The first independent facility in Kerala for comprehensive brain, spine and nerve care, the Aster Centre of Excellence (CoE) in Neurosciences offers advanced neurology, neurosurgery, spine surgery, neuro oncology, neuroradiology, neuropsychology and neuro rehabilitation services to patients of all ages.
Designed to function like an independent neurology hospital in Kochi, the CoE has an outpatient wing, an inpatient wing, a day care unit, dedicated neuro ICUs, digital integrated neurosurgery suites, interventional neuroradiology suites, state-of-the-art imaging facilities including nuclear medicine and a 24-hour emergency division for handling all neurological and neurosurgery emergencies including complex neurotrauma and hyperacute management of stroke. The separate entrance to the facility ensures you quick and personalised medical attention.
Our exceptional team of doctors comprises nationally and internationally trained neurologists, neurosurgeons, spine surgeons, neuroradiologists, and neuropsychologists who are capable of handling the most complex cases. Multidisciplinary in approach, they will ensure you optimal and evidence-based treatment, with the support of speciality-trained nurses, technicians and rehabilitation therapists.
State-of-the-art in terms of technology and clinical support, Aster Centre of Excellence in Neurosciences is the first facility in South East Asia to offer OR1 Karlstroz fusion digital integrated neurosurgical suites with autopilot anaesthesia, the first in India to offer Flat Panel Biplane Vascular Hybrid Cath Lab and CLARITY Cathlab, the first in South India to offer IntelliSpace Critical Care and Anaesthesia (ICCA) Neuro ICUs and the first in Kerala to offer fourth generation PET-CT Scan with Time Of Flight Technology.
Facilities
Well equipped with the latest medical equipment, modern technology & infrastructure, Aster Hospital is one of the best hospitals in India.
Evaluation and treatment of acute and chronic movement disorders
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)
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
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 a high-precision da Vinci Surgery Robot.
Advanced Features
- PACS, HIS, and video recording integrated for single monitor control by Surgeons
- Each Operating Room has 3 cameras and 6 monitors for Doctors to monitor patient parameters and the surgical procedures
- Operative procedures can be transmitted live to various locations within and outside the Hospital
- Facilities for interactive sessions during operation through live transmission of the procedure
- Doctors can join the Surgical team and monitor the patient from any location outside the hospital
- Da Vinci Surgical Robot for performing minimally invasive Robotic Surgery
- State-of-the-art engineering techniques to maintain positive pressure within operating rooms along with heap filters to reduce infections
- Individual air handling unit for each Operating Room
- Equipped with Isocentric C Arm
- Advanced facilities to monitor including depth of Anaesthesia, Neuromuscular Monitoring, Transcranial Doppler and 3D Echocardiogram
- High-end Anaesthesia workstation with precision delivery of Anaesthetic gases
- Autopilot facility Anaesthesia machines
- Capability to export information to all ICUs within the hospital
- Induction bay with facilities for parents to be with children during induction of Anaesthesia
- As all Operating Rooms here are approximate of the same size, they can accommodate a variety of equipment- surgical, as well as those for ensuring the safety and protection of the patient
- Stringent Infection Control measures followed under the surveillance of experienced Doctors
Anesthesia Team
- Perioperative anesthetic care
- Anesthesia for solid organ transplant
- Invasive monitoring of deep hypothermic circulatory arrest and associated techniques
- Anesthetic support for SSEP and MEP
- Anesthesia for infants, neonates, and children
- Anesthesia for craniofacial reconstructive and cosmetic surgery
- Labor analgesia and obstetric Anaesthesia
- Regional anesthetic techniques with ultrasound and PNS
- Transesophageal echocardiography
- Fiber optic bronchoscopy
- Difficult intubation maneuvers
- Intar aortic balloon support
- Inotropes vasodilators and vasopressors
- ECMO and LVAD assistance
- Neuro monitoring: BIS, NIRS, neuromuscular monitoring, TCD
- Special anesthetic techniques for awake craniotomies
- Blood conservative measures
Seamless Team Work
The ORI Fusion Digital Integration system in the Operating Rooms helps create a workflow that’s seamless by enabling virtual participation of Doctors in the procedure, from whichever part of the world they are in at that point in time. As all medical reports and image modalities including the operation procedure can be transmitted live to any location inside or outside the hospital, Doctors can become a part of the Surgery Team on a real-time basis, wherein they can interact with Surgeons in the OR, closely monitor the procedure as well as patient parameters and contribute their expert suggestions.
- Karl Storz OR1 Fusion Technology
- Single monitor control enabled through integration of PAC, HIS & Video Recording
- Live to share all image modalities & medical reports
- 3 cameras and 6 monitors in every OR.
Waiting Lounge
Aster Medcity understands that the time of surgery is stressful for the family of the Patient as well, which is why the bystander’s waiting lounge has been designed in such a way that it provides a calming, comforting ambiance
Scenic view of the backwaters from the visitor's lounge, Recliner Chairs, Cafeteria
Guest Relation Team who updates the bystanders on patient’s progress at regular intervals and ensures a warm, hospitable atmosphere.
Faqs
Want to find out more about the treatment? The answer to your questions can be found below.
What is a treatment for Parkinson's disease?
Parkinson's disease is not curable. Parkinson's disease is initially treated with medicines that relieve the symptoms and enable them to function well. Levodopa is the mainstay of treatment of PD and has been used since the 1960s and gives excellent relief in the first 3-5 years of treatment. With the progression of the disease, the beneficial effects of levodopa reduce and the symptoms of patients fluctuate through the day. These motor fluctuations can be a predictable early wearing off, of the benefits of a dose of levodopa which makes it necessary to take more frequent doses. There can be delayed onset of effect of levodopa or a sudden unpredictable loss of effect of levodopa. Levodopa can also induce dyskinesias which appear as involuntary dance - like flowing movements in the neck, trunk, or limbs. These phenomena occur in about 805 of patients during the course of the disease, within 5-10 years of onset of disease.
Who can undergo scoliosis / spinal deformity surgery?
Children, adolescents with scoliosis
Patients with kyphosis (hunchback / forward curving of the spine)
Adults and elderly patients with spinal deformities
How long does it take to recover from scoliosis surgery?
If the recovery is as expected, the patient can be discharged within a week
Children can get back to school about a month after the surgery
What is scoliosis?
Scoliosis is a condition wherein a person’s spine or back is curved like an “S” or “C”
Scoliosis can be a by birth, acquired or age-related condition
Early detection and correction (in the adolescent age itself) is the key to effective treatment of scoliosis
Severe or visible scoliosis, if left untreated, can lead to complications including disfigurement, pain, breathing difficulties or nerve damage
What is Awake spine surgery?
These are surgeries done under local or regional anaesthesia without using general anaesthesia. Certain Minimally invasive spine surgery can be done in this manner.
What is Endoscopic Spine Surgery?
Endoscopic Spine Surgery is a minimally invasive spine surgery procedure that helps to relieve pain caused by herniated discs pressing on nerve roots.
Can elderly patients or very obese patients undergo spine surgery?
The advantages of minimally invasive spine surgery enable us to safely perform spine surgery in elderly patients with multiple medical problems and also obese /overweight patients, with the best possible medical outcomes.
What is minimally invasive spine surgery (MISS) or keyhole spine surgery?
Minimally invasive spine surgery is a highly advanced spine surgery technique using very small incisions, using cutting-edge intra-operative technology.
What are the early signs of Parkinson's disease?
Parkinson's disease usually starts with physical symptoms like:
- Tremor, on the one hand
- Tremors in both hands or limbs
- Reduces movement
- Stiffness to walk
- Uncoordinated limb movements.
Cognitive symptoms
- Cognitive issues
- Forgetfulness
- Concentration issues.
What is the cause of Parkinson's disease?
Degeneration or date of basal cell ganglia and a part of the brain which releases dopamine can cause Parkinson's disease at a later age. A steep drop in dopamine is responsible for many symptoms of Parkinson's disease.
Loss of nerve endings that release norepinephrine, the chemical responsible for many motor actions. The exact cause of Parkinson's disease is not yet known, but scientists believe it to be a combination of hereditary and environmental factors(toxin exposure).
What's the difference between Parkinson's disease and Parkinsonism?
Parkinson's disease is caused by brain degenerative nerve cells, causing a dopamine drop. In contrast, Parkinsonism can be caused due to several reasons:
- Side effects of medications
- Chronic head injury or trauma
- Metabolic diseases
- After effects of toxins
- Neurological diseases
Parkinsonism is a group of disorders that mimic symptoms of Parkinson's disease.
Is Parkinsonism a progressive disease?
Parkinsonism can worsen only if treatment is not received at the right time. It is a reversible disorder if the reason causing Parkinsonism is removed. For, e.g., an obstructing artery, nerve pressure, or discontinuation of the medication causing it(drug-induced Parkinsonism)
What role does the spine play in neurological disorders?
Your spine connects your limbs and lower body to the brain with the help of nerve fibers and nervous tissue. Any damage to the spine can cause neurological disorders and vice versa. Spinal cord disorders have the potential to cause long-term & severe neurological issues.
Are all neurological disorders incurable?
Neurological disorders hamper the quality of life, are severe, and can be fatal. Though most are still incurable, many treatment outcomes depend on causative factors. With advanced medical procedures and palliative care, many symptoms can be improved and reversed in some cases.
What are the types of neurological disorders?
Neurological disorders are differentiated based on the following:
- Genetic defects: Alzheimer's, Parkinson's, and epilepsy can run in families.
- Anatomic or structural defects: Bell's palsy, cervical spondylitis, carpal tunnel syndrome.
- Degenerative changes due to age: stroke, dementia, precipitation of Parkinson's.
- Blood supply issues(vascular) like brain damage, memory loss, and vascular dementia.
- Cancer: paraneoplastic disorders of the nervous tissues can cause problems like loss of consciousness, loss of muscle movement, thinking, memory, and sensory perception.
- Injuries and trauma related: can be due to physical(acute spinal cord injury, ALS, Ataxia) or emotional trauma(adverse childhood experiences can precipitate neurological symptoms).
- Infections: several viral infections can cause neurological disorders like meningitis, encephalitis, chickenpox, and polio.
- Seizure disorders: epilepsy.
What is Moment Disorder?
Movement disorders are a group of diseases affecting the ability to produce and control body movement. Lakhs of people in India lives with movement disorders, including Parkinson's disease. It is the second commonest neurological degenerative disease of the brain after Alzheimer’s disease. Estimates show that 1-2% of people over the age of 60 years develop this condition.
Are spinal deformity surgeries safe?
Yes, these surgeries are safe. The centre for spine care at Aster Medcity has the latest medical technology for ensuring maximum patient safety and are performed with the help of intra-operative nerve monitoring for unmatched accuracy.
What is scoliosis spine surgery?
Scoliosis spine surgery is a specialised surgery for correction of spine deformity
What are the advantages of awake spine surgery?
Many patients with multiple risk factors (cardiac/liver/kidney disorders) or those who are elderly may not be good candidates for general anesthesia. Awake spine surgery can be performed in such patients. Another advantage would be shorter recovery times and same day discharge from hospital
What is the purpose of Lumbar fusion?
Lumbar fusion is done to correct issues with the vertebrae such as painful motion and stability of the spine.
What is spinal stenosis decompression
The narrowing of the spaces within the spine is known as spinal stenosis. The minimally invasive spine surgery procedure helps decompress the nerves in the narrow spaces between the vertebral bones and spinal joints.
What are the advantages of minimally invasive spine surgery over open surgery?
Very small surgical incisions and scars (approximately 18mm)
Minimal muscle damage
Minimal blood loss
Lesser pain, which reduces the need for pain killers
Fewer post-surgical complications
Minimal hospital stay
Quicker recovery
Faster return to normal life
Lower incidence of surgery related back pain
Why test sudomotor function?
A sudomotor function test is a quick and reliable way of identifying certain types of neuropathies. The presently available tests detect only 50-60% of neuropathies. This test helps the clinician to identify small fiber neuropathies and improve diagnostic accuracy.
What is Parkinson's Disease?
Parkinson's Disease is a progressive neurological disease caused by degeneration of nerve cells in an area in the brain called the substantia nigra. It is a part of the basal ganglia circuit that controls movements. The cells in substantia nigra produces an important chemical called dopamine required for the normal functions of the basal ganglia
circuits which allows us to make the desired type of movements and prevent unwanted movements.
It is estimated that about 7-10 million people have the disease world - wide and about 60,000 new cases are diagnosed each year. While the risk of a PD increases with age (average age of onset in the early 60s), around 5-10 percent develop the symptoms before the age of 50 and about 1-2 % have other family members affected by the same condition.
What are the symptoms of Parkinsonism?
Physical symptoms of Parkinsonism are:
- Muscle stiffness
- Rigid joints
- Tremors
- Imbalance
- Hunching or stooping
- Inability to walk.
What are the causes of Parkinsonism?
- Vascular Parkinsonism: reduced blood supply to some parts of the brain. The brain in that part does not function efficiently and causes Parkinson's symptoms.
- Post-traumatic Parkinsonism: Brian tissue damage due to chronic or repetitive brain injury, which results in reduced blood supply to parts of the brain. E.g., boxing.
- Toxin causing Parkinsonism: toxic chemicals which can cause changes to dopamine-releasing parts of the brain.
- Normal pressure hydrocephalus: this happens when excess CSF causes pressure in parts of the brain
- Postencephalitic: after encephalitis infection, Brain cells are damaged
- Atypical Parkinsonism
- Supra nuclear palsy
- Multiple system atrophy
- Alzheimer's.
- Wilson's disease.
- Huntington's disease.
Is vascular parkinsonism hereditary?
Hereditary transmission of vascular Parkinsonism is rare but can happen with cases involving inherited CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts) & leukoencephalopathy.
Neurological disorder vs mental illness/disorder?
Neurological disorders are caused due to malfunction or damage to the central/ peripheral nervous system.
Mental illnesses or disorders are manifestations of disturbed behavioral issues and emotional problems.
When to go to a neuro physician?
Symptoms that persist for a long time need to be reviewed by a neuro physician like
- Severe or chronic headaches.
- Chronic pain in the body which is not of skeletal origin.
- Dizziness or problems with body balance.
- Chronic numbness or tingling in feet, fingers, wrists, etc
- Mild tremors or chronic twitching of muscles.
- Confused thoughts, random train of thoughts, memory problems.
What is a neurological disorder?
In medical terms, a neurological disorder can be defined as a disease, abnormality, or disorder affecting the brain, nerves, spinal cord, or nervous tissue present anywhere in the body. These disorders involve all electrical, biochemical, and structural problems related to the organs of the nervous system.
What are the symptoms of Moment Disorder?
The different abnormal movements are shaking (tremor), stiffness of muscles, slowness and loss of balance (together called parkinsonism), twisted postures (dystonia) abrupt jerks (myoclonus), dance-like flowing movements (chorea) and stereotyped rapid jerks and involuntary sounds (tics). Many diseases that produce movement disorders result from degeneration of brain cells in areas controlling movement and do not have an obvious cause or may be due to a genetic change.
These movements can develop as a consequence of injury, infections, inflammation, metabolic disturbances and tumours of the brain or as side effects of certain drugs. Neurologists who are specialists in movement disorders offer diagnosis and treatment for such conditions through dedicated movement disorder clinics.
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