Neuroscience Programs at Tufts Medical Center | Working Wonders 2018

Neurology and neurosurgery share the tripartite mission of Tufts Medical Center, which is clinical excellence, research and education. We feel strongly that trying to push the bounds of what we understand can lead to new treatments. We treat the entire nervous system and that includes the brain and the spinal cord and the nerves and the muscles that’s the nervous system, so anything that can go wrong with any of those things is what comes to neurology. And it’s been estimated that about half of all presentations to primary care doctors are potentially neurological problems. Neurosurgery, of course, the brain and spine is heart and soul of everyone and if the brain doesn’t work properly then serious problems occur, so definitely our surgeries are complex and high stakes or high risk. I specialize in skull base surgery which is pathologies that involve the base of the brain that involve the nerves coming out of the brain or the butt that’s just going to the brain. So, it then involves operating through the nose within the scopes or doing bigger open surgeries that go underneath the brain to reach different pathologies. We have neurosurgeons to specialize in brain tumors and blood vessel problems to the brain or what’s called through the vascular surgery, then we have multiple spine surgeons who take care of complex or minimally invasive spine problems. And then we cover pediatric neurosurgery as well. Then we have people going blind, losing vision in one eye or another and take a tumor out and all of the sudden their visions back. We have patients losing spinal cord function, losing their balance, having trouble walking, we operate on them, they come back to come back into clinic walking just fine. Because things are complex, we often work closely with neurology, particularly on things like stroke or blood vessel problems to the brain. I don’t think there’s a department in this hospital that we are not involved in. We can’t do it without them. When you’re trying to treat patients with complex conditions, people of different specialties come to that condition with a different perspective. You know Dr. Malak and the endovascular arena working with the neurologists and Dr. Thaler, he’s pulling clots out of blood vessels. If we pick up the patient fast enough, restoring blood flow to the brain and occasionally on the table. People start moving it side of their body right away, you get to see every day you know concrete absolute improvements right before your eyes. The acute management of stroke has changed fundamentally in the last couple of years because it’s been shown that not just intravenous medicines that neurologists historically have used but endovascular or catheter based removal of blood clots from patients who are having a stroke has a huge impact on their outcomes. We have a focus here on young stroke patients, which are a somewhat forgotten group. For the understanding of young stroke patients has really been old stroke patients sort of applied to young people and the diseases that lead to stroke in young people are very different. My colleague Lester Leung has started a stroke and young adults program which focuses on the peculiarities of stroke in young people. Epilepsy, historically, has been managed with medicines. There have been major advances at identifying the location of the seizure focus, where seizures are starting in the brain, and for many of those patients surgical removal of that little area of the brain can treat their seizures if not cure them. As an academic medical center, a big part of our mission is training the next generation of neurosurgeons. We focus a lot on resident education and make sure that the people we turn out are the highest in their profession and become leaders. We are training the neurologists of the future, both for here in Boston as well as other parts of the country or even other parts of the world.

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