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Jean Peterson

2018 Brazilian Congress of Neurological Surgeons with Drs. Robinson and DeCastro

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Joe Sam Robinson, Jr., MD & Igor DeCastro, MD

Featured Speakers at the 2018 Brazilian Congress of Neurological Surgeons

MACON, September 20 – Georgia Neurosurgical Institute, with practice locations in Macon, Warner Robins, Dublin, Milledgeville, Griffin, and Locust Grove, announced today the recent participation of GNI Neurosurgeons Joe Sam Robinson, Jr., MD and Igor DeCastro, MD as guest speakers at the 2018 Brazilian Congress of Neurological Surgery in Porte Alegre, Brazil.

Dr. Robinson, President of GNI and Chief of Neurosurgery at Mercer University School of Medicine, presented two studies on Cervical Stenosis Impact with regards to sleep apnea and occipital headaches. His third lecture focused on Arnold Chiari Malformations and the absence of appropriate outcome analysis and classification issues. The presentation sought to clarify the confusion surround Chiari I with surgery suggestions including conservative posterior fossa and cervical decompression and an aversion to the blood in the intramural space.

Dr. Igor DeCastro conducted a plenary session on cervical trauma and lectured on the anatomy of the Cranio –Cervical junction with regards to Chiari Malformation. In addition to attending the conference, the surgeons met with the key members of the Brazilian Neurosurgical Society to establish a relationship whereby Brazilian neurosurgeons and neurosurgical residents will travel to Macon to shadow and observe the GNI surgeons for the purposes of training and additional education. For more information, please contact Jean Peterson at jpeterson@ganeuroandspine.com.

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9th Annual International Dementia Conference with Dr. Robinson

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Joe Sam Robinson, Jr., MD

Featured Speaker at 9th Annual Dementia Conference

MACON, October 1 – Georgia Neurosurgical Institute, with practice locations in Macon, Warner Robins, Dublin, Milledgeville, Griffin, and Locust Grove, announced today the recent participation of GNI Neurosurgeon Joe Sam Robinson, Jr., MD at the 9th Annual Conference on Dementia and Dementia Care.

Dr. Robinson, President of GNI and Chief of Neurosurgery at Mercer University School of Medicine, served as a keynote speaker of this conference which was recently held in London, England. In his lecture, Dr. Robinson presented research on the role of Cervical Stenosis-Induced Chronic CSF (Cerebrospinal Fluid) Flow Obstruction as a contributing cause of dementia. The findings suggest that cervical stenosis can significantly compromise CSF circulation leading to potential damage of the neural tissue. Additionally, this restriction may contribute to the development of sleep apnea which leads to other health concerns. Dr. Robinson concluded with a statement that the development of technology to monitor the flow of CSF on a 24-hour basis for patients at risk would be very beneficial.

For more information, please contact Jean Peterson at jpeterson@ganeuroandspine.com.

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Daniel Christopher & Dr. DeCastro

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For the last week, GNI has had the pleasure of hosting fellow neurosurgeon Daniel Christoph, MD, of Rio de Janeiro, Brazil. Dr. Christoph has been practicing neurosurgery in Brazil since he completed his residency in 2009. He travelled to Macon to shadow Dr. DeCastro and learn some of his minimally invasive techniques. While Dr. Christoph can perform some minimally invasive procedures, his desire is to learn additional skills that will shorten surgery time. We have enjoyed having him here at GNI. Come back and visit again, Dr. Christoph!

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Arthur Grigorian, MD and Tigran Khachatryan, MD Create Revolutionary Device for Training

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Macon, GA, July 30, 2018 – Georgia Neurosurgical Institute (GNI), with practice locations in Macon, Warner Robins, Dublin, Milledgeville, Griffin and Locust Grove, today announced the recent collaboration of GNI vascular neurosurgeon Arthur Grigorian, MD and previous GNI Research Fellow Tigran Khachatryan to create a device that will be used across the globe for the purposes of neurosurgical education.

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Published Case Study by our newest physician – Igor DeCastro, MD

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Medulloblastoma (MB) is an embryonal tumor. Most cases in this age group (adults) occur between the third and the fourth decade with a higher incidence in males. MB is associated with many familiar cancer syndromes, but there is no known cause for MB. Prenatal exposure to dietary N-nitroso compounds increases the risk. John Cunningham polyomavirus (JC Virus) T-antigen was identified in MB cells, suggesting a role of this viral infection in tumor physiopathology.
In the pediatric group, MB is the most common malignant brain tumor, but accounts for less than 1% of all adult intracranial tumors,[ 11 5 ] with an annual incidence of approximately only 0.5 per million individuals. Many studies have documented the differences between childhood and adult MBs in terms of location, histological subtypes, as well as the proliferation and apoptotic indices. There are four histological groups – classic and the variant forms (desmoplastic/nodular, anaplasic, and large cell), with desmoplastic/nodular being the most frequent variant. Transcriptional profiling studies have shown that MB is not a single disease. There are four major subgroups according to molecular configuration: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4. These subgroups carry different prognostic outcomes and should be noted when planning the treatment strategy. The studies related to tumor biological and clinical features in adults are limited due to the low incidence of the disease in this age group. This article aims to briefly review the available literature and report a case of MB in a 19-year-old woman.

Read the full article: http://surgicalneurologyint.com/surgicalint-articles/adult-hemispheric-cerebellar-medulloblastoma/

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Published Case Study by our very own Arthur Grigorian, MD

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Currently, microscopic or endoscopic transsphenoidal surgery (TSS) is the preferred method for the treatment of intrasellar pituitary adenomas.[13,17,19,32] Approximately 1,650 cases of TSS are performed annually for removal of pituitary adenomas in the United States.[1,29] One of the preoperative considerations for TSS is an exclusion of “kissing internal carotid arteries: (ICA), a rare anatomical variant and absolute contraindication for TSS.[25,28,38] However, even in the absence of this vascular configuration, the rate of intraoperative arterial injuries remains significant. In different case series, it has been reported to be as high as 1.1%.[2,8,9,14] Thus, the imputed number of iatrogenic vascular injuries encountered during TSS in the United States is approximately 18 cases per year, which is a significant cause of morbidity and mortality as well as physician liability. These injuries are mainly attributed to direct iatrogenic injury to the ICA.[3,18,25,39] However, there is some evidence suggesting that coincidental intracranial aneurysms are found almost seven times more frequently in pituitary adenomas when compared to other intracranial neoplasms.[6] The exact cause of this augmented incidence still remains unclear; however, it raises concern about encountering an ICA aneurysm during TSS, which in some cases may lead to hemorrhagic complications.
We present a case of a patient who was found to have a growth hormone (GH)-secreting pituitary adenoma and a coexisting cavernous ICA aneurysm embedded within the tumor. The patient underwent medical treatment of the adenoma. However, shrinkage of the tumor resulted in simultaneous enlargement of the observed aneurysm warranting endovascular intervention.

Read the full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838828/

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