Department of Surgery, CUHK
INTRANET EVENTS NEWS


INTRODUCTION

Neurosurgery is a discipline of medicine and that specialty of surgery which provides the operative and non-operative management (i.e. critical care, prevention, diagnosis, evaluation, treatment, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the nervous system, including the hypophysis; and the operation and non-operative treatment of pain. As such, Neurosurgery encompasses treatment of adult and pediatric patients with disorders of the nervous system: disorders of the brain, meninges, and the skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland, disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

SERVICES

Organisation of Neurosurgical Services:

The Neurosurgical services are provided by the Division of the Neurosurgery of the Department of Surgery of the Chinese University of Hong Kong (CUHK), the Prince of Wales Hospital (PWH) and the Northern District Hospital (NDH). The medical staffs consists of academic staff (employed by the CUHK) and the non-academic staff (employed by Hospital Authority of Hong Kong). The Division works as a single unit under the leadership of Professor in Neurosurgery of CUHK.

Currently, the academic staff included a professor and an assistant professor in Neurosurgery. There are a number of experienced neurosurgeons serves as adjunct associate professors for teaching of the undergraduate medical students and post-graduate neurosurgical trainees.

Our mission is to serve the public with high quality services, improves the neurosurgical development with research and to educate the medical student and surgical trainee on the specialty of neurosurgery.

The main activities are conducted in three hospitals and their outpatient clinics: the Prince of Wales Hospital (PWH), the Nothern District Hospital (NDH) and the Shatin Hospital (SH). The PWH is the teaching hospital of the CUHK. It serves as secondary for the East New Territory region that has a population of 1.2 million and tertiary referral center for patient from all regions of Hong Kong. The NDH is a major district hospital serving the North New Territory. NDH serves a population of 0.5 million. Both PWH and NDH have 24-hour CT scan services, emergency operation theatre for neurosurgical operation and on-site neurologist for consultation of neurological problems. In addition, the PWH also have neuronavigation facility, and radiosurgery facility. SH is our rehabilitation hospital. It has a comprehensive rehabilitation team (including physiotherapist, occupational therapist, speech therapist, and medical social workers etc.) and facility for both neurosurgical in-patient and a day hospital. SH also have infirmary beds and mid-way house to facilitate the return of patient back to the society. Our medical staff serves directly in the above hospitals to management the acute and rehabilitation care of the neurosurgical patients.

TRAINING  FACILITIES  &  FACULTIES

Inpatient facilities
There are 40-50 adult acute neurosurgical beds, 6 neurosurgical high dependence beds in addition to peadiatric neurosurgical beds and intensive care beds as required in PWH. The neurosurgical beds are concentrated and managed by a team of nurse trained in neurosurgical nursing. There are on average 60 neurosurgical patients in the SH. There is also neurosurgical beds in NDH for elective operations.

Outpatient facilities
There are 3 sessions in the neurosurgical outpatient clinic per week in the Li Ka Shing specialist clinic in the Prince of Wales Hospital.

Operative facilities
There are regular elective operation lists per week in PWH and NDH, and emergency operation facilities in PWH and NDH.

Endovascular neurosurgery facilities
There is weekly session of endovascular neurointervention under general anaesthesia and local anaethesia in PWH. The hospital is equipped with 2 biplanar and 2 monoplanar digital subtraction angiography (DSA) machines.

Radiosurgery facilities
PWH has one of the most sophisticated linear accelerated-based conformal radiosurgery facilities. The computer-controlled micro-multi-leaflet collimator (mMLC) provides high precision conformal radiation delivery. Radiosurgery is performed once or twice a week. The case selection, treatment planning and follow-up are conducted with collaboration between radiotherapist and neurosurgeons.

Functional neurosurgery / Neurology services
There are well established collaborations between neurology, neurosurgery, clinical psychology, neuradiology, and occupational therapy for the workup and perioperative management of epilepsy, Parkinson's Disease, dystonia, and other movement disorders.

Pain services
There is combine pain clinic conducted by the neurosurgeon and the anesthetist with special interest in pain management. After evaluation of the patient in the outpatient clinic, selected patients are admitted to the neurosurgical ward for intervention procedures.

Pituitary tumour services
There is a combine pituitary clinic conducted by the endocrinologist and neurosurgeon for perioperative evaluation of the endocrine function, preoperative workup, and postoperative follow up.

Neuro-otology
There is extensive collaboration between the Division of ENT and Neurosurgery in the assessment, work-up and operation for patient with acoustic neuroma. The division of ENT and the associated audiology services provides the screening of patients with hearing loss and assessment of patients with acoustic neuroma. When appropriate, excision of acoustic neuroma through the trans-labyrinthine approach is performed by both the ENT surgeon and the neurosurgeon. We had also pioneered in the providence of auditory brainstem implant in Asia.

Neuro-rehabilitation facilities
Neuro-rehabilitation facilities are available in the Shatin Hospital. There is a team of rehabilitation therapist in SH. Weekly rehabilitation conferences are conducted in SH with the active participation of our neurosurgical staffs.

RESEARCH  &  ACADEMIC  MEETINGS

The Division of Neurosurgery is active in researches in various areas of neurosurgery. The results were published in renowned international journals including Journal of Neurosurgery, Neurosurgery, and Stroke. Current research projects include clinical and translational studies in subarachnoid hemorrhage, stroke, stem cell treatment, brain tumours, and traumatic brain injuries.

There are regular academic meetings in the Division and the Department. Meetings include mortality and morbidity meetings, neuroradiology meetings, neuropathology meetings, neurooncology meetings, combine neurology-neurosurgery-neuroradiology meetings, research meetings, and grand rounds.

TRAINING

Training in Basic Surgical Skills:

The division of neurosurgery provides training of basic surgical skills for basic surgical trainees. The training is recognized by the College of Surgeons of Hong Kong and the Academy of Medicine of Hong Kong. Basic surgical trainees may attach to our Division for a period of 6 to 12 months. The trainees are provided with education on the basic management of neurosurgical patient, interpretation and understanding of basic neuro-imaging. The trainee should participate in at least 50 neurosurgical operations in a six-month period. During the training, it is expected that the trainee will be able to perform simple operations such as burrholes for ventricular drain insertion, muscle biopsy and tracheotomy.

Training in Neurosurgery:

The Division of neurosurgery is accredited by the College of Surgeons of Hong Kong and the Academy of Medicine of Hong Kong for training of higher surgical trainee specialized in neurosurgery.

All candidates must fulfill the following requirement in addition to the training in basic surgical skills required by the College of Surgeons of Hong Kong for accreditation of intermediate degree.

Each residence must complete a minimum of sixty (60) months of training in neurosurgical. A minimum of 6 months and a maximum of 12 months of the neurosurgical training should be before the passing of the entry examination for higher neurosurgical training (i.e. FRCS, AFRCS (Edinburgh) or equivalent degree). Hence, a minimum of 48 months of neurosurgical training is needed before qualifying for the exit examination leading to the accreditation of the degree of Fellowship of the Hong Kong Academy of Medicine (FHKAM).

The training is conducted in modular format and a general guideline on the progression of training over different years of training which includes (A) General neurosurgical management, (B) Operative neurosurgery, (C) Neuroradiology and Pathology, (D) Neuro-critical care and applied neurophysiology.

The modules includes (I) Adult neurosurgery, (II) Neuro-critical care and peadiatric neurosurgery, (III) general neurosurgery in a district hospital, (IV) overseas neurosurgical training.

PEOPLE
Academic Staff
Professor POON Wai Sang Emeritus Professor & Clinical Professional Consultant
Professor WONG Kwok Chu George Professor
Dr CHAN David Yuen Chung Assistant Professor
HA Staff
Dr CHAN Tat Ming Danny Consultant
Dr ZHU Xian Lun Consultant (Part-Time)
Dr MAK Wai Kit Consultant
Dr CHAN Kit Ying Emily Associate Consultant
Dr YEUNG Kam Tong Leo Associate Consultant
Dr LU Yeow Yuen Gabriel Service Resident
Dr ZHUANG Tin Fong Resident
Dr HE Zhexi Elvin Resident
Dr YUEN Pak To Ryan Resident
Dr SIU Chi Hin Ivan Resident
Dr CHAN Man Yu Resident
Dr LUI Cheuk Hang Hannaly Resident
Dr WAI Ka Kei Gabriel Resident
Dr LEE Yee Ting Andrea Resident

SELECTED PUBLICATIONS

  • Carlson AP, Hänggi D, Wong GK, Etminan N, Mayer SA, Aldrich F, Diringer MN, Schmutzhard E, Faleck HJ, Ng D, Saville BR, Bleck T, Grubb R Jr, Miller M, Suarez JI, Proskin HM, Macdonald RL; NEWTON Investigators.
    Single-Dose Intraventricular Nimodipine Microparticles Versus Oral Nimodipine for Aneurysmal Subarachnoid Hemorrhage.
    Stroke. 2020 Apr;51(4):1142-1149. doi: 10.1161/STROKEAHA.119.027396. Epub 2020 Mar 6. PMID: 32138631.
  • Zheng ZV, Lyu H, Lam SYE, Lam PK, Poon WS, Wong GKC*.
    The Dynamics of Microglial Polarization Reveal the Resident Neuroinflammatory Responses After Subarachnoid Hemorrhage.
    Transl Stroke Res. 2020 Jun;11(3):433-449. doi: 10.1007/s12975-019-00728-5. Epub 2019 Oct 18. PMID: 31628642.
  • Lam PK, Wang KKW, Chin DWC, Tong CSW, Wang Y, Lo KKY, Lai PBS, Ma H, Zheng VZY, Poon WS, Wong GKC*.
    Topically applied adipose-derived mesenchymal stem cell treatment in experimental focal cerebral ischemia.
    J Clin Neurosci. 2020 Jan;71:226-233. doi: 10.1016/j.jocn.2019.08.051. Epub 2019 Aug 17. PMID: 31431402.
  • Loong HH, Wong AM, Chan DT, Cheung MS, Chow C, Ding X, Chan AK, Johnston PA, Lau JY, Poon WS*, Wong N*.
    Patient-derived tumor organoid predicts drugs response in glioblastoma: A step forward in personalized cancer therapy?
    J Clin Neurosci. 2020 Apr 24:S0967-5868(20)30604-4.
  • Chan MTH, Wong JYY, Leung AKT, Lu G, Poon WS, Lau AY, Chan WY, Wong GK*.
    Plasma and CSF miRNA dysregulations in subarachnoid hemorrhage reveal clinical courses and underlying pathways.
    J Clin Neurosci. 2019 Apr;62:155-161.
  • Suarez JI, Sheikh MK, Macdonald RL, Amin-Hanjani S, Brown RD Jr, de Oliveira Manoel AL, Derdeyn CP, Etminan N, Keller E, Leroux PD, Mayer SA, Morita A, Rinkel G, Rufennacht D, Stienen MN, Torner J, Vergouwen MDI, Wong GKC; Unruptured Intracranial Aneurysms and SAH CDE Project Investigators.
    Common Data Elements for Unruptured Intracranial Aneurysms and Subarachnoid Hemorrhage Clinical Research: A National Institute for Neurological Disorders and Stroke and National Library of Medicine Project.
    Neurocrit Care. 2019 Jun;30(Suppl 1):4-19. doi: 10.1007/s12028-019-00723-6. PMID: 31087257.
  • Wong GKC*, Daly JJ, Rhoney DH, Broderick J, Ogilvy C, Roos YB, Siddiqui A, Torner J; Unruptured Intracranial Aneurysm and SAH CDE Project Investigators.
    Common Data Elements for Unruptured Intracranial Aneurysm and Subarachnoid Hemorrhage Clinical Research: Recommendations from the Working Group on Long-Term Therapies.
    Neurocrit Care. 2019 Jun;30(Suppl 1):79-86. doi: 10.1007/s12028-019-00727-2. PMID: 31077078.
  • So HY, Chen PP, Wong GKC, Chan TTN.
    Simulation in medical education.
    J R Coll Physicians Edinb. 2019 Mar;49(1):52-57. doi: 10.4997/JRCPE.2019.112. PMID: 30838994.
  • Lee C, Wong GKC*.
    Virtual reality and augmented reality in the management of intracranial tumors: A review.
    J Clin Neurosci. 2019 Apr;62:14-20. doi: 10.1016/j.jocn.2018.12.036. Epub 2019 Jan 11. PMID: 30642663.
  • Zheng ZV, Cheung CY, Lyu H, Chan HY, Li Y, Bian ZX, Wang KKW, Poon WS*.
    Baicalein enhances the effect of low dose Levodopa on the gait deficits and protects dopaminergic neurons in experimental Parkinsonism.
    J Clin Neurosci. 2019; 64:242-251.
  • Jiang R, Zhao S, Wang R, Feng H, Zhang J, Li X, Mao Y, Yuan X, Fei Z, Zhao Y, Yu X, Poon WS, Zhu X, Liu N, Kang D, Sun T, Jiao B, Liu X, Yu R, Zhang J, Gao G, Hao J, Su N, Yin G, Zhu X, Lu Y, Wei J, Hu J, Hu R, Li J, Wang D, Wei H, Tian Y, Lei P, Dong JF, Zhang J*.
    Safety and Efficacy of Atorvastatin for Chronic Subdural Hematoma in Chinese Patients: A Randomized Clinical Trial.
    JAMA Neurol. 2018 July 30;75(11):1338-1346.
  • Hu T, Kumar Y, Shazia I, Duan SJ, Li Y, Chen L, Chen JF, Yin R, Kwong A, Leung GK, Mat WK, Wu Z, Long X, Chan CH, Chen S, Lee P, Ng SK, Ho TYC, Yang J, Ding X, Tsang SY, Zhou X, Zhang DH; International Cancer Genome Consortium, Zhou EX, Xu L, Poon WS, Wang HY, Xue H*.
    Forward and reverse mutations in stages of cancer development.
    Hum Genomics. 2018 Aug 22;12(1):40.
  • Jaja BNR, Saposnik G, Lingsma HF, Macdonald E, Thorpe KE, Mamdani M, Steyerberg EW, Molyneux A, Manoel ALO, Schatlo B, Hanggi D, Hasan D, Wong GKC, Etminan N, Fukuda H, Torner J, Schaller KL, Suarez JI, Stienen MN, Vergouwen MDI, Rinkel GJE, Spears J, Cusimano MD, Todd M, Le Roux P, Kirkpatrick P, Pickard J, van den Bergh WM, Murray G, Johnston SC, Yamagata S, Mayer S, Schweizer TA, Macdonald RL; SAHIT collaboration.
    Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study.
    BMJ. 2018 Jan 18;360:j5745. doi: 10.1136/bmj.j5745. Erratum in: BMJ. 2018 Sep 26;362:k4079. PMID: 29348138.
  • Backes D, Rinkel GJE, Greving JP, Velthuis BK, Murayama Y, Takao H, Ishibashi T, Igase M, terBrugge KG, Agid R, Jääskeläinen JE, Lindgren AE, Koivisto T, von Und Zu Fraunberg M, Matsubara S, Moroi J, Wong GKC, Abrigo JM, Igase K, Matsumoto K, Wermer MJH, van Walderveen MAA, Algra A, Vergouwen MDI.
    ELAPSS score for prediction of risk of growth of unruptured intracranial aneurysms.
    Neurology. 2017 Apr 25;88(17):1600-1606. doi: 10.1212/WNL.0000000000003865. Epub 2017 Mar 31. PMID: 28363976.
  • Zheng VZ, Wong GKC*.
    Neuroinflammation responses after subarachnoid hemorrhage: A review.
    J Clin Neurosci. 2017 Aug;42:7-11. doi: 10.1016/j.jocn.2017.02.001. Epub 2017 Mar 13. PMID: 28302352.
  • Lu G, Wong MS, Xiong MZQ, Leung CK, Su XW, Zhou JY, Poon WS, Zheng VZY, Chan WY, Wong GK*.
    Circulating MicroRNAs in Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.
    J Am Heart Assoc. 2017 Apr 25; 6(4). pii: e005363. doi: 10.1161/JAHA.116.005363.
  • Tsang KS, Ng CPS, Zhu XL, Wong GKC, Lu G, Ahuja AT, Wong KSL, Ng HK, Poon WS*.
    Phase I/II randomized controlled trial of autologous bone marrow-derived mesenchymal stem cell therapy for chronic stroke.
    World J Stem Cells 2017 Aug 26;9(8):133-143.
  • Lam PK, Wang KKW, Lo AWI, Tong CSW, Ching DWC, Wong K, Yang Z, Kong T, Lo KKY, Choy RKW, Lai PBS, Wong GKC, Poon WS*.
    Interactome and reciprocal activation of pathways in topical mesenchymal stem cells and the recipient cerebral cortex following traumatic brain injury.
    Sci Rep. 2017 Jul 10;7(1):5017.
  • Li Y, Li J, Woo YM, Shen Z, Yao H, Cai Y, Lin MC, Poon WS*.
    Enhanced expression of Vastatin inhibits angiogenesis and prolongs survival in murine orthotopic glioblastoma model.
    BMC Cancer. 2017 Feb 13;17(1):126.
  • Zhu H, Poon W, Liu Y, Leung GK, Wong Y, Feng Y, Ng SC, Tsang KS, Sun DT, Yeung DK, Shen C, Niu F, Xu Z, Tan P, Tang S, Gao H, Cha Y, So KF, Fleischaker R, Sun D, Chen J, Lai J, Cheng W, Young W*.
    Phase III Clinical Trial Assessing Safety and Efficacy of Umbilical Cord Blood Mononuclear Cell Transplant Therapy of Chronic Complete Spinal Cord Injury.
    Cell Transplant. 2016 Nov;25(11):1925-1943.
  • Mak CH, Ho JW, Chan KY, Poon WS, Wong GK*.
    Intra-arterial revascularization therapy for basilar artery occlusion-a systematic review and analysis.
    Neurosurg Rev. 2016 Oct;39(4):575-80. doi: 10.1007/s10143-015-0693-4. Epub 2016 Jan 25. PMID: 26810313.
  • Yu SC, Lee KT, Lau TW, Wong GK, Pang VK, Chan KY.
    Intravenous C-Arm Conebeam CT Angiography following Long-Term Flow-Diverter Implantation: Technologic Evaluation and Preliminary Results.
    AJNR Am J Neuroradiol. 2016 Mar;37(3):481-6. doi: 10.3174/ajnr.A4558. Epub 2015 Nov 19. PMID: 26585252.
  • Chan DY, Abrigo JM, Cheung TC, Siu DY, Poon WS, Ahuja AT, Wong GK*.
    Screening for intracranial aneurysms? Prevalence of unruptured intracranial aneurysms in Hong Kong Chinese.
    J Neurosurg. 2016 May;124(5):1245-9. doi: 10.3171/2015.4.JNS142938. Epub 2015 Oct 16. PMID: 26473778.
  • Dorhout Mees SM, Algra A, Wong GK, Poon WS, Bradford CM, Saver JL, Starkman S, Rinkel GJ, van den Bergh WM; writing groups of MASH-I, IMASH, MASH-II, MASH and FAST-MAG, van Kooten F, Dirven CM, van Gijn J, Vermeulen M, Rinkel GJ, Boet R, Chan MT, Gin T, Ng SC, Zee BC, Al-Shahi Salman R, Boiten J, Kuijsten H, Lavados PM, van Oostenbrugge RJ, Vandertop WP, Finfer S, O'Connor A, Yarad E, Firth R, McCallister R, Harrington T, Steinfort B, Faulder K, Assaad N, Morgan M, Starkman S, Eckstein M, Stratton SJ, Pratt FD, Hamilton S, Conwit R, Liebeskind DS, Sung G, Kramer I, Moreau G, Goldweber R, Sanossian N.
    Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis.
    Stroke. 2015 Nov;46(11):3190-3. doi: 10.1161/STROKEAHA.115.010575. Epub 2015 Oct 13. PMID: 26463689.
  • Etminan N, Brown RD Jr, Beseoglu K, Juvela S, Raymond J, Morita A, Torner JC, Derdeyn CP, Raabe A, Mocco J, Korja M, Abdulazim A, Amin-Hanjani S, Al-Shahi Salman R, Barrow DL, Bederson J, Bonafe A, Dumont AS, Fiorella DJ, Gruber A, Hankey GJ, Hasan DM, Hoh BL, Jabbour P, Kasuya H, Kelly ME, Kirkpatrick PJ, Knuckey N, Koivisto T, Krings T, Lawton MT, Marotta TR, Mayer SA, Mee E, Pereira VM, Molyneux A, Morgan MK, Mori K, Murayama Y, Nagahiro S, Nakayama N, Niemelä M, Ogilvy CS, Pierot L, Rabinstein AA, Roos YB, Rinne J, Rosenwasser RH, Ronkainen A, Schaller K, Seifert V, Solomon RA, Spears J, Steiger HJ, Vergouwen MD, Wanke I, Wermer MJ, Wong GK, Wong JH, Zipfel GJ, Connolly ES Jr, Steinmetz H, Lanzino G, Pasqualin A, Rüfenacht D, Vajkoczy P, McDougall C, Hänggi D, LeRoux P, Rinkel GJ, Macdonald RL.
    The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus.
    Neurology. 2015 Sep 8;85(10):881-9. doi: 10.1212/WNL.0000000000001891. Epub 2015 Aug 14. PMID: 26276380; PMCID: PMC4560059.



Copyright © 2020. All Rights Reserved. Department of Surgery, The Chinese University of Hong KongCUHK

C O N T A C T   U S

Hong Kong Minor Head Injury Study
(CT Rule for Decision Making)

21/10/2020

Please select all the options:

Patient's Age > 60   Yes No
Glasgow Come Score (GCS) 15 14 13
Danagerous Mechanism   Yes No
Presence of Loss of Consciousness   Yes No
Amnesia of the Injury   Yes No
Vomiting   Yes No
Signs of Basal Skull Fracture   Yes No
Closed Skull Fracutre   Yes No