Craniotomy
A temporary bone window to reach the brain. The bone is replaced and fixed at the end — no gap is left behind.
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Cranial and spinal neurosurgical procedures
Twenty procedures, ten cranial and ten of the spine and peripheral nerve, described one by one.
Procedures
Twenty cranial and spinal procedures, explained without small print
These are the twenty cranial and spinal procedures performed by Dr. Noreña, each with its own page: what the operation involves, when it is indicated, the techniques used and the questions patients actually ask about it. None of them is decided from a website — every indication is decided on your own imaging and your own neurological examination.
Brain tumour microsurgery
Removal of gliomas, metastases and other brain tumours under the microscope, with neurological function as the limit of the surgical gesture.
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Meningioma surgery
Resection of convexity, falcine, sphenoid wing and skull base meningiomas, with early devascularisation.
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Pituitary adenoma surgery
Resection of pituitary adenomas, with endocrine assessment and visual field testing before and after surgery.
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Skull base surgery
Approaches to the skull base for tumours and lesions neighbouring cranial nerves and major vessels, with functional preservation as the priority.
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Cerebral aneurysm clipping
Craniotomy and titanium clip placement across the aneurysm neck, with proximal vascular control and microsurgical dissection.
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Arteriovenous malformation surgery
Microsurgical resection of cerebral arteriovenous malformations, alone or combined with prior embolisation.
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Subdural haematoma drainage
Evacuation of acute or chronic subdural haematoma through burr holes or craniotomy, with closed drainage.
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Ventriculoperitoneal shunt
Placement of a valved shunt system for congenital, adult and normal-pressure hydrocephalus.
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Head trauma surgery
Surgical management of head trauma: haematoma evacuation, elevation of depressed fractures and decompressive craniectomy.
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Lumbar microdiscectomy
Nerve root decompression for lumbar disc herniation, through a minimal incision with optical magnification.
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Decompressive laminectomy
Enlargement of the spinal canal for lumbar stenosis, removing lamina and hypertrophied ligamentum flavum.
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Instrumented lumbar fusion
Pedicle instrumentation and bone fusion for instability, spondylolisthesis and lumbar deformity.
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Cervical discectomy and fusion
Anterior cervical discectomy with fusion or disc replacement, for cervical radiculopathy and myelopathy.
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Spinal tumour surgery
Resection and decompression of vertebral, extradural, intradural and intramedullary tumours, with stabilisation where required.
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Vertebroplasty and kyphoplasty
Percutaneous cement stabilisation of osteoporotic and tumoural vertebral fractures, with no open incision.
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Functional neurosurgery
Procedures directed at facial pain, hemifacial spasm, spasticity and drug-resistant epilepsy.
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Peripheral nerve surgery
Release of entrapped nerves, repair of traumatic injuries and resection of nerve sheath tumours.
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Craniosynostosis surgery
Surgical correction of premature cranial suture closure in infants, with vault remodelling.
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Myelomeningocele repair
Closure of the newborn neural defect, with management of associated hydrocephalus and follow-up for tethered cord.
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How care works
From the first call to discharge, in six steps
No surprises: what happens at each stage, what will be asked of you, and at which point the decision to operate — or not to — is made.
Contact and appointment
Call (664) 104-9153 or send the form. You are told which studies to bring, and urgent cases are prioritised the same day.
Clinical history
How it started, what makes it worse, what has already been tried, and what else you live with. Half the diagnosis comes from here.
Neurological examination
Strength, sensation, reflexes, gait, cranial nerves. This is what decides whether an abnormal image truly explains your symptom.
Imaging review
MRI, CT, angiography or plain films are reviewed on screen with you present, and you are told what is there and what is not.
Plan and consent
Whether there is a surgical indication, which technique, and what the alternatives are. Risks and prognosis are handed over in writing.
Surgery and follow-up
Hospital scheduling, surgery, discharge with clear instructions, and follow-up visits until the episode is closed.
Neurosurgical consultation
Bring your imaging and settle the question
One consultation with your MRI or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.