It is the branch of neurosurgery that treats brain tumors. Intracranial and spinal tumors can be located inside or outside the central nervous system. In most of them, one of the mainstays of cancer treatment is oncology surgery which aims to maximum possible tumor resection. In some cases, other forms of add-on treatments such as chemotherapy, radiotherapy and radiosurgery are recommended.

 

Centro International del Cáncer (CIC) at Hospital de Diagnóstico de El Salvador has eduardo_lovo5all the necessary tools to deal comprehensively and accurately with brain and spinal tumors. It has the best specialists and the most advanced equipment in radiotherapy and chemotherapy. Patients are treated with a  multidisciplinary approach, with the joint participation of the Neuro-Oncology, Radiotherapy and Radiosurgery staff in the therapeutic decision making process.

 

Treatments offered at the CIC are:

  • Radiotherapy and Radiosurgery of the entire body using Hi-Art TomoTherapy

  • Chemotherapy

  • Oncology surgery performed at Hospital de Diagnóstico.

  • Nutritional and emotional support

  • Pain Management

 

1.Brain surgery:

CerebroThe brain is the control center of the body. It controls thoughts, memory, speech and movement; it also regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, when problems occur, the results can be devastating.

Below is a brief and simple description of the brain structures and functions:

The frontal lobes are quite large and are associated with executive functions such as self-control, movement, planning, reasoning, memory, mood, etc. The part of the brain associated with sight is also greatly enlarged and is called occipital lobe. The temporal lobe is responsible for the language, behavior, hearing and emotions. The parietal lobe is what distinguishes the left and right, reading, writing, sensations, etc.

 

The human brain performs a lot of functions. Generally, we can say that it is responsible for regulating and maintaining the body functions and for being the organ that is the home of the individual’s mind and conscience. There are several conditions that may affect the brain and its functions and, therefore, other parts of the body; however, they may be treatable with an early diagnosis.

 

2.Cerebrovascular surgery:

si_2733It is a surgical procedure to correct an aneurysm, a weak area in the wall of a blood vessel that causes said vessel to bulge and the possibility to burst. This can cause bleeding somewhere in the area surrounding the brain (also called a subarachnoid hemorrhage) or bleeding within the brain, forming a collection of blood (hematoma). The doctor will decide how best to conduct aneurysm surgery.

There are two methods commonly used to repair an aneurysm:

  • Clipping, which is done during an open craniotomy.

  • Endovascular repair, which is most often done using a “coil” or endovascular embolization; a less traumatic way to treat some aneurysms.

3.Epilepsy:

Enfermedades-CerebrovascularesEpilepsy is a disorder caused by an imbalance in the electrical activity of neurons in any area of the brain. It is characterized by one or more neurological disorders that leave a predisposition in the brain to suffer recurrent seizures, which often lead to neurobiological, cognitive and psychological consequences. The awake craniotomy “version 3.0” was promoted during the last decade. It is characterized by a better understanding of brain anatomy and function supported by CGI, which generate the important areas of the brain. The arrival of brain GPSs or neuronavigators finally allowed to safely navigate corridors considered “forbidden” until then and began to eradicate the notion of inoperable brain tumors.

In our country, this type of surgery has become more frequent after 2007 and allowed us to safely remove more and more tumors, allowing our patients to stay out of intensive care and shorten their hospital stay to only 2 days. From 2007 to date, the group of surgeons of Centro Internacional del Cáncer in El Salvador has performed 135 awake craniotomies, which not only limited to tumor surgery but also epilepsy, abscesses, blood clots inside the brain and other injuries.

tttttThe dramatic evolution in the field of neurosurgery in El Salvador can be greatly attibuted to awake craniotomy. The acquisition of increasingly sophisticated imaging and technology to operate the brain has supported this effort up to the brain radiosurgery program, which leads to a more advanced concept: operating the brain without opening it, bloodless, painless and on an outpatient basis, with Infini. A state-of-the-art equipment to operate brain tumors without the need of scalpels; epilepsy, Parkinson’s, and other brain diseases, making a significant difference in modern medicine.

 

4.Deep Brain Stimulation for Parkinson (DBS):

Parkinson lovoDeep brain stimulation (DBS) therapy is a surgical treatment that can reduce some of the symptoms associated with Parkinson’s disease. This therapy uses a surgically implanted device, similar to a cardiac pacemaker that electrically stimulates the brain by blocking the signals that cause the disabling motor symptoms. Electrical stimulation can be adjusted noninvasively to maximize the benefits of therapy. As a result, many individuals have greater control over their body movements. A DBS system consists of three implanted components: an electrode implanted in the brain, which has four isolated thin wires arranged in a spiral with four poles on the electrode tip; an extension that is connected to the electrode and runs under the skin from the head to the upper chest through the neck; and a neurostimulator that connects to the extension. The implantation is typically performed under the skin in the chest.

 

5.Radiofrequency Ablation for Parkinson:

lesion parkinsonThe most common method to make an ablation is to generate consistent RF thermocoagulation consisting of an alternating current at a frequency of 500,000 Hz through a one-pole electrode producing an oscillating electric field with moving electrolytes to cause significant heat by friction. Temperatures above 45°C produce permanent tissue destruction. The clot has a 1-6 mm diameter at temperatures of 60 to 80 ° C for 60 seconds. The average lesion volume is 75 mm3, 44-127 mm3 in different studies. Other techniques such as radiosurgery ablation are being tested, where radionecrosis is generated.