Brain tumours Major specialty
Brain tumours may be benign (non-cancerous) or malignant (cancerous), and may arise from the brain itself (primary) or spread from elsewhere in the body (metastatic). Common types include gliomas, meningiomas, pituitary adenomas, acoustic neuromas (vestibular schwannomas) and metastases from lung or breast cancer.
When surgery is indicated: when the tumour is causing symptoms, when it is growing, when its location threatens critical brain function, or when tissue is needed for histopathological diagnosis. Not all brain tumours require immediate surgery — many small, benign meningiomas can be watched with serial imaging.
How Dr. Agarwal approaches it: microsurgical resection with neuronavigation, intra-operative monitoring where appropriate, and — for pituitary tumours — endoscopic trans-nasal technique. Every surgical plan is individualised after reviewing MRI, clinical status and the patient's overall health.
Brain aneurysms & vascular malformations Emergency
A cerebral aneurysm is a weak spot in a brain artery wall that balloons outward. Unruptured aneurysms may cause headache or no symptoms at all; ruptured aneurysms cause sudden, catastrophic bleeding (subarachnoid haemorrhage) and are a true medical emergency.
Treatment options: microsurgical clipping (placing a titanium clip at the aneurysm neck) or endovascular treatment (coiling, flow-diverter placement, or stent-assisted coiling) — chosen based on aneurysm size, location, shape and patient factors. Dr. Agarwal is trained in both microsurgical and endovascular techniques and will recommend the option with the best risk/benefit for you specifically.
Also treated: arteriovenous malformations (AVMs), dural arteriovenous fistulae, cavernomas and moyamoya disease.
Stroke — ischaemic and haemorrhagic Emergency
Stroke is an interruption of blood supply to the brain — either from a clot (ischaemic stroke, 80% of cases) or from bleeding (haemorrhagic stroke). Time is brain: every minute of untreated stroke kills approximately 1.9 million neurons.
Neurosurgical role: mechanical thrombectomy for large-vessel ischaemic stroke (within the treatment window), surgical evacuation of large intracerebral haemorrhages, decompressive craniectomy for malignant stroke, and secondary prevention through carotid endarterectomy or stenting when indicated.
If you suspect a stroke — sudden facial droop, arm weakness, or speech difficulty — call emergency services or the clinic immediately. Do not wait to see if symptoms improve on their own.
Disc prolapse, sciatica & lumbar spine disorders
Most back pain does not need surgery. Disc prolapse, sciatica, lumbar canal stenosis and spondylolisthesis typically respond well to a structured programme of medication, physiotherapy and posture management. Surgery is reserved for patients with progressive neurological deficit, severe unremitting pain, or loss of bladder/bowel control (cauda equina — a true emergency).
When surgery is needed: microdiscectomy (removal of the herniated disc fragment), laminectomy (decompression of a narrowed canal), and, in cases of instability, minimally invasive instrumented fusion. Dr. Agarwal favours the least invasive approach that safely achieves the goal.
Cervical spine disorders & myelopathy
The cervical (neck) spine can develop disc disease, bony spurs and ligament thickening that compress the spinal cord (cervical myelopathy) or the exiting nerve roots (cervical radiculopathy). Symptoms include neck pain, arm pain, hand clumsiness, gait imbalance and — in severe cases — weakness of the legs.
Treatment: anterior cervical discectomy and fusion (ACDF), cervical disc replacement in selected patients, posterior laminectomy, or laminoplasty. Dr. Agarwal uses high-magnification microsurgery to protect the spinal cord and nerve roots during every cervical operation.
Head & spinal trauma Emergency
Traumatic brain injury ranges from mild concussion to severe brain contusion with life-threatening swelling. Spinal cord injury can lead to permanent paralysis if not managed urgently. Early, expert neurosurgical assessment is critical.
Common procedures: evacuation of extradural, subdural and intracerebral haematomas; elevation of depressed skull fractures; decompressive craniectomy; stabilisation of unstable spinal fractures with instrumentation.
Hydrocephalus & paediatric neurosurgery
Hydrocephalus is the build-up of cerebrospinal fluid within the brain, causing raised intracranial pressure. In adults it may follow haemorrhage or infection; in children it may be congenital.
Treatment: ventriculo-peritoneal (VP) shunt placement, or — in selected cases — endoscopic third ventriculostomy (ETV), which avoids a permanent implant. Dr. Agarwal also manages other paediatric neurosurgical conditions including congenital malformations and childhood brain tumours.
Trigeminal neuralgia & facial pain
Trigeminal neuralgia is a disorder of the fifth cranial nerve that produces sudden, electric-shock-like facial pain. Most patients are initially managed with medication (carbamazepine or similar), but for those with inadequate control or intolerable side effects, surgery offers durable relief.
Surgical options: microvascular decompression (the Jannetta procedure) for durable pain relief, or percutaneous radiofrequency rhizotomy for medically frail patients.
Peripheral nerve disorders
Compression and injury of peripheral nerves produce numbness, tingling, weakness and pain that can be profoundly disabling. Common examples include carpal tunnel syndrome (median nerve at the wrist), ulnar nerve entrapment (at the elbow) and peroneal nerve compression.
Treatment: microsurgical nerve release, nerve tumour excision and, where relevant, nerve transfer or repair for traumatic injuries.