In the evolving field of neurosurgical care in India, neurovascular surgery is one of the most technically complex and life-altering specialties. In New Delhi, with its significant concentration of advanced medical centers and recognized specialists, patients with complex vascular disorders of the brain and spine are increasingly receiving complex interventions with improved outcomes. One of the foremost practitioners of this discipline is Dr. Shrey Jain, a New Delhi-based neurosurgeon whose practice embodies the current and contemporary model of neurovascular intervention.
What is Neurovascular Surgery?
Neurovascular surgery encompasses the blood vessels of the brain and spinal cord including arteries, veins, and malformations, and the important neurosurgical procedures that may be needed when something goes wrong. Examples include aneurysms (balloon-like dilations of arteries), arteriovenous malformations (AVMs), vascular strokes, cavernous malformations, and other vascular-related issues. It is our goalmouth to reinstate optimal blood flow, avert ruptures and bleeding, and reassure maximal neurological recovery while causing minimal injury.
This field integrates microsurgical technique, advanced imaging, endovascular (minimally invasive catheter-based) techniques, and extensive postoperative neuro-critical care. The stakes are high: the brain cannot tolerate delays or errors in blood supply and the working area is extremely sensitive.
Why Choose New Delhi for Neurovascular Surgery?
1. Modern surgical facilities: Multiple hospitals in New Delhi have hybrid operating theatres (which enable imaging and surgery to be conducted at the same time), advanced intraoperative neuronavigation, and specific neuro- intensive care units.
2. Surgical dual-specialized skill-set: Surgeons such as Dr Jain and his colleagues have training in both open microsurgery and endovascular surgery, and thus the vascular neurosurgeons take a tool-kit of procedures to each case.
3. Patient-centered care: A continuing theme among recognized neurosurgical groups is the emphasis on shared decision making, individualized care plans, and optimizing long-term function over simply completing a surgical procedure. For example, Dr Jain’s website describes a “patient-centered” approach.
4. Access: Given the clustering of tertiary care in Delhi, patients from across India (as well as international patients) have much easier access to these services, compared to patients in more remote areas for Neurovascular surgery in New Delhi.
The Treatment Journey
1. Primary Assessment & Imaging
When a problem with vascular neurosurgery is suspected (for instance, the result of a bleed, a transient neurologic event, or incidental imaging findings), a thorough assessment is performed: typically, high-resolution MRI or CT, angiography (MRI/CT), and digital subtraction angiography (DSA). These studies assess the vessels, flow dynamics (e.g. perfusion) and collateral circulation.
2. Clinical Planning
After the imaging phase, a silly team will comprise the neurosurgeon, an interventional neuroradiologist, a neuroradiologist (if different from the interventional), a neuro-intensivist and on occasion, a rehabilitation specialist. When a case falls within Dr Jain’s practise, there will be discussion about which procedure is best; open microsurgical technique (clipping an aneurysm, surgical excision of an AVM), endovascular (coiling, stenting, flow-diverter, embolization), or a hybrid approach. Dr Shrey Jain, in both situations, think about the stating type of procedure and what viability (team debrief or document) is appropriate. GIRFT (Getting It Right First Time), examples of communication that both surgical and Endovascular were addresses and specified in Pellatt Check lists.
3. Surgical/Endovascular Intervention
• Open microsurgical approach: obtain access to the abnormal vessel through small craniotomy under operating microscope direct via microsurgical technique.
• Endovascular approach: using catheter access, using the groin (or wrist), the neurointerventionalist navigates into the cerebral vessels and deploys device (coils, stents, embolic particles) underway to neutralize this lesion.
• Hybrid approach: in terms of complexity, some cases may best require both approaches in succession or together.
4. Post-operative Care & Rehabilitation
Following surgery, patients are monitored in a neuro-intensive care unit for re-bleeding, vasospasm (a specifically in aneurysm/SAH patients), stroke and are early mobilized. Physiotherapy, Occupational Therapy and neuro-rehabilitation are vital to ensuring maximum functional recovery, which is more valuable than survival; it’s a return to life-roles.
Spotlight: Dr. Shrey Jain’s Practice in Neurovascular surgery in New Delhi
It has been said Dr Jain has “training in most advanced techniques of brain and spine surgery” and an interest in vascular neurosurgery. On his services page, “Neurovascular Intervention” is listed as a remit in the training. What truly set’s Dr Jain apart: the distinct poise in combining minimally invasive procedures in brain/spine, and vascular neurosurgery; the philosophy “each patient is unique” and bespoke care offered as part of shared-decision making; access to analytics of a major tertiary centre, particularly because of linkages to Sir Ganga Ram Hospital in Rajinder Nagar, New Delhi.
Why Early Referral Matters
In the field of vascular neurosurgery time = brain. For example:
•A ruptured aneurysm has the potential to cause subarachnoid hemorrhage: if evaluated quickly, treatment will reduce the risk of dire complications such as vasospasm and/or hydrocephalus.
•An AVM which presents with bleeding or seizures is often treated prior to additional injury.
•Even if lesions are identified incidental (but high-risk), it may be appropriate to intervene.
Delay in diagnosis, or even referral to specialized centers or a lack of multidisciplinary planning will diminish the possibility of an ideal outcome.
How to Choose the Right Centre & Surgeon?
Here are some practical pointers for patients and families:
• Request questions relating to the surgeon’s expertise, relating specifically to neurovascular cases, for example, aneurysms, AVMs, etc.
• Ask whether both open and endovascular, and not just open or endovascular, are available at this institution (or does this institution have a hybrid-team).
• Verify if this institution has a neuro-ICU and neuro-rehabilitation services.
• Ask for clarity about risks, alternatives and your individualized treatment plan (not “we will just do surgery”)
• Ask about subsequent care including imaging, rehabilitation, and clinic visits.
Final Thoughts
Neurovascular surgery in New Delhi is available at a world class level, with modern facilities, renowned expertise, and a patient-centric approach to care. With individuals such as Dr Shrey Jain establishing a leadership role, exciting opportunities for improving outcomes for patients with significant vascular brain and spinal disorders exists. If you or a loved one have a diagnosis that involves cerebral and/or spinal vessels – whether that involves an aneurysm, AVM (arteriovenous malformation), bleed, or some other condition – early assessment and referral to an advanced neurovascular service is essential.
In neurosurgery, we have high expectations of ourselves: to sustain life, restore function, and enable patients to recover their lives. Contributing to this expectation, the presence of platforms that function through multidisciplinary teams, advanced surgical and endovascular techniques, and intensive postoperative management continue to make this ideal more achievable. New Delhi is at the forefront as a destination for individuals seeking high level neurovascular care.