Dr Pang Ka Hung, Peter 彭家雄醫生 MBBS(HK)  FCSHK  FRCS (Edin)  FHKAM (Surgery) Specialist In Neurosurgery  Brain and Spine Neurosurgery  Subspecialised in skull base, neuro-vascular and spine  High dependency unit critical care  Licensed to operate DSA (Digital Subtraction Angiogram) machine for Endovascular therapy Languages Spoken: English, Cantonese

Disease Spectrum, Medical Procedures and Operations:

Brain:

Stroke: 
Prevention Stroke Risks Screening and Assessment 

Medical Risks: Chronic headache, Obesity, Hypercholesterolemia, DM, HT, Family History, Renal disease, Blood disease, Atrial Fibrillation, Drug related (e.g. Warfarin), Soft drug related. Surgical Risks: Heart disease (valvular disease, mural thrombus in AF), Carotid / Vertebral artery stenosis, intracranial arterial stenosis, cerebral aneurysm, Arterio-venous malformation AVM, Arterio-venous Fistula AVF, cavernous haemangioma).

Prophylactic Treatment (Interventional Therapeutic Neuroradiology = Endovascular therapy) 
Conventional Carotid endarterectomy for carotid artery stenosis 
Endovascular Therapy for Wall Stent over carotid / vertebral artery stenosis 
Endovascular Pipeline stent +/- coiling for unruptured Cerebral Aneurysm 
Endovascular Wingspan Stent +/- Balloon Angioplasty for intracranial arterial stenosis 
Endovascular coiling /Onyx Glue Therapy or Microsurgery for cerebral Arterio-venous malformation AVM/ Dural arterio-venous fistula AVF. 
Endovascular coiling for Carotico-Cavernous Fistula CCF presented with protruded red eye 
Microsurgery for clipping unruptured cerebral aneurysm (those not suitable for endovascular therapy)

Acute Ischaemic Stroke Care: Tele-expert opinion, 2nd Medical Opinion in fast- track care Including Inter-hospitals Medical Escort 
Golden 3 hours: Intravenous iv. rTPA thrombolysis for brain re-vascularisation to minimise neurological deficit and mortality. 
Golden 8 hours: Mechanical Thrombolysis +/- (Intra-Arterial) I.A rTPA (Endovascular Therapy) for brain re- vascularisation to minimise neurological deficit and mortality. 
Golden 8 hours Emergency EC-IC Arterial bypass surgery for brain re-vascularisation in to minimise neurological deficit and mortality. 
Decompressive craniotomy and duroplasty for infarct brain swelling.

Acute Haemorrhagic Stroke: Tele-expert opinion, 2nd Medical Opinion in fast-track care Including Inter-hospitals Medical Escort 
Emergency external ventricular drain (intracranial pressure monitoring) for hydrocephalus or intraventricular haemorrhage 
Emergency Craniotomy for blood clot evacuation Decompressive craniotomy and duroplasty for brain swelling 
Subarachnoid Hemorrhage due to ruptured cerebral aneurysm:

Microsurgery for clipping of aneurysm
Endovascular Therapy for coiling or stenting embolisation of aneurysm 
Haemorrhagic stroke due to vascular dissection: Endovascular Therapy for coiling or stenting of the vascular dissection 
Emergency Endovascular Therapy for Carotid blow out in NPC patients

Brain / Skull Bone tumour: Supratentorial, infratentorial and Skull Base tumour (Primary: meningioma / glioma, secondary or metastatic brain tumour) 

Minimally Invasive Navigational Microsurgery for tumour Excision 
Minimally Invasive Endoscopic Excision of Ventricular tumour 
Minimally Invasive Transphenoid Surgery for Pituitary tumour 
Minimally Invasive Supra-Orbital Eyebrow Approach for Anterior Skull Base tumour or Aneurysm 
Function Preserving Glioma Surgery 
Facial nerve preserving Acoustic Neuroma Surgery 
Intra-orbital tumour Surgery

Functional Neurosurgery 
Microvascular decompression for Trigeminal Neuralgia 
Microvascular decompression for Hemi-facial Spasm 
Chronic Headache, Migraine and other Neuropathic Pain Treatment 
Medical and Surgical Treatment for Epilepsy

Others Head / Brain: Trauma (Brain injury, Subdural Haematoma), Infection, congenital abnormality, degeneration (VP Shunt for Normal pressure Hydrocephalus, Subdural Effusion,etc) 
Radiosurgery: X-knife for brain tumour and Arterio-venous malformation AVM. 
Neuro-endoscopy for 3rd ventriculostomy in obstructive hydrocephalus, tumour excision and vascular microsurgery.

Spine: 
Degenerative disease: 
Conventional Open Procedures: 

Anterior Cervical Discectomy and Fusion 
Cervical Artificial Disc Replacement 
Cervical Laminoplasty 
Cervical Foraminotomy 
Thoracotomy and Anterior Apinal Fusion 
Lumbar Laminectomy, Foraminotomy and instrumented Fusion 
Anterior Lumbar Spinal Fusion 
Tarlov Cysts Surgery

Minimally Invasive Spine Surgery:

Endoscopic Spine Surgery 
Microdiscectomy 
Microscopic Posterior Decompression 
Minimally Invasive Spinal Fusion Surgery

Non-Operative Spine Treatments:

Facet Joint Injections 
Transforaminal Epidural Injections 
Selective Nerve Root Blocks 
Medial Branch Block 
SI Joint Injection

Spine tumour: 
Intradural spinal tumour: Neurilemmoa/ Schwannoma, meningioma. Hemi-laminectomy for microsurgery excision under intra-operative neural monitoring

Congenital Anomaly of Spine 
Spinal Bifida Repairing 
Tethering Cord Syndrome Release 
Chiari Malformation Decompression 
Spinal Syringomyelia Decompression

Vascular Anomaly of spine: 
Spinal Arterial Venous Fistula/ Malformation: Microsurgical excision or Endovascular Therapy

Cerebral Palsy 
Selective Dorsal Root rhizotomy for gait Improvement

Spine Infection 
Spine Trauma

Investigations: 
X-Ray Spine 
CT Scan Of Spine 
Bone Scan 
Standing/Weight Bearing MRI Spine 
Dynamic MRI Spine Discogram 
Diagnostic Nerve Blocks

Rehabilitation: 
Multi-Disciplinary Team Approach for Brain and spine Rehabilitation +/- Acupuncture

Other Services:

Medico-Legal Expert Assessment 
Labour Injury Expert Assessment

Perspective of brain systems

Most people interested in understanding brain disorders, but read or heard much of the information nor is getting the right knowledge to be reported, even many incomprehensible content. Moreover, medical advances, new facts were clarified.  Brain is a very complex organ, still has many mysteries unsolved, for understanding brain diseases, to obtain the correct knowledge, we will be starting from the known brain systems.

Generally we find in the central nervous system can be divided into two parts: brain and spinal cord, which includes the brain, the brain stem and the cerebellum, while the latter includes 8 cervical, 12 thoracic, 5 lumbar spinal cord of spinal cord spinal cord and 5 sacral spinal cord.   Relative to the central nervous system of the peripheral nervous system, including the 12 pairs of cranial nerves, and 30 pairs of spinal nerves, as well as the two most of the sympathetic and parasympathetic autonomic nervous system.

Divided into left and right hemispheres of the brain, brain hemispheres, the central part of the basal ganglia.   Appearances hemispheres can be divided into several lobes, the front portion, about where the forehead known as frontal, is the top part of the parietal lobe, sleeping on a pillow where the occipital lobe, beneath the frontal lobe and parietal lobe is the temporal lobe, General commonly known as the location of the temple is located.

Lower end of cerebral hemispheres connected to the brain stem, brain stem control swallowing, breathing and heartbeats and other life-sustaining functions can be subdivided into the midbrain, Pons and medulla oblongata in three parts. Brain leaders handed out 12 pairs of cranial nerves cranial nerve nuclei of the message.  Therefore, the medical uses of "brain stem death" as a standard to one people lost their lives.

The cerebellum is located in the posterior Fossa brain, the cerebellum in sensory perception, coordination and motor control plays an important role in it.   Are connected by pathways, such as the sub thalamic nucleus and cortex of cerebellum, which dominate the coordinating role. Spinal cord extends from the brain stem and spine protection.

Vertebrae in the neck and lower back extensions, in the peripheral nerves of the spine white matter tracts, including sensory and motor neurons used to conduct sensory messages and motor commands.

Neurosurgeon Hong Kong

Who are we?

We are a medical group consists of experience registered nurses of neurosurgery training and experience neurosurgeons who subspecialized in skull base, spine and neurovascular surgery. 

For decades, we have been treating stroke patients and patients with other brain and spine problems in both public sector and private sector in Hong Kong. 

We also provide 24 hours emergency medical advice, assistance and treatments. 

Apart from taking care local patients in Hong Kong, we also serve patients in Macau, Mainland China and other countries by providing emergency medical services, including Distant Tele-medicine Advice, international medical rescue and evacuation, arranging medical air-transfer or ground-transfer,  medical escort, etc.