INSIGHT Neurosurgery

At INSIGHT, we strive to treat our patients as we would treat our own families. Our team of neurosurgeons is highly skilled in neurosurgery and are board-certified or board eligible. Dr. Shah, Dr. Yin, Dr. Ebenzer, Dr. Edem, Dr. Perez, Dr. Torcuator and Dr. McDougall provide an in-depth treatment plan for each of our patients for a variety of issues, including brain tumors, aneurysms, and trigeminal neuralgia, as well as spinal issues such as disc herniations and spinal stenosis.

Our physicians prioritize building a one-on-one relationship with every patient to ensure they have a full understanding of their diagnosis and treatment options. Most of the options you need for diagnosis, treatment, and rehabilitation are under one roof at INSIGHT, including imaging, physical therapy, occupational therapy, speech-language pathology, pain management, chiropractic care, and massage therapy. Our convenient configuration allows our providers to easily connect with our patients’ other providers to discuss care and treatment.

Spine Procedures

Some of the spine procedures covered at INSIGHT

Lumbar Interbody Fusion

Overview

This surgery helps a painful lower spine. It treats a degenerated or damaged disc. The bad disc is removed and the vertebra bones above and below that disc are joined together. A fusion can reduce or eliminate your pain.

Preparation

To begin, you are put to sleep. An incision is made on the front, back, or side of your abdomen. Before your surgery, your surgeon will let you know which type of approach is best for your needs.

Stabilizing your spine

The surgeon removes damaged disc material. Your vertebrae may have shifted out of place, creating pressure against your nerves. If so, the vertebrae are moved into a more natural position. Then, your surgeon puts in one or more interbody devices. An interbody device is an implant that is packed with bone graft material. There are many types. They come in different shapes, sizes, and styles. Your surgeon chooses the type that’s best for you. The implant fills the space where your disc used to be. As your spine heals, the graft material helps new bone grow between your vertebrae. We call this a “fusion.”

End of procedure

After the surgery, you are watched in a recovery room as you wake up. Your surgeon will tell you when you can go home. Follow your surgeon’s advice for a safe recovery.

Lumbar Pedicle Screw Fixation

Overview

This minimally-invasive procedure uses special guides and fluoroscopic imaging to allow a surgeon to precisely implant stabilizing screws and rods in the spine while minimizing damage to muscles, tendons and other soft tissue in the back.

Preparation

After anesthesia is administered and the patient is positioned, the spine is scanned with an imaging system. This allows the surgeon to plot the paths of the pedicle screws down to the vertebrae. The surgeon then creates the entry points – a few tiny incisions on the back.

Positioning Guides

A probe is inserted through the first incision and guided with fluoroscopic imaging to the spine. When the probe is correctly positioned at the point where the screw will be inserted, a guide wire is placed gently down to the pedicle and the probe is removed. The surgeon repeats this for each screw placement point.

Placing the Screws

The pedicle screws are threaded onto the guide wires, gently placed down to the vertebrae, and carefully screwed into the bone.

Placing the Rods.

To stabilize the spine, metal rods are needed to connect the pedicle screws. The benefit of using the Sextant device is the ability to insert the connecting rods without a large incision. A guide is positioned. One at a time, the rods are attached to the device and inserted through small incisions. Each rod is gently placed into the screw heads, locking the screws together.

End of procedure.

The instruments are removed, and the incisions are closed. The patient will typically require a hospital stay of 1-3 days after the procedure. The surgeon will determine the length of the stay and will guide the post-operative recovery. Because the Sextant does not require large incisions, healing time may be faster than for open surgery.

Anterior Cervical Corpectomy

Overview

This surgery relieves pressure on the spinal cord and the spinal nerves. It involves the removal of bone and discs from your cervical spine, followed by a fusion.

Incision Created

In preparation for the procedure, you lie on your back. You are anesthetized. The surgeon creates an incision on the front of your neck. The structures within your neck are carefully moved aside to create a path to your spine.

Eliminating Pressure

The surgeon removes the spinal discs above and below the damaged vertebra. The main portion of this bone, called the “vertebral body”, is removed. For some patients, more vertebral bodies and spinal discs may need to be taken out. If bone spurs or other structures are pressing against your spinal cord or spinal nerves, your surgeon will correct these problems, too.

Inserting the Graft

After the pressure on your nerves has been relieved, the surgeon stabilizes your spine. Often, this is done with a bone graft. The surgeon places the graft into the open space in your spine. It may be secured with a metal plate and screws.

Other Devices

Instead of a graft, your surgeon may choose to use a device such as a cage. This is an implant that holds your vertebrae in the proper position. Many cages have an open space in the center that is filled with bone graft material.

End of Procedure

When the procedure is complete, the incision is closed. You may be placed in a neck brace. In the weeks after the surgery, new bone will grow and attach securely to the graft or implant. This will create a permanent fusion. You may benefit from physical therapy as you heal.

Anterior Cervical Discectomy and Fusion

Overview

This surgery removes a herniated or degenerative vertebral disc in your neck and replaces it with a bone graft. This can relieve painful pressure on spinal nerves.

Preparation

In preparation for the procedure, you are positioned on your back. You are anesthetized. The surgeon creates a small incision in the front of your neck. The structures within your neck are gently moved aside to create a path to your spine. The surgeon carefully removes the damaged disc. This leaves a space between the vertebrae.

Graft Inserted

The surgeon inserts a bone graft into this space. The graft fills the open space. It holds the vertebrae in the proper position. The surgeon may secure the graft with a metal plate and screws.

End of Procedure

When the procedure is complete, the incision is closed. As your spine heals, new bone will grow. The graft will become permanently attached to the vertebrae. This is called a “fusion.”

Anterior Cervical Discectomy and Fusion (ACDF), with Cage

Overview

This surgery replaces a damaged vertebral disc in your neck with a cage containing a bone graft. It’s done to relieve painful pressure on spinal nerves.

Preparation

To begin, you lie on your back and are put to sleep. The surgeon makes a small incision in the front of your neck. Muscles and other tissues in your neck are carefully moved aside to make a path to your spine. The surgeon carefully removes the damaged disc. This leaves a space between the vertebrae.

Cage Inserted

The surgeon then inserts a cage into this space. It is packed with a graft material that can be made from bone or a synthetic bone substitute. The cage fills the open space. It holds the vertebrae in the proper position.

End of Procedure

When the procedure is complete, the incision is closed. As your spine heals, new bone will grow. The cage becomes permanently attached to the vertebrae. This is called a “fusion.”

Anterior Endoscopic Cervical Microdiscectomy

Overview

This minimally-invasive surgical procedure, performed through a tiny hole in the neck, removes the bulging portion of a herniated cervical disc. It is designed to relieve neck and radiating arm pain caused by herniated disc material pressing on nerve roots.

Preparation

The patient is positioned so that the surgeon has access to the front of the neck. Anesthesia is administered, and the neck is cleaned and sterilized.

Accessing the Disc

Vital structures in the neck are pushed aside. The surgeon inserts a needle into the neck, and, using a
fluoroscope to confirm the needle’s position, carefully guides it a short distance to the surface of the disc. A guide wire is inserted through the needle and into the disc. The needle is removed. The surgeon slides a small dilator tube over the guide wire and pushes it down to the disc. A working sleeve is pushed over the dilator, and the dilator is removed.

Correcting the Herniation

Surgical tools and a tiny endoscope are pushed through the working sleeve into the disk. Using the view from the endoscope, the surgeon carefully removes the bulging portion of the disc. This relieves pressure on surrounding nerve roots.

End of Procedure and Aftercare

The instruments are removed, and the opening is covered with a small bandage. Pain relief may begin immediately after the procedure. The patient may wear a cervical neck brace for a few weeks while recovering.

Artificial Cervical Disc Replacement

Overview

This procedure replaces a degenerative or damaged spinal disc with an implant designed to preserve motion in your neck. This procedure can relieve the pain of compressed nerves in the cervical spine.

Removing the Disc

In preparation for the procedure, you are positioned on your back. You are anesthetized. The surgeon creates a small incision in the front of your neck. The structures within your neck are gently moved aside to create a path to your spine. The surgeon carefully removes the damaged disc. This leaves a space between the vertebrae.

Inserting the Implant

The implant has three parts: upper and lower metallic plates and a plastic core that sits between them. The plates have teeth designed to hold them securely in place. These teeth are pressed into the upper and lower vertebrae. Over time, bone will grow and attach to these plates.

Motion

Unlike a rigid neck fusion, which locks your neck in a fixed position, the implant is designed to allow you to move your neck more naturally. The components glide smoothly against each other.
With the implant, you can turn your head and bend your neck forward, backward and side to side, just as you would with an undamaged disc.

End of Procedure and Aftercare

When the procedure is complete, the incision is closed. You may wear a neck support as you heal. You may benefit from physical therapy. Your surgeon will give you specific instructions to aid your recovery.

Artificial Disc Replacement (in the Lumbar Spine)

Overview

This surgery treats a bad vertebral disc in your lower back. It replaces the bad disc with an artificial one. The new disc will let your spine bend and twist. For some, this surgery is an alternative to spinal fusion.

Preparation

To begin, you are put to sleep. The surgeon makes an incision in your abdomen and clears a path to your spine.

Procedure

The bad disc is carefully cleared away. Your vertebrae are spread apart, and metal plates are attached to them. Then, the center of the artificial disc (called the “bearing”) is put between these plates. The bearing holds your vertebrae in their normal positions. It can relieve pressure on compressed nerves.

End of procedure

When the surgery is done, the incision is closed and bandaged. You’ll be watched closely as you wake up. Your surgeon will tell you when it’s safe to leave the hospital. Follow your surgeon’s instructions for recovery.

Intrathecal Pain Pump Implant

Overview

This is a device put inside your body to relieve long-lasting pain. It sends medicine into an area around your spinal cord. We call this the “intrathecal space.” The medicine blocks pain signals. It can work even when other treatments don’t.

Trial procedure

Before your pump is implanted, we need to see if a pump can control your pain. We do this with a trial implant. During the trial procedure, we numb your skin. Then, we insert a catheter into the intrathecal
space. The catheter is connected to a temporary pump. You’ll use this system for several days. If it relieves your pain, we can implant the permanent pump.

Permanent implantation

For this surgery, you’re given medicine to put you to sleep. We remove the trial catheter. Then, through a small incision in your skin, we place the permanent catheter. One end is placed in the intrathecal space. The other end goes under your skin, around your body to your abdomen.

Placing the pump

Now we’re ready to place the pump. We make an incision in your abdomen, and create a space under your skin to hold the pump. We attach the pump to the catheter. Then, we place the pump inside you and close the incision. The pump is programmed with a wireless controller.

End of Procedure

When the surgery is finished, you’re watched in a recovery room. Then, you can go home. Follow your doctor’s plan for a safe recovery. You’ll come back for regular visits so we can check the device and refill the medicine in your pump.

Post-Laminectomy Syndrome

Overview

This condition, also called “failed back surgery syndrome,” is a type of chronic pain. It can develop in some people after spine surgery.

Causes

This pain most often develops after a laminectomy procedure. This is the removal of bone at the rear of your vertebrae. The procedure is done to relieve pressure on your spinal nerves. But after a laminectomy, bone or soft tissue may still press on these nerves. Scar tissue may form. And spinal joints may be irritated and inflamed. Pain from any of these issues may be called “post-laminectomy syndrome.”

Symptoms

Symptoms may include pain in your back at the site of your surgery. The pain may also radiate down to your buttock and leg. This pain may feel sharp, or it may feel dull and achy.

Treatment

Treatment depends on the cause and the severity of your pain. It may include medications, injections or physical therapy. You may benefit from electrical nerve stimulation or other techniques. If these are not helpful, surgery may relieve your pain.

Lumbar Corpectomy

Overview

This procedure is performed to relieve the pain caused when diseased or damaged vertebrae bone blocks and pinches nerve roots. It also corrects spinal column deformities. During this procedure, the patient is positioned on his right side. The surgery is performed through the patient’s left side.

Incision Made

After an incision is made, care is taken to remove the diseased and damaged parts of the vertebral bone. This relieves pressure from the nerve roots.

Diseased Fragments Removed

The discs above and below the affected vertebra are removed along with any diseased vertebral fragments. The bone surfaces are cleared and prepared to receive a bone graft.

Bolts Inserted

Bolts are screwed into the vertebrae above and below the gap to help the surgeon perform the rest of the procedure.

Curvature Corrected

The surgeon opens the vertebral space and corrects the spinal column curvature. This is known as reduction of deformity.

Bone Graft Inserted

While the vertebral space is open, the bone graft is inserted. Closing the vertebral space secures the bone graft tightly into place.

Zplate Inserted

A piece of metal called a Zplate is placed onto the two bolts, bridging the vertebrae levels above and below the bone graft.

Additional Screws Inserted

Two nuts hold the Zplate in place, and two additional screws are inserted.

End of Procedure

The Zplate keeps the area secure while the bone heals. During the healing process, the bone graft will knit with the vertebrae levels above and below to create one solid bone segment, known as a bone fusion.

Micro Endoscopic Posterior Cervical Discectomy

Overview

This surgery removes bone and/or portions of a herniated or diseased disc to relieve neck and radiating arm pain caused by parts of the disc pressing on nerve roots.

Guide Wire Inserted

Through a small incision, a guide wire is inserted to locate the affected disc level. The surgeon uses a special type of x-ray machine called a fluoroscope to ensure that the route to the herniated disc is made in the correct location.

Tubes Inserted

A series of dilation tubes are passed over the guide wire, pushing apart the tissue and creating an opening to the vertebrae. The guide wire then is removed.

Retractor Positioned

The tubular retractor, through which the surgery will be performed, slides over the dilating tubes. It is positioned on the bone surface. All the dilating tubes are then removed.

Instruments Inserted

A surgical light and small camera or microscope are placed through the tube to allow the surgeon to view the disc. The surgeon uses surgical instruments to clear away bone and soft tissue, accessing the spinal canal.

Nerve Exposed

A drill may be used to clear away bone, exposing the pinched nerve root and the herniated disc below it.

Nerve Inspected

A small instrument is passed through the retractor tube and used to check the freedom of the nerve.

Damaged Disc Removed

The surgeon removes the herniated portion of the disc and clears the area, creating room for the nerve to move back to its normal position.

End of Procedure

The tubular retractor is removed, allowing the tissue to close. The surface wound is covered with a small bandage.

OLIF: Oblique Lumbar Interbody Fusion (for L2-L5)

Overview

This is a surgery to correct problems caused by a degenerated disc in your spine. It creates more space for your nerves. OLIF is performed through a small opening in your side.

Preparation

To begin, you are given medicine to put you to sleep. You are positioned on your side. Your surgeon uses a video x-ray device called a “fluoroscope” to find your damaged disc. A tiny opening is made in your skin. The surgeon passes a series of tubes called “dilators” through your soft tissues and down to your disc. A device called a “retractor” is slid over the dilators, and they are removed. Your surgeon will work through this channel.

Removing the disc

Your surgeon carefully removes your degenerated disc. An implant called an “interbody device” is put between your vertebrae and packed with bone graft. The interbody device lifts your vertebrae into the proper position. It relieves compression of nearby nerves.

Stabilizing the spine

Finally, your spine is stabilized with other supports. Your surgeon will choose rods, plates, screws or other devices that are right for your needs. Over time, a solid fusion will form between your vertebrae.

End of procedure

When the procedure is done, the opening in your skin is closed. You are watched closely while you wake up. Your surgeon will give you instructions to help your recovery.

Sacroiliac Joint Fusion

Overview

If you have a painful damaged or diseased sacroiliac joint (we call it the “SI” joint), a fusion may help. With the Rialto SI Fusion System, your surgeon uses titanium implants to join your hip’s ilium bone to the spine’s sacrum. This may relieve pain associated with SI joint dysfunction or SI joint disease.

Preparation

To begin, you are given medicine to put you to sleep or to block sensation in your SI joint. You’re positioned face down. The surgeon makes a small opening in your skin. With the help of a video x-ray device called a “fluoroscope,” a guide pin is placed across your SI joint. The surgeon uses an approach that minimizes contact with your muscles.

Procedure

While protecting your soft tissues, the surgeon carefully drills a channel along the pin. It passes into the ilium, through the SI joint and into the sacrum. A Rialto implant is inserted, locking these bones together. One, two or three implants will be needed to stabilize your joint. Over time, new bone will grow on and around the implants and across the joint, creating a solid fusion.

End of Procedure

When the procedure is done, you are monitored. You may be allowed to go home or you may stay overnight, depending on your needs. Your doctor will give you instructions to help your recovery.

Spinal Cord Stimulation (Medtronic)

Overview

Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, ams and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

Screening Test Implantation

The injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Find the Right Location

Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient’s pain. The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient.

Determine Effectiveness

If the patient and physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.

Permanent Implantation

The permanent implantation may be performed while the patient is under sedation or general anesthesia. First, one or more permanent leads are inserted through an epidural needle or small incision into the predetermined location in the epidural space.

Generator Implantation

Next, a small incision is created, and the implantable pulse generator (IPG) battery is positioned beneath the skin. It is most often implanted in the buttocks or the abdomen. The leads are then connected to the IPG battery.

End of Procedure

The implant’s electrical pulses are programmed with an external wireless programmer. The patient can use the programmer to turn the system on or off, adjust the stimulation power level and switch between different programs.

After Spinal Cord Stimulator Implantation

After surgery, patients may experience mild discomfort and swelling at the incision sites for several days.

Spinal Cord Stimulation (Paddle Lead, Medtronic)

Overview

Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

Screening Test Implantation

The injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Find the Right Location

Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient’s pain. The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient.

Determine Effectiveness

If the patient and physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.

Permanent Implantation

The permanent implantation may be performed while the patient is under sedation or general anesthesia. A small incision is made in the lower back so that the surgeon can access the lamina, the bone that protects the nerve roots and spinal cord.

Removing the Lamina

The surgeon removes a portion of the lamina. This will make space for insertion of the permanent lead.

Inserting the Lead

The paddle lead is passed through the opening in the lamina and into the epidural space. The surgeon confirms correct placement of the lead through the use of an x-ray device called a fluoroscope.

Device Implantation

Next, a small incision is created, and the implantable pulse generator (IPG) battery is positioned beneath the skin. It is most often implanted in the buttocks or the abdomen. The leads are then connected to the IPG battery.

End of Procedure

The implant’s electrical pulses are programmed with an external wireless programmer. The patient can use the programmer to turn the system on or off, adjust the stimulation power level and switch between different programs.

After Spinal Cord Stimulator Implantation

After surgery, patients may experience mild discomfort and swelling at the incision sites for several days.

Lumbar Spinal Fusion

Overview

In many spinal surgeries, two or more vertebral bones are permanently joined with a technique called “spinal fusion.” A fusion creates a solid mass of bone. It stabilizes your spine.

Preparation

In preparation for the procedure, you are positioned and anesthetized. The surgeon makes an incision in your skin. The tissues are gently moved aside to create a path to your spine.

Bone Removal

If your fusion is being performed as part of a procedure to relieve pressure on your spinal nerves, your spine may need to be modified. Your surgeon may remove part or all of the lamina from
one or more vertebrae. Removing this bone creates more space for the spinal nerves. If bony growths are pressing against your nerves, your surgeon removes these as well.

Graft Inserted

To create the fusion, your surgeon uses bone graft. This graft can be taken from your own hip. It can also come from a donor. The surgeon removes some bone from the surface of your vertebrae to create a bed where this graft can grow.

Spine Stabilized

The surgeon stabilizes your spine. This involves implanting hardware to lock the vertebrae together. Many devices are available. Your surgeon may use screws and rods, plates, or other devices. Finally, the graft is placed against your vertebrae.

End of Procedure

When the procedure is complete, the incision is closed. You may be placed in a brace to support your spine. In the weeks after the surgery, new bone grows and attaches securely to the spine. This creates a permanent fusion. You may benefit from physical therapy as you heal.

Kyphoplasty (Balloon Vertebroplasty)

Overview

This minimally-invasive procedure repairs a vertebral compression fracture. It helps restore the spine’s natural shape. Some patients experience rapid pain relief after the procedure.

Preparation

Before the procedure, you are anesthetized. The physician guides a needle through the skin of your back and into your fractured vertebra. A special x-ray device called a “fluoroscope” helps the physician position the needle.

Balloon Inserted

A balloon device is placed through the needle and into the vertebral body. The physician carefully inflates this balloon to expand the fractured bone. When the balloon is deflated, it leaves a cavity in the middle of the vertebral body. The balloon is removed. For some patients, more than one needle and balloon may be used.

Fracture Stabilized

The physician injects bone cement through the needle. This cement fills the cavity. It hardens inside the vertebral body, stabilizing the fracture.

End of Procedure and Aftercare

When the procedure is complete, the needle is removed. The opening in your skin is closed. Your doctor will give you instructions to aid your recovery.

Brain Procedures

Some of the brain procedures covered at INSIGHT

Arteriovenous Malformation (AVM)

Overview

This is an abnormal connection between blood vessels. It happens when arteries connect directly to veins without first sending blood through tiny capillaries. An AVM can look like a tangle of blood vessels. They form anywhere in your body, but most often they form in or around the brain and along the spinal cord.

Causes

We don’t understand what causes AVMs. Most people who have an AVM were born with it.

Symptoms
If you have one, you may not realize it. Many cause no problems. But sometimes an AVM causes noticeable symptoms. An AVM in your head can cause headaches, confusion and seizures. It can
cause buzzing or whooshing noises in your ear. You may have dizziness or other vision problems. An AVM in your head or spine can cause weakness, numbness, balance issues and pain.
AVM Dangers

An AVM can keep your brain or your spinal cord from getting enough oxygenated blood. An AVM also may rupture and let blood leak out. That can cause you to have a stroke. Or, a large pool of blood may press harmfully against your brain or spinal cord. A bleeding AVM is a medical emergency.

Treatment

AVMs can be removed surgically. They can be treated with catheter and radiation techniques. Your healthcare provider will create a plan that is right for you.

Brain Aneurysm

Overview

This condition is a bulge that forms in the wall of a weakened artery in the brain. This bulge can leak or rupture, causing a stroke. An aneurysm can be life-threatening.

Causes

An aneurysm is typically caused by a thinning of the arterial wall. This thinning can develop gradually over time. Aneurysms often develop at the base of arterial branches in the brain, because the arteries are weakest at these points.

Symptoms

Aneurysms can cause a wide range of symptoms. A small aneurysm that has not ruptured may not cause noticeable symptoms. A large aneurysm that has not ruptured may cause pain behind an eye. It may impair vision, and may cause numbness or weakness on one side of the face. When an aneurysm ruptures, it often causes a sudden, severe headache. This pain is frequently described as the worst headache of the person’s life. A ruptured aneurysm can also cause nausea, stiffness of the neck, sensitivity to light, seizures, confusion and loss of consciousness.

Treatment

Treatment options depend on the size and location of the aneurysm and whether or not it has ruptured. In many cases, an aneurysm can be treated with surgical clipping or coil embolization. Other treatment options include medications, pain relievers, and the insertion of a drainage catheter or shunt. Rehabilitative therapy may be required as a part of recovery from a brain aneurysm.

Pituitary Tumor

Overview

Your pituitary gland is found just under your brain. This pea-sized gland makes hormones that affect many of your body’s functions. A pituitary tumor can cause it to release too much or too little of these hormones. This can cause serious problems.

Causes

We aren’t sure why pituitary tumors form. A tumor starts with a mutation in a cell’s DNA. These are the genetic blueprints that tell cells how to grow and function. The mutation makes the cell divide abnormally and uncontrollably. A pituitary tumor is a mass of these abnormal cells. Most pituitary tumors are not cancer.

Symptoms

A pituitary tumor can press against your brain. This can cause headaches and vision loss. Some
tumors change your hormone levels. You may see things like more body hair or enlarged hands and feet. You may have emotional problems like anxiety or depression. You may have sexual problems like loss of sex drive or irregular periods. It can change your weight, your heart rate and your digestion. Many other problems in your body can be caused by changes in your hormones. consciousness.

Treatment

Treatment depends on your needs. If your tumor isn’t causing problems, you may not need treatment. If it is, you may benefit from surgery, radiation therapy or medications. Your healthcare provider can create a care plan that is right for you.

Brain Tumor

Overview

This is a mass of abnormal cells. It may be inside your brain, or it may be next to your brain. It can grow and press harmfully against healthy brain tissue. This can cause a wide range of problems throughout your body. A brain tumor can severely impact your life.

Types

There are many types of brain tumors. They can be classified in different ways. A tumor can be
classified by where it originally formed. A tumor that originates in your brain is called a “primary” tumor. A primary tumor can be noncancerous or it can be cancerous. A tumor that originates in another part of your body and then travels to your brain is called a “metastatic” tumor. Metastatic tumors are always cancerous.

Symptoms

Because the brain is so complex, a brain tumor can affect you in many different ways. A tumor can cause physical problems, such as headaches, nausea, and seizures. It can cause behavioral changes, such as confusion and impulsiveness. Your symptoms depend on your particular tumor and its location.

Treatment

A brain tumor can be treated in many different ways. It can be treated with medications. It can be targeted with radiation designed to shrink its cells. Some tumors can be removed surgically. Your healthcare provider can create a care plan that is right for your needs.

Cerebral Cavernous Malformation (CCM)

Overview

This is a mass of enlarged blood vessels in your brain or spinal cord. Pockets in the mass slow down or even trap blood. This can lead to blood clots, or to a leaking of blood we call a “hemorrhage.”

Causes

What causes a CCM? In most cases, we don’t know. If you have just one, it may have no clear cause. But some CCMs have a genetic link. This is especially true for people who have multiple CCMs. And, a CCM can form after you have radiation therapy in your brain.

Symptoms

What are the symptoms of a CCM? Well, you may not have any symptoms. You can have a cavernous malformation and not even know it. But if your CCM causes a blood clot or a hemorrhage, you can have a wide range of serious problems. These depend on what part of your brain is affected. They can include things like severe headaches, balance difficulties, speech or vision problems, and seizures. This can be life threatening.

Treatment

Treatment depends on your needs. If your CCM isn’t causing problems, your doctor may suggest monitoring. If you’re having certain symptoms, medications may help. Or, you may need surgery.
Your healthcare provider will create a plan that’s right for you.

Chiari Malformation (CM)

Overview

This is a structural problem with the back of the brain. It involves the cerebellum. That’s the part of your brain that controls balance. Normally, the cerebellum sits in a space at the base of the skull. It’s just above the opening to the spinal canal, called the “foramen magnum.” With Chiari malformation, the cerebellum slips down through this opening.

Causes

This condition usually happens as a fetus develops in the womb. It may be linked to a genetic mutation or to other issues. These can cause problems with the development of the skull and brain. It may also develop later in life if you lose a lot of spinal fluid. This can happen because of an injury or an infection.

Symptoms

Chiari malformation can cause symptoms such as neck pain and problems with balance and coordination. It can cause problems with vision, hearing and swallowing. It can cause weakness, numbness and other problems in the arms and legs. And it can cause issues such as headaches, depression and insomnia, among other problems. The symptoms depend on the severity of the malformation. In some people, only a small part of the cerebellum pushes down through the hole. That may not cause any symptoms. In severe cases, much more of the brain’s tissue pushes through. In the most severe cases, this causes death.

Treatment

Treatment options depend on your needs. If your malformation is mild, medications may help. If your malformation is more severe, you may benefit from surgery. Your healthcare provider can create a care plan that is right for you.

Chronic Subdural Hematoma (Hemorrhage)

Overview

This condition is a buildup of clotted blood between the brain’s outer layer and the membrane that covers the brain (called the dura). It usually occurs in the elderly, and can be caused by even a minor bump to the head.

How it Forms

As we age, our brain tissue slowly shrinks. Blood vessels that extend from the brain to the skull stretch and become vulnerable to tears. The vessels can rupture on their own, or they can tear if the head is bumped or jolted. A single episode of leaking may go unnoticed, but repeated leaks can cause a dangerous buildup of blood. Medications that delay blood clotting may make the problem worse.

Symptoms

A chronic subdural hematoma usually progresses slowly. Symptoms may include severe headaches,
drowsiness, and nausea. A hematoma may cause slurred speech, seizures, and cognitive decline. It may cause difficulty with swallowing or walking, and weakness or numbness in the face, arms or legs. These symptoms may happen days or even weeks after the injury.

Treatment

A chronic subdural hematoma that causes symptoms is treated with drainage of the accumulated blood. This usually can be done through a drain passed through a small hole in the skull. If seizures occur as a result of hematoma, they may be controlled with medications.

Subdural Hematoma

Overview

This is a buildup of clotted blood beneath the dura. That’s a membrane that covers your brain. The blood can press harmfully against your brain.

How it Forms

This type of hematoma is often caused by a violent blow to your head that stretches and tears blood vessels around your brain. The blood vessels leak, letting blood pool against the brain. A hematoma can also happen even without a head injury if a weak artery in your head bursts.

Symptoms

If your hematoma is small, you may not notice any symptoms. But a large clot can cause headaches, weakness and nausea. It can cause problems with vision, speech, and confusion. You may have seizures. You may lose consciousness. This can be fatal.

Treatment

An acute subdural hematoma is an emergency condition. You need to be treated quickly to prevent permanent damage. Your healthcare provider can create a plan that is right for you.

How your brain changes with age

Overview

Like every part of your body, your brain changes as you age. And some changes affect how you think. Let’s look at what’s normal, and let’s talk about things that may be cause for concern.

Physical changes

How does the brain change with age? Well, a few things happen. Some parts shrink, including the parts that handle learning and complex mental tasks. Brain cells may begin to have trouble communicating with each other. The brain’s blood flow may decrease. And, the brain may have some inflammation.

Healthy older brain

These normal changes can affect your thinking. You may have mild memory problems. Focusing on more than one thing at a time may be difficult. And it may be a bit harder for you to pay attention. But you can have positive changes, too. You may find that you’re wiser and more insightful. And, you can still learn new things and sharpen your mind.

Unhealthy changes

Your brain can change in ways that aren’t normal, too. For example, a buildup of harmful proteins causes things like Alzheimer’s disease and dementia. These unhealthy changes cause many issues. You may have severe memory problems and confusion. You may have trouble taking care of yourself. These are all warning signs that something is wrong. you.

Conclusion

If you or your loved ones are worried about your brain health, see your doctor. Your doctor will find out what’s wrong and create a care plan that’s right for you.

Normal Pressure Hydrocephalus (NPH)

Overview

This condition, which usually occurs in adults 55 and older, is an excessive accumulation of
cerebrospinal fluid (CSF) in the ventricles of the brain. The ventricles are a system of large, fluid-filled open spaces inside the brain. Too much CSF in the ventricles can distort the brain’s shape. It can make the brain susceptible to injury.

About CSF

Cerebrospinal fluid is a colorless fluid that bathes the central nervous system. It carries nutrients and waste to and from cells. It also absorbs shocks and regulates pressure.

How NPH Develops

As we age, the brain tissue gradually weakens and shrinks, exerting less of its own pressure. This atrophied brain can allow the ventricles to swell with CSF fluid, which distorts the brain’s shape without causing an elevation in normal brain pressure.

Symptoms

One of the first signs of NPH is difficulty walking – people with the condition typically develop a shuffling, stumbling, hesitant gait. It often then progresses to incontinence and dementia. The symptoms are sometimes confused with those of Alzheimer’s or Parkinson’s disease.

Treatment

Normal Pressure Hydrocephalus is treated with a surgically-implanted shunt. The shunt allows the excess fluid to drain and relieves the distortion caused by swollen ventricles.

Hydrocephalus

Overview

This condition is caused by an increased amount of cerebrospinal fluid (commonly called CSF) in the brain’s ventricles. The ventricles are a system of large, fluid-filled open spaces inside the brain. Too much CSF in the ventricles can elevate pressure in the skull. It can damage delicate brain tissue.

About CSF

Cerebrospinal fluid is a colorless fluid that bathes the central nervous system. It carries nutrients and waste to and from cells. It also absorbs shocks and regulates pressure. CSF is produced in the brain. It normally flows through and around the brain and then down the spinal cord, where it is absorbed by the blood stream.

How Hydrocephalus Develops

Hydrocephalus is caused by a disruption of this drainage system, or, in rare cases, by an
overproduction of CSF. The ventricles swell with the excess fluid. This raises the fluid pressure within the skull.

Symptoms (Infants)

Symptoms of hydrocephalus vary greatly with age. In infants, it can cause the head to swell rapidly and to unusually large proportions. This is because infants do not yet have rigid skulls. In addition to a swollen head, infants may experience symptoms such as vomiting, sleepiness, irritability and seizures. Their eyes may be fixed in a downward gaze.

Symptoms (Toddlers, Children)

In toddlers, hydrocephalus can also cause head swelling. Toddlers and children may experience headache, fever, irritability, and problems with coordination and balance. They may experience personality changes, problems with walking or talking, sleepiness, and other issues.

Metastatic Brain Tumor

Overview

This is a cancer that began elsewhere in your body and then spread to your brain, forming one or more tumors. Many different cancers can spread this way. These tumors are actually more common than tumors that begin in the brain’s own tissues.

About CSF

Cerebrospinal fluid is a colorless fluid that bathes the central nervous system. It carries nutrients and waste to and from cells. It also absorbs shocks and regulates pressure. CSF is produced in the brain. It normally flows through and around the brain and then down the spinal cord, where it is absorbed by the blood stream.

Causes

A metastatic brain tumor can begin as bladder cancer, breast cancer, or a cancer of the ovaries or testes. It can begin as a cancer in your blood, kidneys, lungs or skin. And sometimes, we don’t know where the cancer began.

Symptoms

Because your brain is so complex, a brain tumor can affect your mind and body in many ways. A tumor can cause physical problems, such as severe headaches, nausea, and seizures. You may feel weak and tired. You may have pain, numbness or tingling in parts of your body. A tumor can affect your vision and your speech. It can also cause your personality to change. You may have rapid mood swings. You may develop strange behaviors

Treatment

Treatment depends on your needs. You may benefit from radiation, surgery or other options. Your healthcare provider can create a plan that’s right for you.

Meningioma

Overview

This is a tumor in your meninges. These thin layers of protective tissue surround your brain and spinal cord. Most meningiomas are not cancerous. They usually grow slowly

Causes

The cause of a meningioma is not fully understood. It may be linked to your genetics, to your environment or to a combination of factors. It starts with a mutation in a cell’s DNA. This genetic blueprint guides cellular growth and functions. The mutation causes the cell to divide abnormally and uncontrollably. A meningioma tumor is a mass of these abnormal cells.

Risk Factors

Certain factors increase your risk for a meningioma. The tumors are more common in women. You have a higher risk if you have had radiation treatment involving your head. And, you have a higher risk if you have an inherited nervous system disorder called “neurofibromatosis type 2.”

Symptoms

A meningioma can press against your brain, interfering with its function. Symptoms of a meningioma include headache, hearing loss and changes in vision. You may have problems with your memory. You may lose your sense of smell. You may develop weakness in your limbs, and you may have seizures.

Treatment

Treatment options depend on your tumor and your needs. A small, slow-growing tumor may not need to be treated immediately. If your tumor is aggressive, or if it is causing harmful symptoms, you may benefit from surgery, radiation therapy, medications, or other options. Your healthcare provider will create a care plan that is right for your needs

Mini-Stroke Warning Signs (Transient Ischemic Attack TIA)

Overview

You can have a stroke that lasts for only a few minutes and then seems to go away. We call that a “mini-stroke.” It happens when part of your brain’s blood supply is blocked for a short time. But even if your symptoms disappear, a mini-stroke is a dangerous event. You need to seek help right away.

Warning signs

During a mini-stroke, you may experience a wide range of warning signs. They happen suddenly.
You can have numbness or weakness, especially on one side of your body. You may become confused, and you may have trouble speaking. Your sight may be affected, and you may have trouble seeing in one or both eyes. You can have problems with balance and coordination. You may feel dizzy, and you may have trouble walking.

Get help

A mini-stroke is a sign of a serious problem. So if you experience any of these symptoms, get help immediately. Call the emergency number and say “I think this is a stroke.” Do not delay.

Conclusion

The symptoms of a mini-stroke often go away within an hour. But that doesn’t mean everything is OK. Go to a doctor and get examined. By acting quickly during or after a mini-stroke, you may prevent severe disability, or even save your life.

Occipital Neuralgia

Overview

This condition is a distinct type of headache caused by irritation or injury of the occipital nerves. These nerves travel from the base of the skull through the scalp. This condition can result in severe pain and muscle spasms.

Causes

Occipital neuralgia can be caused by direct trauma to the back of the head or neck. It can be caused by overly tight muscles in the neck, or by compression of the nerve roots. It can develop as a result of osteoarthritis. A localized infection or tissue inflammation, or a tumor or lesion can cause occipital neuralgia. It can be caused by conditions such as gout or diabetes. And finally, it can develop from keeping the head in a downward and forward position for lengthy periods.

Symptoms

Symptoms of occipital neuralgia include piercing, throbbing, or electric-shock-like pain. This pain begins in the upper neck and then spreads upward to the back of the head and behind the ears. It usually affects only one side of the head, but it can be felt on both sides. In some cases the scalp becomes hypersensitive. Activities such as brushing or shampooing the hair or lying on a pillow can be painful. The person may experience muscle spasms in the neck and a reduced ability to flex or rotate the neck. The person may also experience extreme sensitivity to light, especially during a headache.

Treatment

Treatment options may include massage, physical therapy and medications designed to reduce inflammation. Options may also include nerve blocks and steroid injections. If those methods are not successful, surgery may be performed to decompress the painful nerve root. Another option is the implantation of a nerve stimulator to block painful occipital nerve signals.

Trigeminal Neuralgia (TN)

Overview

This chronic condition is caused by a misfiring of the trigeminal nerve. An attack causes brief episodes of extreme, shooting pain.

About the Trigeminal Nerve

The trigeminal nerve consists of a thick root at the base of the brain and three branches that extend to the face. These branches sense touch and control the chewing muscles.

Why It Strikes

TN usually occurs when an artery or vein compresses the root of the trigeminal nerve, causing it to misfire. The nerve can also be irritated by a tumor or other disorder.

Triggering an Attack

Flashes of pain are often triggered by some type of contact with the face. Brushing teeth, applying makeup, shaving, eating, talking, or being exposed to wind can all trigger an episode.

Symptoms

A TN attack may last from a few seconds to a few minutes. People describe the pain as like a sudden burn or an electric shock, typically felt on only one side of the face. It’s an incredibly intense sensation that can be physically incapacitating.

Treatment

Treatment options include medication, various types of surgical procedures, and a radiology procedure called stereotactic radiosurgery (or Gamma Knife).

Pseudotumor Cerebri

Overview

This condition, sometimes called a false brain tumor, is a buildup of cerebrospinal fluid pressure in the skull. It most commonly affects obese women ages 20 to 50. The reason it develops is unknown

About CSF

Cerebrospinal fluid, commonly called CSF is produced inside the brain. This colorless fluid absorbs shocks, carries nutrients and waste, and regulates pressure in the skull. It normally flows through and around the brain and down the spinal cord, where it is absorbed by the blood stream.

Excess CSF

In cases of pseudotumor cerebri, this normal flow of fluid becomes disrupted. Excess CSF builds up in the skull and presses against the brain. This pressure can damage the brain’s delicate tissue.

Symptoms

A patient who has this condition may experience a range of symptoms similar to the symptoms caused by an actual brain tumor. Symptoms may include headaches, nausea, blurred or double vision and pulsing sounds in the ears. It can cause permanent vision loss.

Treatment

Treatment options vary depending on the individual. Treatment may include weight loss, medications, and surgical implantation of a shunt to drain the excess fluid. After a diagnosis of pseudotumor cerebri, the patient will need to have periodic vision checkups.

Right Brain Stroke

Overview

Your brain is divided into left and right halves, called “hemispheres.” They specialize in different things. Because of this, a stroke on the right side of your brain can be very different from a stroke on the brain’s left side. Let’s look at some symptoms of a right brain stroke.

Left-side paralysis

Many people experience paralysis after stroke. One side of your face may droop, or you may have weakness in an arm or leg. But did you know that the hemispheres of the brain actually control movement on the opposite side of the body? So when a right brain stroke causes paralysis, the paralysis is on the body’s left side.

Spatial skills

For most people, the right side of the brain handles nonverbal, spatial skills. So a right brain stroke can cause you to misjudge the distance, size, speed and position of objects. This makes tasks such as picking up objects, fastening buttons or tying shoes hard to do. You may even have trouble noticing when something is upside down.

Other issues

A right brain stroke can affect your brain in other ways, too. You may find that you tend to ignore or forget people and things on the left side of your body. We call this “left side neglect.” You may have short-term memory problems. And some people experience a change in behavior. You may become more impulsive, and you may forget that you have some limitations.

Conclusion

No matter which side of your brain is affected, your doctor will create a care plan that is right for you. Recovering from stroke is hard, and it can take a long time. But If you follow the advice of your care team, you can make improvements and get back to the life you enjoy.

Left Brain Stroke

Overview

Your brain is divided into left and right halves,
called “hemispheres.” They specialize in different things. Because of this, a stroke on the left side of your brain can be very different from a stroke on the brain’s right side. Let’s look at some symptoms of a left brain stroke.

Right-side paralysis

Many people experience paralysis after stroke. One side of your face may droop, or you may have weakness in an arm or leg. But did you know that the hemispheres of the brain actually control movement on the opposite side of the body? So when a left brain stroke causes paralysis, the paralysis is on the body’s right side.

Speach and Language

For most people, the brain’s left hemisphere handles language and speech. So a left brain
stroke can cause a wide rage of speech and language problems. You may have trouble speaking, or trouble recalling words. You may be unable to speak. We call these speech problems “aphasia.”

Other issues

A right brain stroke can affect your brain in other ways, too. You may find that you tend to ignore or forget people and things on the left side of your body. We call this “left side neglect.” You may have short-term memory problems. And some people experience a change in behavior. You may become more impulsive, and you may forget that you have some limitations.

Conclusion

No matter which side of your brain is affected, your doctor will create a care plan that is right for you. Recovering from stroke is hard, and it can take a long time. But If you follow the advice of your care team, you can make improvements and get back to the life you enjoy

Migraine Headaches

Overview

A migraine is an intense, throbbing headache that may be accompanied by nausea or dizziness. A migraine can last from hours to days.

Causes

Much about migraines isn’t understood. Many researchers believe that a migraine can be caused
by a change in hormone levels in the brain. Migraines can be triggered by stress, bright lights and certain smells. They can also be caused by medications, and by getting too little or too much sleep. Certain foods may trigger migraines. These include alcohol, aged cheeses, chocolate, and foods containing aspartame or MSG (monosodium
glutamate).

Symptoms

A typical migraine results in moderate to severe pain. This pain is often felt on only one side of the head. The pain may interfere with a person’s activities. Symptoms may also include nausea and sensitivity to light and sound. Some people see sparkling flashes of light, spots, or dazzling lines before a migraine. These are called “visual auras.”

Treatment

Migraines may be treated with pain-relieving medications and with rest in a darkened room.
People who experience migraines regularly may also take medications such as beta blockers or antihistamines. These can reduce the frequency and severity of the headaches.

Tension Headache

Overview

This is a common type of headache that can be painful and frustrating for many people. It tends to start in the back of the head and then move forward to surround your head.

Causes

The exact cause of tension headaches is not fully understood. They were once believed to be caused by tense, contracted muscles in the neck and head. But research has shown they may be linked to a heightened sensitivity to pain and stress. This may stem from changes in brain chemicals called “neurotransmitters.”

Triggers

A tension headache can be triggered by stress, anxiety or fatigue. It can result from eye strain. It can be triggered by holding your head in one position for a long time. This can be a problem if you work with a computer all day, especially if your desk and chair are not set up comfortably for you. Medications can cause tension headaches. Alcohol
and drug use can, too. Some other triggers include overexertion, depression, arthritis, hormonal changes and certain foods.

Symptoms

The most common symptom of a tension headache is mild to moderate pain in your head. This pain is dull and aching. It can feel like a tight band surrounding your head. The muscles of your neck and shoulders may feel tense and tender. Your pain may last for a short time or for days. It may recur, and become a chronic problem.

Treatment

Treatment options depend on the cause and the severity of your headaches. You may benefit from medications. These can reduce your pain. They can reduce the frequency of your headaches. You may also benefit from relaxation techniques and a healthier lifestyle. Your healthcare provider can recommend a care plan that is right for your needs.

Traumatic Brain Injury (TBI)

Overview

This is an injury that damages your brain. It results in brain dysfunction. It can severely impact your life.

Causes

A TBI can result from a violent blow to your head. Such an impact can cause your brain to slam against your skull. This can tear tissues and blood vessels. It can cause bleeding in and around your brain. A traumatic brain injury can also be caused by anything that penetrates your head and enters your brain. And, it can be caused by a piece of skull
being broken off and pushed into your brain. Falls, motor vehicle accidents, sports injuries and assaults are common causes of TBI.

Symptoms

Symptoms depend on how severely your brain is damaged. You may temporarily lose consciousness. You may experience headache, confusion and vision problems. You may have a ringing in your ears. You may have slurred speech. You may have problems with coordination and movement. You may have problems with memory and thinking. You may have changes in your emotions. Your symptoms can be mild, moderate or severe.

Treatment

Treatment options may involve emergency care to prevent further damage to your brain. You may need surgical procedures to correct damage to your skull and soft tissues. You may be placed in a coma temporarily so these injuries can be treated. You may need medications to control fluid and prevent seizures. As you recover from a TBI, you may benefit from therapies to help you relearn skills and daily activities. Your healthcare provider can create a care plan that is right for your needs.

Seizure

Overview

This is a sudden burst of electrical activity in your brain. It overwhelms parts of your brain, usually for
no more than a few minutes. Most seizures don’t cause lasting harm.

Causes

Most commonly, seizures are caused by a brain disorder called “epilepsy.” If you have this disorder, you may have seizures frequently. But seizures can have other causes, too. They can be caused by a high fever, low blood sodium or lack of sleep. They can result from medications, and from alcohol or drug abuse. They can be caused by a head injury or a stroke. And, seizures can be triggered by a brain tumor.

Symptoms

Seizures cause a wide range of symptoms. Depending on the type of seizure, you may lose consciousness or awareness. You may make uncontrollable jerking movements. You may stare. You may have feelings of confusion, fear, anxiety or
déjà vu. And things may look, feel, taste or sound differently. Ask your doctor for a complete list of possible symptoms.

Treatment

Treatment depends on the type of seizure you’re experiencing. For some people, monitoring is all that’s needed. Or, medications may help. And some benefit from surgery. Your healthcare provider will create a care plan that’s right for you.

Stroke

Overview

This is a slow down or blockage of the blood thatnormally flows to part of your brain. When it happens, your brain cells don’t get the oxygen and nutrients they need. Within minutes, they begin to die.

How does it happen?

Why does it happen? Well, sometimes a stroke iscaused by a blood clot trapped in a blood vessel inor near your brain. A clot may form when vessels are narrowed by plaque buildup. Or, a clot can travel to your brain from another part of your body. But not all strokes are caused by blood clots. You can also have a stroke if a blood vessel begins to leak in your brain, or into the space around it.

Symptoms

A stroke can cause serious symptoms, and thesesymptoms can happen suddenly. You may have aheadache and nausea. Your vision may blur. One side of your face or body may become weak or numb. Part of your face may droop. You may not be able to lift one arm. You may be dizzy, and unable to walk. You may become confused, and have trouble speaking or understanding words.

Treatment

A stroke is a medical emergency. Anyone who ishaving a stroke needs to get medical care as fastas possible. Your doctor will create a care plan that’s right for you.

Aneurysm Clipping

Overview

This condition is a bulge that forms in the wall of a
weakened artery in the brain. This bulge can leak or
rupture, causing a stroke. An aneurysm can be
life-threatening.

How does it happen?

An aneurysm is typically caused by a thinning of the
arterial wall. This thinning can develop gradually
over time. Aneurysms often develop at the base of
arterial branches in the brain, because the arteries
are weakest at these points.

Symptoms

Aneurysms can cause a wide range of symptoms.
A small aneurysm that has not ruptured may not
cause noticeable symptoms. A large aneurysm that
has not ruptured may cause pain behind an eye. It
may impair vision, and may cause numbness or
weakness on one side of the face. When an
aneurysm ruptures, it often causes a sudden,
severe headache. This pain is frequently described
as the worst headache of the person’s life. A
ruptured aneurysm can also cause nausea,
stiffness of the neck, sensitivity to light, seizures,
confusion and loss of consciousness.

Treatment

Treatment options depend on the size and location
of the aneurysm and whether or not it has ruptured.
In many cases, an aneurysm can be treated with
surgical clipping or coil embolization. Other
treatment options include medications, pain
relievers, and the insertion of a drainage catheter or
shunt. Rehabilitative therapy may be required as a
part of recovery from a brain aneurysm.

These videos are for educational purposes only. The views and opinions expressed in the videos are those of the authors and do not necessarily reflect the views or position of Insight Institute of Neurosurgery & Neuroscience. Please contact your doctor’s office for questions.

Spine fellowship Training Program

The INSIGHT Spine Fellowship is a two-years combined training program that is recognized by American Association of Neurological Surgeons (AANS). Our fellowship provides a unique experience for training in a multidisciplinary spine care setting, with providers who specialize in Neurosurgical Spine Surgery, Orthopaedic Spine Surgery, and Interventional Spine Pain Management.

INSIGHT Spine fellowship program will provide an outstanding opportunity to learn and work in a private practice setting for common and complex disorders of the spine. It will bring forth an excellent opportunity to excel in spinal surgery, both technically and clinically. A primary goal of our fellowship is to graduate fellows with a highly refined clinical acumen and surgical skill set that will allow them to most effectively treat any type of spinal malady.

Meet Our Neurosurgery Team

Jawad Shah, M.D., FRCSC, FAANS, FACS

Neurosurgeon

Dr. Jawad Shah studied at McGill University in Montreal and the University of Manitoba prior to completing medical school at the University of Manitoba in Winnipeg, Canada. He completed subspecialty training in skull base neurosurgery at the University of Arkansas. His areas of specialty include brain stem surgery, vascular neurosurgery, brain tumors, complex spine, and neuromodulation. He currently practices at McLaren, Hurley, and Genesys hospitals.

He is involved in extensive research projects including clinical, patent work, biological/mechanical and electrical product development, industry-sponsoredstudies, and theoretical philosophy. He is a faculty member at the Michigan State University Medical School and the Co-Director of the Center for Cognition and Neuroethics, jointly administered by the University of Michigan and Insight.

Dali Yin, M.D., Ph.D.

Neurosurgeon

Dr. Dali Yin was an assistant professor in neurosurgery at the University of Illinois at Chicago and attending neurosurgeon at Mt. Sinai Hospital at Chicago before joining Insight. He earned his M.D. in China and Ph.D. in Japan.

He completed neurosurgery residency training in China. He also finished a spine surgery fellowship in neurosurgery at UIC and functional neurosurgery fellowship at UIC and University of Colorado in Denver. He focuses on functional neurosurgery, spine surgery, and general neurosurgery.

Idara J. Edem, MD, MSc, FRCSC

Neurosurgeon

Dr. Idara Edem is a Canadian-trained neurosurgeon, board-certified in Neurosurgery (2019), by the Royal College of Physicians and
Surgeons of Canada. During her residency, she also earned an MSc in Global Health and Global Surgery from King’s College London, UK while performing research in South Africa.

Dr. Edem is passionate about providing excellent patient-centered care to relieve suffering and prolong survival. Dr. Edem will have privileges in all hospitals in the city of Flint and the Insight Surgical Hospital in Warren, where she will be performing cranial, spinal and peripheral nerve neurosurgical procedures. She will serve as Director of Skull base and Neurosurgical Oncology at the Insight Institute of Neurosurgery and Neuroscience.

Expertise: General Neurosurgery, Skull Base Neurosurgery, Complex Spine, Primary and metastatic brain, spine and peripheral nerve tumors, Endoscopic endonasal approaches, Pituitary tumors and Radiosurgery

Dr. Cameron M McDougall

Neurosurgeon

Dr. Cameron M. McDougall is a neurosurgeon at Insight Institute of Neurosurgery and Neuroscience, specializing in general neurosurgery and vascular diseases of the brain, including stroke, brain aneurysms, and arteriovenous malformations.

Originally from rural Saskatchewan, Dr. McDougall graduated from the University of Saskatchewan Medical School and completed his residency in neurosurgery at the University of Alberta. During this time, he also participated in a one-year fellowship at the University of California San Francisco. Following his residency, Dr. McDougall completed a three-year combined open cerebrovascular and endovascular fellowship at the University of Texas Southwestern in Dallas. Prior to joining Insight, Dr. McDougall was an assistant professor of neurosurgery at the University of Texas Health Science Center in San Antonio.

When he is not working, Dr. McDougall enjoys running, hiking, and traveling to new places.

Dr. Ramiro A. Pérez de la Torre

Neurosurgeon

Dr. Ramiro A. Pérez de la Torre is a Neurosurgeon at INSIGHT’s Neurosurgery Center. With over 20 years of experience in neurosurgery, Dr. Pérez de la Torre brings a wealth of knowledge and experience to the team at Insight and is dedicated to providing compassionate, ethical human attention and care for each of his patients.

Graduating from Guadalajara University Medical School with honors in 1992, Dr. Pérez de la Torre continued his education with internships in Italy and Mexico before finishing his neurosurgery residency at XXI Century Medical Center in Mexico City and a stereotactic neurosurgery clinical fellowship in Harper Hospital, Detroit Medical Center from 1998 to 2001. He also completed a two-year spine fellowship at Providence Hospital in Southfield and recently received a PhD in leadership.

Prior to joining Insight, Dr. Pérez de la Torre served as attending neurosurgeon at XXI Century National Medical Center for 19 years, developing programs for movement disorders, brain tumors, and psychosurgery, as well as an advanced pain center. He was also a neurology professor at La Salle University and is active in the national and international neurosurgery community, where he has received numerous awards for his work in neuroscience.

Dr. Pérez de la Torre is excited to return to Michigan with his wife María Lilia and their children Pedro and Lilia Benedetta.

Dr. Roy Torcuator

Dr. Roy Torcuator is a neurosurgeon at Insight Institute of Neurosurgery and Neuroscience with interests in general neurosurgery, spine neurosurgery, and neuro-oncology.

He completed medical school at the University of the East-Ramon Magsaysay Memorial Medical Center and neurosurgery residency training at Jose R. Reyes Memorial Medical Center-St. Luke’s Medical Center in the Philippines. He subsequently completed a clinical fellowship in Neuro-Oncology at the Hermelin Brain Tumor Center- Henry Ford Hospital in Detroit, MI and an Image-guided Neurosurgery fellowship at the Brigham and Women’s Hospital-Harvard Medical School.

Dr. Torcuator was previously a senior staff attending neuro-oncologist at Henry Ford Hospital. He also headed the Comprehensive Brain Tumor Service at St. Luke’s Medical Center and was the Fellowship Director of the Neuro-Oncology Fellowship program and Training Officer for the Neurosurgery residency program in the same institution. He was also a clinical associate professor IV at the St. Luke’s Medical Center-William Quasha College of Medicine.

He likes to spend time with his family, watch movies and play table tennis during his free time.

Sudesh Ebenezer, M.D., Ed.M., FRCSC, FAANS

Neurosurgeon

Dr. Sudesh Ebenezer is an adult and pediatric neurosurgeon and the director of Pediatric Surgery at Insight. He also performs spine surgery and epilepsy surgery. Originally from British Columbia, Canada, he obtained his medical degree and neurosurgery training while in Canada. During his studies, Dr. Ebenezer obtained a Harvard University Scholarship, and went on to obtain a master’s degree from Harvard University. He wrote editorials for various Harvard University School newspapers, including the John F. Kennedy School of Government, and has been a guest lecturer at Harvard Medical School. He received a Congratulatory Certificate from the Government of Canada for his work at Harvard University.

He then completed his pediatric neurosurgery training at Seattle Children’s Hospital – University of Washington. Dr. Ebenezer also served as an Attending Physician at Seattle Children’s Hospital, and was voted to the Staff Honor Role. While in Washington State, Dr. Ebenezer received the Patient’s Choice Award three years in a row for being one of Washington’s Favorite Physicians. He also served as a consulting and treating neurosurgeon for active duty U.S. military stationed in Washington.

Dr. Ebenezer has been recognized by the U.S. Department of Homeland Security as having Extraordinary Ability in Science and Education. He now serves as an advisor for Harvard University’s Alumni Affairs & Development. He is a Fellow of the Royal College of Surgeons of Canada and the American Association of Neurological Surgeons. He is also an active member of the Congress of Neurological Surgeons.

Dr. Ebenezer is also committed to humanitarian medical service, and he has volunteered his time in various countries, from medical clinics in rural Peru to military hospitals in the Ukraine.

Allison Piatt, ACNP-BC

Nurse Practitioner

Allison Piatt, ACNP-BC, is a board-certified nurse practitioner with a specialty in acute care. She completed her nurse practitioner degree with honors from St. Louis University in St. Louis, Missouri, and her nursing degree at the University of Michigan in Flint.

Allison had six years of experience as a registered nurse taking care of step down and ICU surgical patients at area hospitals before pursuing a career as a nurse practitioner. She also worked in general surgery as a nurse practitioner prior to joining Insight in July 2014.

Monica Culver, AGACNP-BC

Nurse Practitioner

Monica Culver is board-certified as an adult-gerontology acute care nurse practitioner. She completed bachelor’s degrees in nursing and biology as well as a Doctor of Nursing Practice from the University of Michigan-Flint.  She was born, raised, and currently resides in the Flint area.

Her previous experience includes working as an ICU RN as well as an interventional pain management and interventional radiology nurse practitioner. She has volunteered abroad on medical missions to Kenya and Cambodia with plans to pursue such endeavors throughout her career.

Joe Danko, AGACNP-BC

Nurse Practitioner

Joe Danko, AGACNP-BC, is a board-certified nurse practitioner with a specialty in acute care gerontology. He finished his bachelor’s degree as a registered nurse at Oakland University in Rochester, Michigan. He went on to complete his master’s degree at Madonna University in Livonia, Michigan.

Joe worked in the medical ICU, pre-op, and recovery room at St. John Hospital in Detroit for 11 years before joining Insight in February 2016.

Julie Widzinski, NP

FNP-BC

Julie Widzinski, FNP-BC, is a board-certified nurse practitioner. She earned her first bachelor’s degree in Biology and Sports Medicine at Adrian College and then shortly after, received her bachelor’s degree in Nursing at the University of Detroit Mercy. She went on to complete her master’s degree at Chamberlain University in Chicago, Illinois, graduating with honors. 

Julie began her career in the emergency room and then moved to the neuro/medical intensive care unit at McLaren Flint. Julie worked for McLaren for 11 years before joining Insight Insitute in June of 2020. Julie sees patients in the Insight Pain Management Center, as well as Hurley Medical Center, Genesys Regional Medical Center, and McLaren Flint. 

Stephanie Olson

DNP, AG-ACNP-BC

Stephanie Olson, DNP, AG-ACNP-BC, is a board-certified nurse practitioner with a specialty in acute care. She completed her doctorate of adult gerontology acute care nurse practitioner degree from the University of Michigan-Flint with honors. Before obtaining her Doctor of Nursing Practice degree, she received an associate degree in nursing from Mid-Michigan Community College and completed her Bachelor of Science in Nursing degree with honors at Ferris State University.

As she completed her associate degree, Stephanie worked as a supplemental instructor for Mid-Michigan Community College, teaching anatomy, physiology, chemistry, biology, and microbiology. She began her career as a float nurse for one year and then moved to the neuro/trauma intensive care unit at Mid-Michigan Health-Midland for seven years while pursuing her BSN and DNP degrees. Stephanie then worked for Mid-Michigan Health-Midland for another eight years before joining Insight Institute of Neurosurgery and Neuroscience in February 2020.

Stephanie sees patients at Hurley Medical Center, McLaren Flint, and Genesys Regional Medical Center, where she also assists in surgery.

Dr. Kelly Hopper

AGACNP-BC

Dr. Kelly Hopper is a board-certified Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC) specializing in comprehensive healthcare for adults of all ages at Insight Institute of Neurosurgery and Neuroscience.

Dr. Hopper received a Doctor of Nursing Practice degree from Maryville University, a Master of Basic Medical Science degree from Wayne State University, a Bachelor of Science Nursing degree from the University of Michigan-Flint with honors, and a Bachelor of Science Degree from Eastern Michigan University with honors.

Prior to joining Insight in July 2019, Dr. Hopper was an NT/SICU nurse from 2012-2016 and an ER nurse from 2011-2019.

Outside of work, Dr. Hopper loves spending time with her close family, including her niece and two nephews. She also enjoys being with her 3 black labs, water and snow skiing, scuba diving, and traveling the world.

Kris Swanson

Chief Operating Officer

Kris Swanson earned his bachelor’s degree in business administration from Alma College in May 2001 and later earned his master’s in business administration from Central Michigan University in May 2002. Since then he has been a manager at INSIGHT since 2012 and has played a crucial role in developing INSIGHT Pain Management when it opened in 2012.

Nina Smith

Chief Experience Officer

Nina Smith is the Chief Experience Officer (CXO) at INSIGHT and is responsible for ensuring every experience between our team and our patients is positive. Nina is incredibly passionate about people and dedicated to going above and beyond to ensure the needs, wants, and desires of everyone associated with INSIGHT are met. From a young age, Nina has been taking care of people and her family and always loved knowing that one small gesture can make an impact in ways we never fully understand. Nina graduated with honors from the University of Michigan-Flint, earning a bachelor of arts degree in human biology. Outside of work, Nina enjoys spending time with her family, traveling to warm destinations and outdoor summer activities.

How can we help?

At INSIGHT Neurosurgery, our top priority is the health and wellbeing of our patients. If you have any questions, concerns, or would like to schedule an appointment, one of our team members would be more than happy to speak to you!