W
elcome to the Neurosurgical Medical Clinic. Our surgeons and nurses provide neurosurgical care in many of the major hospitals in San Diego, California. Our surgeons and staff provide individual and conscientious treatment using the most effective and modern techniques available in the world. We hope our web page can bring you valuable information about our practice...the neurological disorders we treat and the procedures we perform. 
 
A  Forest of Neurons: IBM and the Ecole Polytechnique Fédérale de Lausanne ..... A dye is injected into each brain  neuron and then developed in order to reveal its morphology. This image shows a minute fraction of the cells and connections within the interconections of the brain's neocortex.

Dr.s Altenau and Ostrup in the news. . .

Watch Sharp's TV Documentary

New episode of award-winning documentary series on air now

 Watch Stories of The Sharp Experience

Watch Sharp's compelling half-hour documentary featuring real-life stories of advanced clinical care. Produced on location at Sharp hospitals and medical facilities, the documentary captures stories of hope told entirely in the words of patients, their families and caregivers.

In the latest episode of Sharp's award-winning documentary series, "Stories of The Sharp Experience," rehab specialists strive to help a young motorcycle racer walk again, high-tech surgery is a war veteran’s best chance to return to police work, and a young father battles to overcome a recurring brain tumor. These powerful stories demonstrate the Sharp Experience Sharp’s journey to make health care better.


Comprehensive CyberKnife radiosurgery begins. . .


T
he NMC is participating in the latest and most up-to-date CyberKnife program in San Diego County adding to our successful radiosurgical program at the San Diego Gamma Knife Center in La Jolla. The CyberKnife is a robotic linear accelerator, generating precisely aimed x-ray beams. Powerful computer treatment planning allows curative doses of radiation to be delivered in one treatment session to malignant and benign tumors throughout the entire body. Gamma Knife therapy is limited to tumors within the head and remains the Gold Standard for intracranial radiosurgical therapy. 

With the power of this new radiosurgical device we will develop a comprehensive program for the treatment of metastatic tumors of the spine including radiosurgery, reconstructive surgery and rehabilitation

Gamma Knife Program featured in MD News. . .

Our radiosurgical program at the San Diego Gamma Knife Center was recently profiled in MD News. The article outlined the program developments and advantages. We will participate in a Cyber Knife project in Vista which will begin treating patients in the summer of 2007. This will extend our ability to treat benign and malignant tumors of the spine and peripheral nerves with radiosurgery, just as we have treated intracranial disorders with the Gamma Knife. Over 2700 patients have been treated with Gamma Knife radiosurgery since the center started in October 1994.

The latest technology in radiosurgery, the Leksell Gamma Knife 4C, was installed in January at the San Diego Gamma Knife Center. This new machine incorporates sophisticated software technology to develop single session radiation treatments for a vast variety of benign and malignant brain tumors. Painful trigeminal neuralgia can also be treated in a entirely non-invasive single treatment . The treatment allows radiation to be confined to the tumor and avoids excessive radiation of the nearby brain. Since the radiation is conformal, higher doses may safely be used safely, with increased effectiveness when compared to conventional radiation therapy. 

 Click here for information about gamma knife treatments.


X Stop Interspinous Process Decompression System (IPD) now performed by NMC surgeons. . .


Dr.s Kureshi , Zubay and Greenwald are introducing the X-Stop spinal device to San Diego. This is a minimally invasive procedure, performed with local anesthesia for the treatment of spinal stenosis in selected patients with lumbar spinal stenosis. Spinal stenosis is narrowing of the spinal canal in the low back due to arthritis. This may caused leg pain, numbness and weakness which is relieved by sitting.  The X-Stop system is indicated in patients over 50 years old with symptomatic stenosis  which is relieved by flexion of their low back (for example, sitting or bending forward). Usually these are individuals who for over-all health reasons would not  tolerate a standard decompressive laminectomy for lumbar stenosis.

 


New CD describes our endoscopic procedure for sweaty hands...

Excessive sweating of the hands, feet and underarms is a common problem. Sometimes even the face and scalp are involved. At extremes, this may become not only be embarrassing but become a social, psychological and professional disability.

We have a successful program of surgical treatment for hyperhidrosis, using
endoscopic thoracic sympathectomy. Same day surgery can cure excessive sweating in the hands, underarms and face in the vast majority of patients. This procedure is performed as an out-patient procedure at several of our hospitals. Pathological facial blushing and reflex sympathetic dystrophy also respond this same-day treatment

A CD is available through our office. The CD outlines the experience of suffering from excessively sweaty hands from a patient's point of view and scenes from the operation itself. Contact Glory Hammond for copies...

click here for information about endoscopic sympathectomy

Deep brain stimulation for Parkinson's Disease and tremor....160 patients treated by 2008. . .

tremor thank you 

 

 

 

We have treated more than 160 patients with PD and essential tremor with placement of deep brain stimulators at Scripps Memorial Hospital in La Jolla with considerable success. 

click here for information about our movement disorder program.


A paper describing a promising new treatment for cluster headache. . . delivered at the International Stereotactic and Radiosurgical Society for the June 2007 meeting in San Franisco.

Cluster headache (CH) is a severe and disabling periodic pain disorder. Short periods of periorbital pain are accompanied by parasympathetic effects: lacrimation, conjunctival injection, nasal congestion, etc. Medical treatment of episodic and chronic CH is usually effective, but a small group of patients are refractory to medical treatment. The somatic and autonomic manifestations of CH have challenged the imaginations of surgeons. We report our initial experience treating both the trigeminal nerve and sphenopalatine ganglion (SPG) for CH.  

 In the past, surgical lesions of the trigeminal nerve (TN) have produced initial relief in more than one-half of patients. Gamma Knife radiosurgical lesions of the TN have produced short-lived pain relief and perhaps increased toxicity. In this pilot study we added the sphenopalatine ganglion as an additional target in an effort to extend the degree and length of pain relief. Over an eight year period we carried out 12 Gamma Knife radiosurgical treatments in 7 patients, treating only the TN or later both the TN and SPG contemporaneously. One patient with 3 treatments to the TN enjoyed immediate and complete relief for 5, 22, and 25 months. Four of 5 patients with radiation of both the TN and SPG experienced pain relief for 8 and 30 months, or are continuing to enjoy pain relief  7, 18, and 22 months after treatment or re-treatment at the last follow-up. Most patients reported facial paresthesias following radiation. No profound numbness or deafferentation pain was experienced. These results, in some respects, reflect the morbidity and pain relief experience of Gamma Knife radiosurgery for classical trigeminal neuralgia. The addition of the SPG as a target may prove to be valuable and has not increased the morbidity of treatment.