The Neurosurgery Center
Center Overview
Trigeminal Neuralgia
Rare Trigeminal Neuralgia Conditions
Hemifacial Spasm
Glossopharyngeal Neuralgia
Brain Tumor
Cerebral Aneurysm/Cerebral Arteriovenous Malformation
Endovascular Therapy
Gamma Knife Surgery
Spinal/Spinal Cord Disease
Parkinson’s Disease/Essential Tremor Surgery
International Patients
Inpatient Guide
Inpatient Guide



At our Center, we perform many types of surgery to treat brain tumors using various techniques ranging from keyhole surgery, which is a minimally invasive surgery that can keep damage of the brain to a minimum, to skull base approach techniques. When there is a higher risk in surgically removing the tumor, we combine with stereotactic radiosurgery to offer safer treatment strategy.

Acoustic Neuroma
If a tumor is small, it is possible to treat with only Gamma Knife surgery. If the tumor is medium size or larger, other surgery procedures may be preferred to prioritize for safety. In general, a 6-7cm incision is made behind the ear and a craniotomy is performed with approximately 500 yen coin sized hole to remove the tumor. The length of the surgery depends on the size of the tumor, but it generally requires approximately 3-5 hours. Additionally, if necessary, Gamma Knife surgery may be performed to treat any residual tumor.

At the time of Gamma Knife surgery 1 year post-surgery 3 year post-surgery
Preoperative Total removal with surgery
This tumor can appear at any location inside the skull. Depending on the tumor site, different treatment options are available. It is ideal to remove the whole tumor, but if we need to operate in a region where the risk of surgery is high, Gamma Knife surgery is also performed in combination. If the tumor is in the cranial base, a special approach may be necessary.

Preoperative Postoperative
Pituitary Adenoma/Craniopharyngioma
This tumor tends to grow near the optic nerve, often causing ocular manifestation (eye symptoms). If total removal is achieved, it can be completely cured. However, since the internal carotid artery, cavernous sinus, and cranial nerve run on both sides of the tumor, a thorough treatment plan and delicate procedure are necessary. At our Center, specialists in otorhinolaryngology and transnasal endoscopes create an approach from the nose to the cranial base, then neurosurgeons perform a small craniotomy with a hole about the size of a 1 yen coin to remove the tumor. The surgery takes appropriately three hours. Since the incision is made at the back of the nose, the surgical wound is not visible from the outside.

Prior to removal Total surgical removal from inside the nose
Pituitary Adenoma@Gamma Knife Treatment Plan
Epidermoid Cysts
This is a rare tumor, but it can cause trigeminal neuralgia, and removal is necessary if the tumor is of a certain size. We consider and determine a treatment option appropriate for each patient, ranging from keyhole surgery to special craniotomy.

Metastatic Brain Tumors
Malignant tumors (lung cancer, breast cancer, etc.) could metastasize in the brain. Gamma Knife surgery is extremely effective, but in cases of large tumors, surgical removal may be necessary.

Gamma Knife surgery preoperative 3 months postoperative
Physicians on staff
Hisao Hirai, M.D., Ph.D
PXXP Department of Neurosurgery, Shiga University of Medical Science
PXXQ Department of Neurosurgery, Nagahama Red Cross Hospital
PXXT Department of Neurosurgery, Rakusai Shimizu Hospital
PXXX Department of Neurosurgery, Hino Kinen Hospital
QOOP Department of Neurosurgery, Kotoh Kinen Hospital Kalorinska@University
QOOS Trained at Kalorinska University (Sweden)
Takuro Inoue, M.D., Ph.D.
PXXP Department of Neurosurgery, Shiga University of Medical Science
PXXQ Department of Neurosurgery, Osaka Prefecture Saiseikai Hospital
PXXS Department of Neurosurgery, Daini Okamoto General Hospital
PXXW Studied at University of British Columbia (Canada)
PXXX Department of Neurosurgery, Hino Kinen Hospital
QOOS Trained at Kalorinska University (Sweden)
QOOV Trained at Duke University (U.S.A.)
QOPP Department of Neurosurgery, Kotoh Kinen Hospital
QOPT Consultant, Department of Neurosurgery, Andalusia Hospital (Alexandria, Egypt)


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