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SERVICES

Mr Vindlacheruvu is a full-time substantive NHS consultant neurosurgeon at Queen's Hospital, BHR University Hospitals NHS Trust, Romford. He has been on the specialist register since 2005.  He has undertaken private practice in addition to his NHS practice since 2007. His practice includes all of the specialist areas described below.  The clinical governance associated with NHS practice clearly benefits the private practice immeasurably.

Neurovascular

This subspecialty refers to conditions that can cause brain haemorrhage. Examples are:

  •    Aneurysms;

  •    Arteriovenous malformations (AVM);    dural A-V fistula (dAVF); and

  •    Cavernoma (CVM).

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Brain haemorrhage accounts for around 15% of strokes, and is associated with death and disability. A detailed assessment is necessary to identify the best treatment option.

Brain Tumours

People are very frightened about the prospect of having a brain tumour.

In reality, 2 week wait referrals for suspected brain cancer almost never identify a brain tumour.

Brain tumours generally present via the emergency pathway. Some need urgent treatment, but many need careful timely investigations, followed by planned surgery. Some may be watched for months or years before surgery is indicated.

Head Injury

Head injuries are very common. They can be categorised by severity, mechanism, age, or pathology.

Most neurosurgical units sit within major trauma centres.

Few patients with head injury need admission to a neurosurgical unit. There are important considerations in a proportion of cases that make an important difference to outcome.

These conditions are characterised by a build up of fluid in the brain, which can cause pressure symptoms, or local disturbance.

Paediatric hydrocephalus is quite different to the adult state - both in aetiology and presentation.

ENS provides care for adult patients only.

The main areas of interest are:

  • Obstructive hydrocephalus

  • Post-haemorrhagic hydrocephalus

  • Idiopathic intracranial hypertension (often referred to as Benign Intracranial Hypertension)

  • Normal pressure hydrocephalus

 

Cervical spondylosis, degenerative disease of the neck, osteoarthritis and "wear and tear" are all synonymous terms. It is a feature of ageing. The changes are progressive from young adulthood, and may be exacerbated by occupational factors, and prior injuries, including accidents and sports.

Disc prolapse and chronic degenerative changes can result in compression of the exiting nerve roots and of the spinal cord itself. Surgery may have a role in relieving symptoms by decompressing nerves or the spinal cord.

Expert in:

  • Anterior cervical decompression and fusion (ADCF)

  • Anterior cervical fixation

  • Cervical disc replacement

  • Cervical laminectomy

  • Posterior microforaminotomy

  • Indications for CT-guided injections

 

Back pain affects a huge proportion of the population. Mostly it is mechanical in nature - worse with activity, and due to degenerative changes (age-related wear and tear). Nerve roots in the lumbar canal may be irritated or compressed, and this can cause pain, weakness, and/ or numbness in the distribution of the nerve. This is often termed sciatica. Fortunately most cases settle over a few weeks. It is important to make an accurate diagnosis and have the correct treatment to maximise the chance of a quick and full recovery.

Expert in

  • Microscopic lumbar discectomy

  • Lumbar foraminotomy

  • Lumbar decompression

  • Lumbar laminectomy

  • Interlaminar decompression

  • Bilateral decompression from unliateral approach

  • Targetted nerve root injections

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