http://drlaxminadhneurospecialist.co.in/

Dr. Laxminadh Neurosurgeon, financial district Gachibowli Hyderabad, Hyderabad (2025)

Q: What is the address?

Financial District Gachibowli Hyderabad

09/03/2025

Large skull base meningioma surgery. Received a heartfelt feedback.

18/02/2025

The intricate relationship between mental health and physical health is a complex one, and it's important to see how emotional distress can manifest as physical symptoms.

Mental health significantly impacts physical well-being, as evidenced by recent patient cases:

- A 29 year-old male presenting with severe headache, paresthesias, and giddiness, requesting himself MRI brain. Lost his father recently with a sudden brain stroke. His unresolved grief has led to fear complex and neglect of self-care, resulting in deficiencies in Vit D and B12. Addressing his emotional state through detailed counseling is crucial before resorting to symptomatic treatment alone.

- A 38 -year-old experiencing radiating pain in limbs, headaches, and dizziness post job transfer, highlighting workplace stress as a potential trigger for his symptoms.

- A 35-year-old female, obese, with neck and shoulder pain, panic attacks, and PCOD history. Despite cardiac assessments and X-rays, her emotional struggles manifest in somatic symptoms and requiring two antihypertensives to manage high blood pressure.

It's common to encounter patients with varied physical complaints like chest pain, joint pains, and neuro-related symptoms seeking extensive medical evaluations. However, without addressing their mental well-being and tailoring advice accordingly, complete recovery may remain elusive.

In all these cases, a mere symptomatic treatment or advising imaging tests like MRI would not be sufficient. A thorough history taking, detailed counseling, and addressing the underlying psychological and emotional factors are essential in providing effective treatment and improving the patient's overall well-being. Prioritizing mental health support alongside medical interventions is key to holistic healing.

It's also important to note that mental health can affect physical health in many ways, including:

- Increased stress and anxiety, which can lead to physical symptoms such as headaches, muscle tension, and sleep disturbances
- Neglect of self-care, including poor diet, lack of exercise, and inadequate sleep
- Increased inflammation and oxidative stress, which can contribute to chronic diseases such as diabetes, hypertension, cardiovascular disease.

By recognizing the complex relationship between mental health and physical health, healthcare providers can provide more comprehensive and effective care, addressing both the physical and emotional needs of their patients.

17/02/2025

Life threatening IC bleed in young adult:

A 26-year-old individual experienced a life-threatening intracerebral bleed, presenting with sudden collapse and a massive brain clot as shown in CT scan. Initial assessments revealed a Glasgow Coma Scale score of 6/15, high blood pressure (240/140 mmHg), elevated creatinine levels (1.8), and an INR of 3.8 indicating coagulopathy.

Underwent surgery, could extubate after 24 hours, started obeying commands. Glad that we could avoid tracheostomy, coma stage and prolonged ventilator support.

The surgical technique involved multiple dural openings, trans-sulcal approach to minimize brain tissue damage, and microscopic hematoma evacuation with blood vessel preservation.

Postoperatively, the patient's recovery was remarkable:

- Swift extubation within 24 hours.
- Compliance with commands, signifying improved consciousness.
- Avoidance of tracheostomy, coma, and ventilator assistance, a significant feat given the initial severity.

The patient's current condition is uplifting:

- Responsiveness to commands.
- Mobility with a wheelchair.
- Communication abilities, fostering emotional well-being.
- Intact memory.
- Enhanced left-side body movements.

The patient's journey showcases resilience and progress, highlighting the importance of timely intervention and comprehensive care in critical situations.

04/02/2025

What a remarkable and heartwarming story!

It's truly inspiring to see a patient who sustained a life-threatening bullet injury to the head, and was initially unable to speak and confined to a wheelchair, make such significant improvements after surgery. The fact that they were able to regain some of their speech and mobility is a testament to the power of medical intervention and the human body's capacity for healing.

The patient's journey from being unable to speak and confined to a wheelchair to making significant improvements in speech and mobility is a powerful reminder of the impact that medical care can have on people's lives. It's a testament to the human spirit's capacity for resilience and recovery, and it's a privilege to be a part of such stories.

26/01/2025

Brain Tuberculoma: Addressing Vision Deterioration

In a recent case, a 26 year-old female patient's headache escalated into rapid vision loss, emphasizing the critical need for swift diagnosis and treatment of brain tuberculoma.

**Key Aspects of Brain Tuberculoma:**

- **Tissue Reaction and Edema:** Brain tuberculoma triggers a significant tissue reaction, leading to vasogenic edema. This condition disrupts the blood-brain barrier, resulting in fluid accumulation in brain tissue.
- **Intracranial Pressure and Papilledema:** Elevated intracranial pressure from edema can cause papilledema, optic disc swelling, leading to vision deterioration and potential permanent damage.
- **Vision Deterioration:** Rapid vision decline signals urgency, often linked to increased intracranial pressure and papilledema.

**Treatment and Outcome:**

- **Surgical Intervention:** The patient underwent craniotomy and lesion excision.
- **Diagnostic Confirmation:** A biopsy confirmed the tuberculoma diagnosis.
- **Vision Recovery:** Post-surgery, the patient experienced significant vision improvement, underscoring the impact of timely and effective interventions.

**Key Takeaways:**

- **Urgent Diagnosis and Treatment:** Swift actions are crucial.
- **Collaborative Care:** A multidisciplinary approach enhances outcomes.
- **Ongoing Monitoring:** Regular follow-ups are vital for adjusting treatment and preventing complications.

In summary, brain tuberculoma demands immediate attention and proactive treatment. The patient's vision recovery post-surgery underscores the significance of timely interventions in achieving positive results.

26/01/2025

In a heartwarming tale of relief and resilience, a devoted mother bravely faced the challenging ordeal of severe sciatica pain while caring for her 20-year-old autistic child. The relentless pain, aggravated by daily activities and exacerbated during rest, stemmed from an uncommon far lateral disc prolapse at the L2-3 level, compressing the nerve root at both the axilla and shoulder levels.

Chronic pain not only affects the individual directly but also reverberates within their support system. For this mother, the pain not only disrupted her daily life but also presented hurdles in caring for her child. The emotional toll of enduring chronic pain highlights the caregiver's strength and unwavering dedication to her child's well-being.

Following a discectomy surgery, she experienced immediate pain relief and was discharged the next day.

Post-surgery, her primary concern was not her own recovery but rather her ability to care for her autistic child. Her selfless commitment and steadfast attention to her child's welfare are truly admirable, showcasing her unwavering focus on her child's needs above all else.

This serves as a heartening reminder that with appropriate medical intervention and support, individuals can overcome even the most formidable health challenges, reclaiming their quality of life.

09/11/2024

Non-Operative (Conservative) Treatment for Hemorrhages in the Brain:

Factors considered for treatment decision:

Consideration of multiple factors such as the patient's clinical condition, etiology and probable pathology, age related brain atrophy, intracranial space availability for the accomodation of bleed and edema, imaging findings (herniation, effacement of sulci, midline shift), uni or bilateral bleed and intracranial pressure dynamics is crucial in deciding on treatment options for brain hemorrhages.

Conservative treatment strategies
involve close monitoring of vital signs, seizure prophylaxis, management of comorbid factors, early mobilization, and regular imaging to monitor bleed progress or resolution.

Key principles:

Conservative treatment includes multidisciplinary care, regular assessment, patient education, empathic, extensive daily counselling of the patients and relatives, supportive care, prevention of complications.

Recovery and outcomes vary based on the initial severity, with complete recovery possible in selected cases through rehabilitation and supportive care.

Challenges lie in personalized treatment approaches and understanding brain plasticity for improved outcomes.

Indexed patients with various pathologies including a 79 yrs who was on anti platelets post CABG (major heart surgery) have shown complete improvement and functional recovery with conservative treatment.

09/11/2024

Operating on high-grade glioma (brain tumor) requires meticulous planning and ex*****on to minimize risks and achieve maximal safe tumor excision with optimal outcomes.

Key principles:

1. *Maximize brain relaxation*
- Using steroids (e.g., dexamethasone) and anti-edema medications (e.g., mannitol) to decrease intracranial pressure.

2. *Anesthesia management*:
- Total Intravenous Anesthesia (TIVA) to maintain a stable and relaxed brain.
- Monitor and control blood pressure, CO2 levels, and oxygenation.

3. *Surgical technique*:
- Plan a precise craniotomy to minimize the normal brain (pial) exposure.
- Perform rapid decompression of the tumor (Rapid debulking)
- Gentle minimal brain retraction
- Sound knowledge on orientation and surgical anatomy of white matter tracts/eloquent areas in real time operative field

4. **Intraoperative neuro* *monitoring, navigation, CUSA, microscope and fluorescence dye:*

5. *Minimize complications*:
- Be prepared for potential complications (e.g., bleeding) and have a plan in place.
- Maintain close communication with the anesthesia team to ensure optimal patient management.

09/11/2024

Key Principles for Brain Biopsy:

*Indications:*

1. Diffuse infiltrating tumors
2. Suspected lymphoma
3. Targeted tissue diagnosis for molecular analysis

*Critical measures:*

1. Neuro-navigation to target contrast-enhancing areas
2. Intraoperative consultation with neuro pathologists for frozen section analysis
3. Confirmatory final biopsy pathology
4. Avoidance of critical brain structures and blood vessels

*Precautions to avoid the possible complications like:*

1. Blood vessels injury: Risk of hemorrhage or stroke
2. Post-procedure hematoma
3. Wound-related complications Infection or CSF leak
4. Seizures
5. Brain swelling or edema

*Primary CNS Lymphoma (PCNSL):*

1. Uncommon in immune-competent patients
2. Typically presents with contrast-enhancing lesions on MRI
3.Diagnosis requires histopathological confirmation
4. Molecular biology and immunotherapy play crucial roles in management:
- Gene expression profiling
- Immunohistochemistry
- Targeted therapies (e.g., rituximab, methotrexate)

*Best Practices:*

1. Multidisciplinary team approach (neurosurgeons, neuroradiologists, neuropathologists, oncologists)
2. Standardized biopsy protocol

22/09/2024

Good morning! Recently presented on spine tumor surgeries at the National Neuro Spine Society conference, where I shared my data, experience, and publications with esteemed seniors and audiences. Emphasized on detailed MRI and CT image evaluations pre-surgery, technical nuances, and intraoperative measures for improved clinical outcomes, quality of life and speedy patient recovery.

04/08/2024

Lipomeningocele repair in a four-year-old kid....

Surgery is crucial to prevent severe complications. Here's why:

*Why operate?*

1. *Prevent neurological damage*: Continuous traction on the spinal cord can cause progressive neurological deterioration, weakness in the legs (lower limbs) leading to permanent disability.

2. *Avoid foot deformities*: Untreated lipomeningocele can result in foot deformities, such as clubfoot or uneven leg length

3. *Maintain bladder and bowel control*: Surgery can help in preventing loss of control over bladder and bowel functions, which can significantly impact the child's quality of life.

4. *Emotional and psychological well-being*: Timely surgery can prevent emotional and psychological distress as the child grows and becomes more aware of their condition.

*What are the goals of surgery?*

1. *Release traction*: Relieve pressure on the spinal cord to prevent further neurological damage.

2. *Remove the lipoma*: Excise the fatty tumor (lipoma) causing the traction.

3. *Close the defect*: Close the opening in the spine and proper skin closure.

*What are the benefits of surgery?*

1. *Improved neurological function*: Surgery can halt or even reverse neurological deterioration.

2. *Prevention of further complications*

3. *Enhanced quality of life*:

Successful surgery can significantly improve the child's overall quality of life, enabling them to participate in normal activities and social interactions.

neurosurgery
neuro surgery
of life

19/07/2024

How does an extra or intra-axial tumor in the CP angle impact craniotomy? In intra-axial tumors with a retro sigmoid approach, craniotomy may not be necessary up to the sinuses. Direct tumor decompression is possible, which differs fundamentally from extra-axial tumors where reaching the sinus edges is required during the craniotomy and tumors like large acoustic schwannomas cannot be decompressed unless the cisterns are opened up.

An 18-year-old, with a large cerebellar (brain) tumor exhibited decerebrate posturing attacks. Imaging revealed a right cerebellar tumor with early hydrocephalus. Following surgery, scans confirmed a radical excision of the tumor and resolved hydrocephalus. Further treatment is now required for medulloblastoma, yet the patient was able to attend his board exams within two weeks of surgery with a well-healed wound.

Excision

recovery

Dr. Laxminadh Neurosurgeon

09/03/2025

18/02/2025

17/02/2025

04/02/2025

26/01/2025

26/01/2025

09/11/2024

09/11/2024

09/11/2024

22/09/2024

04/08/2024

19/07/2024

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