General Practitioners

• Primary Care
  If your insurance company requires an insurance referral from your primary care physician, please submit it prior to your appointment. Our office requires a referral directly from your doctor, regardless of insurance. This referral must include your most recent and relevant office notes, demographics, a copy of your insurance card or authorization from workers' compensation, as well as any diagnostic study reports and any previous pain management records.
• Family Practice
  Dr. Willison joined the practice in 2015 as the outreach neurosurgeon at New Market Family Health Center and Multi-Specialty Clinic. She performs neurosurgery consultations, and if surgery is required, she refers to the neurosurgical team at Virginia Brain and Spine Center in Winchester, Virginia.
• High Cholesterol
• Emergency Care
  Jessica is a graduate of Allegheny College of Maryland with an Associates of Science in Nursing (1999), Walden University with her Bachelors of Science in Nursing (2016) and a Master’s of Science in Nursing; Family Nurse Practitioner (2019). She brings 20+ years RN experience with her background in Medical and Trauma/Neuro ICU, Emergency Department, and Case Management.
• Pneumonia

Neurologists

• Carpal Tunnel Syndrome
  The median nerve is an important nerve that supplies muscles and sensation in the forearm and hand. It primarily supplies sensation over the palmar aspect of the thumb and first two fingers. It supplies some of the muscle strength to the thumb and fingers as well. The nerve is frequently pinched at the point in the wrist where it enters the hand and can causes symptoms of carpal tunnel syndrome. Injury to the median nerve can look very similar to pressure or dysfunction of the C6 nerve root in the neck.
• Multiple Sclerosis
  Trigeminal Neuralgia is a facial pain syndrome due to irritation of the fifth cranial nerve, also known as the trigeminal nerve. The trigeminal nerve supplies sensation to most of the face as well as motor supply to some of the facial muscles. The trigeminal nerve has three main branches that supply the upper, middle, and lower face. Typical trigeminal neuralgia results in sharp, shooting, stabbing pain in one or two of the three divisions. The middle and lower divisions are most commonly involved and cause pain in the cheek and jaw. Trigeminal neuralgia often involves very brief but very severe episodes or spasms of pain. The pain can be induced by light touch on the skin or movement of the jaw. Atypical symptoms include constant pain, dull or aching pain, and neurological deficits such as numbness or weakness in the face. It is thought that most cases of trigeminal neuralgia are due to compression of the nerve where it enters the brain stem. The nerve travels in a tight corridor along the side of the brain stem with multiple arteries and veins that can push and pulsate on the nerve. Trigeminal neuralgia can also be symptomatic of a specific disease process. This is much less common and includes tumors in this location, tumors on the nerve itself, or injury to the nerve such as can occur with multiple sclerosis. There is a broad spectrum of similar diseases that can cause similar symptoms and trigeminal neuralgia is often confused with dental problems, TMJ, or many common headache syndromes.
• Epilepsy
  The vagus nerve is the tenth cranial nerve. It exits from the brain stem and transmits information to various parts of the body to control or modulate important automatic functions. It receives input from widespread areas of the brain and it is thought to send information back to the brain in a similar widespread pattern. Stimulation of the vagus nerve in the neck has been proven to decrease seizure activity in some patients with epilepsy.

Psychiatrists

• Mental Health
  Pain is a complex physical phenomenon that is experienced differently by each person. Pain is a necessary part of our anatomy and physiology. It is a strong and convincing signal that injury is occurring to our body and something needs to be done to help it heal appropriately. New or acute pain will often resolve after the injury itself is treated and healed. Chronic pain can occur when an injury does not heal well or the nerves that signal the pain are themselves injured. Pain is a primitive yet complex phenomenon that is closely tied to our mental health and emotions. Chronic pain is therefore best treated by addressing the physical and emotional aspects of pain. Pain specialists often work closely with surgeons, physiatrists, physical therapists, and psychologists to minimize the effects of this otherwise debilitating medical problem.

Endocrinologist

• Diabetes Care

Radiologist

• Ultrasound
  Once the aneurysm is treated there are still significant risks to the patient. The blood that ruptured around the brain is very irritating to the normal blood vessels. This may causevasospasm in which the blood vessels clamp down and decrease blood flow to the brain. This typically is a significant risk for up to two weeks following a ruptured aneurysm. This is monitored closely with serial neurological assessments to detect new symptoms. The vessels can also be monitored with transcranial doppler (TCD) ultrasound. This is a noninvasive way to monitor the flow of blood through the blood vessels in the head. Vasospasm can be treated by keeping a patient well-hydrated, pushing blood pressure higher, and, if necessary, angioplasty. This involves taking the patient back for an angiogram and injecting medicines directly within the blood vessels that will dilate them back open. If vasospasm is severe and unresponsive to treatments then it can cause a stroke.
• MRI
  A series of evaluations are performed before surgery as part of the decision to determine whether someone is a candidate. Preoperative imaging studies are performed to determine whether there are any obvious structural abnormalities that can account for seizures (tumors, developmental changes, trauma to name a few). Functional studies are performed to evaluate for more subtle changes and localization (SPECT, PET, functional MRI). 24 hour or prolonged surface electroencephalography (EEG) is performed to try and localize the origin of seizures within the brain. Neuropsychiatric testing is often performed to determine subtle abnormalities that may lateralize to one side of the brain or the other. The final stage for evaluating is invasive EEG monitoring with placement of electrodes directly on the surface of the brain. At this point, the patient has been determined to be a good candidate for surgery and is admitted to the hospital for a series of surgeries to complete the localization and ultimate resection of the portion of brain where the seizures are thought to originate from.
• Computed Tomography
  CT: A brain CT (Computed Tomography or "CAT" scan) is often obtained first. This is a computer generated image formed from a series of multiple xrays taken in close succession through the head. This is a quick and easy study to obtain that often takes less than ten minutes of imaging time. This characterizes tissues of different densities very well such that the brain is well visualized compared to the surrounding bone and internal fluid spaces. A tumor is often a different density than the normal brain and may cause distortion of the normal symmetric anatomy of the brain. Contrast is often added intravenously to better visualize a tumor. Contrast is dense material that flows in the blood and since tumors often have a large blood supply they may become more bright with the addition of contrast. This study is relatively poor resolution but is the preferred study for initial assessment, for evaluating calcification which may occur in some slow growing tumors, and for evaluating new bleeding within a tumor.
• Chemotherapy
  Gliomas are tumors formed from the supportive cells in the brain known as glial cells. One of the more common types of glial cells are call astrocytes and tumors that arise from these cells are therefore called astrocytomas. Astrocytomas are the most common primary brain tumor in adults. 12,000 new cases occur each year in the United States alone. They can occur anywhere within the brain but are most common in the frontal and temporal lobes. These are classified as either low grade or high grade and their grade correlates strongly with survival. High grade gliomas are either anaplastic astrocytomas or glioblastoma multiforme (GBM) based on cellular characteristics on pathology. These tumors typically do not spread outside of the brain but are very infiltrative with a tendency to recur at the original site they are found at. Unfortunately, most newly diagnosed astrocytomas are high grade. Standard treatment includes maximal surgical resection followed by radiation and chemotherapy. Although there is currently no "cure" for high grade gliomas there are long term survivors. There are a number of ongoing
• Radiation Therapy
  Radiosurgery is a non-invasive form of therapy that is sometimes used as an alternative or as a supplement to standard surgery. Unlike standard radiation therapy, radiosurgery uses computer-guided technology to target the tumor for radiation while preserving the surrounding normal brain. This is typically reserved for tumors smaller than 3 centimeters in cross-sectional size (smaller than a golf ball).

Surgeons

• General Surgery
  Treatment for carotid stenosis includes medical management, carotid endarterectomy, orcarotid stenting. In patients without a history of stroke or TIA, the risk of having a stroke in the five years following diagnosis is about 11%. A carotid endarterectomy can reduce this risk by greater than 50% and is considered the standard first line treatment option for most patients. Medical management is generally reserved for those patients who are too sick to tolerate surgery. In patients with a history of stroke or TIA, the risk of having a stroke in the five years following diagnosis is about 26%. A carotid endarterectomy can reduce the risk by almost 66% and is considered the standard first line treatment option for most patients. Carotid stenting is a new minimally invasive technology that is an option for patients with symptomatic carotid stenosis who can not tolerate general surgery.
• Neurosurgery
  Functional Neurosurgery involves procedures that are done to modulate the activity and function within a specific part of the brain. In general, the surgeries are performed to prevent abnormal activity and behavior without damaging the normal activity of the brain. This is most commonly done to prevent seizures in patients who cannot be managed well with medications alone or to help patients with various movement disorders such as Parkinson's Disease or Essential Tremor. Seizures originate from abnormal neurons on the surface of the brain within the cerebral cortex where as most movement disorders typically originate within the deep clusters of neurons within the brain known as the deep nuclei.

Plastic Surgeons

• Botox
  There are several treatment options for hemifacial spasm. First line treatment is always medication although it is often ineffective. Tegretol and dilantin are the two most common medications prescribed for hemifacial spasm. Botulinum toxin (Botox) may be used to temporarily paralyze the facial muscles involved but will cause weakness and cosmetic changes. The procedure of choice is microvascular decompression which is a surgical procedure to remove pressure on the facial nerve. Complete or partial improvement with this procedure occurs in up to 90% of patients.

Dermatologists

• Skin Cancer
• Lesions
  An awake craniotomy may be performed for tumors or other lesions that are located in or near parts of the brain that have important motor or language functions. Amazingly, the brain does not have any pain receptors and this kind of surgery is very well-tolerated. This procedure is most commonly performed to monitor a patient's ability to move or talk during resection of the brain. Most of the procedure is actually performed while the patient is asleep. After the brain is exposed, the patient is briefly woken up during removal of the abnormality within the brain. Once the resection is completed the patient is again put back to sleep.

Physical Therapists

• Physical Therapy
  Initial treatment involves surgical evaluation, pain medication and physical therapy. Once further surgery has been ruled out as a reasonable option then referral to a pain management specialist is warranted. Various injections and minor pain procedures may be able to improve the symptoms. A multidisciplinary team approach is ideal involving pain management, physical medicine, and psychology specialists. Patients who require chronic narcotic pain medication may benefit from placement of an intrathecal pump. Others may benefit from a spinal cord stimulator.
• Back Pain