Heros, Roberto C., M.D.
Professor, Co-Chaiman & Program Director

Jagid, Jonathan R., M.D.
Assistant Professor

Morcos, Jacques J., M.D.
Professor

Aziz-Sultan, Mohammad, M.D.
Assistant Professor

Cerebrovascular & Skull Base Surgery

Overview
Many techniques apply to both the surgical treatment of cerebrovascular disorders and the surgical treatment of difficult tumors along the base of the skull.

Surgery of Intracranial Aneurysms
Having one of the most experienced teams of physicians and medical professionals in this field, this program has earned a world-class reputation. In addition to a 24-bed neurosurgical intensive care unit, it includes a multidisciplinary aneurysm support group to address the social and psychological needs of patients and their families.

Arteriovenous Malformations
University of Miami School of Medicine's neurological surgeons have contributed extensively to international medical literature on cerebral and spinal arteriovenous malformations and fistulae. These surgeons share a strong collaboration with the medical school's interventional neuroradiologists in the treatment of these complex lesions that frequently require both embolization and surgical excision. Additionally, Gamma Knife® treatment is available for small cerebral arteriovenous malformations that are located in areas of the brain where surgical removal would be too risky.

Carotid Endarterectomy
Medical experts in this program collaborate closely with the Department of Neurology's stroke team in the care of patients with ischemic cerebrovascular disease. Many of these patients can benefit greatly from carotid endarterectomies, which are performed under continuous intraoperative EEG monitoring by a neurologist specializing in this area.

Cerebral Revascularization and Bypass Surgery
The school's neurological surgeons have extensive experience in performing bypass brain surgery using the patient's own scalp arteries and leg veins in some patients who have suffered a stroke or have warning signs of a stroke, or those with complex aneurysms that are not correctable with traditional surgery. Patients undergoing these demanding operations benefit from the school's high-tech equipment, such as SPECT scanning, intraoperative angiography, and direct bloodflow microrecordings.

Skull Base Tumors
Members of this program routinely collaborate with the neuro-otologists, head and neck surgeons, plastic surgeons, and opthalmologists for the treatment of tumors involving the base of the skull. An active skull base laboratory has been developed and a well attended international course on skull base surgery is conducted twice a year.

Transsphenoidal Surgery
Surgery of pituitary tumors via the transsphenoidal route is a subset of skull base surgery. Physicians in this program collaborate with neuroendocrinologists in the care and management of these patients. Through Gamma Knife® surgery, some of these tumors can be treated effectively in cases where traditional surgery is either inappropriate or will not adequately control the disease.

Acoustic Neuromas
The surgery of acoustic tumors is a very specialized subset of skull base surgery in which there is much collaboration with the neuro-otology team. Specialized monitoring techniques developed and supervised by the school's neuro-otologists have saved patients' hearing and facial function. Additionally, Gamma Knife® radiosurgical treatment is available for patients with acoustic tumors for whom traditional surgery is considered inappropriate.