Brain Surgery in Kerala — Advanced Neurosurgical Treatment at Caritas Neuro Sciences

Brain Tumours

Brain tumours represent one of the most challenging areas of neurosurgery. Dr. Bahuleyan’s training at the Cleveland Clinic’s Burkhardt Brain Tumor Center under Dr. Gene Barnett equipped him with expertise in the most advanced tumour resection techniques available. His published study on pituitary macroadenomas — a prospective study of 80 patients demonstrating that conventional MRI signal intensity alone cannot reliably predict tumour consistency — has fundamentally changed preoperative imaging practice worldwide.

This study is now cited in the Congress of Neurological Surgeons/AANS guideline on imaging in non-functioning pituitary adenomas as one of only two Class II (prospective) diagnostic studies. It catalysed the development of AI/machine learning approaches to tumour consistency prediction and is referenced in guidelines across Spain, China, and other national practice standards.

Skull Base Tumours

Dr. Bahuleyan completed a Clinical Fellowship in Neurosurgical Oncology at the Cleveland Clinic, Cleveland, USA where he trained extensively in skull-base approaches and maxillofacial surgeries. Brain tumours at the skull base are managed with the aid of advanced MRI technologies including intraoperative neuronavigation and neuromonitoring (SSEP, MEP, EEG). Tumours are removed microscopically via the transcranial approach or endoscopically through minimally invasive keyhole approaches, depending on tumour location and patient-specific factors.

His 2024 publication on the rare posterior location of the facial nerve in vestibular schwannoma surgery was selected as “Editor’s Choice — Skull-Base Surgery” by Surgical Neurology International, accumulating over 800 full-text views within six months — a testament to its immediate clinical impact.

Head Injury / Neurotrauma

Head injury is managed with the aid of intracranial pressure (ICP) monitoring and advanced neuroimaging protocols. The full spectrum of traumatic brain conditions is treated at Caritas Neuro Sciences, Kottayam.

Hydrocephalus

Two methods of surgical procedures are currently used in treating hydrocephalus: Endoscopic Third Ventriculostomy (ETV) and Ventriculo-peritoneal shunt. Dr. Bahuleyan has performed over 300 ETVs with a published 75% long-term success rate — research that has been incorporated into the CNS 2020 Pediatric Hydrocephalus Guidelines.

This study was selected as the cover illustration of the Journal of Neurosurgery: Pediatrics. It is cited in Nature Reviews Disease Primers and five major textbooks, and serves as a core reference for neurosurgical training programmes worldwide.

Brain Abscess

A brain abscess is a collection of pus within the brain caused by bacterial, fungal, or parasitic organisms. Surgical options for brain abscesses include open surgical excision, neuronavigation-assisted needle aspiration, and stereotactic-guided aspiration.

Epilepsy Surgery

Dr. Bahuleyan has performed more than 200 epilepsy surgeries and other functional neurosurgeries. He was a former epilepsy surgeon at the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum — considered the top epilepsy surgery centre in South-East Asia. He has vast experience in surgically treating complex epilepsies and is currently a visiting epilepsy surgeon at multiple centres across India. He is also invited faculty to various national-level epilepsy surgery workshops.

During his fellowship training in the USA, he demonstrated novel endoscopic epilepsy procedures which became the cover illustration for the Journal of Neurosurgery: Pediatrics. These four first-in-literature techniques are now referenced in international guidelines and textbooks worldwide.

Awake Craniotomy

Dr. Bahuleyan is an expert in awake brain surgery for eloquent-region tumours. His experience spans from residency at Christian Medical College, Vellore through his Cleveland Clinic fellowship. This technique allows real-time monitoring of brain function during surgery, enabling maximal tumour resection while preserving speech, motor, and cognitive functions.

Deep Brain Stimulation

Deep brain stimulation involves implanting electrodes within deep regions of the brain, connected to a pulse generator placed in the chest. Dr. Bahuleyan has a Clinical Fellowship in Functional and Restorative Neurosurgery from the Cleveland Clinic Foundation, Cleveland, USA. He has published and lectured extensively on this topic.

Vascular Diseases of the Brain

The neurosurgery department offers both endovascular and open surgical options to treat vascular disorders of the brain at Caritas Hospital, Kottayam.

Benign Brain Conditions

Arachnoid cysts, colloid cysts, and epidermoid cysts are managed with minimally invasive endoscopic techniques when appropriate. Dr. Bahuleyan’s published research includes a study on epidermoid cysts of the velum interpositum.

Cystic Prolactinomas — Non-Surgical Management

Dr. Bahuleyan’s landmark research demonstrated for the first time that cystic prolactinomas — previously considered resistant to medication and requiring surgery — can respond to dopamine agonist therapy. This paradigm-shifting study has been incorporated into the Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE) Position Statement, and is cited in multiple endocrinology textbooks and board-preparation manuals.