Sample Opinion for Foramen Magnum Decompression

Diagnosis: According to the medical reports shared with us, Mr. XYZ. We have discussed the patient’s medical condition with our Eminent Neurosurgeons at the leading hospitals on our panel in India. Kindly allow me to provide you with their opinion. The diagnosis is the patient is suffering with Chiari Malformation, hydrocephalus and hydro-syringomyelia.

Chiari malformation (CM) is a structural defect where the lower part of the brain (cerebellum) extends into the spinal canal because the skull is too small or misshapen, blocking cerebrospinal fluid flow and causing pressure.

Hydro syringomyelia (or Syringomyelia) is a serious neurological disorder where a fluid-filled cyst, called a syrinx, forms inside the spinal cord, damaging nerve fibres and causing progressive symptoms like chronic pain, weakness, stiffness, numbness (especially to temperature), and loss of reflexes, often starting in the hands/arms and spreading, with causes ranging from Chiari malformation to trauma or tumours. In this case the reason in all possibility is Chiari-malformation.

Hydrocephalus, or “water on the brain,” is a buildup of excess cerebrospinal fluid (CSF) in the brain’s ventricles, causing them to expand and put harmful pressure on brain tissues, potentially leading to brain damage or death if untreated. In this case, it is most probably because of Chiari- Malformation.

Investigations needed to confirm the diagnosis – MRI Brain, MRI Spine, CSF Study and other routine tests.

Possible line of treatment – Mr. XYZ will need Foramen Magnum Decompression surgery with or without Endoscopic third ventriculostomy. Foramen magnum decompression (FMD) is a surgical procedure for Chiari malformation that involves removing a small section of bone from the base of the skull (foramen magnum) and the top of the spine to create more space for the brain and spinal cord. This helps alleviate compression and restore the normal flow of cerebrospinal fluid (CSF), potentially reducing or resolving symptoms and conditions like syringomyelia.

Endoscopic Third Ventriculostomy (ETV) is a minimally invasive neurosurgical procedure to treat obstructive hydrocephalus (water on the brain) by creating a small opening in the floor of the brain’s third ventricle, allowing cerebrospinal fluid (CSF) to bypass a blockage and flow to natural absorption sites, relieving pressure without needing a shunt.

We will recommend the following doctors and Hospitals for Mr. XYZ –

1. Max Healthcare, Gurugram is India’s first truly integrated healthcare system based in India. The Institute is a wholly owned subsidiary company of Max India Limited, established in 1985. Max Healthcare offers three levels of clinical services (Primary, Secondary and Tertiary) within one system. ‘Patient-Centred Care’ ‘Patient-Centred Care’ is the core of everything that Max does. To know more, click on the link – https://hbgmedicalassistance.com/max-super-speciality-hospital/

**Kindly visit the hospital gallery via link – https://pin.it/2sWwqfts7

Dr. Arun Saroha will be the treating neurosurgeon.

2. BGS Gleneagles Global Hospital at Bengaluru, is one of the best super specialty hospitals in Bangalore and one of the Karnataka’s most renowned multi-organ transplant and tertiary care multi-speciality hospital with a key focus on Gastroenterology, Cancer Care, Neurosciences, Renal Sciences and Cardiac Sciences. The NABH and NABL accredited hospital operate 450 beds. A modern Cath Lab, 6 operation theatres, advanced imaging services (Trubeam STX and Tesla MRI) offer cutting edge emergency and critical care management following internationally approved clinical protocols. The hospital also offers Video Consult services to its patients in India, Africa and SAARC nations :- https://hbgmedicalassistance.com/hospitals/gleneagles-global-hospital/

Kindly visit the Hospital Gallery via link: https://pin.it/52clkhqBh

Dr. Keshav G C will be the treating doctor.

3. Artemis Hospital, Gurgaon- Artemis Health Institute (AHI), at Gurgaon is a 300-bed tertiary care super-specialty flagship hospital established by Artemis Health Sciences (AHS). Artemis Hospital is the first JCI and NABH accredited hospital in Gurgaon. To know more about the Hospital, kindly click on the

link https://hbgmedicalassistance.com/hospitals/artemis/

**Kindly visit the Hospital Gallery via link – https://pin.it/1bs51UAGE

Dr. Aditya Gupta will be the treating neurosurgeon.

4.Amrita Hospitals is Asia’s largest healthcare destination in Faridabad, Haryana. Spread across 133 acres, this campus has 2600 bed super specialty Hospital. It has 62 state-of-the-art modular Operation theatres (country’s largest), 540+ Smart Critical Care Beds (country’s largest) with most avant-garde and largest (Intel) Laboratory and Imaging Services. It has country’s highest positive and exclusive negative pressure isolation rooms for Infectious Diseases. Click on the link:

https://hbgmedicalassistance.com/hospitals/amrita/

**Kindly visit the Hospital Gallery via link – https://pin.it/6VWWsyyzq

Dr. Anandh Balasubramaniam will be the treating neurosurgeon.

5.Sarvodaya Healthcare, Faridabad has been serving people with quality medical services and empathetic care for the last 32 years. We bring you experienced medical and non-medical professionals, advanced technology & frontier infrastructure to offer quality clinical services, ensuring good health for you and your family. To know more, click on the link – https://hbgmedicalassistance.com/hospitals/sarvodaya-hospital/

**Kindly visit the Hospital Gallery via link – https://pin.it/6VWWsyyzq

Dr. Yawar Shoaib Ali will be the treating neurosurgeon.

Estimated cost:

The estimated cost of evaluations will be approx. USD 500-700 on OPD basis.

The Estimated Cost of Surgery Foramen Magnum Decompression at various hospitals is as below: –

Hospitals	City	Estimated Cost of Surgery (craniotomy and excision) (Twin Share)
Max Hospital	Gurgaon	USD 7800
Gleneagles Hospitals	Bangalore	USD 9000
Artemis Hospital	Gurgaon (DELHI NCR)	USD 7600
Amrita Hospitals	Faridabad (DELHI NCR)	USD 6900
Sarvodaya Hospital	Faridabad (DELHI NCR)	USD 6800

Kindly Note: The above rates are on approximate basis; actual charges will depend upon the final plan confirmed on the basis of medical evaluation at the hospital.

Stay in India: The patient will require 3-5 days for initial evaluations on an OPD basis and will require 5-7 days of hospitalization for surgery. Post-Discharge the patient may require 10-15 days for follow up and recuperation. Total Length Stay in India will be approx. 3-4 weeks.

Inclusions:

1. The cost of all investigations related to the surgery (craniotomy and excision)

2. The cost of the treatment.

3. The doctor’s fee and surgery charges.

4. The stay of the patient and 1 attendant during hospital admission.

5. All meals for the patient and the attendant as per the available menu while in hospital.

6. Medical Consumables and Medicines while in hospital.

7. The fee for dietician and nursing while in hospital.

8. It also includes complimentary Airport Transfers, Forex Services, and assistance.

Exclusions:

1. Any consultation other than in discussion.
2. Extended stay
3. Treatment for any other illness

On Arrival:

The patient and patient’s attendants will be received at the airport by our Representative. Apart from the medical and nursing team, one Case Manager will take care of all the needs. We shall also assist them with the reasonably charged accommodation near the hospital. The patient and attendant may arrange 35-50 USD per day toward accommodation and food at Guest House.

Hope I have been able to give you a satisfactory answer to the query. Do kindly ask for any clarifications needed. I will be happy to answer & shall look forward to assist you.