What We Do

Modern neurosurgery is highly specialised. Our specialist practice relies on close co-operation particularly with interventional neuroradiologists but also neurologists, radiosurgeons and other specialities. Complex conditions with higher risks benefit from the large experience accrued by this team over the years.

A right parietal arteriovenous malformation of the brain

AVM or Arteriovenous malformations of the brain are complex tangles of blood vessels through which high pressure blood is diverted. Present from birth or very early life they may present with stroke, epilepsy or other neurological symptoms.

A middle cerebral artery aneurysm

Aneurysms are balloon like dilatations of the arteries supplying blood to the brain. Rupture of a brain aneurysm is responsible for a dangerous type of stroke called Subarachnoid Haemorrhage.

A cavernoma in the brain

Cavernomas are low-pressure vascular growths within the brain. Sometimes known and cavernous angiomas, cavernous haemangiogmas or cavernous malformations. Symptoms are relatively uncommon but they may cause stroke and epilepsy.

An MR of the brainI showing a large venous aneurysm caused by a dural arteriovenous fistula
Cranial Dural Arteriovenous Fistula

Cranial dural arteriovenous fistulae (DAVF) are an acquired form of high-flow vascular malformation that recruit the blood supply of the brains coverings and scalp. Certain types pose a high risk of stroke but they also present with pulsatile tinnitus, unsteadiness, facial pain or other neurological symptoms.

A spinal vascular malformation
Spinal Vascular

Spinal vascular malformations comprise a diverse group of conditions that affect the blood flow through the spinal cord. They may be acquired later inlife or form part of a genetic syndrome that appears in childhood often accompanied by other neurological problems.

A reconstructed CT scan showing the window in the skull following a decompressive hemicraniectomy for stroke
Neuroplastic and Reconstructive Surgery

Defects in the cranial vault may result from trauma, infection or surgery to resect tumours. Vascular malformations may also involve the cranium as well as its contents and restoring from as well as preserving neurological function is an important element of treatment.

A CT angiogram showing anastomosis of the superficial temporal artery to the middle cerebral artery (STA-MCA bypass)
Moyamoya Disease and Cerebral Vasculopathy

Cerebral vasculopathies are characterised by impairment of cerebral blood flow, enough to affect brain function or precipitate stroke. Moyamoya disease is a progressive narrowing of the carotid arteries that may be modified by surgical treatment. The microvascular techniques used are sometimes

A hemangioblastoma in the brainstem
Vascular Tumors and Von Hippel-Lindau Disease

Some tumours of the brain and spinal cord arise from cells that usually form blood vessels. Others may have such a highly developed blood supply that they pose similar challenges to vascular malformations in their treatment. Von Hippel-Lindau disease is a multi system, genetic dosroder characterised by vascular central nervous system tumours amongst others,

A large anterior cranial base meningioma

Meningiomas are usually benign tumours that arise from the tissues covering the central nervous system. Usually benign they may produce disability by pressure on adjacent healthy tissues. Occasionally they will involve the bone and scalp as well.

malignant nerve sheath tumour
Tumours of the Spinal Cord, Nerves and Canal

Tumours may develop within the spinal canal, arising from the soft coverings of the nervous tissues or on the nerves that emerge from the spinal cord - meningioma, schwannoma, intradural extra medullary (IDEM) tumours. Tumours may also arise within the spinal cord itself- astrocytoma, ependymoma, haemangioblastoma and occasionally metastases.

Chroni subdural haematoma
Trauma and Chronic Subdural Haematoma

Head injury may resultant in large haematomas that lead to secondary brain injury if not addressed urgently-extradural haematoma, acute subdural haematoma. In later life minor trauma may results in small collections of blood on the brain surface which as they liquify with time produce symptoms more gradually.

Neurophysiology and ultrasound guided nerve biopsy
Peripheral Nerve and Muscle Biopsy

Biopsy of specified peripheral nerves or muscle may assist neurologists in the diagnosis of neurological conditions such as vasculitis or myositis.