The American Heart Association/American Stroke Association has recognized Penn State Hershey Medical Center for its high-level care of stroke patients. The Medical Center has received the Get With The Guidelines®-Stroke Gold-Plus Quality Achievement Award for the sixth consecutive year by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients.
The award is the highest level of recognition available for treatment of patients with stroke and recognizes Penn State Hershey for implementing specific quality improvement measures outlined by the AHA/ASA for the treatment of stroke patients.
Penn State Hershey also received the association’s Target: Stroke Honor Roll for meeting stroke quality measures that reduce the time between hospital arrival and treatment with the clot-buster tPA.
Penn State Hershey is one of only seven Comprehensive Stroke Centers in Pennsylvania, the only one in Central Pennsylvania, and one of only seventy-eight in the country.
Open communication between participants enhances the success of the Penn State Hershey LionNet telestroke system.
Penn State Hershey Medical Center spearheads a sophisticated telestroke system, LionNet, expanding the capabilities of partner hospitals. By exposing more patients to specialized neurological care, LionNet can dramatically increase positive outcomes for patients with both ischemic and hemorrhagic stroke.
Using advanced computer systems with webcams, LionNet allows a Penn State Hershey stroke neurologist or neurosurgeon to consult in real-time with an ED doctor at a partner facility. The specialist examines the patient remotely, reviews scans, and makes a recommendation regarding whether to begin intravenous tPA therapy or transport the patient for possible neurosurgical intervention at Penn State Hershey Medical Center.
Penn State Hershey Movement Disorders Center is home to a research study focused on the early diagnosis of Parkinson’s Disease (PD) and a program for measuring the efficacy of deep brain stimulation (DBS) treatment in advanced cases of the disease.
Associate Professor of Neurosurgery James McInerney, M.D., states, because PD symptoms can be mistaken for other disorders, an accurate PD diagnosis often does not occur until up to 80 percent of dopamine neurons have died. His colleague, Vice Chair for Research and Professor of Neurosurgery Xuemei Huang, M.D., Ph.D., leads a team that studies the dynamics of arm swing coordination during walking in both PD patients and controls, to identify any marked differences.1 Continue reading
As many as 70 percent of epilepsy patients can be controlled with anti-seizure medications; however, the remaining 30 percent are thought to have drug-resistant epilepsy with poorly-controlled seizures. The addition or substitution of medications usually does not significantly improve outcomes in this population; in one study, as few as 1 percent of patients receiving a third medication for epilepsy were seizure-free.1
Image of brain after the completion of Stereoelectroencephalography (SEEG).
The Comprehensive Epilepsy Center at Penn State Hershey Medical Center, designated as a level IV epilepsy center by the National Association of Epilepsy Centers (NAEC), specializes in the treatment of complicated epilepsy cases, and coordinates multi-disciplinary care for the diagnosis, evaluation, and treatment of both adult and pediatric epilepsy. Medical Director Jayant Acharya, M.D., points out that since the facility also participates in both surgical and medical research, eligible patients may have access to pre-approval medications through participation in clinical trials.
If results of both standard and ambulatory EEG prove inconclusive, more extensive monitoring takes place in the inpatient Epilepsy Monitoring Unit (EMU), where patients are monitored by a team of experts while various tests are performed, from noninvasive video-EEG monitoring up to invasive intracranial monitoring with subdural or intracerebral depth electrode placement.
Robert Harbaugh, M.D., professor and chair of Penn State Hershey Neurosurgery and director of Penn State Hershey Neuroscience Institute, has been chosen as president-elect of the Society of Neurological Surgeons (SNS). The SNS is the oldest neurological society in the world and includes leaders in neurosurgical residency education. Harbaugh also serves as president of the American Association of Neurological Surgeons and as vice-chair of the American Board of Neurological Surgery.
Penn State Center for Neural Engineering has combined its research mission with the clinical mission of Penn State Hershey Neuroscience Institute to develop a Smart ICU, using the data collection and synthesis method known as predictive modeling to deliver patient-specific care. Although its use in medicine is relatively new, predictive modeling has proven successful in areas as diverse and complex as weather forecasting and aviation.1
Currently, medical practitioners are presented with a multitude of variables relating to critically ill patients—as many as 200 during one session of rounds alone—and must make time-sensitive clinical decisions based on these data. This can contribute to ongoing information overload and even lead to preventable medical errors.2
J. Christopher Zacko, M.D., director of Penn State Hershey Neuroscience Critical Care Unit, states, “In addition to the standard measurement of intracranial pressure (ICP), factors such as microdialysis, cerebral blood flow, sodium levels, and cerebral oxygen pressure can all be important in the treatment of brain-injured patients.” Continues Steven Schiff, M.D., Ph.D., director of the Center for Neural Engineering, “When all this data is collected and analyzed in real time—we can better determine what’s going on with a patient. It’s too much data to keep in your head, but a predictive computer model can produce recommendations. Call it the ‘Big Data’ approach.” He cites a patient in whom intracranial pressure (ICP) is not yet elevated. Predictive modeling may suggest treatment methodologies that would prevent ICP from rising in the first place – which it almost surely would do otherwise.
L to R: Kevin Cockroft, M.D., Jennifer Humbert, R.N., and Ray Reichwein, M.D.
LionNet, Penn State Hershey’s regional stroke care network, offers real-time video consults with doctors in area emergency departments (EDs) and Penn State Hershey specialists, providing faster diagnosis and treatment of strokes for patients throughout central Pennsylvania.
“When patients come to an ED with suspected stroke, they need immediate evaluation by a specialist who can confirm the diagnosis and make treatment recommendations,” said Jennifer Humbert, R.N., Penn State Hershey LionNet coordinator. Continue reading
Penn State Milton S. Hershey Medical Center’s designation as the only comprehensive stroke center in central Pennsylvania means that patients who require treatment beyond administration of the clot-busting tPA drug can get the care they need.
Several hospitals in the central Pennsylvania region have now become certified or primary stroke centers [see graphic for explanation on the differences between certifications].
Many hospitals have increased their rates of diagnosis and tPA administration as a result of a telemedicine partnership with Penn State Hershey.
Still, about a quarter of stroke patients need advanced interventions that only an academic or comprehensive stroke center like Penn State Hershey can provide.
Penn State Milton S. Hershey Medical Center recently completed its 1,000th Gamma Knife radiosurgery procedure. Gamma Knife radiosurgery uses a single dose of radiation instead of a surgeon’s scalpel to treat a wide range of diseases, including both benign and malignant tumors, Parkinson’s disease, vascular malformations and lesions that cause epilepsy.
Penn State Hershey’s 1,000th Gamma Knife patient was Robert Reynolds from Mifflintown, Juniata County. Reynolds was treated for lung cancer that had spread to his brain. Since undergoing the procedure, Reynolds has returned to work as a Juniata County commissioner.
“We were able to treat five lesions in Mr. Reynolds’ brain,” said Dr. Jonas Sheehan, director of neuro-oncology at Penn State Hershey. “His case is a great example of how our experienced neurosurgeons and radiation oncologists are able to provide advanced care that allows patients with complex conditions to enjoy a high quality of life.” Continue reading
Penn State Milton S. Hershey Medical Center is one of the first hospitals in the area to use a new, minimally invasive tool to treat brain aneurysms and prevent stroke. The Pipeline Embolic Device (PED) is part of a new class of devices called flow-diverters, which treat brain aneurysms in an endovascular fashion, without the need to access the aneurysm itself.
Brain aneurysms are typically sack-like out-pouchings that arise from cerebral arteries. A subarachnoid hemorrhage, the type of stroke that results when an aneurysm ruptures, is particularly devastating, carrying a 40-50 percent thirty-day mortality rate and leaving approximately one-third of the survivors disabled. The Pipeline Embolic Device is used to prevent such a stroke. The device, a mesh-like Nitinol tube—similar to a stent—is placed in the parent artery across the base of the aneurysm outpouching. Over time, blood flow into the aneurysm is reduced, or diverted, allowing the aneurysm to clot off. The clotting prevents the aneurysm from rupturing, and eventually leads to shrinkage of the aneurysm. Continue reading