Surgery treatment of intracranial germinom in Memorial Ankara Hospital

About the department

The Department of Adult and Pediatric Neurosurgery at the Memorial Ankara Hospital offers all the options of modern surgery for the effective treatment of diseases of the central and peripheral nervous system. The highly qualified specialists of the department have state-of-the-art equipment for sparing interventions to treat brain and spinal cord tumors, cerebrovascular diseases, craniocerebral injuries, spinal injuries, myelomeningocele and many other pathologies. The department's neurosurgeons also provide highly effective treatment of diseases of the nervous system in children of various age groups. When admitted to the department, the patients undergo comprehensive diagnostics, including laboratory tests, CT and MRI scans of the brain and spinal cord, angiography and other imaging tests, which help the doctors decide on the advisability of the surgical procedure. Neurosurgical interventions are performed in high-tech operating rooms equipped with innovative systems for neuronavigation, neuromonitoring, surgical microscopes, radiosurgical systems for stereotactic interventions, etc. All these resources guarantee safe and highly effective treatment. The Chief Physician of the department is Prof. Dr. med. Ismail Hakkı Tekkok.

The department's medical team has rich and successful experience in the surgical treatment of benign and malignant tumors of the brain and spinal cord. The treatment is provided for both adults and children. Since neoplasms in the brain and spinal cord are a rather complex clinical task, the department's doctors use an interdisciplinary approach – oncologists, radiologists, neuroradiologists, neurologists and other specialists are involved in the therapeutic process. The doctors cooperatively study the patient's clinical case and develop an individual treatment regimen in order to ensure the best possible result. As a rule, the main treatment methods are neurosurgery, radiosurgery, chemotherapy, and/or radiation therapy. If possible, the specialists prefer radiosurgical techniques, which allow the doctors to get rid of the tumor in just one session without any invasive manipulations. The highest efficiency of cancer cell destruction is ensured by precise focusing of higher radiation doses as compared to classical radiation therapy. Thus, irradiation only affects pathological foci without damaging healthy brain or spinal cord tissues. However, this type of treatment does not always help to achieve the desired results, so neurosurgical operations are quite often performed. Most surgical procedures are performed through a minimally invasive access, which reduces trauma to healthy tissues. The department's neurosurgeons also perform brain surgery with access through the nose, without the need to open the skull. Prior to surgery for tumor removal, the neurosurgeon preliminarily plans each stage of the intervention using data obtained from CT, MRI, PET scans and other imaging tests. Special attention is paid to the assessment of brain activity, vascular changes, as well as to the determination of the exact location of the neoplasm, its size, invasion in the surrounding tissues, metastases in other organs and anatomical structures. When performing surgery, the specialists use the very latest neuronavigation systems, neuromonitoring and other techniques, since they allow the surgeon to perform each manipulation with the highest accuracy, without damaging the vital areas of the brain and spinal cord.

The treatment of spinal diseases and injuries is also one of the priority focuses of the department's medical team. Particular attention is paid to the treatment of patients with hernias of all parts of the spine, spinal injuries, spinal stenosis and congenital spinal anomalies. Whenever possible, the department's specialists carry out endoscopic and microsurgical procedures. The use of neuronavigation and neuromonitoring systems eliminates the risks for the patient, including the risks of damaging spinal cord and nerves.

The department's surgeons often admit patients with functional disorders of the nervous system, which do not respond to conservative treatment, for example, Parkinson's disease, dystonia, tremors, spasticity. Deep brain stimulation is successfully used to treat these diseases and improve the quality of life of patients. The method involves the action of electrical impulses on certain areas of the brain. During this procedure, the special neurostimulator is implanted under the patient's skin (under the collarbone), which transmits impulses through the electrodes. The department's neurosurgeons implant high-quality neurostimulators, which can work for years without the need for replacement. The operation to implant a neurostimulator for deep brain stimulation is performed using sparing minimally invasive techniques, under general anesthesia. The surgeon performs all surgical manipulations under the guidance of the intraoperative MRI system, which excludes damage to functionally important anatomical structures. The implantation of the permanent electrode is preceded by the brain mapping – the surgeon assesses the electrical activity of the brain using a microelectrode and selects the optimal point for the location of the permanent electrode.

The department is also distinguished by its outstanding success in the treatment of neurosurgical diseases in children. The specially trained surgical team works for the benefit of young patients, while each specialist from this team has deep knowledge in the field of neurosurgery and anatomy of the growing child's body. Most often, pediatric neurosurgeons deal with the treatment of children with brain and spinal cord cancer, vascular malformations of the brain, hydrocephalus and spina bifida. The treatment corresponds to the clinical protocols and the requirements of the professional societies for pediatric neurosurgery. In addition, the doctors take care of the emotional state of the child, since the upcoming treatment can cause a strong fear in young patients.

The department's range of medical services includes:

• Surgical treatment of brain and spinal cord tumors, including metastases
• Surgical treatment of traumatic brain injuries
• Surgical treatment of spinal diseases
  • Spinal stenosis
  • Spinal injuries
  • Spinal hernias
• Surgical treatment of cerebrovascular diseases
  • Intracranial aneurysms
  • Arteriovenous malformations of the brain
  • Carotid stenosis
  • Brain hemorrhage
  • Cerebral thrombosis
  • Cerebral venous thrombosis
• Surgical treatment of functional diseases of the nervous system 
  • Parkinson's disease
  • Spasticity
  • Tremor
  • Dystonia
• Surgical treatment of diseases of the nervous system in children
  • Brain and spinal cord tumors
  • Cerebrovascular diseases
  • Hydrocephalus
  • Spina bifida
• Surgical treatment of other diseases of the nervous system