Cerebrovascular Neurosurgery (Neurosurgery By E... [EXCLUSIVE]
Object: As part of a project to devise evidence-based safety interventions for specialty surgery, we sought to review current evidence concerning the frequency of adverse events in open cerebrovascular neurosurgery and the state of knowledge regarding methods for their reduction. This review represents part of a series of papers written to consolidate information about these events and preventive measures as part of an ongoing effort to ascertain the utility of devising system-wide policies and safety tools to improve neurosurgical practice.
Cerebrovascular Neurosurgery (Neurosurgery by E...
Barrow is proud of its reputation as a medical research facility and is home to some of the most sophisticated research programs outside of an academic setting in the Southwestern United States. Researchers in the Barrow Neurosurgery Research Center are devoted to learning more about the causes of and treatments for a wide range of disorders, such as stroke, aneurysms, spinal cord injury, and hydrocephalus. Our research has led to treatments that are being used around the world. Within the Department are neurosurgeons who subspecialize in cerebrovascular and skull base, functional and stereotactic, pediatric, spine, tumor, and endovascular neurosurgery.
Curtis Doberstein, MD, is the director of cerebrovascular surgery at Rhode Island Hospital and vice chair of clinical operations. In addition, Dr. Doberstein is director of the Neurosurgery Residency Program and professor of neurosurgery at The Warren Alpert Medical School of Brown University. Dr. Doberstein received his medical degree in 1988 from McGill University in Montreal and completed his residency in neurosurgery and fellowship at the University of California at Los Angeles.
Neurosurgery at Wayne State continues the tradition of research begun by our founder, Dr. E. Stephen Gurdjian. We are dedicated to a search for new knowledge and refinement of existing knowledge, committed to excellent care and treatment of our patients. This commitment is reflected through our involvement in several research projects, obtaining federal and private grant monies for all ongoing research projects. Basic science research in our neuroanatomy labs includes the investigation of basal ganglia connections, variability of blood supply to the basal nuclei and neuronal plasticity in the endocrine hypothalamus. We also are studying anatomical models of skull base anatomy, microsurgical anatomy of the cerebral veins and microvascular temporary occlusion models. In the area of cerebrovascular research, we are studying several subjects, including management of giant cerebral aneurysms and temporary occlusion times and prevention and drug management of cerebral ischemia. Stroke, cerebral vasospasm, cerebral revascularization and management of complex vascular and neoplastic lesions with skull base techniques are being investigated by clinical and basic science approaches. Our pediatric neurosurgeons are researching the neuroendocrine response to hydrocephalus, and actively studying management of craniofacial abnormalities and complex pediatric tumors. Wayne State University neurosurgeons are exploring computer-assisted resection of brain tumors and vascular lesions using virtual reality and telepresence neurosurgery. Our stereotactic scientists and engineers work with neurosurgeons in developing real-world and multimedia information systems. The focus of the Neuro-oncology research faculty of the Department is on development of therapeutic strategies against glioblastoma multiforme, the most malignant of brain tumors. The studies are aimed at targeting these tumors via both biochemical/molecular biological and immunological perspectives. Hydrocephalus research has a focus on bioengineering strategies that could improve treatment. Experimental bench top data is integrated with translational studies involving patients, to deepen knowledge of this complex disorder. High-throughput, high-resolution confocal microscopy is utilized to develop quantifiable comparisons across datasets. Additional studies are aimed at understanding the biological interaction of other neural engineered devices with the brain. Our Neurotrauma Institute research focuses on head injury and spinal cord injury. Wayne State University is one of ten national centers investigating drug therapies to prevent head injury from worsening. We also have a fully functional lab investigating the biomechanics of spinal cord injury and spinal instrumentation. The neurosurgery physiology labs are investigating electromyography to evaluate low back pain, electroencephalography analysis of transient global ischemia and brain electrical activity mapping. We also proud to report that we have recently finished our research into a computer assisted research laboratory, or CASL. Our mission was to research, develop and use state of the art software, hardware, and visualization techniques to optimize surgical outcomes for brain surgery patients through complete resection with minimum damage to surrounding tissues and eloquent brain and vascular structures.
The one-year clinical fellowship offered by the Department of Neurological Surgery at UH Cleveland Medical Center trains physicians in the surgical management of neurovascular disorders and complex skull base tumors. It provides a comprehensive educational experience in cerebrovascular and skull base neurosurgery. Fellows like Dr. Stephens become an integral part of the department and actively participate in the training and education of residents and medical students.
Besides world renowned clinical care, the cerebrovascular and endovascular neurosurgery program at Cleveland Clinic is a world leader in research and innovation. Our program is involved in numerous interventional trials pioneering devices and new techniques from flow diverting stents to minimally invasive intracerebral hemorrhage evacuation.
Part of the Neurosurgery by Example series, this volume on cerebrovascular neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication management of common and uncommon disorders. The cases explore the spectrum of clinical diversity and complexity within cerebrovascular neurosurgery, including aneurysms, ischemic/occlusive disease, arteriovenous malformation, dural arteriovenous fistula, and more. Each chapter also contains 'pivot points' that illuminate changes required to manage patients in alternate or atypical situations, and pearls for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Cerebrovascular Neurosurgery is appropriate for neurosurgeons who wish to learn more about a subspecialty, and those preparing for the American Board of Neurological Surgery oral examination.
Peter Nakaji, MD, is Professor of Neurosurgery at the Barrow Neurological Institute (BNI) in Phoenix, Arizona, where he serves as the program director of the neurosurgery residency program. Dr. Nakaji specializes in cerebrovascular, skull base, and minimally invasive and endoscopic cranial surgery. His special surgical interest is in constantly improving the technical aspects of neurosurgery to improve patient outcomes.Michael R. Levitt, MD, is a board-certified neurosurgeon at the Neurological Surgery Clinic and Cerebrovascular Lab at Harborview Medical Center and the University of Washington. Dr. Levitt is Assistant Professor of Neurological Surgery and Radiology, an adjunct Assistant Professor of Mechanical Engineering, and the scientific director of the Stroke and Applied Neuroscience Center at the University of Washington.
Dr. Liptrap then entered her neurological surgery internship and residency at the University of Maryland Medical Center under the direction of Dr. Howard Eisenberg from 2011-2018. During her residency, she completed an enfolded fellowship in Neuroendovascular Surgery under the direction of Dr. Dheeraj Gandhi from 2015-2016. Upon completion of her neurological surgery residency, Dr. Liptrap was asked to stay at the University of Maryland Medical Center for a combined fellowship and instructorship in Neuroendovascular Surgery from 2018-2019. Dr. Liptrap then joined the faculty of the University of Alabama at Birmingham as an Assistant Professor of Neurosurgery and Radiology. Her clinical practice includes the operative and endovascular treatment of cerebrovascular disease, as well as brain tumors, general neurosurgery and neurosurgical critical care. Her clinical and research interests focus on cerebrovascular disorders. 041b061a72