Issue link: https://viewer.e-digitaledition.com/i/1129198
Today, White Plains Hospital offers a full spectrum of sophisticated procedures to effectively address complex bra in tumors and debilitating neurologica l conditions, such as epilepsy, Parkinson's disease and trigeminal neuralgia. SPECIALIZED SKILL AND TECHNOLOGY Dr. Das, Vice President of Brain and Spine Surgeons of New York, highlights the ben- efits of obtaining advanced care locally. "I've been living in this community since high school, and I get it," he says. "When someone in your family is ill, you want the best for them, but all else being equal, it's much easier for them to be close to home. Most patients want to stay in Westchester. They don't want to go to the city to get the care they need." The investment in building a premier cranial neurosurgery program to meet that local need has taken many forms, he points out. In addition to the newly incorporated Varian Edge radiosurgery system, which delivers precisely targeted, high-dose radiation to brain tumors with minimal damage to surrounding tissue, the hospital has acquired more operating room microscopes, an updated stealth image guidance system for biopsies and navigated brain surgery, and increased EEG monitoring for epilepsy patients. Dr. Das, a general neurosurgeon and spine specialist who also treats primary and metastatic brain tumors, has developed a monthly neuro-oncology conference in coordination with the hospital's cancer center as well. "The administration is definitely com- mitted," he says. "Since I've been here and we've handled increasingly complex cases, we've had numerous discussions about what we need to take the service to the next level, whether it's equipment or support. As one example, we now have seven-day-a- week coverage from physician assistants to help attending physicians focus on the most complicated cases." T he phy sicia n s t a f f ha s g row n t o include 17 neurosurgeons, w ith eight providing on-ca ll ser vices a round the clock . T he ICU fa ci l it ies h ave been upg raded, a nd cli n icia ns t here have u nder gone s p e c i a l i z e d t r a i n i n g t o ha ndle complex cases. These i nvest ment s helped lay t he foundation for a world-cla ss cra nia l neurosurger y progra m at W hite Pla ins Hospita l, ref lecting a commitment to patients a nd the disting uished neuro- surgeons who treat them. ADVANCED TUMOR TREATMENTS In the course of his three fellowships — at Mayo Clinic, Emory University a nd t he Un iver sit y of N e w S o u t h Wa l e s — Dr. Agarwa l has helped pioneer several advances in open skull base surgery. He later built Montefiore's skull base program and ha s now ex pa nded the range of tumors surgica lly treated at White Plains Hospital to include acous- tic schwannomas, pituitary adenomas and skull base tumors. Dr. Agarwal uses minimally invasive approaches, working through the nose and sinuses, whenever possible. For the treatment of cerebrospi- nal fluid (CSF) leaks and encephaloceles, as well as pituitary tumors, he works together with an ear, nose and throat (ENT) surgeon. Like his colleag ues, Dr. Agarwa l uses minima lly invasive techniques to reduce morbidity and speed recovery. Some of his techniques are rare at even the most elite medical facilities. "There are some things we've done that nobody else in the state and few neuro- surgeons in the country are doing," he says. "For instance, we perform eyebrow craniotomies, using a small, nearly invis- ible incision along the eyebrow to reach deep-seated brain tumors. Our patients have had excellent outcomes and rapid recovery with this technique." W hile treatment for bra in tumors is determined on a case-by-case basis, Dr. Agarwal says symptomatic tumors causing seizures, visual impairment or other neurologica l symptoms require treatment. Surgical treatment for large tumors or tumors that are close to a critical part of the brain comes with greater risk to memory, speech or other neurological function, making the surgeon's experience level critical. Dr. Eskandar recruited his esteemed colleague, Dr. Agarwal, to join him at White Plains Hospital to further develop the neurosurgical program. Vijay Agarwal, MD, Assistant Professor of Neurosurgery and of Otorhinolaryngology at Albert Einstein College of Medicine and Director of the Skull-Base Tumor Center at Montefiore, consults with a patient at White Plains Hospital Center for Cancer Care. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 019 0 7