Informed Consent Documents
Consent Forms
Akşan Clinic — examination, surgery, injection and personal-data consent forms. Please read the relevant form carefully before your procedure and note down your questions. You will be informed again with the printed form at the clinic.
Dr. Özgür Akşan — Neurosurgery (Brain and Nerve Surgery)
Examination Consent Form
1 formsInjection Consent Forms
2 formsEOF-001
Intramuscular Injection
Injection into the buttock — simple intramuscular medication (pain reliever, NSAID, antibiotic, vitamin B, muscle relaxant)
EOF-002
Intramuscular Therapeutic Injections
Trigger point · Neural therapy · Intra-articular cortisone · Botulinum toxin · Prolotherapy
Surgical Consent Forms
26 formsAOF-001
Lumbar Spine Surgery
Classic microdiscectomy or decompressive laminectomy (lumbar disc herniation / lumbar spinal stenosis)
AOF-002
Endoscopic Spine Surgery
Lumbar + cervical endoscopic (monoportal / biportal) — minimally invasive approach
AOF-003
Anterior Cervical Discectomy (ACD)
Cage / cage+plate / disc prosthesis (herniated neck disc, cervical stenosis — anterior approach)
AOF-004
PSE — Lumbar Stabilization
Posterior segmental instrumentation (lumbar stabilization with a screw-rod system)
AOF-005
Cervical Posterior Surgery
Laminectomy / laminoplasty / foraminotomy (posterior neck approach)
AOF-006
Carpal Tunnel Syndrome
Median nerve decompression at the wrist level (numbness, night pain)
AOF-007
Cubital Tunnel Syndrome (Ulnar)
Ulnar nerve decompression at the elbow level (numbness of the ring and little fingers)
AOF-008
Interventional Pain Treatment
Facet / transforaminal / epidural / radiofrequency / nucleoplasty (minimally invasive procedures for chronic pain)
AOF-009
Vertebroplasty / Kyphoplasty
Percutaneous bone cementing for osteoporotic / pathological vertebral compression fracture
AOF-010
Diagnostic Lumbar Puncture
Cerebrospinal fluid sampling (CSF analysis, for diagnostic purposes)
AOF-011
Supratentorial Tumor Removal
Surgical removal of a brain (supratentorial) tumor via craniotomy
AOF-012
Infratentorial (Posterior Fossa) Tumor Removal
Surgical removal of a cerebellum / brainstem region (posterior fossa) tumor via craniotomy
AOF-013
Intracranial Hematoma Evacuation
Evacuation of an epidural / subdural / intracerebral intracranial blood collection by burr hole or craniotomy
AOF-014
Ventriculo-Peritoneal (VP) Shunt
Placement of a shunt system that transfers cerebrospinal fluid to the abdominal cavity for the treatment of hydrocephalus
AOF-015
EVD and Intracranial Pressure Monitoring
Placement of an external ventricular drain (EVD) and measurement of intracranial pressure (ICP)
AOF-016
Cervical Posterior Stabilization
Spinal fixation with lateral mass / pedicle screws via a posterior neck approach (fusion)
AOF-017
Spinal Tumor Removal
Microsurgical removal of a spinal / spinal cord tumor (intradural / extradural)
AOF-018
Chiari Malformation / Suboccipital Decompression
Suboccipital decompression for cerebellar herniation (Chiari) ± duraplasty
AOF-019
Peripheral Nerve Tumor / Injury / Repair
Excision of a peripheral nerve tumor, repair of a nerve injury (neurolysis / graft / anastomosis)
AOF-020
Cerebral Aneurysm (Surgical Clipping)
Closure of a cerebral vascular ballooning (aneurysm) by placing a titanium clip via craniotomy
AOF-021
AVM / Cavernoma Removal
Removal of a brain vascular malformation (arteriovenous malformation / cavernoma) by craniotomy
AOF-022
Pituitary Tumor (Endoscopic Endonasal)
Endoscopic transsphenoidal removal of a pituitary gland tumor through the nose
AOF-023
Deep Brain Stimulation (DBS)
Implantation of a deep brain electrode + neurostimulator (battery) in Parkinson's / movement disorders
AOF-024
Epilepsy Surgery
Resective surgery, cortical mapping and invasive EEG monitoring in drug-resistant epilepsy
AOF-025
Craniosynostosis Surgery
Correction of the premature closure of the skull sutures in infants by open or endoscopic surgery
AOF-026
Congenital Midline Anomaly (Meningocele / Meningomyelocele)
Neural tube defect (meningocele / meningomyelocele) sac repair — congenital midline anomalies