Neurology

Through its highly regarded programs, Winthrop neurologists provide diagnosis and medical management for a range of problems.

Epilepsy Program
Epilepsy and seizure disorders are diagnosed and treated by a specialized, dedicated staff. Evaluation might include 24-hour video EEG telemetry, as well as outpatient testing. An individualized treatment approach is emphasized, with a focus on finding the appropriate medication regimen to provide each patient with optimum seizure control while ensuring the highest possible degree of functional independence. For those patients whose seizures do not respond to medication management, neurosurgeons in the Institute for Neurosciences are adept at the implantation of the vagal nerve stimulator, a pacemaker-like device that often prevents and controls seizure activity.

Headache Program
For patients who suffer from chronic headaches such as migraines, finding relief becomes the ultimate goal. Winthrop's specialists work in tandem with anesthesiologists and Board certified pain management specialists to fine-tune each treatment approach to the individual needs of the patient. New medications that specifically target headache pain are among the treatment options.

Movement Disorders Program
Movement disorders are the focus of discrete clinical programs spearheaded by physicians with expertise in managing these conditions. Patients with Parkinson's disease, essential tremor, other types of tremor, dyskinesias and dystonias find medical professionals from a variety of disciplines who function as part of a comprehensive team that is dedicated to improving quality of life and ameliorating symptoms through the latest techniques and medications. Support groups for patients with these conditions also exist at Winthrop.

Multiple Sclerosis Treatment Center
Affiliated with the National Multiple Sclerosis Society, the Multiple Sclerosis Treatment Center offers the full range of diagnostic testing for the disease, as well as the latest treatments. Physical therapy, psychological support and education are important elements of the treatment plan. Patients benefit from the availability of specialists in other disciplines for consultation when necessary, and from the opportunity to participate in clinical research trials of the most current treatment options.

Pain Management Program
Neurological and neuromuscular conditions sometimes bring associated pain syndromes, including spasticity and trigeminal neuralgia. Working with specialists in Winthrop's Center for Pain Management, as well as surgeons and other related practitioners, physicians in the Institute for Neurosciences help patients find optimal pain relief using the latest available methods.

Stroke Program
With new clot-busting medications available, and others under investigation, the treatment of acute stroke has moved into the emergency arena. Winthrop has responded with its Stroke Team, which is on-call 24-hours-a-day, seven-days-a-week, ready to respond to any patient exhibiting stroke symptoms. Follow-up treatment includes modification of risk factors to prevent subsequent stroke. The team participates in many clinical research trials, giving patients access to new therapies in the pipeline for FDA approval.

With a blend of technical precision, thorough knowledge and compassion, highly skilled neurosurgeons, specially trained orthopaedic surgeons and experienced vascular surgeons offer patients the most advanced surgical interventions.

Brain & Skull Base Surgery
Intricate surgical procedures are accomplished with exceptional precision and accuracy with the help of stereotactic frame and frameless computer systems. These create a virtual roadmap of the surgical field, guiding the surgeon through the innermost depths of the brain. These techniques expand the parameters of what is operable, and enable surgeons to visualize tumors, identify abnormal growths or lesions in three-dimensional space, and thus pre-plan and strategize surgical procedures. The system is used for a wide range of computer-based stereotactic neurosurgical techniques, including volumetric tumor resection, serial tumor biopsy, third ventriculostomy, interstitial irradiation catheter placement, depth electrode implantation, thalamotomy, cingulatomy and mesencephalotomy. Winthrop's neurosurgical staff provides treatment for many types of brain tumors, including gliomas, astrocytomas, acoustic neuromas, meningiomas and pituitary adenomas.

Spinal Surgery
Neurosurgeons and orthopaedic surgeons collaborate to provide the most advanced techniques for delicate spinal surgery. One of the latest procedures to be offered is percutaneous vertebroplasty, a minimally invasive technique that involves injecting a plastic-like substance into the site of vertebral compression fractures caused by osteoporosis or bone cancer to relieve pain and aid in healing.

Device Implantation
Winthrop neurosurgeons are on the leading edge of surgical care, offering both pediatric and adult patients the option of the latest generation of implantable devices to help control certain conditions. Patients whose seizures do not respond to medication may experience a vastly improved quality of life through the implantation of the vagal nerve stimulator, a pacemaker-like device that uses electrical impulses to control and prevent seizures. Other patients who suffer from the severely debilitating effects of spasticity caused by cerebral palsy or other neurological problems may find relief from the implantation of a baclofen pump, which delivers a muscle relaxing medication on a continuous basis.

Traumatic Brain Injury
The availability of the latest diagnostic technology, including the newest generation multi-slice CT scanner, magnetic resonance imaging (MRI), magnetic resonance angiography, and two fully equipped interventional radiology suites, allows for swift diagnosis of life-threatening conditions and qualify Winthrop as a Level I Regional Trauma Center. Winthrop's fully equipped operating suites and full, round-the-clock staffing mean that any patient requiring emergency neurosurgery receives expert, immediate attention. Each year, countless lives are saved thanks to the quick response of professionals in the Institute for Neurosciences.

Carotid Endarterctomy
Current studies suggest that patients whose carotid artery is more than 70% blocked by artherosclerosis may benefit from carotid endarterectomy, a surgical procedure to remove plaque from the artery. Performed by skilled, experienced vascular surgeons, this procedure reduces the risk of a potentially disabling stroke. Selected patients might be candidates for carotid stent placement, a non-surgical approach to opening a blocked carotid artery. Performed by neuroradiologists in the Institute for Neurosciences' Special Procedures Suite, stent placement involves threading a spring-like device through a catheter into the artery, where it is deployed to hold the arterial walls in an open position. Winthrop's Institute for Neurosciences is fully equipped with the necessary diagnostic and monitoring devices to ensure that patients receive care in a safe, supervised environment. Pre-operative testing might include neuroimaging, transcranial Doppler ultrasound and arteriography to pinpoint the percentage of stenosis, or narrowing, of the vessel. Patients recover in Winthrop's Neurosciences Unit, an intensive care unit dedicated to neurological and neurosurgical patients.

A highly specialized intensive care unit, dedicated to patients recovering from neurological or neurosurgical procedures, is located within a designated neuroscience floor at Winthrop. Patients here benefit from the latest technology, including 24-hour monitored beds, as well as round-the-clock physician's assistant staffing. Once patients are ready to leave the closely monitored intensive care environment, they remain on the neuroscience floor, clustered with other patients recovering from similar medical events. Nurses, social workers, physical and occupational therapists, and other allied health professionals on the floor are uniquely trained and focused on the specific needs of neurosciences patients.

Interventional Radiology
Winthrop's Institute for Neurosciences is equipped with a state-of-the-art Neuro-Interventional Radiology Suite, where neuroradiologists are able to precisely image structures in the brain, head and neck and spine, as well as perform minimally invasive procedures. This is often accomplished through the introduction of a catheter through the artery.

Neuroangiography
Neuroradiologists use interventional techniques to "see" clots in the brain. By introducing clot-reducing drugs through the same catheter that permits visualization of the area, they are often able to dissolve the clot. Similarly, dilating agents may be delivered to vessels that are in spasm to limit the damage caused by subarachnoid hemorrhage.

Aneurysm Treatment
Neuroradiologists use advanced imaging equipment to diagnose and evaluate aneurysms and arterial venous malformations (AVMs) in the brain. Together with neurosurgeons, they assess treatment options, which may include non-surgical interventions such as the placement of coils through a catheter. Surgical treatment is also an option and may be performed on an emergent basis.

Ultrafast CT Scanning & Magnetic Resonance Imaging (MRI)
Winthrop's Institute for Neurosciences includes the most current versions of these diagnostic techniques that enable rapid diagnosis of emergent neurological episodes. Other diagnostic techniques include SPECT scans, a nuclear medicine scan that demonstrates brain metabolism; carotid ultrasound, which provides information about the carotid artery; transesophageal ultrasound, which provides valuable information about heart function; magnetic resonance angiography, which provides images of blood vessels inside the brain without the need to inject radioactive agents; and CT angiography.

PET Scanning
Positron Emission Tomography (PET) scanning is a highly sophisticated technique that provides valuable information about organ function and structure, simultaneously. PET scans can image blood flow, assess brain function, and detect and stage tumors. They are useful in evaluating movement disorders such as Parkinson's disease, as well as Alzheimer's disease.

From tiny premature infants in the most precarious health, fighting for life in Winthrop's highly regarded Neonatal Intensive Care Unit, to growing children and adolescents, youngsters receive the full range of care from neurologists, neurosurgeons and others working hand-in-hand in the Institute for Neurosciences. Professionals here work in collaboration with their colleagues in the Institute for Family Care's Children's Health Services to provide the highest quality, most comprehensive care available to children at every stage of development.

Neurodevelopmental Screening & Early Intervention
As more and more premature and gravely ill newborns survive, they sometimes do so with neurological or other deficits. These NICU "graduates" are seen on a regular basis in order to ensure early detection of any potential developmental lags. A coordinated team of pediatric neurologists, neonatologists, developmental pediatricians and physical therapists performs comprehensive neurodevelopmental evaluations. If developmental delays are detected, arrangements are made to provide appropriate therapy in a variety of settings, including the home, community-based early childhood centers such as the Little Village School in Bellmore, with which Winthrop holds an affiliation, or within the local school system. In addition, every newborn at Winthrop undergoes hearing screening. Early detection of hearing impairment provides the opportunity for early intervention in order to prevent associated language and speech delay.

Seizure Disorders
Tracking down the precise origin of seizures is crucial to prescribing appropriate treatment. Pediatric neurologists have access to the most up-to-date diagnostic techniques to isolate the genesis of seizure disorders, thereby honing in on the most effective medical and/or surgical treatments. With the advent of newer generations of medications, there are now many more options for medical management of seizures with fewer side effects. Children who are not well managed with medication may be candidates for surgical implantation of a vagal nerve stimulator to complement or replace medication in the control and prevention of seizures.

Attention Disorders & Learning Disabilities
Pediatric neurologists function as part of a multidisciplinary team that provides comprehensive evaluation and diagnosis of children with learning disabilities and attention disorders, including Attention Deficit Hyperactivity Disorder (ADHD). A team approach is emphasized, with close collaboration between pediatric neurologists, teachers and school personnel, behavioral psychologists, and, of course, the family. Recommendations might include counseling, educational assistance, psychological support and medication when appropriate. The ultimate goal is to enable the child to achieve his or her fullest potential.

Hydrocephalus & Other Central Nervous System Anomalies
Hydrocephalus is a swelling of the brain, which can occur in premature or full-term babies. Babies with hydrocephalus as well as those with general disorders of the central nervous system are evaluated and treated by pediatric neurologists and geneticists. In the Institute for Neurosciences, hydrocephalus may be treated with sophisticated endoscopic equipment to assess the cause of the condition and create a pathway to relieve the fluid accumulation, often minimizing the need for a shunt.

Headaches in Children
Headaches and migraines are common in adults, however most people would be surprised to learn that they can affect up to 5 percent of children as well. Although more often seen in adolescents, and in girls more than boys, headaches can occur in young children and toddlers. The primary categories are migraines and chronic, recurrent headaches. Headaches in children are rarely linked to a more serious underlying condition. Fortunately, there are new medications that specifically target migraine pain and can be effective in managing these headaches. There are also preventative medications and techniques to bring relief, sparing youngsters missed days at school and psychological distress that can accompany chronic pain.

Evaluation & Treatment of Neurological Disorders
Pediatric neurologists in the Institute for Neurosciences are skilled at diagnosing and managing children with a range of neurological issues, including brain tumors, muscular dystrophy and other neuromuscular disorders, Bell's Palsy and others. Long-term management of these often-chronic conditions focuses on meeting each family's individual needs for care and support.

Treatment of neurological problems is a constantly evolving field. Specialists in the Institute for Neurosciences at Winthrop stay abreast of the latest developments and help pave the way for new discoveries through their participation in clinical research trials. This enables them to provide their patients with access to tomorrow's most promising therapies.

"...I am writing...to let you know what a wonderful staff you have in your Neurosurgical Department...My family and I were overwhelmed with my medical condition and your staff helped to ease and comfort our suffering..."

Think About It...
For additional information on the Institute for Neurosciences, or a physician referral, call 1-866-NEURO Rx.