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Medical Conditions Treated
- Brain and Spinal Cord Tumours
- Spine Conditions
- Paediatric Conditions
- Stroke
- Functional Neurosurgery
- Head trauma
- Chronic Pain Management
Dr Keith Goh
Brain and Spinal Cord Tumours
Surgical management of all primary brain (glioma, meningioma, pituitary adenoma, skull base, medulloblastoma) and secondary (metastatic) tumours; and spinal cord tumours (intramedullary, neurofibroma, schwannoma) in adults and children.
Spine Conditions
Emergency treatment of spinal trauma, fractures and acute prolapsed intervertebral discs, including surgical decompression and internal fixation.
Elective treatment of degenerative spine conditions, such as cervical spondylosis, disc prolapse, neural foraminal stenosis and spondylolisthesis. Surgical management includes microdiscectomy, minimally invasive neural foraminotomy, artificial disc replacement, pedicle screws and various fusion techniques, and vertebroplasty.
Paediatric Conditions
Management of children with congenital and developmental conditions, including:
- Paediatric brain and spinal cord tumours: Craniopharyngioma, optic nerve glioma, brainstem glioma, medulloblastoma, benign neuroectodermal tumours, neurofibroma.
- Hydrocephalus: Congenital aqueduct stenosis, Dandy-walker malformation, arachnoid cyst, acquired hydrocephalus, complex shunt problems.
- Spinal cord malformations: Spina bifida, tethered cord syndrome, spinal lipoma.
- Chiari malformation and syringomyelia
- Craniosynostosis and related cranio-facial syndromes
Together with in-house paediatricians, children with neurological conditions can be treated surgically with the latest microinstruments and endoscopic equipment, in a minimally invasive manner.
Stroke
- 24-hour emergency service for the treatment of acute ischaemic stroke (infarct) and haemorrhagic stroke (intracerebral haematoma and subarachnoid haemorrhage).
- Elective stroke risk assessment, by evaluating the carotid arteries and intracranial vasculature, using CT and MR angiogram techniques.
Functional Neurosurgery
A range of conditions causing functional problems can be treated with surgical techniques, including:
- Hyperhidrosis (sweaty palms): Thoracoscopic sympathectomy is performed.
- Spasticity: Rhizotomy is performed or intra-thecal baclofen pumps are placed.
- Facial hemispasms: microvascular decompression
- Epilepsy surgery: Epileptogenic lesions can be excised; vagal nerve stimulator can be placed, and various other surgical options are available for intractable epilepsy.
Head Trauma
- 24-hour emergency service available for the treatment of all kinds of adult and paediatric head injury, including simple and compound fractures; concussions and its sequelae, severe injuries requiring craniotomy for haematoma evacuation, intracranial pressure (ICP) monitoring and neuro-intensive care.
- Elective surgical treatment for reconstruction of skull defects (cranioplasty) using custom-made titanium mesh implants for adults and polymer-based implants for children.
Chronic Pain Management
The treatment team includes a certified pain specialist and anaesthetist who will evaluate the patient together with the neurosurgeon. Apart from tailoring medication to the patient’s needs, the pain specialist is also able to administer injections, nerve blocks and acupuncture. In certain cases, such as cancer patients with widespread disease, spinal cord pumps can be placed to administer pain-relief drugs (morphine) intra-thecally. In addition, implantable nerve stimulators can also be placed in the spinal cord or the brain for intractable neuropathic pain.
Trigeminal neuralgia is one condition that is treated by gamma-knife radiosurgery, or microvascular decompression. 80% of patients report good-to-excellent pain relief after gamma-knife treatment, with significant reduction in medication.
Mount Elizabeth Medical Centre,
#09-10, 3 Mount Elizabeth
Singapore 228510
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