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Neurosurgical treatments & procedures

Brain, spine, blood vessel and nerve procedures, carried out in hospital after consultation, with neurointervention and radiosurgery arranged with partner centres.

By appointment

Available at these clinics

Our services

Brain & Spinal Tumour Surgery

Not every tumour needs surgery. Some are watched with regular scans, and others are treated with radiosurgery, radiotherapy or medicines. Where surgery is recommended, the approach depends on the type of tumour, where it is and how close it is to important structures such as nerves and blood vessels.

Surgery takes place at the hospital where Dr Chou practises, after a consultation to review your scans and discuss the options. The aim of each operation, whether to obtain a diagnosis, remove some or all of a tumour, or relieve pressure, is explained beforehand.

  • Brain biopsy
  • Craniotomy and brain tumour resection
  • Transsphenoidal pituitary surgery
  • Selected skull-base and cerebellopontine-angle tumour surgery
  • Selected spinal tumour surgery

How it works

  1. Consultation and imaging review

    Dr Chou reviews your symptoms, examines you and goes through your MRI or CT scans. Further tests are arranged if needed.

  2. Discussing options

    The options, including observation and non-surgical treatment where appropriate, are explained with their likely benefits and risks, so you can decide together.

  3. Surgery in hospital

    If you decide to go ahead, surgery is scheduled at the hospital where Dr Chou practises. You are told what to expect before, during and after the operation.

  4. Recovery and follow-up

    After discharge, follow-up visits check your recovery and review any scans or results. Rehabilitation is arranged with partner therapists where needed.

Brain biopsy

A small sample of tissue is taken when a diagnosis is needed before deciding on treatment.

Craniotomy and tumour resection

A craniotomy is a surgical opening of the skull to reach the brain. Tumours are removed using microsurgical techniques, with the approach planned around the tumour's location, type and relationship to important structures.

Transsphenoidal pituitary surgery

Suitable pituitary tumours are removed through the nose and the sphenoid sinus, without an opening in the skull.

Skull-base and spinal tumours

Selected skull-base and cerebellopontine-angle tumours are treated with microsurgical approaches tailored to the tumour, such as the retrosigmoid approach, with attention to preserving cranial nerve function. Selected spinal tumours may be removed to relieve pressure on the spinal cord or nerves.

Cerebrovascular Microsurgery

Cerebrovascular microsurgery treats conditions of the blood vessels of the brain using an operating microscope. Whether surgery, endovascular treatment, radiosurgery or observation is most suitable depends on the type, size and position of the abnormality and on your general health.

Surgery takes place at the hospital where Dr Chou practises, after consultation and review of vascular imaging such as CT angiography, MR angiography or catheter angiography. Bleeding from a ruptured aneurysm is an emergency and is treated in hospital.

  • Cerebral aneurysm clipping
  • Extracranial-to-intracranial (EC-IC) cerebral bypass
  • Selected surgery for arteriovenous malformations and other vascular malformations

Aneurysm clipping

A small clip is placed across the neck of the aneurysm to close it off from the circulation while preserving the normal blood vessels.

EC-IC cerebral bypass

An artery from outside the skull is connected to an artery inside it, to improve blood flow to the brain in selected patients with impaired cerebral blood flow or complex cerebrovascular disease.

Vascular malformations

Selected arteriovenous and other vascular malformations may be removed surgically. Others may be better suited to embolisation or radiosurgery arranged with partner centres, or to observation.

Fluid Circulation & Decompression Procedures

Some conditions affect the flow of cerebrospinal fluid around the brain and spinal cord, or cause pressure on the brain, brainstem or cerebellum. Procedures can help the fluid drain or create more space, depending on the cause.

These procedures take place at the hospital where Dr Chou practises, after consultation and imaging. Emergency decompression, for example after a serious head injury or bleeding in the brain, is carried out in hospital.

  • CSF shunt insertion and revision
  • Endoscopic third ventriculostomy
  • Neuroendoscopy for selected cysts and lesions
  • Posterior-fossa decompression, including for Chiari malformation
  • Selected emergency cranial decompression (in hospital)

Shunts

A shunt is a thin tube placed under the skin to drain excess cerebrospinal fluid from the brain to another part of the body, usually the abdomen. It is used for selected types of hydrocephalus, including normal pressure hydrocephalus.

Endoscopic third ventriculostomy and neuroendoscopy

A thin camera is passed into the fluid spaces of the brain. An opening can be made to let fluid bypass a blockage, or selected cysts and lesions can be treated, without a large opening in the skull.

Posterior-fossa decompression

Bone at the back of the skull is removed to relieve crowding of the cerebellum, brainstem or fluid pathways, for example in Chiari malformation.

Spinal Decompression & Stabilisation

Many spine problems, such as slipped discs and spinal stenosis, improve with time, medicines and physiotherapy. Surgery may be considered when pain or nerve symptoms persist, when there is weakness, or when the spinal cord or nerves are significantly compressed.

Procedures are chosen according to your condition and take place at the hospital where Dr Chou practises, after consultation and review of your MRI or CT scans.

  • Discectomy for slipped discs
  • Laminectomy and spinal decompression
  • Foraminotomy
  • Spinal fusion
  • Selected vertebroplasty and kyphoplasty

Decompression

Discectomy removes disc material pressing on a nerve or the spinal cord. Laminectomy removes part of the bone at the back of the spine to widen the spinal canal. Foraminotomy widens the opening where a nerve leaves the spine. These may be used for degenerative disease, disc prolapse, tumours or other causes of compression.

Spinal fusion

Two or more vertebrae are joined and stabilised where there is instability, deformity, degeneration or another structural problem.

Vertebroplasty and kyphoplasty

Vertebroplasty and kyphoplasty involve injecting bone cement into selected painful or unstable vertebral compression fractures; in kyphoplasty, a space is first created inside the vertebra.

Cranial Nerve Treatments

Trigeminal neuralgia and hemifacial spasm are often first managed with medicines. When medicines do not control symptoms or cause side effects, other treatments may be considered, depending on the cause, your general health and your preferences.

Microvascular decompression takes place at the hospital where Dr Chou practises, after consultation and MRI. Radiosurgery is arranged with partner centres.

  • Microvascular decompression
  • Selected percutaneous trigeminal treatments
  • Stereotactic radiosurgery, arranged with partner centres
  • Injections to ease facial spasm, where appropriate

Microvascular decompression

Through a small opening behind the ear, a blood vessel pressing on the nerve is moved away and a small cushion is placed between them. It may be considered for selected patients with trigeminal neuralgia or hemifacial spasm.

Other options

Percutaneous treatments reach the trigeminal nerve with a needle through the cheek, without an open operation. Stereotactic radiosurgery uses focused radiation and is arranged with partner centres. For hemifacial spasm, injections into the affected muscles may ease the spasm and are repeated over time.

Partner-Delivered Neurointervention & Radiation Treatment

Some conditions are suited to treatment from inside the blood vessels (endovascular treatment) or with focused radiation. These treatments are delivered by partner specialists, such as interventional neuroradiologists and radiation oncologists, at partner centres.

Dr Chou assesses whether these treatments are suitable, discusses them alongside surgical and non-surgical options, coordinates the referral, and continues to follow you up afterwards.

  • Aneurysm coiling or flow diversion
  • Embolisation of arteriovenous malformations
  • Selected stroke thrombectomy
  • Stereotactic radiosurgery

Endovascular treatment

Coiling, flow diversion and embolisation are carried out through a thin tube passed into the blood vessels, usually from the groin or wrist, by partner interventional specialists in hospital.

Stroke thrombectomy

Selected patients with a blocked brain artery may need urgent removal of the clot. This is an emergency treated in hospital; call 995 if you notice signs of stroke.

Stereotactic radiosurgery

Focused radiation for selected tumours, vascular malformations and trigeminal neuralgia, delivered at partner centres.

Before you book

Common questions

The doctor explains the cost of any medicines, tests or procedures before going ahead.