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Neuroscience (SNI) Blog

'neurology' Neuroscience (SNI) posts

Do you know the symptoms of a brain aneurysm?

It’s easy to get caught up in day-to-day demands and ignore changes in our health. It may not be wise, however, to dismiss those changes as symptoms of a hectic life. Blurred vision, dizziness or headaches that don’t get better can signal something serious.

Anywhere from 1 to 6 percent of Americans have a brain aneurysm but don’t know it. An aneurysm is a blister-like bulge on the wall of a blood vessel. It can go unnoticed for a long time. If it’s not treated, the pressure of the blood weakens the vessel, and the aneurysm grows like a balloon filling with air. If the aneurysm bursts, it causes a stroke.

An aneurysm can put pressure on nerves or tissue in the brain, which may cause:

  • Headache or neck pain
  • Vision problems, enlarged pupil, drooping eye lid
  • Numb face
  • Severe drowsiness

If you have a brain aneurysm, your doctor may ...

The Spring Issue of BrainWaves Is Now Available

The Spring 2011 edition of BrainWaves is now available online.

BrainWaves is the newsletter of the Swedish Neuroscience Institute. Published quarterly, BrainWaves provides information about neurological conditions treated at the Institute, and also profiles the programs, services, and new initiatives of the institute and its staff.

Also check out our past editions of the BrainWaves newsletter.

Advances in thrombolysis

 Washington State has one of the high est stroke mortality rates in the nation. To improve this situation, acute intervention al therapies for stroke are being employed to restore circulation to ischemic brain tissue that surrounds areas of completed infraction, while avoiding risk of hemor rhage due to reperfusion of large areas of infracted brain tissue.

Urgent thrombolysis with intrave nous alteplase is the only therapy known to improve clinical outcomes following acute stroke. Unfortunately, alteplase has had limited usage because many patients arrive in an emergency department after the three-hour treatment window. The FDA has also approved two clot removal devices based on the ability to restore circulation. These devices are used up to eight hours after symptom onset. Several approaches to improved acute stroke care are now under way, including extension of the thrombolysis window to 4.5 hours, identification of safer thrombolytic agents and research identifying brain at risk of in farction following a stroke.

A recent European study demonstrat ed the efficacy of alteplase up to 4.5 hours after ischemic stroke in patients younger than age 80 years who have neither dia betes mellitus or prior stroke. The safety profile during this longer window for these patients appears similar to that at three hours.

Another promising advance employs a new thrombolytic agent called des moteplase.

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.

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