X
View Mobile Number
Hi
I agree to the terms and privacy policy
Verifying...
1

Have a requirement?
Get Best Price

Hi
I agree to the terms and privacy policy
Verifying...
1

Have a requirement?
Get Best Price

Other Services

Our service range includes a wide range of Brain And Spinal Cord Trauma Treatment Services, Hydrocephalus Treatment Services, Antenatal Counseling Treatment Services, Surgery Epilepsy Treatment Services, Craniosynostosis Treatment Services and Brain and Spinal Cord Tumors (Pediatric Neuro-oncology).

Brain And Spinal Cord Trauma Treatment Services
Interested in this product?
Get Best Quote

Trauma is the second leading cause of death in children less than 15 years of age and head injury is responsible for 20% of these deaths. The outcome in the children depends on the severity of the injury as well as management. Children have a large number of productive years ahead - it is imperative that these children require utmost care and attention. The mechanism of injury in children is distinct from adults with common causes being falls (35%), recreational activities (29%) and traffic accidents (24%). There is also age specific variation with child abuse seen frequently in children less than 2 years of age. Falls are a major cause of head injury in children less than 3 years. Road traffic accidents account for larger numbers as the age of the child increases.

Children as mini adults and treat them similarly. The immature skull has different mechanical properties and the child’s brain is undergoing maturation and development and. The newborn’s skull has pliable thin bones which can significantly deform.The pliability of the skull makes it more vulnerable to injury especially diffuse injury. The child’s brain is much larger in proportion to the body as compared to adults - the newborn’s brain constitutes 15% of body weight compared to 3% in the adult. The relatively larger size of the brain of a child in comparison to the body makes it more vulnerable to injury.

Head injury could be primary or secondary. The primary injury is the immediate Contact forces may result in fractures, localized contusions and hematoma ,hemorrhages and diffuse injury. Secondary injury results from an array of reactive events which follow the primary event and can worsen the initial injury or cause new injury to brain. These events include hypoxia, hypotension, metabolic alterations, fluid and electrolyte imbalance, brain edema, seizures, local and systemic infections etc The secondary injury are preventable and this constitutes an important aim in the management of the head injured child. Various pathologies may be seen in head injured patients.

View Complete Details

Yes, I am interested!

Hydrocephalus Treatment Services
Interested in this product?
Get Best Quote

Hydrocephalus comes from the Greek: "hydro" meanswater, "cephalus" means head. Hydrocephalus is an abnormalaccumulation of cerebrospinal fluid (CSF) within cavities called ventriclesinside the brain. CSF is produced in the ventricles, circulates through theventricular system and is absorbed into the bloodstream. CSF is in constantcirculation and has many important functions. It surrounds the brain and spinalcord and acts as a protective cushion against injury. CSF contains nutrientsand proteins necessary for the nourishment and normal function of the brain. Italso carries waste products away from surrounding tissues. Hydrocephalus occurswhen there is an imbalance between the amount of CSF that is produced and therate at which it is absorbed. As the CSF builds up, it causes the ventricles toenlarge and the pressure inside the head to increase.

CSF Pathways
The Choroid plexus is the mainsource of CSF. The CSF formed in the lateral ventricles gains access to thethird ventricle through the paired foramina of Munro. From there through theAqueduct of Sylvius it enters the fourth ventricle from which is exits throughthe foramina of Luschka and Magendie. Part of it flows down into the spinalsubarachnoid space. The bulk flows over the hemispheres and the subarachnoidpathway to be absorbed by the arachnoid villi in the superior sagittal sinus. Primary site of absorption is thearachnoid villi  - by a pressuredependent process. The other sites of absorption are the parenchymalcapillaries and root sleeves of the large cranial nerves). The production,circulation and absorption of CSF is a continuous and dynamic process.

Etiopathogenesis
Hydrocephalus can result from
1. Over production of CSF
2. Under absorption of CSF

Over production
The only known condition causing hydrocephalus by overproduction is ChoroidPlexus tumor.

Underabsorption
Under absorption may result from:
1. A block in the CSF pathways interfering with the flow of CSF (i.e. obstructive hydrocephalus).
2. A defect in the absorptive mechanism itself.

Both result in an accumulation of CSF. In theformer the obstruction can be inside the ventricular system (referred to as noncommunicating hydrocephalus) or in the subarachnoid spaces (termedcommunicating hydrocephalus).

Clinical Features Infants: The skull is pliable and yielding in thisage. The common manifestations are increased head size, bulging or fullanterior fontanelle, sutural separation, sunset sign, poor feeding,irritability, vomiting, and dilated scalp veins.  Cracked pot resonance is often mentioned butseldom elicited.

Hydrocephalus that is congenital (present at birth) iscaused by a complex interaction of environmental and perhaps genetic factors.Aqueductal stenosis and spinal bifida are two examples. Acquired hydrocephalusmay result from intraventricular hemorrhage, meningitis, head trauma, tumorsand cysts. Hydrocephalus is believed to occur in about 2out of 1,000 births. Hydrocephalusin infants and young children is frequently diagnosed at birth or shortlythereafter, With the advent of sophisticated imaging technologies such asmagnetic resonance imaging (MRI) and ultrasonography, hydrocephalus can bediagnosed in utero, before the baby is born.
Children: The common manifestations includeincreasing head size, vomiting, bulging fontanelles (if it is still open),irritability, poor feeding or even refusal of feeds, headache, visual deficits,abnormal ocular movements, gait disturbance, increased tone in the lowerextremities, paralysis of upward gaze and papilledema. Serial measurements ofthe head size are a good indicator of the evolution of hydrocephalus.

View Complete Details

Yes, I am interested!

Antenatal Counseling Treatment Services
Interested in this product?
Get Best Quote
I offer parents of children with inuteroabnormalities prenatal counseling. This allows us to provide education toprospective parents about their child's diagnosis and prognosis, allowing themmaking important decisions about the pregnancy and new born. Disordersdiagnosed in utero include hydrocephalus, intracranial cyst, spinal dysraphism,vascular anomalies, and rarely, tumors.

What Is Prenatal Hydrocephalus?
Prenatal hydrocephalus describes hydrocephalus that is diagnosed in utero (before birth).

Hydrocephalus can be detected in a fetus as early as the latter part of the first trimester of pregnancy. Around 20 to 24 weeks of gestation, abnormal dilation of the fetus's ventricles is more clearly detectable. Prenatal ultrasound, performed by a radiologist skilled in obstetric ultrasound, is highly reliable and accurate. It will establish that there is an abnormal cerebrospinal fluid (CSF) collection but it may not show the precise site of flow obstruction. The more important question is what caused the hydrocephalus and to what degree is there other malformations within the central nervous system. Amniocentesis (needle aspiration of intrauterine fluid) can often detect the presence of open neural tube defects, such as myelomeningocele, chromosome abnormalities and in utero infections, and may indicate the severity of the fetal condition. In general, early (first trimester) development of significant hydrocephalus can be a bad prognostic sign for infant mortality and developmental progress. In some cases, mild ventricular dilation identified by ultrasound has resolved itself by the third trimester.

Prenatal hydrocephalus is generally not treated until after birth, After birth a shunt may be inserted into the baby's brain to divert CSF fluid to treat the hydrocephalus.

There are many unknowns surrounding a prenatal diagnosis of hydrocephalus. This can be very frightening, distressing and sad for expectant parents, and extremely frustrating for the medical specialists who provide care. Although the outlook and success rate for infants diagnosed at or after birth is generally very high, there are limited studies available on the long-term prognosis of those with prenatal-onset hydrocephalus. Much seems to depend on the extent of associated brain and systemic abnormalities, structural changes in the brain and the extent of the hydrocephalus. It is very difficult to accurately predict future function based on morphology or imaging. The more significant factor in the future development of children with prenatal-onset hydrocephalus is the presence of continuing care and the absence of complications such as infection or hemorrhage.

I also do antenatal counseling for cyst in brain like Dandy-Walker malformation, Arachnoid cyst and spinal dyrasphism.

View Complete Details

Yes, I am interested!

Surgery Epilepsy Treatment Services
Interested in this product?
Get Best Quote
Epilepsy
Epilepsy is an intermittent derangement of the nervous system due to a sudden, excessive, disorderly electrical discharge of cerebral neurons. The term epilepsy is derived from the Greek word epilamvanein .Prevalence rate of epilepsy in India is 5.59 per 1000 population with no gender or geographical difference. More than two-thirds of all epilepsy begins in childhood, when seizures can have drastic and devastating results on the child's psyche and development. Recent advances over the past decade in the understanding of pathogenesis mechanisms and in the diagnosis of epilepsy have had a significant impact on every aspect of epilepsy management including surgical management of epilepsy.

Surgical treatment is highly effective in the treatment of many of the epilepsies that have not responded to medical therapy. Nearly 40 percent of children with partial epilepsy are candidates for surgical therapy.

I work in close association with a team. Our Pediatric Epilepsy Surgery team includes Pediatric Neurologists, Pediatric Neurosurgeons, Neuropsychologists and Neuroradiologist. Children with medically intractable epilepsy are extensive evaluations include video-EEG, Neuroimaging like MRI. and Neuropsychological assessments. We conduct monthly meetings to discuss pediatric epilepsy cases in our forum to provide the best surgical management and plan [tailored to the individual’s case]and care. The department is experienced in performing temporal lobectomy, lesionectomy, corpus callostomy and hemispherectomies and placement of vagal nerve stimulator. I also conduct Awake craniotomy when appropriate.

Why epilepsy surgery?
AED is main stay in the treatment. The untoward cognitive side effects of AEDs coupled with the long-term effects of recurrent seizures, reduced quality of life and increased co-morbidities for the majority of patients. So in children with epilepsy where surgical option is available, more and more children are recruited for epilepsy surgery.

Patients with unsatisfactory seizure control often seek alternative care. The number or severity of the seizures may be unacceptable to the patient, family, or treating physician. Other reasons for referral for epilepsy surgery include the results of diagnostic tests that may show a structural focal brain lesion, unsatisfactory psychosocial adaptation due to poor seizure control, unacceptable sedation, or other drug side effects.

The morbidity and mortality of seizures include accidental injury; cognitive decline; sudden death; and psychological, social, and vocational impairment. Accidental injuries commonly include fractures, burns, dental injuries, lacerations, and head injuries. Cognitive decline over time has been demonstrated to occur in patients with certain epilepsy syndromes who have recurrent convulsive seizures or episodes of status epilepticus. Both depression and anxiety are very common among patients with medically refractory epilepsy. Vocational issues include inability to be employed or, if employed, underemployment.Prolonged anticonvulsant drug therapy also affects cognition, memory, behaviorand motor developmentin substantial number of children.

Type of surgery
Epilepsy surgery may be divided into two major categories: Resective and Functional. The aim of Functional surgery is to decrease seizure frequency.
Resective surgeries
The aim of resective surgery is to remove the epileptogenic zone and render the patient seizure free. Surgeries done are:
1. Anteromedial Temporal Resection [AMTR],
2. Selective Amygdylohippocapectomy
3. Lesionectomy [Temporal and Extra-temporal]

View Complete Details

Yes, I am interested!

Craniosynostosis Treatment Services
Interested in this product?
Get Best Quote

Skull deformities are a very common reason for referral to pediatric neurosurgery.Premature fusion of cranial suture closure is called craniosynostosis.

Incidence and Aetiology :
Isolated craniosynsostosis occurs due to the premature fusion of a single suture or multiple sutures. The overall prevalence of craniosynostosis is around 1 in 2500 live births, with ranges of 1 in 709 to 1 in 3225 of births. The wide variation seen is due to differences in the various criteria under which one labels craniosynsostosis. Isolated craniosynostosis is far more common than multiple ‘syndromic’ synostosis.Sagittal seems to be commonest, followed by coronal and metopic. True lambdoid synostosis appears rare and is difficult to distinguish from deformational posterior asymmetry, which is considered to be because of positional molding of the cranium.

Common Syndromic Craniosynostosis like Apert and Crouzon have prevalence of about 1 in 65000, each about 4-6 per cent of all craniosynostosis. There is evidence of FGFR2 mutation in Apert Syndrome, FGFR3 in Crouzon syndrome and FGFR1 in Pfeiffer syndrome. Almost all Aperts and about 50 per cent of Crouzons arise de novo and there is a correlation with increase in paternal age. The prevalence of Pfeiffer syndrome is lower than others but there is no definite percentage data.

Apart from this there are rarer types of single gene syndromes associated with other malformations, metabolic storage disorders and learning disabilities.There are chromosomal aberrations of which craniosynostosis may be a feature. There are teratogenic causes associated with anticonvulsants, (Valproate, Hydantoin)cytotoxic agents, (Methotraxate, Cyclophosphomide, Cytarabine) abortifacients, and nitrosatable drugs(Chlorpneramine,Nitrofurantoin, Chlordiazepoxide and Fluconazole).

Classification and Terminology
Over the years, the nomenclature for various craniofacial deformities has remained constant, but with the entry of molecular genetics, there have been additional terms given to the complex multi sutural synostosis. However, in simple terms these deformities can be classified into three different varieties.



Simple, Complex and Secondary:
The Simple anomalies include single suture or two suture involvement and are named as
  1. Sagittal synostosis or Scaphocephaly or Dolichocephaly, is so called when the sagittal suture is singularly prematurely fused and the head attains a longish anteroposterior length with or without frontal bossing.
  2. Unicoronal synostosis [Anterior-Plagiocephaly] when there is flattening of one side of the forehead and a mild facial scoliosis, due to premature fusion of one coronal suture.
  3. Metopic synostosis or Trigonocephaly, when there is premature fusion of the metopic suture, and the forehead assumes a triangular shape like the keel of a boat.
  4. Lambdoid synostosis [Posterior Plagiocephaly] when a single lambdoid suture fuses to produce asymmetric occipital flattening.
  5. Bicoronal synostosis or Brachycephaly, where both coronal sutures fuse prematurely and the skull assume spherical shape.
  6. Acrocephaly or Turricephaly or Oxycephaly , where both coronals and anterior Sagittal sutures fuse and the skull assumes a pointed tower like shape.

View Complete Details

Yes, I am interested!

Brain tumors are second most common neoplasm of childhood after leukaemia, primary brain tumors are responsible for 20% of all cancers in children, and for 20% of childhood cancer deaths. The yearly incidence of childhood brain tumors is reported to be 24 per million children less than 15 years of age. The neurologic functional outcome and quality of life of children is goal of treatment .

View Complete Details

Yes, I am interested!

Contusions

Get Latest Price

The Contusions may be at the site of impact[coup], counter coup.  Contusions associated with tears in the cortical surface are called lacerations Concussion is a clinical syndrome characterized by a transient and reversible impairment of consciousness which does not leave any residual deficit.  Rotational forces are responsible for causing a Diffuse Axonal Injury characterized by stretch and shearing injury to the axons and the myelin sheath at the grey white matter junction, in the corpus callosum, dorsolateral pons and superior cerebellar peduncle.  Head injury could also be classified as mild, moderate or severe based on the Glasgow Coma Scale (GCS) of 13 to 15, 9 to 12 and 3 to 8 respectively.  In children mild injuries account for 80% of all head injuries whereas moderate and severe injuries constitute 10% each. Radiological assessment includes Skull X-Rays and CT scan.  Except for a few children, most children with mild head injury make remarkable recoveries and full recovery is the norm. The major concern in these patients is parental anxiety and overprotection. The overall focus of care in moderate and severe head injuries would be to prevent brain ischemia by controlling ICP and removing focal symptomatic mass lesions.

View Complete Details

Yes, I am interested!

Skull Fractures

Get Latest Price

Skull fractures are common in children with the vast majority being linear skull fractures.  The parietal bone is the most common site and patients present with pain and swelling.  Subgaleal and subperiosteal hematomas may occur with the fracture and in neonates and infants may be substantial enough to require blood transfusion.  Depressed fractures may require surgery if associated with a dural tear or if compound or if large underlying contusion / hematoma.  There is no evidence that elevation of a simple depressed fracture would improve neurological outcome or prevent seizures Compound depressed fractures should be explored because of concerns of infection.  Depressed fractures in frontal area may need to be elevated for cosmetic purposes. Infants are prone to Ping-pong fracture.

View Complete Details

Yes, I am interested!

Mass Lesion Neurosurgeon

Get Latest Price

Intracranial hematoma are serious pathology and require urgent attention.  Extradural hematomas are fairly uncommon in children because the dura is tightly adherent to the periosteum.  Also the groove of the middle meningeal artery is shallow and therefore the artery is less prone to tear with injury.  Almost all extradural hematomas are associated with a fracture.  Subdural hematoma are second common and may be associated with rotational forces and assoacited brain injury. Intracerebral hematomas and contusions occur with increasing frequency with increasingage and occur as a result of acceleration – deceleration injury.  Management of these mass lesions would depend upon the clinical condition of the child and the size of the lesions.

View Complete Details

Yes, I am interested!

Non Accidental Injury

Get Latest Price

Non accidental injury is injury deliberately inflicted on the child. Also know ‘Shaken Baby syndrome’.  This resulted from a relatively large infant head pivoting back and forth on the cervical spine They are brought to the hospital either with non specific complaints like lethargy, irritability, unresponsiveness or even apnea or with a history of a minor injury - usually fall from short height. Also associated with soft tissue and skeletal injury in different stages of healing.  Fractures are bilateral, multiple or stellate. Retinal hemorrhages occur in 65 – 95% . The outcome of such injuries depends upon the condition of the child on presentation.

View Complete Details

Yes, I am interested!

Birth Injuries

Get Latest Price

Birth injuries could be due to mechanical forces during childbirth or could result from hypoxic / ischemic insults. The mechanical forces could result in scalp injuries, fractures or intracranial hematoma. Scalp injuries in the newborn could be of three types – Caput Succedaneum, Subgaleal hematoma and Cephalhematoma.  Caput is seen in almost all children and involves edema of the outer layers of the scalp. It usually resolves in a day or two.  Subgaleal hematoma is rare but potentially life threatening because the large subgaleal space can accommodate the whole blood volume of a neonate. The cephalhematoma is underneath the periosteum and is limited by the cranial sutures.

View Complete Details

Yes, I am interested!

Majority of the cerebrovascular lesions in children are asymptomatic and only found incidentally or at autopsy, so the incidence of these malformations is unclear. There are five major categories according to the patho-anatomic characteristics viz.
  • Telangiectases
  • Venous Malformation
  • Cavernous Haemangiomas
  • Arteriovenous Malformations (AVMs and Aneursyms)
  • Moya Moya disease

View Complete Details

Yes, I am interested!

Brain tumors are second most common neoplasm of childhood after leukaemia, primary brain tumors are responsible for 20% of all cancers in children, and for 20% of childhood cancer deaths. The yearly incidence of childhood brain tumors is reported to be 24 per million children less than 15 years of age. The neurologic functional outcome and quality of life of children is goal of treatment .

View Complete Details

Yes, I am interested!

Surgery for Epilepsy

Get Latest Price

Epilepsy is an intermittent derangement of the nervous system due to a sudden, excessive, disorderly electrical discharge of cerebral neurons. The term epilepsy is derived from the Greek word epilamvanein .Prevalence rate of epilepsy in India is 5.59 per 1000 population with no gender or geographical difference. More than two-thirds of all epilepsy begins in childhood, when seizures can have drastic and devastating results on the child's psyche and development. Recent advances over the past decade in the understanding of pathogenesis mechanisms and in the diagnosis of epilepsy have had a significant impact on every aspect of epilepsy management including surgical management of epilepsy. 

Surgical treatment is highly effective in the treatment of many of the epilepsies that have not responded to medical therapy. Nearly 40 percent of children with partial epilepsy are candidates for surgical therapy.

View Complete Details

Yes, I am interested!

Trauma is the second leading cause of death in children less than 15 years of age and head injury is responsible for 20% of these deaths. The outcome in the children depends on the severity of the injury as well as management. Children have a large number of productive years ahead - it is imperative that these children require utmost care and attention. The mechanism of injury in children is distinct from adults with common causes being falls (35%), recreational activities (29%) and traffic accidents (24%).  There is also age specific variation with child abuse seen frequently in children less than 2 years of age.  Falls are a major cause of head injury in children less than 3 years. Road traffic accidents account for larger numbers as the age of the child increases.

Children as mini adults and treat them similarly. The immature skull has different mechanical properties and the child’s brain is undergoing maturation and development and.  The newborn’s skull has pliable thin bones which can significantly deform.The pliability of the skull makes it more vulnerable to injury especially diffuse injury. The child’s brain is much larger in proportion to the body as compared to adults  - the newborn’s brain constitutes 15% of body weight compared to 3% in the adult.  The relatively larger size of the brain of a child in comparison to the body makes it more vulnerable to injury.

View Complete Details

Yes, I am interested!

Majority of the cerebrovascular lesions in children are asymptomatic and only found incidentally or at autopsy, so the incidence of these malformations is unclear. There are five major categories according to the patho-anatomic characteristics viz.

View Complete Details

Yes, I am interested!

I offer parents of children with inutero abnormalities prenatal counseling. This allows us to provide education to prospective parents about their child's diagnosis and prognosis, allowing them making important decisions about the pregnancy and new born. Disorders diagnosed in utero include hydrocephalus, intracranial cyst, spinal dysraphism, vascular anomalies, and rarely, tumors.

View Complete Details

Yes, I am interested!

Growing Skull Fractures

Get Latest Price

This is an uncommon condition found in very young children with a growing brain.  Also known as Leptomeningeal Cyst and Craniocerebral Erosion. It happens when there is  fracture with a dural tear and an outward driving force such as a growing brain, a cyst or hydrocephalus.  The pulsations of the brain against the bone edges and the pressure exerted result in erosion of the bone edge and subsequent eversion. The underlying brain gets attached to the dura an This results in the development of and prevents from fracture from healing.Epileptic focus often with intractable seizures and also of progressive neurological deficit.  All such cases need surgery as the fractures never heal and the clinical and pathologic changes are progressive

View Complete Details

Yes, I am interested!

Brain And Spinal Cord Tumors Treatments Services
Ask for Details

Spinal Dysraphism Treatment Services
Ask for Details

Get Price & Details
Tell us what you need, and we’ll help you get quotes
Tell us what you
need
Receive seller
details
Seal the deal
Pay with IndiaMART
Tell us what you need, and we’ll help you get quotes
I agree to the terms and privacy policy