Department of Neurological Surgery
The mission of the department and the UC Davis School of Medicine is excellence in teaching, research and patient care.
The opportunities for growth for the resident as an individual and also as a team member are substantial. The faculty encourages each resident to develop areas of specialty and research interests of his or her own choosing. With their diverse background, the faculty also offer training from varying points of view: Dr. Muizelaar trained at University of Amsterdam, the Netherlands; Dr. Boggan - UC San Francisco; Dr. Chang - Temple University, Philadelphia and McGill University / Montreal Neurological Institute; Dr. Kim - Johns Hopkins and UC Davis; and Dr. Schrot - SUNY - Buffalo and UC Davis. Dr. Muizelaar, the present chair, is world-renown for his contributions to the management of severe head injury and intensive care. Dr. Youmans, professor emeritus, is known world-wide for his six-volume text Neurological Surgery. Dr. Franklin C. Wagner, Jr., (former chairman) professor e meritus, is currently practicing at the University of Illinois in Chicago.
Within the the hospital, the UC Davis Medical Center, there is a dedicated 10-bed NSICU with specially trained nurses. The operating room also has a team of neuro-trained nurses. Included in the operating room suite are two dedicated full-time neurological surgery rooms. Elective surgery is scheduled five days of the week. As the Chief Resident performs approximately 400-500 cases/year, a substantial number of surgeries will be entrusted to the remaining residents, creating the opportunity for assisting at and performing surgery early in their training.
Midlevel practitioners are provided as support for faculty and resident staff. This includes a certified physicians’ assistant and four certified nurse practitioners who function as an integral part of the clinical team, making patient rounds, performing diagnostic and therapeutic procedures, facilitating referrals, and assisting in management of patients across the spectrum from the emergency room to clinic; and a nurse specialist who provides ongoing patient and family education, coordinates the brain tumor support group, and assists in daily patient care.
The Department of Neurological Surgery offers multidisciplinary outpatient and inpatient care for patients with head or spinal cord injuries; brain, spinal cord and peripheral nerve tumors; degenerative spine disease; medically intractable epilepsy; and chronic pain from neurological disease. Treatment is also available for children with craniofacial anomalies, craniosynostosis, or hydrocephalus.
A comprehensive multidisciplinary referral center has been established for treatment of cerebrovascular disease and stroke, including carotid endarterectomy, cerebral revascularization, endovascular and surgical treatments of cerebral aneurysms, arteriovenous malformations, carotid-cavernous fistula, and vasospasm.
Also, a comprehensive multidisciplinary pediatric referral center is being established for evaluation and treatment of congenital spine disorders, neurofibromatosis and neuro-oncology.
Other services include: comprehensive angiography, hexamethylpropylene amine oxime single photon emission computed tomography (HMPAO SPECT), xenon cerebral blood flow measurement, transcranial Doppler ultrasonography, intraoperative angiography, multi-modal evoked potential monitoring, and stereotactic localization of deep-seated vascular malformation.
The department is one of a handful of centers in Northern California offering...
- intraoperative angiography
- stereotactic brain surgery
- lateral minicraniotomy in aneurysm surgery
- epilepsy surgery
The department is noted as one of only two centers in the western United States specializing in a bold new surgery for skull base tumors once thought inoperable and incurable. Dr. James E. Boggan is associate director of the Center for Skull Base Surgery.
Clinical research projects include tumor detection and treatment using lasers and photosensitizing drugs, a new way of preventing vasospasm in patients with aneurysmal subarachnoid hemorrhage; and treatment of severely brain injured patients with an NMDA-receptor antagonist. The Department recently participated in the investigation of hypothermia treatment of severely brain injured patients and treatment of severely brain injured patients with a neuron-specific presynaptic calcium channel blocker. For the latter study, Dr. Muizelaar was the worldwide clinical investigator. Experimental research is being conducted on recombinant tissue plasminogen activator (r-tpa) treatment for embolic stroke, evaluation of transient cerebral ischemia, and high-energy phosphate metabolism in stroke.
The department also was one of two California centers participating in the five-year National Acute Spinal Cord Injury Study (NASCIS). Dr. Wagner, co-principal investigator in the NASCIS studies (Phases I, II, and Phase III) was a co-recipient of the Wakeman Award, one of the highest honors for neuroscience research, for Phase II of the research.
Drs. J. Paul Muizelaar and Franklin C. Wagner, Jr. were co-PI’s on a substantial grant to study the effects of hypothermia in cerebral trauma. The four-year grant, awarded by the National Institute of Health, was a prospective, randomized, controlled multi-center clinical trial to study the effectiveness of moderate systemic hypothermia in the treatment of severely brain injured patients. Seven centers will be participating in the study which began in September, 1994 and completed in Fall 1998.
Dr. James Boggan has begun a promising new research project in the field of neutron capture therapy (NCT) for the treatment of primary brain and other relatively radio-insensitive tumors, such as melanoma. The project encompasses basic research, veterinary and human clinical components. The multidisciplinary venture involves the joint work of neurological surgeons, veterinarians, neuroscientists, radiologists, radiation oncologists, radiation physicists and nuclear physicists. This collaborative effort with the United States Air Force involves working on a promising new form of brain tumor therapy.
Robert F. Berman, Ph.D. is a Professor in the Department of Neurological Surgery with more than 20 years of experience studying various forms of brain injury, including traumatic brain injury, epilepsy and prenatal drug effects on brain growth and development. Dr. Berman initiated and directs the Department’s Neurotrauma Research Laboratories. These laboratories are focused on the study of mechanisms of brain injury using experimental rodent models of focal and diffuse brain trauma. The laboratory is full operational with surgical facilities, histological laboratory with brightfield and fluorescent microscopy, and equipment for neurochemistry, computerized image analysis system, blood gas analysis, HPLC, electrophysiology and a facility for studying neurobehavioral outcome after investigational treatment protocols for traumatic brain. The laboratory is currently engaged in funded research examining the role of excitatory amino acids and calcium in brain injury, as well as the potential neuroprotective activity of metabotropic glutamate receptor antagonists and selective calcium channel blockers for traumatic brain injury. The Neurotrauma Research Laboratories are located within the Medical Neuroscience Research Complex which supports animal care facilities and shared equipment (e.g. centrifuges, scintillation counters, dark rooms, etc.) The laboratory is designed to provide state-of the-art research training and experience for interested neurological surgery residents and fellows, and has a staff of nine individuals, including two medical research fellows and three doctoral students. Dr. Berman is also responsible for the education of Neurological Surgery residents, and along with Dr. Bruce Lyeth provides a weekly basic neuroscience lecture series during the academic year.
Professor Bruce Lyeth, Ph.D. joined the UC Davis Neurological Surgery faculty in April 1998 from the Medical College of Virginia where he was member of their head injury research team for the last 14 years. He works with Dr. Berman in the new, basic science Neurotrauma Research Laboratories providing additional research and educational opportunities for residents. Dr. Lyeth’s research interests include mechanism of injury and recovery of traumatic brain injury and was recently awarded a 5-year RO1 research grant from NIH to study the role of metabotropic glutamate receptors in brain injury.