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14100 Parkway Commons Dr, Suite 100 · Oklahoma City, OK 73134
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Neurosurgical Specialty

Cranial Neurosurgery

Our neurosurgeons are trained in the full scope of cranial surgery. While spinal care is our primary practice emphasis, we continue to evaluate and treat select cranial conditions — bringing the same board-certified expertise to every case.

Our Approach

Precision, Expertise,
and Honest Guidance

Neuroscience Specialists has been a comprehensive neurosurgical practice since 1948. Our surgeons hold board certification in neurological surgery and are trained in cranial procedures alongside our primary focus in spinal surgery. For patients with cranial diagnoses, we offer thorough evaluation, honest assessment of whether surgery is indicated, and — when it is — highly skilled operative care.

We believe in clarity: if your condition is better served by another specialist or a major academic center, we will tell you that. When we can help, we bring the same precision and conservative philosophy we apply to every case in our practice.

This information is for general educational purposes. Please consult one of our physicians to discuss your specific condition and treatment options.

Why Choose Neuroscience Specialists
🎓
Board-certified neurosurgeons
All physicians are board-certified in neurological surgery with comprehensive cranial training
🔬
Microscope-assisted precision
Operative microscopy and neuronavigation for accuracy in delicate cranial cases
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Conservative first
Surgery recommended only when clearly indicated — we'll tell you honestly if it's not
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70+ years of experience
Oklahoma's most established neurosurgical practice since 1948
Procedures

Cranial Procedures We Perform

Chiari Malformation Decompression

Chiari malformation occurs when brain tissue — specifically the cerebellar tonsils — extends into the spinal canal, disrupting normal cerebrospinal fluid flow and placing pressure on the brainstem. Surgical decompression is the definitive treatment for symptomatic Chiari malformation when conservative management has failed or when neurological deficits are present.

The procedure enlarges the space at the back of the skull and upper cervical spine to relieve compression and restore normal CSF circulation. When associated with syringomyelia (a fluid-filled cavity within the spinal cord), successful decompression often leads to gradual resolution of the syrinx.

When it may be recommended
  • Persistent headaches aggravated by coughing or straining
  • Balance problems, dizziness, or difficulty with coordination
  • Progressive weakness, numbness, or sensory changes in the arms or legs
  • Syringomyelia confirmed on MRI
  • Symptomatic Chiari malformation unresponsive to conservative care
Please note: Not all Chiari malformations require surgery. Many patients with incidental findings on MRI are monitored over time rather than treated operatively. A thorough neurological evaluation and symptom review is essential before any recommendation is made.
Techniques & approaches
  • Posterior fossa decompression via suboccipital craniectomy
  • C1 laminectomy to expand the decompression as needed
  • Duraplasty (dural patch graft) to increase posterior fossa volume
  • Intraoperative ultrasound to confirm CSF flow restoration
  • Intraoperative neuromonitoring to protect brainstem and spinal cord

Microvascular Decompression

Microvascular decompression (MVD) is a surgical treatment for cranial nerve pain syndromes caused by compression of a nerve by a blood vessel near the brainstem. It is most commonly performed for trigeminal neuralgia — one of the most severe pain conditions known — and is also used for hemifacial spasm. MVD offers the highest long-term cure rates of any treatment for these conditions.

A small opening is made behind the ear, the offending blood vessel is identified under the operative microscope, and a small cushion is placed between the vessel and the nerve to permanently relieve the compression. MVD avoids the facial numbness associated with percutaneous procedures and is appropriate for healthy patients who have failed medical therapy.

When it may be recommended
  • Trigeminal neuralgia with typical lancinating facial pain
  • Failed or intolerable medical management (carbamazepine, oxcarbazepine)
  • Hemifacial spasm with involuntary facial muscle contractions
  • Vascular compression confirmed on high-resolution MRI
  • Medically fit patients who prefer a durable, nerve-preserving solution
Please note: MVD is a major intracranial procedure and not appropriate for all patients. Medical management is always the first-line treatment for trigeminal neuralgia. Surgery is considered when medications fail or cause unacceptable side effects.
Techniques & approaches
  • Retromastoid (behind-the-ear) craniotomy approach
  • High-powered operative microscope for vessel and nerve identification
  • Teflon felt or similar implant placed to separate vessel from nerve
  • Intraoperative brainstem auditory evoked potential monitoring
  • Typically 2–3 hour procedure with 2–3 day hospital stay

Brain Tumor Surgery

Brain tumor surgery — craniotomy for tumor resection — involves opening the skull to access, biopsy, or remove a tumor affecting the brain. The goal varies by tumor type: benign tumors may be curable with complete resection, while malignant tumors require a multidisciplinary approach that includes surgery, radiation, and chemotherapy. Safe maximal resection is the surgical objective in most cases.

Our surgeons evaluate patients with intracranial masses — including meningiomas, metastatic lesions, and other accessible brain tumors — and perform resections when surgery is the appropriate next step. Complex or high-grade primary brain tumors may warrant referral to a neuro-oncology center for combined care.

When surgery may be recommended
  • Symptomatic brain tumor causing headache, seizures, or neurological deficits
  • Meningioma with mass effect or growth on serial imaging
  • Solitary or limited brain metastasis amenable to resection
  • Need for tissue diagnosis when biopsy is required
  • Hydrocephalus caused by tumor obstruction
Please note: Brain tumor management is complex and often involves multiple specialists. We coordinate with neuro-oncology, radiation oncology, and neurology as appropriate for each patient's specific situation. Patients with high-grade gliomas or complex skull base tumors may be best served at a major academic center — we will provide honest guidance.
Techniques & approaches
  • Craniotomy with image-guided neuronavigation
  • Intraoperative neurophysiologic monitoring
  • Awake craniotomy for tumors near eloquent cortex (selected cases)
  • Operative microscopy for tumor-brain interface definition
  • Fluorescent dye techniques (5-ALA) for high-grade glioma resection
  • Stereotactic biopsy when open resection is not appropriate
(405) 748-3300  ·   Fax: (405) 749-1671  ·  Monday – Friday 8:00 AM – 5:00 PM

Ready to Get Answers?

Our team will review your imaging, give you an honest evaluation, and help you understand your options.

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