Neuro Sciences

ORI Fusion Digital Integrated Operation Theatres With 22 Operating Rooms that are on par with some of the largest in the world, Aster Medcity, for the first time South India, introduces ORI Fusion Digital Integrated Operation Theatres using Karlstorz OR1 Fusion - Asia Pacific’s first complete digital integration system.
The integration enables real-time sharing of images, videos and medical reports, which not only facilitates virtual participation from any location in the world, but also helps the rest of the surgical team to monitor the patient closely during the operative procedure, much to the benefit and safety of the patient undergoing the surgery.
Aster Medcity is also the first surgical facility in the state to offer Robotic Surgery using high-precision da Vinci Surgery Robot.

We combine our expertise in the areas of patient-care, clinical research and academics in order to provide the highest level of specialised services to our patients. The Aster spine center was conceived as part of the overall scope of neurosurgery and was incorporated into our original vision document. As part of the transformation into a global COE a dedicated aster spine center was proposed. This would be a multispeciality service including neurosurgical and orthopaedic spine surgeons covering the entire gamut of spine pathology, both elective and emergency. The primary spine service would be supported by a very active physical medicine and rehabilitation service, and other departments like neurology, endocrinology, radiology and oncology. It might be possible to include an element of holistic care into the spine center by association with indigenous systems of medicine like Ayurveda.

• OR1 Fusion Digital Integrated Green OT certified surgical Suites
• IntelliSpace Critical Care and Anaesthesia (ICCA) ICUs
• Level 3 PICU
• 3.0 Tesla Widebore MRI
• 256 Slice Philips iCT Scan
• DEXA for bone density measurement
• Philips Astonish True Flight Select
• PET-CT with Time Of Flight Technology
• GE SPECT-CT Optima NM 640 Gamma Camera>
• True Beam Linear Accelerator with FFF Technology
• Karl Storz Endoscope
• Siemens Isocentric 3D C-arm
• Medtronic Stealth Station Navigation System
• Leica M530 OH6 Operating Microscope
• Leica M525 OH4 Operating Microscope
• Medtronic Legend high-speed pneumatic drills
• Medtronic Legend EHS Stylus electric drills
• Medtronic Legend oscillating and reciprocating microsaws
• Intraoperative Bone CUSA
• Intraoperative electrophysiological monitoring
• Allen Spine System Table
• Needle biopsy
• Soft tissue and bone pathology
• Spine and peripheral nerve pathology
• Immunohistochemistry & frozen section
• Advanced navigation system
• Endoscopy and MISS systems
• Intraop MRI
• Gamma (SPECT) Camera
• Whole body bone scan
• Regional three-phase bone scan
• Regional infection imaging

A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of some of your internal organs. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures.

Positron emission tomography (PET) scans detect early signs of cancer, heart disease and brain disorders. An injectable radioactive tracer detects diseased cells. A combination PET-CT scan produces 3D images for a more accurate diagnosis.

MRI protocol for epilepsy is a group of MRI sequences put together to improve sensitivity and specificity in identifying possible structural abnormalities that underlie seizure disorders.

This is a procedure used intraoperatively to confirm the location and extent of epileptic tissue by recording electrical activity directly from the surface of the cerebral cortex.

Invasive EEG recordings are those recordings that are made with electrodes that have been surgically implanted on the surface or within the depth of the brain.

A video EEG records what is happening when you have a seizure or event and compare the picture to what the EEG records at the same time.

An EEG records the electrical activity of your brain via electrodes affixed to your scalp. EEG results show changes in brain activity that may be useful in diagnosing brain conditions, especially epilepsy and other seizure disorders.

• Deep Brain Stimulation (DBS) surgery: For Parkinson’s Disease, Essential Tremor, Dystonia ( primary and selected secondary dystonias), intractable Tourettes Syndrome)
• Focused ultrasound therapy: for Essential Tremor (if FUS is set up in COE Neurosciences under brain tumour centre)

Evaluation and treatment of acute and chronic movement disorders

We trained in nervous system conditions , brain and nervous system surgery, and other areas work together to determine the most appropriate treatment for your condition.

We run a number of Specialty Clinics at Aster Medcity. Each clinic runs on a particular day of the week and offers a gamut of services to the needy patients. Our services include, but not limited to:

• Clinical evaluation ,diagnosis and medical treatment of Adult and pediatric Movement Disorders
• Selection of cases of Movement Disorders for DBS treatment
• Selection for Apomorphine pump treatment for advanced Parkinson’s disease (OP assessement of eligibility and IP for initial titration). Indicated for those who opt for non surgical treatment or in whom surgery is contraindicated
• Cognitive and Neuropsychological evaluation
• Neuropsychiatric assessment
• Physiatry assessment and physiotherapy
• Autonomic function tests
• Sleep studies
• TRODAC studies, MRI through Radiology and nuclear medicine dept
• Speech, swallowing and gait rehabilitation
• Pain and palliation in advanced movement disorders
• Selection of patients for clinical trial and research
• Movement Disorder Clinic
• Deep Brain Stimulation (DBS) Programming Clinic
• Botulinum Toxin Clinic
• Pediatric Movement Disorder Clinic
• Memory Clinic

24/7 neuro trauma & critical care
Dedicated Neuro ICUs
Carotid ultrasound and transcranial doppler
Diagnostic cerebral angiography
Thrombolysis and mechanical thrombectomy for stroke
Angioplasty and stent for stroke management
Inpatient electrophysiological procedures including: Long-term video EEG Invasive intracranial monitoring Sleep lab Nerve conduction and evoked potential studies (somatosensory, motor, visual & auditory) Intraoperative electrophysiology

Consultation
Outpatient electrophysiological diagnosis including: Nerve conduction studies Somatosensory, visual and auditory evoked potential studies EEG, Video EEG Carotid ultrasound and transcranial doppler
Speciality clinics for neurological problems

An electroencephalogram (EEG) is a test used to find problems related to electrical activity of the brain.
An EEG tracks and records brain wave patterns. Small metal discs with thin wires (electrodes) are placed on the scalp, and then send signals to a computer to record the results. Normal electrical activity in the brain makes a recognizable pattern. Through an EEG, doctors can look for abnormal patterns that indicate seizures and other problems.

Flat panel bi-plane vascular hybrid cathlab
Fourth generation Time of Flight 16 Slide PET CT
True Beam Linear Accelerator for high-precision radiotherapy
Low radiation CLARITY cath lab
256 slice Philips iCT scanner
3 Tesla Wide Bore Digital MRI
GE SPECT-CT OPTIMA NM 640 Gamma Camera EPIQ
Image fusion for guided biopsies
OR 1 Karlstroz fusion integrated, Green OT certified Operation Theatres with autopilot anaesthesia
Stealth Station Navigation
C- Arm for surgical imaging
Dedicated ICCA (IntelliSpace Critical Care and Anaesthesia) Neuro ICUs
Level 3 Paediatric ICU

Physical therapy
Occupational therapy and rehabilitation for patients with neurological/ physical disabilities
Speech therapy for patients with language disabilities

Immunohistochemistry
Molecular diagnosis and genetic mutation analysis

Neuropsychology is the systematic evaluation of higher cognitive abilities including intelligence, memory, academic skills, cognitive and language, attention span, sensory motor, problem solving abilities, executive abilities, visual motor skills and personality/emotional functioning. The Neuropsychology Clinic at the Aster Centre of Excellence in Neurosciences offers:

Cognitive evaluation/ rehabilitation/ remediation in patients with neurological conditions like epilepsy, stroke, Alzheimer’s disease, Parkinson’s disease and tumours
Study of functional aspect of brain through pre & post-operative evaluation
Study of decline of cognitive skills in the elderly
Evaluation of changes in thinking/ behavior pattern with people with serious illnesses
Evaluation/ management of behavioural problems
Counselling/ management of depression and anxiety
Counselling and management of depression and anxiety
Family counselling

Brain perfusion imaging
Ictal SPECT imaging
Technetium TRODAT imaging
I - 131 MIBG therapy for malignant neuroendocrine tumours

This comprehensive rehabilitation regimen can help the patient to maximise and regain normal muscle movement and function after a stroke or for neurological conditions such as:

Parkinson’s disease
Multiple sclerosis
Spinal cord injury
Head injury
Balance dysfunction
Bell’s palsy

Routine 32 channel digital video EEG
Round-the-clock, long-term 128 channel video EEG monitoring
Functional MRI and WADA study to assess eloquent cortex regions.
3T MRI and an exclusive intraoperative MRI
PET (positron emission tomography)
SPECT (single-photon emission computerized tomography)
ECOG (ElectroCorticography)
Cortical Mapping
SSEP (Somatosensory Evoked Potential)
MEP (Motor Evoked Potential)
Different surgeries available:
Respective Surgery
Lesionectomy
Amygdalohippocampectomy
Corticectomy
Lobectomy (e.g. temporal lobectomy)
Multilobar resection
Disconnective/Palliative Surgery:
Hemispherectomy
Corpus Callosotomy
Multiple Subpial Transections
Conditions treated:
Mesial temporal sclerosis
Focal cortical dysplasia
Lesions like ganglioglioma, DNET
Hemimegalencephaly
Rasmussen’s Encephalitis

The Neuro ICU at the department combines the service of ICU staff with advanced critical care training together with technological expertise. It facilitates round-the-clock close monitoring and personalised care for the patients.

Continuous assessment of Intracranial Pressure is necessary to evaluate the efficacy of therapeutic measures and for evaluating the evolution of brain injury. This is being carried out using ICP monitoring system, ensuring an optimal level of Cerebral Perfusion Pressure.

Neuronavigation systems facilitate image-guided neurosurgery ensuring accurate resection of brain tumours or biopsies of brain lesions and detailed brain surgery. Basic principles of navigated surgery are to see the tip of a pointer in an image space.

Outpatient (6 days in a week), Inpatient, follow-up clinic
24 hours emergency services
Neurocritical care
Comprehensive Neuro rehabilitation services
Cerebral angiography
Electroencephalogram (EEG)
Nerve conduction studies (NCS)
Electromyography (EMG)
Evoked potential (VDP, SSEP, BERA)
Nerve and muscle biopsies
Polysomnography
Video EEG monitoring

Imaging tests:
- CT
- MRI
CT cisternography
Cerebral arteriogram
Neurosonography
Myelogram
Electromyography
Intracranial pressure monitoring

Electroencephalography
Electromyography
Transcranial doppler