Brain Surgery in Kerala —
Advanced Neurosurgical Care

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, including intraoperative MRI, laser interstitial thermal therapy (LITT), Gamma Knife radiosurgery, and diffusion tensor imaging (DTI)-based surgery.

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 cited as one of only two Class II diagnostic studies in AANS/CNS guidelines.

Dr. Bahuleyan completed a Clinical Fellowship in Neurosurgical Oncology at the Cleveland Clinic where he trained extensively in skull-base approaches and maxillofacial surgeries. Skull-base tumours are managed with intraoperative neuronavigation and neuromonitoring (SSEP, MEP, EEG) and removed either microscopically via the transcranial approach or endoscopically through minimally invasive keyhole approaches.

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 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, with round-the-clock specialised neurocritical care.

Two methods of surgical procedures are 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 Paediatric Hydrocephalus Guidelines.

A brain abscess is a collection of pus within the brain caused by bacterial, fungal, or parasitic organisms. Surgical options include open surgical excision, neuronavigation-assisted needle aspiration, and stereotactic-guided aspiration — selected based on abscess location, size, and causative organism.

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

His study on DTI in acoustic neuroma won the Second-Best Paper Award at the Kerala State Neurosurgery Conference 2021, and his epilepsy research is cited in UpToDate® — the world's leading clinical decision support tool.

Deep brain stimulation (DBS) involves implanting electrodes within deep regions of the brain, connected to a pulse generator placed in the chest. Dr. Bahuleyan holds a Clinical Fellowship in Functional and Restorative Neurosurgery from the Cleveland Clinic Foundation and has published and lectured extensively on this highly specialised technique.

The neurosurgery department at Caritas Hospital offers both endovascular and open surgical options to treat vascular disorders of the brain. Early and expert intervention is critical in conditions such as ruptured aneurysms and arteriovenous malformations to prevent catastrophic neurological damage.

Arachnoid cysts, colloid cysts, and epidermoid cysts are managed with minimally invasive endoscopic techniques when appropriate. Dr. Bahuleyan's published research includes a landmark study on epidermoid cysts of the velum interpositum — a rare and surgically challenging entity.

His research on cystic prolactinomas demonstrated for the first time that these tumours — 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.