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Even the mention of brain surgery or concerns related to the brain can be very frightening and stressful. Our highly esteemed surgeons, Dr. Sam Safavi-Avvasi, and Dr. Brad Nicol have collectively over XX years of experience and have performed over XX surgeries.

Many techniques are non-invasive, although others require more involved processes. Regardless, we are here to help you and your loved ones understand the processes and surgeries needed once we carefully assess and diagnose you through advanced diagnostic systems. All of our procedures and surgeries are prescribed to relieve your pain and suffering, with the most efficient, current, and minimally invasive steps.


Burr Hole for Subdural Hematoma

This procedure creates one or more holes in the skull to release excess fluid pressure in the brain caused by chronic subdural hematoma.

The surgeon makes a tiny incision in the scalp and drills one or two holes through the skull, exposing the dura.  The dura is then opened to allow the fluid to drain from the inside of the skull, reducing the pressure.  Saline may be injected to help wash out the fluid.  The wound is then closed with sutures or surgical staples.

Craniectomy for Chiari Malformation

This surgery is used to treat Chiari Malformation, an abnormality that results in a part of the brain extending into the spinal canal.

The surgeon creates an incision in the back of the head extending down to the upper neck in the midline. The soft tissue and upper neck muscles are pulled back to expose the skull and first vertebra. Using a high-speed drill a section of the base of the skull is removed to create more space for the brain. Then the back arch of the C1 vertebra is moved, known as a laminectomy. In most cases, more space also needs to be created in the dura. A Y-incision is created in the dura so that it can be expanded and then a patch of natural or synthetic graft material is placed.

The bone is not replaced. In some cases, a small strip of titanium mesh may be places across the top portion of the hole in the skull to provide a place for the muscles to reattach. The muscles are closed and the skin flap is folded back and closed with sutures or surgical staples.

Craniotomy for Aneurysm

This surgery is used for clipping of an aneurysm.

The surgeon makes an incision in the skin, the bone is exposed, part of the skull is cut and the bone flap is lifted. The exposed dura is opened. The blood vessel with the aneurysm is located. The aneurysm is treated by placing a titanium clip around its base. Then the surgeon will confirm that blood is still flowing normally in the vessels around the aneurysm.

The dura is closed, the bone flap is replaced, and the skin flap is folded back and closed with sutures and surgical staples.

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Craniotomy for Meningioma (Brain tumor)

This procedure creates an opening through the skull for removal of a meningioma. This type of tumor is found in the dura.

The surgeon creates a long, arched incision in the scalp overlying the tumor. The soft tissue is folded back to expose the skull.  One or more holes are drilled into the skull and then they saw between the holes to free a section of the bone.  The bone flap is removed and stored.

Soft, flexible retractors are used to hold the healthy brain tissue aside. The surgeon then removes as much of the meningioma as can safely be removed. Once the meningioma have been removed, the skull flap will be put back in place and anchored with plates and screws. The skin flap is folded back and sealed with sutures or surgical staples.

In some cases, the entire tumor may be removed, but it may be necessary to leave a small amount of the tumor and treat this portion with other methods such as focused radiation.


Craniotomy for Tumor

The surgeon creates one or more small holes in the skull, then cuts the skull between these holes to free a section of the bone.  This section, called the bone flap, is removed and stored. The surgeon carefully opens the thin membrane that covers the brain, called the dura. Flexible retractors are then used to hold the healthy brain tissue aside. This exposes the tumor, and the tumor is removed. When the removal is complete, the surgeon closes the dura and replaces the bone flap. This section of the bone is anchored to the skull with small plates and screws. The skin flap is folded back and sealed with sutures, staples or a combination of both.

After the procedure, the patient can expect to stay in the hospital for approximately three days. The patient usually will be able to get out of bed the day after surgery. Full recovery usually takes several weeks, but can take up to two months. The patient may feel fatigued during this time.

Endoscopic Surgery for Pituitary Tumor

This endoscopic procedure is used to remove a tumor near the pituitary gland located behind the nose. This procedure is preformed jointly with a neurosurgeon and ENT surgeon.

The ENT surgeon enlarges a passageway in the back of the nasal cavity. An endoscope and surgical tools are placed in an open space behind the nose called the sphenoid sinus. A portion of the wall of the sphenoid sinus is removed to expose the dura. The dura is then cut open to expose the tumor. The tumor is carefully scooped away and removed in pieces, leaving the pituitary gland intact. The nostrils are packed with gauze.

Ventriculoperitoneal Shunt for Hydrocephalus

Ventriculoperitoneal Shunt for Hydrocephalus (VP Shunt)

The surgeon creates a small hole in the skull and places a flexible catheter into the fluid compartment of the brain. A second catheter is inserted under the skin from the scalp to the abdomen. The end of this catheter is inserted into the abdominal cavity. Both catheters are connected to a valve placed beneath the scalp. The valve regulates the amount of cerebrospinal fluid in the brain, allowing the excessive fluid to drain out of the brain and into the abdominal cavity. The incisions are closed with sutures.