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Neurosurgery

The department of Neurosurgery at MMHRC continues its long-standing legacy and the unwavering pursuit of its mission:
Dedication to providing technically superb, compassionate, and timely medical care to our patients

We have achieved the status of a tertiary regional referral centre and our aim is to  establish an international reputation for both clinical and academic excellence. This department plays a vital role in emergency trauma services in addition to performing elective surgeries. Neurosurgery at MMHRC is a major service utilizing almost 10% of the hospital's beds and encompassing the full range of contemporary neurosurgical practice. Our team uses a multidisciplinary approach to provide a complete range of services for the diagnosis, treatment and rehabilitation of patients with neurological disorders.

Currently, the Neurosurgical Service has an average daily census of about 45 to 50 patients, and approximately 600 neurosurgical operations are performed yearly. We have a state-of-the-art operating room dedicated to neurosurgical procedures and a dedicated 11 bed Neuro ICU that is staffed round the clock. The department has 2 full time neurosurgeons specializing in all phases of neurological surgery for comprehensive management of brain, spinal cord, and peripheral nerve diseases and disorders. We also provide facilities for DNB training.
 
The department is equipped with an advanced operating microscope. This has improved the neurosurgical techniques in areas such as excision of brain tumours (supratentorial and infratentorial), spinal cord tumours, and congenital spinal cord lesions. Clipping of intra cranial aneurysms, evacuation of intracerebral and extracerebral hemorrhages, microscopic decompression of spinal cord and microdiscectomy are also being done routinely. The availability of 64-slice CT scanning and MRI scanning with SPECT within the hospital has allowed a far more precise diagnosis and localization for surgical procedures. The department is ably supported by a Neuro intensive care unit equipped with the necessary vital equipment.

We conducted along with our ENT department an International Endoscopic Skull Base Surgery Conference with experts Dr. Paul Gardner and Dr. Sony Dermann from St. Pittsburg University US. This was first of its kind to be held in Tamilnadu.

The Department of Neurosurgery at MMHRC will continue to grow in strength and position as one of the leaders in the field of neurosurgery.

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Facilities

  • AESCULAE Neuro Endoscope System
  • STRYKER Neuro Drill System
  • 11 bedded Neuro ICU
  • Neuro rehabilitation unit,
  • Zeiss Vario 700 Microscope
  • 32 bedded general ward
  • Separate state-of-the-art Neuro Theater.
  • Codman ICP Monitors
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Faculty

  • Dr. K.Selvamuthukumaran, M.Ch., (Neuro)- Sr. Consultant
  • Dr. K.Bagatsingh, MS., M.Ch., (Neuro) – Consultant
  • Dr. V.Inbasekaran, MS, M.Ch. – Hon. Visiting Consultant
  • Dr. G.Sudheer Kumar, MS., M.Ch., (Neuro) – Jr.Consultant

The department also has three full time, trained medical officers.

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Brain Surgeries

Specialized Services - Brain operations

Brain Tumour


From Right side to Left side

The management of brain tumours requires a comprehensive, multidisciplinary approach. Treatment is often made possible by the cooperation of a team comprising of neurosurgeons, oncologists, radiation oncologists, and neuropathologists.

Typical Neurosurgical Procedures

Acoustic Neuroma Tumor Removal (Craniotomy/Radio surgery)

Acoustic tumours arise from the eighth cranial nerve, which is the nerve that transmits auditory information from the ears to the brain. Acoustic neuromas typically present with a hearing loss, dizziness or an abnormality such as tinnitus (continuous high pitched noise). Patients can have two options for treatment, either open craniotomy or radiosurgery.

  • Aneurysm Surgery (Craniotomy/ Radiosurgery/ Endovascular)

    An aneurysm is an abnormal outward bulging of blood vessels that occur at sites along arteries where the vessel walls are weak. Depending on the location and size of the aneurysm, it can be treated by either open craniotomy or placement of a clip on the aneurysm or by coil embolization. Endovascular treatment of brain aneurysms involves insertion of a catheter (small plastic tube) into the femoral artery in the patient's leg and navigating it through the vascular system, into the head and into the aneurysm. Tiny platinum coils are threaded through the catheter and deployed into the aneurysm, blocking blood flow into the aneurysm and preventing rupture.

  • AVM (Craniotomy/ Radiosurgery/ Endovascular)
    Arteriovenous malformations (AVMs) are collections of abnormal blood vessels that can steal blood supply from normal brain tissue causing seizures or that can haemorrhage causing blood clots in or around the brain. Typically patients will have three surgical options for treatment of AVM’s: conventional surgery (craniotomy), endovascular embolization and radiosurgery. The choice of treatment depends on many factors, including the size, location, and extent of the AVM.

  • Brain Tumor Surgery (Craniotomy/Stereotaxy)
    Brain tumours treated any MMHRC include primary and metastatic tumours of the central nervous system, pituitary gland, third ventricle, brain stem, pineal region, eloquent brain regions, skull base, cavernous sinus, and paediatric brain tumours. Craniotomy, radiosurgery and steroetactic removal are few of the options for treatment of these tumours.

  • Pituitary Tumors (Transsphenoidal procedure)
    Pituitary adenomas are benign tumours which arise from the pituitary gland. Pituitary tumours are rarely malignant. These tumours are usually treated by surgical removal, using a trans-sphenoidal approach. This procedure is now done by Endoscope and is the least invasive procedure done on the brain. Patients can often leave the hospital as early as within two to four days after surgery.

  • Epilepsy (Craniotomy)
    Select patients with intractable epilepsy can benefit from temporal lobectomy. This is usually a two-step procedure with a craniotomy and grid placement performed to localize the seizure focus followed by a craniotomy to remove the focal point of the seizure.

Craniotomy
Any operation on the cranium or incision into the cranium. (Dorland, 28th ed). Craniotomy is the name of the opening for most intracranial neurosurgical procedures. A craniotomy can also be a small opening advanced by the new minimally invasive approaches. Craniotomy is actually not the most commonly performed neurosurgical procedure (actually, almost 80% of the cases done annually by neurosurgeons are surgeries of the spine.)

Skull Base Surgery

Skull base is the term used to describe the area of the skull that provides the base on which the brain rests. Contained within the skull base are the eye orbits, ear canals, two carotid arteries, two vertebral arteries, 12 cranial nerves and the blood drainage system of the brain. These many intricate structures make the skull base one of the most complex areas on which to operate.

  • Disorders of the skull base
    Two kinds of disorders may make skull-base surgery necessary for the patient. The first, vascular lesions include aneurysms, malformations of the veins and arteries, and fistulas. The second are benign and malignant tumours. Benign tumours can also be life-threatening; doctors will determine whether surgical intervention is necessary.
  • Recent advances in skull-base surgery
    Traditionally, many tumours at the base of the skull have been inoperable. In the past, surgical techniques were just not satisfactory, and many patients faced a high risk of neurological problems after surgery. Advances in diagnostic imaging, surgical techniques and instruments, and a better understanding of the skull-base anatomy have allowed neurosurgeons to remove tumours at the base of the skull. Previously inoperable lesions, can now be removed with minimal risk to the patient.

From Right side to Left side

Diseases of the skull base are rare but potentially life threatening disorders. Treatment is challenging due to the complex anatomy of the cranial base. Diseases in this area include benign and malignant tumours (cancers), infections, birth defects and complicated head trauma. Diseases can affect the function of the brain or complex senses such as hearing, vision, hearing and balance. We offer the most up-to-date diagnostic and treatment modalities in skull base tumour. Now we at our centre perform extended endoscopic skull base surgery whereby large anterior skull base lesions are tackled through nose.

Head Injury Care

MMHRC is certified to treat the highest severity of trauma patients with severe head injuries. Madurai Government Hospital admits, on an average, 600 head injury and another 300 emergency surgery patients per year. A vast majority of our patients are from southern and eastern part of Tamilnadu.

The Trauma Center Team provides 24-hour coverage for trauma and emergency surgery cases. The presence of neuro surgeons, along with the excellent multidisciplinary collaboration with specialists in Orthopaedics, Plastic Surgery, Psychiatry, Oral and Maxillofacial Surgery and many other services, provides for the ideal management and treatment options for trauma and emergency surgery patients. It takes a whole team of surgeons, nurses, physical and occupational therapists, social workers, chaplains, respiratory therapists, and others to help patients regain good health and function.
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Spinal and Neck Surgery

Spine Surgery

Most spine patients respond well to non-surgical treatment. However, some back and neck problems are best treated with surgery. If you are facing surgery, you probably have questions about the procedure, its benefits and risks.

  • Discectomy
    Cervical discectomy removes a cervical disc herniation through an anterior approach to relieve spinal cord or nerve root pressure and alleviate corresponding pain, weakness, numbness and tingling. The anterior approach to the cervical spine (from the front of the neck) can provide exposure from C2 down to the cervico-thoracic junction. Discectomies can be performed on other parts of the spinal column and are often performed in conjunction with a laminectomy from a posterior approach.

  • Laminectomy
  • A laminectomy removes a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve neural impingement and give it more space. This procedure treats spinal stenosis (cervical, lumbar and rarely thoracic), relieving the pressure on the nerves.


The department of Neurosurgery, MMHRC offers Comprehensive Treatment of

  • Skull Fracture
  • Brain & Spinal cord Tumour
  • Spinal Trauma
  • Disc Herniation
  • Disc Disease
  • Bone Spurs  
  • Compressed Nerve Root
  • Degenerative Spine Diseases
  • Spinal Stenosis
  • Spinal Cord Injury
  • Spondylolisthesis

Minimally Invasive Spine Procedures

  • Cervical Microscopic Discectomy - Developed by a practicing neurosurgeon
  • Microscopic Lumbar Discectomy
  • Thoracoscopic Spine Surgery
  • Minimally Invasive Posterior Lumbar Interbody Fusion (PLIF)

Additional Complex Spine Procedures

  • Instrumented Spinal Fusions
  • Anterior Discectomy & Fusion
  • Anterior & Posterior Spinal Instrumentation
  • Anterior Odontoid Screw Fixation
  • C 1-2 Transarticular Screw Fixation & Fusion
  • Pedicle Screw Fixation Posterior Lumbar Interbody Fusion (PLIF)

Benefits of choosing a Neurosurgeon

Why Choose a Neurosurgeon?

  • The common misconception about neurosurgery is that neurosurgeons specifically perform "brain surgery".
  • However, a neurosurgeon can also provide the highest level of expertise in spine disorder treatment. In fact, the majority of operations performed by neurosurgeons are spine surgeries.
  • Neurosurgeons spend about 80 percent of their time treating spine disorders.
  • Neurosurgeons are exclusively trained to perform procedures on the entire spine, including the spinal cord and the inside lining of the spinal canal. With the spine encasing the spinal cord and nerves, many patients choose to take the extra measure of safety when undergoing spine treatment and choose a neurosurgeon.
  • Neurosurgeons complete more spinal surgery training than any other specialty.
  • Neurosurgeons are trained in treating diseases of the spine throughout a 5-year residency.
  • Neurosurgeons are the only surgeon who treats the entire spine including the spinal cord.
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Bio - Data

Name - Dr.K.Selvamuthukumaran
Age - 41
Sex - Male
Date of birth - 24-11.1973
Qualifications - M.B.,B.S ., M.Ch ( neuro )
E.Mail I.D - neuroselva73@ yahoo.co.in
Contact Address - Meenakshi Mission Hospital and Research Center
Lake area, Melur Road, Madurai, Tamilnadu 625107

Dr. K. Selvamuthukumaran completed his M.B.B.S at the prestigious Madras Medical College Chennai in 1997, and passed with Distinction. Soon after, in 1997 he joined M.Ch (neurosurgery) at the world famous Institute of Neurology, Madras Medical College,Chennai, completing the course in 2002. This was followed by a one year microneurosurgical training under the eminent neurosurgeon Dr.K.R. Sureshbapu of Apollo Hospitals, Chennai.

In 2003 Dr. K. Selvamuthukumaran joined MMHRC, the only 800 bedded, tertiary care Hospital in the South, as a Consultant Neurosurgeon. He has operated on over 2500 cases, including complicated neurosurgery cases like Skull base neurosurgery, Endoscopic surgery for pituitary tumours and C.S.F rhinorrhea, surgery for aneurysm and AVM’S of the brain, complicated spinal stabilization procedures, surgery for facial pain namely Microvascular Decompression for Trigeminal Neuragia etc.

Dr. K. Selvamuthukumaran has also attended several national conferences and workshops on neurosurgery, and presented many posters and platform presentations. He also attended the new Endoscopic workshop on Ghert, held in Belgium. He has co- authored a chapter on Carpal Tunnel syndrome in the "Textbook of Neurology."
He is the Senior Consultant Neurosurgeon at MMHRC, and has strived hard to get the recognition of the D.N.B programme in neurosurgery, for his department.

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Contact Us

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Call us at:
Dr. K.Selvamuthukumaran : + 91-9894356498
Dr. T.Mani maran: +91-9443853527

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Emergency Contact : 0452-2581212 ,Cardiac Emergency : 0452 -2585001