MDNews - Central New York

+ Fluorescein-g uided neurosurger y — Using a g reen-water soluble dye know n a s sodium f luorescein, neurosurgeons ca n more a ccu rately i nvestigate a t u mor site. The dye accumu lates on a rea s of the bra in where the blood-bra in ba rrier ha s been da ma ged, high lighting the tumor tissue more clea rly. "In some patients, we do not think that we ca n see ever y single cell with our eyes or a n MR I machine," Dr. Babu says. " W hen we inject the dye a s pa r t of surger y, the tumor cells w i l l lig ht up dif ferent ly compa red to t he nor ma l bra in. That helps us remove those tumors a nd keep the norma l pa r ts of the bra in in intact." + Focused radiation Ga mma K nife — This computerized treatment planning software helps neurosurgeons precisely locate ta rgets in the bra in a nd deliver concentrated doses of radiation to the a ffected a rea . A s a result, surrounding tissue is spa red. Ga mma Knife radiation may be used to treat a va riet y of neurolog ic conditions, including benig n brain tumors, such as meningiomas and pituitary adenomas, ma lig na nt bra in tumors, such a s prima r y bra in tumors a nd metastatic tumors, blood vessel defects, such as a r te- riovenous ma lformations, a nd functiona l complications like trigemina l neura lgia. The region's only Ga mma Knife is considered to be patient f r iend ly a s it is a one-ti me outpatient procedure. + Awake craniotomy — Using specialized anesthesiology tech- niques, neurosurgeons are able to operate while a patient is still awake. Neurosurgeons may ask a patient who is undergoing an awake craniotomy to perform an action, such as playing the violin or singing, during the surgery. "We do this to make sure that the function of the brain is preserved, and we are not cutting into important brain tissue," Dr. Krishnamurthy says. Expert Neuro- Oncologic Care UP STATE UNI V ER SIT Y HOSPITA L is pleased to welcome Ruham Alshiekh Nasany, MD. A graduate of Upstate's residency program, Dr. Nasany serves as Assistant Professor of Neurology, Director of the Brain Tumor and Neuro-Oncology program at the Upstate Cancer Center. "Dr. Nasany completed her neuro-oncology fel- lowship at Memorial Sloan Kettering Cancer Center in New York City, which is a major cancer institute in the world," says Luis Mejico, MD, Professor and Chair of the Department of Neurology at SUNY Upstate Medical University. "She has special train- ing in neuro-oncology, which allows us to develop a program that will inspire new protocols." Expert Epilepsy Care A LEVEL 4 comprehensive epilepsy center, Upstate University Hospital is equipped with the technology and expertise to deliver effective epilepsy care. The epilepsy program has expanded during recent years, increasing the monitoring unit in the hospital. If surgery is needed, fellowship-trained neurosurgeons can perform a range of procedures, includ- ing Robotic Stereotactic Assistance (ROSA) for localization and treatment of the epileptic foci using minimally invasive surgical methods. + Minimally invasive robotic surgery — Operating through small incisions, can avoid some complications associated with surgery that requires a larger opening. Using stereotactic laser ablation, the neurosurgery team can address multiple neurological condi- tions, including epileptic foci and tumors. + Endoscope — "Using an endoscope, we are able to investigate the nooks and crannies of the brain in a manner that does not disturb surrounding tissue," Dr. Babu says. "We can use endoscopes through the nose to reach the brain for surgeries. Then we can use pointed lasers to burn tumors. We also have computerized microscopic navigation techniques, which are like a GPS for the brain that allows you to target a specific pinpointed area." Robert Beach, MD, monitoring patient Amyee Rodriguez of Gouverneur, New York 0 8

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