Neurological care

A craniotomy is a type of brain surgery commonly performed to remove a tumor or blood clot, control hemorrhaging and relieve pressure inside the skull. Our neurosurgeons can treat you with technology that provides more precise navigation of your brain through viewing on a monitor.

If a neurological emergency happens to you or a loved one, the experienced teams at our emergency room (ER) are standing by to provide immediate support. We provide emergency care for strokes, severe back and spine injuries, seizures and a host of other neurological conditions.

Our main ER is a Certified Stroke Center and an American Heart Association “Get with the Guidelines” Stroke Gold-Plus Quality Achievement Award winner. Our award-winning care is available for patients of all ages.

Our spine specialists are experts in neurological and orthopedic care. We offer numerous procedures to treat a wide variety of causes of back and neck pain, including spinal fractures and degenerative disc disease.

Our highly-trained team works to identify stroke symptoms as quickly as possible, beginning with emergency medical service in the field. By the time you arrive at the hospital, our stroke team is ready.

Our neurological team is ready and equipped to treat all types of stroke. The three main types that many people experience are hemorrhagic strokes, ischemic strokes and transient ischemic attacks (TIAs).

Hemorrhagic strokes

Hemorrhagic strokes occur less frequently than ischemic strokes. However, they're responsible for 30 percent of all stroke deaths, even though they only account for 13 percent of all strokes . As opposed to a blockage, a hemorrhagic stroke happens when there's a rupture in a blood vessel in the brain. This causes blood to flow freely into the skull and brain tissue, which damages the brain cells. Some people have abnormalities in their brain's blood vessels that make make a hemorrhagic stroke more likely to occur.

Ischemic strokes

Ischemic strokes, the most common type of stroke, occur when a blood-supplying artery is greatly narrowed or blocked from the brain. A buildup of plaque causes the artery to narrow. Plaque in the arteries have potential to break into small pieces, and sometimes the rough edges can cause blood clots, which eventually become stuck in small blood vessels in the brain after breaking free.

Transient ischemic attacks (TIAs)

Often referred to as "mini strokes," TIAs are caused by a temporary blockage of the artery, and do not leave permanent damage to the brain. Depending on which artery has been blocked, TIA symptoms will go away within 24 hours. Because the symptoms can be similar to a stroke, however, it's often treated the same as stroke.

TIAs are an indicator that it's time to speak to your physician.

To help reduce your chance of having a stroke, take the following actions:

• Follow your doctor's recommendations for keeping your blood pressure in a safe range.
• Don't use recreational drugs, such as cocaine, heroin, marijuana and amphetamines.
• Drink alcohol only in moderation (no more than two drinks per day).
• Eat more fruits and vegetables, and limit your intake of salt and fat.
• Exercise regularly.
• Increase your consumption of fish.
• Maintain a healthy weight.
• Seek medical care if you have symptoms of a stroke (even if they stop).
• Stop smoking.
• Take a low dose of aspirin (50 to 325 milligrams per day) if your doctor says it is safe.
• Take steps to keep chronic medical conditions under control, including high cholesterol and diabetes.
• Talk to your doctor about the use of a "statin" drug, which may help prevent certain kinds of strokes.

Stroke symptoms occur suddenly, but differ depending on the part of the brain affected. Also, multiple symptoms can happen at the same time. If you notice any or a combination of the issues below, call 911 right away and get to an emergency room as soon as possible:

• Confusion
• Dizziness, trouble walking, loss of balance or loss of coordination
• Severe headache with no known cause
• Trouble seeing in one or both eyes
• Trouble speaking or understanding
• Vision change
• Weakness or numbness of face, arm or leg, especially on one side of the body

Severe headaches, vertigo or dizziness can accompany a stroke, but these symptoms aren't typical. However, a sudden change of vision associated with weakness may signal a stroke. Be sure to note when symptoms first appeared, and don't try to drive yourself or a loved one to a hospital. Call for an ambulance so treatment can begin immediately.

If someone is having a stroke, remember to B.E. F.A.S.T.:

• Balance — Does the person have a sudden loss of balance?
• Eye — Has the person lost vision in one or both eyes?
• Face — Watch for facial drooping. Ask the person to smile, and check if one side of the face droops.
• Arms — Ask the person to raise both arms. Does one arm drift downward?
• Speech — Listen for slurred speech. Ask the person to repeat a simple phrase. Can they do it?
• Time — If you notice any of these symptoms, call 911 immediately. Even if the symptoms go away, you should still call for help.

We are proud to offer interventional neurology, a subspecialty within neurology, for stroke treatment. It uses catheters and radiology to diagnose and treat various conditions and diseases of the central nervous system using minimally invasive neurosurgical techniques.

During an interventional procedure, neurointerventionalists thread a catheter into the brain and manually remove the clot, allowing for blood to flow. This can aid in restoring brain function immediately.

Neurointerventional radiology is most effective within a few hours of when stroke symptoms begin. This type of care can be effective for both types of stroke, ischemic as well as hemorrhagic.

While interventional neurology typically plays an important role if you have experienced a stroke, this program can also be vital for diagnosing and treating various conditions affecting the central nervous system.

At our hospital, we offer TCAR, one of the most advanced types of stroke treatment. Using TCAR provides potential benefits for those with conditions that pose high risks for stroke during surgery and stenting procedures, such as carotid artery disease (CAD) . TCAR prevents the need to navigate catheters through the aortic arch, which previously has been linked to stroke during carotid stenting through the groin. TCAR eliminates the need to navigate catheters through the aortic arch, and also prevents fragments of plaque released during stenting from traveling with the bloodstream to the brain and causing small or bigger strokes.

To reduce the risk of stroke during the stent insertion, the TCAR procedure uses a special transcarotid neuro-protection system (NPS). The NPS device allows the surgeon to directly access the common carotid artery in the neck and initiate high-rate temporary blood flow reversal to protect the brain from stroke while delivering and implanting the stent.

Performed through a small incision at the neckline just above the clavicle, a surgeon places a tube directly into the carotid artery and connects it to the NPS, directing blood flow away from the brain to protect against plaque from reaching the brain.

Your blood flows through the NPS, and any material is captured in a filter outside the body. The filtered blood is returned through a second tube in your upper leg. After successful stent placement, flow reversal is turned off, and blood flow resumes in its normal direction .