Of All The Nerve(s): Inside the Mind of Neurosurgeon Dr. Ali Krisht

Dr. Ali Krisht is the director and co-founder of the Arkansas Neuroscience Institute at CHI St. Vincent. A neurosurgery innovator, Krisht is director of the cerebrovascular and neuroendocrine clinics, whose areas of expertise are cerebrovascular, pituitary tumors and skull base tumors.

Krisht has published more than 50 peer-reviewed papers and edited several books, is a sought-after lecturer with more than 170 national and international presentations under his belt, is a member of several national and international societies and has received numerous honors, including honorary citizenship of Taipei, Taiwan, for his work in neuroscience education in the Taipei community.

Soirée sat down with Dr. Krisht to go inside the mind of a neurosurgeon to discover what he wishes his patients knew and the most interesting case he’s ever seen.

What are signs of a possible brain tumor that a person should not ignore?

Weakness, numbness that stays constant or is increasing, changes in your behavior or cognitive abilities such as memory or inability to calculate anymore, inability to mention names or recognize things that are familiar, any problems with vision, double vision or one eye not seeing well can all be related to tumors in the brain. If you have a headache that is starting to increase, gets more intense or more frequent and you are not normally a headache person, it is always good to seek medical advice. Tumors are not usually caused by family history.

What misconceptions about brain tumors and neurological disorders do you often encounter?

The biggest myth about brain tumors is around the treatments, that brain surgery is like cracking your head open, and this is not true. It is one of the most delicate surgeries and is extremely safe nowadays if done in good and experienced hands — that is most important. And in fact, if anybody says there is something that cannot be treated, you should always look for another place. There is always somebody doing it one step further.

Are there preventive lifestyle tips for people to enhance the health of the brain and prevent some of the problems that you end up treating?

You have to think about the brain as a muscle. If you practice it, it will grow. To provide good health to the brain you need good blood flow, good oxygen levels, and those can be provided with exercise. If you are exercising, you are providing that. If you are eating healthy, you don’t have clogged arteries and don’t have strokes, meaning the environment of the brain is good.

The next thing is using your brain. The more you challenge yourself with cognitive activities and thoughts, the more your brain will be healthy.

One thing that is also detrimental is recreational or illegal drug usage. Every time you take drugs, you have a direct effect of damaging areas of the brain and brain cells. Plus, you raise the brain pressure to malignant levels to where you injure the arteries going to the brain which can cause a mini-stroke and bleeding in the brain. Smoking is also something to avoid. There are a lot of changes and side effects we’ve seen when smoking occurs.

What do you find most exciting about your field of work?

There is a universe of cells in somebody’s head and your universe of cells is working on the other universe to fix it. And we know very little, really, how these universes work. We do our best to come up with the best result when they interact — the patient’s head and my head. The evolution of what we do to reach this level to where you are working on somebody else’s head is a fascinating thing if you think about it.

What is the work and mission of the Arkansas Neuroscience Institute?

We have pioneered certain procedures that used to be very unsafe and not possible, and now they are safe and possible. These procedures give patients longevity and good quality. …We see patients who are referred to us after a lot of long stories of failure.

We are the future of neurosurgery. We pride ourselves in the fact that we are restless until we get better treatments and are tackling things that other surgeons have given up on. We are a lighthouse for both patients and other neurosurgeons who want to come and learn from us. We are always researching and improving the care of our patients.

What is the most interesting case you’ve seen or surgical procedure you’ve performed?

We have treated certain types of aneurysms that nobody else is treating like the Basilar Aneurysms, which are the deep-seated aneurysms. They used to be very risky to operate on, and when treated with other means, they tend to fail. Now the treatment is safe. More than 95 percent of our patients come out with an excellent result and it is more durable.

In addition, we do surgeries on the different types of brain tumors such as the cavernous sinus, which is an area behind the eye and below the brain. This has been considered a no man’s land and it was seen as an area that was inconceivable to operate on. …

When dealing with malignant brain tumors, we have a neuro-oncology program. The treatment plan that we have established for these patients is based on staying ahead of the tumor so we know when it is coming back before the patient does. We have close follow-up resulting in three-year survival rates that are three times higher than national averages.

We also have a cutting-edge stroke treatment program that is alert 24/7 and a team that is able to get on the ball with top speed to take care of patients quickly and minimize or prevent deficits. We cover the entire spectrum of neurological problems including epilepsy, spine, functional disorders and just the whole gamut.

One case in particular about a year ago was a cavernous sinus tumor. We were able to extract the tumor and the patient woke up with no deficits whatsoever. It was amazing because it was the first time a patient woke up without deficits.

Related Articles