Nordic Neurosurgery Services
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At Nordic Neurosurgery we offer a comprehensive range of services that begin when your primary healthcare provider arranges a referral or you contact us. With clinics in both Hamilton & Cambridge we are able to offer our patients two convenient locations for consultations. Dr Raunio and Sandra are aware that patients may be unclear as to what specific services and surgical procedures are covered by our speciality so we have provided an overview below.
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History
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Examination
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Consent
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Essential to our caring philosophy at Nordic is a sufficient appreciation of each patient's medical history and the undertaking of a detailed examination and appropriate imaging. Should a neurosurgery procedure be indicated we are committed to explaining what is involved so patients are adequately informed when giving their consent. The neurosurgery and spine services that Dr Raunio provides are outlined below:
Health assessment for nerves, central nervous system, or spine issues:
During this, we discuss your previous medical history, your symptoms, and how these have been managed so far.
Neurological health assessment includes assessing the function of your central nervous system and peripheral nerves. In this cognitive, motor, and sensory nerve functions are tested. With spine issues, mobility and stability of the spine are examined. The spread and depth of investigation are tailored to your needs.
You might need further imaging investigations, such as X-rays, CT scans, MRI imaging, or nerve conduction tests. These are organized in short wait time and a follow-up appointment is booked to summarize the findings and tailor an optimized treatment with you for you.
During this, we discuss your previous medical history, your symptoms, and how these have been managed so far.
Neurological health assessment includes assessing the function of your central nervous system and peripheral nerves. In this cognitive, motor, and sensory nerve functions are tested. With spine issues, mobility and stability of the spine are examined. The spread and depth of investigation are tailored to your needs.
You might need further imaging investigations, such as X-rays, CT scans, MRI imaging, or nerve conduction tests. These are organized in short wait time and a follow-up appointment is booked to summarize the findings and tailor an optimized treatment with you for you.
Neuro-oncology surgery:
Tumors inside the skull can be benign or cancerous, malignant type. Sometimes people only know about a benign tumor incidentally with a head scan for another reason, for instance after a head injury. These do not necessarily need to be operated on, but the treatment decision is always made individually.
Intracranial tumors causing symptoms, such as headaches, seizures, bleeding or decline of neurological function typically need surgical intervention. Risks related to surgery are always weighted with the patient against the expected benefit from the operation.
The main aims for intracranial tumor surgery are reduction or complete removal of symptoms related to it and attaining a tumor sample for histological diagnosis of the tumor type. For tumors originating from the brain itself, complete tumor cells removal by surgery is rarely attainable. If the tumor growth is from the lining under the skull, a complete removal is a common surgical outcome.
Tumors arising from the brain itself often need adjuvant therapies, radiation, chemotherapies, or a combination of both in addition to tumor surgery. These treatments are targeted at tumor cells remaining after surgery. The adjuvant treatment decisions are based on the histological tumor diagnosis.
When an intracranial tumor is found, patients are followed up with brain imaging. Whether this is for incidental, conservatively managed tumor or treated tumor, imaging reveals if there is a remaining tumor and how it behaves in the long run.
Tumors inside the skull can be benign or cancerous, malignant type. Sometimes people only know about a benign tumor incidentally with a head scan for another reason, for instance after a head injury. These do not necessarily need to be operated on, but the treatment decision is always made individually.
Intracranial tumors causing symptoms, such as headaches, seizures, bleeding or decline of neurological function typically need surgical intervention. Risks related to surgery are always weighted with the patient against the expected benefit from the operation.
The main aims for intracranial tumor surgery are reduction or complete removal of symptoms related to it and attaining a tumor sample for histological diagnosis of the tumor type. For tumors originating from the brain itself, complete tumor cells removal by surgery is rarely attainable. If the tumor growth is from the lining under the skull, a complete removal is a common surgical outcome.
Tumors arising from the brain itself often need adjuvant therapies, radiation, chemotherapies, or a combination of both in addition to tumor surgery. These treatments are targeted at tumor cells remaining after surgery. The adjuvant treatment decisions are based on the histological tumor diagnosis.
When an intracranial tumor is found, patients are followed up with brain imaging. Whether this is for incidental, conservatively managed tumor or treated tumor, imaging reveals if there is a remaining tumor and how it behaves in the long run.
Neuro-vascular surgery:
About 3% of people have intracranial aneurysms; a pouch or dilatation of the cranial vessel. Much rarer are arteriovenous malformations or dural arteriovenous fistulas. These have blood flow directly from arteries to veins, increasing pressure inside weaker walled veins. These abnormal vessel structures intracranially can increase the risk of bleeding and are commonly found after a rupture. These can also be picked incidentally on brain imaging or after a seizure.
Unruptured intracranial vessel abnormalities need to be assessed individually, whether there is a significant risk for bleeding and need for preventive interventions. Treatment can include filling the bleeding risk area from inside the vessel by interventional radiology, excluding the risk area from normal brain vasculature by surgery or stereotactic radiosurgery to reduce the bleeding risk. Sometimes more complex vessel anomalies require a combination of these options. Risks related to treatment are always weighted to the risks of natural progression risk to bleeding.
About 3% of people have intracranial aneurysms; a pouch or dilatation of the cranial vessel. Much rarer are arteriovenous malformations or dural arteriovenous fistulas. These have blood flow directly from arteries to veins, increasing pressure inside weaker walled veins. These abnormal vessel structures intracranially can increase the risk of bleeding and are commonly found after a rupture. These can also be picked incidentally on brain imaging or after a seizure.
Unruptured intracranial vessel abnormalities need to be assessed individually, whether there is a significant risk for bleeding and need for preventive interventions. Treatment can include filling the bleeding risk area from inside the vessel by interventional radiology, excluding the risk area from normal brain vasculature by surgery or stereotactic radiosurgery to reduce the bleeding risk. Sometimes more complex vessel anomalies require a combination of these options. Risks related to treatment are always weighted to the risks of natural progression risk to bleeding.
Minimally invasive spine surgery:
Back pain is a very common health issue, about 80% experience it during their lifetime. Neck pain is also an increasingly common issue in developed countries, with about 1/5 of the population prevalence.
If you have had an accident and experience back or neck pain or any new symptoms, you need to seek immediate care.
Warning signs related to non-emergent back or neck pains are:
Fever related to pain
Weight loss
Radiating pain or numbness to limb (continuing more than 6 weeks)
Very severe pain either on back, neck or radiating to limb
The clumsiness of hand or hands, arm or leg weakness, muscle loss
Rapidly appeared or progressed incontinence
Any of these warning signs would need urgent assessment by a spine specialist. In the assessment, we decide if further imaging, such as MRI is needed. For instance in limb radiating pain, imaging might reveal a pinched nerve structure. Commonly this resolves over time by itself. However, if the symptoms are severe or imaging indicates significant nerve compression, surgical decompression via a minimally invasive approach can provide symptom relief and quick surgical recovery.
Prolonged back pain alone also benefits from spine specialist assessment. There can be underlying joint instability or irritation that can be difficult to manage with conservative treatment methods alone.
Back pain is a very common health issue, about 80% experience it during their lifetime. Neck pain is also an increasingly common issue in developed countries, with about 1/5 of the population prevalence.
If you have had an accident and experience back or neck pain or any new symptoms, you need to seek immediate care.
Warning signs related to non-emergent back or neck pains are:
Fever related to pain
Weight loss
Radiating pain or numbness to limb (continuing more than 6 weeks)
Very severe pain either on back, neck or radiating to limb
The clumsiness of hand or hands, arm or leg weakness, muscle loss
Rapidly appeared or progressed incontinence
Any of these warning signs would need urgent assessment by a spine specialist. In the assessment, we decide if further imaging, such as MRI is needed. For instance in limb radiating pain, imaging might reveal a pinched nerve structure. Commonly this resolves over time by itself. However, if the symptoms are severe or imaging indicates significant nerve compression, surgical decompression via a minimally invasive approach can provide symptom relief and quick surgical recovery.
Prolonged back pain alone also benefits from spine specialist assessment. There can be underlying joint instability or irritation that can be difficult to manage with conservative treatment methods alone.
Cranial and peripheral nerve decompressions
Trigeminal neuralgia is excruciating pain on one side of the face. It is commonly an electric shock type of pain, aggravated by touch on the area. This is often self-limiting and manageable with nerve pain medications, such as Carbamazepine. In prolonged pain that is not medically manageable, neurosurgeon assessment is advisable. Often there is an underlying cause of vascular compression to the nerve. This can be effectively treated by managing the pain cause by microvascular decompression; by separating the vessel contact to the nerve. If this is not a suitable option, a momentary nerve compression treatment can also provide good long-term results.
Other cranial nerve symptoms seen with vascular compressions are facial spasms and glossopharyngeal pain, localizing in the throat, tongue, and ear area. In severe and prolonged symptoms surgical possibilities should be investigated.
Tailored treatment can be a life-changer to these patients.
Carpal tunnel syndrome causes numbness on the hand and fingers leaving the little finger usually intact. The handgrip can get weaker over time. About 5% of the adult population suffers from these symptoms. Using a nighttime splint, adjusting ergonimics at work and pain medications commonly alleviate these symptoms. If the situation persists despite conservative management, releasing the carpal tunnel compression to the pinched median nerve provides symptom improvement to about 90% of the patients.
Trigeminal neuralgia is excruciating pain on one side of the face. It is commonly an electric shock type of pain, aggravated by touch on the area. This is often self-limiting and manageable with nerve pain medications, such as Carbamazepine. In prolonged pain that is not medically manageable, neurosurgeon assessment is advisable. Often there is an underlying cause of vascular compression to the nerve. This can be effectively treated by managing the pain cause by microvascular decompression; by separating the vessel contact to the nerve. If this is not a suitable option, a momentary nerve compression treatment can also provide good long-term results.
Other cranial nerve symptoms seen with vascular compressions are facial spasms and glossopharyngeal pain, localizing in the throat, tongue, and ear area. In severe and prolonged symptoms surgical possibilities should be investigated.
Tailored treatment can be a life-changer to these patients.
Carpal tunnel syndrome causes numbness on the hand and fingers leaving the little finger usually intact. The handgrip can get weaker over time. About 5% of the adult population suffers from these symptoms. Using a nighttime splint, adjusting ergonimics at work and pain medications commonly alleviate these symptoms. If the situation persists despite conservative management, releasing the carpal tunnel compression to the pinched median nerve provides symptom improvement to about 90% of the patients.
Hydrocephalus treatments
With age cerebrospinal fluid circulation can be impaired, causing excess fluid accumulation, into brain fluid spaces, ventricles. This is called normal pressure hydrocephalus. About 10% of dementia symptoms are caused by hydrocephalus and it is unfortunately often mistaken for Alzheimer's or Parkinson's disease. It can also cause walking difficulties, ”sticky feet to the ground” and urinary incontinence. Hydrocephalus can also appear after a head injury, infection, bleeding, or surgery on the brain.
Hydrocephalus diagnosis entails memory assessment, gait analysis, and brain imaging. In uncertain situations, cerebrospinal fluid can be drained via lumbar puncture and reassess these functions again for possible improvement. All these assessments can be done in our clinic.
If normal pressure hydrocephalus is causing the patient symptoms, a ventriculoperitoneal shunt surgery can control or reverse the symptoms.
With age cerebrospinal fluid circulation can be impaired, causing excess fluid accumulation, into brain fluid spaces, ventricles. This is called normal pressure hydrocephalus. About 10% of dementia symptoms are caused by hydrocephalus and it is unfortunately often mistaken for Alzheimer's or Parkinson's disease. It can also cause walking difficulties, ”sticky feet to the ground” and urinary incontinence. Hydrocephalus can also appear after a head injury, infection, bleeding, or surgery on the brain.
Hydrocephalus diagnosis entails memory assessment, gait analysis, and brain imaging. In uncertain situations, cerebrospinal fluid can be drained via lumbar puncture and reassess these functions again for possible improvement. All these assessments can be done in our clinic.
If normal pressure hydrocephalus is causing the patient symptoms, a ventriculoperitoneal shunt surgery can control or reverse the symptoms.
Head injury management
A head injury can have significant alterations to life. Patients might experience long-term headaches, sensitivity to light, sound, and other stimuli. Fatigue, problems with memory, concentration, and sleeping as well as low mood after an injury are common. In more severe injuries, speech or limb mobility can be affected. Head injury can affect the ability to work and manage at home. Luckily, over time and proper management head injury symptoms can improve. The individual rehabilitation needs after a head injury are assessed in the clinic and organized together with ACC.
A head injury can have significant alterations to life. Patients might experience long-term headaches, sensitivity to light, sound, and other stimuli. Fatigue, problems with memory, concentration, and sleeping as well as low mood after an injury are common. In more severe injuries, speech or limb mobility can be affected. Head injury can affect the ability to work and manage at home. Luckily, over time and proper management head injury symptoms can improve. The individual rehabilitation needs after a head injury are assessed in the clinic and organized together with ACC.