The Department of Neurosurgery consists of 5 units:

  • Brain Trauma Unit
  • Brain Surgery Unit
  • Spinal Neurosurgery Unit
  • Paediatric Neurosurgery Unit
  • Intensive Care Unit

The Brain Trauma Unit treats patients who have had brain injuries. Operations are performed for intracranial haematomas, elimination of cranial bone depression, drainage of hygromas, cerebral shunt surgery, and cranyoplasty.

The Spinal and Peripheral Neurosurgery Unit performs all highly complex spinal and peripheral nerve surgeries, spinal fixations with both anterior and posterior approaches, implantation of artificial discs, discectomy, vertebroplasty procedures, complex spinal fixations due to scoliosis, trauma, spinal tumour surgeries.

The Paediatric Neurosurgery Unit treats children with:

  • injuries to the head and brain, back, spinal cord, and peripheral nerves;
  • benign and malignant neoplasms including cranial, orbital, brain and meningeal, spinal and spinal cord as well as spinal cord meningeal, nerve roots, and peripheral nerves;
  • various cerebrovascular disorders of the brain and spinal cord;
  • cerebrospinal fluid circulation disorders such as hydrocephalus and various cerebral cysts;
  • cranial, spinal, brain and spinal cord diffusion defects (including cranial and spinal hernias, premature fusion of cranial sutures, deformities, etc.);
  • with focal epilepsy; – brain and spinal cord abscesses;
  • spastic complications of neurological diseases;
  • movement disorders of neurogenic origin;
  • intracranial hypertension.

The Brain Surgery Unit specializes in the expert treatment of cerebrovascular diseases, brain tumour removal, epilepsy, skull base and functional stereotactic surgeries, using the latest surgical technologies. This is the only facility in Lithuania that is referred to and performs surgeries on patients with cerebral aneurysms with the most complex and rare localizations, arterial-venous malformations, cavernous angiomas, carotid-cavernous sinus fistulas, cerebral ischaemic and haemorrhagic strokes. The Unit treats patients with epilepsy, consults and performs surgeries on patients with Parkinson’s disease, pathologic tremour having various etiology, torsion dystonia, choreoathetosis, haemiballism, and other types of extrapyramidal hyperkinesis.


The restoration of independence was the fulfilment of the secret aspirations of many Lithuanian people and the opening of new opportunities. For us, it was also an opportunity to learn more about neurosurgery in the rest of the world that used to be on the other side of the Iron Curtain.

To understand what you need to accomplish, you need a benchmark. Many neurosurgeons from the middle generation got to know how neurosurgery was organised and performed in the UK, the USA, Germany, Australia, Japan, France and other countries, participated in training courses, and worked in university hospitals abroad. We realised the damage that isolation had done to us. Neurosurgery is perhaps the sole discipline that cannot function effectively without extremely expensive diagnostic and surgical technologies.

After all, the neurosurgical microscope has been in use worldwide since the 1960s, the computed tomography (CT) scanner since the early 1970s, magnetic resonance imaging (MRI) since the 1980s or 90s, and the ultrasonic aspiration device and head mounts since the 1980s. In Lithuania, the standard diagnostic and surgical equipment was only acquired in the last decade.


The period of independence has witnessed numerous substantial changes in the field of diagnostics. Hardly would anyone in Lithuania imagine diagnosing complex neurosurgical conditions without modern spiral CT, MRI or digital angiography. We were the first and only in Lithuania to start using the gamma camera to diagnose cerebrovascular diseases and brain tumours. In recent years, we have reached international standards in the treatment of brain injuries with the introduction of intracranial pressure monitors.

The first Gamma Knife Centre in the Baltic States and the 100th Gamma Knife Centre in the world was opened at the Department of Neurosurgery of Kaunas Clinics on 3 June 2019.

Gamma Knife (Leksell Gamma Knife Icon) is the most advanced radiosurgery instrument currently available to neurosurgeons. Until the summer of 2019, patients from the Baltic countries did not have access to this option locally, and some patients were referred to other countries.

This technology treats even the deepest tumours or other diseases in the skull without making an incision or opening the skull. Without delivering a significant dose of radiation to healthy brains, the Gamma Knife only targets specific structures, reducing or stopping the growth of tumours and vascular malformations.

The Gamma Knife uses gamma rays from 192 cobalt-60 sources sources, which intersect at a target point at the accuracy of 1 tenth of a millimetre (about the thickness of a sheet of paper). This precision keeps intact the vital nearby structures such as nerves, blood vessels, or the brainstem. The Gamma Knife is more precise and delivers 2-4 times less radiation to healthy brains than other radiation therapy devices, giving patients a better chance of preserving their vision, hearing, and cognitive function. The radiation dose to the patient’s body can be up to 130 times lower than that of other radiation therapies.

The latest Gamma Knife model, owing to its advanced features, can record the patient’s head movements with precision down to of a millimetre. This allows patients to undergo several treatments using a special mask instead of a frame. To ensure even greater targeted effect of gamma rays only on the specific structures, CT scans can be performed during the examination.

Stereotactic radiosurgery planning is conducted using high-resolution MRI scans and the latest software, which enables the beams to be formed into the desired shape and volume.

It is an extremely safe treatment method that has been used worldwide since 1968. Gamma Knife treatment is applied to around 70,000 patients every year. Since the development of Gamma Knife technology, more than 1 million patients have received treatment.


Major changes took place after 1995. It was eventually understood that the performance of neurosurgery is determined by not just buildings and walls (which are, of course, also important), but also by highly qualified specialists and advanced technology. As a result, an operating wing with 7 operating rooms dedicated exclusively to neurosurgery was renovated up to modern standards. 3 modern microscopes, an ultrasonic aspiration device, a craniotome, a neurosurgical high-speed drill, neuroendoscopic equipment, and other equipment were procured. All the necessary resources are at our disposal and enable us to perform all the surgeries same as the ones carried out in the world’s most advanced neurosurgical centres.

In 1995, we started and are still the only ones in Lithuania to perform transsphenoidal surgery for pituitary adenoma removal.

In 1996, we began to develop sophisticated skull base surgery using the most advanced techniques. Previously, this area was not operated on or only palliative surgery was performed.

In 1998, we started performing surgery on giant cerebral aneurysms using artificial blood circulation and hypothermia. These complex surgeries are only performed in a handful of university clinics worldwide.

In 2002, we started using endoscopic surgery for pituitary tumours, followed by ventricular brain surgery.

Our neurosurgeons collaborate with doctors of related specialties. The introduction of endovascular coiling in interventional radiology has led to a significant expansion in the treatment of CNS vascular diseases and to safer surgery for haemorrhagic intracranial tumours. Surgical teams including neurosurgeons and cardiac surgeons, ENT and plastic surgeons, ophthalmologists and traumatologists have already become a standard phenomenon.

Since 2014, the Department of Neurosurgery has been participating in the activities of the Centre of Rare Neurosurgical Disorders of Kaunas Clinics (Kauno Klinikos) under the Lithuanian University of Health Sciences Hospital. Since December 2016, it has been participating in the programme activities of the EURACAN, European reference network for rare adult cancers (solid tumours), subgroup Brain tumours. This important fundamental research contributes to improving clinical solutions for rare diseases.

This is just a small part of the innovations that have been implemented over the last decade, yet this year it appears to be an inherent aspect of daily life.

Improvements in diagnostic tools and work organisation have led to an increase in the number of surgeries, accounting for 77% in some units. The number of neuro-oncology surgeries doubled. This was due to improved diagnostics and the growing authority of Kaunas neurosurgery specialists in Lithuania.

Many former Kaunas neurosurgery scientists and researchers are successfully working and passing on their valuable experience to younger colleagues and residents. We value their experience and are immensely grateful to them.

The decrease in the number of neurosurgery beds in the Department is also a natural outcome of the improved performance. After all, patients now come for elective surgery, not for tests. Due to advancements in diagnostics and surgery, and the growing qualifications of our doctors, we are performing more surgeries and treating a higher number patients each year. This has resulted in reduced bed days, allowing us to discharge patients to their homes or referring for rehabilitation sooner.

The Neuroscience Laboratory is gaining even more solid grounds, focusing on two key topics: neuro-oncology and central nervous system (CNS) vascular neurosurgery. This research laboratory, closely linked to the Department of Neurosurgery, is unique in Lithuania. It further solidifies the significance of our Department as the centre of neurosurgery in Lithuania. This combination aligns with the organisational structure of the world’s leading university clinical departments, where practising neurosurgeons work alongside fundamental scientists in research and teaching. This facilitates collaboration with laboratories and universities abroad. Our laboratory has already started genetic testing of CNS tumours to determine the sensitivity of tumours to chemotherapy, and is compiling a database of patients and a CNS tumour bank for further studies.

In the last decade, neurosurgeons have defended 16 doctoral theses and one habilitation thesis. Most of them have been well evaluated by neurosurgeons from clinical departments of foreign universities such as Harvard, West Berlin, Nagoya and others.

In 2003, we were awarded the annual prize of the Journal Seminars in Neurology for a series of articles in neuro-oncology.
In the last five years, our neurosurgeons’ work has been published in the world’s most prestigious neurosurgery journals. This is yet another recognition of the achievements of our Department.

Neurosurgeons from our Department are invited to give lectures at universities in the U.S., Japan, Australia, and Latvia. Doctors working at the Department of Neurosurgery are not only members of world or European neurosurgical associations, but are also participate in the activities of the American Congress of Neurological Surgeons, the International Society of Pituitary Surgeons, the Board of the European Skull Base Society and other international societies. Our neurosurgeon has become the only representative of the neurosurgeons of the Baltic States to be involved in the evaluation of EU medical projects and to receive the invitation to become a reviewer of a foreign scientific journal. This could doubtlessly be considered a recognition of our neurosurgery.

The past decade has been an interesting period. We had to revise former standards and transition to the Western ones, as Lithuania itself chose this path. This implies not only continuous modernisation of diagnostic or surgical methods (which is one of the prerequisites for progress), but also the improvement of knowledge, science, and work organisation principles. Improvement and development are continuous processes and it is only us who decide where to draw the limits.

Our Department gives lectures and conducts practical work for the 5th year students of the Faculty of Medicine. The Department has 3 CPD courses for doctors with a duration of 36 hours.



From now on, residents at the LSMU Department of Neurosurgery will receive training according to the same standards as those in all European Union countries.

The UEMS (Union Europeenne des Medecins Specialistes) is an organisation of medical specialists from European Union countries and associated member organisations. The Lithuanian Medical Association is also a member of the UEMS. The union includes sections for all specialties. In terms of neurosurgery, the UEMS accreditation panel (i.e. a joint panel including representatives of the EANS (European Association of Neurosurgeons, which also includes the Lithuanian Society of Neurosurgeons) and the UEMS) performs assessment of neurosurgery departments that provide training to neurosurgery residents to ensure that they comply with the European standards. Not only the residency programmes, but also the qualifications of the teaching staff, the number and complexity of surgeries, the provision of equipment, etc. are inspected.

According to Prof. Arimantas Tamašauskas, Head of the Department of Neurosurgery, accreditation is a lengthy process taking many years, with its primary aim being to ensure that neurosurgery residents across Europe are trained according to the same standards, i.e. their qualifications meet the requirements that are unified across Europe.

The professor notes that the Clinic of Neurosurgery at LSMU had been preparing for the accreditation procedure for almost a year and a half. During the preparation, they had to fill out piles of documents and complete various tasks outlined in the requirements, including establishing a library for residents’ training, setting up a research laboratory, procuring equipment for complex surgeries, and undertaking many other things. Two experts from the UEMS organisation, Prof. T. Trojanowski (Poland) and Dr. Guy Matge (Luxembourg), were appointed to visit the Department of Neurosurgery during several days, verifying a wide range of surgical procedures. The visited the library, attended the resident programmes, the surgeries and the doctors’ meetings, and finally held the resident examinations. Following this expert visit, the LSMU Department of Neurosurgery received an official certificate confirming its compliance with all European standards.

According to Prof. Tamašauskas, the primary advantage of this accreditation is that residents won’t need to travel to Brussels, incur significant expenses attending courses, or undergo additional exams to work in any European country. The accreditation of the Department of Neurosurgery means that the residents can invite an expert to Lithuania and take the same exam in their home country. The resulting certificate would be the same as the one received abroad.

Although the accreditation is complete, i.e. no major findings to be corrected were detected at the LSMU Department of Neurosurgery, the experts shared several valuable recommendations for the future. One of the recommendations was to extend the training programme for neurosurgery residents by one year as the neurosurgery residents in Lithuania are trained for five years, while in the rest of Europe they are trained for six years. The accreditation is granted for four years, subject to reapproval procedure upon its expiry.

The LSMU Department of Neurosurgery is the only clinical department in Lithuania that has received the official European recognition.

LSMU MA MF Department of Neurosurgery
Prof. Arimantas Tamašauskas
Head of the Department of Neurosurgery
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