Asiri Central Brain & Spine Centre (ACBSC) is the most advanced Neurosurgical Centre in Sri Lanka. It addresses all forms of brain and spine diseases and works in collaboration with a team of leading Neurologists, Neuroradiologists and Interventional Radiologists, using an array of the best neuroimaging equipment including CT, MRI scans and the most advanced Biplaner Neuroangiography. The centre is capable of diagnosing most Brain & Spine related diseases.

ACBSC is a world class Neurosurgical facility which includes three dedicated Neurosurgical Theatres with top of the range Neurosurgery Operating Microscopes, latest Neuronavigation Platforms, and Intraoperative Monitoring Equipment. In the hands of a team of the most eminent Neurosurgeons, this allows us to offer our patients a Neurosurgical Service on par with the best in the world.

Our Neuro Intensive Care Unit has 12 separate full facility rooms and a dedicated NICU team provides the precise care that is necessary for patients after major neurosurgery is performed. It is deemed to be the best in Sri Lanka. Our 37-bed ward complex, situated on the 10th floor of the Asiri Central Hospital, provides care that is praised by all our patients.

• Dedicated Neurosurgery Ward with 40 Patient Rooms
• Dedicated Neurosurgical ICU with 12 Separate Rooms with latest equipment
• Dedicated Neurosurgery Theatre Complex with three separate theatres
• Most Advanced Equipment used in Neurosurgery
• Neurosurgery Microscopes (Zeiss)
• Neuronavigation (Brainlab & Stealth Station)
• Cavitron Ultrasonic Surgical Aspirator (CUSA)
• Intra Operative Monitoring for Cranial and Spinal Surgery including Epilepsy Surgery
• Fully equipped Physiotherapy Centre with a Hydrotherapy Unit
• Comprehensive Neuro Imaging Centre with MRI, CT Scan and Angiography Facilities.

How our Brain and Spine Centre Operates

The Brain and Spine Centre comprises the neuro-catheterisation laboratory, the neuro-ward, ICU, and operating theatres.

The Neuro-Ward, ICU, and theatre function together to provide the following services:

• The pre-admission evaluation unit is where patients are assessed and clerked before being admitted to the wards.
• Neuro-wards are responsible for managing the pre-operation, post-operation, and rehabilitative care of all neuro-related patients. The neuro-operating theatre receives patients who have been prepared for surgery. After the surgery is performed and the patient has recovered, they are transferred to either the ICU or the ward.
• Neuro-ICU is responsible for receiving and caring for patients from the operating theater (post-operation), and the accident and emergency department or ward. Once stable, the patients are transferred to the ward.

The Neuro-Ward Complex

The ACBSC Ward Complex occupies the entire 10th floor of the 13-floor hospital. It comprises of 37 individual air-conditioned rooms (except for a few which are reserved for patients who prefer not to use air conditioning), and 2 luxury rooms for patients who need more comfort. Almost 50% of the rooms have a magnificent view of the Colombo Skyline and the rest have a view of the courtyard below, which houses the cafeterias and relaxing areas for patients and visitors.

Each individual room has an ICU type electrically operated bed, which can be adjusted to multiple positions. There is an over-bed panel, which has ports for oxygen, suction and air as in the ICU.

The skilled core team including the in-ward doctors, nurses, physiotherapists, and ancillary staff are experienced in managing neurosurgical patients with all types of cerebral conditions such as head injuries, brain tumors, etc. and spinal conditions such as injuries, disc prolapse, tumors, etc. pre and postoperatively. All other types of neurological conditions are also managed in this ward.

There is an in-house physiotherapy program which is tailor-made for patients who cannot be transported to the Department of Physiotherapy.

Theatre Complex

The ACBSC theatre complex is the best designed ultra-modern Neurosurgery Theatre Complex in the country. It is comparable to any such complex in the world. It is a stand-alone facility with three spacious theaters catering to neurosurgery only. Approximately 1500 neurosurgical procedures are performed here annually. ACBSC being a center catering to some of the most difficult neurosurgical patients, this theatre complex is geared to perform any complex neurosurgical procedure.

We were the first in the country to acquire a Neuronavigation Platform (Medtronic Stealth Station) in 2004, followed by the latest BrainLab Neuronavigation Platform in 2016. Our intraoperative CT Scan (BrainLab-Aero), the first in the country has significantly augmented our surgical capabilities with intraoperative neuro and spinal navigation. From the time of establishing Neuronavigation in Asiri Hospitals, we have done more than 2500 Neuronavigation Guided surgical procedures in our theaters.

We have also been the first theater in the country to acquire Neuro Intraoperative Monitoring Equipment (Nihon Kohden). This has the capability to help monitor the EEG wave pattern for Epilepsy Surgery and Motor and Sensory Evoked Potential Monitoring for Brain and Spinal Surgery specially to assist in removing eloquent area lesions in the brain and removal of spinal tumors and also in surgery for complex myelo and lipo meningoceles. This has allowed extremely safe neurosurgery to be performed in this theater complex and we are proud to say that we were the first to perform “Awake Neurosurgery” and DBS insertion for Parkinson’s disease in this country. We were the first private sector hospital to perform Epilepsy Surgery in Sri Lanka and now the only hospital to continue with Epilepsy Surgery in the country.

Additionally, we have the following equipment to support our high-end neurosurgery.

1. Neurosurgery Microscopes x 3
   • Zeiss Pentero 900
   • Moller Wedel
   • Zeiss NC 4
2. Cavitron Ultrasound Aspirator (Integra) x 2
3. High-Speed Neurosurgery Drill Systems x 4
4. Stereotactic Frame
5. Endoscope

In addition to the surgical equipment, we also have high-end anesthetic and monitoring equipment necessary for highly complex neurosurgery including Awake Neurosurgery and surgery in the Seated Position for posterior fossa lesions.

Our highly skilled assisting doctors and nurses are probably the best in the country and are capable of assisting in the most complex neurosurgical procedures. The team of Consultant Neurosurgeons and Anesthetists are the best in the country and compare to some of the best in the world.

Intensive Care Unit

ACBSC, being a center addressing the most complex neurosurgical conditions in the country, knows well the pivotal role the Neurosurgery ICU plays in a patient's recovery. Guided by the motto 'All our patients survive' the unit ensures even the most critical of patients are given the best chance of survival. We are proud of a 99% success rate.

The dedicated team includes highly skilled Doctors, Nurses, Consultant Neurosurgeons and Ancillary Staff tethered by two 'In-Charge' Consultant Anesthetists working 24/7. The perfect understanding and collaboration with which the team works together is a primary reason for the unit's success rate.

Improving the service in this unit professionally and technologically, to be abreast with the best Neuro ICUs in the world, is our commitment.

High Dependency Unit

As a value addition to the Brain and Spine Centre, Asiri Central Hospital opened its 4 Bed HDU in August 2016. This is to help critically ill Neurosurgical patients in their transition from the ICU to the neurosurgical ward. The HDU provides patients who have recovered from a critical status but not yet ready to be looked after in individual wards, without constant supervision, a pathway to be managed less intensely but closely till the doctors are ready to move them to the ward. This helps the patient to know that they are on the path to recovery and also will help financially as the cost in the HDU is much less than in the ICU. However, the patients are looked after by experienced ICU nurses and the HDU has monitoring equipment and other necessities to handle any emergency. Being situated next door to the Neuro ICU and the Neurosurgery theater is an additional advantage to manage any patient in the HDU who may need urgent care.

The central nervous system of the human body is primarily composed of the brain and spinal cord. The brain, often referred to as the body's ‘command center,’ directs almost everything we do. It controls important processes like breathing, heart rate, and body temperature while also controlling our thoughts, emotions, and memories.

The spinal cord acts as a communication route between the brain and the rest of the body. It transmits messages that let us feel touch, move our muscles, and feel pain. Our bodies can adapt to changes in our surroundings due to this connection.

Disorders of the spine and the brain can impair these vital processes. Alzheimer's disease and Parkinson's disease both have an impact on memory, cognition, movement and coordination. Paralysis or loss of feeling below the injury site are potential consequences of spinal cord injuries. Additionally, depending on where in the brain they are, diseases like stroke or brain tumors can produce a variety of symptoms.

Medical, surgical, and rehabilitative therapies are used in the treatment and management of various illnesses with the goal of restoring or improving the function of these essential organs.

Neurological symptoms can vary due to the several body functions being controlled by the central nervous system.

Typical Neurological Symptoms:

• Pain (back/neck/head/along a nerve pathway)
• Muscle malfunction (weakness/tremor/paralysis/clumsiness/difficulty walking/rigidity)
• Changes in smell, taste, vision, and hearing
• Sleep problems
• Changes in consciousness (fainting/seizures/coma)
• Changes in cognition (dementia/poor memory/difficulty understanding or using language)