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Guidelines for sites linking to mayoclinic.orgArticles about current trends in neurology and neurosurgery at Mayo Clinic.
In the 27 years since he founded the autonomic testing laboratory at Mayo Clinic in Minnesota, neurologist Phillip A. Low, M.D. and colleagues have established the norms and national standards for quantified evaluation of autonomic function. Referrals for autonomic evaluation are increasingly coming from outside the field of neurology, reflecting wider appreciation for the utility of autonomic testing for differential diagnosis and management. Learn more.
Most benign intracranial tumors are noninvasive, well-defined, well visualized on MRI and have a slow rate of progression. These features makes them good candidates for radiosurgery, which can deliver a destructive dose of radiation to the target with little or no radiation effects on adjacent structures and that it is conducted in a single session. Learn more.
A newly installed intraoperative MRI (iMRI) at Mayo Clinic Hospital in Jacksonville, Fla., will improve precision in tumor removal and other procedures, including epilepsy surgery. iMRI also provides a real-time neuronavigational tool for catheter placement and implanting deep brain stimulators. The iMRI is the only unit in Jacksonville's geographic region. A similar unit is available at Mayo Clinic's Minnesota campus. Learn more.
Collaboration between different specialists is often needed to address the complicated care of children with brain tumors. At Mayo Clinic, the efficient integration across pediatric neuro-oncology, neurology, neuroradiology, neurosurgery, neuropathology and other specialties smoothes the diagnostic and treatment process for the patient and family. Learn more.
Children with Down syndrome are screened for neck instability before they are allowed to participate in the Special Olympics. A Mayo Clinic pediatric neurosurgeon would like to see effective screening for occipital-cervical instability in children with other genetic conditions that put them at risk. Congenital instability can be caused by ligament laxity, abnormal bone segmentation or bone deficiencies and other abnormalities in the occipital-cervical junction. These problems may affect the enclosed nervous system structures. Learn more.
At Mayo Clinic, surgery is recommended if a cavernous malformations (CM) is symptomatic and in an accessible location. If not, the CM is observed closely unless intractable seizures, repeat hemorrhage or worsening focal symptoms develop. Learn more.
Spinal cord tumors can be broadly classified by location relative to the spinal cord and the dura mater. Those outside the dural sac and cord are called extradural extramedullary tumors. Because of their location within the dural sac and cord, intradural intramedullary tumors were considered inoperable as recently as a decade ago. Mayo Clinic neurosurgeons were among the first to resect such tumors and, today, improved imaging and microsurgical techniques continue to advance surgery for tumors of this type. Learn more.
Occipital nerve stimulation (ONS) for medically refractory headache pain is most commonly used to treat migraine and cluster headaches that do not respond to conventional medications. Mayo Clinic in Arizona is investigating a microstimulator that is not yet commercially available. Learn more.
Inborn errors of cellular metabolism occur much more frequently than has been thought previously. To date, more than 1,000 inborn errors of metabolism (IEM) have been identified, affecting approximately 1 in 1,000 Americans. IEMs may be rare individually, but taken collectively, they are common. Many of the milder forms have been under recognized. "All IEMs are treatable," says Neurologist Marc C. Patterson, M.D. Learn more.
One in five children with epilepsy have intractable seizures. Surgery may be an option, but the path to that decision is complex. At Mayo Clinic, the surgical work-up can be done in one to two weeks and includes state-of-the art functional brain mapping and seizure locus studies.
The face of interventional neuroradiology and endovascular neurosurgery is changing. In recent years, increasing numbers of neurosurgeons are also training to become neurointerventionalists.
A glioblastoma is called a "grow-and-go" tumor — it grows at an extremely rapid rate in a given brain site, but it also moves to new sites within the brain. Across Mayo's three locations, a team addresses both the growth and movement properties of glioblastomas.
Image guidance is a real-time navigation system that continues to improve outcomes for surgical procedures involving the spine, including spinal reconstruction. A Mayo Clinic neurosurgeon demonstrated just how much image guidance can increase safety in a recent retrospective study. In 1,200 spinal screws placed using 3-D image guidance, there were no vascular, visceral, or spinal cord injuries and the incidence of injury to the nerve roots was less than 1%.
The Mayo Clinic led International Study of Unruptured Intracranial Aneurysms set out to shed light on the issue of whether small unruptured intracranial aneurysms (UIA) should be treated. Among the many findings was that size and location mattered relative to risk for rupture.
The research frontier in treatment for Alzheimer's disease is being defined by the search for disease-modifying therapies—therapies that would alter the course of the disease by delaying its onset, slowing it down or stopping its progression.
Deep brain stimulation restores function by stimulating brain tissue. Mayo Clinic has expanded its deep brain stimulation program to include new treatment approaches and innovative research to refine and improve this treatment.
Refractory neuropathic pain, one of the most intractable and difficult types of pain to treat, often can be reduced or alleviated through neuromodulation (stimulation) techniques. Most prominent among them is spinal cord stimulation, previously called dorsal column stimulation.
Acute inflammatory demyelination, limited remyelination, progressive axonal loss, and development of multifocal sclerotic plaques is the typical sequence of injury to the brain in patients with multiple sclerosis (MS). Symptomatic treatments are often successful, but no treatment can stop the progression of the disease. So the focus of MS research is understanding why demyelination occurs and what can be done about it.
The administration of tissue plasminogen activator (t-PA) in the first three hours can limit the amount of brain tissue injured in an ischemic stroke. But according to the American Stroke Association, an average of only 5% to 10% of those eligible receive t-PA. Administration of t-PA is one of 10 quality-of-care indicators Mayo Clinic in Arizona tracks in compliance with the American Stroke Association's "Get With the Guidelines-Stroke" program. For the past three years, 100% of eligible patients received t-PA within the first three hours after onset.
The most common causes of malignant skull base tumors are esthesioneuroblastoma, neuroendocrine carcinoma, sinonasal melanoma, sinonasal undifferentiated tumor, and squamous cell carcinoma. Because skull base tumors can involve the nose and nasal passages and can invade and compress the brain, they are best managed through a coordinated team approach.
Understanding the where and when of seizure initiation (ictogenesis) is as important to epilepsy research and patient care as discovering the why. A single neuron cannot have a seizure; a seizure requires populations of neurons firing in synchrony. The question asked by two Mayo Clinic neurologists is how many neurons does it take, or, in effect, what is the smallest anatomic unit that gives rise to a seizure. The smallest unit could translate into the earliest possible moment of detection, and that could be the key to seizure suppression.
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