“融合外科医学与医疗技术，提升脑部肿瘤手术治疗的安全性，帮助患者重新回归正常生活。”
脑部肿瘤的治疗方案分为两类
对于无需手术的脑肿瘤患者，可通过临床症状观察和磁共振成像（MRI）进行随访监测治疗。
需要接受手术或放疗的患者群体。
诊疗辅助技术
1. 三维高清手术显微镜
三维高清手术显微镜是脑部肿瘤显微外科手术的核心技术设备。借助这款设备可开展 3D 放大下的手术操作，其最高放大倍率可达 39 倍，能为外科医生提供超清晰的术中视野；所呈现的三维影像具备宽度、长度与深度的立体维度，可助力医生精准处理毗邻微小血管、神经的重要区域脑部肿瘤，同时能有效降低手术对周边重要微小脏器组织的损伤率。
2. 神经内镜手术系统
这款内镜的使用方式，与胆囊或疝气手术中所用内镜的操作方式相近，成像为高清的二维画面。在部分脑部肿瘤的手术治疗中，例如垂体瘤，可将该神经内镜经鼻腔置入，以此实现肿瘤的微创切除，无需在皮肤表面做切口、也无需开颅，既降低了脑组织的损伤风险，也让颅底区域的脑部肿瘤手术安全性大幅提升。
3. 超声吸引肿瘤切除系统（CUSA）
该器械在脑部肿瘤手术中发挥着至关重要的作用，其通过发射高频超声波击碎肿瘤细胞，使其分解为微小碎片，再经由微型吸引装置将肿瘤组织吸出。这一方式大幅提升了肿瘤切除的安全性，同时能有效减轻脑组织及周边脏器的损伤。
4. 显微外科手术器械
由于绝大多数脑部肿瘤手术都需要借助显微镜来获得清晰的放大视野，因此手术器械也必须做到极致微型化，从而实现毫米级的手术操作精度。
5. 神经导航仪
该导航设备可帮助医生精准掌握脑部肿瘤的位置，以及手术区域内重要脏器的分布情况，大幅提升手术的精准度，降低因手术定位偏差导致并发症的风险。
6. 磁共振成像（MRI）专用特殊技术，如弥散张量成像纤维束追踪技术（DTI fiber tracking）
磁共振成像（MRI）专用特殊技术可清晰呈现颅内重要神经纤维束与肿瘤的相对位置。部分脑部肿瘤会浸润神经纤维束，若贸然切除与神经纤维束粘连的肿瘤组织，极易导致患者出现术后功能障碍。因此，该技术能辅助医生制定最优手术方案，在最大程度切除肿瘤的同时保留脑部正常功能，降低术后功能障碍的发生风险。此外，磁共振波谱成像（MRI SPECTROSCOPY）技术可有效鉴别可疑病灶的性质，区分肿瘤与其他病变（如感染、放疗后改变），为制定精准的治疗方案提供可靠依据。
7. 术中神经功能监测设备（Intra operative Monitoring）
术中神经功能监测设备可在患者全麻或清醒状态下的手术过程中，对神经系统的功能状态进行实时监测。该设备运用神经生理学技术，捕捉神经系统的电生理反应信号，助力医生在手术中精准评估神经系统的功能状况，降低手术操作对神经系统造成损伤的风险。目前，这项技术已成为脑部肿瘤手术中一项重要的临床标准技术。
医生建议
肿瘤切除术后，所有病例均需进行病理学检查，以确定肿瘤类型，并进一步分析蛋白质品种即使在显微镜下形态相同、但蛋白质表达存在差异的肿瘤亚型，从而帮助医生更准确地评估疾病的预后情况้和辅助治疗。此外，在明确肿瘤类型后，某些类型的肿瘤可能还需要在术后接受放射治疗或化学药物治疗，以实现对脑肿瘤的完整、彻底治疗。
Pituitary Tumor Patient
After about 3-4 days of headaches
"I saw a doctor who thought it was early-stage migraines. They gave me medication and an injection, but it didn't help. The doctor then requested a scan, and the results showed nothing. The next day, I couldn't eat or do anything, so my husband rushed me back to the hospital."
"The doctor re-examined the CT scan and immediately saw something, so I was admitted. The doctor informed me late that night that it might be a tumor, specifically on my pituitary gland. I asked about treatment, and the doctor said the easiest way was endoscopic surgery to avoid opening the brain. Once removed, that was it. I'm living a normal life now. I used to get sick easily, but I haven't been sick since the surgery."
Pituitary Tumor Patient
"I was exercising as usual, then after a while, I started staggering and feeling like the room was spinning."
I didn't think much of it for a day or two. Then, when I slept, I had the same spinning sensation, like someone with an inner ear imbalance. I couldn't open my eyes; everything just spun.
So I called 1669 and asked to go to Ramkhamhaeng Hospital, thinking it best to get admitted and thoroughly checked. I saw Dr. Puripun, who checked my eye and ear nerves. An MRI finally revealed a tumor. The doctor advised urgent surgery, so I decided to proceed immediately.
Talking with the doctor, I wasn't worried about the surgery's outcome, whether I'd live or die; I was indifferent, just ready to fight. I wanted to get better, so I decided on the surgery. Now, I'm completely normal; I can walk and move around typically. Overall, I've improved.
Pituitary Tumor Patient
Ms. Wannarat, the daughter, shares her story:
"Initially, my mother complained of eye pain and vision loss. We thought it was just age-related poor eyesight. After two or three months, her symptoms worsened, so we decided to take her to an eye doctor first."
The eye doctor conducted a thorough examination and ultimately concluded that her eyes were fine, suspecting a tumor pressing on the optic nerve. The doctor immediately sent her for an MRI with contrast. The results confirmed it was a pituitary tumor.
The doctor recommended seeing Dr. Nophasin. Luckily, Dr. Nophasin was on duty that day. He explained everything, assuring us it wasn't dangerous and that it would be endoscopic surgery through the nasal cavity, with Dr. Puripun creating the access.
After the surgery, the doctors invited us to the ICU to check on my mother. We were amazed; it was hard to believe she had just undergone brain surgery because she was fully aware of everything. Many thanks to Dr. Nophasin and Dr. Puripun.
Pituitary Tumor Patient
Over 7-8 months, I started experiencing nasal congestion, sneezing, and a runny nose, initially thinking it was allergies.
It began with congestion in one nostril, then both, until I couldn't breathe through my nose at all. A mass then became visible in my nose, forcing me to breathe through my mouth constantly. Despite ongoing treatment, my condition worsened. One day, I had a severe nosebleed from my right nostril (since the left was blocked) that also flowed down my throat all day without stopping.
I went to a provincial hospital where I had social security coverage. The doctor examined me and referred me to a hospital in Bangkok to biopsy the nasal mass. The results showed it was cancer that had spread to my brain, making surgery impossible there. I was then transferred to Ramkhamhaeng Hospital, as they had the necessary medical team and equipment. The doctor told me my tumor was very large and would require a long surgery. I was scared.
I was afraid to sleep, fearing I wouldn't be able to breathe. I even asked a nurse to hold my hand and stay until I fell asleep before leaving.
"My right eye was blurry, I couldn't see well, and I had a sharp, throbbing pain that radiated to my right temple, sometimes making tears stream down my face."
Ms. Kunlapat, daughter of Mr. Wang Techo, shared her mother's story:
"My mother was already taking medication for blood pressure, but about 1-2 weeks before the surgery, she developed severe headaches. The pain was so intense she couldn't sleep. Her children realized they couldn't ignore it, so they took her to a hospital where an MRI revealed a tumor. We searched online for a reputable hospital for brain tumor treatment and found Ramkhamhaeng Hospital. We chose to go there and met Dr. Naphason Thakekindej. After another MRI scan, the doctor confirmed a 2.5 cm tumor behind her right eye, in the space between the brain, which was operable. My mother was apprehensive, fearing she wouldn't recover, essentially afraid of dying. The doctor reassured her, stating he had handled more challenging cases and to not worry. My mother recovered at Ramkhamhaeng Hospital for a week. After a follow-up MRI scan, the doctor reviewed the results and told us to return in two years. We were very impressed with the doctor; he even called us at midnight after the surgery to let us know she was safe and the surgery was successful. He knew we were worried, especially since my mother was afraid she wouldn't wake up, which made us, her children, worried too. Brain surgery is inherently frightening for everyone. But the doctor told us not to worry, and we definitely made the right choice in finding Dr. Naphason. Additionally, we've been taking my mother to Dr. Panadda for her diabetes, blood pressure, and enlarged heart, who manages all her conditions. We bring her for check-ups every 2-3 months."
Former Brain Tumor Patient
"I had no headaches, but displayed severe depression-like symptoms; I preferred to be alone, only slept, and neglected my appearance."
Starting around September 2019, I would just sleep, refusing to speak or interact with anyone, and stopped teaching. I also experienced dizziness and neglected work. My mother suggested I get checked at Ramkhamhaeng Hospital. We called to consult with a nurse, describing symptoms that, from our research, resembled depression. We brought him to a psychiatrist, even though he had no headaches. For about a month, starting in December, he came weekly but didn't improve. He started losing bladder and bowel control, suggesting a brain issue, as the brain controls everything. So, that day, he had to undergo an MRI, waiting four hours to ensure he was ready. The doctor informed us it was extensive, with tumors all around.
The doctor told us to prepare for a 10-hour surgery. We agreed, and the surgery began. Afterward, he was disoriented and agitated, trying to pull at his stitches and tubes, so we had to constantly monitor him. Gradually, he improved, recognizing people and remembering everything. Each time he saw the doctor, they would check his brain function by having him do simple math. He continued to improve, able to recall and do calculations. The doctor explained that after the surgery, the brain tissue where the tumor was removed needed time to recover from the compression it had endured.
Former Brain Tumor Patient
"After 4 hours of surgery, I woke up completely normal, a stark difference from before."
My mother's behavior had drastically changed: she slept all day, responded slowly to questions, couldn't think clearly, and forgot her birth year and date. She would just lie in bed, refusing food and baths. I grew very concerned and took her to the hospital.
During her appointment, the doctor asked about her symptoms and then ordered an MRI with contrast. The results showed a brain tumor. She had to be admitted that day and undergo surgery the next because her brain was severely swollen.
Four hours after the surgery, she regained consciousness. Her children gathered around her bed, asking if she remembered them. They were worried she wouldn't recognize anyone or anything. But she remembered everyone and everything, communicating clearly and fluently. We were all overjoyed, crying tears of happiness that she was back to her old self.
โรคเนื้องอกในสมอง กับการใช้ Fiber tractography
Pituitary Tumor Patient
After about 3-4 days of headaches
"I saw a doctor who thought it was early-stage migraines. They gave me medication and an injection, but it didn't help. The doctor then requested a scan, and the results showed nothing. The next day, I couldn't eat or do anything, so my husband rushed me back to the hospital."
"The doctor re-examined the CT scan and immediately saw something, so I was admitted. The doctor informed me late that night that it might be a tumor, specifically on my pituitary gland. I asked about treatment, and the doctor said the easiest way was endoscopic surgery to avoid opening the brain. Once removed, that was it. I'm living a normal life now. I used to get sick easily, but I haven't been sick since the surgery."
Pituitary Tumor Patient
"I was exercising as usual, then after a while, I started staggering and feeling like the room was spinning."
I didn't think much of it for a day or two. Then, when I slept, I had the same spinning sensation, like someone with an inner ear imbalance. I couldn't open my eyes; everything just spun.
So I called 1669 and asked to go to Ramkhamhaeng Hospital, thinking it best to get admitted and thoroughly checked. I saw Dr. Puripun, who checked my eye and ear nerves. An MRI finally revealed a tumor. The doctor advised urgent surgery, so I decided to proceed immediately.
Talking with the doctor, I wasn't worried about the surgery's outcome, whether I'd live or die; I was indifferent, just ready to fight. I wanted to get better, so I decided on the surgery. Now, I'm completely normal; I can walk and move around typically. Overall, I've improved.
Pituitary Tumor Patient
Ms. Wannarat, the daughter, shares her story:
"Initially, my mother complained of eye pain and vision loss. We thought it was just age-related poor eyesight. After two or three months, her symptoms worsened, so we decided to take her to an eye doctor first."
The eye doctor conducted a thorough examination and ultimately concluded that her eyes were fine, suspecting a tumor pressing on the optic nerve. The doctor immediately sent her for an MRI with contrast. The results confirmed it was a pituitary tumor.
The doctor recommended seeing Dr. Nophasin. Luckily, Dr. Nophasin was on duty that day. He explained everything, assuring us it wasn't dangerous and that it would be endoscopic surgery through the nasal cavity, with Dr. Puripun creating the access.
After the surgery, the doctors invited us to the ICU to check on my mother. We were amazed; it was hard to believe she had just undergone brain surgery because she was fully aware of everything. Many thanks to Dr. Nophasin and Dr. Puripun.
Pituitary Tumor Patient
Over 7-8 months, I started experiencing nasal congestion, sneezing, and a runny nose, initially thinking it was allergies.
It began with congestion in one nostril, then both, until I couldn't breathe through my nose at all. A mass then became visible in my nose, forcing me to breathe through my mouth constantly. Despite ongoing treatment, my condition worsened. One day, I had a severe nosebleed from my right nostril (since the left was blocked) that also flowed down my throat all day without stopping.
I went to a provincial hospital where I had social security coverage. The doctor examined me and referred me to a hospital in Bangkok to biopsy the nasal mass. The results showed it was cancer that had spread to my brain, making surgery impossible there. I was then transferred to Ramkhamhaeng Hospital, as they had the necessary medical team and equipment. The doctor told me my tumor was very large and would require a long surgery. I was scared.
I was afraid to sleep, fearing I wouldn't be able to breathe. I even asked a nurse to hold my hand and stay until I fell asleep before leaving.
"My right eye was blurry, I couldn't see well, and I had a sharp, throbbing pain that radiated to my right temple, sometimes making tears stream down my face."
Ms. Kunlapat, daughter of Mr. Wang Techo, shared her mother's story:
"My mother was already taking medication for blood pressure, but about 1-2 weeks before the surgery, she developed severe headaches. The pain was so intense she couldn't sleep. Her children realized they couldn't ignore it, so they took her to a hospital where an MRI revealed a tumor. We searched online for a reputable hospital for brain tumor treatment and found Ramkhamhaeng Hospital. We chose to go there and met Dr. Naphason Thakekindej. After another MRI scan, the doctor confirmed a 2.5 cm tumor behind her right eye, in the space between the brain, which was operable. My mother was apprehensive, fearing she wouldn't recover, essentially afraid of dying. The doctor reassured her, stating he had handled more challenging cases and to not worry. My mother recovered at Ramkhamhaeng Hospital for a week. After a follow-up MRI scan, the doctor reviewed the results and told us to return in two years. We were very impressed with the doctor; he even called us at midnight after the surgery to let us know she was safe and the surgery was successful. He knew we were worried, especially since my mother was afraid she wouldn't wake up, which made us, her children, worried too. Brain surgery is inherently frightening for everyone. But the doctor told us not to worry, and we definitely made the right choice in finding Dr. Naphason. Additionally, we've been taking my mother to Dr. Panadda for her diabetes, blood pressure, and enlarged heart, who manages all her conditions. We bring her for check-ups every 2-3 months."
Former Brain Tumor Patient
"I had no headaches, but displayed severe depression-like symptoms; I preferred to be alone, only slept, and neglected my appearance."
Starting around September 2019, I would just sleep, refusing to speak or interact with anyone, and stopped teaching. I also experienced dizziness and neglected work. My mother suggested I get checked at Ramkhamhaeng Hospital. We called to consult with a nurse, describing symptoms that, from our research, resembled depression. We brought him to a psychiatrist, even though he had no headaches. For about a month, starting in December, he came weekly but didn't improve. He started losing bladder and bowel control, suggesting a brain issue, as the brain controls everything. So, that day, he had to undergo an MRI, waiting four hours to ensure he was ready. The doctor informed us it was extensive, with tumors all around.
The doctor told us to prepare for a 10-hour surgery. We agreed, and the surgery began. Afterward, he was disoriented and agitated, trying to pull at his stitches and tubes, so we had to constantly monitor him. Gradually, he improved, recognizing people and remembering everything. Each time he saw the doctor, they would check his brain function by having him do simple math. He continued to improve, able to recall and do calculations. The doctor explained that after the surgery, the brain tissue where the tumor was removed needed time to recover from the compression it had endured.
Former Brain Tumor Patient
"After 4 hours of surgery, I woke up completely normal, a stark difference from before."
My mother's behavior had drastically changed: she slept all day, responded slowly to questions, couldn't think clearly, and forgot her birth year and date. She would just lie in bed, refusing food and baths. I grew very concerned and took her to the hospital.
During her appointment, the doctor asked about her symptoms and then ordered an MRI with contrast. The results showed a brain tumor. She had to be admitted that day and undergo surgery the next because her brain was severely swollen.
Four hours after the surgery, she regained consciousness. Her children gathered around her bed, asking if she remembered them. They were worried she wouldn't recognize anyone or anything. But she remembered everyone and everything, communicating clearly and fluently. We were all overjoyed, crying tears of happiness that she was back to her old self.
