Wellington The Magazine-July 2016

JFK Medical Center’s Neuroscience Institute Leads The Way In Treating Complex Disorders

The neuroscience team at JFK is committed to using the most advanced surgical and medical treatments.

The Neuroscience Institute at JFK Medical Center is a leader in treating brain, spine and nervous system disorders. Collaboration is key in caring for such complex issues, and JFK’s team of neurosurgeons, neurologists, neuro-interventional radiologists and specialty trained staff team up to provide the best care possible for patients.

The neuroscience team is committed to using the most advanced surgical and medical treatments, as well as the most cutting-edge technologies to treat all disorders of the nervous system, which are classified as:

• Vascular disorders such as stroke, transient ischemic attack (TIA), subarachnoid hemorrhage, subdural hemorrhage and hematoma;
• Infections such as meningitis, encephalitis and epidural abscess;
• Structural disorders, such as brain or spinal cord injuries, Bell’s palsy, brain or spinal cord tumors, peripheral neuropathy and Guillain-Barré syndrome;
• Functional disorders, such as headache, epilepsy, dizziness and neuralgia; and
• Degeneration, such as Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), Huntington’s disease and Alzheimer’s disease.

Physicians who treat nervous system disorders may have to spend a significant amount of time working with a patient before making a specific diagnosis. Often, this involves performing a number of tests to eliminate other conditions.

JFK Medical Center is designated as a Comprehensive Stroke Center and is known as one of the best-equipped hospitals in the state to treat any kind of stroke or stroke complication. The hospital receives a large number of transfers from surrounding primary stroke centers. The main goal for stroke patients is to stop the area of the brain where the stroke occurred from dying by restoring blood flow as quickly as possible.

Fast treatment is critical. Dr. Teresita Casanova, medical director of neuroscience and stroke, said the key to remember during a stroke is that “time is brain.” The chances of survival are best if a stroke is identified and treated immediately.

In 2015, JFK Medical Center treated more than 600 stroke patients, of which 87 percent had an ischemic stroke, which occurs as a result of an obstruction within a blood vessel supplying blood to the brain.

The remaining 13 percent had a hemorrhagic stroke, which is caused by a ruptured blood vessel, aneurysm or abnormal tangle of blood vessels (AVM).

The only FDA-approved treatment for ischemic stroke is a tissue plasminogen activator (tPA), which works by dissolving the clot and improving blood flow to the part of the brain that needs it. If administered within three hours, tPA can improve the chances of recovering from a stroke. Unfortunately, a significant number of those who experience a stroke do not get to the hospital in time for tPA treatment. This is why it is so important to identify a stroke immediately. Round-the-clock access to minimally invasive catheter procedures to treat a stroke, as well as neurosurgical availability to perform complex neurovascular procedures, are also available at JFK Medical Center.

Neuro-interventional radiologists specialize in the minimally invasive, endovascular approach of navigating microcatheters through the blood vessels under X-ray guidance. This procedure might be used in the case of a stroke, cerebral aneurysm, or brain and spine arteriovenous malformations (AVMs). Coiling is one type of procedure performed by neuro-interventional radiologists Dr. Abraham Obuchowski and Dr. Nana Amiridze. This procedure is used to treat aneurysms in the brain. A catheter is introduced into the femoral artery in the groin, passed up through the arteries of the body, inside the head, and into the aneurysm. The aneurysm is then packed off from the inside with wire coils, which are very pliable, soft platinum coils. Conditions that would have required open surgery in the past can now be considered for this type of minimally invasive treatment.

In some cases, it is too difficult to pass a catheter through the carotid artery to reach the aneurysm. If this is the case, alternative treatments such as surgery are performed by a neurosurgeon. Surgery could include a craniotomy and clipping of the aneurysm in which it is sealed off with a clip.

The neurosurgeons at JFK Medical Center are highly trained and skilled in the most modern treatment options. Their comprehensive capabilities, advanced surgical techniques and collaboration with experts in the field of neurosciences enable them to manage a wide array of conditions. Procedures can range from a straightforward insertion of a lumbar drain to the very complex removal of a malignant brain tumor. The most common procedures performed by a neurosurgeon are clot removal, aneurysm repair, tumor removal, brain bleed stoppage, shunt insertion/revision and endovascular procedures.

One of the most recent neurosurgery programs begun at JFK is the Endoscopic Skull Base Surgery Program. Skull base surgery, a procedure performed not within the brain, but at the skull base behind the nose, uses minimally invasive techniques that can replace open surgery in many cases. Neurosurgeons can remove tumors using the openings of the face instead of through incisions. Tiny endoscopes are used to navigate to the tumors.

Minimally invasive endoscopic skull base surgery is often an option for pituitary tumors, which are often inaccessible through open surgery. Diagnosing and treating anterior skull base conditions and tumors require the expertise of a multi-disciplinary team of specialists all working together. At JFK, this team of physicians includes Dr. John Cantando (neurosurgery), Dr. Alfredo Archilla (ENT) and Dr. Abraham Obuchowski (neuro-interventional radiology).

Also included within JFK’s Neuroscience Institute is spine surgery. JFK Medical Center has neurosurgical and orthopedic fellowship-trained spine specialists on staff. There are also pain management consultants, who work closely with physicians, nurses, physical therapists and occupational therapists to help determine an accurate diagnosis and develop a plan of care designed specifically for each patient to bring quicker recovery with less pain and complications.

With such an in-depth neuroscience program, it is important to have a dedicated neuroscience intensive care unit, as well as a specialized neuroscience inpatient unit. Staff members who work within these areas receive specialized training to care for patients with neurological disorders.

To learn more about the services offered at the Neuroscience Institute at JFK Medical Center, visit www.jfkmc.com or call (561) 548-4535.