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Heart Care, Close to Home Telecardiology is an alternative to an in-person visit with a heart specialist. It connects you to a Renown cardiologist by using a secure, video-enabled device. It can be used for consultations, examinations and follow-up appointments. Patients are seen from their local rural community clinic, close to work, home and family, minimizing the cost and time of long-distance travel for heart care.  Your Telecardiology Visit Before Your Visit You may need to have a heart test or blood draw prior to your visit. In most cases, you can have the test done locally and our heart doctor will have the results when they meet with you via telecardiology. If this is your first visit, your doctor will determine if you need any tests.   During Your Visit After check-in, a medical assistant will check your vital signs in a telecardiology room. Videoconferencing equipment will then connect you to a medical assistant to review your health information. Your cardiologist will talk with you remotely. When it is time for a physical examination, the medical assistant in the room with you will follow the doctor's instructions, facilitating the examination. A digital stethoscope will be used so the doctor can hear your heart and lung sounds.   After Your Visit Your heart doctor will talk then review their findings and you will be able to ask questions.

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While February is recognized as American Heart Month, it’s important to prioritize your heart health 365 days a year. Cardiologists play an integral role in our overall health and wellbeing – they are the experts when it comes to preventing and treating heart and vascular diseases. Dr. Jad Al Danaf of Renown Institute for Heart & Vascular Health shares eight reasons to visit a cardiologist. 1. Abnormal EKG The American Heart Association states an electrocardiogram, abbreviated as EKG or ECG, is a recording of the heart’s electrical activity to measure the rate and rhythm of the contractions in the upper and lower chambers of the heart. An EKG detects heart problems or abnormalities. If you have an EKG that shows abnormal results, you’ll want to see a cardiologist. An abnormal EKG can mean many things, such as irregular heart rate, heart rhythm abnormalities in the shape or size of the heart, medication side effects, and more. A cardiologist is most qualified to evaluate an abnormal EKG and determine the cause. 2. Immediate family history of heart disease or sudden cardiac death Knowing your family health history is essential to identify if you’re at risk for certain health conditions such as heart disease. For example, if you’re aware of anyone in your immediate family who had or has had heart problems or passed away from sudden cardiac death. In that case, you’ll want to discuss it with a cardiologist so they can determine if screenings, medications, or lifestyle changes are needed to help lower your risk. 3. Chest pain or shortness of breath with exertion If you have chest pain or shortness of breath that starts or worsens with activity, it may indicate a heart problem, and you should schedule a visit with a cardiologist immediately. Severe chest pain might be a sign of a heart attack or other serious medical emergency. If you’re experiencing severe chest pain, shortness of breath, or any other signs of a heart attack, call 911 immediately. 4. High blood pressure Have you had a high blood pressure reading? If so, it’s recommended to consult with a cardiologist for further evaluation. High blood pressure puts you at risk for heart disease and stroke, as uncontrolled high blood pressure can damage arteries, reducing blood flow and oxygen to your heart and brain.

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When it comes to your neurological health, seeking the expertise of a specialist is crucial. The Renown Institute for Neurosciences provides comprehensive care for complex diseases affecting brain, spinal cord and peripheral nerves. Let us help guide you through the appointment process to ensure a productive and informative first appointment. What to Expect at Your First Appointment at the Renown Institute for Neurosciences Duration and Purpose: Your first appointment will last approximately one hour. This time allows the doctor to ask specific questions, do a thorough neurological exam and discuss your concerns. Specialized Care: You will be matched with a provider who specializes in assessing and treating your specific ailment or condition. This tailored approach ensures that you receive care from an expert who has the specialized interest and expertise to address your needs effectively. Initial Assessment: During your visit, you will first see a medical assistant who reviews your medication history and standard screening questions provided by your doctor. Following this portion of your appointment, the neurologist will ask specific and detailed questions about your condition and conduct a non-invasive neurological examination to evaluate your brain and nervous system functioning. This exam involves painless tests assessing your cognitive function and nerve operation, including tests for sensation, strength and coordination. Treatment: After performing the neurological exam and addressing your questions, the neurologist will review the possible diagnosis and treatment plan, including any medication needs to help with your condition. Finally, your doctor may discuss the role of additional testing, including imaging studies (CT/MRIs), peripheral nerve testing (EMG) or brain wave testing (EEG), which will be scheduled for a later date. Making the Most of Your Visit To make your appointment as beneficial as possible, consider the following tips: Arrive Early: Plan to arrive at least 10 minutes early to fill out any necessary check-in items before your appointment's scheduled start time. This will ensure a smooth and timely visit. Bring Insurance Information: Have your insurance details readily available to facilitate the administrative process. This will help avoid any delays or confusion. Gather Medical Records: If you have received treatment or undergone tests with other healthcare providers relevant to your condition, bring along any medical records or test results. This information will assist your neurologist in gaining a comprehensive understanding of your medical history. Prepare Questions and Concerns: Consider noting the following, which can help you better answer questions the neurologist may ask during your appointment. The frequency, duration and severity of your symptoms. Share information about any medications or treatments you have tried for the condition and the outcomes. Prioritize questions to help the neurologist answer your most significant concerns during the initial visit. Your first appointment with a doctor at the Renown Institute for Neurosciences is an opportunity to receive expert care and gain insights into the best method of treatment for your condition. By understanding what to expect and following the tips provided, you can maximize your visit and be on your way to achieving overall health and wellness.

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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Renown Health patient, Alden Nash, hiking Death Valley National Park just three months after a Transcatheter Aortic Valve Replacement. Alden Nash isn’t your average 80-year-old. For much of his life, he could be found outdoors enjoying nature and hiking some of the west coast’s highest elevations. A husband and father of two, Alden turned his passion into a career as a Yellowstone park ranger in 1965. Alden believes his passion for the outdoors is responsible for his many years of health – until the unavoidable happened. The Hardest Climb The number one doctor recommendation for a healthy heart – lead a healthy, active lifestyle. Any cardiologist would be thrilled to have Alden as a patient due to his robust physical activity regimen. “Don’t have a TV set or a lounge chair in your house and you’re all set,” said Alden when asked how he has remained so fit throughout his senior years. Unfortunately, many other factors come into play when it comes to heart health, one of which is the reason we are telling Alden’s story today. Familial history - it’s a hot topic in the world of medicine. Understanding your genetic risk factors can help care providers develop updated care plans based on your results. Alden’s family has a long history of high cholesterol, which he avoided for much of his life by staying active. This combined with his age resulted in his first heart attack in December 2021. Doctors later determined that Alden was suffering from a type of heart valve disease known as aortic valve stenosis. Aortic stenosis is the narrowing of your aortic valve opening that impedes normal blood flow. Over time, the leaflets of your aortic valve become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, your heart must work harder to push blood through the aortic valve of your body. Eventually, your heart gets weaker, increasing the risk of heart failure. People who are most at risk for aortic stenosis include those who have had certain heart conditions present at birth, have chronic kidney disease or have heart disease risk factors such as high cholesterol and high blood pressure. However, generally, aortic stenosis is a degenerative process of aging with no modifiable risk factors. The incidence of aortic stenosis increases rapidly with age and is very common above the age of 80 – with 1/10 having the condition and 1/50 with a problem severe enough to warrant surgery. When symptoms are present, the disease can be rapidly disabling or even deadly, often progressing over several months unless treated.

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The Acute Care Rehab Therapists at Renown Regional and South Meadows serve a wide variety of patients and their families with varying acuity levels and diagnoses. The 2 departments (inpatient and outpatient) are made up of around 80 employees, including 14 therapists with over 20+ years of experience and over 700 years of combined experience.    What is Acute Care Therapy? The acute care setting is a very fast paced environment with a high volume of therapy orders and fluctuating census.  The therapists are considered a consult service with a primary goal of helping with discharge planning and moving patients throughout our system.  Depending on location, the therapists generally cover 1-3 floors within the hospital and manage a daily caseload of about 15-20 patients.  Our general population ranges from Neonates to Geriatrics. The therapists provide comprehensive diagnostic and therapeutic rehabilitative services (Physical Therapy, Occupational Therapy, and Speech Language Pathology for the treatment of patients with various disorders and related medical conditions. Treatment may include a variety of activities and exercises to maximize a patient’s functional independence.  Renown Outpatient Rehab Therapy Services Outpatient Physical, Occupational, and Speech Therapy services to help individuals improve & regain function to allow for higher quality of life and a more active lifestyle. We provide treatment for: Orthopedic Conditions Nerve Injuries Spinal Cord Injuries Sport-Related Injuries Worker’s Compensation Injuries Trauma and Post-Surgical Recovery Vestibular Dysfunction Hand Injuries Speech/Language Difficulties Swallowing Dysfunctions Cognitive Issues Specialty Services Include: Lymphedema Therapy Dry Needling Chronic Pain LSVT Big and LSVT Loud Modified Barium Swallow Studies (MBSS) South Meadows Campus Lite Gait & Solo Step Systems Pre-Driving Assessments and Computer Driving Simulation Wheelchair Evaluations-Basic and Complex Custom Splinting All treatments are one-on-one with a licensed Outpatient Therapist

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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February is American Heart Month, but our incredible heart heroes are here to serve you all year long. So please join us in honoring the Cardiac Cath Lab team at Renown Health! At the core of who we all are, we find the heart: one of the largest sources of life that gives us the blood and oxygen we need to live full and healthy lives. When the heart doesn’t function to the best of its ability, a delicate approach led by cardiac experts might be necessary. These individuals can not only save lives but also help facilitate a higher quality of life.  The team entrusted to protect that vital source of life includes the hard-working and talented individuals in the Cardiac Catheterization Lab (a.k.a. “Cardiac Cath Lab” or “Cath Lab”) at Renown Health. These team members are known for their expertise, precision and quick-thinking in emergencies. When it comes to the function of your heart, you are in the best hands with this team. Their passion for Renown’s mission of making a genuine difference in the health and well-being of the people they serve is a testament to what they do every day.  Cardiac Champions  Whether the procedure is emergent or planned, the Cardiac Cath Lab wears many different hats. The team is a well-coordinated group of nurses, imaging professionals, electrophysiology technologists, interventional technologists and more who band together to provide a diverse array of services, including stent placements, pacemakers, balloon pumps, interventional angioplasties, TAVRs and of course, catheters.  “A day in the life in the Cath Lab can go various ways,” said Erica Drummer, RN at Renown Health. “Every day, you are either a part of the electrophysiology team, doing cardiac ablations and placing devises such as pacemakers; the structural heart team, which includes MitraClips for mitral regurgitation and TAVRs; or the heart catheterization team, which includes diagnostic angiograms, heart catheterizations, angioplasties and stents for clogged arteries.”  With the wide variety of cases the team sees daily, an average day in the Cath Lab consists of many moving parts.  “We handle cases from left and right heart catheterizations, where we can diagnose and fix the artery right then, to electrophysiology cases like heart ablations and pacemaker implants, all the way to emergency STEMI (heart attack) patients,” said Michael Blankenship, Electrophysiology Technologist at Renown Health.  “We do so many things in the Cath Lab,” added Laurel Douglas, RN, Imaging Manager at Renown Health. “We ensure we have 24/7 coverage for emergencies, as we often have to act at a moment’s notice to care for emergent situations.”  Many of those emergency situations involve heart catheterization.  If someone has a heart attack, the team immediately steps in to place stents to open the coronary arteries that are causing the attack. If a patient’s heart needs any assistance during an emergency, the team can place devices such as Impella (temporary ventricular support) or intra-aortic balloon pumps. Renown is a major advocate for advanced medical technology, and the Cardiac Cath Lab team embraces these technologies to perform life-saving procedures, all while working together as a cohesive unit.  “We work amongst each other to ensure sterility, safety and the best outcome for each patient,” said Zohra Benbrahim, RN at Renown Health. “We try to fit in as many cases as possible into the workday, and sometimes after hours, so patients can get the care they need.”  “Each team usually has 3-4 members, and each member has a critical job to carry out in order to implement excellent cardiac care,” added Erica Drummer, RN. “Many of our patients tell us that we all work well together, and I couldn’t agree more. We have become like a well-oiled machine or a NASCAR pit crew.”  Naturally, patients undergoing any heart procedure might feel frightened and anxious. Never fear – the compassionate Cardiac Cath Lab team is here to ease those fears throughout each patient’s entire visit. Their main solution? Communication.  “Being a patient in the Cath Lab can be daunting,” said Erica Drummer, RN. “When we have patients who may feel scared or have concerns, we try our best to connect with them, keep them informed and educate them on the procedure and the step-by-step process, including what they may feel before, during and after.”  “Overall, we try to keep spirits light,” said Zohra Benbrahim, RN. “Our team is excellent at explaining the procedure as it is happening. We also advocate for comfort throughout the procedure, which helps tremendously with anxiety, including giving patients warm blankets and music of their choice!”  Our experts in the cardiac Cath Lab make sure that no stone goes unturned when it comes to optimal heart function for every patient. Together, the team mends hearts and saves lives, day in, day out.  A Growth Mindset  Always learning, always improving, always reaching new heights – that's the Cardiac Cath Lab team.  This team’s accomplishments speak for themselves on both a local and national scale.  “Over the years, we have achieved several milestones, including becoming a STEMI Receiving Center, gaining our Chest Pain Center Accreditation (which is achieved by Cath Labs who provide emergent percutaneous coronary intervention for heart attack patients 24/7) and having our accredited electrophysiology program,” said Laurel Douglas, RN. “We also offer services that other facilities do not offer. We have brought in several new procedures to the Cath Lab over the years. This is impactful, as the community members get to stay here for treatment.”  The Cath Lab team is anything but ordinary. There is never a dull moment in this department, and despite an ever-growing caseload, the team is always ready to rise to the challenge and continue pushing to surpass the average.  “I am so proud of my team for providing care for such sick patients,” said Zohra Benbrahim, RN. “We never really know how the day is going to go because emergencies happen, and things always change. Recently, we had a record high volume of cases, and my team powered through these busy weeks like champs.”  “We strive to get our STEMI door-to-balloon times at or below 60 minutes,” added Erica Drummer, RN. “Door-to-balloon time refers to the time from when a patient arrives in the ER to the time the Cath Lab has a catheter guide wire crossing the culprit lesion in the coronary artery that is causing the heart attack. The national average (and current guideline) is 90 minutes, so our 60-minute time is a notable accomplishment for us.”  The importance of staying on top of your heart health comes center stage during American Heart Month, which is a prime opportunity for our cardiology professionals to educate the community and help them grow their cardiac knowledge. The cardiac quality team participates in community events throughout the month (and beyond!) to raise awareness for cardiac health. The team also outreaches to other health systems and healthcare partners to highlight what Renown has to offer in the way of heart care. Each Cath Lab team member always reminds patients about lifestyle choices and diet changes that can improve cardiovascular health, and they take this outreach with them all around Renown Regional Medical Center as well, walking through the hallways promoting many different ways of living a heart-healthy life.  The journey continues! The team will soon welcome a new Cardiac Cath Lab at Renown South Meadows Medical Center. The new lab will allow our experts in heart care to treat patients at our South Meadows location experiencing a heart attack and needing immediate intervention to open vessels in their hearts. The team is looking forward to embracing even more access to emergent cardiac care for our community at large.   Learn more about how Renown is building more ways to care for our community.  Now Hiring for Heart Heroes  Those looking to join a caring, committed and tight-knit group of cardiac care professionals will be in good company with the Cath Lab team. According to the members of this department, being a quick-thinking, dependable team member is key to predicting a successful Cath Lab professional.  “A good coworker communicates with everyone and is able to be flexible when things get hectic,” said Zohra Benbrahim, RN. “Our team stays so close with each other because of everyone’s ability to recognize where help is needed. Especially in the Cath Lab, it is important to be always aware of the patient’s vitals and clinical presentation so you can speak up if you notice changes. There are always new procedures or products coming out that become integrated into our practices, so it’s also good to welcome new policies and be adaptive.”  “We are a small team, and everyone sees each other as a friend,” added Laurel Douglas, RN. “We all know we will need help at some point, whether it be covering an on-call shift or helping during a procedure, so we all help each other. Teamwork and positive attitude are really what makes you a good team member.”  Not only are these individuals dedicated to impacting the lives of patients with the very organ that beats life into them, but they also are devoted to Renown – and it shows.  “I started working for Renown when I was 19 years old, and Renown was the medical system I went to for care; as I spent more time working here and becoming a part of the community, I could not see myself working anywhere else or getting care at any other hospital,” said Zohra Benbrahim, RN. “I truly believe Renown provides the best care and best serves the growing community of northern Nevada.”  The Cath Lab team members agree that Renown is a great place to both start and continue your career. Many of them have taken advantage of Renown’s training and educational opportunities, which in turn have helped them expand their knowledge to better serve the community.  “I chose to work at Renown because it gave me the place to grow in my career and experience different avenues within my career,” said Michael Blankenship. “I first started off as a student here, and I quickly realized that everybody I worked with genuinely cares for our patients. I started off in x-ray seeing patients and eventually did rotations up in the operating room, and I got hired full time in the Cath Lab.  After a short time being here, I was crossed trained in the electrophysiology lab, where I furthered my knowledge in my career.”  This dynamic department is actively hiring, and many open positions are sign-on bonus eligible. The team cannot wait to welcome you to their, as Erica Drummer puts it, “well-oiled machine.”  “Being a Cath Lab nurse is very rewarding, especially when you’re able to be a part of a team that can save someone’s life,” Erica closes.

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Cardiac Imaging Heart imaging plays a vital role in healthcare, offering critical insights into the structure, function and overall health of the heart. By utilizing advanced imaging techniques, imaging specialists can accurately diagnose, monitor and treat various cardiac conditions. At Renown Health we offer comprehensive diagnostic imaging services, including echocardiogram (echo), nuclear imaging, Coronary CT angiography and vascular ultrasound. Follow-up imaging can also be completed for post-surgical procedures to measure success rates.

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Renown Neurosurgery Using a collaborative approach, our experts use leading-edge diagnostic tools to identify neurological conditions and treat them with the most effective surgical and non-surgical treatment techniques available.    What is a Neurosurgeon? A neurosurgeon is a doctor that specializes in surgical treatment and management of conditions for the nervous system, including the brain, spinal cord and nerves. In addition to the nervous system, neurosurgeons can also treat conditions that impact the surrounding supporting structures, including your skull, spinal vertebrae, spinal disks, and blood vessels. If your care team determines surgery is the best plan of treatment, you will be referred to a neurosurgeon for consult. Conditions We Treat

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