Neurosurgery and Neurology

In the specialty of Neurosurgery and Neurology, we primarily work with the Karolinska University Hospital. Karolinska University Hospital provides world-class neurosurgery and neurology hospital care for adult patients. Foreign patients are offered advanced neuroradiology and neurophysiology investigations, and a broad range of therapies as well as second opinions. All referrals are assessed at multidisciplinary specialist conferences and coordinated for further investigations or neurosurgical treatment. In cooperation with Rehab Station Stockholm we offer world-class neuro rehabilitation after treatment of spinal cord injury, stroke, MS and others.

Neurosurgery

The Department of Neurosurgery at Karolinska University Hospital has an extensive national and international collaboration network in the areas of advanced neurosurgical procedures, basic science and education. Approximately 3,000 surgical procedures are performed each year.

Karolinska University Hospital’s neurosurgery clinic has a proud history. It was established in 1932 by professor Herbert Olivecrona who was a pioneer in modern neurosurgery. More than 30 years later Professor Lars Leksell and Radiobiologist Börje Larsson invented the gamma knife after developing the concept of radiosurgery. Today neurosurgery comprises the entire neurosurgical field.

Our neurosurgical program for foreign patients includes the following specific areas:

Gamma Knife Surgery (tumors, vascular malformations, trigeminal neuralgia)

The Leksell Gamma Knife, which originates from Karolinska, is now being used in hundreds of clinics around the world. The Gamma Knife is used where traditional brain surgery is not an option. Gamma Knife surgery does not require a surgical incision, thereby avoiding surgical or anesthesiological complications. Gamma Knife treatment is used effectively on brain tumors, vascular malformations and trigeminal neuralgia. The ultra-modern Gamma Knife Icon at Karolinska University Hospital is the sixth generation of the Leksell Gamma Knife technology. This is a very sensitive radiosurgery device with precise techno­logy that automatically shapes and moves the beams to best conform to the target. The shape and dose of the radiation is optimized to focus on the target, sparing the surrounding healthy tissue, i e the patient receives a high dose of radiation focused precisely on the lesion resulting in an effective and safe treatment.

Tumors (meningiomas, vestibular schwannomas, gliomas)

This is one of the major patient groups treated within the area of neurosurgery at Karolinska University Hospital. Patients are offered a broad range of therapies and neurosurgical interventions to treat the tumors in a highly advanced manner, including Gamma Knife surgery. When required, the neurosurgical team cooperates closely with the oncology department.

Vascular Neurosurgery (aneurysms, AVM, cavernomas)

This area includes patients with all kinds of vascular malformations. The malformation can be treated in several ways, including open surgery, endovascular treatment, microsurgery and Gamma Knife surgery. The decision regarding treatment is always based on knowledge of the malformation’s size, place and the patient’s symptoms and overall health.

Neurotrauma (traumatic brain and spinal cord injury)

Neurotrauma is included in the emergency medical services area. If neurosurgery is required where there has been a traumatic injury to the brain or spinal cord, Karolinska University Hospital has all the necessary skills and the most advanced technical equipment at their disposal.

Functional Neurosurgery (deep brain stimulation)

This field involves patients suffering from pain, epilepsy and movement-related disorders such as Parkinson’s disease. One of the techniques offered is known as DBS (deep brain stimulation). During the procedure, the surgeon will implant DBS electrodes in selected areas of the brain that influence the patient’s condition. This is done using advanced navigation technology.

Spinal Surgery (disc herniation, other degenerative events)

Karolinska University Hospital has quite a reputation when it comes to medical conditions emanating from the spine. Besides surgeons and specialist nurses the multidisciplinary team includes physiotherapists and occupational therapists. The clinic offers:

  • Invasive discectomies to remove herniated discs,
  • Invasive spinal fusions
  • Surgery for spinal tumors and spinal trauma
  • Advanced pain management, including psychological methods with strong evidence

Pediatric neurosurgery (Tumors, Vascular Lesions)

For children, up to the age of 15 neurosurgery and consultations are offered at the Astrid Lindgren Children’s Hospital (ALB). It is the only ward in Sweden offering neurosurgical pediatric expertise throughout the hospital stay.

Neurology

The neurology clinic at Karolinska University Hospital was founded in 1887 and is the second oldest in the world. It offers highly specialized neurological care and clinical research in close collaboration with the Karolinska Institute, making it one of the most research-intensive neurological clinics in the western world.

Within the area of neurology, Karolinska University Hospital offer foreign patients with Remitting Relapsing Multiple Sclerosis (RRMS) treatment with Autologus hematopoietic stem cell transplantation (HSCT) in collaboration with the Center for Allogeneic Stem Cell Transplantation (CAST).

Multiple sclerosis – remitting relapsing (RRMS)

Karolinska University Hospital has more than 30 years’ experience in the area of hematopoietic stem cell transplantation (HSCT) and more than 10 years’ experience treating RRMS with excellent results. For this treatment Karolinska University Hospital uses the same protocol as Dr. Richard K. Burt, MD in Chicago, USA.

Karolinska University Hospital offer HSCT only to patients diagnosed with RRMS, when other options have proven insufficient or considered inappropriate. The stem cell transplantation can strongly lower the risk of future relapses and worsening condition. However, it is important to acknowledge that the treatment is not curative, nor does it reverse neurological dysfunctions.

Criteria’s for selecting suitable patients for treatment include:

  • Diagnosis of relapsing-remitting type of MS (RRMS) with clinical signs of disease activity
  • Mild to moderate permanent disability, normally less than EDSS 6.5, and with preserved cognitive functions
  • Disease modifying drugs have been tested with non-sufficient result or found inappropriate
  • Relatively younger age, normally < 50 years (after this age relapsing-remitting MS is rare)
  • Short disease duration, normally <10 years (occasionally longer, if the disease activity has significantly increased recently)
  • No other severe diseases

A medical report is required, preferably written by the patient´s neurologist, which should include:

  • The patient’s MS history
  • Information about possible concomitant diseases
  • Results from recent MR brain and spinal cord examinations (not older than three months)
  • Laboratory tests (not older than three months)
  • Clinical performance at present of all MS disease modifying treatments that have been tested
  • Present general health status

The patient needs access to a neurologist in their home country for support post treatment, and a general practitioner that can conduct health checks, blood tests etc.

A plan for rehabilitation, after HSCT treatment, is often needed for successful results. In collaboration with Rehab Station Stockholm, Stockholm Care can offer a customized rehabilitation plan for patients after HSCT treatment.

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