Lumbar Microsurgical Discectomy

A lumbar disc herniation occurs when the disc capsule tears (ruptures) and a fragment of the disc nucleus (disc cartilage) comes out of the disc space into the spinal canal to compress a nerve root. In this video, removal of the herniated disc fragment from under the nerve root is demonstrated during a lumbar microsurgical discectomy. Read More...

Anterior Cervical Fusion

This video shows the steps involved in an anterior cervical fusion operation. This is one of the more common and successful operations currently performed for treatment of cervical spine disorders. The video starts after two abnormal cervical discs have been removed and shows the steps involved in the fusion process. For more informtion about this and other neurosurgical ... Read More...

42-year-old man with a suprasellar mass

A 42-year-old man presents with a suprasellar mass, shown on the post-contrast T1-weighted MRI shown here. Several years ago, he had an operation through his nose at another country. No records are available and he can not provide any additional history. His neurological exam is remarkable for a patchy bitemporal hemianopia. Neuroendocrine testing is normal except for low ... Read More...

25-year-old man with hearing loss and neck pain

A 25-year-old man presents with progressive bilateral hearing loss, tinnitus, and neck pain. His neurological exam is remarkable for bilateral sensorineural hearing loss, mild gait instability, and diffuse hyper-reflexia. MRI of the cervical spine is shown. What is the lesion on the cervical spine MRI? What other study or studies would you order to evaluate the hearing loss? What ... Read More...

Modern NeuroImaging

Neurological imaging modalities have come a long way in the past three decades. Our ability to peer into the brain now far surpasses anything that we imagined possible in the early days of CT and MRI scanning. As a result, much of the guesswork has been taken out of neurosurgical diagnoses and we are empowered with the ability ... Read More...

PICA Aneurysm

Aneurysms of the posterior inferior cerebellar artery (PICA) are the second most common aneurysms of the posterior circulation (after basilar tip aneurysms). They generally arise at the junction of PICA and vertebral artery and are in close proximity to the lower cranial nerves (glossopharyngeal, vagus, spinal accessory, and hypoglossal). The challenge in surgical treatment of PICA aneurysms is twofold: 1) ... Read More...

Aneurysms

An aneurysm is a balloon-like enlargement of the wall of an artery in the brain. Aneurysms usually occur at the junction of the blood vessels of the brain. They may remain small and not cause problems or may enlarge with time and put pressure on the adjacent brain structures. Most importantly, aneurysms can rupture on an unpredictable ... Read More...

A Neurosurgery Operating Room

This is my operating room. The centerpiece of a modern neurosurgery OR is the operating microscope. The microscope is a sophisticated machine which not only magnifies and illuminates the surgical field, but also integrates the image with CT and MRI data in a stereotactic workstation. As a result, the neurosurgeon can not only see the delicate structures within the brain ... Read More...