Delving the Depths of the Mind and Spine

Partners

If you need complex brain or spinal surgery, and you live in the Lake County area, there's one place to go Condell Medical Center in Libertville.

Condell began expanding its Neurosurgery  Department in 2001 to provide Lake County with a greater capacity to treat the most complex medical conditions. Along with a myriad of other benefits, availability of neurosurgical care means patients with spinal cord and head injuries can receive sophisticated care in the center of Lake County, rather than being transported to distant facilities in Milwaukee or Chicago.

Neurosurgery involves treating disorders of the brain, spinal cord and peripheral nerves.

Neurosurgeons at condell perform many kinds of procedures to correct brain and spinal conditions that do not respond in medication, physical therapy or other patients treatments. Some of these conditions include brain disorders such as tumors, epilepsy, aneurysms and hydrocephalus: spinal disorders including tumors, herniated discs and spinal stenosis and peripherial nerve disorders, such as ulnar neurophaty and carpal runned syndrome.

“The best part about my job is being able to make a huge difference in someone's life in a relatively short time,” said Jonathan Citow, M.D., Chief of Neurosurgery at Condell. He and his partners, Dr. Jeffrey Karasick and Dr. Sheldon Lazar, along with other neurosurgeons on the medical staff at Condell, have helped more than 850 patients during the last three years by performing brain, spinal and other nervous system – related surgeries- many of which have been lifesaving and life changing.

Removal of a ruptured blood vessel in the brain allows a  young nurse to return to saving other lives. A  horrible headache, followed by vomiting, double vision and paralysis of her left leg, led 30-year-old intensive care nurse Missy Csiha to the Emergency Department at Condell last fall. CT scans of her head showed that an arteriovenous malformation (AVM) had ruptured, spiling blood into her brain.

An AVM is an abnormal tangle of blood vessels formed at birth, consisiting of a group of one or more arteries directly connected to one or more vens.  What's missing between them are capillaries, which lesson the pressure as blood flows between the arteries and veins. Because the than-walked veins have difficulty accepting high-pressure blood flow directly from the arteries.

AVMs eventually can rupture and bleed into the brain. That's what happened to Missy, who lost about a tablespoon of blood before a clot formed to close off the leak.

Bleeding in the brain can affect neurological functions such as speech, vision and motor control, but thankfully, Missy experienced none of these problems. After a radiological procedures to seal off the AVM, missy returned to Condell to allow Dr. Citow to remove the AVM permanently, using state-of-the-art image-guided technology called VectorVision.

He began the surgery by first driling into the skull at the location of the AVM, forming a bone flap to reveal the brain tissue underneath. CT and MRI scans were then loaded into the VectorVision computer. The scans acted as guidelines as Dr. Citow lined them up with the actual arteries and veins inside  Missy's brain to identify precisley where to make the cuts.

Just two months after surgery, Missy was back at work at Condell in perfect health and on the opposite side of the bed once again, taking care of patients in the Institute Critical Care Unit.

Surgical repair of a brain malformation puts a 30-something UPS supervisor back on the road to good health. Disabling symptoms, including blackouts and loss of strength and sensation in his arms, led  to a diagnosis of a chiars malformation in 35-year-old Jerome Wallace's brain.

A chiars malformation occurs when the cerebellum (back and botton parts of the brain) “slips” into the space where the spinal cord meets the skull. This slippage causes the cerebellum to push on the upper spinal cord, resulting in symptoms such as head and neck pain and dizziness. Surgery is required to decompress the affected area.

To treat Wallace's condition, Dr. Citow removed a small area of the bone at the base of his skull, exposing the tough outer membrane of the brain called the dura. He then made an incision into the dura, revealing the cerebellum and upper spinal cord.

Using a synthetic gurtex graft, he patched the area, enlarging the region to prevent the previous “slipping” of the cerebellum.

Two weeks after surgery, Wallace was symptoms free and on the road back to his normal routine as a United Posted Service supervisor, husband and father of two.

Expanding Opportunities

Condell's $90 million expansion and renovation project, much of which was completed this spring, offers several new features that will enhance neurosurgery. The new Surgery Department offers 12 operating rooms, compared to the previous 10, and operations have been strenlined, allowing a smoother and more efficient experience for both patients and staff.

“The new arrangement combines the surgical areas into one so we can pool our resources, staff and supplies, and admit and discharge patients from one central location.” said Valerie Sosnowski, Administrative Coordinator of Surgical Services.

“This new arrangement allows for a smoother, more efficient experience”.

Visitors will benefit from a spacious, bright waiting area offering floor to ceiling views of Libertville, and NonCare, a computerized tracking system to help visitors follow the progress of their loved one throughout surgery.

Although Condell's overall hospital expansion project will he hearing an end in the next year or two, the inroads into neurosurgery at Condell are not Close to $1.5 million have been invested into neurosurgery equipment alone during the past year, and as new techniques and technologies emerge, Condell will continue to invest its resources into the most technologically advanced techniques and equipment available.