Bringing Much Needed Expertise to New Mexico

In 2005, after nearly 30 years at the University of Pittsburgh, Howard Yonas, MD decided to make a change. The University of New Mexico Health Sciences Center was searching for a department chair for its Neurosurgery division, and Yonas was searching for a new challenge. “I felt like I had stagnated—I wanted to take on a new challenge,” says Yonas.

Yonas found that challenge in New Mexico. With a nationwide shortage of neurosurgeons, New Mexico was already suffering with only about one-third of the number of neurosurgeons than other states of similar population. To make matters worse, UNM’s neurosurgery program was at risk of closing, despite the enormous need in the state. “I couldn’t stand the idea of a program closing, especially one that was needed so badly” says Yonas. In May of 2005, Yonas was named Division Chief for Neurosurgery at UNM. The following year, Neurosurgery became the first new department at the UNM School of Medicine in over a decade.

In less than two years, Yonas has already had an enormous impact. “We are building a strong cerebrovascular program in New Mexico,” he says. In the past, every aneurysm case in New Mexico (140 in 2004) was sent out of state for treatment, says Yonas. “Now they are staying home.”

When Yonas arrived, he joined existing faculty members Paul Taylor, MD, a neurosurgeon in spine, pituitary and pediatrics and Marcus Keep, MD, who has expertise in gamma knife radiosurgery and functional neurosurgery. Since then, the department has hired Christopher Taylor, MD, a neurointerventional radiologist/neurosurgeon and is searching for several more neurosurgeons and an outstanding stroke neurologist to join the joint program with neurology, says Yonas.

“Together with Gary Rosenberg, the chair of Neurology, we are building a strong clinical and research neuroscience program.” When the Barbara and Bill Richardson Pavilion opens next year, it will house a 24-bed neurointensive care unit—one of only a dozen dedicated units of this size in the entire country.

New Mexicans who suffer from stroke, aneurysms and other cerebrovascular and traumatic brain disorders also benefit from Yonas’ extensive research background. Yonas was a pioneer in the study and implementation of xenon computation tomography, and he is now sharing this expertise with New Mexican patients. With this imaging technology, a patient inhales xenon, which enters the blood and circulates through the blood-brain barrier. Areas of the brain with low blood flow (due to stroke or blockages) absorb less xenon, making it relatively easy to measure with a computed tomography (CT) scan.

UNM Hospital recently acquired a portable CT head scanner which besides being able to provide routine CT scans for ICU patients at their bed side, also provides better diagnosis and improves risk assessment through xenon computation tomography. “By combining the portable scanner with the xenon blood flow technology, we will be able to provide the very best of care for that uniquely ill population that we will be caring for in our new ICU.” The portable scanner is about one-quarter of the size of a standard scanner, but it is able to deliver images of equal quality. UNM Hospital is one of the first hospitals in the country to have this amazing capability, says Yonas.

“Now that we can measure blood flow at the bedside, we will have a much better understanding of what is happening with our patients,” says Yonas. “Because xenon studies provide an accurate measure of blood flow, we will be able to not only understand the critical levels of blood flow in a patient, but also how those levels are effected by therapies. This can be directly monitored at the bedside by repeating the blood flow study after introducing a new therapy,” he explains.

This is important, says Yonas, because once you know a person is at risk, preventive measures can be employed. One such measure is surgery for patients with symptomatic carotid occlusion, called extracranial-intracranial bypass. UNM is currently participating in a multi-institutional clinical trial funded by the National Institutes of Health to determine whether brain bypass surgery can prevent stroke in high risk patients, including those who have already suffered mild strokes.

With a portable CT scanner, a thriving neurosurgery department, and a state-of-the-art neurosurgery ICU on the horizon, Yonas says he is excited to be part of UNM’s tremendous growth. “We have phenomenal strengths here,” says Yonas, citing UNM’s Biomedical Research and Integrative Neuroimaging (BRAIN) Center and the university’s extraordinary neurosciences research faculty as examples.

For New Mexicans with cerebrovascular disorders and those who may face these health concerns in the future, these strengths and the addition of Howard Yonas are definitely good news.

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