“A Chiari malformation results when a patient has too little room for their cerebellum in the back part of the skull. The cerebellar tonsils get forced down into the spinal canal. The result can be a syrinx or fluid filled cavity within the spinal cord that can cause pain, weakness and numbness. The Chiari malformation…
“Taking a call at a Level 1 trauma center is stressful and takes time away from family and a neurosurgeon’s precious free time. I was reminded recently why I still feel passionate about taking a Level 1 trauma call when I met this simply miraculous 89-year-old woman. She was involved in a motor vehicle collision…
Surgery for cancer that has spread to the spine is extensive and recovery can be long. It is always appropriate to carefully consider all options including surgery and other treatments because many patients with metastatic spine cancer have a limited lifespan. The most important reason to do surgery is that some patients will beat the…
Here is a recent case that shows why spinal fusion is often needed along with laminectomy (decompression) surgery. It also illustrates the importance of having a thorough evaluation done by your doctor. What makes a thorough evaluation is having a complete history and proper X-rays. Image 1: This patient had spinal stenosis at L4-5 on…
Here is an example of another cervical spine case: MRI and CT scans show a 54 year-old male who had a cervical fracture dislocation at C5-6 after diving forward into shallow water and striking his head. He was fortunate not to be paralyzed. The patient also had chronic conditions in his cervical spine that put…
Cervical refers to the neck while myelopathy is a disorder of the spinal cord. Thus, cervical myelopathy is a spinal cord compression in the neck. Myelopathy can cause the following symptoms: Neck pain or stiffness, tingling, weakness, or numbness in arms, fingers, hands, Balance issues that could affect walking, and trouble with fine motor skills…
Here is a picture from another recent case of trigeminal neuralgia cured with microsurgical intervention. The patient is a 60-year-old female who had severe, debilitating pain along her left jaw that would not respond to medication or other treatments. The picture shows a nice intraoperative view of the Fourth (blue arrow) cranial nerve and Fifth…
Lumbar microdiscectomy surgery for a left L4-5 herniated disc in a patient with severe left leg pain and ankle weakness. ⠀ ⠀ The First picture shows the swollen, compressed L5 nerve root before discectomy (arrow). ⠀ ⠀ The Second picture shows the herniated disc material during removal from below the L5 nerve root. ⠀ ⠀…
Brain metastasis is a growth that appears in the brain from cancer that originates elsewhere in the body. A brain metastasis is not the same thing as a primary brain tumor because those begin in the brain. While any cancer can spread to the brain, the most common cancers that cause metastases are lung, breast,…
Sometimes the very best technology that we have is not the newest. Awake craniotomies have been performed safely for decades and maybe even centuries (if you count trephinations). Awake craniotomy is a simple and elegant procedure that has become even better with modern pharmacology. The core principles of the procedure have remained the same since…