Baguio Neurosurgery

03/07/2025

Petrotentorial meningiomas (named due to their attachment to the petrous bone and tentorium) are among the most challenging cases a neurosurgeon can encounter.

A 35 year old bedridden male, was referred after an MRI done due to right sided weakness, deafness, left sided facial paralysis. The MRI revealed a large tumor deep within the skull, compressing the brainstem and the surrounding cranial nerves.

The operation (done at Baguio General Hospital) was done in 2 stages due to the anticipated length and complexity.

1st stage : Petrosectomy- This involved drilling off bone which blocked access to the tumor. This was complex due to the complicated anatomy of the petrous bone. This took 4 hours.

2nd stage, done 2 days after the 1st stage: tumor excision- This involved a slow, methodical removal of the tumor and dissection (Peeling off) from the surrounding brain and nerves. The tumor was completely removed in 8 hours.

Post op, the patient showed improvement of the left sided paralysis and of the deafness. there was no change in the facial paralysis.

After 6 months of intensive rehab, the patient is now cleared for work.

15/01/2025

Arteriovenous Malformations, or AVMs, are abnormal tangles of blood vessels which can cause hemorrhages (strokes).

This patient presented with an unruptured AVM and was a good candidate for excision of the AVM. Post op angiograms show no residual AVM and the patient made a full recovery.

08/01/2025

62 year old man complained of a months-long history of right facial weakness, right ear deafness, weakness of the left arm and leg (hemiparesis), difficulty speaking (dysarthria) and swallowing (dysphagia). MRI revealed a right sided vestibular schwannoma. After discussing options with the family, patient was admitted for surgery.

A right posterior petrosal-translabyrinthine approach was chosen. The Tumor was removed in its entirety. The patient's hemiparesis, dysarthria and dysphagia resolved within a week. As is common with tumors this size, the deafness and facial weakness did not improve. On follow up, the patient was able to walk, talk and swallow normally.

28/12/2024

44 year old female, complaining of quadriparesis (weakness of all 4 extremities) and dysphagia (difficulty swallowing). Imaging revealed a foramen magnum meningioma attached anterolaterally pushing the brainstem to the opposite side.

We decided to do the surgery via a far lateral craniotomy, transcondylar approach.

The patient made a full recovery and had no neurological deficits on follow up.

Skull base approaches such as the far lateral approach enable the neurosurgeon to visualize and manipulate the tumor with minimal to no brainstem retraction. This, combined with careful, meticulous dissection of critical neurovascular structures result in better patient outcomes.

06/03/2024

05/02/2024

07/10/2023

45 year old male with a right frontal meningioma, excised using digital hybrid 3d visualization (Zeiss Kinevo 900). Digital hybrid 3d visualization offers superior ergonomics for the surgeon and superior visualization for the OR team. Procedure was done at Baguio General Hospital.

10/07/2023

13/12/2022

5 cm incision for a mini OZ craniotomy for clipping of aneurysm, with intraoperative fluorescein angiography to verify patency of parent arteries

02/08/2022

Ruptured aneurysms are a common cause of fatal stroke. Preventing re-rupture improves survival. This can be achieved by surgical clipping. An experienced neurosurgeon, high magnification, good illumination and a steady hand are all needed for a safe surgery.

25/07/2022

4th ventricular ependymomas are brain tumors seen most commonly in the young, and often need surgery. Complete excision leads to better outcomes and is potentially curative.

06/07/2022

This 38 y/o female came to my clinic complaining of Left sided weakness, having had partial removal of her brain tumor (meningioma) at another institution (Right FTP craniectomy, partial excision of tumor. After a thorough work-up, she was admitted and underwent surgery ( reopening craniectomy, anterior clinoidectomy, gross total removal of tumor). 2 months post op, she is now able to walk with assistance and continues to improve...