Dr. Keith Goh Yu Ching
Dr Keith Goh presently is the Consultant Neurosurgeon and Director of International Neuro Associates, which provides Neurology & Neurosurgery Services at Mount Elizabeth Hospital (Orchard), and the other Parkway Hospitals in Singapore. He is also Honorary Associate Professor of Neurosurgery at the Prince of Wales Hospital of the Chinese University of Hong Kong.
Dr Goh earned his medical degree from the National University of Singapore in 1985 and subsequently underwent neurosurgical residency at the Chinese University of Hong Kong and advanced specialty training in paediatric neurosurgery at the Beth Israel Institute of Neurology & Neurosurgery in New York. His bibliography includes 40 original articles, 10 book chapters, and 104 abstracts and lectures on his various research interests, such as brain and spinal cord tumours, conjoined twins and congenital malformations in children.
Apart from general neurosurgery, he specializes in treatment of brain and spinal cord tumours, pediatric neurosurgery for children, and minimally invasive spine surgery. He is an active member of the International Society for Pediatric Neurosurgery and the World Federation of Neurosurgical Societies.
During his tenure in Singapore, he achieved international acclaim for leading surgical teams in rarely performed surgeries to separate 3 sets of conjoined twins from Nepal, Iran and Korea in 2001 and 2003. He was featured extensively on various local and international print and television media agencies including BBC, CNN, ITN and the Discovery Channel.
Dr Keith Goh's Neurosurgery services include:
1) Head Trauma
24-hour emergency service is available for the treatment of various adult and paediatric head injuries, including simple and compound fractures, concussions and its sequelae, severe injuries requiring craniotomy for haematoma evacuation, intracranial pressure (ICP) monitoring and neuro-intensive care.
Elective surgical treatment for reconstruction of skull defects (cranioplasty) using custom-made titanium mesh implants for adults and polymer-based implants for children.
24-hour emergency service for the treatment of acute ischaemic stroke (infarct) and haemorrhagic stroke (intracerebral haematoma and subarachnoid haemorrhage).
Elective stroke risk assessment, by evaluating the carotid arteries and intracranial vasculature, using CT and MR angiogram techniques.
3) Brain and Spinal Cord Tumours
Surgical management of all primary and secondary brain and spinal cord tumours in adults and children, including:
a) Meningiomas: convexity, parafalcine, olfactory groove, suprasellar, petroclival, foramen magnum, spinal cord
b) Gliomas: astrocytoma, grades 1- 4 (glioblastoma), oligodendroglioma, ependymoma
c) Skull base tumours: acoustic neuroma, chordoma, pituitary tumours, brainstem tumours
d) Spinal cord tumours: neurofibroma, intramedullary tumours
e) Metastatic tumours: secondary tumours from breast, lung, colon, etc
The operating theatres are fully-equipped with micro-neurosurgical equipment, intra-operative ultrasound guidance and nerve stimulation. Stereotactic equipment (frame and frameless) for biopsy and image-guided surgical resections are also available. Treatment using adjuvant radiotherapy and chemotherapy, as well as radiosurgery, is available, and will be recommended where appropriate. The latest immunotherapy treatment using antibodies against receptors on the brain tumour cells is also available.
4) Paediatric Conditions
Management of children with congenital and developmental conditions, including:
a) Hydrocephalus: congenital aqueduct stenosis, Dandy-walker malformation, arachnoid cyst, acquired hydrocephalus, complex shunt problems
b) Spinal cord malformations: spina bifida, tethered cord syndrome, spinal lipoma
c) Chiari malformation and syringomyelia
d) Craniosynostosis and related cranio-facial syndromes
e) Paediatric brain and spinal cord tumours: craniopharyngioma, optic nerve glioma, brainstem glioma, medulloblastoma, benign neuroectodermal tumours, neurofibroma
Together with in-house paediatricians, children with neurological conditions can be treated surgically with the latest micro-instruments and endoscopic equipment, in a minimally invasive manner.
5) Spine Conditions
Emergency treatment of spinal trauma, fractures and acute prolapsed intervertebral discs, including surgical decompression and internal fixation.
Elective treatment of degenerative spine conditions, such as cervical spondylosis, disc prolapse, neural foraminal stenosis and spondylolisthesis. Surgical management includes microdiscectomy, minimally invasive neural foraminotomy, artificial disc replacement, pedicle screws and various fusion techniques, and vertebroplasty.
6) Chronic Pain Management
The treatment team includes a certified pain specialist and anaesthetist who will evaluate the patient together with the neurosurgeon. Apart from tailoring medication to the patient's needs, the pain specialist is also able to administer injections, nerve blocks and acupuncture. In certain cases, such as cancer patients with widespread disease, spinal cord pumps can be placed to administer pain-relief drugs (morphine) intra-thecally. In addition, implantable nerve stimulators can also be placed in the spinal cord or the brain for intractable neuropathic pain.
Trigeminal neuralgia is one condition that is treated by gamma-knife radiosurgery, or sometimes microvascular decompression. 80% of patients report good-to-excellent pain relief after gamma-knife treatment, with significant reduction in medication.
7) Functional Neurosurgery
A range of conditions causing functional problems can be treated with surgical techniques, including:
a) Hyperhidrosis (sweaty palms): thoracoscopic sympathectomy is performed.
b) Spasticity: rhizotomy is performed or intra-thecal baclofen pumps are placed.
c) Parkinson's disease: deep brain stimulation or lesionectomy can be performed.
d) Epilepsy surgery: epileptogenic lesions can be excised, vagal nerve stimulator can be placed, and various other surgical options are available for intractable pilepsy.
Dr Goh is best known for leading surgical teams to perform complicated surgeries to separate conjoined twins. In 2001 and 2003, he operated to separate 3 sets of conjoined twins from Nepal , Iran and Korea . He was part of the medical team which was awarded the Excellence for Singapore award in 2002.
a) 2001 to 2002
Singapore Health Services Cluster Research Fund: “Intraoperative EMG in Skull Base, Spinal and Orthopaedic Surgery”
National Healthcare Group Research Fund: “National Database for Adult and Pediatric Patients with Central Nervous System Tumours”
- Hong Kong College of Surgeons, Systematic Review: “The Role of Adjuvant Adiotherapy or Chemotherapy for the Treatment of Low-Grade Gliomas”
Selected Original Articles (Total: 40)
Goh KYC, Tsoi WC, Feng CS, Wickham N, Poon WS. Haemostatic changes during surgery for primary brain tumours . Journal of Neurology, Neurosurgery and Psychiatry 1997;63(3):334-338.
Goh KYC, Poon WS. Recombinant tissue plasminogen activator for the treatment of spontaneous adult intraventricular haemorrhage . Surgical Neurology 1998;50:526-532.
Goh KYC, Velasquez L, Epstein FJ. Paediatric intramedullary spinal cord tumours: is surgery alone enough? Paediatric Neurosurgery 1997;27:34-39.
Goh KYC, Kockro RA, Serra L, C Chan. Virtual reality simulation and intraoperative neuronavigation in the surgical separation of craniopagus twins . Child's Nervous System 2001;17(7):436-437.
Book Chapters (Total: 10)
Goh KYC, Muszynski , CA , Teo JGC, Constantini S, Epstein FJ. Excision of Intramedullary Tumours . In: Black PM, Kaye AH, eds. Operative Neurosurgery. London : Churchill Livingstone 2000; 1947-1960.
Abstracts & Lectures (Total: 92)
Goh KYC, Carson B, Lim W, Chan C, Yeong KY, Goh P, Kwok R, Sitoh YY, Hui F, Lim SH, Pang A, Lasjaunias P. Pre-operative evaluation of craniopagus twins . 11th Asian-Australasian Congress of Neurological Surgery, 22-26 November 2003, Singapore .