MDNews - Long Island

CONSERVATIVE MANAGEMENT IN APPROPRIATE CASES After taking careful imaging of an AVM or GA, assessing it clinically and consulting with the patient, NSPC physicians may determine that the risks of a procedure outweigh the benefits, or that management of potential complications down the road should govern the approach to a particular case. In fact, as the field has advanced, NSPC physicians are now in a better place to assess each lesion with a keen eye to whether intervention will lead to better results than the natural outcomes of the defect, Dr. Brisman explains. "Our understanding of how best to treat rare cerebrovascular conditions has evolved," he says. "We've learned that some rare diseases are highly dangerous, while some are more benign than we thought. The question is whether we are performing better than the natural history. As a result, while some problems obviously mandate surgical procedures, we've often been treating certain lesions more conservatively." For this reason, NSPC specia lists created the surveillance program known as CUBA — the Center for Unruptured Brain Aneurysms. By carefully selecting patients for this program, NSPC providers take advantage of the fact that only about 4% or fewer patients with an unruptured brain aneurysm experience a brain bleed annually and that many can be successfully managed with medication a lone. Jae Choi, MD, a dua l fellowship tra ined cerebrovascular neurologist, has acted as the Medical Director of CUBA since joining NSPC in 2016. Dr. Choi notes that because he and the physicians of the NSPC neurovascular team have followed "nearly 1,000 patients with unruptured brain aneurysms for an average of five years," they are uniquely equipped to " At NSPC, we treat all neurovascular diseases, rare and common. We aim to provide the least invasive solutions for these lesions when feasible; however, we also have a full spectrum of operative resources to offer. Our complication rate is very low. We also have a unique availability. We see patients much faster than they can typically make an appointment elsewhere — usually within 24 hours." — JONATHAN L. BRISMAN, MD, FACS, ATTENDING NEUROSURGEON, CEREBROVASCULAR AND ENDOVASCULAR SPECIALIST, NSPC BRAIN & SPINE SURGERY Jonathan L. Brisman, MD, FACS A F TER E A RNING HIS undergraduate degree, magna cum laude, from Harvard University, Dr. Brisman went on to receive his medical degree from Columbia College of Physicians and Surgeons. He completed his internship in general surgery and his residency in neurosurgery at Massachusetts General Hospital, where he also served as Chief Neurosurgical Resident. Dr. Brisman completed his interventional neuroradiology fellowship at Roosevelt Hospital in New York City, as well as a microvascular neurosurgical fellowship at Swedish Hospital in Seattle. Board-certified in neurosurgery, Dr. Brisman specializes in the treatment of cerebrovascular and endovascular conditions and is one of roughly 200 neurosurgeons in the United States trained to perform endovascular and micro-neurosurgical techniques. Dr. Brisman has authored numerous articles published in peer-reviewed neurosurgery journals. He has also written extensively about arteriovenous malformation, carotid artery disease, intracranial aneurysms, subarachnoid hemorrhage and vasospasm. Board-certified in neurosurgery, Jonathan L. Brisman, MD, FACS, attending neurosurgeon, cerebrovascular and endovascular specialist at NSPC, specializes in the treatment of cerebrovascular and endovascular conditions. He is one of about 200 neurosurgeons in the United States trained to perform endovascular and micro- neurosurgical techniques. 0 8❱❱❱❱❱ C O V E R F E A T U R E

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