Dr. Khoo Chee Min James

Dr. Khoo Chee Min James

Brain and Spine Specialist - Neurosurgeon

  , Novena, Singapore

  41 Years of experience

BIOGRAPHY

Dr. Khoo Chee Min James is one of the finest Brain and Spine Specialist in Singapore. He is an experienced Neurosurgeon in the Singapore. The Medical practitioner has been associated with various reputed hospitals in the Singapore. The physician is currently working as a Consultant neurosurgeon, Mount Elizabeth Novena Hospital, Singapore. The doctor is a well-reputed and sought after medical expert and is

  • MBBS (Singapore)
  • FAMS (Neurosurgery)
  • MD (Neurosurgery) Singapore

qualified. Dr. Khoo Chee Min James has been associated with many hospitals over the course of his illustrious and experienced career.

The hospitals include:

  • Mount Elizabeth Medical Centre, Central (Primary)
  • National University Hospital, Queenstown

Dr. Khoo Chee Min James has more than 41 Years of clinic experience. The Clinician specializes in and performs the following surgeries:

  • Brain Cancer Treatment
  • Brain Tumour Treatment
  • Craniotomy
  • Deep Brain Stimulation
  • Kyphoplasty
  • Neurology
  • Oncology
MEMBERSHIPS (2)
  • Royal Australasian College of Surgeons
  • Academy of Medicine, Singapore
RESEARCH PAPERS AND PUBLICATIONS (2)
  • Response to Re: The Australasian contribution to the development of neurosurgery in Singapore.
  • A Tribute to Tham Cheok Fai, "Founding Father" of Singapore Neurosurgery
Procedures
Brain Cancer Treatment

 

Brain cancer can interfere with normal brain functions such as speech, movement, thoughts, feelings, memory, vision, and hearing. It is a disease of the brain in which abnormal, cancerous cells grow in the brain tissues. Typically, brain cancer is a developed form of a brain tumour. Primary brain cancer or a brain tumour develops from cells within the brain.

However, all brain tumours are not brain cancer. But one thing to note is that even benign tumour can cause serious problems by increasing intracranial pressure or obstruct vascular structures or cerebrospinal fluid flow in the brain.

Different types of cells in the brain such as gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, and primitive neuroectodermal (medulloblastomas) can become cancerous. Gliomas have several subtypes, which include astrocytomas, oligodendrogliomas, ependymomas, and choroid plexus papillomas.

Types of Brain Cancers

There are two types of brain cancer, including:

  • Primary brain cancers: Primary brain cancers result when cancer cells develop in the tissues of the brain itself. Primary brain cancer cells may travel short distances within the brain but generally would not travel outside of the brain itself.
  • Secondary brain cancers: Secondary brain cancer is called metastatic brain cancer. It occurs when cancer develops elsewhere in the body and spreads to the brain. Primary cancer tissues can spread via direct extension, or through the lymphatic system or through the bloodstream.

Metastatic cancer in the brain is more common than primary brain cancer. They are usually named after the tissue or organ where cancer first develops. Metastatic lung or breast cancer in the brain is the most commonly found brain cancers.

Brain Cancer Causes

The exact brain cancer cause is still unknown. However, its occurrence has been linked to several risk factors, including the following:

  • Exposure to radiation
  • HIV infection
  • Inherited abnormality
  • Smoking
  • Exposure to environmental toxins
  • Exposure to chemical toxins, especially those used in rubber industry and oil refinery

Brain Cancer Symptoms

Some types of brain cancers such as meningeal and pituitary gland may produce few or no symptoms. Some of the brain cancer symptoms typically experienced by patients include:

  • Difficulty walking, seizures, dizziness and vertigo
  • Extreme fatigue and muscle weakness
  • Severe headaches and blurry vision
  • Sleepiness, nausea, and vomiting
  • Reduction in mental alertness, capacity or memory
  • Difficulty in speaking, impaired voice or inability to speak
  • Personality changes and hallucination
  • Weakness on one side of the body and coordination problems
  • Reduced touch sensation
Brain Tumour Treatment

A brain tumor is a cancerous or a non-cancerous growth of cells in the brain. This growth of abnormal cells can take place in any part of the brain or it can happen in any other body party and spread to the brain.

It is a fairly common condition that affects millions of people around the world. An undiagnosed brain tumour can prove fatal and therefore, it is necessary to undergo specific tests and initiate treatment as soon as the diagnosis is confirmed.

The symptoms of a brain tumour can be confused with some other medical condition, especially migraine. Increasingly strong headache and blurred vision are the two most common symptoms of a brain tumour. People with this condition can also experience seizures, confusion, nausea, vertigo, impaired voice, and loss of balance.

Treatment for a brain tumour depends on several factors. The type, size, and the location of a tumour, in addition to the overall health of the patient and his or her age, are some of the considerations made by the doctor while preparing a brain tumour treatment plan.

Different treatment modalities can be used to treat brain tumour patients and surgery, chemotherapy, and radiation therapy are among them. Usually, a combination of treatment modalities is used to conduct brain tumour treatment.

Craniotomy

Craniotomy surgery is one of the most common types of brain surgery conducted to treat a brain tumor. It mainly aims at removing a lesion, tumor, or a blood clot in the brain by opening a flap above the brain to access the targeted area. This flap is removed on a temporary basis and again put in place when the surgery is done. Around 90 percent of the cases of brain tumors are diagnosed in adults aged between 55 and 65. Among children, a brain tumor is diagnosed within an age range of 3 to 12 years.

Craniotomy procedures are conducted with the help of magnetic resonance imaging (MRI) scans to reach the location precisely in the brain that requires treatment. A three-dimensional image for the same is achieved of the brain in conjunction with localizing frames and computers to view a tumor properly. A clear distinction is made between abnormal or tumor tissue and normal healthy tissue and to access the exact location of the abnormal tissue.

Who requires a craniotomy?

In a minimally invasive craniotomy procedure, a burr hole or a keyhole may be created to access the brain to fulfill the following purposes:

  • To drain out cerebrospinal fluid in case of hydrocephalus by inserting a shunt into the ventricles
  • To treat Parkinson’s disease by inserting a deep brain stimulator (DBS)
  • To insert an intracranial pressure monitor
  • To conduct needle biopsy, where a small sample of abnormal tissue is removed for study
  • For stereotactic hematoma aspiration, in which a blood clot is drained out
  • For insertion of an endoscope to clip aneurysms and for the removal of small tumors

When there are complex craniotomies involved, the procedure may be referred to as a skull base surgery.  In this kind of surgery, a small portion of the skull is removed from the bottom of the brain. This is the region where delicate arteries, veins, and cranial nerves exit the skull. Complicated planning is done to plan such craniotomies and understand the location of the lesions. This type of approach is usually employed for:

  • The removal or treatment of large brain tumors and aneurysm in the brain
  • Treatment after a skull fracture or major injury like a gunshot
  • The removal of a malignant tumor affecting the bony skull

Primary brain tumors are much less common than secondary brain tumors. Primary ones are found to originate very close to the brain itself or in the tissues very close to it, such as the covering membranes of the brain, including the meninges, cranial nerves, pineal, or pituitary gland. It begins with normal cells, which at a later period undergoes some mutational errors in their DNA. The mutation triggers cells to grow and divide at a very high rate while healthy cells keep dying around it. This results in a mass of abnormal cells which gives rise to a tumor. Unlike primary tumors, the secondary tumors begin as cancer elsewhere and spread to the brain.

Symptoms of brain tumor

  • Different patterns of a headache
  • Headaches get more frequent and acutely painful
  • Nausea
  • Blurred vision, double vision, or loss of peripheral vision
  • Loss of sensation in the arm or any leg gradually
  • Balance difficulty
  • Speech problems with confusion in simple matters
  • Hearing problems
  • Personality change
  • Sudden seizures and attacks or bouts of pain

Types of Craniotomy

No matter what the goal of the surgery is, it is best to ensure that the incision is made to address the intracranial lesion keeping some principles in mind. A wide variety of intracranial processes can be done via a craniotomy with a different variety of incisions. Some of these variations include frontal craniotomy, pterional craniotomy, temporal craniotomy, decompression craniectomy, and suboccipital craniotomy.

Deep Brain Stimulation

Deep brain stimulation (DBS) is a neurosurgical procedure that involves implantation of electrodes within the specific targeted areas of the brain. It is used to treat a variety of disabling neurological symptoms. Deep brain stimulation procedure can be opted for treating a number of neurological conditions, including Parkinson's disease, Essential tremor, Dystonia, Epilepsy, Tourette syndrome, obsessive-compulsive disorder and chronic pain. Deep brain stimulation uses a neurostimulator, commonly referred to as deep brain stimulator,  to deliver electrical stimulation to targeted areas in the brain that control movement.

The impulse sent by deep brain stimulator interferes with and blocks the electrical signals that cause tremor and other Parkinson’s disease symptoms. The targeted areas most often include the thalamus, subthalamic nucleus and globus pallidus. Deep brain stimulation procedure has a long history of research. It was first introduced in 1987 and The Food and Drug Administration (FDA) approved deep brain stimulation treatment for essential tremor and Parkinson's disease in 1997.

What is deep brain stimulation treatment?

Deep brain stimulation treatment is recommended for people who have had Parkinson’s disease for at least four years, are still getting benefited from medications, but have motor complications, such as significant on-off time periods. Brain stimulation therapy works by inactivating the parts of the brain that cause Parkinson's disease symptoms. However, DBS Parkinson does not damage the healthy brain tissue by destroying nerve cells. It blocks electrical signals from targeted areas of the brain.

Deep brain stimulation treatment has proven effective in most of the cases, but it could potentially result in serious complications and side effects. This is the main reason why deep brain stimulation treatment is used only for patients whose symptoms are not appropriately controlled with medications.

Kyphoplasty

Kyphoplasty is also known as balloon kyphoplasty. It is a minimally-invasive surgical procedure that can repair spinal fractures caused by cancer, osteoporosis, or benign lesions. It is not used for spinal stenosis treatment.

Kyphoplasty procedure is designed to relieve the intense pain caused by vertebral compression fractures, to stabilize the bone or to bring back some or all of the lost vertebral body height due to the compression fracture. Kyphoplasty or balloon kyphoplasty is a superb replacement of the typical conventional therapies such as analgesic use, bed rest, and bracing. It is a quick remedy for severe pain due to vertebral compression. It eliminates the pain almost immediately and the risk of complications during kyphoplasty is low. However, it is not intended for the treatment of arthritis or intervertebral disc disease. Kyphoplasty is different from discectomy, which is conducted in case of a herniated disc. Discectomy completely removes the damaged or herniated disc from the vertebrae of the patient.

Laminectomy and vertebroplasty are two other procedures that follow different techniques for stabilizing fractures. Laminectomy works by removing the lamina to create space, vertebroplasty works by injecting cement into the broken or cracked spine. For the same reason, vertebroplasty cost is different from kyphoplasty cost.

Who is the best candidate for kyphoplasty?

Kyphoplasty is typically suggested in case of:

  • Severe pain that cannot be controlled by pain-relieving medications
  • Severe functional restraints such as inability to walk or stand
  • Fractures resulting in loss of height and alignment
  • Multiple fractures in spine
  • Fractures with radical collapse
  • Fractures located at the thoracolumbar junction
  • Spondylolisthesis, that is, displacement of one vertebra over another

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Frequently Asked Questions
What area of specialization does Dr. Khoo Chee Min James have?
Dr. Khoo Chee Min James is specialized in Singapore and of the most sought after doctors in Brain and Spine Specialist.
Does Dr. Khoo Chee Min James offer Telemedicine Consultation through Medigence?
No, this doctor dose not offer telemedicine via MediGence
How many years of experience does Dr. Khoo Chee Min James have?
Dr. Khoo Chee Min James is one of the most sought after specialists in Singapore and has over 41 Years years of experience.
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