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Holly S. Gilmer, M.D.
Holly S. Gilmer, M.D.
Adult & Pediatric Neurosurgery
Peripheral Nerve Surgery

Approximately one in 1,000 people is affected by a group of brain abnormalities known as Chiari malformations. Named for Hans Chiari, the Austrian pathologist who first described them, Chiari malformations affect the brain in the place where the skull meets the spine. Brain tissue extends into the spinal canal because part of the skull is misshapen or undersized and presses the brain downward.

While it’s possible to have a Chiari malformation without knowing it, these abnormalities can cause symptoms that may affect a person’s quality of life. Understanding Chiari malformations, including potential symptoms and treatment options, can help you determine whether you might have one of these malformations.

Chiari Malformation Types and Symptoms

There are at least five types of Chiari malformations, but the most common types are Chiari I and Chiari II.  Chiari I may be congenital, or may develop over time as the brain and skull grow. The main symptom is headaches, but people may also experience:

  • Neck pain
  • Problems with balance and coordination
  • Dizziness
  • Numbness and tingling in the hands and feet
  • Trouble swallowing
  • Gagging and choking
  • Difficulty speaking clearly
  • Weakness
  • Curved spine (scoliosis)

Chiari malformation type II is congenital, meaning a person is born with it. People born with type II almost always have myelomeningocele, a type of spina bifida in which the backbone and the spinal canal don’t close properly before birth. Symptoms of type II include:

  • Difficulty breathing regularly
  • Gagging/trouble swallowing
  • Arm and leg weakness
  • Involuntary eye movements

Diagnosing Chiari Malformations  

Congenital types of Chiari malformation can often be diagnosed with an ultrasound of the unborn baby. For children and adults, the most reliable way to spot a suspected Chiari malformation is with an MRI of the brain.

Treating Chiari Malformations

Many people with Chiari malformations experience no symptoms and may not even realize they have one. Others may deal with mild or infrequent symptoms that don’t bother them or can be easily managed with over-the-counter medications like Tylenol.

For those with a Chiari malformation who’ve had symptoms for more than six months, occurring more often than not and interfering with their ability to function, surgery is an option.

Surgery to treat Chiari malformation is an inpatient procedure that requires a hospital stay of a few days. But many patients report feeling much less pain immediately after surgery and typical recovery takes about 3 – 6 weeks, but individual experiences vary.

When to See a Doctor

If you struggle with frequent headaches or other symptoms of Chiari malformation that are affecting your quality of life, consider reaching out to a specialist who can make a diagnosis. Together, you can discuss next steps, including whether you’re a good candidate for surgical treatment.

If you or a loved one is seeking treatment for Chiari malformation, or to schedule an appointment with Dr. Gilmer or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

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Although it’s relatively new, endovascular neurosurgery is being used to treat an increasing number of health problems — with remarkable results. Through research and collaboration, experts from a variety of fields are coming together to innovate a type of surgery that is helping some of the highest risk patients.

What is Endovascular Neurosurgery? 

Endovascular neurosurgery is a subspecialty of neurosurgery that combines multiple types of expertise. Incorporating both neurosurgery, which treats conditions of the brain and nervous system, and interventional radiology, which uses imaging and minimally invasive techniques to diagnose and treat injuries and health conditions, endovascular neurosurgery uses small catheters to diagnose and treat health problems affecting the brain and spinal cord.

What Conditions Endovascular Neurosurgery Treat?

Endovascular neurosurgery can be used to diagnose and treat a variety of injuries, diseases and health conditions including:

  • Strokes
  • Brain aneurysm
  • Cerebrovascular malformations including arteriovenous malformations (AVMs) and dural arteriovenous fistula (dAVF)
  • Carotid artery disease
  • Atherosclerosis (narrowing) of the vessels of the brain
  • Idiopathic intracranial hypertension (formerly pseudotumor cerebri)

This is merely a partial list of the many health concerns that can be addressed with endovascular neurosurgery — a list that will continue to grow as neurosurgeons, interventional radiologists, and interventional neurologists work together to advance the science surrounding these techniques.

What Are the Benefits of Endovascular Neurosurgery?

The blood vessels of the brain are deep within the brain itself, meaning they’re not readily accessible without open surgery. Because it involves the use of catheters to pass through blood vessels, endovascular neurosurgery is a minimally invasive technique that provides an alternative to more invasive options.

Rather than opening the skull to get into the brain, endovascular neurosurgeons often only need to make a tiny puncture to insert the catheters they use in surgery.

The minimally invasive nature of endovascular neurosurgery means that some patients who receive elective (non-emergency) types of this procedure can go home the same day.

Even in cases where recovery takes a little longer, patient outcomes are generally very good. Many people can go home within one day of surgery and are back at work within a week.

Another major benefit of endovascular neurosurgery is that it offers hope for people with diseases or conditions that would have been otherwise untreatable. These are patients who didn't have a different treatment option — or at least a good treatment option — and these endovascular techniques are allowing neurosurgeons to provide life-altering or even life-saving care for them.

Advancing Technology, Saving Lives 

Endovascular neurosurgery is an exciting field that allows surgeons to greatly improve outcomes for patients who were otherwise at the mercy of their disease.

Treatment options that weren’t available only a few decades ago are now saving people’s lives — and will continue to do so as the field grows and expands through continued collaborative research and innovation.

If you or a loved one is seeking treatment for a condition of the spine, or to schedule an appointment with any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

 


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Approximately 50 million people in the United States — one in five adults — report struggling with pain on most days or every day. This type of chronic pain can interfere with every aspect of life, making even the simplest of tasks unmanageable.

Fortunately, recent advances in technology have resulted in a new tool for treating chronic pain called neuromodulation. Understanding this treatment, including what it involves and how it works, may help you decide if neuromodulation is right for you.

What is Neuromodulation?

Neuromodulation refers to altering or modulating the function of the nervous system using targeted electrical stimulation or drug delivery. This can be accomplished using non-invasive devices such as transcutaneous electrical nerve stimulation (TENS) units or implantable devices such as spinal cord and deep brain stimulators.

The nervous system can be targeted anywhere along its course, including the brain, spinal cord or peripheral nerves.

How Does Neuromodulation Help With Chronic Pain?

In simple terms, Neuromodulation alters or blocks pain signals as they travel to the brain. Depending on a patient’s pain pattern, the device can be placed at different locations in the spine or on certain nerves to block pain.

Chronic pain can be described as aching, sharp, stabbing or burning sensations. Neuromodulation devices override these sensations, instead providing a soothing or gentle tingling feeling in painful areas.

Can My Pain Be Treated With Neuromodulation?

Ideal candidates for neuromodulation for pain are those with chronic (not acute) pain, usually defined as pain lasting more than 3 months. This is typically pain that affects the neck, back or extremities, although there are options for facial pain and other pain patterns as well.

These patients have usually tried different medications or injections and continue to experience pain. Many have had back or neck surgery and continue to have pain, and others don’t qualify for surgery or don’t want to have additional or more invasive surgery.

What Happens During the Procedure?

For spinal cord stimulation, patients require a “trial” before the permanent device is implanted to ensure that the therapy is effective and worthwhile. A trial of spinal cord stimulation typically involves placing thin electrodes through two needles into the back, similar to an epidural injection. These are threaded to the appropriate region that matches the patient’s pain pattern.

These electrodes are then connected to an external device and patient’s “trial” the therapy at home for about a week. If the trial is successful, meaning pain severity is reduced by at least 50%, the temporary electrodes are removed in office and the permanent implant is planned.

This next step involves placement of the same electrodes in the same location, although now they are anchored into the back and connected to a small battery which is also implanted into the back or buttocks through two small incisions in the back. For some patients, a small laminotomy (opening in the spinal vertebra) is necessary to place the electrode.

Deciding which devices are used and where they are implanted requires an individualized approach based on each patient’s unique needs and anatomy.

What Does Recovery Look Like?

These are almost universally outpatient surgeries, and patients tend to experience some slight post-operative discomfort which resolves after a few days.

Patients should limit twisting, bending and lifting more than 5-10 pounds for the first two weeks after implantation to allow for healing, and for the electrodes to scar or “set” into place.

Once patients are seen at their first post-operative visit, we typically discuss a gradual return to activity and lifting of restrictions. Patients also have their devices programmed at that time, during which we map their pain distributions with the stimulation.

Are There Risks Associated With Neuromodulation?

Infection is the most common complication, particularly with implantable devices; on average this risk is 2% for any infection. Important risk factors that can contribute to infection are diabetes, smoking and obesity.

The risk of a spinal fluid or cerebrospinal fluid (CSF) leak is approximately 1%. The risk of a devastating complication such as spinal cord injury is very rare, occurring in much less than 1% of cases.

Although almost all neuromodulation devices currently manufactured and implanted are MRI-compatible, certain precautions must be taken in terms of what type of MRI machine can be used.

Who Else Can Benefit From Neuromodulation?

In addition to chronic pain, neuromodulation devices are often used for movement disorders such as tremors, Parkinson’s disease and dystonia. Additional conditions that can be treated with neuromodulation include obstructive sleep apnea and urinary incontinence.

Neuromodulation also has a long history of use for psychiatric disorders, including obsessive compulsive disorder and depression.

Pain Relief is Possible

Patients with complex regional pain syndrome tend to do very well with spinal cord stimulation, and my last patient was a young woman who went from being unable to walk on her own feet to regaining full strength and having greater than 90% pain relief.

For deep brain stimulation, it’s very gratifying to test the stimulator in the operating room with the patient awake—one of my more recent patients started crying when she realized that her tremor was completely gone for the first time in decades.

If you or a loved one are dealing with chronic pain and feel like you’ve tried everything, talk to a healthcare provider about neuromodulation. You may be only one outpatient procedure away from finally finding relief.


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Migraines affect more than 10 percent of the world’s population, and migraine disease is considered to be one of the main causes of disability worldwide.

One study of people with migraine disease in the United States found that over half were unable to engage in day-to-day activities, including work or school, because of migraines.

Women are hit especially hard by migraines; migraine disease is 3 times more common in women than men, affecting around 1 in 5 American women.

Understanding migraines including how they're different from other headaches and what can trigger them and why the triggers might change may help you manage them better.

Symptoms, Phases Set Migraines Apart

Migraine is produced by chemical activity in the brain, nerves and blood vessels surrounding the skull and muscles of the head and neck.

Migraine is different from other headaches because it comes as a cluster of symptoms, and usually occurs with the same triggers and symptoms every time, though triggers can change over time, especially with hormonal changes.

Classic migraine is also unique in that it typically occurs in four phases.

During prodrome (pre-migraine) phase, you might experience:

  • Sensitivity to light, sound and smells
  • Mood changes
  • Pain and/or stiffness in the neck
  • Yawning
  • Food cravings
  • Constipation
  • Diarrhea

Aura phase, which doesn’t happen for everyone, is usually characterized by visual and sensory changes such as:

  • Seeing flashing lights and/or zigzag lines
  • Blurred vision
  • Tingling
  • Numbness
  • Slurred speech
  • Difficulty thinking or writing clearly

Headache phase is characterized by:

  • Intense pain on one or both sides of the head

Postdrome phase is the post headache phase when symptoms generally include:

  • Exhaustion
  • Confusion
  • Feeling unwell

Although not everyone with migraine disease goes through all four phases, the symptoms and phases an individual experiences tend to be the same every time. Recognizing this pattern helps people know they’re having a migraine.

Common Migraine Triggers

While not all migraines are triggered, some people find that certain factors tend to kick off a migraine for them. Common migraine triggers include:

  • Stress
  • Sleep disturbances, including a change in sleeping patterns such as sleeping late on the weekends
  • Hormone changes
  • Foods that contain a compound called tyramine (including fermented foods, certain aged cheeses, red wine, smoked foods and cured meats)
  • Changes in weather/humidity fluctuations
  • Dehydration
  • Altitude changes
  • Strong smells such as perfume
  • Medications

Another surprising (and surprisingly common) migraine trigger? Chewing gum. Up to 50 percent of people with migraine disease also have temporomandibular joint (TMJ) disorders, conditions affecting the jaw joints and surrounding muscles and ligaments that can be aggravated by gum chewing.

It’s a good idea to pay attention to your personal triggers; if you’re able to identify and avoid them when possible, you may be able to lessen the number of migraines you experience.

Why Triggers May Change Over Time

Some people — especially women — may find that their migraine triggers change as they get older, or that they experience fewer or more migraines at certain times (such as during pregnancy or menopause). This is because hormone levels fluctuate throughout a woman’s life, and hormone changes can trigger a migraine.

Other things that might cause triggers to vary over time include nutrient deficiency (such as low vitamin D levels) and thyroid problems. But you shouldn’t assume that these things are triggering your migraines without talking to a healthcare provider.

When to See a Doctor

If you notice a change in the pattern of your headaches — particularly if they become more frequent and you have them more than three times per week — it’s a good idea to talk to your doctor about an evaluation.

More concerning are headaches that occur during physical activity such as exercise or bending over, or if a headache is severe enough to wake you from sleep. If you’re awoken by a headache or suddenly develop a headache more painful than any you’ve had before, it’s an emergency and you should seek care immediately.

Other headache symptoms that necessitate emergency treatment:

  • Neck stiffness with fever and/or rash
  • Shortness of breath
  • Dizziness
  • Neurological symptoms such as loss of balance, slurred speech or paralysis on one side of your body
  • Nausea and vomiting (if severe and you’ve never had it with a headache before)

In general, it’s better to be safe than sorry when it comes to headaches, so don’t hesitate to reach out to your doctor if you’re concerned.

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

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Dr. John Steele
John J. Steele, M.D., Ph.D.
Neurosurgeon

Knowing the signs and symptoms of a stroke, and what to do when you spot them, may save someone’s life. The acronym, BEFAST, can help.

Catching Stroke Quickly Increases Chances of Survival

In the last three decades, medicine has made huge strides in stroke management — but the window of treatment is very narrow.

A stroke can get very bad, very quickly, meaning you have a limited amount of time to respond if you hope to have a good outcome.

In most cases, stroke can be treated with either medical or surgical therapy. But stroke remains the fifth leading cause of death and the number one cause of loss of independence, which is why it’s so important that people know the signs and act quickly.

Because of this, experts created the acronym BEFAST to help people remember and recognize the most common stroke symptoms.

  • Balance problems, dizziness, and/or loss of coordination
  • Eye trouble, including blurred vision and difficulty seeing out of one or both eyes
  • Facial drooping or numbness on one side of the face
  • Arm weakness or numbness on one side
  • Speech difficulty, including stuttering and/or slurred speech
  • Time to call 911 if a person shows any of these symptoms, even if they go away

Even with an acronym to remind you of stroke symptoms, you might not recognize the signs right away. It may be helpful to focus on the physical signs; if someone is unable to speak, has a facial droop or can’t move one side of their body, or if their hand flops down when you raise it, there’s a good chance that person is having a stroke.

The Importance of Comprehensive Stroke Treatment

Once you’ve identified signs of a stroke using BEFAST, it’s time to get help.

When you call 911, request that the person be taken to a comprehensive stroke center to ensure the most accurate diagnosis and best possible treatment.

The most crucial step when it comes to diagnosing a stroke is getting an image of the brain with a CT or CAT scan to determine the cause and type of stroke. Ideally, imaging will be followed by a more comprehensive evaluation using the stroke scale developed by the National Institutes of Health (NIH). This 42-point evaluation goes far beyond BEFAST, allowing healthcare providers to learn details about a stroke that help them determine how best to treat it.

Managing Expectations About Stroke Treatment and Recovery

How effectively a stroke can be treated, and how well a person recovers, depend largely on how early the stroke is diagnosed; the earlier the stroke is detected, the better the outcome is likely to be. When blood flow to the brain is blocked, which is what happens during a stroke, there’s going to be a certain amount of damage even after normal blood flow is restored.

This means stroke patients who have been successfully treated can still experience effects such as weakness on one side of the body or problems with speech, but often will recover to the point of independence. Recovery from a stroke usually takes between three and six months, but is highly dependent on the extent of the stroke.

Even better than catching a stroke early is not having one at all. Preventive measures such as maintaining a healthy weight and keeping blood pressure and cholesterol in check can go a long way in keeping your heart healthy and reducing your risk of stroke.

 

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with Dr. Steele or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

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Dr. Fredrick Junn
Fredrick S. Junn, M.D.
Neurosurgeon

While most people have heard of Parkinson’s disease, which affects nearly 1 million people in the United States, fewer of us are aware of its symptoms, risk factors and treatment.

Knowing about Parkinson’s Disease, including early signs to watch for, can help you and your loved ones catch the disease earlier, understand its signs, and learn how to manage it.

What Is Parkinson’s Disease?

Parkinson’s disease is a disorder of the central nervous system that affects movement, specifically how your brain communications with the rest of your body to create and execute movement.

With Parkinson’s disease, damage to nerve cells in the brain lead to reduced levels of dopamine, which plays a role in movement. When dopamine decreases, the brain and the body can’t communicate properly, leading to symptoms of Parkinson’s disease.

Parkinson’s disease is a progressive neurological condition, meaning it starts slowly and gets worse over time. It typically starts in one portion of the body, such as the arm or leg, and eventually crosses over to affect the other side of the body as well. Early- to mid-stage symptoms of Parkinson’s disease include:

  • Tremors/shaking in fingers, thumb, hand or chin
  • Stiffness
  • Constipation
  • Trouble sleeping
  • Smaller handwriting (micrographia)
  • Speaking in a lower or softer voice (hypophonia)
  • Dizziness
  • Slowed movement (bradykinesia)
  • Loss of smell
  • Stooped posture

Very recently, new research has identified two more early signs of Parkinson’s disease: hearing loss and epilepsy.

Since many of these symptoms could be caused by other health conditions, it’s important to talk with your healthcare provider to potentially rule out Parkinson’s disease if you’re experiencing them.

As Parkinson’s disease progresses, so do the symptoms. Some that may show up later in the course of the disease include:

  • Tremors and stiffness on both sides of the body
  • Walking problems
  • Loss of balance
  • Shuffling gait
  • Markedly stooped posture

Parkinson’s disease can also affect a person’s mental health, and is linked to conditions such as depression, anxiety and dementia.

Risk Factors for Parkinson’s Disease

Although scientists haven’t been able to pinpoint what causes Parkinson’s disease, they have identified some risk factors. These include:

  • Genetics
    When people develop Parkinson’s disease at a young age (in their 20s or 30s), the cause is often genetic.
  • Advanced age
    The average age of onset for Parkinson’s disease is around 60 years old.
  • Gender
    Parkinson’s disease is more common in men than women.
  • Environmental triggers
    Exposure to pesticides/herbicides, heavy metals and other toxic chemicals has been shown to increase the risk for developing Parkinson’s disease. A street drug called “synthetic heroin” is also associated with Parkinson’s disease.

Treatments and Management for Parkinson’s Disease

There is no cure for Parkinson’s disease, but it can be managed and even slowed, depending how early the disease is diagnosed. Treating Parkinson’s disease typically involves increasing the amount of dopamine in the brain. This can be done with medications, including some types of antidepressants; newer anti-Parkinsonian medications are designed to provide a steady level of dopamine so patients don’t experience the crash associated with earlier treatments.

In addition to medication, deep brain stimulation (DBS) can be helpful for managing Parkinson’s disease symptoms. DBS is a surgical procedure where electrodes are implanted that deliver tiny electrical impulses to the parts of the brain that control movement. A major advantage of DBS is that it levels off dopamine levels without the side effects associated with some Parkinson’s disease medications.

Keeping the body healthy and moving are also key to controlling Parkinson’s disease symptoms, and many people find physical therapy to be helpful for maintaining movement.

If you think you may be experiencing Parkinson’s disease symptoms, or if you have a family history of the disease, you may want to ask your healthcare provider for a neurological referral. A neurologist can provide a diagnosis and start you down the path of managing your Parkinson’s disease.

 

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with Dr. Junn or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

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Dr. John Whapham
John Whapham, M.D., MS, FSNIS, FAAN
Neurosurgeon

Surgery has always been an option for certain types of intracranial cerebral aneurysms, but in recent years, minimally invasive procedures have greatly reduced both physical trauma as well as recovery times.

Cerebral aneurysms occur when part of a blood vessel wall weakens, allowing it to bulge, widen and potentially burst or rupture, which can be life-threatening.

Aneurysms can exist for years without detection. Because of this, there are often no symptoms until an aneurysm ruptures. Once that happens, symptoms may develop suddenly and violently, depending on the location of the aneurysm.

Usually, symptoms come on quickly and are unlike anything you might have experienced before. If you don’t often get headaches but suddenly experience an intense migraine, a ruptured brain aneurysm could be the culprit.

Call 911 and seek immediate medical attention if you or someone you know is having aneurysm signs and symptoms including:

  • Severe headache
  • worst headache of life
  • Stiffness or swelling in the neck
  • loss of consciousness
  • speech difficulty
  • focal motor or sensory symptoms weakness or numbness
  • Dizziness
  • Vision changes
  • Confusion
  • Hoarseness
  • Difficulty swallowing
  • Nausea and vomiting
  • Shock (low blood pressure, rapid heart rate, clammy skin, decreased awareness)

Sometimes an unruptured aneurysm is found when performing unrelated diagnostic testing such as MRIs or CAT scans.

Minimally Invasive Aneurysm Surgery Saves Lives

Aneurysm treatment has greatly improved in the last 25 to 30 years. In the past, major surgery, such as open craniotomy, was commonplace. In this procedure, a small metal clip is placed across the base of the aneurysm bulge that seals off blood flow to the ballooned blood vessel.

However, modern advances have made this major procedure less common.

These days, minimally invasive procedures such as coiling and stenting are the norm. Both divert the flow of blood away from the aneurysm making it less likely to rupture and are performed without opening the skull.

  • Coiling, also called endovascular embolization, uses a catheter passed through the groin up into the artery containing the aneurysm where tiny platinum coils are released. The coils induce clotting of the aneurysm and that clotting prevents blood from entering the aneurysm.
  • Stenting is when a catheter is used to place a stent (a soft, flexible mesh tube) into the blood vessel where an aneurysm has formed. The stent prevents blood from entering the aneurysm. In time, new cells grow on the stent, sealing the aneurysm and healing the vessel.

These minimally invasive procedures allow for a much shorter recovery period, and it is possible to return to daily living as early as one day after hospital discharge.

In fact, some patients with an unruptured aneurysm check in at the hospital, undergo a procedure that is finished in a couple of hours, stay overnight for observation and are discharged the next morning with only a small bandage covering the spot in the groin or wrist where the needle access was made.

Quick Treatment Is Key

It’s crucial to contact first responders at the first sign of an intense, sudden headache since that may indicate a ruptured aneurysm.

If you are diagnosed with an unruptured aneurysm, call us right away to make an appointment.

Depending on the aneurysm’s size and location, you may require regular checkups from a physician trained in aneurysm treatment and surgery. A treatment plan, including lowering your blood pressure, quitting smoking and medical intervention, can help you reduce the risk of rupture.

 

If you or a loved one is seeking treatment for a condition of the brain, or to schedule an appointment with Dr. Whapham or any of our MHSI experts, visit www.mhsi.com/appointments or call 248-784-3667.

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Dr. Richard D. Fessler
Richard D. Fessler , M.D. Neurosurgeon

In 2013 Dr. Richard Fessler predicted the use of telehealth would become the norm as technology was in place to create visits for patients via a smart phone. Fast forward to 2020, Dr. Fessler saw his prediction become reality. The pandemic of a lifetime gave the entire healthcare industry a push into telehealth. Insurance companies expanded coverage for this type of visit with a push from Center for Medicare Service or CMS to cover costs.

“At MHSI we were ready to offer our patients this option when COVID caused concerns about safety for our patients and staff.  With the insurance barrier removed, it brought reassurance we could deliver the telehealth option and patients didn’t have to be concerned about unnecessary out-of-pocket-costs,” said Dr. Fessler. “We are thankful that our patients accepted the technology and the new way we are able to provide care.”

For example, when Tony couldn’t take his back pain any longer, he met with Neurosurgeon Dr. Ratnesh Mehra virtually and had trust that his surgical experience would be equally the same and relieve his back pain. Dr. Mehra recalls the day they met online, “Tony was able to effectively communicate with me about his pain and what he was feeling. At that point we decided that surgery for Tony was the right course of treatment and I met Tony in pre-op in person for the first time.” Tony says, “One week after surgery I was walking…dancing.”

 

Watch how intense pain stopped Tony in his tracks!:

 

To schedule a telehealth appointment with an MHSI neurosurgeon, call 248-784-3667 or visit MHSI.us.

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Every year neurosurgeons advance the procedures performed to treat brain and spine conditions. Just a few short years ago minimally invasive surgery of any type was unheard of. Yet today, an incision of less than 2 inches allows a neurosurgeon to fix or replace a disc in the neck or spine.

Minimally invasive nasal endoscopy is yet another advancement to treat tumors of the brain. This approach allows the neurosurgeon to access the brain to remove a tumor without performing a craniotomy, which makes a “window” in the bone to allow access to the brain.

Dr. Jeffrey T. Jacob
Jeffrey T. Jacob, M.D. Neurosurgeon

Deciding between a craniotomy or using the nasal cavity to reach the brain, depends on what is best for the patient. “The goal is to be able to reach the tumor and remove all of it,” says Jeffrey Jacob, M.D. “Often, we are able to do that going through the nose with an endoscope, with a very small camera device.”

There are many types of brain tumors that can be treated with this approach. Brain tumors that are removed using the nasal endoscopic approach can be benign or malignant, and typically sit at the base of the skull or under the brain. This procedure removes the tumor and the blood supply to the tumor.

To perform a nasal endoscopy, Dr. Jacob partners with Adam Folbe, M.D., a rhinologist and endoscopic skull base surgeon at Michigan Sinus and Skull Base Center. Dr. Folbe goes through the nose and opens the window to the brain. He says, “There is no cutting of skin, muscle or fat resulting in no scars. Using this approach maximizes retrieval of the tumor with lesser disruption to the brain compared to the craniotomy approach.”

Patients who experience this approach have no signs of surgery on the outside of their body, because the nasal cavity is repaired with the patient’s own tissue, without stitches or sutures. During the post-surgical healing, patients are restricted from sneezing, blowing their nose, lifting and bending over for about three weeks.

Like any surgery, there can be side effects, like in Valerie’s case. Because of the location of her tumor, she lost her ability to smell. For Stephen, he experienced added restrictions as he waited for his vision to return to normal once the tumor was removed. Kevin didn’t experience difficulties after his surgery, but he did work hard to regain his strength and balance.

If you or a loved one is diagnosed with a brain tumor, consider all of your options and seek a second opinion. Like Valerie, you might find an option you didn’t expect.

 

Watch Stephen’s brain tumor story below:

Watch how a large pituitary tumor interrupted Kevin’s life:

Watch Valerie’s full story below:

 

To schedule an appointment with Dr. Jacob or any of the neurosurgeons at MHSI, call 248-784-3667 or visit MHSI.us