St. Mary Neurosciences Center EXPERIENCED ADVANCED LEADERSHIP ADVANCED LEADERSHIP EXPERIENCED EXPERIENCED LEADERSHIP EXPERIENCED ADVANCED ADVANCED St. Mary Neurosciences Center 1
Dear Fellow Physician: At the St. Mary Neurosciences Center, your patients will find specialized care for a wide range of injuries and illnesses from the most common to the most complex that affect the brain, nervous system, and spine. Our team of board-certified neurologists and neurosurgeons, specially trained registered nurses, and highly skilled rehabilitation professionals has distinguished itself as a trusted resource for the expert care of stroke, seizure disorders, brain tumors, traumatic brain and spinal cord injuries, chronic back pain, sleep disorders, and neurodegenerative disorders such as Parkinson s disease, Alzheimer s disease, and multiple sclerosis. Our goal is to lessen or prevent disabling long-term complications, ensure the best possible clinical outcomes, and help patients maintain or regain their independence and mobility. At every point along the continuum of care, we provide a high level of personal attention to every patient and the loved ones involved in their care and we regularly update you on the diagnosis and treatment progress of the patients you refer to us. Our approach brings together some of the region s most accomplished medical and surgical experts, who provide collaborative, quality care for patients with serious and potentially life-threatening neurological conditions. We have prepared this helpful guide to give you a greater understanding of St. Mary Medical Center s numerous capabilities in the field of neurosciences, as well as of the specialized technologies and treatment techniques used by our physicians for diagnosis and treatment. We are confident that you and your patients will be very satisfied with the highly specialized, technologically advanced, and compassionate care that we provide. For more information about any of the services or physicians at the St. Mary Neurosciences Center or to discuss a patient referral, please call 215.710.2006. Sincerely, Joseph Conroy, MD VP and Chief Medical Officer
Neurosciences Specialty Care The St. Mary Neurosciences Center assists physicians in treating patients with a wide array of neurological and neurosurgical needs. Who receives care at the St. Mary Neurosciences Center? 2 People with acute stroke needs 2 Those living with chronic back or neck pain 2 People with brain or spinal cord tumors or traumatic injuries 2 Individuals with suspected or diagnosed brain tumors 2 People with seizure disorders 2 Patients with neurodegenerative disorders such as Parkinson s disease, Alzheimer s disease, and multiple sclerosis 2 People with concussions 2 Children and adults who are experiencing difficulties with sleep or wakefulness 2 Individuals needing evaluation, diagnosis, and treatment of other complex neurological disorders or dysfunctions Effective treatment of these conditions makes all the difference in your patients quality of life. That s why we have developed one of the region s most comprehensive neurosciences centers known for its consistently positive patient outcomes and high levels of patient satisfaction. St. Mary Neurosciences Center 1
St. Mary Comprehensive Stroke Center Stroke is the most common cause of long-term disability and, after heart disease and cancer, the third-leading cause of death in America and right here in Bucks County. At the St. Mary Comprehensive Stroke Center, our multidisciplinary healthcare team provides rapid assessment, diagnosis, and treatment of stroke using proven evidence-based medical protocols. Our experts include board-certified neurologists, neurosurgeons, and emergency medicine physicians; radiologists; and registered nurses with advanced training in stroke care. During a stroke, doctors have a brief window of opportunity to deliver treatment and reduce the risk of disability and death. For this reason, we have established a dedicated rapid-response stroke team, which is fully prepared to diagnose and treat stroke emergencies at any time, day or night. Our entire team works together to provide expert evaluation and treatment of stroke emergencies from the moment a potential stroke patient arrives in our Emergency Department. Our goal is to prevent or minimize the potential for brain damage or disability by providing expert intervention with the most advanced medical therapies, pharmaceuticals, and interventional neurosurgical techniques. St. Mary Comprehensive Stroke Center Key Elements: 2 24/7 stroke emergency coverage by specially trained neurologists and neurosurgeons 2 Integrated emergency response team EMS personnel specially trained to recognize and evaluate stroke victims and provide immediate transport for treatment 2 Emergency Department rapid-response stroke team 2 Critical care services supported by the state-accredited St. Mary Trauma Center 2 Dedicated acute stroke program coordinator, a nurse practitioner who oversees the standards of care for acute stroke patients 2 Clot-busting thrombolytic therapy (t-pa) for appropriate patients 2 Clot retrieval for strokes beyond three hours 2 An Intensive Care Unit with monitored neurosciences care, staffed by specially trained physicians and nurses 2 Advanced CT scan, MRI, and laboratory testing 2 Social services discharge planning 2 Home healthcare, including full range of home therapies and after-care 2 Rehabilitation therapies 2 St. Mary Neurosciences Center
St. Mary neurosurgeons now have the ability to deliver the clot-busting drug t-pa using a catheter directly to the site of the clot in the brain. This is amazing technology to benefit stroke patients, as it can extend the timeframe we have to reverse the devastating effects of stroke and improve outcomes for critically ill patients. Emil Matarese, MD Neurologist and Director, St. Mary Comprehensive Stroke Center St. Mary Neurosciences Center 3
Diagnostic Technologies and Techniques: 2 Neurological examinations 2 NIH stroke assessment protocols 2 CT scans and magnetic resonance imaging (MRI) 2 Carotid ultrasound, MRA angiography of the brain and cervical arteries, and conventional angiography 2 Clinical laboratory testing for bleeding or clotting disorders 2 EKG or echocardiogram ultrasound examination of the heart to identify potential for blood clots that could travel to the brain 2 Tests that gauge functional impairments 2 CTA/CT perfusion 2 EEGs Treatment Technologies and Techniques: 2 Pharmacotherapy with thrombolytic therapy (t-pa), anticoagulants Coumadin (warfarin), or antiplatelet medications (aspirin or ticlopidine) 2 Endarterectomy to remove fatty plaques from inside of blood vessels 2 Medicines that stop the chain reaction of damage from the ischemic cascade (neuroprotective agents, promising but still experimental) 2 Procedures to dilate blocked blood vessels 2 Treatment advances for hemorrhagic stroke, including medicines that maintain normal clotting, surgery to remove blood in the brain and decrease pressure on the brain, surgery to fix broken blood vessels, and medications to prevent or reverse swelling in the brain 2 Therapeutic hypothermia 2 Mechanical clot retrieval Quality Designations St. Mary Comprehensive Stroke Center St. Mary Medical Center is among a distinguished group of U.S. hospitals to be recognized for our comprehensive and high-quality stroke care: In 2002, St. Mary was the first hospital in Pennsylvania to meet the Guidelines for Acute Stroke Treatment established by the National Brain Attack Coalition. St. Mary has earned the Joint Commission s Gold Seal of Approval for Comprehensive Stroke Centers. The American Heart Association and American Stroke Association have recognized St. Mary for our consistent adherence to all Get With The Guidelines stroke performance achievement indicators and quality measures. 4 St. Mary Neurosciences Center
Delivering Targeted t-pa This alternative therapy is targeted for patients who arrive more than three and within six hours from the start of stroke symptoms. A small catheter can be placed within the blockage to deliver tissue plasmogen activator (t-pa) directly into the clot and dissolve it, restoring normal blood flow to the brain. Patient Resources: Educational Programs St. Mary Medical Center offers educational sessions on different topics of interest to stroke survivors and family caregivers. Sessions are provided free of charge. Call 215.710.2604 for more information. Stroke Support Group Stroke survivors and their loved ones are invited to take part in the St. Mary Stroke Support Group. Meetings are held the second Tuesday of each month at the Medical Center, and feature guest speakers who discuss their personal experiences. Call 215.710.5828 for more information. St. Mary Neurosciences Center 5
Neurodiagnostics The neurosciences physicians on staff at St. Mary Medical Center specialize in evaluating, diagnosing, and treating epilepsy, aneurysms, Parkinson s disease, multiple sclerosis, Alzheimer s disease, brain tumors, uncommon headaches, dizziness, and other neurological conditions. St. Mary has invested heavily in technologies that aid our specialists in making an expert diagnosis and developing individualized plans of care for every patient. Neurodiagnostic Capabilities: 2 Nasopharyngeal (T1-T2) electroencephalograms (EEGs) 2 Routine EEGs 2 Sleep-deprived EEGs 2 Visual and brainstem evoked potential 2 Somatosensory testing of upper and lower limbs, trunk, and head 6 St. Mary Neurosciences Center
Epilepsy The distinguished medical staff of the St. Mary Neurosciences Center includes board-certified neurologists who specialize in the research and treatment of epilepsy. The comprehensive epilepsy program at St. Mary provides a full range of outpatient and inpatient services with new and established diagnoses of seizure disorders. Our specialists emphasize a team approach to patient care, working closely not just with our skilled nurses and technical staff, but also with referring physicians. Our goal is to control patients seizures and help them enjoy a more fulfilling and productive life. Our specially trained technologists have a wide range of non-invasive medical technologies digital electroencephalography (EEG), MRI, and PET/CT scanning for the diagnosis, treatment, and monitoring of seizure disorders. In addition, long-term EEG monitoring is available in our state-of-the-art Neurophysiology Laboratory. An excellent resource for your patients with seizure disorders is the Epilepsy Support Group. It meets each month at St. Mary Medical Center. For more information, call 215.629.5003, ext. 102. St. Mary Neurosciences Center 7
Neurosurgery The highly accomplished neurosurgeons at the St. Mary Neurosciences Center are dedicated to caring for people who need specialized surgical interventions for some of the most challenging conditions that affect the brain, spine, and nervous system. Every day, St. Mary neurosciences experts solve the most complex cases using advanced procedures and advanced treatment technologies never before imagined. Whenever clinically appropriate, our team uses a minimally invasive approach, which enables us to take on even the most difficult cases with greater levels of surgical skill and precision. Areas of Expertise: Acoustic neuromas Aneurysms Arteriovenous malformations Cerebrovascular diseases Cervical neck surgery Neurosurgical Capabilities: 2 Brain Lab computerized brain mapping, which allows our specialists to biopsy and treat brain tumors with unprecedented precision 2 Complex and minimally invasive spinal surgery, including kyphoplasty for the treatment of spinal compression fractures due to osteoporosis 2 Frameless Stereotactic Radiosurgery (SRS), a non-invasive treatment for cancer that requires no anesthesia 2 High-definition microscopes for brain and spine surgery Chiari malformations Chronic back pain Colloid cysts Degenerative disc disease Epilepsy Intracranial hemorrhages Meningiomas Metastatic brain tumors Movement disorders Peripheral nerve disorders Spine surgery Traumatic head and spinal cord injuries Neurovascular Surgery and Endovascular Neurosurgery Two of the fastest-growing subspecialties within the St. Mary Neurosciences Center are in the areas of neurovascular surgery and endovascular neurosurgery. Our highly skilled surgeons specialize in the evaluation, diagnosis, and treatment of aneurysms, arteriovenous malformations (AVMs), intracranial hemorrhages, stenosis, stroke, transient ischemic attacks (TIAs), and other vascular disorders that affect the brain and spinal cord. In appropriate patients, many of the procedures are performed with minimally invasive techniques. Neurovascular and Endovascular Capabilities: 2 Aneurysm coiling 2 Carotid stenting 2 Clot retrieval 2 Endovascular neurosurgery 2 Epilepsy surgery 2 Minimally invasive coronary and cerebral angiography procedures 2 Tumor embolization to reduce bleeding during surgery 2 Vascular malformation management 8 St. Mary Neurosciences Center
Interventional Neurosurgery The neuro-interventional surgeons at St. Mary Medical Center are medical doctors with specialized training and board certification in their field of expertise. These highly skilled physicians use image guidance to perform a variety of advanced, minimally invasive techniques to diagnose and treat vascular diseases of the central nervous system. Some of the technologies used by our interventional team include threedimensional digital imaging, ultrasound, CT scans, digital X-rays, and MRI. conditions that once required highly invasive surgical interventions. Conditions that now can be treated non-invasively include: 2 Aneurysms 2 AVMs 2 Tumors of the brain and spine Further, our neuro-interventional surgeons can provide treatment in emergency situations, when minutes or even seconds are critical to successful outcomes. Our neuro-interventionists are available 24/7. For many patients, neuro-interventional procedures are an excellent treatment option for neurological Treating medical conditions of the head, neck, and spine requires a sophisticated level of expertise and skilled techniques. St. Mary has dedicated the resources to advance its neurosciences program to provide the highest standards of leading-edge care. Mark McLaughlin, MD Neurosurgeon and Medical Director of Brain and Spine Surgery at St. Mary Medical Center St. Mary Neurosciences Center 9
ICU and Step-Down Unit with Dedicated Neurosciences Care, Neurosciences Operating Rooms, and Technology At the St. Mary Neurosciences Center, we have embraced the single-roof concept to streamline the delivery of care for patients with serious neurological conditions. In deploying this concept, we have centralized all of our talents and capabilities in a single unit which means your patients don t have to travel outside of their community to find the specialized care they need. Because the incidence of stroke, seizure, debilitating headaches, cancer, concussions, and trauma with neurology deficits continues to increase in our growing and aging community, St. Mary is committed to meeting these healthcare needs with advanced technologies and skilled specialists to treat complex cases. Most recently, our ongoing investment in neurosciences services has enabled us to: 2 Expand our Surgery Department with advanced neurosciences technology 2 Upgrade our Intensive Care Unit with neurosciences capabilities 2 Expand our inpatient facilities to better meet the needs of patients receiving care for neurological disorders 2 Recruit expert physicians and nurses in the field of neurosciences Neurosciences Operating Rooms Further demonstrating St. Mary s commitment to providing our community with top-tier neurosciences care, we offer two state-of-the-art operating rooms (ORs), designed specifically to allow neurosurgeons to perform minimally invasive and image-assisted procedures. A hybrid OR is equipped with an advanced biplane imaging system that generates highly detailed, threedimensional views of small blood vessels, soft tissue, and the patient s anatomy. The advanced software technology of the imaging system creates detailed images of soft tissue such as brain tissue similar to images generated by a computed tomography (CT) scanner. Two flat-panel X-ray detectors also help physicians visualize interventional devices, such as guidewires and catheters, in precise detail and from almost any angle. The extremely detailed high-resolution images allow surgeons to perform complex interventions with newly emerging procedures used to treat patients with conditions previously considered too difficult for surgery. The biplane system also is designed to provide patients with the lowest possible radiation dose, and to reduce the need to reposition patients for imaging studies. 10 St. Mary Neurosciences Center
The amazing detail provided by this high-tech imaging system enhances our capabilities to perform the most delicate procedures in the most vulnerable regions of the body. This will greatly benefit the existing and future healthcare needs of our community. Robert Rossenwasser, MD Neurosurgeon and Medical Director of Endovascular Services at St. Mary Medical Center St. Mary Neurosciences Center 11
The Neurosciences ORs also are well equipped for neurosurgical evaluation of the neck and spine to diagnose and treat: 2 Chronic pain 2 Nerve and peripheral nerve compression 2 Herniated intervertebral discs 2 Spinal cord compression syndromes and repair surgery 2 Spinal cord and head injuries resulting from trauma 2 Malignant and benign tumors of the brain, spine, and peripheral nerves ICU with Dedicated Neurosciences Care St. Mary offers a specially equipped state-of-the-art Intensive Care Unit (ICU) to provide the highest level of expert care for our most critically ill patients. The patient-centered design of the ICU is exceptional, with: 2 Large private patient suites, each with its own bathroom, and comfortable lounge chairs for family members 2 Flush-to-the-wall bed panels and glass dividers between nursing stations serve to improve line of sight and enhance interaction for staff, patients, and families 2 Overhead lifts to assist with repositioning and transporting patients 2 Motorized patient beds outfitted with special air mattresses to help prevent pressure ulcers, an internal music system for soothing sound therapy, and a language-translation program of standardized yes and no questions relating to patient care The nursing care provided in our ICU is among the most specialized available for patients recovering from stroke, back injuries, aneurysms, seizures, neurovascular diseases, brain tumors, and more. Our ICU nurses are specially trained to provide: 2 Advanced monitored care for subtle changes in a patient s condition 2 Treatments such as medically induced coma and therapeutic hypothermia 2 Bispectral monitoring of a patient s level of consciousness and monitoring levels of intracranial pressure, electrical activity, and tissue oxidation in the brain 12 St. Mary Neurosciences Center
The high level of patient care in the ICU will benefit the intense care needs of some of the most vulnerable patients we treat. This is a significant resource that strengthens the capabilities of our entire neurosciences program. Benjamin Solomon, MD Medical Director, St. Mary ICU St. Mary Neurosciences Center 13
Fighting Brain and Spine Tumors According to the National Institute of Neurological Disorders and Stroke, there are more than 120 types of brain and spinal cord tumors, and more than 195,000 people in the United States are diagnosed with a brain tumor each year. Neurosurgery, radiation therapy, radiosurgery, and chemotherapy are among the most widely used treatment options for patients with brain cancer. Physicians at the St. Mary Neurosciences Center personalize each patient s treatment plan based on the type, stage, and size of the tumor, as well as his or her ability to tolerate certain medications or surgery. With all brain and spine cancers, the goal of treatment is to preserve healthy tissue while destroying tumors at their point of origin. In some cases, treatment also may target cancer cells that may have spread to other areas of the body. For patients diagnosed with a brain tumor, St. Mary is among the first in the region to offer Frameless Stereotactic Radiosurgery (SRS) as a breakthrough treatment to fight cancer. The goal of SRS is to destroy the target tumor without open surgery and without harming nearby healthy tissue. SRS uses focused high-energy radiation beams to destroy tumors. Traditional methods for delivering SRS required an invasive frame that was screwed into the patient s skull bone. Today, new technology known as Image-Guided Radiation Therapy (IGRT) has been introduced to allow for the more comfortable Frameless SRS. 14 St. Mary Neurosciences Center
Neuro-Oncology Tumor Conferences On a regular basis, a team of neurosciences and oncology specialists at St. Mary Medical Center comes together to participate in multidisciplinary conferences, where a patient s case is evaluated from every angle. The team arrives at the single best plan for that patient, and starts the right treatment sooner. Oncology Clinical Research As part of our commitment to provide patients with the latest developments in treatment, St. Mary Medical Center participates in clinical trials of new therapeutic agents for spine and brain tumors. Radiation Oncology At the St. Mary Neurosciences Center, radiation oncology is a crucial component of the care we provide to patients who are diagnosed with tumors in the brain or spine, brain malformations, or nervous system disorders. Our collaborative approach offers effective treatment options, as it brings together our neurosurgeons and radiation oncologists. The disorders we confront on a daily basis pose complex challenges. We ve met the challenges with equally complex, non-invasive technology. When it comes to evaluating, diagnosing, and treating neurological conditions, St. Mary Medical Center proudly offers the latest advances in: 2 Magnetic resonance imaging (MRI) 2 Positron emission tomography and multi-slice CT scanning (PET/CT) 2 3D CT scanning for treatment planning and treatment techniques 2 Intensity-modulated radiation therapy (IMRT) 2 Frameless Stereotactic Radiosurgery (SRS) 2 HI-ART TomoTherapy combines IGRT with real-time CT scanning St. Mary Neurosciences Center 15
St. Mary Sleep/Wake Disorders Center Often unrecognized, sleep disorders take a national toll. With more than 80 identifiable sleep and wake disorders, it is estimated that three out of five adults will experience sleep difficulty at some time in their lives. These individuals might benefit from a consultation with the specialists at the nationally accredited St. Mary Sleep/Wake Disorders Center. Since the center s founding in 1994, we have performed more than 2,500 polysomnograms each year. The St. Mary Sleep/Wake Disorders Center is the largest of its kind in Bucks County, with spacious accommodations for up to 10 bedroom suites. The suites are fully soundproofed and designed with the amenities of a hotel room, including queen-sized beds, private bathrooms, wardrobe closets, and flat-screen televisions. We have rooms with handicap-accessible bathrooms and rooms that can accommodate bariatric patients. All adult and pediatric sleep studies are performed and scored by our registered polysomnographic technologists many with multiple credentials in respiratory therapy and neurophysiology and reviewed by our board-certified physicians. A full report is sent to your office, with recommendations for follow-up or treatment options if needed. Among a select few facilities in the area to perform sleep studies of children, St. Mary offers a comforting pediatric suite with a connecting parent room equipped with video monitoring. The St. Mary Sleep/Wake Disorders Center has earned the highest level of accreditation from the American Academy of Sleep Medicine, as well as Disease-Specific Care certification from the Joint Commission. We are one of an elite few centers nationwide to earn both of these distinctions. Howard Lee, MD Medical Director, St. Mary Sleep/Wake Disorders Center 16 St. Mary Neurosciences Center
Diagnostic and Therapeutic Services 2 Polysomnographic studies adult and pediatric 2 Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) titration 2 Nocturnal seizure monitoring and evaluation 2 Multiple sleep latency tests (MSLT) and maintenance of wakefulness tests (MWT) 2 Patient education and support groups, including AWAKE support group meetings 2 Sleep consultations 2 On-site mask fittings and clinics The St. Mary Sleep/Wake Disorders Center offers Two easily accessible locations: St. Clare Medical Building, Ground Floor, 1201 Langhorne-Newtown Road, Langhorne 3034-A Knights Road, Bensalem To register for a sleep study call 215.710.6744. St. Mary Neurosciences Center 17
Rehabilitation For patients receiving treatment for stroke, neurosurgery, or traumatic injury, rehabilitation is an important part of the recovery process. Under the guidance of a board-certified physiatrist, our team of licensed rehabilitation professionals works individually with patients and their families. The goal of rehabilitation which may include speech, physical, occupational, and recreational therapy is to improve patients physical and mental capabilities, help them adapt to any limitations, and regain as much independence as possible. All of our certified specialists emphasize a team approach, providing a high level of personal attention to every patient, explaining what to expect during diagnosis and treatment, answering questions, and offering caring support. St. Mary physical therapists have trained in neurodevelopmental techniques and have a variety of assistive devices to help patients improve limb mobility, strength, and function as they recover from a stroke, traumatic injury, or neurological disorder. Therapy is an important part of recovery for many stroke survivors. The goal of neurological rehabilitation is to help patients regain function and strength, as well as their ability to perform activities of daily living. The physical, speech, and occupational therapists at St. Mary use a variety of specialized rehabilitation equipment and medical devices with people who are recovering from stroke, traumatic brain injuries, and other neurologic conditions: 2 LiteGait Treadmill Training Unit 2 Bioness L300 2 Bioness H200 2 SaeboFlex 2 SaeboReach Our speech-language pathologists are also certified brain injury specialists who develop individualized treatment plans from advanced assessments to maximize recovery from communication, cognitive, and swallowing disorders for individuals who have survived a stroke, traumatic brain injury, or neurological disorder. Our Speech Therapy Department utilizes advanced treatment options, including LSVT LOUD. At the St. Mary Neurosciences Center, it s the care continuum fast, accurate diagnosis; effective, targeted treatment; and patient-centered plans of rehabilitation that sets apart the care we provide. And for patients whose conditions require after-care upon their discharge from the hospital, St. Mary Home Health Care is available to provide skilled healthcare services in the comfort and privacy of an individual s home. 18 St. Mary Neurosciences Center
Our outpatient center is unique in the fact that we offer speech therapy, occupational therapy, and physical therapy to patients, which makes it extremely convenient for them to receive their multidisciplinary services at the same site. Chrissy Colistro, MPT Chief of Physical Therapy St. Mary Neurosciences Center 19
St. Mary Regional Trauma Center The St. Mary Regional Trauma Center meets the tough standards required for accreditation in the Commonwealth of Pennsylvania by the Pennsylvania Trauma Systems Foundation (PTSF). Our Trauma Center is fully equipped to handle all types of critical care. We combine this with neurological needs, providing 24/7 neurosurgery coverage. As such, patients receive some of the most comprehensive treatment and follow-up care available in our community today. The most common causes of injury that bring patients to a trauma center are falls and motor vehicle crashes. These events cause life-threatening trauma in multiple areas of the body. Other common causes of injury include burns, gunshot wounds, and assaults. The major component that differentiates a Trauma Center from emergency care is the requirement for 24-hour availability of a team of specially trained healthcare providers who have expertise in the care of severely injured patients. The St. Mary Regional Trauma Center includes state-of-the-art trauma bays with immediate access to diagnostic services, and a sterile operatingroom environment. Trauma patients receive priority admission and immediate access to full services, including OR and CT scans. The trauma team, neurosurgeons, and neurologists use a collaborative approach to the treatment of brain and spine trauma. The new investment in neurovascular neurosurgery, continuous EEG, and dedicated neurosciences ICU will better serve our community. 20 St. Mary Neurosciences Center
St. Mary Medical Center 1201 Langhorne-Newtown Road Langhorne, PA 19047 For physician services, call 215.710.5388. For physician referral, call 215.710.5888. www.stmaryhealthcare.org Find us on Facebook