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Patients requiring surgery have almost every type of neurosurgical procedure. About half of the procedures are craniotomies and the remainder peripheral vascular surgeries, spine surgeries and "functional" neurosurgeries for patients with epilepsy or movement disorders involving basal ganglion disease. Craniotomies are performed for patients with intracerebral tumors, vascular lesions and control of epilepsy. The Epilepsy Center at CUMC refers many patients for surgery. While many cases are performed under general anesthesia, some are performed as "awake craniotomies" particularly when cerebral areas associated with language have to be examined intraoperatively. The CUMC has a long tradition as a center of excellence in the management of patients with vascular lesions. We provide anesthesia for patients with arteriovenous malformations, cerebral aneurysms, and carotid artery stenosis coming for surgery. Spine surgery represents another area of strength. Besides the routine spinal discectomies, we also provide anesthesia for patients having more complicated spinal procedures requiring spinal stabilization. Many of these involve intraoperative electrophysiologic monitoring. Our invasive neuroradiology department is very active. The neuroradiologists perform neuroradiographic procedures primarily for intracerebral or spinal vascular lesions. These include arteriovenous malformations, aneurysms, and carotid artery stenosis. In addition, vascular lesions involving the periphery are treated. Anesthesia is provided for patients requiring electroconvulsive therapy. The Division of Biological Psychiatry for many years has provided these services. Members of this division are involved in a number of clinical and laboratory research projects to determine the mechanisms of efficacy of this type of therapy. In summary, the division of neurosurgical anesthesiology provides a broad experience in traditional as well as in special neurosurgical cases. Faculty: Zirka H. Anastasian, MD: Research Interest: Assessing the effect of hypotension in elderly patients during surgery and strategies to provide neuroprotection. Robert Berko, MD Mitchell Berman, MD: Research interests: Using perioperative databases for outcome studies and OR efficiency, and using state and national databases for epidemiologic research. Eric J. Heyer, MD, Ph.D.: Research Interest: Assessing cerebral dysfunction and evaluating cerebral protective agents during neurosurgical vascular surgery. Division Chief. Shailendra Joshi, MD: Research interest: Pharmacological manipulation of cerebrovascular resistance. Eugene Ornstein, MD, Ph.D.: Research interest: Mathematical modeling of cerebral vascular perfusion, deliberate hypotension and the pharmacology of neuromuscular blockade. Robert A. Whittington, MD: Research interests: Toxicity of cocaine and its metabolites; cocaine toxicity in parturients. For more information please contact Dr. Heyer (ejh3@columbia.edu). |
The division of neurosurgical anesthesiology is an extremely active division performing over 2100 anesthetics annually. Neurosurgery and Neurology ranked #4 in the U.S. News and World Report, July 2002 specialty ranking - meaning that the caseload for the anesthesiologist is excellent for a superb teaching experience. There are currently eight anesthesiology attendings associated with this division, headed by Dr. Eric J. Heyer. Members of this division provide anesthesia in the operating room, neuroradiology suite, and psychiatric area for patients having electroconvulsive therapy. Teaching occurs both in the operating room as well as in a didactic session held every morning before the start of cases, "morning report".