Neurosurgery Department

The Alfred Neurosurgery Department has a team of experienced general neurosurgeons who all have subspecialty interests as follows:

• Prof Jeffrey Rosenfeld in cerebrovascular surgery, skull base surgery, brain tumours and neuro-endoscopy, which involves a small telescope instrument passed into the brain to improve the circulation of cerebrospinal fluid and to biopsy and sometimes remove tumours or cysts;

• Assoc Professor Peter Hwang in cerebrovascular surgery, skull base surgery and other brain tumours and neuro-endoscopy;

• Mr Patrick Chan in complex spine surgery, which includes spine trauma, spine tumours and degenerative spine disease, and a clinical interest in brain tumour surgery;

• Mr John McMahon in cerebrovascular surgery (intracranial aneurysms, arteriovenous malformations and trigeminal neuralgia), pituitary surgery and cranial microsurgery.

• Mr Niki Maartens in pituitary surgery, complex spine surgery and cranial microsurgery.

The Neurosurgery Department provides a comprehensive inpatient and outpatient neurosurgical service, treating the full range of intracranial, spinal and peripheral nerve disorders.

The Unit treats around 1,750 inpatients annually with around 50% being elective and 50% emergency.  Trauma accounts for approximately 35% of the caseload.  We have a very busy outpatient clinic, seeing 2,335 outpatients per year.

The Department has developed sub-specialty interests in cerebrovascular surgery, spine surgery, skull base surgery, pituitary surgery, and neurotrauma.

We are committed to providing excellence in neurosurgical care through quality management, education and training of health care professionals in clinical and laboratory research.

We also have an ongoing commitment to enhancing our links with other Alfred departments, general practitioners and outside institutions.

The department accommodates a number of neurosurgical training positions, including four Registrars, four Residents and international neurosurgical trainees and fellows. Previously, neurosurgical fellows from Canada, Germany, the United Kingdom, People's Republic of China, Kenya, Papua New Guinea, Sri Lanka and Laos have undertaken training within this department.

The department also provides a clinical neuropsychology inpatient and outpatient service to assess and treat patients with brain injury or neuro cognitive deficits following brain injury or illness. The service can provide opinion regarding differential diagnoses, evaluation of pre and post surgical changes, treatment and management recommendations, rehabilitation strategies and behavioural intervention, family or carer counselling and education, a monitoring process of patient changes in functioning over time, and assessments for legal Guardianship and Administration Tribunal hearings.

In collaboration with the neurosurgical team, a Neurosurgery Support Group (NSG), comprising of voluntary ex-patients and carers, provides professional support to new patients to assist them in their recovery process.  The NSG can provide pre-surgery information, hospital visits pre or post surgery, public education leading to early diagnosis of neurosurgical conditions, financial support for and organisation of group meetings, fundraising for state-of-the art equipment for the care of neurosurgery patients, and promotion of awareness of neurosurgical care via the media, video distribution and talks to appropriate organisations.  The NSG can be contacted on Tel: 9076 3380 and Fax: 9076 6067.

Research Activities

• POLAR Study -The Prophylactic hypOthermia trial to Lessen trAumatic bRain injury

• Diagnostic and prognostic evaluation of diffusion tensor imaging and cognitive function after traumatic brain injury

• DECRA - A multi-centre randomised trial of early decompressive craniectomy in patients with severe traumatic brain injury.

• The correlation of clinical and radiographic findings with long term outcomes in road trauma patients with acute cervical discoligamentous injury.

• Establishment of a neurotrauma tissue/fluid bank within the National Neural Tissue Resource Centre (NNTRC).

• Identification of risk factors for the development of postoperative bleeding after cranial neurosurgery.

• Intentional forgetting in frontal lobe tumour patients.

• The determination of the expression of calcitonin receptor (CTR) and the characterization of CTR-positive cell types in human brain tumours.

• Cerebral Autoregulation Monitoring in Paediatric Traumatic Brain Injury.

• A study of the assessment and management of blunt cerebrovascular injury in patients presenting with trauma: A study of 90 patients treated between 2004 and 2006.

• Trauma reception and resuscitation - Time for a new approach.

• An investigation into the cognitive outcome of patients undergoing stereotactic radiotherapy for the treatment of arteriovenous malformations (AVMs).

• Review of spontaneous epidural abscess.

• Review of acute subdural haematoma in the elderly - outcome study.

• Melatonin in CSF and serum after severe traumatic brain injury.

• BIS monitoring after severe TBI - Correlation with episodes of intracranial hypertension.

• Bionic Eye project.

• Ndfip 1 Expression after experimental brain injury.

• Endogenous Neural Precursor Biology after Experimental Brain Injury.

• Modelling Traumatic Brain Injury (TBI) using Neuropsychological, Neurosurgical, Neurochemical and Neuroradiological measures of Brain Damage. Multi-centre Study.

• Quality of Life after Brain Injury (QOLIBRI).

• Review of anterior cranial fossa fractures

• Managing fatigue and sleep disturbance following traumatic brain injury

• Spinal injury database (2011)

Department Files

• Neurosurgery Hospital Referral & Management Guidelines (126.6 KB, PDF)
• Nuerosurgical Publications - Professor Jeffrey V Rosenfeld (340.1 KB, PDF)
• Neurosurgical Publications - Assoc Professor Peter Hwang (38.0 KB, PDF)
• Neurosurgical Publications - Mr Niki Maartens (802.0 KB, PDF)