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Neurosurgery in Mexico
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brain surgery at an affordable cost
brain surgery at an affordable cost

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NORMAL PRESSURE HYDROCEPHALUS: A treatable cause of dementia

Normal pressure hydrocephalus occurs when excess cerebrospinal fluid accumulates in the brain's ventricles, which are hollow fluid-filled chambers. As brain ventricles enlarge with the excess cerebrospinal fluid, they can disrupt and damage nearby brain tissue, causing symptoms of NPH.
NPH primarily affects people in their 60s and 70s.
The following symptoms are considered hallmarks of normal pressure hydrocephalus:
Symptoms
-Difficulty walking that's sometimes compared to the way a person walks "on a boat," with the body bent forward, legs held wide apart and feet moving as if they're "glued to the deck."
-Decline in thinking skills that includes overall slowing of thought processes, apathy, impaired planning and decision-making, reduced concentration and changes in personality and behavior.
-Loss of bladder control, which tends to appear somewhat later in the disease than difficulty walking and cognitive decline.
Diagnosis
If symptoms and an MRI or CT strongly suggest NPH, a large-volume spinal tap may be used to identify those who may benefit from a shunt.
Treatment
NPH can sometimes be treated with surgical insertion of a shunt, a long, thin tube that drains excess CSF from the brain to the abdomen.
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GAMMA KNIFE SURGERY

Gamma Knife radiosurgery is a type of radiation therapy used to treat tumors, vascular malformations and other abnormalities in the brain.
Gamma Knife radiosurgery is not surgery in the traditional sense because there is no incision.
Instead, Gamma Knife radiosurgery uses specialized equipment to focus about 200 tiny beams of radiation on a tumor or other target with submillimeter accuracy. Although each beam has very little effect on the brain tissue it passes through, a strong dose of radiation is delivered to the place where all the beams meet.
The precision of brain stereotactic radiosurgery results in minimal damage to healthy tissues surrounding the target.
Gamma Knife radiosurgery is usually a one-time therapy completed in a single day. Currently, there are only two gamma knife centers in Mexico.

Why it is done

Gamma Knife radiosurgery is often a safer alternative to standard brain surgery (neurosurgery), which requires incisions in the skull, membranes surrounding the brain and brain tissue. This type of radiation treatment is usually performed when:

-A tumor or other abnormality in the brain is too hard to reach with standard neurosurgery
-A person isn't healthy enough to undergo standard surgery
-A person prefers a less invasive treatment
In some cases, Gamma knife radiosurgery may have a lower risk of side effects compared with other types of radiation therapy.

Gamma Knife radiosurgery is most commonly used to treat the following conditions:
-Brain tumors (not all tumors, depending on size and characteristics)
-Recurrence of previously operated brain tumors
-Arteriovenous malformations
-Trigeminal neuralgia
-Acoustic neuroma
-Pituitary tumors

Procedure
The procedure may take less than an hour to about four hours, depending on the size and shape of the target. During the procedure:
You won't feel the radiation
You won't hear any noise from the machine
You'll be able to talk with the doctors via a microphone
Gamma Knife radiosurgery is usually an outpatient procedure, but the entire process will take most of a day.

If you are unsure if Gamma Knife would be a suitable treatment for your condition or you would like to find out more please contact us.
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SPINE SURGERY IN MEXICO
The main reason why patients travel abroad to have spine surgery is due to the very high costs in the US. In Canada, patients with severe back pain face long waits to see a spine surgeon and undergo spine surgery. Depending on each particular case, spine surgery can be performed in the traditional way (open surgery) or minimally invasive.
If you are a candidate for spine surgery, it is essential to decide where to have it done. Therefore, it is crucial to be informed about the credentials and training of the doctors who will perform your surgery.
Neurosurgery in Mexico is formed by a group of neurosurgeons specializing in different areas. Dr Felipe Nares treats complex spine cases. He completed a spine surgery clinical fellowship in one of the most renowned programs for the treatment of spinal disorders, the Combined Spine Surgery fellowship at the University of Calgary, based at Foothills Medical Centre in Calgary Alberta, Canada. He is trained to perform anterior and lateral approaches to the spine from cervical to lumbar spine, as well as minimally invasive surgery. So, feel confident to be treated with high-quality standards.
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WHEN TO WORRY ABOUT A HEAD INJURY
A head injury can result from a fall, a collision while playing sports, a car accident, or other factors, and can vary in severity from minor to life threatening. Many head injuries are minor, as the skull often provides adequate protection of the brain. However, the skull doesn’t need to be broken for a head injury to be considered severe. Below is a list of symptoms that can indicate that a head injury warrants worrying. Keep in mind that symptoms of a head injury may be immediately apparent or may not be noticeable for hours or even days after an incident.
• Continous headache
• Drowsiness
• Confusion
• Changes in the appearance of the pupils
• Fracturing of the skull
• Difficulty remembering
• Changes in personality or behavior
• Seizure
• Trouble with coordination
• Nausea or vomiting
• Dificulty to move arms or legs
• Loss of consciousness
Also note that any improvement in symptoms followed by a sudden reoccurrence of symptoms can be a sign of a problem.
If you suspect that a head injury may be serious, seek immediate medical care
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DYNAMIC CERVICAL IMPLANT, the newest stabilization system for the cervical spinal.
One of the most common surgeries in the cervical spine is ¨discectomy¨ (removal of a disc), normally this surgery is performed to decompress the spinal cord or nerve roots. When the disc is removed, traditionally it is replaced with a graft to fuse this segment of the spine, leading to immobilization of this part of the spine. This immobile segment my cause problems in the future. For his reason, several years ago the artificial disc replacement (ADR) was created to preserved movement in the dis that was operated on. However, ARD is not indicated for every patient who have a discectomy. In addition, evidence has also show that ADR may add stress on spine joints due to hyper mobility, causing pain.
A new device called Dynamic cervical Implant (DCI) has been used in Europe (and now is being used in Puerto Vallarta). It stabilizes the cervical spine while still providing stable, controlled motion allowing the spine to be functionally dynamic.Thus, the DCI implant aims at combining the advantages of the gold standard “Fusion” with a motion preservation philosophy. The DCI has much greater indications than conventional static fusions & even ADR.
The displayed images show the device and a radiograph of a patient treated by our neurosurgeons in Puerto Vallarta. She had the device inserted in 2 different levels.
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2016-04-06
2 Photos - View album
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LUMBAR SPINE STENOSIS
Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves inside of spine. This is usually due to the common occurrence of spinal degeneration that occurs with aging. It can also sometimes be caused by spinal disc herniation, osteoporosis or a tumor. In the cervical (neck) and lumbar (low back) region it can be a congenital condition to varying degrees. 
LSS results in low back pain as well as pain or abnormal sensations in the legs, thighs, feet or buttocks, or loss of bladder and bowel control. The leg symptoms in LSS include pain (sciatica), weakness, and tingling , which may radiate down to the feet.
MRI is the preferred method of diagnosing and evaluating spinal stenosis of all areas of the spine.
An initial trial of conservative treatment is typically recommended which include analgesics, physical therapy or spine injections.
Surgery is indicated when conservative treatment fails ti improve patient's symptoms. Type of surgery will depend on patient symptoms and MRI findings.
The image shows a MRI displaying a normal lumbar spine (left)
and a lumbar spine with stenosis (right). The white column is the spinal canal containing nerve roots.
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HYDROCEPHALUS
Hydrocephalus is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain. 
Hydrocephalus can be caused by congenital or acquired factors. Congenital causes include Arnold–Chiari malformation, craniosynostosis, Dandy–Walker syndrome, and Vein of Galen malformations. Acquired causes include hemorrhage, meningitis, head trauma, tumors, and cysts.
The clinical presentation of hydrocephalus varies with chronicity. Acute dilatation of the ventricular system is more likely to manifest with the nonspecific signs and symptoms of increased intracranial pressure. By contrast chronic dilatation (especially in the elderly population) may have a more insidious onset presenting, for instance.
Symptoms of increased intracranial pressure may include headaches, vomiting, nausea, papilledema, sleepiness or coma.
Hydrocephalus treatment is surgical, generally utilizing various types of cerebral shunts. It involves the placement of a ventricular catheter (a tube made of silastic), into the cerebral ventricles to bypass the flow obstruction/malfunctioning arachnoidal granulations and drain the excess fluid into other body cavities, from where it can be resorbed. Most shunts drain the fluid into the peritoneal cavity.
Picture 1 shows a normal brain CT scan, the dark part in the center of brain are the ventricles. Picture 2 shows a CT scan of a patient with hydrocephalus (look how the ventricles are enlarged)
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2015-03-09
2 Photos - View album
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  CERVICAL DISC REPLACEMENT SURGERY
An artificial cervical disc is a device inserted between two cervical vertebrae after an intervertebral disc has been surgically removed in the process of decompressing the spinal cord or a nerve root. The intent of the device is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following such a disc removal, which necessarily eliminates motion at the operated disc space in the neck. The indications for a cervical disc replacement are generally the same as for a cervical discectomy and fusion. A person must have a symptomatic cervical disc, which may be causing arm pain, arm weakness or numbness with some degree of neck pain. These symptoms may due to a herniated disc and/or osteophytes compressing adjacent nerves or the spinal cord. 
An artificial disc surgery may be done instead of an anterior cervical discectomy and fusion. The theoretical advantages of the artificial cervical disc over a fusion include:
-Maintaining normal neck motion
-Reducing degeneration of adjacent segments of the cervical spine
-Eliminating the need for a bone graft
-Early postoperative neck motion
-Faster return to normal activity
This surgical approach is the same as that presently used for a discectomy and fusion operation. The affected disc is completely removed including any impinging disc fragments or osteophytes (bone spurs).After that, the artificial disc device is implanted into the prepared disc space. Postoperatively, the patient typically can go home within 24 to 48 hours with minimal activity limitations.
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