Neurosurgical Procedures Directory
Detailed clinical overviews of cranial, vascular, spinal, and trauma surgical procedures performed and evaluated by Dr. Vitowanu.
Burr-Hole Evacuation and Closed Subdural Drainage
A targeted, minimally invasive neurosurgical procedure to drain chronic subdural blood collections and relieve pressure on the brain.
- Progressive neurological deficits (e.g., unilateral limb weakness, gait instability, speech difficulty)
- Cognitive impairment or confusion attributable to mass effect and midline shift on brain imaging
Microsurgical Craniotomy & Brain Lesion Resection
High-precision surgical opening of the skull utilizing operative microscopy and neuronavigation to safely resect brain tumors and cranial lesions.
- Histopathological diagnosis and total or subtotal resection of intracranial neoplasms (meningiomas, gliomas, metastases, acoustic neuromas)
- Relief of elevated intracranial pressure and mass effect caused by expanding lesions
Ventriculoperitoneal (VP) Shunting & Endoscopic Third Ventriculostomy (ETV)
Surgical diversion and physiological restoration of cerebrospinal fluid flow to alleviate hydrocephalus and normalized intracranial pressure.
- Obstructive or communicating hydrocephalus causing headache, vomiting, lethargy, or visual impairment
- Normal Pressure Hydrocephalus (NPH) causing classic gait disturbance, urinary incontinence, and dementia
Spinal Decompression, Discectomy & Instrumentation
Surgical alleviation of neural element compression combined with rigid biomechanical stabilization for infection, trauma, and disc pathology.
- Severe pyogenic spinal infection (spondylodiscitis / epidural abscess) with bone destruction, progressive deformity, or neurologic compromise
- Cervical or thoracic spinal cord compression causing spasticity, loss of dexterity, and gait impairment (myelopathy)
Microsurgical Resection of Vascular Malformations (AVMs & Cavernomas)
Advanced microvascular dissection and excision of abnormal intracranial vascular niduses to eliminate hemorrhage risk.
- Ruptured arteriovenous malformations with documented intracerebral or intraventricular hemorrhage
- Symptomatic or expanding cavernous malformations in non-eloquent or accessible cortical/subcortical locations
Cranioplasty & Complex Calvarial Reconstruction
Surgical reconstruction of cranial bone defects to restore cerebral protection, normalize CSF dynamics, and re-establish natural cranial symmetry.
- Protection of the vulnerable brain against physical trauma following previous craniectomy
- Resolution of the 'syndrome of the trephined' (headache, dizziness, mood changes, cognitive slowing due to atmospheric pressure pushing on the unprotected brain)