Department of Neurosurgery, STNM Hospital

26/11/2025

We conducted a clinical workshop last Saturday, focusing on "Treatment of Radicular pain due to Lumbar Disc bulge with Radio Frequency Disc Ablation". Dr. Ravisuman Reddy from Yashoda Hospital, Hyderabad, brought his expertise and equipment to provide this free service to the people of Sikkim.

Radicular pain, a type of pain that radiates along the path of a nerve root, is a common condition caused by compression or irritation of the nerve roots. In the case of lumbar disc bulge, the herniated disc compresses the adjacent nerve root, leading to pain, numbness, and weakness in the lower back and legs.

Traditional treatment options often include medication and physical therapy, but these may not always provide adequate relief. Surgery, while effective, can be too radical an approach for some patients, carrying risks and requiring lengthy recovery times. This is where minimally invasive procedures like Radio Frequency Disc Ablation offer a promising alternative, providing effective pain relief without the need for major surgery.

_Objective:_ To enhance clinical skills and knowledge in Minimally Invasive Percutaneous techniques of treatment of Compressive Radiculopathy

_Agenda:_
- Introduction and overview
- Hands-on practice sessions

We successfully treated 6 patients with root and facet block, caudal epidural block, and Radiofrequency ablation of disc bulge causing root compression. The patients experienced significant relief from symptoms. Thanks to Dr. Ravisuman Reddy for his generosity and the cooperative staff of Main OT 7 for their support.

We're planning to introduce these procedures at STNM soon, offering hope for effective pain management and improved quality of life for patients with radicular pain.

25/09/2025

BRAIN SURGERY THROUGH THE EYE??!!

Yes it's possible!! We did it here in STNM!!

A young boy from east sikkim had a head collision during a football match. Following this he had bulging of his right eye with double vision and blurry vision. Traumatic Exopthalmos! CT and MRI of the brain showed a large right frontal region Extra Dural Hematoma (accumulated blood) causing mass effect (pressure) over the brain. In addition he also had an intraorbital (Eye socket) hematoma which was pushing the right eye globe outwards from the socket (proptosis).

He defined required surgery but how to address both issues???!!

Conventionally a transcranial approach (through the skull/head) could allow good access to both the EDH as well as the orbital hematoma. But is a very radical approach and uses a large incision over the scalp. It also can result in a lot of blood loss, pain and a bad scar.

Another approach would be to go through the eye itself!!
The orbital hematoma could be evacuated directly and drilling the orbital roof could give access to the EDH as well. The best way to go would be to use an endoscope, which we do not have in STNM yet. To go with a Microscope would risk poor exposure and in case of profuse bleed it may impose great risk.

So we decided to take a chance for the boy. We planned to go with the transorbital approach and keep the transcranial approach as a rescue method if such a bleed was encountered.

Luckily we were able to evacuate both hematomas safely through the transorbital approach. The proptosis resolved almost immediately. The eye movements were restored and vision also improved significantly. The scar hardly shows as it coincides with the eyelid crease. The 2nd week follow up scans shows complete resolution of both hematoma and the eye globe in good position within the orbital cavity.

Overall a good result in a challenging case done IN A MINIMALLY INVASIVE TECHNIQUE!!

15/11/2024

29/10/2024

Let's all be informed about STROKE!!
On this World Stroke Awareness Day I would like everyone to know the essentials of Stroke. Every Second Counts and small steps may save life!!
We get multiple patients with stroke in STNM each day. And we are not always successful in the treatment. This Message to the society may help greatly in reducing the effects of Storke in the community

A stroke, also known as a brain attack, occurs when the blood supply to the brain is interrupted or reduced, depriving the brain of oxygen and nutrients.

*Types of Stroke:*

1. Ischemic Stroke (85%): Blood clot blocks blood flow to the brain.
2. Hemorrhagic Stroke (15%): Blood vessel ruptures, causing bleeding in the brain.
3. Transient Ischemic Attack (TIA or "mini-stroke"): Temporary blockage, resolving within 24 hours.

*Effects of Stroke:*

1. Brain damage
2. Weakness or paralysis
3. Speech and language difficulties
4. Vision loss
5. Cognitive impairment
6. Emotional changes

*Key Statistics:*

1. 1 in 4 adults will have a stroke.
2. Every 40 seconds, someone in the US has a stroke.
3. Stroke is the 5th leading cause of death and 1st leading cause of disability.

The main risk factors for Stroke are
1. High blood pressure.
2. Obesity.
3. Physical inactivity.
4. Poor diet.
5. Smoking.

People with such risk factors have to be careful and get regular medical checkups. SMOKING IS TO BE AVIODED

Here are some simple steps that one can take when someone appears to have Stroke

*Act F.A.S.T., Save a Life!!*

A stroke can happen to anyone, at any time. Know the signs, act fast, and save a life.

*Recognize the Signs:*

F - Face: Ask the person to smile. Does one side of their face droop?

A - Arm: Ask the person to raise both arms. Does one arm drift downward?

S - Speech: Ask the person to repeat a simple sentence. Is their speech slurred or difficult to understand?

T - Time: Time is of the essence. Call for emergency medical services immediately if you observe any of these signs.

*Additional Signs:*

- Sudden numbness or weakness in the face, arm, or leg
- Sudden confusion or trouble speaking
- Sudden trouble seeing in one or both eyes
- Sudden severe headache
- Sudden trouble walking, dizziness, or loss of balance

*Take Action:*

1. Call your local emergency number immediately.
2. Provide the location and any relevant information.
3. Stay with the person until medical help arrives.

*Prevention is Key:*

1. Manage blood pressure.
2. Control diabetes.
3. Exercise regularly.
4. Eat a healthy diet.
5. Quit smoking.

*Every Minute Counts*

Prompt medical treatment can save lives and reduce disability. Spread awareness, and let's fight stroke together!

*Share This Message*

Help create a stroke-aware community. Share this message with friends, family, and social networks.

22/10/2024

A short video of a successful Excision of an outgrowing meningioma.
⚠️ Sensitive images. Not of the faint hearted

08/10/2024

The will to survive is the strongest medicine of all.

This young gentleman was brought to us in a state of deep coma because of a severe head injury in an accident few months ago. Fighting for his life he remained unconscious for about a month during his hospital stay.

He had what is described as Diffuse Axonal Injury (DAI) which is one of the worst kind of Traumatic Brain Injury and is usually associated with poor recovery and high risk for death. The injury occurs at the cellular level of the brain which causes extensive Neuronal Dysfunction. There is not much that can be done surgically in such injuries and everything depends on good ICU care.

Despite other multiple serious injuries and infections he fought his way through. And after about 2 months of intensive treatment he gradually regained his consciousness .

Today it was a great surprise to us to see hom walk in normally like nothing had ever happened. All thanks to the excellent care provided by our ICU care team led by Dr. Deepesh Tiwari and the Staff of TICU and Neurosurgery ward at STNM Hospital. Another life saved and many lives enriched!

30/09/2024

Neurosurgery will never be the same again without Dr. Sandip Chatterjee sir. A great loss to Neurosurgery in India and to the world.

We had the opportunity to do the first ever live neurosurgical workshop with him in the State of Sikkim on CVJ. His talks left us all mesmerised.

A great mind and a great character. An unforgettable personality of admiration and inspiration. He inspired hundreds and saved many more lives throughout his career.

It was a privilege to know him and learn from him. The whole of world of Neurosurgery mourns to the loss of a True Legend. May his soul rest in peace🙏🏼 💐

19/08/2024

15/08/2024

Wishing everyone a Happy 78th Independence Day!!
🇮🇳

10/08/2024

Trans Nasal Excision of a large Pituitary macroadenoma done successfully.

Our Teachers always told us that "Its Not how well you do your surgery but how well you manage your complications after surgery that makes you a good surgeon".

This Patient had a frank CSF Rhinorrhoea in the post op period but with timely placement of a Lumbar drain and some resilience and patience it resolved over time and he showed good recovery. Now he's ready to go home soon.