Issue link: https://viewer.e-digitaledition.com/i/1429214
Sundeep Mangla, MD, interventional neuroradiologist at NSPC, exams a patient as part of an initial consult. Advancing Cerebrovascular Care: NSPC Specialists Elevate the Treatment of Rare Conditions BY K ATY MENA-BERKLEY NEUROENDOVA SCUL AR SPECIALISTS AT NSPC BR AIN & SPINE SURGERY ARE DEDICATED TO THE DELIVERY OF TAILORED CARE FOR R ARE CEREBROVA SCUL AR CONDITIONS, INCLUDING ARTERIOVENOUS MALFORMATIONS IN THE BR AIN, GIANT INTR ACR ANIAL ANEURYSMS AND MOYAMOYA DISE A SE. IN THE 1970S, a few forward-thinking physicians in the United States began to develop neuroendovascular, catheter- ba sed treatment options to ma na ge cerebrovascular conditions. In so doing, t hey en g i neered soph ist icat ed new methods of disease management that NSPC Brain & Spine Surgery specialists embrace today. Joh n P i le - Spel l m a n , M D, FACR , i nt er vent ion a l neu ror a d iolog i s t at NSPC Brain & Spine Surgery, is one of the innovative clinicians responsible for the development of the catheter-based treatments. His work continues to stand the test of time, offering hope and effective solutions to patients while also inspiring the next generation of clinicians to explore neu roendova scu la r, cat heter-ba sed treatment methods. " Dr. Pile-Spellma n wa s one of the pioneers of that whole endeavor, a nd then there were about three or four neurosurgeons in the country who went for the training. Then those three trained the next generation, and I was part of that nex t generation," says Jonathan L . Br i s m a n , M D, FAC S , a t t end i n g neurosurgeon, cerebrova scu la r a nd endovascular specialist at NSPC Brain & Spine Surgery. "Now there may be 200 neurosurgeons who have this training, which is invaluable to the patients we serve. Having the ability to manage a disease entity using all of the operations at your disposal — that is a privilege that benefits our patients who are living with rare cerebrovascular conditions." ADDRESSING BRAIN AVMS W hi le t hey may go undetected for a significant period of time, arteriovenous ma lfor mations (AV Ms) in t he bra in can cause catastrophic and even fata l consequences, underscoring the need for the adva nced diag nostic methods offered at NSPC Brain & Spine Surgery. "Patients with AV Ms of ten present with seizures or headaches a nd, less often, with bleeds in the head," Dr. Pile- Spellma n says. "Neurologists, fa mily practitioners and radiologists may be the first to detect cha nges a nd ma ke referra ls to our tea m at NSPC Bra in & Spine Surgery. We work very closely with referring physicians to ensure that there is excellent continuity of care in a ll aspects for each patient." To investigate suspected brain AVMs, speci a l i s t s at NSPC Bra i n & Spi ne Surgery can use an array of diagnostic tools, including CT scan, MR A and MRI. " When we are able to determine the presence and architecture of the brain AVM, which includes the arteries that feed it, the arteries that are in passage, and the actua l nidus and the draining veins, as well as issues rega rding a ny a ssociated a neur ysms, we ca n ma ke a treatment pla n," Dr. Pile-Spellma n says. "This may include embolization as adjuvant or definitive therapy, as well as direct surgery with a craniotomy or stereotactic radiosurgery." Sundeep Mangla, MD, interventional neuroradiologist at NSPC, notes that many procedures the neurointerventionalists perform routinely at NSPC would be 0 6❱❱❱❱❱ C O V E R F E A T U R E