Neurological care

An aneurysm is an enlargement of an artery caused by a weak arterial wall. They can occur anywhere there are blood vessels, including in the brain. When the artery is enlarged, this pocket of blood can put pressure on parts of the brain and may eventually rupture, causing cranial bleeding. A rupture can cause serious health complications, so early detection and diagnosis are key.

You may be experiencing an aneurysm if you have:

• Loss of consciousness
• Nausea and/or vomiting
• Seizure
• Stiff neck
• Sudden blurred and/or double vision
• Sudden severe headache
• Sudden trouble moving your arms and legs

If you have a family history of brain aneurysms, talk to your doctor about getting screened. Preventative treatment options include surgery and interventional techniques, including clipping and coil embolization.

Brain aneurysm risk factors include:

• Being 40 years old or older
• Drug use
• Family history
• High blood pressure
• Smoking
• Use of oral contraceptives

Johnston-Willis Hospital offers personalized, comprehensive care for brain cancer and tumors. From diagnosis and treatment to recovery and survivorship, our neurology and oncology teams are with you every step of the way.

Epilepsy is a neurological disorder characterized by abnormal brain activity. Typically, this activity can result in seizures or the onset of unusual sensations, behaviors and emotions. We offer an epilepsy monitoring unit (EMU) where our neurology team will carefully monitor you so we can best design a personalized treatment plan.

We are one of the only hospitals in Central Virginia to offer access to minimally invasive stereotactic radiosurgery, also referred to as "knifeless" surgery. This procedure uses extremely precise radiation beams to treat a variety of neurological disorders.

The procedure is painless and, unlike other treatment options, it does not require you to cut or shave your hair. Because there is no incision, recovery time is reduced, and most patients leave the hospital the same day as the treatment.

Movement disorders are neurological conditions which can hinder your ability to walk, speak, balance or perform other day-to-day tasks.

Our experienced neurosurgeons treat a variety of movement disorders, with the ultimate goal of your being able to effectively manage symptoms of your disorder, whether they be tremors, slow movement, stiffness and problems with balance and walking. Treatments we use to address movement disorders include brain stimulation and focused ultrasound.

Deep brain stimulation (DBS)

DBS is a surgical procedure. It involves the implantation of a device that sends electrical signals to areas of the brain that are responsible for body movement. These electrical signals can help reduce the symptoms of movement disorders.

It's important to understand that DBS is not a cure for movement disorders, but it can successfully treat symptoms and help restore your quality of life.

Focused ultrasound

Focused ultrasound requires no anesthesia, incisions or implanted hardware. You will be awake throughout the procedure and can interact with your neurosurgeon so they can monitor your results and make any needed adjustments. Typically, you will not need to stay in the hospital overnight and can rapidly return to normal activities.

After this procedure, people will often have an immediate and significant reduction in tremors, improving their ability to perform daily activities.

Candidates for focused ultrasound

You may be a candidate for focused ultrasound if you:

• Are age 22 years or older
• Are able to tolerate the procedure and communicate sensations during the procedure
• Are not candidates for, or are unwilling to have, invasive surgery
• Have a confirmed diagnosis of medication-refractory essential tremor

Essential tremor care

Essential tremor is a progressive neurological condition that causes shaking of the hands, head and voice. In some patients, the severity of essential tremor progresses to the point that it significantly impacts daily activities, such as eating, dressing and writing.

For interested patients, we offer access to a dedicated nurse navigator to help you understand your diagnosis and coordinate treatment, ensuring you feel supported in your care.

Depending on your condition, physical rehabilitation may be required after a neurological event, such as a stroke. Our physical therapists, speech pathologists and occupational therapists develop personalized neurological rehabilitation programs to help you regain skills and function. We offer rehabilitation services on both an inpatient and outpatient basis.

A stroke happens when blood flow to an area of the brain is cut off, depriving brain cells of oxygen and causing them to die. Our stroke care team is prepared 24/7 to receive, diagnose and treat strokes, and we work with our local emergency medical services (EMS) partners to streamline your care on the way to the hospital.

Johnston-Willis Hospital is the first hospital in Virginia to use a special neuroimaging platform that allows our physicians to expand the stroke treatment window. Receiving treatment for a stroke within the first few hours is critical for ensuring the best results, so we work to keep that window of time open.

Depending on the type of stroke, we may administer clot-dissolving medication, clot retrieval devices or perform coiling or stenting procedures.

Symptoms of stroke

If you suspect someone is having a stroke, remember to "BE FAST" to identify symptoms. "BE FAST" is an acronym that stands for:

• Balance — Is the person suddenly having trouble with balance or coordination?
• Eyes— Does the person have suddenly blurred or double vision or a sudden loss of vision in one or both eyes without pain?
• Face — Ask the person to smile. Does one side of the face droop?
• Arms — Ask the person to raise both arms. Does one arm drift downward?
• Speech — Ask the person to repeat a simple phrase. Is their speech slurred or strange?
• Time — If you observe any of these stroke warning signs, call 911 immediately.

If you believe someone close to you is experiencing a stroke, call 911 immediately.

Trigeminal neuralgia is an intense, sharp, severe pain that occurs on one side of your face. Although the extreme burning or shock-like pain from this chronic condition typically lasts for only a few minutes, the intensity can be physically and mentally draining.

We are one of only a few neuroscience centers in the nation to offer a full range of treatment options for trigeminal neuralgia, including medications, glycerol injections, microvascular decompression and surgery.

Triggers for the intense flashes of face pain can include vibration or contact with the cheek from simple activities including, makeup application, shaving or washing your face. Diagnosing trigeminal neuralgia can be difficult because many other conditions can cause facial pain. An accurate diagnosis is key to designing an effective treatment plan, so we will work with you to diagnose quickly to begin treatment.