The Department of Imaging Services at Cayuga Medical Center is the most comprehensive in the region and has a reputation for remaining at the forefront of this critically important field of diagnostic medicine. We are technologically equal to the country’s premier medical centers. Our board-certified neuroradiologist works closely with an experienced team of registered radiological technologists who have earned additional certifications in specialty areas, including CT, MRI, nuclear medicine, and PET (Positron Emission Tomography) scan.
A leading edge computerized picture archiving communication system (PACS) captures digital images and maintains them electronically, eliminating the need to print and store film. With connectivity to our PACS through a secure network, our physicians can review their patients’ imaging studies and radiologists’ reports as soon as they are completed. This system also facilitates physician consultations and patient referrals to the University of Rochester Medical Center (and other tertiary care centers), which provides a very high level of integrated care.
Our newly renovated neurodiagnostics clinic comprises three testing rooms and is located on the medical center’s third floor, offering a view of Cayuga Lake. The clinic provides EEG (electroencephalogram) and EMG (electromyogram), which are the two principal neurological testing modalities used to confirm or to rule out several different diagnoses.
Patients can be referred to the clinic by primary care providers and by physician specialists. Testing is performed under the direction of our department supervisor, a board-registered EEG technologist with 25 years of experience in the field. Test results are interpreted by members of our team of board-certified neurologists, all of whom have subspecialty training within the field of neurology including pediatric neurology, dementia, neuromuscular disease, epilepsy, and stroke.
- EEG is used in the diagnosis of conditions such as epilepsy, syncope (fainting, loss of consciousness), memory disorders, stroke, headache, and altered mental status. For additional information on EEG testing.
- EMG is used to determine the cause of neck and back pain, numbness and tingling, neuropathy, carpal tunnel syndrome, and peripheral pain, such as a burning sensation in the feet or hands. For additional information on EMG testing.
Adult and Pediatric Neurology
Neurologists diagnose and treat disorders of the central nervous system, which includes the brain, spine, and peripheral nervous system and muscles. The Department of Neurology, a subspecialty of internal medicine, was established at Cayuga Medical Center in the mid-1980s. Our team includes both adult and pediatric neurologists.
There are many types of medical diseases of the central nervous system. Among the most common neurologic conditions we treat are:
- Parkinson’s disease and other movement disorders
- Multiple sclerosis (MS)
- Migraines and other headache disorders
Epilepsy is a neurological disorder that causes a person to have recurrent, unprovoked seizures. These seizures occur when the electrical activity in the nerve cells of the brain are disrupted. Seizures vary from person to person and can involve staring, abnormal movements and loss of consciousness. Epilepsy can occur at any time of life; however, it has the highest incidence in the very young and in the elderly. Among people with epilepsy, two-thirds are able to satisfactorily control their seizures and lead a normal life. However, one-third of those with epilepsy are still coping with uncontrolled or poorly controlled seizures.
There are two basic categories of epilepsy: generalized seizures and focal seizures.
- Generalized seizures involve all areas of the brain at once and cause loss of awareness and often loss of consciousness. This type of epilepsy is most commonly diagnosed in children.
- Focal (or partial) seizures begin in one part of the brain and may only impact the part of the body controlled by that specific area of the brain. The onset of focal seizures can begin at any time of life. Within each of those basic categories there are several different types of seizures.
At Cayuga Medical Center we treat pediatric and adult epilepsy, employing various types of treatment.
Cayuga Epilepsy Center
Epileptologist Dr. Deana Bonno, supervises the epilepsy monitoring unit on the third floor of Cayuga Medical Center. The unit allows her to evaluate electroencephalograms of brain waves and videotapes of patients’ body movements on a 24-hour basis. She uses this data to determine the type of epilepsy a patient has and the type of treatment to recommend.
Treatment of Conditions of the Brain and the Spinal Cord
Neurosurgeons specialize in the surgical treatment of conditions of the brain and the spinal cord. They use the most advanced computer and imaging technology in the diagnosis of neurologic problems and in the operating room during surgery. Our neurosurgeons manage the surgical treatment of patients with cerebrovascular hemorrhage and aneurysms, head injuries, spinal problems, tumors of the central nervous system, and congenital abnormalities.
Cayuga Medical Center launched its neurosurgery program in 1996. In 2013, after nearly two decades of steady growth, we became clinically connected with the University of Rochester Medical Center (URMC) Department of Neurosurgery. This important relationship has increased regional access to advanced neurosurgery.
- Area residents have the advantages of excellent local neurosurgery and a direct link to one of the most highly rated neurosciences programs in the nation.
- Patients who can be treated in Ithaca stay here and receive their care locally.
- Patients with more complicated brain and spinal cord injuries or aneurisms that require highly specialized care are referred to URMC.
- This tiered system is a very effective model of care that avoids unnecessary transfers of patients who are best served at Cayuga Medical Center.
Comprehensive medical center services support the work of our neurosurgeons:
- Cayuga Neurologic Services of Cayuga Medical Associates, comprising a very experienced team of board-certified neurologists
- Outstanding neurological imaging provided by the region’s most comprehensive Department of Imaging Services and the experienced specialists at Radiology Associates of Ithaca, including a fellowship trained neuroradiologist
- A talented team of intensive-care medicine specialists and hospitalists
- One of the most consistently highly rated inpatient Physical Medicine Rehabilitation Units in the country
- The most extensive outpatient physical therapy programs in the region, including practitioners with experience and training in neurologic conditions and musculoskeletal problems of the neck and spine
- The Ithaca Center for Pain Management, staffed by physicians who are board certified in physical medicine, anesthesiology and pain management
Chronic Pain Problems
Our caregivers treat patients with a variety of chronic pain problems including:
- neck and back pain from spinal disorders, herniated disks, and osteoporosis
- myofascial pain
- chronic regional pain syndrome
- post-herpetic neuralgia
- intractable cancer pain
- post-operative pain that remains unresolved.
The scope of pain management includes both medical and non-medical therapies. Our pain management specialists treat pain with medication, nerve blocks, and implanted technologies (such as dorsal column stimulators). The pain management team also works closely with a number of physicians and area health-care practitioners on a referral basis, including specialists in neurology, physiatry (physical medicine specialists), psychology, physical and occupational therapy, chiropractic, massage, acupuncture, and spiritual healing. An individual treatment plan is designed for each patient, depending on the patient’s problem and preferences.
Designated Stroke Center
Cayuga Medical Center is designated as a Stroke Center by the New York State Department of Health. This designation process is part of a statewide initiative to raise diagnostic and treatment standards and improve access to high quality care for patients with a diagnosis of stroke, which is the fifth leading cause of death in the United States and the leading cause of adult disability. Studies published in the Journal of the American Medical Association have shown that patients treated at hospitals with a Stroke Center have reduced mortality and morbidity, fewer complications, improved long-term outcomes, and increased patient satisfaction.
Stroke, also known as “brain attack,” is a medical emergency requiring swift transportation to the nearest medical center and immediate medical treatment by the stroke team. This is a multidisciplinary group including emergency physicians and nurses, neurologists, radiologists, neurosurgeons, vascular surgeons, and rehabilitation specialists. Team members are available to respond 24/7 in the Emergency Department for the evaluation and treatment of stroke patients.
In the management of acute stroke, the pressing issue is time. A Code Gray calls the stroke response team into action and things happen very quickly. The timely administration of thrombolytic agents to dissolve a possible clot blocking blood flow to the brain, is vital to save brain cells.
- The EMS responders start the process with their assessment of the patient in the field.
- As soon as the ambulance calls in, the response begins. CT imaging techs are in the hospital 24-hours a day so they can immediately prepare the CT scanner and call the radiologist for stand-by alert.
- Other stroke team members go to the Emergency Department where they are ready and waiting at the door to receive the patient.
- Our neurologists collaborate closely with the stroke neurologists at the University of Rochester Medical Center, who direct the care of patients arriving with symptoms of stroke.
There are two types of stroke: Ischemic (caused by a clot or vessel narrowing that blocks the flow of blood in the brain) and hemorrhagic (caused by bleeding into the brain or an aneurysm that leaks or ruptures). By examining a CT scan of the brain, a radiologist can determine if the patient has had a stroke and which type of stroke it is. If diagnosed in time, ischemic strokes can be treated with thrombolytic (“clot-busting”) medication to dissolve the clot and restore blood flow in the brain.
As soon as the initial CT images are taken, they are transmitted to the radiologist for interpretation. Additional brain imaging studies can be helpful, as well, to determine the extent of the impact the stroke has had on the brain. These images are also available to our colleagues at the University of Rochester Medical Center.
How to Recognize a Stroke
Signs and symptoms of stroke usually occur suddenly and may include:
- Numbness or weakness of the face, arm, or leg on one side of the body
- Confusion, trouble speaking or understanding
- Trouble seeing from one or both eyes
- Trouble walking, dizziness, or loss of balance or coordination
- Severe, unexplained headache, especially of sudden onset
If you have any of these symptoms, call 911 immediately. Do not try to drive yourself to the hospital – your symptoms could get worse while you’re driving.
Risk factors for stroke you can change with your doctor’s help
- High blood pressure
- Tobacco use
- Carotid and other artery disease
- Irregular heart rhythm
- Illegal drug use
- Transient ischemic attacks
- Certain blood disorders
- High blood cholesterol
- Physical inactivity and obesity
- Excessive alcohol use
Who We Can Help
Before anyone is admitted to our medical rehabilitation unit, our multidisciplinary care team conducts a thorough patient assessment to determine if our approach to care and level of intensity is appropriate for the individual. To be admitted to the unit, you must be determined to have the stamina necessary to participate in three hours per day of active therapy. We will only accept you into the program if we believe we can truly help.
Our Philosophy of Care
Each patient who comes to us for help is an individual with specific challenges to overcome. Our goal is to help you recover abilities, regain confidence, and return home with the skills needed to live life to the fullest.
You will work hard and so will our care team. We focus our efforts and our attention on your progress; we celebrate your successes and help you plan for the future. Families and friends are an integral part of the rehabilitation process, and we teach them how to reinforce the gains made through therapy. The work you and family do here prepares you to cope with changes in lifestyle following your trauma or illness.