From our CEO The Joe Niekro Foundation Partnership

Sleep Center of Excellence
Kingwood Medical Center’s Sleep
Center of Excellence provides outpatient
diagnostic sleep studies for patients
suffering from the following conditions:
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Insomnia
Narcolepsy
Apnea
Parasomnias
Restless leg syndrome
Sleep/wake rhythm disorders
Many sleep conditions are neurological
in origin, so a typical sleep study uses
painless patches to monitor brain wave
function. Oxygen saturation, carbon
dioxide levels, eye movement, and heart
rate are also closely watched to give
physicians a complete picture of your
sleep habits and tendencies.
Outpatients with sleep disorders should
note that our Sleep Center of Excellence
has comfortable, private bedrooms for
overnight monitoring.
Overnight Testing
Patients referred by their primary
care physician will first undergo a
comprehensive consultation. If it is
determined that an overnight sleep study
is necessary, an appointment will be
scheduled at that time.
During your overnight stay, a technician
will be present the entire time, helping to
set up and monitor the medical equipment,
answer your questions, and assist you
when you’d like a drink or need to use
the restroom. The room itself is designed
to mimic bedroom-like conditions. You
can adjust the temperature and lighting
to your preference, even fall asleep while
watching television, if that’s your routine.
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For questions about the Sleep Center
for Excellence—especially concerning
procedures, physician referral, or
accepted insurance—please call us at
281-348-8373.
The Joe Niekro Foundation
Partnership
Natalie Niekro – President & Founder of
The Joe Niekro Foundation
Kingwood Medical Center and
The Joe Niekro Foundation have
partnered to help raise awareness
about brain aneurysms. Every eight
minutes an aneurysm ruptures and
20 percent of those who suffer an
aneurysm will
die within
minutes.
The Joe Niekro
Foundation
was established
to educate
the public
about brain
aneurysms, help
fund aneurysm
research,
and support
aneurysm
patients and
their families. The foundation is named
in honor of legendary pitcher,
Joe Niekro, who died from a
ruptured cerebral brain aneurysm
on October 27, 2007.
HCA affiliated Kingwood Medical
Center’s team of neurointensivists,
neurointerventional radiologists, and
neurosurgeons are providing the
multiple levels of care needed to
detect, treat, and prevent the rupture
of brain aneurysms.
By partnering with The Joe Niekro
Foundation, Kingwood Medical
Center is helping to raise the level of
community awareness about cerebral
aneurysms and helping to fund
research, education, and support
where it is needed most.
From our CEO
For more than 20 years, Kingwood
Medical Center has worked hard to
position ourselves as a leading provider
of healthcare, not only to the Kingwood
community, but also to individuals living in
Houston, Lufkin, and beyond.
Our success is your success, and both
start with the amazingly talented team of
physicians, surgeons, and nurses who have
chosen to bring their specialized experience
and expertise to Kingwood Medical
Center. This includes our neurologists,
neurosurgeons, neurointerventional
radiologists, critical care intensivists, and
neuro-nurse practitioners. These people truly
are the best brains in their field.
In 2011, a $25.5 million expansion
added 54,000 square feet and 56 private
patient rooms to our footprint—all this just
two years after a $27 million, 68,000
square-foot expansion. Thanks to a separate
$2 million investment, our dedicated
Neurosurgery Operating Room and Neuro
ICU, the only one in Montgomery County,
recently opened. Additionally, we plan
to open a dedicated neurointerventional
radiology suite in the summer of 2012 – a
$7.3 million investment. Simply put, more
and more patients have been seeking our
expert care, so we have grown our space
and capabilities to better meet those needs.
Specifically for our neurosciences
program, all this hard work has been
recognized time and time again. The Joint
Commission has granted us Primary Stroke
Center Accreditation, and the South East
Texas Regional Advisory Council (SETRAC)
has designated us a Level I Comprehensive
Stroke Center. Together, the American
Heart Association and the American Stroke
Association have awarded us the prestigious
Gold Plus Designation in accordance with
their “Get with the Guidelines” national
program.
Awards and accreditations serve as
testaments to our commitment to excellence,
but nothing is more satisfying than saving a
patient’s life and helping him or her recover
to their full potential. At Kingwood Medical
Center, those extraordinary moments have
become the ordinary.
We hope you will consider us for your
future healthcare needs.
Sincerely,
Melinda Stephenson
CEO, Kingwood Medical Center
Neurosciences at Kingwood
Medical Center
There are a number of hospitals that can
stabilize patients after isolated neurological
incidents, but patients are far better served
when they enter a comprehensive circle of
care capable of treating and rehabilitating
a range of complex neurological situations.
From an initial moment of crisis to complete
recovery, Kingwood Medical Center is there
every step of the way.
Our neurosciences team can successfully treat
the following:
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Stroke caused by lack of blood
flow (ischemia), blocked blood flow
(thrombosis, arterial embolism), or
hemorrhage
• Brain aneurysms
• Cerebral vasospasm
• Brain tumors, including
medulloblastoma,
glioblastoma multiforme,
oligodendroglioma, acoustic
neuroma, and colloid cyst
• Spinal tumors, including
extradural, intradural, and
cerebral intramedullary
sites, both benign and
malignant
Vascular malformations
Sleep disorders, including insomnia,
narcolepsy, parasomnias, restless leg
syndrome, and sleep/wake rhythm
disorders
Back and neck pain, including arthritis,
scoliosis, herniated disc, compression
fracture, and nerve root compression
Our neurosurgeons can perform the following
procedures:
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• Aneurysm clippings
• Tumor resections
• Cerebral shunts
• Cervical laminectomies
• Lumbar laminectomies
• AVM resections
Throughout Texas, very few physicians can
claim a specialty in neurointerventional
radiology, so having that rare resource on
staff at Kingwood Medical Center allows us
to offer some unique treatment options.
Our neurointerventional radiologist can
perform the following procedures:
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Thrombolysis or thrombectomy
Cerebral angioplasty
Cerebral stent procedures
Cerebral coiling
Cerebral embolization
To meet with a member of our neuroscience
team and discuss any of the conditions or
procedures listed here, a physician referral
is required. Call 1-800-258-5064 for more
information.
Rehabilitation Overview
We can help with:
When a neurological event or neurological
condition brings a patient into our care,
the immediate intervention is only part of
a larger treatment plan that we develop to
uniquely meet the needs of each patient.
Because the brain directs function throughout
the entire body, physical or mental
debilitation often results from neurological
emergencies, even when they are treated
quickly and correctly. This is especially true
of stroke.
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At Kingwood Medical Center, specialists in
neuro-rehabilitation can help people on both
an inpatient and outpatient basis to recover
function of their brain and body, overcome
and minimize pain, and ultimately, resume
a quality of life similar to pre-event or
pre-condition state.
Case Study Success
Julia Rodriguez
I’ve been conscientious about my health
for as long as I can remember, never even
missing a check-up. So when nausea
and sharp pains in my neck gave way to
my eventual passing out, everyone was
surprised.
My husband called 911, and EMS
rushed me to Kingwood
Medical Center. After
an angiogram, it was
determined I had a
ruptured brain aneurysm.
Dr. Weir performed a
coil procedure to occlude
the ruptured aneurysm.
A second aneurysm was
found, and Dr. Fayaz
performed a clipping procedure two
weeks later. I had two aneurysms! I had
no previous symptoms of stroke and no
family history. It just goes to show you that
these things happen fast, and I was lucky
to be near a facility as sophisticated as
Kingwood Medical Center.
Today, I’m back teaching CCE at St.
Martha’s Catholic Church—doing what I
love and caring for the people I love.
Case Study Success
Crystal Larkin
With our first child, Jack, everything was
wonderful. The pregnancy and labor were
textbook, and I was holding a healthy baby
boy in my arms. But that joy soon turned to
fear. The day after Jack was born, I began
suffering from seizures.
Because I was already at Kingwood
Medical Center, doctors were immediately
able to evaluate my condition with CT and
MRI. They found a brain
tumor, and even though
it was the size of a
tangerine, I never showed
any symptoms prior to the
seizures.
I went into surgery, and
Dr. Fayaz was able to
successfully remove the
tumor. To this day, I’ve not
had any repeat seizures or further issues.
Kingwood Medical Center helped me
bring one life into the world. Then the next
day, they saved mine. Our family is forever
grateful to their medical team.
Physical therapy
Occupational therapy
Speech therapy
Stroke Rehabilitation
As the only hospital in Greater Northeast
Houston to be named a Comprehensive
Stroke Center, we’re experienced at helping
people recover to their fullest potential. It can
take determination, patience, and trust that
your caregivers know what’s best—let us
help you in this journey.
The most pronounced post-stroke effects
are limited range of motion and limited
speech ability, but even simple tasks like
rolling over in bed or swallowing a drink
of water can prove difficult. We can aid in
the recovery process through incremental,
repetitive exercise and assistive technology
(wheelchair, walker, cane, etc.) or surgery.
Aneurysm Rehabilitation
Recovery from an elective (non-ruptured)
aneurysm surgery is no different than
recovery from any other cranial surgery,
simply accounting for the standard healing
time. However, when a prolonged brain
bleed causes permanent disability, we
can assist patients as they cope with new
limitations, teaching them approaches to
overcome or compensate for lost skills.
Tumor Rehabilitation
Removal of tumors in and around the brain
and spine can affect delicate nervous system
pathways that may alter your post-surgery
abilities for speech and movement. We can
help you overcome the accompanying pain
and frustration to regain the skills needed to
live a happy, productive life.
For more information on our neurorehabilitation program please call
281-348-8600 or visit kingwoodmedical.com.
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Brain and Spinal Tumor
Awareness
Brain and spinal tumors are abnormal
masses of tissue resulting from cell division
that impinges on the body’s nervous
system. They can be malignant or benign,
but this determination alone does not
indicate its threat to an individual’s well
being. A tumor’s size, location, and stage
of development can account for adverse
bodily effects regardless of the presence of
cancerous cells.
Primary brain tumors rarely spread into
other organs: however, secondary brain
tumors grow in the intracranial sphere and
are the result of metastisis from other sites.
Spinal tumors, more often than not, are
the result of cancers
originating elsewhere
(breast, prostate, and
lung especially) and
then spreading to the
spine.
Risk Factors
A 2008 study indicates
that family history
plays a major role.
For example, those
with immediate family
members who developed glioblastomas
are at twice the risk, and those with
immediate family members who developed
astrocytomas are at four times the risk.
Individuals with cancer in other areas of
their body are more likely to develop
spinal tumors.
Symptoms
Symptoms of brain tumors include:
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Headaches
Nausea and vomiting
Impaired vision and other sensory
deterioration
Facial paralysis
Emotional or personality changes
Symptoms of spinal tumors include general
back pain, decreased sensitivity in the
buttocks, incontinence, and difficulty
moving about.
Diagnosis
A medical examination will often reveal
symptoms that merit further investigation,
via diagnostic imaging—MRI and CT scan
for brain tumors, MRI, CT, and myelogram
for spinal tumors.
Treatment at Kingwood Medical Center
Two main methods for treating brain
tumors, with physicians often electing to
combine the approaches, are surgery and
chemotherapy.
The goal of surgery is to remove as much
of the tumor as possible via a craniotomy.
Some pituitary adenomas can actually be
removed through the nasal cavity. Even
if imaging suggests that a neurosurgeon
cannot remove the entirety of a tumor,
they will often proceed in hopes that a
significantly reduced tumor will be easier
to eliminate via other post-surgery therapy
methods. This is referred to as debulking.
For tumors causing spinal cord compression,
surgery and radiation therapy have proven
effective for reducing swelling surrounding
the area, which minimizes symptoms.
Our Facilities
Coming off a recent expansion, Kingwood
Medical Center offers modern medicine
in a modern setting, combining a
comfortable patient environment with the
latest medical technology.
With a new, dedicated Neurosurgery
Operating Suite and ten-bed
Neurosurgical/Cardiovascular Intensive
Care Unit, we are capable of handling
multiple complex cases. And of course,
easy access off US Highway 59 North
means we’re never far away during a
medical emergency.
Accreditations and Awards
Many government regulatory commissions
and independent health organizations
have confirmed what our patients already
know—that the neurosciences program
at Kingwood Medical Center is one of
excellence.
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Primary Stroke Center as designated
by The Joint Commission
Comprehensive Stroke Center as
designated by the South East Texas
Regional Advisory Council (SETRAC)
Gold Plus Achievement Award from
the American Heart Association and
the American Stroke Association in
accordance with their “Get with the
Guidelines” national program
For a physician referral, please call
1-800-258-5064.
Kingwood Medical Center
combines a comfortable
patient environment
with the latest medical
technology.
For more information on Kingwood
Medical Center’s neurosciences program,
including a breakdown of specialty
services, visit kingwoodmedical.com.
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Stroke Awareness
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A stroke, sometimes referred to as a
cerebrovascular accident (CVA), is the
developing loss of neurological function
due to a disturbance in blood supply to
the brain. A number of things can cause
this, including decreased blood flow
(ischemia), blocked blood flow (thrombosis,
arterial embolism), or leaked blood flow
(hemorrhage).
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Stroke is the leading cause of adult disability
in the United States and the second leading
cause of death worldwide.
Risk Factors
The most significant risk factor for stroke
is hypertension, or high blood pressure.
Kingwood Medical Center
offers two treatment options
for cerebral aneurysms:
surgical clipping and
endovascular coiling.
Studies suggest that even a small reduction,
as little as 5-6 mmHg systolic and 2-3 mmHg
diastolic, can result in a 40% reduction in
risk for stroke.
Other risks include:
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Diabetes mellitus
High cholesterol
Obesity
Atrial fibrillation
Cigarette smoking
Alcohol and drug use
Symptoms
The American Stroke Association promotes
the acronym FAST as a way to remember
and recognize the symptoms of stroke.
It breaks down as:
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F(ace) – drooping near the person’s
eyes or mouth
A(rms) – when both arms are raised,
one arm drifts downward
S(peech) – difficulty pronouncing words
or expressing thoughts
T(ime) – time lost results in brain loss!
Diagnosis
A physical evaluation allows physicians to
account for observable symptoms and plot
them on the National Institute of Health’s
Stroke Scale, with scores ranging from 0-42.
That number provides a sound baseline to
supplement any information gathered during
diagnostic imaging.
Aneurysm Awareness
A brain aneurysm results from weakness in
a cerebral vein or artery, sometimes leading
to swelling and even rupture of the vessel.
Small aneurysms are more common than
people realize and often go unnoticed,
producing no symptoms and causing
no complications. Ruptured aneurysms,
however, require immediate emergency
treatment. Prognosis for patients with a
ruptured aneurysm can be as serious as
permanent disability or death.
CT scan, MRI, ultrasound, and angiography
are integral in determining subtypes and
causes of stroke.
Kingwood Medical Center is proud to
partner with The Joe Niekro Foundation,
named in memory of the former Houston
Astros pitcher, to promote community
education efforts and aneurysm research.
Visit joeniekrofoundation.com to learn more.
Treatment at Kingwood Medical Center
Risk Factors
As the only hospital in Greater Northeast
Houston to be named a Primary Stroke
Center by The Joint Commission and a
Level 1 Comprehensive Stroke Center by
SETRAC, Kingwood Medical Center is
accustomed to receiving patients throughout
the region for stroke treatment.
In cases when blood flow to the brain is
slowed or blocked, thrombolysis (or “clot
busting”) can provide a pharmacological
solution through a catheter in the artery
to deliver the medication directly at the
clot. A mechanical thrombectomy relies
on a corkscrew like device placed inside
the cerebral artery that snares the clot
for removal. Cerebral angioplasty can
circumvent a vascular blockage by widening
the problem vessel, and the implanting of a
cerebral stent can help keep it open.
For strokes resulting from hemorrhage,
immediate neurosurgery may be required
to stop the bleeding. Correct diagnosis is
crucial though, because anticoagulants
used to treat other types of stroke will only
complicate the situation. That’s when having
a comprehensive team of experts by your
side matters most.
Current research indicates that there are
few modifiable risk factors that lead to brain
aneurysms. Some result from congenital
defects, others from the result of head
trauma. They are more common in adults
than children (though the latter are not
exempt), and women are more likely to
develop aneurysms by a ratio of 3:2.
Symptoms
Days or weeks prior to an aneurysm
rupturing, individuals may experience
a severe headache, nausea, blurred
vision, and even loss of consciousness,
but sometimes, no warning symptoms are
present before the rupture. Onset is usually
sudden.
Diagnosis
Screening for aneurysms is sometimes
recommended for individuals with a family
history of the condition and done by
magnetic resonance angiogram (MRA) or
computed tomography angiogram (CTA).
Most insurance plans, however, do not
cover annual screening. These same exams
are used to confirm when an aneurysm has
ruptured.
The Hunt and Hess scale determines the
prognosis and mortality of subarachnoid
hemorrhage:
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Grade 1 – no symptoms or a
minimal headache
Grade 2 – moderate to severe
headache, stiff neck
Grade 3 – drowsiness, confusion
Grade 4 – lack of cognitive function,
weakness in the body
Grade 5 – deep coma
Grade 6 – death
The Fischer Grade allows physicians to
evaluate a brain bleed based on diagnostic
imaging results for risk of cerebral
vasospasm:
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Grade 1 – no hemorrhage visible
Grade 2 – hemorrhage less than
1 mm thick
Grade 3 – hemorrhage more than 1
mm thick with localized clot
Grade 4 – hemorrhage of any
thickness and extension into the brain’s
ventricular system
Treatment at Kingwood Medical Center
Kingwood Medical Center offers two
treatment options for cerebral aneurysms:
surgical clipping and endovascular coiling.
Surgical clipping is the most common
treatment. Beginning with a craniotomy,
surgeons then use a microscope to identify
the affected blood vessel and attach a clip.
This halts blood supply to the aneurysm and
prevents bleeding by removing the aneurysm
from circulation.
Endovascular coiling is a more recently
developed approach that is far less invasive.
A catheter is passed up the femoral artery,
through the aorta, and into the affected
cerebral artery. Once inside the aneurysm
detachable coils initiate the clotting
process and eliminate the possibility of
bleeding or rupture.