For patients experiencing stroke, head and spine trauma, movement disorders, or cancer of the brain or spine, highly trained physicians—including neurologists, neurosurgeons and neurointerventional surgeons—provide specialized care to help achieve the best possible outcomes. At Sentara Martha Jefferson Hospital, our neuroscience experts are committed to providing safe, compassionate, effective care that is focused on patients and their needs.
Expanding the Interventional Neuroradiology Program
Interventional neuroradiology, also known as neurointerventional surgery, is a subspecialty within the neurosciences that uses minimally invasive surgical methods to provide treatment inside the vessels of the brain, head, neck and spinal column. These physicians frequently treat patients with conditions such as stroke and brain aneurysm, which is a weakened section in the wall of a blood vessel that has started to balloon or enlarge (a ruptured aneurysm can result in disability or death, depending on the aneurysm’s size and location).
Joining the neurointerventional program at Sentara Martha Jefferson are Mary E. (“Lee”) Jensen, MD, FSNIS, FACR, and Andrew J. DeNardo, MD. They join John R. Gaughen Jr., MD, founder of the Sentara Blue Ridge Neurointerventional Surgery program, and Genevieve Harway, NP-C. Dr. Gaughen has been providing neurointerventional surgery services at Sentara Martha Jefferson since 2015.
A pioneer in her field, Dr. Jensen has 38 years of experience in diagnostic and interventional radiology. While completing her fellowship at the University of California, Los Angeles, she participated in the first brain coiling procedures ever performed for treating brain aneurysms (see Dr. Jensen’s article on cerebral aneurysm treatment, beginning on page 6).
Dr. DeNardo comes to Charlottesville from Indianapolis, where he served in many leadership roles, including director of neurointervention and stroke at both St. Vincent Hospital and Indiana University Health University Hospital, two of the largest trauma and stroke centers in the United States.
Dr. Jensen previously trained both Dr. Gaughen and Dr. DeNardo in minimally invasive endovascular techniques, including the coil endovascular procedure for treating brain aneurysms.
“The three of us have all worked together at different points in our careers, so it kind of feels like we got the band back together,” says Dr. Jensen. “We have a strong sense of collegiality and teamwork, and it’s always exciting to work with people who have such high levels of expertise.”
All three physicians are considered to be among the most renowned practitioners in their field.
The neurointerventional surgery program sees patients from throughout Central Virginia, including many stroke patients from Sentara RMH Medical Center in Harrisonburg who are transferred to Sentara Martha Jefferson for removal of blood clots from the brain arteries. This procedure, known as mechanical thrombectomy, is an emergency treatment performed on patients experiencing a stroke from a sudden blockage in a brain artery.
“As our technologies improve, we are finding enormous demand throughout Central Virginia for our endovascular stroke service,” says Dr. Gaughen. “We’ve expanded the interventional neuroradiology program to provide expert management of this ever-growing patient population.”
In the near future, the neurointerventional surgeons also will begin seeing patients on a periodic basis in their clinic at Sentara RMH Medical Center in Harrisonburg.
Growing Neurosurgery Services
Sentara Martha Jefferson’s highly skilled neurosurgeons offer a wide range of treatment options for adult patients with brain and spinal disorders. Typical spine conditions treated include degenerative disc disease, spine injuries, herniated discs, spinal stenosis (narrowing), spinal tumors, osteoarthritis and osteoporosis fractures. Brain disorders treated include brain tumors; hemorrhage; and bleeding and bruising outside the brain (epidural and subdural hematomas), which are often caused by severe head trauma.
New to Sentara Martha Jefferson Neurosurgery Services are David F. Slottje, MD, and Osmond C. Wu, MD. They join Jacob Young, MD, who has been with Sentara Martha Jefferson since 2010, and Margaret Kleinot, PA-C.
Fellowship-trained in neurocritical care, Dr. Slottje brings several new procedures to Sentara Martha Jefferson, including endoscopic resection and radiosurgery for pituitary tumors. His clinical interests include neuro-oncology, cerebrovascular disorders and central nervous system infections.
“I understand that the diagnosis of a brain or spine disease is a source of tremendous personal stress for individuals and families,” says Dr. Slottje. “I’m committed to learning about my patients as complete individuals, and not just as they’re defined by their medical condition alone. It’s my role to educate my patients about their illness, and then we can work together to formulate and enact a personalized treatment plan that best suits their needs.”
Fellowship-trained in minimally invasive and complex spine surgery, Dr. Wu also brings several new procedures to Sentara Martha Jefferson, including minimally invasive spine surgery, adult spinal deformity correction and stereotactic spine surgery. His interests include surgical management of spinal degenerative disease, spine trauma and spinal tumors.
A Collaborative Approach to Patient Care
The Neurosciences Center also includes five board-certified neurologists and a nurse practitioner in neurology. Using the latest technology and treatments, these caregivers work together to diagnose and provide care for a wide range of challenging problems affecting the brain, spine and nervous system.
The practice of modern neurology, neurosurgery and neurointerventional surgery often involves the collaboration of many specialists, as well as other clinicians and support staff. Located on the fourth floor of the Phillips Cancer Center, adjacent to the main hospital, the Sentara Martha Jefferson Neuroscience Center provides a central location where physicians and other clinicians can consult with one another easily and efficiently.
“Having ready collaboration among members of the neurosciences team allows us to take advantage of the subspecialty expertise of our colleagues and helps ensure that we provide the most comprehensive and evidence-based care for our patients,” says Melanie J. Winningham, MD, medical director of the Sentara Martha Jefferson stroke program.
Working closely with providers in the Neurosciences Center are the physical, occupational and speech rehabilitation therapists in the Sentara Martha Jefferson Outpatient Care Center, who provide comprehensive, effective care to patients recovering from stroke and other neurological disorders and disabilities. Using the latest evidence-based treatments and state-of-the-art equipment, as well as individualized home-exercise regimens and one-on-one education, these caregivers are key in helping neurological patients achieve their rehabilitation goals and regain control of their lives.
“We can provide patients with a very high level of care in a community hospital setting, which is where many people feel more comfortable,” says Dr. Jensen. “Sentara Martha Jefferson offers a warm, quiet environment that is very conducive to healing.”
Award-Winning, Nationally Recognized Stroke Care
Although stroke care at Sentara Martha Jefferson Hospital was initially focused on Charlottesville and the surrounding counties, the 2016 opening of the helipad adjacent to the Sentara Martha Jefferson Emergency Department now allows patients to be transferred more quickly and from greater distances to the hospital’s emergency services, including stroke care. One chief beneficiary of this new transport system has been Sentara RMH Medical Center in Harrisonburg, which now can rapidly transport many of its stroke patients in need of neurointerventional surgery to Sentara Martha Jefferson for advanced care.
As Sentara Martha Jefferson has worked on improving transport times, hospital caregivers also have seen improvements in overall treatment times for stroke patients. One example is the stroke team’s “door-to-groin time”—the amount of time between a stroke patient’s arrival at the hospital and the initiation of neurointerventional treatment—which typically involves accessing the patients’ artery system through a small incision in the wrist or groin. Sentara Martha Jefferson’s door-to-groin time for all patients is currently 21 minutes—well below the 90 minutes recommended in national stroke guidelines established by the American Heart Association/American Stroke Association.
The hospital’s door-to-revascularization time—the time from arrival until a patient has his or her stroke-causing clot removed—is currently 64 minutes, well below the national guidelines recommendation of 120 minutes. This removal is accomplished through a neurointerventional procedure called mechanical thrombectomy, during which a neurointerventional radiologist inserts a thin, flexible catheter (tube) into the patient’s artery and mechanically removes the clot through the catheter.
“This outstanding work to improve patient care was honored earlier this year, when Sentara Martha Jefferson became the first hospital in the nation to receive DNV Primary Plus Stroke Certification (PSC+),” notes John Gaughen, MD. “The certification is a strong indicator of the high-quality level of stroke care patients receive when they come to Sentara Martha Jefferson.”