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Johnston-Willis Hospital - Neurosciences and Stroke

When your brain and nervous system - the command center for your life - are at risk, you want the best care in the business. That means the most experienced surgeons and specialists, the latest technology, and a successful track record of helping people recover their health and regain critical skills. At Johnston-Willis Hospital's Neuroscience and Gamma Knife Center, we're nationally recognized for our quality of care, and we get results.

  • The first and only hospital in the United States to be accredited and receive the Certificate of Distinction in the Management of Brain Tumors from The Joint Commission.
  • Comprehensive Stroke Certification by DNV-GL Healthcare, the highest level of competence possible for stroke care. Johnston-Willis is the first non-academic community hospital and only second in Virginia to achieve this certification.
  • The widest range of technologies and solutions for brain care available in Central Virginia
  • One of very few hospitals on the East Coast with operating suites and teams completely dedicated to brain and nervous system care, with the most sophisticated intensive care units and patient transition facilities.

From advanced technology through our Centers for Surgical Innovation, and across our patient care areas to one-on-one support for your specific condition and circumstances, Johnston-Willis provides everything you need for brain, nervous system, and stroke care. Take advantage of our many conventional, alternative and advanced services and treatments, including:

  • Brain stents and balloon angioplasty that returns blood flow to arteries in the brain, head, and neck
  • Cancer resource centers that are sources for educational materials, staff, and support services for all types of cancers
  • Code Neuro which is an integrated, fast-response process and a continuum of care for stroke
  • Interventional neuroradiology through our Neurovascular Center, which includes stereotactic radiosurgery for conditions of the brain, head, neck and spine, especially to reach previously inoperable tumors
  • Kyphoplasty/vertebroplasty which is a minimally-invasive surgical treatment for acute compression fractures of the thoracic and lumbar spine, performed by the interventional radiology department
  • Neurosurgery includes delicate procedures performed by expert teams using advanced tools to precisely locate and treat or remove targets inside the brain or spinal cord. These tools used by the neurosurgeon and team also assist in avoiding critical structures such as the optic nerve, brain stem, motor strip, and others
  • Neuroscience Intensive Care Units (NSICUs) with Step-Down Units are standard-setting neuroscience postoperative care facilities designed with large private rooms for the comfort and convenience of patients and families and to help with the transition from acute inpatient care to outpatient support; includes specially outfitted epilepsy monitoring rooms
  • Trilogy targeted radiation therapy is a treatment program to help prevent tumors from recurring after surgery by effectively controlling cell growth
  • Tumor embolization cuts off blood flow to a tumor before surgery, which means shorter surgical procedures, less blood loss and reduced need for transfusion - this is part of the neurovascular center/interventional neuroradiology

  • Acoustic neuroma
  • Aneurysm
  • Arteriovenous malformation (AVM) and other neurovascular abnormalities
  • Back pain
  • Brain tumors and disorders
  • Degenerative and herniated discs
  • Epilepsy
  • Guillain-Barre
  • Head injury and concussion
  • Intracranial hemorrhage
  • Movement disorders such as Multiple sclerosis, Parkinson's and essential tremors, Spasticity
  • Myasthenia gravis
  • Spine tumors and conditions such as vertebral fracture, spine curvature and more
  • Stroke
  • Trigeminal neuralgia (face pain)
  • Vertebral fractures

As a neuroscience patient or family member at Johnston-Willis Hospital, you'll also appreciate our free valet parking and free parking with 24-hour security monitoring and shuttle service, as well as 24/7 chaplain services, palliative care options, and inpatient and outpatient rehabilitation services.


Treatment Resources

With coordinated brain, nervous system, and stroke care and resources such as Johnston-Willis Hospital’s Neuroscience and Gamma Knife Center and Centers for Surgical Innovation, you gain the benefits of advanced technology. Our tools for highly precise imaging lead to more accurate diagnoses and more targeted treatment. Our minimally invasive options result in shorter surgeries with better outcomes, including more tumor cells removed in a single procedure, less time in the hospital and a quicker return to daily life.

Our staff of board-certified radiologists and technologists works closely with your physician throughout your journey from diagnosis onward. Additional neuroscience and stroke diagnostic and imaging services at Johnston-Willis include:

  • Computed Tomography (CT) scans
  • Electroencephalogram (EEG)
  • Magnetic Resonance Imaging (MRI)
  • >Nuclear Imaging
  • Ultrasound

We offer Central Virginia's only digital biplane angiography unit, also known as 3DRA (three-dimensional rotational angiography). This rapid scanning process quickly captures detailed images of the brain, spine and delicate body systems such as blood vessels. At Johnston-Willis Hospital, you're in the expert care of Richmond's only interventional neuroradiologist, whose extensive experience and skill in this specialty means you'll receive a speedy diagnosis and customized treatment that targets your particular neurologic condition. Other conditions that are better diagnosed with the benefit of 3DRA imaging include:

  • Aneurysm
  • Arteriovenous malformation (AVM)
  • Brain tumors and spinal conditions such as fracture or pain
  • Stroke

During Deep Brain Stimulation (DBS) at Johnston-Willis Hospital, a neurologist and neurosurgeon work together to implant wire electrodes into targeted areas of the brain that control movement. When connected to a programmable pacemaker-like device called a pulse generator or neurostimulator, the constant electrical signals interrupt the overactive brain cells that seem to cause the involuntary movements of Parkinson’s and essential tremor, and other brain-related conditions. Because DBS does not damage brain tissue or destroy nerve cells, the effects are reversible and can be tailored to your specific status. Our neurosurgeon and neurologist are together in the Operating Room to implant the neurostimulator in the exact location that will be of the most benefit.

Is DBS for You?

You may be a candidate for treatment with deep brain stimulation if your parkinson’s symptoms have previously been well controlled with medication but you are now experiencing abrupt on/off fluctuations, involuntary movements called dyskinesias that are caused by medication, or other side effects of medication limiting their usefulness. Also, if you have a tremor (whether caused by parkinson’s disease or essential tremor) that is not responding well to medical therapy.

Your care is customized for your specific condition and supported by an experienced and caring clinical team. Led by neurologists and rehabilitation therapists, we focus completely on your comfort and convenience, coordinating everything from testing, diagnosis and evaluations for physical and occupational therapy to helping you effectively manage your condition. Our goal is to maximize your independence and mobility while optimizing the quality of life for you and your loved ones.

Gamma Knife treatment, also known as stereotactic radiosurgery (SRS) or CyberKnife, isn't really a knife or surgery at all but a noninvasive outpatient procedure that uses extremely precise cobalt radiation beams to treat disease. The beams destroy the tissue a doctor would typically remove with a scalpel during an operation. Often used for brain tumors or other disease in locations too difficult to reach via traditional surgery, Gamma Knife enables the team to find and remove diseased cells without cutting through healthy tissue.

Johnston-Willis Hospital is designated as a Gamma Knife host site by the manufacturer, which means others come to us to learn how to use this innovative technology. With more than 2,000 Gamma Knife surgeries completed, our team has the expertise you need when facing a brain tumor or other disease.

Delays can cost you brain cells when you're having a stroke. Johnston-Willis Hospital is Virginia’s first non-academic hospital to become Comprehensive Stroke Certificated through DNV-GL Healthcare, a world-leading certification body. This is the highest level of competence possible for stroke care. We work closely with local EMS to deliver brain-saving care within the critical first three hours after symptoms appear. We can administer new clot-dissolving drugs and help avoid permanent brain damage, diminished capacity or death. Together, our fast actions and response give you the greatest chance of recovery that preserves the best possible quality of life.

TIME = BRAIN

Delay in treatment can mean loss of brain cells when you’re having a stroke. As Certified Primary Stroke Centers, all of our hospitals work with local EMS to deliver brain-saving care within the critical first three hours after symptoms appear. We can administer new clot-dissolving drugs and help avoid permanent brain damage, diminished capacity or death. Our fast response and treatments give you the greatest chance of recovery that preserves the best possible quality of life.

Johnston-Willis Hospital is the only hospital in the United States to receive The Joint Commission’s Gold Seal of Approval for our brain tumor program. Our comprehensive program includes real-time disease clinics with specialists from multiple disciplines who design a treatment program specifically for your patient.

Because of our lead role in management of brain tumors, patients and their families come from up and down the East Coast for treatment of brain and nervous system conditions. Our neurosurgeons spend the majority of their time operating on tumors and treating disorders of the brain, placing them in an elite group of surgeons in the United States and among the very best in Richmond and Virginia. We treat malignant and benign tumors, as well as rare, unusual and skull-base lesions, cerebrovascular (blood vessels of the brain), abnormalities, and nerve disorders.

With extensive diagnostic testing options and treatment methods available through our comprehensive approach, you’ll find everything you need right here. Treatment options include:

  • Surgery: Translabyrinthine, suboccipital, middle fossa
  • Endoscopy
  • Trilogy stereotactic targeted radiation therapy
  • Chemotherapy
  • Stereotactic radiosurgery (noninvasive Gamma Knife)

Johnston-Willis Hospital’s Chief of Neurosurgery, K. Singh Sahni, MD, has managed the care of more than 2,500 Trigeminal Neuralgia patients. Johnston-Willis is one of only a few neuroscience centers in the nation to offer the full range of treatment options for unbearable face pain, including medications, glycerol injections, microvascular decompression, or Gamma Knife Perfexion surgery.

Sharp, severe, shooting pain on one side of the face is known as trigeminal neuralgia or tic douloureux. Named for the three-pronged trigeminal (fifth cranial) nerve, this chronic pain condition causes sudden, intermittent, extreme burning or shock-like pain in the face. Although the pain seldom lasts more than a few seconds or, at most, a minute or two, the intensity can be physically and mentally draining. More women than men develop this condition, which often worsens over time with fewer and shorter pain-free periods between unpredictable episodes.

Triggers for the intense flashes of pain of trigeminal neuralgia can include vibration or contact with the cheek from activities such as:

  • Washing the face or brushing teeth
  • Applying makeup
  • Shaving
  • Eating, drinking, and/or talking
  • Exposure to wind or breezes

Diagnosing trigeminal neuralgia can be difficult because many other conditions can cause face pain. Treatments for various types of face pain differ, so finding the cause and making an accurate diagnosis is the key to effectively dealing with trigeminal neuralgia. We are one of only a few centers in the nation that takes a multimodality approach to TN. This means that you will get all of your care in one place, saving you multiple trips to multiple doctors who may not have the same information or perspective on the latest and best approaches for your specific circumstances.


Patient Care Continuum

Multidisciplinary Care Team

Specialists involved in your care collaborate in weekly multispecialty team conferences, coordinating their efforts to ensure you receive the best possible treatments with the best possible results. Members of our neuroscience team perform surgery in operating rooms exclusively reserved and equipped for neurosurgery.

Neuroscience Intensive Care Units (NSICU), Step-Down, and Epilepsy Monitoring Units

As you continue your recovery process, you'll transition to our spacious and comfortable NSICU rooms, equipped with ceiling-mounted Stratus-Critical Care Booms that eliminate medical equipment clutter while providing easy physician access to the patient's head, as well as important status and treatment information.

Our family waiting rooms include bays for minimal disturbance, kitchen facilities and onsite computer terminal with free Internet access and Wi-Fi. In our NSICU Step-Down Units and the specially outfitted rooms of our Epilepsy Monitoring Unit (EMU), you'll benefit from the latest in nurse call (patient assistance alerting) and patient monitoring technology, which means faster response, more effective care and a quieter environment for recovery.

Rehabilitation

Whether you're coping with the aftermath of a stroke or working to overcome functional limitations created by multiple sclerosis, Parkinson's disease, brain injuries, balance disorders or other neurological conditions, you want to restore your capacity for active living as fully and quickly as possible. At Johnston-Willis, you can expect us to be with you all the way along your path to recovery. While you're still an acute care hospital patient, we begin your rehabilitation right in your room, helping you launch the process of reclaiming your abilities.

Within our comprehensive healthcare network, you can also take advantage of additional rehabilitation services and treatments, including:

  • Inpatient Rehabilitation - Focused, intensive treatments and therapies for qualified candidates during a designated period of time at a live-in facility
  • Outpatient Rehabilitation - Extensive range of multifaceted treatments and therapies (speech/language, swallowing, physical, occupational, aquatic, and more) delivered with one-on-one support and tailored to your situation
  • Advanced Therapies and Treatments - Variety of options (Bioness, LiveOn, VitalStim, SaeboFlex) to retrain the body's electrical impulses and nervous system and improve function and control in hands, arms, legs, throat and other areas
  • Driving Assessment and Education - One-on-one evaluation and training, approved by the Department of Motor Vehicles, and provided by registered occupational therapists; designed to help you regain skills and return to independence

Progress, Convenience, Continuity

As you get better and better, you can mark your improvements while continuing as a member of our caring community. You can maintain your physician relationships and the comfort of interacting with our compassionate clinical staff while receiving care in a familiar and welcoming environment.