Neurosciences

Caritas Holy Family's Neurosurgery Department performs more than 700 neurosurgical procedures annually, including brain surgeries, pallidotomies, thalamotomies and deep brain stimulator implants. The technologically advanced equipment available at Caritas Holy Family makes it possible for patients to undergo locally the kind of delicate neurosurgical procedures usually performed only in the country's premier teaching hospitals.

This technology includes:

• Zeiss Stereotactic Neuronavigational System -- an operating room 3-D computer imaging work station, used with or without a frame and in conjunction with radiologic technology, to guide neurosurgeons in the performance of delicate brain surgery by turning radiologic images through three planes. The frameless system is used during a craniotomy, while the framed system is used for deep brain and movement disorder procedures because of the extremely precise tolerance of its measurements. The technology works by superimposing in real time the images from a CT scan, X-ray, MRI or PET scanner into three dimensions from within the skull onto the operating room computer. This neuronavigational map guides the surgeon to the exact location that needs treatment. Infrared sensors attached to the operating room table transmit a signal to the infrared sensing device on the surgical instrument to pinpoint the position and angle of entry and the depth of penetration for the surgeon.

• Linear accelerators -- with some brain abnormalities, such as benign or malignant tumors and abnormal blood vessels, the neurosurgeon and radiation oncologist can use a noninvasive procedure -- stereotactic radiosurgery -- using a sophisticated machine called a linear accelerator. Utilizing a network of computers linking the hospital imaging scanners with a work station in the radiation oncology area, treatment can be designed to supply a high dose of radiation to the brain lesions while sparing the surrounding normal brain tissue. A single fraction of a radiation dose can be given, precisely removing the lesions -- and it can be done on an outpatient basis using local anesthesia only. This technique can be used in place of surgery if surgery is not technically feasible, as an adjunct to surgery, or as a boost treatment after conventional radiation treatment.
• CT Scanner -- the Computed Tomography scanner, which is wired into the operating room computer, is typically used in diagnostic imaging of both soft tissue and bone. CT is used extensively for neurological imaging, surgical planning, and treatment planning for radiation oncology because it clearly shows the shape and location of organs and tissues in any cross-sectional slice of the body, including the brain.
• MRI -- Magnetic Resonance Imaging equipment is typically used in diagnostic imaging of soft tissue, such as in the central nervous system, the spinal cord, the abdomen/pelvis, and the cardiovascular system. Without using conventional X-ray radiation, it provides excellent contrast detail between different tissue, even with very similar densities, and is effective in every region of the body. It is an important noninvasive technique for the early detection of any abnormal changes in tissues and organs, including the brain. The new MRI at Holy Family includes a 3-D imaging module and is wired into the operating room computer.
• SPECT Camera -- Single Photon Emission Computed Tomography cameras are typically used in the diagnosis of cardiology functioning via myocardial perfusion scans. An isotope called sestimibi is used to create a vivid picture for 3-D imaging to detect blocked arteries. SPECTs of the brain can also be done and are particularly helpful to neurologists and radiation oncologists in determining whether or not a brain lesion is a new lesion or the result of scanning or damage from radiation treatment. If it is the former, new treatment can be initiated. If the latter, the patient can be spared further biopsy or invasive procedures.

If you would like more information, please call the Neurosurgery Department at (978) 687-0156, extension 2510.