University Hospitals Neurological Institute Physician Referral Guide

Transcription

1 University Hospitals Neurological Institute Physician Referral Guide 2009 Summer 2010

2 University Hospitals Neurological Institute is Northeast Ohio s first designated neurological institute providing integrated and comprehensive care for patients with diseases affecting the nervous system. The institute comprises 16 Centers of Excellence, which bring together some of the country s foremost experts in neurology, neurosurgery, neuroradiology, neuro-oncology, neuro-ophthalmology, neurotology, neuropathology, neuropsychology, neuropsychiatry and related specialties. Through a dedicated multidisciplinary team of skilled specialists with access to cutting-edge technologies, facilities and research, the institute delivers first-class care for the full range of neurological disorders. From minor management of common disorders to the most advanced treatments and surgeries, no case is too complex. Warren R. Selman, MD Director, UH Neurological Institute Chairman, Department of Neurological Surgery Office Phone: Anthony J. Furlan, MD Co-Director, UH Neurological Institute Chairman, Department of Neurology Office Phone: Robert H. Miller, PhD Director, Translational Neurosciences Center Office Phone: David E. Riley, MD Director, Movement Disorders Center Office Phone: Leadership University Hospitals neuroscience specialists are available to you as a resource for second opinions or to consult or operate on complex diseases. By referring patients into the University Hospitals Neurological Institute, you can count on unparalleled communication keeping you informed on your patients progress, and returning them to your practice for ongoing care and follow-up. With personalized treatment plans from specialists in any of our 16 Centers of Excellence, patients may also receive care from our nationally recognized colleagues at University Hospitals Rainbow Babies & Children s Hospital and University Hospitals Ireland Cancer Center. Nancy Tinsley, RN, MBA, FACHE Vice President, UH Neurological Institute Office Phone: Alan R. Cohen, MD Director, Minimally Invasive Neurosurgery Center Office Phone: Appointment Phone: Robert J. Ronis, MD, MPH Associate Director, UH Neurological Institute Director, Neuropsychiatry Center Chairman, Department of Psychiatry Office Phone: Appointment Phone: Martha Sajatovic, MD Director, Neurological Outcomes Center Office Phone: , Centers of Excellence Include: Brain Tumor & Neuro-Oncology Community Neurology Epilepsy Michael A. DeGeorgia, MD Director, Music & Medicine and Neurocritical Care Center Co-Director, Cerebrovascular Center Office Phone: Mark S. Scher, MD Director, Rainbow Neurological Center Office Phone: Memory & Cognition Minimally Invasive Neurosurgery David J. Hart, MD Director, Spinal Neurosurgery Center Office Phone: Cathy A. Sila, MD Director, Stroke & Cerebrovascular Center Office Phone: Movement Disorders Music & Medicine Neurocritical Care Bashar Katirji, MD Director, Neuromuscular Center Office Phone: Andrew E. Sloan, MD Director, Brain Tumor & Neuro-Oncology Center Office Phone: Neurological Outcomes Neuromuscular Neuropsychiatry Daniel Koontz, MD Director, Community Neurology Center Office Phone: Appointment Phone: Erin Supan, RN Director, Neuroscience Nursing Practice Center Office Phone: Neuroscience Nursing Practice Rainbow Neurological Spinal Neurosurgery Alan J. Lerner, MD Director, Memory & Cognition Center Office Phone: Appointment Phone: Robert W. Tarr, MD Associate Director, UH Neurological Institute Section Chief, Department of Neuroradiology Office Phone: Stroke & Cerebrovascular Translational Neurosciences Hans O. Lüders, MD, PhD Director, Epilepsy Center Office Phone:

3 Innovations in Caring UH Case Medical Center is internationally renowned for its innovations in healing and discovery. In addition to providing state-of-the-art care for patients with neurological diseases, the UH Neurological Institute educates medical students, neurology residents and fellows in neurology subspecialties. Center of Excellence The University Hospitals Neurological Institute has been designated as a Center of Excellence the only Neuroscience Center of Excellence in the State of Ohio with a Stage 4-Institute Designation. The COE Survey is the only one of its kind in neurosciences and is the industry standard for evaluating program infrastructure. The Stage 4-Institute Designation reflects the UH Neurological Institute s multispecialty approach to care and ability to offer the most comprehensive range of neurological specialists and patient services available anywhere. Leading Innovations: First in the world to test the diaphragm pacing stimulation system on patients with amyotrophic lateral sclerosis (ALS) Annual Performance Achievement Award for Stroke: Awarded by the American Heart Association University Hospitals Case Medical Center, the only major teaching hospital in Ohio to be recognized by Thomson Reuters 100 Top Hospitals Beacon Award for Critical Care Excellence Leapfrog Top 50 Hospitals Magnet Status for Nursing Novel Research: There are currently over 110 research protocols under way at UH Case Medical Center in basic and clinical neurosciences with research funding over $10 million directed at understanding diseases of the nervous system and developing new treatments based on that knowledge. Our partner institution, Case Western Reserve University School of Medicine, continues to have one of the top NIH-funded neuroscience departments in the country. For more information on current research protocols, visit UHhospitals.org/neuro/clinicaltrials. Brain Tumor & Neuro-Oncology Center UH Neurological Institute s Brain Tumor & Neuro-Oncology Center facilitates seamless collaborations between University Hospitals world-renowned main campus facilities, UH Ireland Cancer Center and UH Rainbow Babies & Children s Hospital to treat adult and pediatric patients with both benign and malignant tumors. The interdisciplinary approach enables UH Case Medical Center to offer a personalized treatment plan for each patient and their referring physician, while simultaneously giving them access to top experts in the field and the most advanced clinical trials available. Surgical solutions: Laser Interstitial Thermotherapy (LITT) in the intraoperative MRI Gamma Knife and CyberKnife Radiosurgery for brain and spine tumors Image-guided surgical navigation Intraoperative magnetic resonance imaging operating room Intraoperative brain mapping of tumor and functionally critical brain involving motor, language, sensory, visual and cranial nerves Endoscopic neurosurgical techniques Multidisciplinary skull-base approaches Conditions treated: The Brain Tumor & Neuro-Oncology Center treats adult and pediatric patients with both benign and malignant tumors, including: Acoustic neuromas Astrocytomas Brain stem gliomas Ependymomas Glioblastomas Gliomas Medulloblastomas Meningiomas Mixed gliomas Oligoastrocytomas Oligodendrogliomas Optic nerve gliomas Pilocytic Astrocytomas Skull-base tumors Brain Tumor & Neuro-Oncology First in North America to perform deep brain stimulation of the thalamus to successfully treat symptoms of Tourette s syndrome One of only nine hospital centers within the United States experienced in using AutoLITT for minimally invasive brain tumor surgery First in Ohio to offer both Gamma Knife and CyberKnife in our Stereotactic Radiosurgery suite Physician Advice Line: The UH Neurological Institute partners with you to improve communication and provide immediate, decision-making advice to physicians seeking clinical expertise. Our experts provide advice on common and complex neurological problems, and information on the latest diagnosis and treatments. For an immediate consultation, call Minimally invasive and nonsurgical solutions: Laser Interstitial Thermotherapy (LITT) in the intraoperative MRI Gamma Knife Radiosurgery CyberKnife Radiosurgery Neuroscience Intensive Care Unit is one of only 25 centers in the nation offering fellowships in neurocritical care The region s only provider of pterygoid botox injections for treatment of movement disorders One of Ohio s first physician-led Brain Attack programs now one of the largest in the nation with 24/7 availability for emergency transfers One of only 25 centers in the United States offering surgical therapy for dystonia First comprehensive pediatric autonomic lab in the country Only program in the United States that offers multiple hippocampal transections for the treatment of epilepsy Physician Communication: The model for interaction with physicians who refer to the UH Neurological Institute emphasizes communication and mutual respect. We ensure continuity of care from referring physician to specialist by providing prompt communication after each patient visit and carefully coordinated perioperative management. To refer a patient, call UH4-CARE. 24-hour Rapid Referral If you have a patient requiring immediate consultation, our Rapid Referral line is available for appointments with all of our specialists within 24 hours. Call UH4-CARE. Laser Interstitial Thermotherapy (LITT) in the intraoperative MRI Pioneered by UH Case Medical Center in 2008, AutoLITT technology enables the surgeon to use MRI-guided lasers to destroy previously inoperable tumors without damaging the surrounding healthy tissue. Approved by the U.S. Food and Drug Administration in 2009, this revolutionary technology and minimally invasive approach is especially effective in treating glioblastoma, one of the most aggressive and difficult-to-treat brain cancers. UH Case Medical Center is one of only nine hospital centers in the United States using this technology. National Recognitions: National Association of Epilepsy Centers: The highest designation as a Level IV Epilepsy Center Certified Primary Stroke Center: Awarded to UH Case Medical Center and UH Geauga Medical Center. The highest available designation from The Joint Commission. 4 To learn more about the UH Neurological Institute, please visit UHhospitals.org/neuro. Receive decision-making advice from UH neurological or neurosurgical experts 5 by calling or visit UHhospitals.org/neuro/healthprofessionals.

4 Brain Tumor & Neuro-Oncology Innovations: Surgeons at UH are pioneering new approaches of minimally invasive brain surgery including: Laser Interstitial Thermotherapy with real-time MRI using the Monteris AutoLitt System Brain mapping with functional MRI (fmri), Diffusion Tensor Imaging (DTI) and/or magnetoencephalography (MEG) to optimize identification of brain tumors and surrounding normal tissues Intraoperative MRI to maximize safety and completeness of tumor removal New techniques for optical and fluorescence imaging to better identify infiltrating tumor Convection Enhanced Delivery (CED): A technology to improve delivery of small anti-tumor molecules and chemotherapy to brain tumors Stereotactic Radiosurgery using Gamma Knife or CyberKnife Current Clinical Trials: UH provides both standard and advanced nonoperative treatments for patients with brain tumors through our advanced and extensive clinical trials. Many of these are offered in collaboration with the NCI-funded Adult Brain Tumor Consortium (ABTC), a group of 15 elite Brain Tumor Centers of Excellence which collaborate to offer the most innovative treatments to patients with brain tumors. Clinical trial offers change frequently, but current offers include: Tumor vaccines (immunotherapy) to teach the patient s own immune system to fight their tumor New drugs specifically targeting brain tumor stem cells which are resistant to current therapies Specific trials include: ABTC 0603 A Phase I/II Trial of Hydroxychloroquine in conjunction with Radiation therapy and concurrent and Adjuvant Temozolomide in Patients with Newly diagnosed Glioblastoma Multiforme (Version 01/08/09) ABTC 0703 Phase I/II study of the poly (ADP-ribose) polymerase-1(parp-1) inhibitor BSI-201 in patients with newly diagnosed malignant glioma (version 02/06/09) ABTC 0904 A Biomarker and Phase II Study of GDC-0449 in Patients with Recurrent Glioblastoma Multiforme ABTC 0901 An Open Label, Phase 2 Study Evaluating the Safety and Efficacy of IMC-3G3 or IMC-1121B in Patients with Recurrent Glioblastoma Multiforme Daily interactions among multidisciplinary team members, combined with the most current treatment protocols, facilitate rapid response to individual therapeutic needs and modifications as necessary. Programs: Specialized programs allow physicians to develop appropriate paths to create personalized treatment plans with specialists from other areas of excellence within UH. Programs include: Benign Brain Tumor Program: Incorporates minimally invasive and image-guided approaches, endoscopic, skull base and radiosurgical techniques to treat and often cure benign tumors of the brain. Malignant Brain Tumor Program: Offers patients and referring physicians a personalized approach to innovative new therapies including new surgical techniques and technology and advanced therapeutic agents. Surgical trials include minimally invasive laser interstitial therapy with real-time intraoperative MRI, new methods of imaging to improve resection including optical imaging of tumor and intraoperative MRI guided resection. Other novel therapies include tumor vaccines (immunotherapy), targeting tumor stem cells, use of normal hematopoetic stem cells to minimize chemotherapy induced complications, and advanced chemotherapy in combination with anti-angiogenic approaches through internal trials at UH Case Medical Center, the Case Comprehensive Cancer Center, the Adult Brain Tumor Consortium (ABTC) and the Radiation Therapy and Oncology Group (RTOG). Metastatic Brain Tumor Program: Treatment approaches include integration of radiotherapy and radiosurgical approaches with Gamma Knife and CyberKnife, as well as advanced surgical techniques, to optimize outcomes and minimize risk. Skull Base Surgery Program: A multidisciplinary team of neurosurgeons, head and neck surgeons, otolaryngologists, ophthalmologists and radiation oncologists who use minimally invasive, image-guided and radiosurgical techniques to optimize outcome and minimize risk. Treatment of Brain Tumors in the Elderly: Integrated and multidisciplinary approach to tailoring treatments from other programs to accommodate patients over the age of 65. Neuro-Oncology Cancer Pain Program: Integrated multidisciplinary approach to treatment of cancer-related pain for patients with brain tumors. Stereotactic Radiosurgery: Multidisciplinary team of neurosurgeons, spine surgeons, radiation oncologists, physicists and medical oncologists utilizing state-of-the-art technology Gamma Knife Perfexion and CyberKnife for minimally invasive approaches to the treatment of lesions of the brain and spine. Specialized Equipment: Laser Interstitial Thermotherapy (LITT) in the intraoperative MRI Gamma Knife CyberKnife Intraoperative MRI (imri) Brain Tumor & Neuro-Oncology Gene therapy for brain tumors New agents targeting angio-genesis, the need for tumors to acquire a new blood supply Convection Enhanced Deliver (CED). New ways to deliver drugs and immunotoxins specifically to the tumor while avoiding toxicity from the normal brain. Innovative combinations of chemotherapeutic agents which are more powerful together than apart Pituitary/Neuro-Endocrine Program: Multidisciplinary team of neurosurgeons, skull base surgeons, radiation oncologists and endocrinologists employ a team approach to diagnose and treat disease of the pituitary and neuroendocrine system. Spine Tumor Program: Integrated team of radiation oncologists, spinal surgical oncologists, medical oncologists, orthotics and rehabilitation specialists focused on diagnosis and treatment of spinal neoplasms. CyberKnife 6 Access the library of innovative publications and earn free CME at UHhospitals.org/neuro/publications. Clinical trials are ongoing in our Centers. Learn more at UHhospitals.org/neuro/clinicaltrials. 7

5 Brain Tumor & Neuro-Oncology Andrew E. Sloan, MD Office Phone: Special Interests: Convection Enhanced Delivery (CED), Tumor Vaccines (Immunotherapy), Brain Tumors, Skull Base Surgery, Gamma Knife and CyberKnife Stereotactic Radiosurgery, Image Guided Neurosurgery, Stereotactic Surgery, Neuro-oncology Baha Arafah, MD Office Phone: Appointment Phone: Special Interests: Endocrinology, Pituitary Disorders, Adrenal Disorders Deborah R. Gold, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurology, Neurooncology, Pediatric Stroke UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Mentor Health Center Daniel P. Hsu, MD Office Phone: Special Interests: Neuroradiology, Diagnostic Radiology, Interventional Neuroradiology Janice A. Lyons, MD Office Phone: Appointment Phone: Special Interests: Radiation Oncology, Breast Cancer UH Chagrin Highlands Health Center, Mitchell Machtay, MD Office Phone: Appointment Phone: Special Interests: Lung Cancer, Head and Neck Cancer, Brain/Spine Tumors, IMRT and Radiosurgery, Bone & Soft Tissue Cancer, Neuro-oncology, Genitourinary Oncology, Gynecologic Cancer, Malignant Hematology, Pediatric Hematology/ Oncology Warren R. Selman, MD Office Phone: Special Interests: Cerebrovascular Surgery, Aneurysms, Arteriovenous Malformations and Occlusive Disorders, Skull Base Tumors, Acoustic Neuromas, Meningiomas, Pituitary Tumors Paula Silverman, MD Office Phone: Appointment Phone: Special Interests: Hematology and Oncology, Breast Cancer UH Chagrin Highlands Health Center, Brain Tumor & Neuro-Oncology Nicholas C. Bambakidis, MD Office Phone: Special Interests: Neuro-oncology, Spine Surgery, Skull Base Surgery, Cerebrovascular Surgery Alan R. Cohen, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurosurgery, Minimally Invasive Neurosurgery, Brain and Spinal Tumors, Craniofacial Surgery UH Rainbow Babies & Children s Hospital Mark L. Cohen, MD Office Phone: Special Interest: Diagnostic Neuropathology Henry B. Koon, MD Office Phone: Appointment Phone: Special Interests: Hematology/Oncology, Melanoma, Cutaneous Lymphoma, Renal Cell Carcinoma, Immunotherapy, Bone & Soft Tissue Cancer UH Chagrin Highlands Health Center, Charles Kunos, MD, PhD Office Phone: Appointment Phone: Special Interests: Gynecologic Radiation Oncology, Radiosensitizer Drug Development, Bone & Soft Tissue Cancer, Breast Cancer, Gynecologic Cancer, Malignant Hematology, Pediatric Hematology/ Oncology Charles Lanzieri, MD Office Phone: Special Interests: CNS Imaging, Head and Neck Imaging, Interventional Neuroradiology Cliff A. Megerian, MD Office Phone: Appointment Phone: Special Interests: Hearing Loss, Otitis, Chronic Ear Disease, Surgery for Hearing Loss and Tumor, Vertigo, Meniere s Disease, Dizziness, Neurotology, Skull Based Surgery, Acoustic Neuromas UH Chagrin Highlands Health Center, Charles Nock, MD Office Phone: Appointment Phone: Special Interests: Melanoma, Genitourinary Malignancies, Neuro-oncology Lisa Rogers, DO Office Phone: Special Interests: Neuro-oncology, Brain Tumor, Neurological Complications of Cancer UH Chagrin Highlands Health Center Jeffrey L. Sunshine, MD, PhD Office Phone: Appointment Phone: Special Interests: Neuroradiology, Interventional Neuroradiology, Head and Neck Imaging, MRI, Acute Stroke Treatment, Brain Aneurysm, Carotid Stenosis, Brain and Spine AVM, Intracranial Stenosis, MR Imaging Head, Neck, Spine 8 Discover upcoming educational opportunities including grand rounds and CME programs UH has established a Neurological Outcomes Center, committed to studying quality improvement and outcomes. 9 at UHhospitals.org/neuro/cme. Learn more at UHhospitals.org/neuro/outcomes.

6 Community Neurology Community Neurology Center At the Community Neurology Center, our experienced doctors use an interdisciplinary, highly integrated approach to care for patients with undiagnosed neurological disorders or those seeking second opinions. Offering appointment accessibility in many locations throughout the greater Cleveland area, patients receive a comprehensive evaluation, treatment, prevention and rehabilitation services. The programs are led by clinicians who are recognized and respected for accomplishments in their respective fields of expertise. Patients who visit our community facilities receive the same level of clinical expertise and comprehensive range of neurological services available at UH Case Medical Center. The neurologists and neurosurgeons at these locations are supported by the UH Neurological Institute and have unfettered access to its multidisciplinary team of specialists, cutting-edge technology and complete range of medical resources. Conditions treated: The Community Neurology Center provides comprehensive care for patients with diseases of the nervous system. Conditions treated include: Advanced back and spine surgery Alzheimer s and dementia disorders Autonomic disorders Brain surgery Chronic pain Epilepsy Fibromyalgia General neurology conditions and disorders Headache (including migraine) Multiple sclerosis Neuromuscular diseases Parkinson s disease Peripheral neuropathy Radiculopathy Stroke And more Clinical trials: Specialists in the Community Neurology Center collaborate with physicians within the UH Neurological Institute s Centers of Excellence to manage clinical trials and build research opportunities by connecting patients with specialists managing trials. Programs: Headache Management: Diagnose and treat migraine, cluster, sinus and tension headaches. Daniel Koontz, MD Office Phone: Special Interests: EMG, General Neurology, Neuromuscular Disorders, Peripheral Nerve Disorders UH Bedford Medical Center, UH Chagrin Highlands Health Center Neuro-ophthalmology: Diagnose and manage treatment for patients experiencing visual disturbances from optic nerve diseases, central nervous system disorders, ocular motility dysfunction and pupillary abnormalities. Patients benefit from collaboration between clinicians and world-renowned investigators in the field of eye movements. Multiple Sclerosis: Experienced experts provide early diagnosis and treatment with the latest disease-modifying drugs to positively alter the course of multiple sclerosis. Pain Management: Management of neuropathic pain syndromes such as radiculopathies, trigeminal neuralgia, postherpetic neuralgia, phantom limb pain, complex regional pain syndromes and the various peripheral neuropathies. Sleep Disorders: Diagnose and manage a variety of sleep disorders including sleep apnea, narcolepsy, restless leg syndrome, insomnia, circadian rhythm disorders and parasomnia. Specialized Equipment: EEG are recorded in community locations and read by world renowned epileptologists at UH Case Medical Center. EMG tests are performed by registered technologists and physicians with subspecialty training in neuromuscular and electrodiagnostic medicine. Autonomic Lab full tests are performed throughout community locations. Programs at the Community Neurology Center are led by nationally recognized clinicians with expert knowledge and experience in state-of-the-art diagnostic techniques and treatment disorders. James Bates, MD Office Phone: Appointment Phone: Special Interests: Neuro-Ophthalmology, Brain Disease Affecting Vision, Medical Ophthalmology UH Hudson Health Center Tina F. Blitz, MD Office Phone: Special Interests: Epilepsy, Neurophysiology, Headache, Sleep Disorders UH Chagrin Highlands Health Center Marek A. Buczek, MD Office Phone: Special Interests: General Neurology, Electrophysiology, Headache, Chronic Pain Syndromes, Head Injury, Language Mapping, St. John Medical Center Michael W. Devereaux, MD Office Phone: Special Interests: Multiple Sclerosis, Epilepsy, General Neurology, Neuro-Ophthalmology UH Richmond Medical Center, UH University Suburban Health Center Rose M. Dotson, MD Office Phone: Appointment Phone: Special Interests: Neuromuscular Disorders, Autonomic Dysfunction, Neuropathy, Neuropathic Pain, Autonomic Disorders, Headache, EMG UH Geauga Medical Center Brian B. Koo, MD Office Phone: Special Interests: Obstructive Sleep Apnea, Restless Leg Syndrome, Sleep Disorders UH University Suburban Health Center Richard J. Leigh, MD Office Phone: Special Interests: Dizziness, Vertigo, Unsteadiness, Visual Implants, Neuro-Ophthalmology, Language Mapping, Higher Cortical Functions VA Daniel W. Miller, MD Office Phone: Special Interests: General Neurology, Neuromuscular Disorders, Neurophysiology, EMG UH University Suburban Health Center Sagarika Nayak, MD Office Phone: Appointment Phone: Special Interests: Multiple Sclerosis, Headache, General Neurology, Stroke, Movement Disorders St. John Medical Center Marie Tani, MD Office Phone: Appointment Phone: Special Interests: General Neurology, Multiple Sclerosis UH Concord Health Center Colleen B. Tomcik, MD Office Phone: Special Interests: Higher Cortical Functions, Medical Education, Neurology, Headache UH Bedford Medical Center, UH Twinsburg Health Center Leonard Weinberger, MD Office Phone: Appointment Phone: Special Interests: General Neurology, Parkinson s Disease, EMG UH Concord Health Center Edward L. Westbrook, MD Office Phone: Special Interests: Cerebrovascular Disorders, Epilepsy, Multiple Sclerosis, Parkinson s Disease, General Neurology, Stroke UH University Suburban Health Center Norton A. Winer, MD Office Phone: Appointment Phone: Special Interests: Sports Related Neurological Injuries, Cerebrovascular Disease, Carotid Ultrasonography, Pain Management UH Richmond Medical Center Community Neurology 10 Access to high-tech, minimally invasive Radiosurgery techniques make life-altering differences in patient recovery for Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral 11 many types of neurological diseases. Learn more about UH options at UHhospitals.org/Radiosurgery. for a Rapid Referral within 24 hours.

7 Epilepsy Epilepsy Center With a level IV designation from The National Association of Epilepsy Centers, the UH Epilepsy Center provides services to adult and pediatric patients for consults or after previous treatments have failed. Personalized treatment plans include clinical drug trials, novel medications and advanced surgical therapies. Epileptologists accurately classify, quantify and localize seizure-producing areas of the patient s brain by using the most advanced diagnostic methods. Surgical solutions: Seizures that do not respond to pharmaceutical management may be reduced or eliminated through epilepsy surgery. Advances in presurgical diagnostic techniques, including brainmapping, expand therapeutic options to a larger percentage of epileptic patients. Temporal lobe resections Extratemporal lobe resections Lesionectomies Corpus callosum sections Selective amygdalo-hippocampectomies Multiple subpial transections Multiple hippocampal transections Hemispherectomies Vagal nerve stimulations Stereo-Electroencephalography (seeg) Minimally invasive and nonsurgical solutions: Precise, noninvasive localization of epileptic foci by sourceimaging the electric or magnetic signal directly on the patient s MRI Specialized MRI epilepsy-specific imaging protocols using 4 Tesla MRI, which can detect formerly hidden lesions Conditions treated: The epileptologists at UH specialize in all types of epilepsy, including: Adult epilepsy Developmentally delayed epilepsy Geriatric epilepsy Intractable epilepsy New onset epilepsy Pediatric epilepsy Women s epilepsy Innovations: Cortical stimulation identifies brain areas involved with specific cognitive functions like reading, writing and mathematical calculations, recognition of faces, etc. Cortico-cortical evoked potentials uncover brain to brain connections Advanced computer programs permit automatic recognition of the interictal and ictal epileptiform activity Multiple hippocampal transections reduce seizure activity while preserving memory functions Current clinical trials: UH researchers are pioneering advances in the understanding of and causes of seizures through participation in various clinical and surgical studies including: A Double-Blind, Randomized Conversion to Monotherapy Study to Evaluate the Efficacy and Safety of Brivaracetam in Subjects With Partial Onset Seizures. Only a limited number of antiepileptic drugs (AEDs) are approved for use as monotherapy. The objective of this study is to evaluate the efficacy of Brivaracetam when changing treatment for patients with partial onset seizures from combination treatment to monotherapy. Visual Field Assessment With Subjects Who Receive Either Lyrica Or Sugar Pills. Patients with partial seizures will take either Lyrica 300 mg per day or placebo in addition to their current medication. Visual field tests will be done at the beginning of the study, before Lyrica or placebo is added and at the end of the study. By the end of the treatment the person s visual field test results will be compared to the tests collected at the beginning, prior to taking the study drug, to see if there are any changes. Efficacy And Safety Study Of Pregabalin (Lyrica) As Monotherapy In Patients With Partial Seizures. This study will determine the safety and efficacy of pregabalin (Lyrica) when administered by itself (without any other anti-epileptic medication) to epilepsy patients for the treatment of partial seizures. Advances in presurgical diagnostic techniques, including brain-mapping, now offer surgical options to a significantly larger percentage of epileptic patients with medically intractable seizures. Programs: Epilepsy Monitoring Units (EMU): Provides separate units for both adult and pediatric patients where antiepileptic medications are reduced or removed and seizures are recorded with video/eeg to more precisely diagnose the type of epilepsy a patient has. Monitoring is also used to precisely localize the epileptogenic focus in patients who are candidates for epilepsy surgery. The UH Electroneurodiagnostics (END) Lab: Provides comprehensive testing of the electrical activity of the brain and nervous systems. The lab is equipped with electroencephalogram (EEG), continuous video EEG monitoring and evoked potentials. We also offer technology used for monitoring EEG or evoked potentials during surgery for brain or spinal cord tumor, trauma, aneurysm, vascular malformations or blockage, congenital abnormalities, spinal cord malformations, epilepsy surgery and movement disorders. Epilepsy Center at UH Rainbow Babies & Children s Hospital: This Level IV center is a key component of the Division of Pediatric Epilepsy that provides comprehensive, integrated and state-of-the-art patient care to children with epilepsy across all age groups. With access to a vast number of specialists and surgeons as well as the dedicated Epilepsy Monitoring Unit and Pediatric Intensive Care Unit the center offers the most advanced approaches to diagnosing, managing and treating epilepsy in infants and children. Intra-operative monitoring (IOM): Provides comprehensive monitoring of evoked potentials and other neurophysiologic parameters during surgery to immediately identify changes in brain, spinal cord and peripheral nerve function prior to irreversible damage. IOM also is effective in localizing anatomical structures, including peripheral nerves and sensorimotor cortex, which helps guide the surgeon during dissection. Hans O. Lüders, MD Office Phone: Special Interests: Clinical Neurophysiology, Higher Cortical Functions, EEG Electroencephalography, Epilepsy, Language Mapping Shahram Amina, MD Office Phone: Special Interest: Epilepsy UH Chagrin Highlands Health Center, UH University Suburban Health Center Specialized Equipment: 4 Tesla MRI Functional MRI Intracarotid amobarbital testing Ictal SPECT scans Mapping of seizure onset zones PET scans Specialized MRI epilepsy-specific imaging protocols Tina F. Blitz, MD Office Phone: Special Interests: Epilepsy, Neurophysiology, Headache, Sleep Disorders UH Chagrin Highlands Health Center Michael W. Devereaux, MD Office Phone: Special Interests: Multiple Sclerosis, Epilepsy, General Neurology, Neuro-Ophthalmology UH Richmond Medical Center, UH University Suburban Health Center Epilepsy 12 The Neuroscience Intensive Care Unit provides continuous, state-of-the-art monitoring and treatment To learn more about the UH Neurological Institute, please visit UHhospitals.org/neuro. 13 for critically ill patients. Learn more about our capabilities at UHhospitals.org/neuro/NSU.

8 Epilepsy Kitti Kaiboriboon, MD Office Phone: Special Interests: Clinical Neurophysiology, Epilepsy Mohamad Z. Koubeissi, MD Office Phone: Special Interests: Psychological Testing, Epilepsy, Surgery for Epilepsy, Memory, Forgetfulness, Seizures, Language Mapping, Higher Cortical Functions UH University Suburban Health Center Pamela Lang, CNS Office Phone: Special Interest: Epilepsy UH University Suburban Health Center Samden Lhatoo, MD Office Phone: Special Interests: Epilepsy, Neurophysiology UH Twinsburg Health Center Jonathan Miller, MD Office Phone: Special Interests: Pain Neurosurgery, Movement Disorders Surgery, Cancer Pain, Facial Pain, Peripheral Nerve Surgery, Stereotatic & Functional Neurosurgery, Epilepsy Surgery, Gamma Knife Stereotactic Radiosurgery, Neuro-oncology Shenandoah Robinson, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurosurgery, Pediatric Epilepsy Surgery, Spasticity Surgery UH Rainbow Babies & Children s Hospital Mark S. Scher, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurology, Pediatric Epilepsy, Fetal-Neonatal Neurology, Pediatric Neurointensive Care, Sleep Disorders UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake Susan Stagno, MD Office Phone: Special Interests: Adult Psychiatry, Consultation, Clinical Ethics, Anxiety Disorders, Psycho-Oncology, Psychiatric Aspects of Epilepsy Tanvir U. Syed, MD Office Phone: Special Interests: Intraoperative Monitoring, Epilepsy, Language Mapping, Higher Cortical Functions, Pseudoseizures, Outcomes Research, Biostatistics, Psychogenic Nonepileptic Seizures, St. John Medical Center, UH Medina Health Center Ingrid Tuxhorn, MD Special Interests: Pediatric Epilepsy, Pediatric Epilepsy Surgery, Neurology, Neurophysiology UH Rainbow Babies & Children s Hospital Max Wiznitzer, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurology, Autistic Spectrum Disorders, Developmental and Behavioral Disorders, Neurocognitive Disorders, Pediatric Stroke, ADHD Attention Deficit Hyperactivity Disorder UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake, UH Medina Health Center, Firelands Regional Medical Center Memory & Cognition Center UH Neurological Institute s Memory & Cognition Center has internationally recognized experts who devote themselves to caring not only for patients, but their families too. Through an interdisciplinary and longitudinal approach, treatment processes help maintain cognitive, physical and emotional fitness, as well as a measure of stability and reassurance. Programs for community and caregiver education, quality of care giving and risk factors for memory loss have been a center priority. Surgical solutions: Ventriculo-Peritoneal Shunting For individuals diagnosed with Normal Pressure Hydrocephalus. Conditions treated: Alzheimer s disease Mild cognitive impairment Frontotemporal dementia Parkinson s disease dementia Dementia & dementia with Lewy bodies Adult Attention Deficit-Hyperactivity Disorder Trisomy 21 (Down s syndrome) Vascular dementia Normal pressure hydrocephalus Innovations: The Memory & Cognition Center has established an interdisciplinary care model that has been adopted by neurological institutes nationwide. It has been a leader for research in Alzheimer s disease and has contributed to studies of the natural history, genetics and behavioral aspects of Alzheimer s disease. Patients and their families benefit from staff expertise and resources in the following areas: Neurology Radiology Geriatrics Pharmacy Social work Neuro-Psychology Pathology Geropsychiatry Nursing Speech Pathology Current clinical trials: Over the past two decades, our physicians have emerged as leaders in Alzheimer s disease evaluation and genetic studies. Clinical trials are ongoing to determine the safety and efficacy of pharmaceutical alternatives, including: Studies change frequently, following are those we are currently recruiting for: Randomized, Controlled Study Evaluating CERE-110 in Subjects with Mild to Moderate Alzheimer s Disease. The purpose of this study is to evaluate the potential benefits of CERE-110, an experimental drug that is designed to help nerve cells in the brain function better, in the treatment of Alzheimer s disease. CERE-110 uses a virus to transfer a gene that makes Nerve Growth Factor (NGF), a protein that may make nerve cells in the brain healthier and protect them from dying. A Phase 3 Study Evaluating Safety and Effectiveness of Immune Globulin Intravenous (IGIV 10%) for the Treatment of Mild to Moderate Alzheimer s Disease. The purpose of this study is to determine whether IGIV administered at two different doses for nine and 18 months results in a significantly slower rate of decline of dementia symptoms in subjects with mild to moderate Alzheimer s disease. Safety and Efficacy Study Evaluating Dimebon in Patients With Mild to Moderate Alzheimer s Disease on Donepezil (CONCERT). The purpose of this study is to determine if Dimebon is safe and effective in patients with mild to moderate Alzheimer s disease on Donepezil (Aricept). Cataract removal and Alzheimer s disease. The investigators have designed this study to determine whether or not cataract removal will improve the AD patient s quality of life, vision and cognition. Memantine (10mg BID) for the Frontal and Temporal Subtypes of Frontotemporal Dementia. Memantine (Namenda) has been approved for the treatment of Alzheimer s disease; this study seeks to understand if its use can be applied to Frontotemporal dementia to effectively decrease the rate of behavioral decline in frontotemporal dementia. For a current list of clinical trials within the Memory & Cognition Center, visit UHhospitals.org/trials/neuro/clinicaltrials. Memory & Cognition 14 UH neuroscience specialists are available to present at grand rounds or conferences. Receive decision-making advice from UH neurological or neurosurgical experts 15 To request a presentation, call or visit UHhospitals.org/neuro/physicianrequest. by calling or visit UHhospitals.org/neuro/healthprofessionals.

9 Memory & Cognition Programs: Our center coordinates with primary care physicians to go beyond treating biological issues by offering specialty services, such as: Alzheimer s Disease & Memory Disorders Program: Evaluates and treats individuals with Alzheimer s disease and related dementia syndromes. Services include traditional medical treatments and state-of-the-art clinical research programs. Memory Health Program: Targets individuals with concerns about maintaining brain health. The program offers a variety of services related to maintaining cognitive wellness in the context of aging. Sports Concussion Program: Evaluation of the severity and consequences of sports concussion in athletes, including assessment of safety for return to play and indicators of prognosis from head injury. Alan J. Lerner, MD Office Phone: Appointment Phone: Special Interests: Alzheimer s Disease, Dementia, Behavioral Neurology, General Neurology, Higher Cortical Functions, Adult Attention Deficit Disorder (adult ADD/ADHD) UH Foley Elderhealth Center Our staff works closely with the Neurology Department at Case Western Reserve University School of Medicine, and has access to the latest NIH-funded research as well as that of the pharmaceutical industry and top physicians around the world. Philip Fastenau, PhD Office Phone: Special Interests: Alzheimer s Disease, Attention- Deficit/Hyperactivity Disorder (ADD/ADHD), Concussion, Deep Brain Stimulation Surgery, Dementia, Epilepsy and Epilepsy Surgery, Hydrocephalus, Learning Disability (LD), Memory Loss, Mild Cognitive Impairment, Neuropsychological Test Development, Pediatric/Adult/Geriatric Neuropsychology, Traumatic Brain Injury (TBI) Minimally Invasive Neurosurgery Center UH Neurological Institute s Minimally Invasive Neurosurgery Center is the most experienced in Northeast Ohio and pioneered minimally invasive technology and applications for treatments of brain and spinal cord tumors and related conditions in both adults and children. Minimally invasive approaches and robotic technology enable surgeons to treat a wide range of conditions without having to cut through skull, face or back to reach the target. These methods spare sensitive tissue, minimize the risk of disabilities or disfigurement and significantly decrease recovery periods. Personalized treatment plans are developed by a multidisciplinary team of neurosurgeons, otolaryngologists, ophthalmologists, radiologists and plastic surgeons. Minimally invasive and nonsurgical solutions: Neuroendovascular surgery (also called interventional neuroradiology) is a subspecialty within the fields of radiology and neurosurgery that manages and treats complex neurologic lesions using minimally invasive techniques. Interventionists treat lesions from within rather than from outside, by delicately threading small catheters through veins and arteries. Treatments include: Endovascular aneurysm repair Angioplasty/pharmacological vasodilation for subarachnoid hemorrhage vasospasm Mechanical/pharmacological revascularization for acute stroke Angioplasty/stenting for intracranial and extracranial atherosclerotic disease Endovascular repair of post traumatic and neoplastic-related vascular injuries Minimally Invasive Spine Treatments enable spinal neurosurgeons to diagnose and treat all spinal disorders, including cervical spinal stenosis, lateral femoral cutaneous nerve syndrome, scoliosis, spinal cord injury and tethered cord syndrome. Treatments include: Extreme Lateral Interbody Fusion (XLIF) Posterior (keyhole) cervical forminotomy or microdiscectomy Removal of synovial cyst and certain spinal or paraspinal tumors Percutaneous lumbar facet screws Posterior spinal instrumentation (pedicle screws and rods) Presacral Transsacral L5-S1 Interbody Fusion (AxiaLIF) Thoracoscopic discectomy (with or without fusion) Transforminal Lumbar Interbody Fusion (TLIF) X-sopt implantation ( titanium bullet ) Minimally Invasive Neurosurgery Christopher Bailey, PhD Office Phone: Special Interests: Adult/Geriatric Neuropsychology, Alzheimer s Disease, Attention-Deficit/Hyperactivity Disorder (ADD/ADHD), Concussion, Dementia, Disability/Legal, Deep Brain Stimulation Surgery, Epilepsy and Epilepsy Surgery, Forensic Neuropsychology, Hydrocephalus, Memory Loss, Mild Cognitive Impairment, Neuropsychological Independent Medical Exam, Traumatic Brain Injury (TBI) UH Richmond Medical Center, UH Westlake Health Center Brian Dyko, NP Office Phone: Appointment Phone: Special Interests: General Neurology, Headache, Memory & Cognition, Neuromuscular Sees patients at: UH Case Medical Center,, UH Foley Elderhealth Center Steven A. Gunzler, MD Office Phone: Special Interests: Ataxia, Neurology, Dystonia, Memory and Aging, Botulinum Toxin Injections, Movement Disorders, Dementia, Parkinson s Disease, Huntington s Disease, Tremors UH University Suburban Health Center, UH Foley Elderhealth Center Paula K. Ogrocki, PhD Office Phone: Appointment Phone: Special Interests: Alzheimer s Disease & Dementia, Geriatric Neuro-Psychology, Memory and Aging, Licensed Clinical Psychologist, Forgetfulness, Psychological Testing UH Foley Elderhealth Center Peter J. Whitehouse, MD, PhD Office Phone: Appointment Phone: Special Interests: Geriatric Neurology, Dementia, Narrative Medicine, Cognitive Enhancement UH Foley Elderhealth Center Embolization of vascular malformations of the brain, head, neck and spine Embolization of brain, head and neck and spine neoplasms Radiosurgery (also known as stereotactic radiotherapy) allows noninvasive treatment of benign and malignant conditions by directing beams of ionizing radiation. Using a precise dosage of radiation, radiotherapy can be used to treat intracranial and extracranial tumors and lesions that would otherwise be inaccessible with open surgery. Treatments include: Gamma Knife: Uses 201 narrow beams of cobalt gamma radiation, all precisely focused on a single tumor or blood vessel abnormality. The tissue being treated receives the highest does of radiation, while surrounding healthy tissue is spared. The Gamma Knife procedure is generally performed on an outpatient basis with local anesthesia. CyberKnife : Is the only radiosurgery system that delivers high-dose, nonisocentric beams to the tumor from virtually unlimited positions, enabling physicians to aggressively treat tumors with submillimeter accuracy while minimizing damage to surrounding healthy tissue. This painless, noninvasive technology gives patients new hope for treatment of tumors and lesions that were previously diagnosed as untreatable or inoperable. Neuroendoscopic surgery allows surgeons to access and treat most areas of the brain and spine by navigating endoscopes and miniature instruments through the nasal passages or tiny incisions. Neuroendoscopic surgery minimizes scars and disfigurement, side effects, complications and recovery times. Treatments include: Brain tumors and cysts Craniosynostosis Hydrocephalus Pituitary tumors Spinal surgery Minimally invasive neurosurgery makes surgery far safer and less traumatic through the use of miniature computers and image guidance endoscopes. 16 Access the library of innovative publications and earn free CME at UHhospitals.org/neuro/publications. Clinical trials are ongoing in our Centers. Learn more at UHhospitals.org/neuro/clinicaltrials. 17

10 Minimally Invasive Neurosurgery Innovations: UH physician-researchers have been at the forefront of developing new, minimally invasive therapies and technologies to treat brain and spinal cord tumors. Center benchmarks include: One-of-a-kind minimally invasive neurosurgery lab, which focuses on developing new instruments and operative approaches, as well as teaching new surgical techniques (housed at UH Rainbow Babies & Children s Hospital) Virtual Reality Surgical Simulator: The flight simulator for the brain, the only such technology in the region International leadership role in minimally invasive (Endoscopic) neurosurgery First in the region to implement MR/OR: Intraoperative Magnetic Resonance Imaging (MRI), which enables surgeons to determine the extent of a tumor while the patient is undergoing surgery and ensure its accurate removal Alan R. Cohen, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurosurgery, Minimally Invasive Neurosurgery, Brain and Spinal Tumors, Craniofacial Surgery UH Rainbow Babies & Children s Hospital Kristine Blackham, MD Office Phone: Appointment Phone: Special Interest: Interventional Radiology David J. Hart, MD Office Phone: Special Interests: Minimally Invasive Spine Surgery, Complex Spine Surgery and Instrumentation Craniocervical Junction and Cervical Surgery, Spine Trauma, Spinal Cord Tumors, Spinal Column Tumors, Peripheral Nerve Entrapment, Endoscopic Spine Surgery, Hyperhydrosis Surgery UH Chagrin Highlands Health Center, UH Richmond Medical Center Teaching location for the AANS minimally invasive neurosurgery course Minimally invasive neurosurgery fellowship, including on-site laboratory training in a state-of-the-art simulation laboratory Daniel P. Hsu, MD Office Phone: Appointment Phone: Special Interests: Neuroradiology, Diagnostic Radiology, Interventional Neuroradiology Warren R. Selman, MD Office Phone: Special Interests: Cerebrovascular Surgery, Aneurysms, Arteriovenous Malformations and Occlusive Disorders, Skull Base Tumors, Acoustic Neuromas, Meningiomas, Pituitary Tumors Jeffrey L. Sunshine, MD, PhD Office Phone: Appointment Phone: Special Interests: Neuroradiology, Interventional Neuroradiology, Head and Neck Imaging, MRI, Acute Stroke Treatment, Brain Aneurysm, Carotid Stenosis, Brain and Spine AVM, Intracranial Stenosis, MR Imaging Head, Neck, Spine Robert W. Tarr, MD Office Phone: Special Interests: Neuroadiology, Interventional Neuroradiology Movement Disorders Center UH Neurological Institute s Movement Disorders Center is comprised of a multidisciplinary team of specialists that offer pharmaceutical therapy and surgical management to treat the complex implications of movement disorders. Surgical solutions: Functional and Restorative Neurosurgery: State-of-theart Deep Brain Stimulation (DBS) surgery, as well as comprehensive preoperative and postoperative care for patients undergoing DBS. Careful, fine-tuned programming of DBS stimulators, balanced with medical management, is provided on an ongoing basis. Deep Brain Stimulation (DBS) Program: Manages tremors, movement and walking problems via surgical implantation of electrodes in the brain and pulse generators in the upper chest just beneath the collarbones. Minimally invasive and nonsurgical solutions: Botulinum Toxin Therapy: Used to treat movement disorders, spasticity, drooling, migraine and other indications Conditions treated: Parkinson s disease Essential tremor Dystonia Innovations: First in North America to perform DBS of the thalamus to treat symptoms of Tourette syndrome successfully. The first group worldwide to complete a prospective randomized double blinded trial of thalamic DBS for Tourette syndrome in a pilot clinical trial of five patients. Greatest experience in Ohio with botulinum toxin injections, and uses the procedure for the broadest range of neurological indications. One of only 25 centers nationwide offering surgical therapy for dystonia. We use DBS to treat patients with dystonia, Parkinson s disease and essential tremor. DBS has been demonstrated to relieve tremors and other motor dysfunctions such as rigidity, bradykinesia, dyskinesia, and gait and balance problems. Current clinical studies: Establishment of a CTSC Parkinson s Disease Phenotypic and Genotypic Registry. The purpose of this research study is to establish a registry of people with Parkinson s Disease (PD) to examine the effects of genes on PD. Investigators will compare disease features in people with certain gene mutations associated with PD but without those mutations, attempting to identify any distinctive characteristics. Investigators will also try to determine how the mutations contribute to the damage done to nerve cells in PD. Assessment of Objective Measures of Motor Impairment in the On and Off Motor States of Parkinson s Disease. The purpose of this study is to test a new computer-based device called Quantitative Motor Assessment Tool (QMAT) in people diagnosed with Parkinson s disease (PD) to measure various tasks reflecting motor performance and compare the results to the Unified Parkinson s Disease Rating Scale (UPDRS). Assessment of Objective Measures of Motor Impairment In Parkinson s Disease: Evaluation of a Computer-Based Test Battery. This study tests the same new computer-based device as the previous study, the Quantitative Motor Assessment Tool (QMAT). This project involves the measurement of performance of PD subjects at random times, and represents a simpler version of the previous study. Genetic and Environmental Risk Factors for Progressive Supranuclear Palsy (PSP): The purpose of this study is to gain a better understanding of the genetic and environmental risk factors associated with the development of PSP. Participating subjects supply information about possible exposure histories by reviewing where they have lived, the diets they have consumed, and the jobs they have held, among other data. Subjects also furnish DNA through a blood draw. Thus the investigators will be able to look at both genetic and environmental risk factors to see if PSP patients share any common threads. Functional Magnetic Resonance Imaging (fmri) Investigations of the Pathophysiology and effects of Deep Brain Stimulation in Dystonia: This NIH-sponsored study aims to reveal changes in the integration of brain sensory and motor systems in patients with dystonia using advanced imaging techniques and to also use these techniques in patients undergoing Deep Brain Stimulation to understand how the integration of these systems change as dystonia improves. This information will lead to understanding into both the pathophysiology of dystonia, and the mechanism by which DBS produced its improvement. This may furthermore be used to advance the treatment of dystonia by improving the location or method by which DBS is delivered and through the development of new therapeutic approaches. Functional Magnetic Resonance Imaging (fmri) Investigations of the Pathophysiology of Parkinson s disease: This pilot study aims to understand brain network changes involved in changes in the handling and perception of proprioceptive information in patients with Parkinson s disease. Information gained from this study may be used to develop functional markers for progression of Parkinson s disease and may reveal the neural circuitry involved in the alterations of perception of scale in patients with Parkinson s disease. Movement Disorders 18 Discover upcoming educational opportunities including grand rounds and CME programs UH has established a Neurological Outcomes Center, committed to studying quality improvement and outcomes. 19 at UHhospitals.org/neuro/cme. Learn more at UHhospitals.org/neuro/outcomes.

11 Movement Disorders David E. Riley, MD Office Phone: Special Interests: Parkinson s Disease, Movement Disorders, Botulinum Toxin Injections, Tremors, Dystonia, Language Mapping, Higher Cortical Functions, Deep Brain Stimulation UH University Suburban Health Center, Steven A. Gunzler, MD Office Phone: Special Interests: Ataxia, Neurology, Dystonia, Memory and Aging, Botulinum Toxin Injections, Movement Disorders, Dementia, Parkinson s Disease, Huntington s Disease, Tremors UH University Suburban Health Center, UH Foley Elderhealth Center Jonathan Miller, MD Office Phone: Special Interests: Pain Neurosurgery, Movement Disorders Surgery, Cancer Pain, Facial Pain, Peripheral Nerve Surgery, Stereotatic & Functional Neurosurgery, Epilepsy Surgery, Gamma Knife Stereotactic Radiosurgery, Neuro-oncology Sagarika Nayak, MD Office Phone: Appointment Phone: Special Interests: Multiple Sclerosis, Headache, General Neurology, Stroke, Movement Disorders St. John Medical Center Benjamin L. Walter, MD Office Phone: Special Interests: Dystonia, Tremors, Movement Disorders, Functional Magnetic Resonance Imaging (MRI), Mechanisms of Effect of DBS, Deep Brain Stimulation, Parkinson s Disease UH University Suburban Health Center, UH Medina Health Center Ellen Walter, NP Office Phone: Special Interest: Movement Christina Whitney, CNS Office Phone: Special Interest: Movement Music & Medicine Recognizing that musicians often develop unique medical problems that can be devastating to their musical abilities and careers, the UH Neurological Institute has recently established the Center for Music & Medicine. Clinical trials, specialized equipment, and innovative treatment options make UH Case Medical Center uniquely qualified to correctly diagnose and manage music-related injuries. A full range of patient services relevant to music-related medical problems is available at UH Center for Music & Medicine Wellness Program. UH Case Medical Center and Case Western Reserve University School of Medicine collectively have researchers covering the entire spectrum of care, from perception of music, speech and voice, to memory and motor performance. Musician Wellness Program and Treatment of Music-Related Injuries: Tinnitus Musculoskeletal disorders Dizziness Voice and throat disorders Hearing loss Pulmonary disorders Depression Memory loss Visual loss Neuromuscular Disorders Overuse Syndrome Neural Impingement Focal Dystonia Psychiatric Disorders Anxiety Bipolar Disorder Depression & Substance Use Otological Disorders Hearing Loss Tinnitus & Vertigo Laryngological Disorders Laryngitis Voice Disturbance Aphonia Music & Medicine Michael DeGeorgia, MD Office Phone: Special Interests: Critical Care Bioinformatics, Hemorrhagic Stroke, Hypothermia, ICU Monitoring, Ischemic Stroke, Neurocritical Care Mohamad Z. Koubeissi, MD Office Phone: Special Interests: Epilepsy, Forgetfulness, Higher Cortical Functions, Language Mapping, Memory, Psychological Testing, Seizures, Surgery for Epilepsy UH University Suburban Health Center Jonathan Lass, MD Office Phone: Appointment Phone: Special Interests: Cataract and Lens Implant Surgery, Corneal and External Diseases, Corneal Transplantation, Eye Exams, Eye Injury, Eye Trauma, Intra-ocular Lenses, IOL, Ophthalmology, Vision Exams UH Landerbrook Health Center, UH Zeeba Surgery Center Alan J. Lerner, MD Office Phone: Appointment Phone: Special Interests: Alzheimer s Disease, Dementia, Behavioral Neurology, General Neurology, Higher Cortical Functions, Adult Attention Deficit Disorder (adult ADD/ADHD) UH Foley Elderhealth Center 20 The Neuroscience Intensive Care Unit provides continuous, state-of-the-art monitoring and treatment For more information, visit UHhospitals.org/musicandmedicine. 21 for critically ill patients. Learn more about our capabilities at UHhospitals.org/neuro/NSU.

12 Music & Medicine Hans O. Lüders, MD Office Phone: Special Interests: Clinical Neurophysiology, EEG Electroencephalography, Epilepsy, Higher Cortical Functions, Language Mapping Nicole Maronian, MD Office Phone: Special Interests: Ear, Nose & Throat, Head and Neck Cancer, Otolaryngology, Voice and Swallowing Disorders Cliff A. Megerian, MD Office Phone: Appointment Phone: Special Interests: Hearing Loss, Otitis, Chronic Ear Disease, Surgery for Hearing Loss and Tumor, Vertigo, Meniere s Disease, Dizziness, Neurotology, Skull Based Surgery, Acoustic Neuromas UH Chagrin Highlands Health Center, Jonathan Miller, MD Office Phone: Special Interests: Pain Neurosurgery, Movement Disorders Surgery, Cancer Pain, Facial Pain, Peripheral Nerve Surgery, Stereotatic & Functional Neurosurgery, Epilepsy Surgery, Gamma Knife Stereotactic Radiosurgery, Neuro-oncology Gail Murray, PhD, MEd Office Phone: Appointment Phone: Special Interests: Pediatric Audiology, Central Audiotory Processing, Cochlear Implantation UH Rainbow Babies & Children s Hospital, UH Chagrin Highlands Health Center David C. Preston, MD Office Phone: Special Interests: Neuromuscular Disorders, Electrophysiology, Myasthenia Gravis, Entrapment Neuropathies, Peripheral Neuropathies, Peripheral Nerve Disorders UH University Suburban Health Center, UH Richmond Medical Center Robert J. Ronis, MD, MPH Office Phone: Appointment Phone: Special Interests: Community Psychiatry, Adult Ambulatory, Psychopharmacology, Chemical Dependency, Psychotherapy, Addiction Psychiatry, Community Mental Health Robert Schilz, DO, PhD Office Phone: Appointment Phone: Special Interests: Bronchoscopy, Critical Care, Lung Transplantation, Pulmonary Vascular Disease Maroun Semaan, MD Office Phone: Appointment Phone: Special Interests: Cochlear & Brainstem Implants, Facial Nerve & Balance Disorders, Hearing, Neuro Fibromatosis Type II, Skull Base Surgery UH Chagrin Highlands Health Center, UH Twinsburg Health Center, UH Ireland Cancer Center Westlake Barbara E. Shapiro, MD Office Phone: Special Interests: Lysosomal Disorders, Tay-Sachs Disease, Peripheral Neuropathy, Metabolic & Muscular Dystrophy, Neuromuscular Disorders UH Chagrin Highlands Health Center Benjamin L. Walter, MD Office Phone: Special Interests: Dystonia, Tremors, Movement Disorders, Functional Magnetic Resonance Imaging (MRI), Mechanisms of Effect of DBS, Deep Brain Stimulation, Parkinson s Disease UH University Suburban Health Center, UH Medina Health Center Peter J. Whitehouse, MD, PhD Office Phone: Appointment Phone: Special Interests: Geriatric Neurology, Dementia, Narrative Medicine, Cognitive Enhancement UH Foley Elderhealth Center Neurocritical Care Center UH Neurological Institute s world-renowned Neurocritical Care Center is one of only a few available in Ohio and provides continuous state-of-the-art monitoring and treatment for patients who are critically ill, need postoperative care or require intensive neurological monitoring. The Neurocritical Care Center is a dedicated, multidisciplinary center structured to provide the best patient care and improve communication and coordination of research, while promoting education and advanced administrative efficiency. It is the only such center for neurocritical care in the Midwest. Hospital staff at UH Case Medical Center as well as our community hospitals receive continuous training in the latest, most effective techniques and technology to benefit patient treatment. Studies show that involvement of a dedicated neurological intensive care team correlates to a significant reduction in length-of-stay and controlled cost and, most importantly, a reduction of in-hospital mortality and better patient outcomes. Conditions treated: Neurocritical care is comprehensive multisystem care of the critically ill neurological patient. In the NSU, we care for a broad spectrum of patients including postoperative neurosurgical patients and patients with massive ischemic stroke, status epilepticus, encephalitis and neuromuscular respiratory failure, as well as trauma, intracerebral hemorrhage and subarachnoid hemorrhage. Innovations: University Hospitals created the world s first neurological intensive care medicine practice nearly three decades ago. We literally wrote the book on Neurocritical care (our textbook, Critical Care Neurology and Neurosurgery, is the standard textbook of the field). UH is one of 25 institutions in the United States that offers a fellowship in Neurocritical Care and our annual international CME conference is the benchmark meeting for the field. University Hospitals is a world leader when it comes to heart and brain resuscitation after cardiac arrest. In fact, George Crile, MD, former Professor and Chief of Surgery at University Hospitals, was the first to successfully use external chest compression in 1903 and the first to use adrenaline (epinephrine) in resuscitation in Claude Beck, MD, Professor of Cardiothoracic Surgery, is credited with performing the first successful cardiac defibrillation in humans in 1947 and introduced the first CPR course for the lay public in Continuing with this strong tradition, University Hospitals was one of the first institutions to adopt hypothermia after cardiac arrest to protect the brain from damage. We have been working closely with Cleveland EMS to cool patients as early as possible to achieve the best possible outcome. Michael DeGeorgia, MD, Director of the Neurocritical Care Center, is one of the world s leading authorities in hypothermia. University Hospitals introduced the world to neurological intensive care medicine nearly three decades ago. Our textbook, Critical Care Neurology and Neurosurgery, is the standard textbook for the field. Neurocritical Care 22 Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral Access to high-tech, minimally invasive Radiosurgery techniques make life-altering differences in patient recovery 23 for a Rapid Referral within 24 hours. for many types of neurological diseases. Learn more about UH options at UHhospitals.org/Radiosurgery.

13 Neurocritical Care Case Critical Care Bioinformatics Consortium: We believe the future of intensive care monitoring lies in: (1) Integration and time-synchronization of multiple channels of physiological data continuously and simultaneously (2) Processing of this data in real-time, using new tools such as multivariate analysis and nonlinear time series analysis (3) Presenting this data to the clinician using innovative and intuitive clinician-centric visual displays The Annual Neuro Critical Care workshop is the only one of its kind in the U.S. You can watch the 2008 and 2009 conferences at workshop.html. Special Equipment: We review minute-to-minute progress with the most advanced monitoring equipment in the world, including: Brain tissue oxygenation monitoring Cerebral blood flow monitoring Continuous video EEG monitoring CT angiography and CT perfusion studies Intracranial pressure monitoring MRI perfusion diffusion imaging Positron Emission Tomography (PET) Transcranial Doppler (TCD) ultrasonography Induced hypertension (Hypertensive hypervolemic hemodilution) Induced hypothermia Intravenous and intra-arterial thrombolysis Plasmapheresis Ventricular drainage Mission of the Center To improve patient care by implementing best medical practices for acute neurological disorders. To foster clinical, experimental, and outcomes research focused on developing innovative interventions. To improve education of residents and fellows by developing standards for training in neurocritical care. To advance administrative efficiency and quality improvement. To deliver nursing care in a manner that promotes interdisciplinary collaboration, caring and compassion. To strive to be the world leader in Neurocritical Care. Neurological Outcomes Center UH Neurological Institute s Neurological Outcomes Center is one of the first centers of its kind in the United States devoted exclusively to studying outcomes and quality improvements in patients with neurological conditions. By establishing the center, the UH Neurological Institute is creating an infrastructure to accurately evaluate patient outcomes, refine performance improvement processes and increase health care value. Contributions to Neuroscience The Neurological Outcomes Center identifies, develops and assists with implementing methods and approaches that incorporate the latest education and research to deliver the highest value health care to patients with neurological disorders. The center has established four priority areas with a strong focus on treatment adherence in which to enhance both clinical work and research efforts: Brain Tumor Epilepsy Memory and Cognition Stroke Center infrastructure is designed to generate new research ideas and help investigators shape their ideas into proposals and grant applications. Working with investigators from the UH Neurological Institute, Case Western Reserve University School of Medicine, the Veterans Health Administration and the Weatherhead School of Management, faculty and staff collaborate on creating projects designed to improve clinical care and increase knowledge to drive underlying advances in neurology, neurosurgery and psychiatry. Focused on education, center faculty are engaged in mentoring junior UH Neurological Institute investigators and students in various stages of their research careers serving as a resource for the development of research protocols and proposals. They also are active in teaching colleagues by speaking locally and internationally. The center is also supported by an NIH Clinical and Translational Science Award (CTSA) to Case Western Reserve University. The university is one of 38 medical research institutions working together as a national consortium to improve the way biomedical research is conducted across the country. The consortium shares a common vision of reducing the time it takes for laboratory discoveries to become treatments for patients and to engage communities in clinical research efforts. Martha Sajatovic, MD Office Phone: , Special Interests: Adult Psychiatry, Geropsychiatry, Geriatric Psychiatry, Health Services, Bipolar Disorder, Treatment Adherence Neurological Outcomes These monitoring capabilities are combined with the latest interventions to save brain function, including: Burst suppression Cerebral angiography and intervention (angioplasty, stenting) Endovascular coiling Michael DeGeorgia, MD Office Phone: Special Interests: Critical Care Bioinformatics, Hemorrhagic Stroke, Hypothermia, ICU Monitoring, Ischemic Stroke, Neurocritical Care Seth Alan Hoffer, MD Office Phone: Special Interests: Neurocritical Care, Spine Surgery UH Richmond Medical Center, UH Bedford Medical Center Vikram Dhawan, MD Office Phone: Special Interests: Advanced Airway Management, Hypothermia, Neurocritical Care, Surgical Critical Care St. John Medical Center 24 To learn more about our annual Neurocritical Care and Stroke Conference, UH neuroscience specialists are available to present at grand rounds or conferences. 25 visit UHhospitals.org/neuro/criticalcareconference. To request a presentation, call or visit UHhospitals.org/neuro/physicianrequest.

14 Neuromuscular Neuromuscular Center UH Neurological Institute s Neuromuscular Center has established itself as one of America s foremost institutions for the treatment of complex neuromuscular disorders by combining extensive clinical experience for a wide variety of specialties. UH provides diverse testing, diagnosis and treatment labs to address the full range of neuromuscular conditions. Labs are available at many community facilities and offer: Autonomic Laboratory: As one of only 12 such labs in the country and the first pediatric lab, we test all aspects of autonomic function including cardiac, vasomotor and sudomotor (sweat) functions; and to diagnose chronic regional pain syndrome, peripheral neuropathies, Postural Orthostatic Tachycardia Syndrome (POTS) and syncope of unknown etiology. It provides full support in the assessment of patients seen in the interdisciplinary program clinics. Electromyography (EMG) Lab: The EMG Lab provides high-quality, state-of-the-art electrodiagnostic testing of neuromuscular disorders. The EMG test includes nerve conduction studies performed by the EMG technologists under physician supervision and the muscle needle examination performed by the EMG physician. Computerized EMG machines are available at all six EMG lab locations within the UH system. These machines enable lab personnel to perform detailed electrodiagnostic testing on every patient with instant report generation. Highly specialized testing such as single fiber EMG and quantitative testing are also offered. Surgical solutions: Diaphragmatic Pacing for high cervical spinal cord injury and patients with Amyotrophic lateral sclerosis Conditions treated: Neuromuscular conditions treated include: Amyotrophic Lateral Sclerosis (ALS) Cervical and lumbar radiculopathy Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Entrapment neuropathies Guillain-Barre syndrome Muscular dystrophies Myasthenia gravis Peripheral neuropathy Polymyositis/Dermatomyositis Autonomic conditions treated in interdisciplinary clinics include: Orthostatic hypotension Syncope Small Fiber Neuropathies Postural Tachycardia Syndrome (POTS) Chronic Regional Pain Syndrome (CRPS) Interstitial cystitis Fibromyalgia Multiple System Atrophy Parkinson s Disease Chronic Pelvic Pain Hyperhidrosis Current clinical trials: Research is a cornerstone in the treatment options Neuromuscular Center physicians offer to patients. Our physicians and scientists contribute to: Use of thymectomy vs. no thymectomy for myasthenia gravis Safety and Efficacy Study of Eculizumab in Patients With Refractory Generalized Myasthenia Gravis The purpose of this study is to determine whether eculizumab is safe and effective in the treatment of patients with generalized myasthenia gravis, despite treatment with currently available immunosuppressants. ICEPAC NIH Grant: (Interstitial Cystitis Evaluation of Psychophysiologic and Autonomic Characteristics) to understand the role of the nervous system in this debilitating chronic pain disorder, as well as in another pelvic pain disorder called myofascial pelvic pain syndrome. CRPS Bakken Grant (Complex regional pain syndrome) to determine if CRPS affects just the involved body part or the entire body, and to what extent. The Neuromuscular Center is one of only a few nationwide participating in an NIH-Funded Trial testing the efficacy of thymectomy in the treatment of myasthenia gravis. Programs: For the proper development of personalized patient treatment plans, the Neuromuscular Center has designated leading-edge diagnostic and treatment programs: Autonomic Disorders Interdisciplinary Program: This program provides interdisciplinary clinics for diagnosis and treatment for adults and children with mysterious episodes of dizziness, fainting, vomiting or unexplained stomach pain. Physicians also address complex regional pain syndrome, unexplained or unmanaged pain in the pelvic region and issues of excessive sweating or other sweat or flushing related issues. Autonomic Lab Program The Neuromuscular Center s Autonomic Lab Program performs four different types of tests depending on the diagnosis of the referring physician: Autonomic Screen Reflex Sympathetic Dystrophy/Chronic Regional Pain Syndrome Screen Quantitative Sensory Test Thermoregulatory Sweat Test Amyotrophic Lateral Sclerosis (ALS) Program: This nationally renowned program takes an interdisciplinary approach by combining strengths of specialists from the Neuromuscular Center, pulmonary medicine, speech pathology and nutrition to manage the symptoms and treatment for each patient. UH uses diaphragmatic stimulation and pacing to help patients breathe and speak more normally, and it helps stave off respiratory complications during the progression of ALS. Pediatric and Young Adult Autonomic Program: For patients aged 1-30 years old, with dizziness, fainting, vomiting, headaches, stomach pain, unexplained weight loss (after a medical evaluation), and slow stomach or bowel. Specialists include pediatric gastroenterology, autonomic neurology, pediatric psychiatry and sleep neurology. Dizzy Clinic: For adult patients with fainting, lightheadedness and dizziness. Specialists include cardiology, psychology and autonomic neurology. CRPS Clinic: For patients of all ages with complex regional pain syndrome. Specialists include anesthesiology, neurology and psychology. Pelvic Pain Clinic: For patients of all ages with pelvic pain, especially interstitial cystitis and myofascial pelvic pain syndrome. Specialists include anesthesiology, neurology, uro-gynecology and psychology. Myasthenia Gravis Program: For over a decade, patients have been treated with immunosuppressive drugs as well as plasma exchange and intravenous immunoglobulin. Currently UH provides the only such program in Ohio. Muscular Disease Program: Partnering with the United Way, this program brings a multidisciplinary approach to the diagnosis and management of patients with inherited Bashar Katirji, MD Office Phone: Special Interests: Peripheral Nerve Disorders, Neuromuscular Disorders, Amyotrophic Lateral Sclerosis, Myasthenia Gravis, Entrapment Neuropathies, Electrodiagnosis, EMG UH University Suburban Health Center neuromuscular disorders, including muscular dystrophies and peripheral neuropathies, as well as acquired conditions such as postpolio-myelitis syndrome and inclusion body myositis. Patient Convenience: Perhaps the most significant benefit to patients is that they have access to expert consultation and advanced diagnostics close to home in our community facilities. In addition to the main UH Case Medical Center campus, our renowned specialists see patients at UH Bedford Medical Center, UH Chagrin Highlands Health Center, UH Richmond Medical Center, UH University Suburban Health Center and. Advanced diagnostic screening is available at: EMG Lab UH Case Medical Center UH Bedford Medical Center UH Chagrin Highlands Health Center UH Richmond Medical Center UH University Suburban Health Center Autonomic Lab UH Case Medical Center UH Chagrin Highlands Health Center Marek A. Buczek, MD, PhD Office Phone: Appointment Phone: Special Interests: General Neurology, Electrophysiology, Headache, Chronic Pain Syndromes, EMG, Head Injury The Neuromuscular Center operates the first pediatric autonomic multidisciplinary clinic in the nation. Its pediatric program draws patients from all over the United States for diagnosis and treatment., St. John Medical Center 26 Access the library of innovative publications and earn free CME at UHhospitals.org/neuro/publications. Clinical trials are ongoing in our Centers. Learn more at UHhospitals.org/neuro/clinicaltrials. 27 Neuromuscular

15 Neuromuscular Gisela Chelimsky, MD Office Phone: Appointment Phone: Special Interests: Functional & Motility Disorders of the Gastrointestinal Tract, Gastrointestinal Dysfunction in Autonomic Disorders of the Nervous System, General Pediatric Gastrointestinal Diseases UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook Thomas C. Chelimsky, MD Office Phone: Special Interests: Syncope, Sweat Disorders, Mitochondrial Disorders, Autonomic Disorders, Bladder Disorders Postural Tachycardia Syndrome, Orthostatic Hypotension, Adult & Pediatric Autonomic Disorders, Sexual Dysfunction Mary Alice Dombrowski, NP, DNP Office Phone: Appointment Phone: Special Interests: Autonomic Disorders, General and Pediatric Neurology Brian Dyko, NP Office Phone: Appointment Phone: Special Interests: Autonomic Disorders, General Neurology, Headache, Memory & Cognition, Neuromuscular Sees patients at: UH Case Medical Center,, UH Foley Elderhealth Center Mary Jo Elmo, CNP Office Phone: Special Interest: Diaphragm Pacing System Referral Gerald E. Grossman, MD Office Phone: Special Interests: Neuromuscular Disorders, EMG UH Chagrin Highlands Health Center Jeff Janata, PhD Office Phone: Appointment Phone: Special Interests: Autonomic Disorders, Behavior Therapy, Behavioral Medicine, Cognitive Behavioral Psychotherapy, Health Psychiatry, Health Psychology, Pain Management UH MacDonald Women s Hospital, W.O. Walker Center Daniel W. Koontz, MD Office Phone: Special Interests: Autonomic Disorders, Peripheral Nerve Disorders, General Neurology, EMG UH Bedford Medical Center, UH Chagrin Highlands Health Center Daniel W. Miller, MD Office Phone: Appointment Phone: Special Interests: General Neurology, Neuromuscular Disorders, Neurophysiology, EMG UH University Suburban Health Center Raymond P. Onders, MD Office Phone: Appointment Phone: Special Interests: Minimally Invasive Surgery, General Surgery, Diaphragm Pacing, Anti-Reflux Surgery UH University Suburban Health Center, David C. Preston, MD Office Phone: Special Interests: Neuromuscular Disorders, Electrophysiology, Myasthenia Gravis, EMG, Entrapment Neuropathies, Peripheral Neuropathies, Peripheral Nerve Disorders UH University Suburban Health Center, UH Richmond Medical Center Barbara E. Shapiro, MD, PhD Office Phone: Special Interests: Lysosomal Disorders, EMG, Tay-Sachs Disease, Peripheral Neuropathy, Metabolic & Muscular Dystrophy, Neuromuscular Disorders UH Chagrin Highlands Health Center Neuropsychiatry Center UH Neurological Institute s Neuropsychiatry Center treats co-occurring disorders in adults and pediatric patients. This crossfunctional treatment plan works for psychiatric syndromes ranging from adjustment disorders, to depression or anxiety, to a primary medical illness or to an underlying mood or anxiety disorder that was previously unrecognized or untreated. Primary services are available at our community-based University Hospitals Richmond Medical Center. Minimally invasive and nonsurgical solutions: Treatment refractory disorders may also be helped by the most advanced neuro-stimulation techniques, including: Electroconvulsive Therapy (ECT): External electrical stimulation of the brain to induce controlled seizure activity to treat refractory depression Conditions treated: Mood and anxiety disorders Drug and alcohol addiction recovery Delirium, Dementia and Psychiatric Disorders of Aging Psychiatric Sequellae of Neurologic Conditions Innovations: The Neuropsychiatry Center is nationally renowned for pioneering advanced protocols for treatment refractory disorders, or disorders that are resistant to traditional therapy. Patients may have access to pharmacologic treatments currently under investigation through research protocols of UH Case Medical Center National Institutes of Mental Health Bipolar Disorder Across the Lifespan Center, the first funded Bipolar Center of Excellence in the United States. Current clinical trials: Patients in our programs benefit through access to novel antipsychotic medications, antidepressants and various mood stabilizers that are generally not available. Following is an abbreviated list of current trials: Patients diagnosed with major depression or bipolar disorder may benefit from participation in an ongoing research study being conducted within the Mood & Metabolic Clinic. We are currently enrolling participants in a National Institutes of Health (NIH)-sponsored research project to test whether the treatment of insulin resistance can reduce symptoms of depression. Patients with obesity or those who have not responded to traditional antidepressant medications are encouraged to participate. Longitudinal Assessment of Mania Symptoms (LAMS) An epidemiological based study that assesses symptoms of mania every six months for a five-year period. Collaborative Lithium Trial (COLT) A multiphase study designed to assess the safety and efficacy of Lithium in children and adolescents with Bipolar I disorder. For more information on available clinical trials call or visit UHhospitals.org/neuro/clinicaltrials Programs: Addiction Recovery Services: The Neuropsychiatry Center houses an addiction recovery program at the W.O. Walker Center. Here, patients can be treated on an intensive outpatient basis where they come to the center three to five days a week and return home in the evening. Treatment includes an innovative concept of a UH unique 12-Step Program for patients suffering from both a mental illness and an addiction problem. Neuro-geriatric Program: Provides comprehensive inpatient and outpatient assessment and treatment for older adults with psychiatric illness or adults with psychiatric illness and co-occurring medical or neurological illness. Discovery & Wellness Center for Children: Our Mission is to compassionately conduct clinically meaningful research that will better the lives of children and adolescents suffering from psychiatric illnesses. Research based treatment programs are currently available for children and adolescents who suffer from problems such as Schizophrenia, Bipolar Disorder, Adult and childhood ADHD and disruptive behavior disorders and depression. All of these programs are provided at NO cost to the family. Mood & Metabolic Clinic (MMC): Developed out of the recognition that depressive disorders frequently co-occur with illnesses affecting the body s metabolism. This program delivers personalized outpatient care to patients with mood disorders and co-occurring metabolic illnesses such as obesity, pre-diabetes and the metabolic syndrome. Consultation Psychiatry/Psychosomatic Medicine: The Division of Psychiatry and Medicine is a newly formed addition to the University Hospitals Department of Psychiatry, and offers comprehensive psychiatric care for patients with significant co-occurring medical illnesses in both outpatient and inpatient settings. Our primary goal is to foster a multidisciplinary team approach and to recognize the importance of the mind-body connection in patient care. Current sections of the Division include: Emergency Department-UH Case Medical Center, Transplant Service, Psycho-Oncology and Dermatology. Neuropsychiatry 28 Discover upcoming educational opportunities including grand rounds and CME programs UH has established a Neurological Outcomes Center, committed to studying quality improvement and outcomes. 29 at UHhospitals.org/neuro/cme. Learn more at UHhospitals.org/neuro/outcomes.

16 Neuropsychiatry Robert J. Ronis, MD, MPH Office Phone: Appointment Phone: Special Interests: Community Psychiatry, Adult Ambulatory, Psychopharmacology, Chemical Dependency, Psychotherapy, Addiction Psychiatry, Community Mental Health Francoise Adan, MD Office Phone: Special Interests: Integrative Psychiatry, Mood and Anxiety Disorders, Pharmacotherapy and Psychotherapy Philipp L. Dines, MD, PhD Office Phone: Special Interests: Adult Psychiatry, ECT, Geropsychiatry, Forensic Psychiatry, Geriatric Mood Disorders, Geriatric Psychotic Disorders, Dementia, Brain Injury, Mental Retardation, Psychiatric Issues in Neurological and Medical Primary Illnesses UH Foley Elderhealth Center, W.O. Walker Center Keming Gao, MD, PhD Office Phone: Special Interests: Adult Psychiatry, Anxiety Disorders, Bipolar Disorders Research, ECT, Moods, Phenomenology and Psychopharmacotherapy Irina Korobkova, MD Office Phone: Special Interests: Dementia, ECT, Geriatric Psychiatry, Geropsychiatry, UH Richmond Medical Center Jeanne Lackamp, MD Office Phone: Special Interests: Adult Psychiatry, Consultation, Medical Education W.O. Walker Center Zinaida Lebedeva, MD Office Phone: Special Interests: Adult Psychiatry, Geriatric Psychiatry UH Geauga Medical Center Joseph A. Locala, MD Office Phone: Special Interests: Adult Psychiatry, Psychosomatic Psychiatry, Psychiatric Care of Medically Ill Patients, Transplant Psychiatry, Mood Disorders in the Medically Ill, Anxiety Disorders in the Medically Ill W.O. Walker Center Michel Magiera, MD Office Phone: Special Interests: Child & Adolescent Psychiatry Martha Sajatovic, MD Office Phone: Special Interests: Adult Psychiatry, Geropsychiatry, Geriatric Psychiatry, Health Services, Bipolar Disorder Rebecca R. Schlachet, DO Office Phone: Special Interests: Adult Psychiatry, Geriatric Psychiatry Susan Stagno, MD Office Phone: Special Interests: Adult Psychiatry, Consultation, Clinical Ethics, Anxiety Disorders, Psycho-Oncology, Psychiatric Aspects of Epilepsy Neuroscience Nursing Practice Center UH Neurological Institute s Neuroscience Nursing Practice Center is dedicated to the development and implementation of best practices in neuroscience nursing. Our mission is to improve patients long-term outcomes by providing care according to the most advanced protocols based on the latest research findings; offering highly personalized care; and maximizing efficiencies during every stage of treatment. These strategies are implemented throughout the continuum of patient care from first diagnosis, through treatment and follow-up. Clinical practice is based on three core principals: Evidence-based nursing practice bridges the gap between nursing research and clinical practice Patient-centered care places responsibility for important aspects of self-care and monitoring in the patients hands by providing tools and support Relationship-based nursing maintains a standard of excellence by relying on the principles of relationship-based nursing Treatment from UH neuroscience nurses provides multidisciplinary services including rehabilitation, pharmacy, social work, nutrition and medical services. Patient-centered care also takes into consideration individual circumstances including lifestyle, family situations, cultural traditions, religious beliefs and other factors during care planning and implementation. Patients are able to contribute to important aspects of their care and healing, and are prepared with the tools and support needed to carry out this responsibility. In this way, patient-centered care can reduce unneeded and unwanted services as well as improve outcomes. Innovations: The Neuroscience Nursing Practice Center aims to bridge the gap between nursing research and clinical practice by creating mechanisms to facilitate the translation of information from evidence-based research to practice. In this way, we ensure critical, succinct, reasonable evaluation and application of research findings as they relate to point-of-care delivery. Neuroscience Education Ambassador Program: Offered to nurses within the UH health system to provide education on conducting a neuro-assessment, completing the NIHSS as an added assessment tool, and caring for patients with stroke. This program was developed to offer a standardized neurological nursing assessment that would target nonneuroscience nurses and would be used throughout the health system. Preoperative Bundle for Neurosurgery: Nursing worked in collaboration with Neurosurgery and Infection Control to develop a presurgical regimen which is now used for the outpatient preoperative neurosurgery patients and also for inpatient neurosurgery patients going for surgery. This process includes screening patients for MRSA/MSSA and prophylactically treating with mupirocin as well as bathing the patient with an alcohol-based scrub. With the implementation of the presurgical bundle, the rate of postoperative infections has shown a decrease. External Ventricular Drain: Nurses in the Neuroscience Intensive Care Unit (NSU) developed a guideline to standardize care of external ventricular drains (EVD). The standardized guideline provides instruction for drain placement which includes giving prophylactic antibiotics prior to drain placement including nursing management of the drain as well as CSF sampling techniques. Data is being collected to evaluate the positive effect this guideline has on improved EVD management. Current clinical trials: To bridge the gap between nursing research and clinical practice, the center aims to put evidence-based research into practice. This ensures high-quality care backed by scientific nursing services. The Neuroscience Nursing Practice Center, in collaboration with the CWRU Frances Payne Bolton School of Nursing, is working on a quality improvement research project to standardize nursing care of external ventricular drainage systems to decrease infection rates. Neuroscience Nursing Practice 30 The Neuroscience Intensive Care Unit provides continuous, state-of-the-art monitoring and treatment Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral 31 for critically ill patients. Learn more about our capabilities at UHhospitals.org/neuro/NSU. for a Rapid Referral within 24 hours.

17 Rainbow Neurological Rainbow Neurological Center UH Neurological Institute s Rainbow Neurological Center combines all aspects of neurological services into the caring, supportive environment UH Rainbow Babies & Children s Hospital is known for around the world. Pediatric neurology faculty are certified by the American Boards of Neurology and Pediatrics and contribute expertise in specific areas of epilepsy, metabolic-genetic disease, sleep medicine, headaches, neuro-oncology, behavioral and cognitive neurology (including ADHD, Tourette syndrome and autism), and the care of multiply handicapped children, including those with cerebral palsy and spina bifida. Rainbow pediatric neurosurgeons are certified by the American Board of Pediatric Neurological Surgery, and they work closely with their colleagues in all of the pediatric specialties to provide the best, integrated, comprehensive, family-centered care to infants and children with potential surgical problems of the brain, spine and skull. Pediatric patients have access to the world-renowned Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU), providing the highest level of critical care while covering a wide range of problems including fetal consultations as well as referrals for tumors, seizures, stroke, congenital malformations and trauma. We are one of the few centers for childbirth where mothers can safely deliver infants only steps away from the resources of UH Rainbow Babies & Children s Hospital, and remain in close proximity to critically ill newborns. The Rainbow Neurological Center team includes pediatric neurologists, neurosurgeons, epileptologists, neuroradiologists, anesthesiologists, neuropsychologists, intensivists, advanced practice nurses, behavioral psychologists, social workers, child life specialists and occupational, speech and physical therapists who all collaborate to develop an individualized treatment plan based on each child s needs. Surgical solutions: Brain tumors through image-guided surgical navigation Intraoperative magnetic resonance imaging operating room Intraoperative brain mapping of functionally critical brain areas Endoscopic neurosurgical techniques for brain and skull surgeries Spasticity Hydrocephalus Epilepsy Congenital malformations Brain and spine trauma Minimally invasive and nonsurgical solutions: Neurological surgeons are pioneers in minimally invasive surgery techniques to increase safety, minimize risks and shorten hospital stays and recovery. The innovative UH Rainbow Babies & Children s Hospital minimally invasive lab provides a training site for surgeons and physicians, and investigates new surgical approaches. Endovascular repair of vascular malformations Endovascular repair of post-traumatic and neoplastic-related vascular lesions Embolization of brain, head and neck and spine neoplasms Selective dorsal rhizotomy with single level laminectomy Blood conservation neurosurgery Conditions treated: UH Rainbow Babies & Children s Hospital evaluates over 15,000 outpatients, and 2,000 inpatients every year using state-of-the-art procedures in diagnosis and care for children with neurological problems, including: Autistic spectrum disorders Brain and skull-base tumors Brain and spine trauma Developmental delay Genetic neurological disorders Headaches Learning and behavioral problems Spasticity Seizures Congenital malformations Craniosynostosis Hydrocephalus UH Rainbow Babies & Children s Hospital consistently ranks as one of America s Best Children s Hospitals for successful removal of cancerous brain tumors by U.S.News & World Report Innovations: UH Rainbow Babies & Children s Hospital houses a one-of-akind Minimally Invasive Neurosurgery Lab which focuses on developing new instruments and operative approaches, as well as teaching new surgical techniques Development of the Smart Start Computer Guided Balloon Reactor, a computer-guided balloon retractor to locate deepseated tumors in the brain with precision accuracy, much like the technology used in aviation to land planes, that will make surgery safer for children Leading scientific research Neuroprotection for perinatal brain injury on how the brain damage that causes cognitive and behavorial problems in preemies occurs, and how it can be reversed in the neonatal period through neuroprotective agents Current clinical trials: The Rainbow Neurological Center leads in the field of research related to fetal and neonatal neurology, neuro-intensive care and pediatric epilepsy. Center physicians and scientists are involved in multiple NIH-funded research projects including: Designing new technologies for bedside continuous brain monitoring in the intensive care setting for the diagnosis and assessment of children at high risk for neurological sequelae after brain disorders. Drug and surgical outcomes research for pediatric epilepsy. Developmental care in the neonatal nursery and the impact of specific nursing care practices on the development of the brain. These studies culminate in evaluation for development neural plasticity concentrating primarily on high-risk preterm populations. Programs: Autism Center: Multidisciplinary medical professionals specializing in the diagnosis of autistic disorders and their impact on the development, educational and family function. Our specialists are frequently quoted and interviewed in national media regarding advancements and developments in the treatment of autism. Jennifer Ferchill Brain Tumor Center: This program provides top-notch care, the most promising new treatments, nationally known researchers and educators for infants, children and teenagers with brain cancer. Neuromuscular and Spasticity Program: Considered the rehabilitation arm of the Neurocritical Care Center, this program comprises a multidisciplinary team of specialists in pediatric neurology, neurosurgery, orthopaedics, and physical and occupational therapy, all dedicated to offering the highest level treatments and therapies available. Epilepsy Center at UH Rainbow Babies & Children s Hospital: This Level IV center is a key component of the Division of Pediatric Epilepsy that provides comprehensive, integrated and state-of-the-art patient care to children with epilepsy across all age groups. With access to a vast number of specialists and surgeons as well as the dedicated Epilepsy Monitoring Unit and Pediatric Intensive Care Unit the center offers the most advanced approaches to diagnosing, managing and treating epilepsy in infants and children. Rainbow Neurological 32 UH neuroscience specialists are available to present at grand rounds or conferences. Access to high-tech, minimally invasive Radiosurgery techniques make life-altering differences in patient recovery 33 To request a presentation, call or visit UHhospitals.org/neuro/physicianrequest. for many types of neurological diseases. Learn more about UH options at UHhospitals.org/Radiosurgery.

18 Rainbow Neurological Mark S. Scher, MD Office Phone: Special Interests: Pediatric Neurology, Pediatric Epilepsy, Fetal-Neonatal Neurology, Pediatric Neurointensive Care, Sleep Disorders UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake Christine T. Barry, PhD Office Phone: Special Interests: Autism, Pediatric Brain Disease, Brain Injury, Neuropsychological/Learning Evaluations, Autistic Spectrum Disorders, Asperger s Syndrome UH Rainbow Babies & Children s Hospital Westlake Nancy E. Bass, MD Office Phone: Special Interests: Pediatric Neurology, Neurocutaneous Disorders, Neurogenetics, Neurometabolism UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Mentor Health Center, UH Rainbow Specialty Center Westlake, UH Rainbow Specialty Center Strongsville Christopher Bedosky, PhD Office Phone: Special Interests: Child Adolescent and Adult Psychotherapy and Psychological Testing, Disruptive Behavioral Disorders Denise Bothe, MD Office Phone: Special Interests: Developmental and Behavioral Pediatrics, Anxiety, ADHD, School Issues, Stress Management UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake, W.O. Walker Center Alan R. Cohen, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurosurgery, Minimally Invasive Neurosurgery, Brain and Spinal Tumors, Craniofacial Surgery UH Rainbow Babies & Children s Hospital Yael T. Crawford, PhD Office Phone: Special Interests: Family Therapy, Parenting, Psychotherapy, Play Therapy, Animal Assisted Therapy, Child & Adolescent Psychiatry, Family Therapy & Parent Guidance, Psychotherapy for a Wide Range of Problems and Ages, Play Therapy with Very Young Children Carin L. Cunningham, PhD Office Phone: Special Interests: Pediatric Psychology, Children with Gastrointestinal Problems, Anxiety Problems in Children (i.e., Selective Mutism, Social Anxiety), Toileting Problems, Inflammatory Bowel Disease UH Rainbow Specialty Center Landerbrook, W.O. Walker Center Mary C. Deckelman, MD Office Phone: Special Interests: Child and Adolescent Psychiatry, Foster Care and Adoption, Foster Children/Families Robert L. Findling, MD Office Phone: Special Interests: Pediatric Psychopharmacology, Pediatric Mood Disorders, Psychobiology, Disruptive Behavioral Disorders, Treatment Resistant Consultation, Child & Adolescent Psychiatry, Pediatric Bipolar Disorder, ADHD Deborah R. Gold, MD Office Phone: Special Interests: Pediatric Neurology, Neurooncology, Pediatric Stroke UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Mentor Health Center Howard W. Hall, PhD, PsyD Office Phone: Special Interests: Hypnosis, Biofeedback, Relaxation Training, Holistic approaches to Health, Sports Psychology, Sufism, Anxiety, Headaches UH Rainbow Specialty Center Landerbrook, W.O. Walker Center Mary C. Hall Mennes, MD Office Phone: Special Interests: Child & Adolescent Psychiatry, Consult-Liaison Psychiatry, Teaching, Parent Guidance, Development Disabilities Rebecca A. Hazen, PhD Office Phone: Special Interests: Behavioral Pediatrics, Behavior Problem in Young Children, Attention Defict/ Hyperactivity Disorder, ADHD, Oppositional Behavior, Tantrums UH Rainbow Specialty Center Landerbrook, W.O. Walker Center John Hertzer, MD Office Phone: Special Interests: Child Psychiatry, Adolescent Psychiatry, Psychopharmacology for Kids Jane Holan, MD Office Phone: Special Interests: Autistic Spectrum Disorders, Developmental Delay, Down Syndrome UH Twinsburg Health Center, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake, UH Medina Health Center, W.O. Walker Center Brenda Kidder, APN, CNS Office Phone: Special Interest: Pediatric Neurology Lia H. Lowrie, MD Office Phone: Special Interests: Pediatric Critical Care, ECMO UH Rainbow Babies & Children s Hospital Stephen Maricich, MD, PhD Office Phone: Special Interests: Pediatric Neurology, Brain Malformations, Developmental Genetics UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake Kathleen Maxwell, APN, CNS Office Phone: Special Interest: Pediatric Neurology Nora K. McNamara, MD Office Phone: Special Interests: Child Psychiatry, Adolescent Psychiatry, Pediatric Psychopharmacology Noah L. Miller, MD Office Phone: Special Interest: Child & Adolescent Psychiatry Lynn H. Milliner, MD Office Phone: Special Interests: Child and Adolescent Psychology, Attention Deficit/Hyperactivity Disorder, Disruptive Behavior Disorders, ADHD, Anxiety, Depression, Behavior Problem in Young Children, UH Rainbow Specialty Center Landerbrook Rainbow Neurological 34 Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral Receive decision-making advice from UH neurological or neurosurgical experts 35 for a Rapid Referral within 24 hours. by calling or visit UHhospitals.org/neuro/healthprofessionals.

19 Rainbow Neurological Dararat Mingbunjerdsuk, MD Office Phone: Special Interests: Cerebral Palsy, Developmental Delay, Epilepsy, Headache UH Rainbow Babies & Children s Hospital Karen L. Olness, MD Office Phone: Special Interests: Behavioral Pediatrics, International Child Health, Disaster Management, Hypnosis, Biofeedback Shenandoah Robinson, MD Office Phone: Appointment Phone: Special Interests: Pediatric Neurosurgery, Pediatric Epilepsy Surgery, Spasticity Surgery UH Rainbow Babies & Children s Hospital H. Gerry Taylor, PhD Office Phone: Special Interests: Traumatic Brain Injury in Children, Low Birth Weight/Premature Birth, Neuropsychological/Learning Evaluations Karen J. Tien, PhD Office Phone: Special Interests: Child & Adolescent Psychology, Child Chronic Illness & Injury, Cognitive Behavioral Therapy, Pediatric Injury, Psychological Adjustment Problems, Health Promotion, Parenting, Cognitive- Behavioral Therapy Ingrid Tuxhorn, MD Office Phone: TBD Special Interests: Pediatric Epilepsy, Pediatric Epilepsy Surgery, Neurology, Neurophysiology Spinal Neurosurgery Center UH Neurological Institute s Spinal Neurosurgery Center offers the most innovative and sophisticated surgical techniques along with proven conventional methods to treat the full range of spinal disorders. Our physicians are nationally recognized for their expertise in minimally invasive spinal surgery techniques and have taught numerous courses on the subject around the country. Our emphasis is on the total care of the patient, viewing their spinal problem as it affects their whole person, not just the spine. Surgical solutions: Spinal decompression (laminectomy, discectomy) Minimally invasive surgery Microsurgery of the spinal cord Microvascular surgery Spinal implants Numerous fusion techniques Dynamic spinal stabilization Spinal cord and cauda equina Revision spine surgery Deformity correction Image guided surgery Conditions treated: The Spinal Neurosurgery Center fosters an interdisciplinary collaboration with pain medicine interventionalists, orthopaedic surgeons and physical therapists to develop treatment plans according to each patient s individual needs. Conditions treated include: Arthritis Degenerative disorders/aging of the spine Fractures Herniated discs Infections of the spine Injury, trauma to back, neck, spine or spinal cord Malignant and benign spinal tumors Spinal Neurosurgery Nancy J. Roizen, MD Office Phone: Special Interests: Down Syndrome, ADHD, Autism, Hearing Loss, Autistic Spectrum Disorders, Developmental and/or Behavioral Problems Heather Schober, NP Office Phone: Appointment Phone: Special Interest: Peds-Neurosurgery Robert Stansbrey, MD Office Phone: Special Interests: Child Psychiatry, Adolescent Psychiatry, General Child Psychiatry, Preadolescence Rachel B. Tangen, PhD Office Phone: Special Interests: Neuropsychology, Pediatric Brain Disease, Brain Injury, Neuropsychological/ Learning Evaluations, Seizure Disorders, Cochlear Implantation UH Rainbow Babies & Children s Hospital Michele C. Walsh, MD Office Phone: Special Interests: Neonatal Lung Disease, Health Services Research, Quality Improvement UH Rainbow Babies & Children s Hospital Cheryl Wills, MD Office Phone: Special Interests: Child & Adolescent Psychiatry, Forensic Psychiatry, Child Psychiatry UH Rainbow Babies & Children s Hospital, W.O. Walker Center Max Wiznitzer, MD Office Phone: Special Interests: Pediatric Neurology, Autistic Spectrum Disorders, Developmental and Behavioral Disorders, Neurocognitive Disorders, Pediatric Stroke, ADHD Attention Deficit Hyperactivity Disorder UH Rainbow Babies & Children s Hospital, UH Rainbow Specialty Center Landerbrook, UH Rainbow Specialty Center Westlake, UH Medina Health Center, Firelands Regional Medical Center Minimally invasive and nonsurgical solutions: CyberKnife Radiosurgery for spinal tumors Kyphoplasty X-stop device David J. Hart, MD Office Phone: Special Interests: Minimally Invasive Spine Surgery, Complex Spine Surgery and Instrumentation Craniocervical Junction and Cervical Surgery, Spine Trauma, Spinal Cord Tumors, Spinal Column Tumors, Peripheral Nerve Entrapment, Endoscopic Spine Surgery, Hyperhydrosis Surgery UH Chagrin Highlands Health Center, UH Richmond Medical Center Nicholas C. Bambakidis, MD Office Phone: Special Interests: Neuro-oncology, Spine Surgery, Skull Base Surgery, Cerebrovascular Surgery Chronic spinal pain Spinal cord compression Spinal deformities (scoliosis, kyphosis) Spinal stenosis Special Equipment: CyberKnife Radiosurgery Image guidance in spinal surgery for trauma (Iso-C) BrainLAB Seth Alan Hoffer, MD Office Phone: Special Interests: Neurocritical Care, Spine Surgery UH Richmond Medical Center, UH Bedford Medical Center Jonathan Miller, MD Office Phone: Special Interests: Pain Neurosurgery, Movement Disorders Surgery, Cancer Pain, Facial Pain, Peripheral Nerve Surgery, Stereotatic & Functional Neurosurgery, Epilepsy Surgery, Gamma Knife Stereotactic Radiosurgery, Neuro-oncology 36 Access the library of innovative publications and earn free CME at UHhospitals.org/neuro/publications. Clinical trials are ongoing in our Centers. Learn more at UHhospitals.org/neuro/clinicaltrials. 37

20 Stroke & Cerebrovascular Stroke & Cerebrovascular Center UH Neurological Institute s Stroke and Cerebrovascular Center is the most experienced Stroke Center in Northeast Ohio. It comprises a world-class, multidisciplinary team including five board-certified vascular neurologists, four neurointensivists, four interventional neuroradiologists and two cerebrovascular neurosurgeons. The Joint Commission has designated UH Case Medical Center, UH Geauga Medical Center and St. John Medical Center as certified Primary Stroke Centers the highest available designation. UH Case Medical Center also meets Brain Attack Coalition criteria for a comprehensive stroke center and has a dedicated stroke inpatient service. Minimally invasive and nonsurgical solutions: Treatment of complex vascular malformations deemed inoperable with knifeless procedures such as Gamma Knife and CyberKnife Stereotactic Radiosurgery Experienced team of neuro-interventionalists offering minimally invasive endovascular ablation of aneurysms and AVMs, angioplasty and stenting of extracranial and intracranial stenosis, and emergency treatment of acute stroke or vasospasm Conditions treated: Diagnosis and management of complex diseases in patients with vascular disorders of the brain or spine including those considered high-risk due to age, co-morbid conditions or inability to tolerate anesthesia Emergent evaluation of transient ischemic attacks and stroke Aneurysms Arteriovenous malformations (AVMs), dural and cavernous malformations Intracranial stenosis Carotid artery atherosclerotic stenosis or occlusion Stroke due to cardiac disease, including patent foramen ovale (PFO) Lacunar or small vessel disease Carotid or vertebral artery dissection Cerebral vasculitis Other unusual causes mitochondrial disorders, CADASIL, migraine Innovations: Current clinical trials: The Stroke and Cerebrovascular Center participates in groundbreaking clinical research trials to provide patients with access to therapies that are not otherwise available or reimbursed by their insurance. Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS). The purpose of this study is to compare the safety and effectiveness of either Intensive Medical Therapy alone or with intracranial angioplasty and Stenting in preventing stroke. Insulin Resistance Intervention After Stroke Trial (IRIS). The purpose of this study is to determine if pioglitazone is effective in preventing future strokes or heart attacks among nondiabetic persons who have had a recent ischemic stroke. Secondary Prevention of Small Subcortical Strokes Trial (SPS3). The goal of this study is to learn if combination antiplatelet therapy (aspirin and clopidogrel) is more effective than aspirin alone for the prevention of recurrent stroke and cognitive decline, and if intensive blood pressure control is associated with fewer recurrent strokes and cognitive decline. Interventional Management of Stroke III Trial (IMS III). The purpose of this study is to compare two different treatment approaches combined intravenous and intra-arterial recombinant tissue plasminogen activator (rt-pa) versus standard intravenous (IV) rt-pa to restoring blood flow to the brain. Carotid Occlusion Surgery Study (COSS). The purpose of this study is to determine if extracranial-intracranial bypass surgery, when added to best medical therapy, can reduce the subsequent risk of ipsilateral stroke in high-risk patients with recently symptomatic carotid occlusion and increased cerebral oxygen extraction fraction measured by PET. Intraoperative Stereotactic CT-guided Endoscopic Surgery (ICES). The purpose of the ICES trial is to determine the safety of using endoscopic surgery to remove blood clots in the brain following intracerebral hemorrhage. A Randomized Evaluation of Recurrent Stroke comparing PFO Closure to established Current Standard of Care Treatment (RESPECT). The goal of this study is to compare minimally invasive closure of a Patent Foramen Ovale (PFO) with the Amplatzer PFO Occluder to the current standard medical care in patients with cryptogenic stroke and a PFO. Programs: Dedicated Stroke Prevention Clinic: Initial evaluation, ongoing therapy with rehabilitation specialists who employ state-of-the-art techniques to speed recovery after stroke and management of co-morbid conditions. Neuroscience Intensive Care Unit staffed by neurointensivists and specialty-trained nurses providing round-the-clock care for critically ill patients. Special Equipment: Extensive array of diagnostic modalities including MR diffusion/perfusion, MRA, MRV, CTA, CT perfusion, SPECT, PET, carotid duplex and Transcranial Doppler To access the stroke team at UH Case Medical Center 24/7 for patient transfers or urgent advice, call the transfer line at For patients or physicians requesting outpatient consults, second opinions or stroke prevention trials call Stroke & Cerebrovascular Surgical solutions: Aneurysm repair, vascular reformations and diseased-artery bypasses Carotid revascularization and EC-IC bypass procedures The Stroke and Cerebrovascular Center s connection with the Case Western Reserve University School of Medicine enables basic science research to be translated to findings that will improve future patient care. Recent major activities include: Joseph LaManna, PhD, Director of the BrainLab, has been involved in cerebral blood flow and metabolism research for over 30 years. Dr. LaManna is investigating energy demand, energy metabolism and blood flow in the brain, as well as the roles of mechanisms associated with tissue response to pathological insults such as stroke (cerebral edema), hypoxia and seizures. Efficacy and Safety of Clazosentan in Reducing Vasospasm- Related Morbidity and All-Cause Mortality in Adult Patients With Aneurysmal Subarachnoid Hemorrhage Treated by Surgical Clipping (CONSCIOUS-2) or endovascular coiling (CONSCIOUS-3). The aim of this study is to demonstrate that clazosentan, administered as a continuous intravenous infusion at 5 mg/h until Day 14 post aneurysmal subarachnoid hemorrhage (asah), reduces the incidence of cerebral vasospasm-related morbidity and all-cause mortality within six weeks post-asah. Sophia Sundararajan, MD, PhD, is leading an NIH-funded, K08-award investigating the role of PPAR agonists to limit inflammation and damage caused by a stroke. Janis J. Daly, PhD, MS, Director, Cognitive and Motor Learning Research Program, EUREKA study to treat the brain (where the stroke occurred), using electroencephalography (EEG) signals to direct brain retraining following stroke to measure the potential to more completely restore normal brain and motor function to a greater number of patients in shorter rehabilitation time. Cathy A. Sila, MD Office Phone: Special Interests: Stroke in the Young, Stroke, TIA, Intracranial Stenosis, PFO, Cerebral Vasculitis, Carotid Stenosis, Dissection, Stroke Prevention UH Chagrin Highlands Health Center Nicholas C. Bambakidis, MD Office Phone: Special Interests: Neuro-oncology, Spine Surgery, Skull Base Surgery, Cerebrovascular Surgery 38 Discover upcoming educational opportunities including grand rounds and CME programs UH has established a Neurological Outcomes Center, committed to studying quality improvement and outcomes. 39 at UHhospitals.org/neuro/cme. Learn more at UHhospitals.org/neuro/outcomes.

21 Stroke & Cerebrovascular Kristine Blackham, MD Office Phone: Appointment Phone: Special Interest: Interventional Radiology Rose M. Dotson, MD Office Phone: Appointment Phone: Special Interests: Neuromuscular Disorders, Autonomic Dysfunction, Neuropathy, Neuropathic Pain, Autonomic Disorders, Headache, EMG UH Geauga Medical Center Anthony J. Furlan, MD Office Phone: Special Interests: PFO, Thrombolysis, heart disease and stroke, Acute Stroke Treatment, Stroke, Cerebrovascular Disorders, Stroke Systems and Outcomes UH Chagrin Highlands Health Center Daniel P. Hsu, MD Office Phone: Appointment Phone: Special Interests: Neuroradiology, Diagnostic Radiology, Interventional Neuroradiology Warren R. Selman, MD Office Phone: Special Interests: Cerebrovascular Surgery, Aneurysms, Arteriovenous Malformations and Occlusive Disorders, Skull Base Tumors, Acoustic Neuromas, Meningiomas, Pituitary Tumors Sophia Sundararajan, MD Office Phone: Special Interests: Cerebrovascular Disorders, Acute Intervention, Stroke Recovery, Stroke, Acute Stroke Treatment, TIA UH Mentor Health Center Jeffrey L. Sunshine, MD, PhD Office Phone: Appointment Phone: Special Interests: Neuroradiology, Interventional Neuroradiology, Head and Neck Imaging, MRI, Acute Stroke Treatment, Brain Aneurysm, Carotid Stenosis, Brain and Spine AVM, Intracranial Stenosis, MR Imaging Head, Neck, Spine Robert W. Tarr, MD Office Phone: Special Interests: Neuroadiology, Interventional Neuroradiology Translational Neurosciences Center UH Neurological Institute s Translational Neurosciences Center serves as a comprehensive link between Neurological Institute clinical investigators and basic scientists to decrease the time for findings in conventional research to be translated to the care of patients. The focus is on developing new approaches to treating major neurological disorders and transferring them from bench-to-bedside in record time. The Translational research team is composed of over 60 clinical researchers whose purpose is to develop scientific interactions that promote understanding of the pathology of neurological disease and to develop novel therapeutic strategies for the treatment of those diseases. Innovations: The Translational Neurosciences Center is funded by a variety of extramural sources including the NIH and other health care agencies, as well as grants and contracts from corporate and philanthropic organizations. Research is currently being conducted in the following areas: In models of stroke, researchers have identified new molecules in the brain that have a neuroprotective function. These, or related molecules, may prove useful in future stroke treatment. Researchers have discovered that drugs used for other treatments stop the growth of some brain tumor cells. These drugs are now being tested in neurological clinical trials. Investigators in the center are developing new insights into how to maintain viable neurons after ischemic insults. Several new targets have been identified and will be developed to determine whether they are drug-treatable. A novel project defining the responses of the embryonic and newborn brain to inflammation, prematurity and ischemia is identifying new strategies for treating babies with these problems. Stem cell therapies for multiple sclerosis and stroke are in development. Current clinical trials: Center investigators use genetic, cellular and molecular analyses to investigate the ways in which the nervous system processes information and which dysfunctions lead to the many kinds of neurological diseases and conditions, including: Stroke Brain tumors Multiple sclerosis Spinal cord injury Alzheimer s disease Translational Neurosciences Daniel W. Koontz, MD Office Phone: Special Interests: Stroke, Neonatal Nutrition and Metabolism, Peripheral Nerve Disorders, General Neurology, EMG UH Bedford Medical Center, UH Chagrin Highlands Health Center Colleen B. Tomcik, MD Office Phone: Special Interests: Higher Cortical Functions, Medical Education, Neurology, Headache UH Bedford Medical Center, UH Twinsburg Health Center, UH University Suburban Health Center Our research efforts coordinate with or are parallel to many NIH studies. We welcome inquiries from potential collaborators. The Neuroscience Community at Case Western Reserve University School of Medicine is currently ranked in the top 15 percent for NIH funding worldwide. Sagarika Nayak, MD Office Phone: Appointment Phone: Special Interests: Stroke, General Neurology, Headache, Movement Disorders, Multiple Sclerosis St. John Medical Center Norton A. Winer, MD Office Phone: Appointment Phone: Special Interests: Stroke, Sports Related Neurological Injuries, Cerebrovascular Disease, Carotid Ultrasonography, Pain Management UH Euclid Health Center, UH Mentor Health Center 40 The Neuroscience Intensive Care Unit provides continuous, state-of-the-art monitoring and treatment Access the library of innovative publications and earn free CME at UHhospitals.org/neuro/publications. 41 for critically ill patients. Learn more about our capabilities at UHhospitals.org/neuro/NSU.

22 Index Name Specialty Page Office Phone Adan, Francoise, MD Neuropsychiatry Name Specialty Page Office Phone Gao, Keming, MD, PhD Neuropsychiatry Index Arafah, Baha, MD Brain Tumor & Neuro-Oncology Amina, Shahram, MD Epilepsy Bailey, Christopher, PhD Memory & Cognition Bambakidis, Nicholas C., MD Brain Tumor & Neuro-Oncology, Spinal Neurosurgery, Stroke & Cerebrovascular 8, 37, Gold, Deborah R., MD Brain Tumor & Neuro-Oncology, Rainbow Neurological 8, Grossman, Gerald E., MD Neuromuscular Gunzler, Steven A., MD Memory & Cognition, Movement Disorders 16, Hall, Howard W., PhD, PsyD Rainbow Neurological Barry, Christine T., MD Rainbow Neurological Hall Mennes, Mary C., MD Rainbow Neurological Bass, Nancy E., MD Rainbow Neurological Bates, James, MD Community Neurology Bedosky, Christopher, PhD Rainbow Neurological Blackham, Kristine, MD Minimally Invasive Neurosurgery, Stroke & Cerebrovascular 18, Hart, David J., MD Leadership, Minimally Invasive Neurosurgery, Spinal Neurosurgery 3, 18, Hazen, Rebecca A., PhD Rainbow Neurological Hertzer, John, MD Rainbow Neurological Hoffer, Seth Alan, MD Neurocritical Care, Spinal Neurosurgery 24, Blitz, Tina F., MD Community Neurology, Epilepsy 11, Holan, Jane, MD Rainbow Neurological Bothe, Denise, MD Rainbow Neurological Buczek, Marek A., MD Community Neurology, Neuromuscular 11, Hsu, Daniel P., MD Brain Tumor & Neuro-Oncology, Minimally Invasive Neurosurgery, Stroke & Cerebrovascular 8, 18, Chelimsky, Gisela, MD Neuromuscular Janata, Jeff, MD Neuromuscular Chelimsky, Thomas C., MD Neuromuscular Kaiboriboon, Kitti, MD Epilepsy Cohen, Alan R., MD Leadership, Brain Tumor & Neuro-Oncology, Minimally Invasive Neurosurgery, Rainbow Neurological 3, 8, 18, Katirji, Bashar, MD Leadership, Neuromuscular 3, Kidder, Brenda, APN, CNS Rainbow Neurological Cohen, Mark L., MD Brain Tumor & Neuro-Oncology Koo, Brian B., MD Community Neurology Crawford, Yael T., PhD Rainbow Neurological Koon, Henry B., MD Brain Tumor & Neuro-Oncology Cunningham, Carin L., PhD Rainbow Neurological Deckelman, Mary C., MD Rainbow Neurological DeGeorgia, Michael A., MD Leadership, Music & Medicine, Neurocritical Care 3, 21, Koontz, Daniel, MD Leadership, Community Neurology, Neuromuscular, Stroke & Cerebrovascular 3, 10, 28, Korobkova, Irina, MD Neuropsychiatry Koubeissi, Mohamad Z., MD Epilepsy, Music & Medicine 14, Devereaux, Michael W., MD Community Neurology, Epilepsy 11, Kunos, Charles, MD, PhD Brain Tumor & Neuro-Oncology Dhawan, Vikram, MD Neurocritical Care Lackamp, Jeanne, MD Neuropsychiatry Dines, Philipp L., MD, PhD Neuropsychiatry Lang, Pamela, CNS Epilepsy Dombrowski, Mary Alice, NP, DNP Dotson, Rose M., MD Neuromuscular Community Neurology, Stroke & Cerebrovascular 11, Dyko, Brian, NP Memory & Cognition, Neuromuscular 16, Elmo, Mary Jo, CNP Neuromuscular Fastenau, Philip, PhD Memory & Cognition Findling, Robert L., MD Rainbow Neurological Furlan, Anthony J., MD Leadership, Stroke & Cerebrovascular 3, Lanzieri, Charles, MD Brain Tumor & Neuro-Oncology Lass, Jonathon, MD Music & Medicine Lebedeva, Zinaida, MD Neuropsychiatry Leigh, Richard J., MD Community Neurology Lerner, Alan J., MD Leadership, Memory & Cognition, Music & Medicine 3, 16, Lhatoo, Samden, MD Epilepsy 14 TBD Locala, Joseph A., MD Neuropsychiatry Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral 43 for a Rapid Referral within 24 hours. for a Rapid Referral within 24 hours.

23 Index Name Specialty Page Office Phone Lowrie, Lia H., MD Rainbow Neurological Name Specialty Page Office Phone Schober, Heather, NP Rainbow Neurological Index Lüders, Hans O., MD, PhD Leadership, Epilepsy, Music & Medicine 3, 13, Lyons, Janice A., MD Brain Tumor & Neuro-Oncology Selman, Warren R., MD Leadership, Brain Tumor & Neuro-Oncology, Minimally Invasive Neurosurgery, Stroke & Cerebrovascular 3, 9, 18, Machtay, Mitchell, MD Brain Tumor & Neuro-Oncology Semaan, Maroun, MD Music & Medicine Magiera, Michel, MD Neuropsychiatry Shapiro, Barbara E., MD, PhD Music & Medicine, Neuromuscular 22, Maricich, Stephen, MD, PhD Rainbow Neurological Sila, Cathy A., MD Leadership, Stroke & Cerebrovascular 3, Maronian, Nichole, MD Music & Medicine Silverman, Paula, MD Brain Tumor & Neuro-Oncology Maxwell, Kathleen, APN, CNS Rainbow Neurological Sloan, Andrew E., MD Leadership, Brain Tumor & Neuro-Oncology 3, McNamara, Nora K., MD Rainbow Neurological Stagno, Susan, MD Epilepsy, Neuropsychiatry 14, Megerian, Cliff A., MD Brain Tumor & Neuro-Oncology, Music & Medicine 9, Miller, Daniel W., MD Community Neurology, Neuromuscular 11, Miller, Jonathan, MD Epilepsy, Movement Disorders, Music & Medicine, Spinal Neurosurgery 14, 20, 22, Miller, Noah L., MD Rainbow Neurological Miller, Robert H., MD Leadership Milliner, Lynn H., MD Rainbow Neurological Mingbunjerdsuk, Dararat, MD Rainbow Neurological Murray, Gail, PhD, MEd Music & Medicine Stansbrey, Robert, MD Rainbow Neurological Sundararajan, Sophia, MD Stroke & Cerebrovascular Sunshine, Jeffrey L., MD, PhD Brain Tumor & Neuro-Oncology, Minimally Invasive Neurosurgery, Stroke & Cerebrovascular 9, 18, Supan, Erin, RN Leadership Syed, Tanvir U., MD Epilepsy Tangen, Rachel B., PhD Rainbow Neurological Tani, Marie, MD Community Neurology Tarr, Robert W., MD Leadership, Minimally Invasive Neurosurgery, Stroke & Cerebrovascular 3, 18, Nayak, Sagarika, MD Community Neurology, Movement Disorders, Neuromuscular, Stroke & Cerebrovascular 11, 20, Nock, Charles, MD Brain Tumor & Neuro-Oncology Ogrocki, Paula K., MD Memory & Cognition Olness, Karen L., MD Rainbow Neurological Onders, Raymond P., MD Neuromuscular Preston, David C., MD Music & Medicine, Neuromuscular 22, Riley, David E., MD Leadership, Movement Disorders 3, Robinson, Shenandoah, MD Epilepsy, Rainbow Neurological 14, Rogers, Lisa, DO Brain Tumor & Neuro-Oncology Roizen, Nancy J., MD Rainbow Neurological Ronis, Robert J., MD Sajatovic, Martha, MD Leadership, Music & Medicine, Neuropsychiatry Leadership, Neurological Outcomes, Neuropsychiatry 3, 22, , 25, Scher, Mark S., MD Leadership, Epilepsy, Rainbow Neurological 3, 14, Schilz, Robert, DO, PhD Music & Medicine Taylor, H. Gerry, PhD Rainbow Neurological Tien, Karen J., PhD Rainbow Neurological Tinsley, Nancy, RN, MBA, FACHE Tomcik, Colleen B., MD Leadership Community Neurology, Stroke & Cerebrovascular 11, Tuxhorn, Ingrid, MD Epilepsy, Rainbow Neurological 14, 36 TBD Walsh, Michele C., MD Rainbow Neurological Walter, Benjamin L., MD Movement Disorders, Music & Medicine 20, Walter, Ellen, NP Movement Disorders Weinberger, Leonard, MD Community Neurology Westbrook, Edward L., MD Community Neurology Whitehouse, Peter J., MD, PhD Memory & Cognition, Music & Medicine 16, Whitney, Christina, CNS Movement Disorders Wills, Cheryl, MD Rainbow Neurological Winer, Norton A., MD Community Neurology, Stroke & Cerebrovascular 11, Schlachet, Rebecca R., DO Neuropsychiatry Wiznitzer, Max, MD Epilepsy, Rainbow Neurological 14, Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral Need an urgent appointment? Call UH4-CARE or visit UHhospitals.org/rapidreferral 45 for a Rapid Referral within 24 hours. for a Rapid Referral within 24 hours.

24 Locations Locations for Neurological Care at University Hospitals The UH Neurological Institute offers unparalleled access and availability through its hub at UH Case Medical Center and an evergrowing network of community facilities. The continued expansion of neurology, advanced neurodiagnostics and neurosurgical capabilities at our community medical and health centers brings our expertise and personalized care closer to home to those in outlying areas of Northeast Ohio. Each of our systemwide locations have access to treatment options using advanced technology, such as: neurostimulators for movement disorders, invasive monitoring and magnetoencephalography for epilepsy, epilepsy surgical options, minimally invasive spine surgery and artificial disc replacement, image guided neurosurgery, and endovascular therapy. In addition, all sites have access to leading-edge Stereotactic Radiosurgery services, including Gamma Knife and CyberKnife therapy. UH Case Medical Center Euclid Avenue Cleveland, Ohio UH4-CARE Northeast Ohio Locations Refer patients to any of the following UH community locations. UH Bolwell Health Center Euclid Avenue, Suite 3100 Cleveland, Ohio UH4-CARE ( ) UH Bedford Medical Center 44 Blaine Avenue Bedford, Ohio UH Chagrin Highlands Health Center 3909 Orange Place Orange Village, Ohio UH4-CARE ( ) UH Concord Health Center 7500 Auburn Road Concord Township, Ohio UH4-CARE ( ) UH Foley Elderhealth Center 3619 Park East Drive, Suite 211 Beachwood, Ohio UH Geauga Medical Center Ravenna Road Chardon, Ohio UH Landerbrook Health Center 5885 Landerbrook Drive Mayfield Heights, Ohio UH4-CARE ( ) UH Medina Health Center 4001 Carrick Drive Medina, Ohio UH4-CARE ( ) UH Mentor Health Center 9000 Mentor Avenue Mentor, Ohio UH4-CARE ( ) UH Richmond Medical Center Chardon Road Richmond Heights, Ohio St. John Medical Center Center Ridge Road Westlake, Ohio UH Twinsburg Health Center 8819 Commons Boulevard Twinsburg, Ohio UH4-CARE ( ) UH University Suburban Health Center 1611 South Green Road South Euclid, Ohio UH4-CARE ( ) 960 Clague Road Westlake, Ohio UH4-CARE ( ) 46 The Neuroscience Intensive Care Unit provides continuous, state-of-the-art monitoring and treatment for critically ill patients. Learn more about our capabilities at UHhospitals.org/neuro/NSU.

25 2010 University Hospitals NEU 00121