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Last updated: 12 Nov 2020
- Brain tumours
- Spinal tumours
Hello! I am a Consultant Neurosurgeon who is primarily based at the University Hospital of Wales where I have my NHS practice. As part of that role, I undertake emergency work in all aspects of adult and paediatric neurosurgery.
However, my specialist interests lie in brain tumour surgery and surgery for many of the Facial Pain syndromes such as Trigeminal, Glossopharyngeal and Geniculate Neuralgias. They represent very different niches but have turned out to be very professionally and clinically rewarding in equal measure. I also come with Fellowship experience in Neurooncology and Complex Spinal Surgery.
Awake brain surgery for gliomas is something that is very close to my heart and I regularly undertake these at the University Hospital of Wales. I find that there is no other standard that can match the benefits of monitoring important and socially enabling brain function with someone who is temporarily awake during their surgery. A lot of this I learnt from Prof. Hugues Duffau - a doyen of awake brain surgery for low grade glioma with whom I spent a few months in observership at Montpelier in the South of France. I truly believe in pushing functional brain boundaries to achieve maximal tumour removal whilst preserving what makes one a normal functioning human being capable of spontaneous and enjoyable social interaction.
Diametrically opposite to brain tumour surgery - in both principle and approach, lies my other but equally passionate interest in Facial Pain. Trigeminal Neuralgia is rare - but can be one of the most painful and invisible conditions known to man, and often undiagnosed for many months or years. This is because other conditions that mimic this pain are so varied that they require the expertise of different clinical specialists - and a lot of them may not be available to you locally. However, there is a good proportion of you who will be very suitable for a range of treatment options from simple medication to microvascular decompression surgery. The challenge lies in choosing the correct option, and the dilemma will be in balancing risk vs benefit. I can help with that.
Moreover, the guidance on medical management continues to evolve and it is important that the correct first line medications are prescribed to corner the pain whilst investigating for any potential causes that are remediable. Conditions like Glossopharyngeal Neuralgia and Geniculate Neuralgia are far more uncommon but have excellent outcomes with Microvascular Decompression surgery - as do a large proportion of people with Trigeminal Neuralgia.
As part of my NeuroOncology remit, I also have expertise in spinal cord tumour surgery. However, these are rarer in occurrence than tumours elsewhere in the central nervous system.
Notwithstanding the above, I routinely perform surgery for degenerative spinal disease of the neck and the lower back for sciatica and similar conditions.
In NHS Wales, I am the Lead for Neurosurgical Oncology and also the Welsh Cancer Lead for Brain and CNS. I also steer the Facial Pain Network in South and West Wales. From time to time I provide specialist advice to the Parliamentary Health Service Ombudsman.
Areas of interest
Surgery for facial pain (Trigeminal, Glossopharyngeal, Geniculate neuralgia) - microvascular decompression (MVD)
Awake Brain Surgery;
Low Grade Glioma Surgery;
Brain surgery for benign and malignant tumours;
Surgery for Spinal cord Tumours;
Spinal Surgery for degenarative spinal conditions such as lumbar discectomy, cervical discectomy and laminectomy;
Nerve root decompression and foramenotomy;
Shunt for hydrocephalus;
Carpal Tunnel Decompression
Current NHS consultant posts held
Consultant Neurosurgeon - University Hospital of Wales
Welsh Cancer Lead for Brain and CNS
Lead for Facial Pain
Lead for Neurosurgical M&M
Advisor to the Parliamentary Health Service Ombudsman
Dynamics of neurovascular conflict in Trigeminal Neuralgia
(Additional) Languages spoken
- Malayalam - Fluent
- Tamil - Conversational
- Kannada - Conversational
Reference number 5208251
Post treatment communication
Following treatment of a Bupa member, I will communicate with GPs in line with Department of Health, GMC and appropriate professional bodies guidelines.