Memorial Hermann-Texas Medical Center

Mischer Neuroscience Institute

Comprehensive Center for Cerebrovascular Surgery

Established in 1997, the Comprehensive Center for Cerebrovascular Surgery is a multidisciplinary, subspecialty program dedicated to the treatment of complex cerebrovascular disorders.

Annually, the program treats approximately 200 patients with acute subarachnoid hemorrhage and conducts the surgical and endovascular evaluation and treatment of more than 120 cerebral aneurysms. Other conditions managed include cerebral and dural arteriovenous malformations (AVM) and fistulae as well as cavernous malformations and cerebrovascular occlusive disease.

Treatment options may range from surgery to interventional radiological procedures to Gamma Knife stereotactic radiosurgery. The broad range of diagnostic and therapeutic procedures includes:

• Selective cerebral angiography and CTA with 3-D reconstruction
• Magnetoencephalography (MEG)
• Transcranial Doppler and intraoperative microdoppler methodology
• Wada (behavioral) testing and electrocorticography
• Endovascular techniques such as detachable coils, intraarterial thrombolysis, angioplasty and intracranial stenting
• Surgical procedures including clipping of complex and giant aneurysms, resection of AVMs and cavernous angiomas, EC-IC bypass procedures and carotid endarterectomy
• Stereotactic focused beam radiosurgery

A dedicated, 28-bed neurocritical care unit, staffed by neurointensivist physicians and practitioners, is available to provide ongoing intensive care to critically ill patients with these disorders. The Stroke Team works closely with the Center to provide expertise and consultation in this specialty area.

Treatment of Brain Tumors

Neurosurgeons specialize in the management of intrinsic and skull-based brain tumors. Patients with intrinsic brain tumors (astrocytomas, oligodendrogliomas, ependymomas and glioblastomas) are managed with aggressive surgical therapies.

These may include, motor mapping, language mapping and awake craniotomies for tumors located in the eloquent cortex and the placement of intra-cavitary chemotherapy. Imaging data (from MEG) is routinely used in the operating room to localize language and motor cortex.
   

Skull base tumors (meningiomas, acoustic neuromas, pituitary adenomas and craniopharyngiomas) are managed with a team approach which includes a fellowship-trained skull-base neurosurgeon, ENT surgeons, intra-operative neurophysiologists and consultations with the Gamma Knife Team as necessary.

In addition, the tumor team uses multiple types of frameless stereotactic navigation for approaches that are minimally invasive to surrounding brain tissue. To further enhance functional outcomes following tumor resections, the team is exploring the use of diffusion tensor imaging, a new procedure for mapping major brain connection pathways.

Each year, approximately 2,000 American children are diagnosed with brain tumors. As a leader in the diagnosis and treatment of tumors, our goal at the Children's Neuroscience Center is to provide quality care focused on the best possible outcome for each child.

Our Neurosurgery team utilizes innovative techniques and cutting-edge procedures, such as Gamma Knife, a minimally invasive alternative to surgery for small to medium–size tumors, arteriovenous malformations and other abnormalities located deep in the brain.

When conventional surgery is required, we use advanced brain-mapping techniques that minimize patient risk. Surgery is aided by state-of-the art imaging technology, including MRI, CT and magnetoencephalography (MEG).

For more information or physician referral, call 713-222-CARE (2273).