We are a highly experienced team specialising in the use of endoscopic techniques, ensuring the best possible outcome for his patients.

Brain Surgery


We are a highly experienced team specialising in the use of endoscopic techniques, ensuring the best possible outcome for his patients.


Endoscopic Brain Surgery

Mr. Ian Wang is leading neurosurgeon in endoscopic techniques, also allowing minimally invasive approaches to skull base brain tumours. A minimally invasive technique, uses a small incision at the back of the nasal cavity and causes little disruption of the nasal tissues.

You may be a candidate for trans-sphenoidal surgery if you have a, but not limited to: pituitary adenoma, meningioma, glioma or chordoma.

Importantly, we will carefully look at your condition in a detailed examination to find the appropriate treatment for you.

Learn More


Primary brain tumours

Gliomas

The most common primary brain tumour is a glioma. A glioma may be a low-grade astrocytoma, an anaplastic astrocytoma, or a glioblastoma multiforme depending on the aggressiveness of the cells. Treatment for these tumours include a combination of surgery, radiotherapy and chemotherapy.

Each treatment regime is individualised for the specific patient and tumour type. In general, surgery is required for biopsy and debulking (to reduce intra-cranial pressure). Higher grade gliomas (anaplastic astrocytomas and glioblastomas) will usually be given radiotherapy following maximal surgical debulking. Chemotherapy may be used at the same time for glioblastomas, or following a relapse with anaplastic astrocytomas. Treatment will be optimised and co-ordinated with the neuro-oncologist, radiation oncologist and neurosurgeon.

Meningiomas

A meningioma arises from the strong protective covering of the brain called the dura. The majority of meningiomas are benign however meningiomas grow locally and may cause symptoms from pressure effects on surrounding structures. A meningioma is slow growing. Just because a meningioma is found on CT does not mean it must be removed. It is reasonable to monitor a small meningioma with regular MRI scans annually to confirm it is not growing, particularly in older patients.

How are brain tumours diagnosed?

Suspicious symptoms should be investigated with a CT scan of the head. This will demonstrate a brain tumour, however an MRI scan will be needed to further delineate the margins of the tumour and also to create a treatment plan for each individual. Occasionally an angiogram will be required pre-operatively to identify the blood supply of tumours and obliteration of this blood supply may be performed to minimise the risks of surgery.

How do brain tumours present?

In general, brain tumours present in one of three ways.

Raised intra-cranial pressure: The brain is enclosed in a bony skull. Any growth within the skull cavity will increase the resting pressure inside the head. This may manifest itself with headaches, nausea/vomiting, or drowsiness/sleepiness. Raised intra-cranial pressure is an emergency situation as the brain is reliant on oxygen to survive and any drop in blood flow (and oxygen delivery) from raised pressure may result in brain damage.

Focal neurological deficit: Brain tumours growing in, or pressing on vital brain structures may result in stroke-like symptoms or focal neurological deficits. This may be transient, permanent or progressive. Tumours in deeper, more eloquent areas of the brain may cause focal neurological deficits at small sizes (less than 1cm) whilst tumours in less eloquent areas of the brain (frontal lobes) may grow to significant size before causing neurological deficits.

Seizures: Primary brain tumours may invade the surrounding neural tissue, or compress it and cause significant swelling of the brain. Either of these effects may result in abnormal firing of the nerve cells and cause seizures. These may be partial (no loss of consciousness) or generalised (with loss of consciousness).

Non-functioning Macro-adenoma

These tumours may present is several ways. The first is by increased pressure on the normal pituitary tissue surrounding the adenoma resulting in hypo-pituitarism. This means that the normal pituitary tissue does not function normally resulting a lack of circulating hormones such as cortisol, growth hormone, sex hormones and thyroid hormones. The second is by direct mass-effect on the surrounding structures of the pituitary fossa. As the optic chiasm sits directly above the pituitary gland, the most common clinical effect will be for a gradual loss of the peripheries of ones’ visual fields, culminating in tunnel vision or even blindness. Pressure on the sides of the pituitary fossa may also result in blurring or double vision.

Contact

Appointment (GP Referral needed)

03-9939-7112