Tags
Blog

'neurology' posts

Options widening for wide-necked aneurysms

Intracranial aneurysms are present in up to 4 percent of the population. These potentially dangerous vascular lesions are being detected with increasing frequency in asymptomatic patients by advances in noninvasive imaging techniques, such as magnetic resonance angiography (MRA). Appearing like blisters on the wall of the brain’s blood vessels, aneurysms develop when the blood vessel’s native repair ability is exceeded by the mild, but constant, injury created by flowing blood under high pressure. The five most common risk factors for developing an aneurysm are: smoking, female gender, high blood pressure, middle age and family history.

Intracranial aneurysms are complex lesions that require a highly specialized, multidisciplinary approach that is individualized for each patient. Key members of the care team for these patients include endovascular neuroradiologists, neurosurgeons with special expertise in aneurysm surgery and neuroanesthesiologists. Availability of dedicated neurocritical care units is an essential care component. A consensus recommendation by these specialists may include close observation, obliteration of the aneurysm with a surgical clip, or filling the vascular outpouching with filamentous coils that are introduced by endovascular microcatheters via an artery in the leg. This latter process is called “coiling.”

Swedish Expands Radiosurgery Services

There was cause for celebration in the Swedish Radiosurgery Center on Thursday, Dec. 16, as neurosurgeon Ronald Young, M.D. (left), medical director of the Gamma Knife® program, and radiation oncologist Bob Meier, M.D. (below), medical director of the CyberKnife program, treated the center’s first two Gamma Knifepatients. The center, formerly known as the Seattle CyberKnife Center, supports both the Swedish Cancer Institute and the Swedish Neuroscience Institute.

The center has offered CyberKnife services since 2006. This year Swedish installed an Elekta Leksell Perfexion Gamma Knife®, making it one of the most advanced stereotactic radiosurgery centers in the country. CyberKnife can be used to treat cancerous and noncancerous tumors in all areas of the body.

At Swedish, Gamma Knife will be used to treat cancer of the brain and some neurological conditions, such as essential tremor, trigeminal neuralgia and arteriovenous malformations. Providing Swedish neurosurgeons and radiation oncologists access to both of these advanced technologies gives them greater flexibility in selecting the best radiation therapy for their patients. For more information, go to www.swedish.org/radiosurgery or call 206-320-7130.

New center brings tertiary neurological care to children

The Pediatric Epilepsy and Pediatric Neurology services at Swedish Medical Center have combined to create the new Swedish Pediatric Neuroscience Center. As part of the Swedish Neuroscience Institute (SNI), comprehensive neurological care for newborns, infants, children and adoles­cents is now located at the Swedish First Hill campus in Seattle. Marcio Sotero de Menezes, M.D., has been appointed direc­tor of the new center.

The center has a high patient volume for the medical and surgical treatment of seizure disorders, including complex epi­lepsy syndromes and genetic epilepsies. It is accredited by the National Association of Epilepsy Centers as a Level-4 epilepsy center.

In addition to epilepsy, the center’s specialists treat pediatric patients for a wide range of neurological disorders, in­cluding headache and migraine; move­ment disorders, tics and Tourette’s syn­drome; genetic and metabolic disorders; neurodevelopmental disorders and learn­ing disabilities; brain malformations; cere­bral palsy; stroke; tuberous sclerosis; and neurofibromatosis.

The center’s pa­tients will also benefit from a broad spectrum of pediatric neurol­ogy inpatient hospital services, including epilepsy monitoring unit, pediatric and neonatal intensive care units, procedural seda­tion services, pediatric neurosurgery and intraoperative EEG monitoring, imaging services, and neuropsychological testing. Physical, occupational and speech therapy services are also available to the center’s patients.

For more information about the Swedish Pediatric Neuroscience Center, please call 206-215-1440.

Clinical Neurophysiology Lab Receives Accreditation

Congratulations are in order for the Clinical Neurophysiology Laboratory for attaining Accreditation by the EEG Laboratory Accreditation board of ABRET. We are the first and only Lab to receive Accreditation in Washington State and one of only 10 labs west of the Mississippi. Accreditation means the Lab has met strict standards and is recognized as a place where patients and physicians can have confidence they are receiving quality diagnostics. Thanks for all the great work and CONGRATULATIONS to everyone on the team who made this possible!

-Colleen Douville

Director for Cerebrovascular Ultrasound
Program Manager for Clinical Neurophysiology

The neurophysiology laboratory at Swedish is a critical component to the Epilepsy program.

Staying Fit to Prevent Stroke

A brisk walk for as little as 30 minutes a day can improve your health in many ways and may reduce your risk for stroke. Join me, and one of our exercise physiologists to learn how to stay fit and reduce your risk for stroke. Free blood pressure screening will also be available.

Cherry Hill - Pinard Foyer

Tuesday, Oct. 12, 11 a.m.-1 p.m

For more information, please contact Sherene Schlegel:

sherene.schlegel@swedish.org

Office: 206-320-3484

SNI Fellowship Opportunities Available

The Swedish Neuroscience Institute (SNI) at Swedish Medical Center in Seattle, Washington, is committed to improving the delivery of neurologic care through evidence-based protocols, research and education. SNI offers advanced training through five fellowships:

Applications are reviewed as received, with fellowships beginning bi-annually on January 1 and July 1. For one hundred years Swedish has been the premier health-care provider in the Pacific Northwest and a trusted resource for people when it truly counts. As a high-volume, urban medical center located at the epicenter of the Puget Sound area, Swedish attracts nationally recognized physicians and scientists, and provides a broad population base that enhances the patient care, research and education efforts at SNI. Applying for an SNI fellowship You can also email your inquiries to SNIFellowships@swedish.org

Gamma Knife Radiosurgery for Treatment of Essential Tremor

Essential tremor (ET) is the most common type of movement disorder, affecting approximate­ly four out of 1000 people, and is significantly more common, though less recognized, than Parkinson’s disease. ET affects men and women equally and is inherited as an autosomal-dominant condition in about 60 percent of cases.

Although often referred to as benign essen­tial tremor, it is hardly benign in patients who may not be able to write legibly, hold a glass of water or use a knife and fork. ET is primarily an action tremor of the upper extremities but may involve resting tremor of the head and neck and/or lower jaw, and also tremor of the voice. The latter may be so severe that speech becomes unintelligible.

Medication and surgical treatment options

Primidone and beta blockers are useful in re­ducing tremor in the early stages of ET, but as the tremor progresses, medical management often becomes less effective or side effects can prevent the use of adequate doses of medication. ET pa­tients then are candidates for surgical or radiosur­gical treatment.

The mainstay of the surgical treatment of ET is deep brain stimulation (DBS), in which an electrode is implanted in the ventral inter­mediate nucleus (VIM) of the thalamus. Neurosurgeons Peter Nora, M.D., and Ryder Gwinn, M.D., have been implant­ing DBS electrodes at Swedish Medical Center for several years. The treatment is effective, but it requires implantation of permanent hardware (wires and batteries) into the brain and chest wall. Patients who take anticoagulants or have severe cardio­vascular disease are not suitable candidates for DBS. These patients, however, may be candidates for radiosurgical treatment.

A new option for difficult-to-treat patients

Results 8-14 of 17