Mount Sinai's team of neurological experts works with each patient and their family to determine which treatment option is right for them. We provide cutting-edge treatments, including the following:
Acoustic Neuroma Removal
An acoustic neuroma is a noncancerous tumor which grows on the acoustic nerve. In order to access the area to remove the tumor, surgeons use three different approaches. Based on the location, severity and symptoms related to the acoustic neuroma, our surgeons will determine which of the following approaches is most appropriate:
- Translabyrinthine - often used when significant hearing loss has already occurred, a small portion of the skull and bone in the inner ear bone are removed in order to reach the tumor
- Retrosigmoid/Sub-occipital - an opening is made behind the ear to reach the tumor
- Middle Fossa - the tumor is accessed from the upper surface of the ear canal. This approach is most commonly used when the patient has experienced little to no hearing loss
A craniotomy is any surgery where a portion of the skull needs to be removed to reach a part of the brain. This can include a biopsy, removal of brain cancer, treatment of a cerebral aneurysm, head trauma or a blood clot, amongst other conditions. The size of the part of the skull which needs to be removed depends greatly on what the patient is being treated for.
Once under general anesthesia a piece of skull is removed and depending on the need of the surgery a tumor will be removed, a biopsy will be taken or a tube may be placed. Once the skull is replaced staples or stiches will be used to close the wound. Patients usually stay in the hospital for 3-7 days following a craniotomy.
Deep Brain Stimulation
Neurosurgeons at Mount Sinai's Center for Neuromodulation perform deep brain stimulation surgery (DBS) to alleviate the symptoms of movement disorders, such as Parkinson's disease. DBS has also been FDA approved for the treatment of obsessive compulsive disorder (OCD) and dystonia.
An electroencephalogram, also known as an EEG, is a test which uses sensors placed on the patients head to monitor electrical brain activity. Your surgeon might order an EEG to help diagnose or determine the side effects of:
- Brain Trauma
- Brain Infection
An EEG is a painless test where the patient stays away while electrodes are placed on their scalp. The test usually takes about an hour to complete.
General Neurosurgery Treatments
A small sample of tissue or cells can be biopsied and examined by a pathologist to determine if the sample is abnormal. Our neurosurgeons use biopsies to rule out cancer, or to specify a type and level of cancer. They can also be used to troubleshoot causes of infection, swelling or growth.
There are various types of biopsies your doctor may order depending on what they are looking for. Some biopsies are simple outpatient procedures, while others require general anesthesia and a short hospital stay. Some of the most common types of biopsies include:
- Needle biopsy – cells are removed using a thin needle
- Endoscopic biopsy – a long thin tube is used with a camera to navigate to the desired area, at which point a small tool is used to collect the biopsy sample
- Excisional biopsy – a larger portion of the mass is removed to get a more complete sample
- Bone marrow biopsy – a long needle is inserted into the bone marrow to collect a sample
CT Scan Of The Head
A CT scan is a common type of x-ray that uses computers to create images of the inside of the head. A CT scan can be done with or without contrast. Contrast is a chemical inserted into the vein used to provide clearer images of certain disorders. The CT scan takes approximately 5 minutes and patients usually experience little to no pain or discomfort during the test.
Carpal Tunnel Release
Carpal tunnel release surgery is used to treat carpal tunnel syndrome that cannot be managed with physical therapy, injections or braces. The goal of the surgery is to relieve pressure on the median nerve by cutting the transverse carpal ligament open. The surgery can be done one of two ways:
- Open Carpel Tunnel Release: a short opening is made in the lower palm for surgeons to access the carpal ligament. After they have removed the pressure on the median nerve the wound will be closed.
- Endoscopic Carpal Tunnel Release: Two small incisions are made in the palm and wrist. A small endoscope with a camera attached is passed through one incision, while tools are passed through the other. The surgeon will use the camera to locate the median nerve and will then use the tools to open the carpal ligament.
This is a study measuring the conduction of nerves from the body to the brain.
Our surgeons use intrathecal drug delivery to deliver pain medication directly to the spinal cord. The use of this "pain pump" reduces the pain of conditions such as:
- Chronic Pain
- Failed Back Syndrome
Magnetic Resonance Imaging
Your doctor may order an MRI or Magnetic Resonance Imaging test. The results from an MRI are used to diagnose brain injuries or conditions or to check the effectiveness of medicines or other treatments. An MRI can be used with contrast, meaning that imaging dye will be inserted into the patient's veins to provide a more detailed image. The test takes between 40 and 90 minutes and is generally painless. There are open MRI machines for patients with fear of closed spaces.
Peripheral Nerve Stimulation
Mount Sinai's neurosurgeons use peripheral nerve stimulation to treat chronic pain, as well as a variety of other back and neck conditions. The procedure works by applying an electronic current to the peripheral nerves.
Our team of surgeons provides relief from chronic severe pain for our patients by placing electrodes into the nerve structure, which blocks the pain signals to the brain.
Mount Sinai's specialists use stereotactic radiosurgery as an alternative to surgery to treat conditions such as trigeminal neuralgia.
Mount Sinai's spine neurosurgeons perform a laminectomy to remove a small portion of the vertebra, also known as the back bone in order to remove pressure on the spinal cord or a nerve, or to gain access to an area of the spinal cord.
The surgery can be done through minimally invasive techniques where the surgeons will create a few small incisions to insert a scope and tools through.
Also known as a myelogram, a myelography is an imaging test used with contrast to view the spinal cord. Your surgeon may order this test in order to diagnose spinal tumors, herniated disks or narrowing of the spinal canal. A small amount of contrast dye is injected in the back of the patient before the test, after which the doctor will take images of your back. Occasionally a CT scan is ordered afterwards to see the spread of the contrast dye. The procedure usually takes 30-60 minutes and the patient is allowed to return home an hour after the test.
Our specialists provide spinal cord stimulation to treat patients suffering from chronic pain disorders.
Our spine surgeons perform spinal fusion surgery to weld together two vertebrae. This is done to treat a variety of conditions:
The bones will be held together with either grafts made from pieces of bone or with a small metal cage, held in place with screws, plates or rods. Post-surgery rehabilitation will be needed in either the hospital or in an outpatient clinic setting. Complete healing of the bones may take up to one year, depending on rehabilitation, age and overall health.
Combination Minimally Invasive Surgery and Radiation or Chemotherapy
Combination Minimally Invasive Surgery and Radiation or Chemotherapy is a new, minimally invasive technique which can be tailored to the particular tumor of the spine, either metastatic or primary. During our weekly spine tumor board, the treatment plan will be devised to include some combination of minimally invasive radiation treatments and chemotherapy tailored to the particular tumor biology. Resection of the tumor can, when appropriate, be combined with a form of stabilization that prevents further collapse or deformity, without the extensive surgical exposure and recovery times associated with classical operations.
An angiogram is an x-ray exam which uses a dye injected into the blood vessels to make them more visible. An angiogram is used to help our surgeons identify disorders of the blood vessels and vascular system. The procedure, which usually takes about an hour, uses a needle puncture into an artery over the groin or in the arm where a catheter is then inserted.
The main artery which carries blood from the heart to the brain is the carotid artery. The blockage of this artery can lead to stoke and transient ischemic attacks. In order to restore blood flow to the brain surgeons need to open the artery to clear it of buildup. Surgeons go in through the neck, open and clean the artery and occasionally need to remove a part of the artery. The whole procedure usually takes between 2-4 hours and results in a 1-3 night hospital stay.
Carotid Artery Stenting
Similar to carotid endarterectomy, this procedure uses a stent to increase blood flow in the carotid artery to prevent stroke. A stent is navigated through catheters and is inserted into the arterial through a needle puncture over the groin.
An embolization is a procedure used by our neurosurgeons to treat disorders of the blood vessels using devices that are delivered through small catheters. These devices can be used to close abnormal vessels such as aneurysms or vascular malformations. Other devices, such as stents can be used to open blood vessels that have been blocked. The procedure is done through a tiny incision in the groin, where a catheter is inserted to access an artery, and then is threaded through the artery into the site of the abnormality. A common alternative to open surgery, this procedure can be used to treat:
Mount Sinai neurosurgeons use endarterectomy surgery to remove built up plaque in the carotid artery, the main supply of blood to the brain. If left untreated, this buildup can cause stroke, leg pain or digestive problems.
During surgery an incision will be made over the artery and the surgeon will reroute the blood around the incision to keep blood flowing to the brain. After the surgeon has cleaned out all of the plaque, the incision will be closed with sutures or staples.
Magnetic Resonance Angiography
Used to make two-dimensional and three-dimensional pictures of blood vessels, Magnetic Resonance Angiography or MRA, is the study of blood vessels using an MRI test. MRA is used to identify internal bleeding, diseased or blocked blood vessels. This test can be done with or without contrast, which is a dye inserted into the patients vein to provide a more detailed image. The test takes between 40 – 90 minutes and is generally painless.
Our neurosurgeons use this procedure to relieve the pressure on nerves which cause trigeminal neuralgia and hemifacial spasm.
Department of Neurosurgery
1468 Madison Avenue
Annenberg Building 8th floor
New York, NY 10029-6574
Mount Sinai ranks No. 15 for Neurosurgery in the 2014-2015 "Best Hospitals" issue of U.S. News & World Report. Learn More