parkinson’s disease who are resistant to drug therapy or have too many side effects. For many of them, surgery provides a chance to improve their quality of life.

Cerebrovascular Surgery

At present, cerebrovascular diseases can be treated successfully by experienced medical teams aided by advanced technology. Stroke, brain aneurysms, arteriovenous malformations, cavernous malformations, and other neurovascular disorders requiring surgery are managed routinely at ACIBADEM, including complex cases. Minimally invasive techniques, endovascular methods, microsurgery, and radiosurgery can be used, according to the case, for optimal results.

Gamma Knife Radiosurgery

Gamma Knife is a non-invasive tool for stereotactic radiosurgery (SRS) without incisions. It uses multiple radiation beams precisely focused on the sick cells. The Gamma Knife device can be used for the treatment of various problems within the brain, including:

• Benign or malignant brain tumors with clear margins
• Functional problems, like Parkinson’s disease and trigeminal neuralgia
• Vascular brain problems, like arteriovenous malformations and cavernomas

Disc Herniation Treatment (Discectomy)

If a patient is diagnosed with disc hernia, the doctor may recommend a brief period of rest, anti-inflammatory drugs, painkillers, physical therapy, exercise, and epidural steroid injections. If conservative treatments do not help or the symptoms worsen, the patient may benefit from surgical treatment. Discectomy is a type of surgery performed to relieve nerve compression by removing part of the herniated disk (partial discectomy) or all of it. During the operation, the surgeons need to be very careful to separate the nerves and expose the disc tissue avoiding any damage. Nowadays, it is possible to protect the nerves better using endoscopic interventions or microdiscectomy, which is performed with a microscopic approach. At ACIBADEM, we prefer minimally invasive discectomy that ensures a faster recovery and rapid return to social life for the patient.

Surgery for Trigeminal Neuralgia

If medications do not help against trigeminal neuralgia symptoms, various surgical options may be considered. Microvascular decompression (MVD), rhizotomy, balloon compression can be applied to reduce or eliminate the pain. Gamma Knife treatment is also possible. 

Why Choose Acıbadem?

Our patients can benefit from:

• Comprehensive neurological care by a multidisciplinary team of experts;
• Access to advanced medical, surgical, and minimally invasive options;
• Treatment of complex and challenging neurological diseases and disorders;
• The latest technology for the highest safety and efficacy;
• A-class service for international patients by a world-renowned healthcare brand.