Chicago, IL – August 12, 2026 – In a new study published today in Science Advances, Northwestern Medicine researchers have uncovered a previously hidden immune environment in the thymus that may help drive myasthenia gravis (MG), a chronic autoimmune disease that causes muscle weakness and fatigue, mainly impacting women under age 40 and men over age 60. Using the largest known cellular and spatial map of the MG thymus ever assembled, researchers identified specialized immune cells and survival signals that may help sustain the disease, opening new avenues for future research and treatment.

Myasthenia gravis occurs when the body's immune system mistakenly attacks the communication point between nerves and muscles. The symptoms worsen with activity and improve with rest. Most often, the disease affects the muscles that control the eyes, facial expressions, talking, swallowing and chewing. In severe cases, breathing muscles can become dangerously weak.

While researchers have long known that harmful antibodies play a major role in MG, they do not fully explain why symptoms vary among patients or why some people continue to experience disease activity despite treatment, including the surgical removal of the thymus called a thymectomy.

“During childhood, the purpose of the thymus is to train the body’s immune cells, but in adulthood, the thymus shrivels up and starts to malfunction, which can lead to myasthenia gravis,” said Ankit Bharat, MD, senior author of the study, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. "Our study suggests there's more to myasthenia gravis than antibodies alone. We found evidence that the thymus may create an abnormal immune environment that helps certain B cells survive and persist, even after the thymus is removed. Understanding that environment gives us an entirely new framework for studying and possibly treating the disease."

What this means for patients

For patients like 30-year-old Marissa Humayun of Chicago, the latest research gives her hope, especially after three years of ups and downs.

In early 2023, at the age of 26, Humayun went to the emergency department with stroke-like symptoms that came out of nowhere, including a droopy eyelid and double vision. When bloodwork came back negative for the main MG antibodies, Neena Cherayil, MD, a neuro-ophthalmologist at Northwestern Medicine, diagnosed Humayun with ocular myasthenia gravis (OMG) and seronegative myasthenia, a rare form of MG, where three of the known antibodies for MG don’t show up in standard blood tests, but patients still present symptoms.

Three months after her diagnosis, Humayun underwent robotic surgery with Dr. Bharat to have her thymus removed and donated the small gland to his research study. Even though the thymectomy was a success, Humayun’s symptoms returned, which can happen in some patients. Humayun now relies on infusion therapy at Northwestern Memorial Hospital to help control her symptoms and is treated by Arjun Seth, MD, a neuromuscular medicine specialist at Northwestern Medicine.

“When symptomatic, I have droopy eyelids, fatigue and double vision – especially if I’ve pushed myself too hard or didn’t rest enough. Myasthenia gravis is such a discouraging disease, but I must honor my body for what it can do today,” said Humayun. “Dr. Bharat is an inspiring surgeon and researcher, and Northwestern Medicine has truly taken care of me throughout my diagnosis and treatment. I’m optimistic for the future, knowing scientists right here in Chicago are working to find solutions for patients in the myasthenia gravis community.”

“Our hope is that we can now identify patients – like Marissa – who are at risk of having a recurrence after the thymectomy and after treatment,” said Dr. Bharat. “Also, this study gives us clues as to why some patients don’t respond to the conventional medical treatments. What we’re hoping to do is identify those patients who are at risk and then ultimately design clinical interventions that can kill those cells and then prevent the recurrences.”

A surprising discovery

To better understand what happens inside the thymus, Northwestern Medicine researchers analyzed 23 thymus samples from 16 patients and combined several advanced technologies, including single-cell RNA sequencing, immune receptor analysis and spatial transcriptomics. Together, these techniques allowed scientists to identify individual cell types and determine where those cells were located within the tissue.

After integrating their data with previously published datasets, the team created an atlas containing nearly 347,000 cells, making it the most comprehensive map of the MG thymus to date. Researchers expected to find evidence of a single rogue immune-cell population driving disease, but instead, they found something very different.

The study revealed a diverse population of class-switched B cells clustered within and around abnormal germinal centers in MG tissue. Rather than showing signs of traditional immune regulation, these cells appeared to rely on a separate survival pathway involving molecules known as BAFF and BCMA.

The researchers describe the finding as a potential "tolerance checkpoint swap" in which B cells move away from normal immune-control mechanisms and become supported by survival signals from the surrounding tissue environment.

"We did not find one dominant B-cell clone taking over," said Dr. Bharat. "Instead, we found a diverse population of B cells living within an abnormal immune neighborhood. The neighborhood itself may be helping these cells survive."

What happens next?

The findings may help explain several longstanding mysteries surrounding myasthenia gravis, including why antibody levels do not always match disease severity and why improvement after thymus-removal surgery can vary from patient to patient. However, the researchers caution that the current study did not directly test those questions.

“This study is not a treatment announcement and does not change current recommendations for patients with myasthenia gravis,” said Dr. Bharat. “Thymectomy remains an evidence-based treatment for appropriately selected patients, and additional research will be required to determine whether the newly identified pathways play a direct role in disease progression.”

Instead, the work provides a detailed roadmap for future investigation.

"This study gives us a map," said Dr. Bharat. "The next step is to determine whether these pathways actively drive disease and whether they can be targeted to restore immune tolerance. That's the promise of this research."

The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 15 straight years and No. 4 in the U.S., according to U.S. News & World Report, 2026 – 2027. For more information, visit nm.org.

CHICAGO - June 1, 2026 - After Lisa Fasone had her first child in 2022, she knew she eventually wanted to have a second. But following the birth of her first daughter, Fasone started experiencing postpartum hormonal issues. She had persistent symptoms, including night sweats, continued lactation, no menstrual cycle and infertility while trying to conceive.

Bloodwork revealed her prolactin – the hormone produced by the pituitary gland that stimulates lactation and influences fertility – levels were elevated. Medication to reduce her prolactin levels worked at first, and her hormone levels went back to normal. But over time, her symptoms returned and stopped responding to the medication. Bloodwork continued to show elevated prolactin levels, and by winter 2023, her symptoms had not normalized.

An initial MRI was inconclusive and Vijay Eranki, MD, an endocrinologist at Northwestern Medicine Huntley Hospital, suspected the 32-year-old from McHenry, Ill., may have a pituitary tumor that was not being picked up by imaging.

“The medication isn’t well studied for pregnancy,” said Fasone, a urology physician assistant in the Chicagoland area. “I just didn’t feel comfortable trying to have a baby without good data to suggest it was safe. If you get pregnant, you must stop the medication right away because there’s no data to suggest it’s safe and if you stop taking the medication, there’s a chance the tumor could get worse. I was not comfortable accepting that risk."

After the medication stopped working, a repeat MRI found a visible tumor on her pituitary gland, located at the base of the brain, which is known as a prolactinoma. The tumor was causing her pituitary gland to make too much prolactin. While prolactinoma is not life-threatening and is the most common pituitary tumor, it can make it extremely difficult to become pregnant since it lowers the body’s levels of the sex hormones estrogen and testosterone. The condition is seen more commonly in women than men.

Medication is the first treatment for prolactinoma, but after exhausting all conservative treatments, Fasone’s only other option was surgery to remove the tumor.

“I had to make a decision,” Fasone said. “Do I continue increasing the dosage of this medication that’s not making me feel great and doesn’t seem to be working, or am I going to face the issue and have it surgically addressed?”

Doctor Eranki and Northwestern Medicine endocrinologist Wenyu Huang, MD, PhD, – who specializes in pituitary disorders - referred her to Northwestern Medicine neurosurgeon Stephen Magill, MD, PhD, to have the tumor surgically removed.  

“While removing a tumor on the pituitary gland is a common operation, removing one for a prolactinoma, like Lisa’s case, is less common,” Dr. Magill said. “We knew she really wanted to have another baby. We carefully counseled Lisa on the risks and benefits of the procedure, what the surgery would entail and what the expected outcome would be. We were hopeful her hormone levels would return to normal, and she would be able to have a child safely without having to be on medical therapy.”

On April 14, 2025, Fasone underwent brain surgery with Dr. Magill to remove the tumor and Northwestern Medicine otolaryngologist Kevin Welch, MD, who helped gain access to Fasone’s brain through her nose. A few weeks later, she got her menstrual cycle back and discovered she was pregnant. Her daughter, Natalie, was born on February 11 and is a happy, healthy baby. Fasone will continue to receive imaging every six to 12 months to make sure the tumor has not recurred.

“Dr. Magill really gave me my life back,” Fasone said. “I was able to get off the medication, my body returned to normal, and I was able to complete my family. I recently introduced Dr. Magill to my daughter, and that was such an emotional moment – one I certainly won’t forget.”

June is World Infertility Awareness Month, a time dedicated to raising awareness and educating the public that infertility affects approximately 1 in 6 people worldwide. To learn more about fertility and reproductive medicine at Northwestern Medicine, visit nm.org.  

CHICAGO – Dec. 16, 2025 – Researchers at Northwestern Medicine – along with the University of Michigan – have developed a new and faster approach to determine if a treatment for the brain cancer glioblastoma is working.

Glioblastoma is universally lethal as neurosurgeons cannot remove all of the tumor cells and most drugs used for cancer can’t cross the blood-brain barrier into the brain to target the remaining cancer. This leads to leftover tumor cells surviving.

Northwestern Medicine Malnati Brain Tumor Institute researchers have previously done trials with the Sonocloud-9 device from Carthera in Lyon, France, a therapeutic ultrasound device that opens up the blood-brain barrier for about an hour so that chemotherapy can get in. But in a new analysis published in Nature Communications, Northwestern Medicine and University of Michigan researchers found that opening the blood-brain barrier lets tumor content leak into the blood, making it possible to test for brain cancer response to chemotherapy in the blood.

“Instead of removing tumor tissue, we analyzed blood for tumor material, known as extra-cellular vesicles or exosomes.” said Northwestern Medicine neurosurgeon Adam Sonabend, MD, one of the study’s authors. “Historically, that has not worked for brain tumors because of the blood-brain barrier posing a challenge for liquid biopsy for brain diseases.”

The researchers tested tiny particles released by the brain tumors - called extracellular vesicles (EVs) – that could be measured in the blood after temporarily opening the blood-brain barrier.

To do this, Northwestern Medicine researchers worked with University of Michigan researchers to develop a microfluidic chip called GlioExoChip that isolates tumor-derived exosomes and provides a minimally invasive way to monitor treatment response.

“Opening the blood-brain barrier allows tumor-derived vesicles to be measured in blood, providing a clinically meaningful liquid biopsy signal,” said Mark Youngblood, MD, PhD, a neurosurgery resident at Northwestern Medicine and co-lead author of the study. “The GlioExoChip provides a quick and minimally invasive way to monitor treatment response in a disease where MRI scans often give misleading results.”

"There are tiny particles floating in patient blood, called extracellular vesicles, that have been released by the cancer cells. These particles act as messengers, carrying special bits of genetic tumor material and proteins”, said Sunitha Nagrath, PhD, the Dwight F. Benton Professor of Chemical Engineering at the University of Michigan and co-corresponding author of the study. “The big challenge is figuring out how to find and pull out only those that come from cancer cells and not from elsewhere in the body.”

The next steps for the researchers will be to validate their findings with other therapies and explore the potential to expand to other therapies.

“Instead of waiting months, after one dose we can know if a given treatment is working,” Dr. Sonabend said. “That is huge for glioblastoma patients. It could potentially prevent patients from getting prolonged treatments that are ineffective, thus also avoid unnecessary side effects.”

This study was primarily funded by the National Institutes of Health. Additional support for the study was provided by the Lou and Jean Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, the Moceri Family Foundation, the University of Michigan Forbes Institute for Cancer Discovery, the United States Department of Defense, the American Brain Tumor Association, Tap Cancer Out and the Focused Ultrasound Foundation.

CHICAGO – July 8, 2025 - New research from Northwestern Medicine finds that a usually harmless virus might be an environmental trigger or contributor to Parkinson’s disease, which affects more than one million people in the United States. While some cases are linked to genetics, most Parkinson’s cases are not, and the cause is unknown. The new findings were published on July 8 in the latest issue of JCI Insight.

“We wanted to investigate potential environmental factors – such as viruses – that might contribute to Parkinson’s disease,” said Igor Koralnik, MD, chief of neuroinfectious diseases and global neurology at Northwestern Medicine. “Using a tool called ‘ViroFind’, we analyzed post-mortem brain samples from individuals with Parkinson’s and from those who died of other causes. We searched for all known human-infecting viruses to identify any differences between the two groups.”

Northwestern Medicine researchers detected the Human Pegivirus (HPgV) in the brains of individuals with Parkinson’s disease, but not in those without it. While HPgV belongs to the same family as hepatitis C and is a blood-borne virus, it is not known to cause any disease.

“HPgV is a common, symptomless infection previously not known to frequently infect the brain,” Dr. Koralnik said. “We were surprised to find it in the brains of Parkinson’s patients at such high frequency and not in the controls. Even more unexpected was how the immune system responded differently, depending on a person’s genetics. This suggests it could be an environmental factor that interacts with the body in ways we didn’t realize before. For a virus that was thought to be harmless, these findings suggest it may have important effects, in the context of Parkinson’s disease. It may influence how Parkinson’s develops, especially in people with certain genetic backgrounds.”

Dr. Koralnik and his team including post-doctoral fellow Barbara Hanson, PhD, studied post-mortem brains from 10 people with Parkinson’s and 14 without. They found HPgV in the post-mortem brains of five out of 10 people with Parkinson’s and none of the 14 control brains. It was also present in the spinal fluid of Parkinson’s patients, but not in the control group. Individuals with HPgV in their brains exhibited more advanced or distinct neuropathological changes, including increased tau pathology and altered levels of certain brain proteins.

For the blood analysis, researchers used samples from over 1,000 participants in the Parkinson’s Progression Markers Initiative, which was launched by The Michael J. Fox Foundation and scientists to create a robust biosample library to help speed scientific breakthroughs and new treatments.

“With the blood samples, we observed similar immune-related changes, mirroring those found in the brain,” Dr. Koralnik said. “People who had the virus showed different signals from the immune system than those who didn’t, and this pattern was the same, no matter the genetics. But as we followed each person over time, we saw a more complicated picture.”

The study found that in patients with a certain Parkinson’s-related gene mutation – LRRK2 – the signals from the immune system were different in response to the virus compared to Parkinson’s patients without the mutation.

“We plan to look more closely at how genes like LRRK2 affect the body’s response to other viral infections to figure out if this is a special effect of HPgV or a broader response to viruses,” added Dr. Koralnik.

Going forward, the research team plans to study more people to find out how common the HPgV virus is in Parkinson’s patients and whether it plays a role in the disease.

“One big question we still need to answer is how often the virus gets into the brains of people with or without Parkinson’s,” said Dr. Koralnik. “We also aim to understand how viruses and genes interact; insights that could reveal how Parkinson’s begins and could help guide future therapies.”

According to the Parkinson’s Foundation, over one million people in the United States are living with Parkinson’s disease and 90,000 new cases are diagnosed every year. The number of people living with Parkinson’s disease is expected to rise to 1.2 million by 2030.

For more information on Parkinson’s disease, visit nm.org.

CHICAGO – Nov. 22, 2024 – Since older adults have been more severely affected by acute COVID-19, researchers have hypothesized that older adults may have worse long COVID symptoms as well. But according to new research published in the Annals of Neurology, an official journal of the American Neurological Association, Northwestern Medicine researchers found on an average of 10 months after COVID-19 onset, younger (ages 18-44) and middle-aged (ages 45-64) adults had worse neurologic symptoms of long COVID than adults 65 and older. Symptoms included headache, numbness and tingling, problems with smell and taste, blurred vision, depression, anxiety, insomnia, fatigue and a decrease in cognitive function. These symptoms occurred regardless of if the patient had mild or severe COVID-19 infections.

“While deaths from COVID-19 continue to decrease, people still get repetitive infections with the virus and may develop long COVID along the way,” said Igor Koralnik, MD, chief of neuroinfectious diseases and global neurology at Northwestern Medicine, who oversees the Neuro COVID-19 Clinic and is the co-director of the Northwestern Medicine Comprehensive COVID-19 Center. “Long COVID is causing an alteration in patients’ quality of life. Despite vaccinations and boosters, about 30 percent of COVID patients develop some long COVID symptoms. These findings have an immense public health impact, given that long COVID significantly contributes to the leading global burden of disability and disease caused by the neurological disorders.”

STUDY HIGHLIGHTS

·       The study included the first 1,300 patients at the Northwestern Medicine Neuro COVID-19 Clinic with neurologic long COVID symptoms between May 2020 and March 2023.

·       Among those patients, 200 had been previously hospitalized for severe COVID-19 pneumonia while the rest had mild initial COVID-19 symptoms and never required hospitalization.

·       The study is a first-of-its-kind to look at the neurologic symptoms of long COVID over an adult lifespan.

·       The goal was to determine if the neurologic symptoms of long COVID affect adults differently based on their age group.

 “The impact of long COVID is causing disproportionate morbidity and disability in younger adults in their prime who provide much of the workforce, productivity and innovation in our society,” Dr. Koralnik said. “This may have a negative impact on the economy and cause additional burden on the health care system. This study highlights the importance that people of all ages suffering from Long COVID should be provided with the necessary treatment and rehabilitation services to alleviate their symptoms and improve their quality of life.”

To date, the Neuro COVID-19 Clinic has treated more than 2800 long-haulers from 44 states. For more information, visit nm.org and to schedule an appointment, please call 312.695.7950.

CHICAGO – July 30, 2024 – Known as the “woman who doesn’t like to sweat at the gym,” 70-year-old June Furlan of Arlington Heights, Ill., credits dead bugs for saving her life.

 In February 2022, Furlan noticed she was getting weaker, had less energy and struggled to stand up or walk normally. At times, she’d have to rely on her husband to help her get dressed or comb her hair. At first, Furlan blamed her age. She was 68 years old, and thought to herself, “Is this just part of getting older? It must be!”

 But, the avid gym-goer, who exercised every day and worked out with a personal trainer twice a week, knew it was more than just her age when she couldn’t lift her legs in the middle of a dead bug exercise – something she had perfected over the years.

 “On an average day, I could easily do three sets of 15 dead bugs pretty quickly, but when I couldn’t lift my legs at all, I knew something was seriously wrong,” said Furlan.

Furlan turned to Rachel Amdur, MD, an internal medicine specialist at Northwestern Medicine, who took one look at Furlan and immediately called Arjun Seth, MD, a neuromuscular specialist and co-director of the Northwestern Medicine Myositis Clinic. After running several tests, Furlan was diagnosed with a rare autoimmune muscle disease called HMGCR necrotizing myopathy (also known as myositis), which affects the muscles connected to Furlan’s bones, making it more difficult to move.

It’s estimated that approximately 50,000 to 75,000 people in the United States have myositis. Symptoms include muscle weakness, pain and fatigue. While there’s no cure for myositis, which is a type of myopathy, there are medications and physical therapy exercises to help manage the disease.

 “When my insurance company denied one of the medications I needed, Dr. Seth worked really hard to find an alternative. I currently receive monthly infusion treatments at Northwestern Memorial Hospital, which allows me to feel immediate improvement so I can get back to the gym for my daily workouts,” said Furlan.

 Myositis, also known as inflammatory myopathies, includes dermatomyositis, inclusion body myositis, anti-synthetase syndrome, immune-mediated necrotizing myopathy, and overlap syndromes. These rare and complex diseases require care across multiple disciplines. Established in 2021, the Northwestern Medicine Myositis Clinic combines the expertise of specialists in neuromuscular medicine/neurology, rheumatology, pulmonology, dermatology, and physical medicine and rehabilitation to provide the best outcomes possible through comprehensive, coordinated myositis care. Rheumatologist Christine Hsieh, MD, and Dr. Seth are co-directors of the clinic.

“Most patients are first referred to us for weakness – whether it’s not being able to lift their arms above their head or stand up. These diseases are rare, so it’s important to create a comprehensive, multidisciplinary clinic to provide the best care. We’re also enrolling patients in a clinical registry (observational study) and clinical trials to see if new drugs and therapies can help,” said Dr. Seth. “In June’s case, she’s on medications to help manage her symptoms, is back to working out and is largely back to normal in terms of her strength.” 

“Dead bugs and Dr. Seth saved my life, paving a path for me to recover,” said Furlan. “I hope my story serves as a lesson for others that sometimes symptoms aren’t related to our age, but instead, a more serious problem that should be checked out by a physician.”

To learn more or make an appointment, patients can call 312.695.7950.

CHICAGO – May 19, 2024 – Since July 2023, Dancing With Parkinson's – a collaborative program from Northwestern Medicine and The Joffrey Ballet – has helped more than 90 people with Parkinson’s disease and their care partners stay active while confronting the social and emotional challenges of this progressive brain disorder. On Sunday, May 19, participants from the program will take the stage for their first-ever public performance at Joffrey Tower’s Black Box Theatre. The 30-minute show will feature dances from both the Chicago and Northwestern Medicine Lake Forest Health & Fitness Center classes, and will include performances from The Joffrey Ballet’s JAM (Joffrey Abilities in Motion) program, created for individuals with disabilities and neurodivergent children and teens.

“Coming out of COVID, many people with Parkinson's felt very isolated, but Dancing With Parkinson’s has created a wonderful sense of community for our patients,” said Katie Fagan, senior program coordinator and clinical social worker for the Northwestern Medicine Parkinson’s Disease and Movement Disorders Center. “In the beginning, many participants felt some initial trepidation about joining the program, either because they don't have a dance background, or because of where they are in their Parkinson's journey. The success of this class shows how willing our participants are to explore new ways to help themselves when given a supportive environment to do so.”

Attendees can expect to see the groups perform synchronized routines in both jazz and lyrical dance styles. Tom Dobrinski, a Dancing With Parkinson’s participant who was diagnosed with Parkinson’s disease in 2021, says he is looking forward to the performance highlighting much of what his class has worked on over the last year.

“It’s been fun,” said Dobrinkski. “At first, I didn’t know what to expect. I’m not much of a dancer, but my balance and movement feel more fluid after class, so I keep coming back. Who knew a year later we’d be performing on a Joffrey stage. My wife and I are so fortunate to have a program like this available to us. The sense of community and camaraderie have been a plus for us in this journey.”

“As Dancing With Parkinson’s turns a year old this summer, it’s amazing to look back and think about all the people who never thought of themselves as a dancer completely embrace the artform,” said Carly Liegel, community engagement program coordinator with The Joffrey Ballet and Dancing With Parkinson’s instructor. “Between this program and our JAM classes, this show will celebrate a diverse range of ages and movement abilities. I hope it serves as a reminder that there is no right or wrong way to move. Any body is a dancing body.”

General admission tickets are free and can be reserved here. Doors to the theatre will open at 12:30 p.m., performances begin at 1:00 p.m. There is no planned intermission.

More information about Dancing With Parkinson’s

Built for individuals with Parkinson’s disease (PD) and their care partners, Dancing With Parkinson’s aims to enhance physical, mental and emotional well-being through the joy of dance. This research-backed program connects the mind to movement, in conjunction with others and with music, to address both physical and social-emotional symptoms of the disease. Whether dancing in a standing or seated position, participants engage in movements tailored to their abilities, fostering strength, flexibility and creativity.

“Dance involves highly coordinated and controlled movements, which might help with the stiffness, slowness, and postural instability associated with Parkinson’s disease,” said Danny Bega, MD, movement disorders specialist at Northwestern Medicine. “Dance is proposed to offer cognitive and social benefits as well. The sense of community and enjoyment that comes from dancing and listening to music with other people may also address common PD-related problems such as depressed mood, fatigue, and isolation.”

The class series explores various dance styles including ballet, jazz, tap, modern and improvisation. All Dancing With Parkinson’s teachers have completed at minimum an introductory training through Dance For PD, a New York City-based program that pioneered dance classes for people with the movement disorder.

Classes are currently offered downtown at The Joffrey Ballet’s South Loop Studios and at the Northwestern Medicine Lake Forest Health & Fitness Center. There is no cost for patients and their care partners to attend. Summer sessions will begin in Lake Forest, Ill., on June 24 and downtown sessions will begin on August 6.

To register for classes, or to learn more about offerings for Northwestern Medicine Parkinson’s patients, please contact movementdisorders@nm.org.

When Dale Stanish developed an intense headache, blurred vision and vertigo, it nearly stopped him in his tracks. When testing revealed the Ingleside resident had a pituitary tumor, he was relieved to not have to travel far for surgical treatment. He became the first patient at Northwestern Medicine McHenry Hospital to undergo resection of a pituitary tumor through the nose.

The minimally invasive surgery is done using a tiny endoscope camera and light to remove tumors with long instruments inserted through the nostrils. McHenry Hospital has recently significantly invested in developing neurosurgery, ear nose and throat (ENT) surgery and neurological critical care. Many patients, Stanish included, who previously required a transfer to other institutions can now receive world class care in McHenry County.

“It is a very delicate surgery due to the location of the pituitary at the base of the skull close to the optic nerves, carotid arteries and sinuses,” said Michael Caron, MD, neurosurgeon at Northwestern Medicine McHenry Hospital. “We were fortunate to assemble a team of highly experienced physicians to now offer this surgery locally.”

The surgery requires a team approach. ENT surgeon Mobeen Shirazi, MD, a specialist in sinus surgery, drilled small holes in bones behind the nose and sinus to create a pathway to the pituitary. Once the final thin bony structure under the pituitary was opened up, Dr. Caron removed the tumor in small pieces. During the procedure, surgeons use computer-assisted neuro-navigation, similar to a fighter jet navigation system.

“Once the tumor is removed, we patch the hole in the bone. The nasal mucosa grows back over the patch,” said Dr. Caron. “Patients heal very well, and the cure rate, depending on the type of pituitary tumor is as high as 90%.”

Just three weeks after the surgery, Stanish returned to his job as head of inventory for a paper company. He says his coworkers were astonished to see he didn’t have his head shaved or a scar.

“I’m so happy to have avoided a hole in my head, and I was grateful to have surgery close to home,” said Stanish. “My sister traveled from several hours away and stayed at my house. She and my father-in-law could easily visit me during my week in the hospital.”

Northwestern Medicine established neurosurgery services at McHenry Hospital and Huntley Hospital in February 2021 under the direction of Michael Walsh, MD, chief of neurosurgery, Northwestern Medicine Health Network.

“We are incredibly fortunate to have high caliber surgeons with valuable experience. This successful pituitary surgery marks a particularly special milestone in the growth of the program at McHenry Hospital,” said Dr. Walsh. “It is a real honor and joy to be able to improve the delivery of care to local residents.”

George E. DePhillips, MD, joined the neurosurgery program in August 2021 with a focus on spinal surgery. Dr. Caron, and Kevin Jackson, MD, members of the Northwestern Medicine Department of Neurological Surgery, joined the local team in August 2022. Dr. Caron, a neurosurgeon with more than 30 years' experience, began to develop a brain and pituitary tumor program.

To support the brain tumor program, Northwestern Medicine invested in a new neuro navigation system, operative microscope, and tumor ultrasonic aspiration instrument at McHenry Hospital. ENT instruments and endoscopes were purchased to facilitate the first trans nasal endoscopic resection. The next step is the development of a formal brain tumor clinic.

The program requires coordination among a large staff. Stanish’s treatment team included Alok Patel, MD, critical care neurologist; Adam Tiagonce, MD, anesthesiology; and Ayla Bakar, MD, endocrinology. The large support team consisted of a physician assistant, operating room (OR) nurses, OR and intensive care unit leaders, an equipment vendor coordinator, vendor representatives and additional staff.  

“Now we can perform surgery close to home for 80 to 90 percent of patients with brain tumors in the McHenry and Huntley areas,” said Dr. Caron. “Additionally, we are a destination for patients in Rockford and southern Wisconsin who want to access the Northwestern Medicine system.”

Anchored by Northwestern Memorial Hospital, Northwestern Medicine is among the nation’s leading centers in comprehensive care for brain, spine, and nervous system disorders. Northwestern Memorial Hospital is consistently ranked among the top 10 neurology and neurosurgery programs in the country by U.S. News & World Report. 

CHICAGO – March 5, 2024 – A Northwestern Medicine neurosurgeon is the first physician in the U.S. to successfully use a new neurosurgical drill to save the life of a patient in the intensive care unit. The emergency procedure took place in October 2023 at Northwestern Memorial Hospital when Northwestern Medicine neurosurgeon Matthew Potts, MD, used the Hubly Drill – an auto-stopping cranial drill developed by students at Northwestern University –  to create a hole in the skull of a patient with a brain bleed. After inserting a catheter through the hole, Dr. Potts was able to drain excess cerebrospinal fluid from the patient’s brain, relieving pressure inside the skull and ultimately saving the patient’s life.

“The first time I used it, I was able to drill a hole in the patient’s skull in only 15 seconds – far faster than the average for the hand-crank drill that we typically use for these types of procedures,” said Dr. Potts. “Hand-crank drills are also prone to plunging and slipping, which can be dangerous for the patient. This new drill has taken a common bedside procedure and made it quicker, safer and more accurate.”

In the U.S., medical professionals perform more than 25,000 ventriculostomies each year. The neurologic procedure requires surgeons to act quickly to relieve pressure inside the skull due to serious conditions such as hemorrhage, traumatic brain injury, ruptured aneurysm, or stroke. Given the urgency, patients can not afford to wait hours for an operating room to become available, so the procedure is commonly performed in the ICU at patients’ bedsides.

Modernizing the cranial drill

While studying neuroscience as an undergraduate at Northwestern University, Casey Qadir, the 24-year-old chief executive officer of Hubly Surgical, learned that ventriculostomies are typically performed using hand-powered drills. The device, she said, initially reminded her of primitive surgical tools one might see in a museum.

“I was surprised to learn about some of the antiquity that still exists in neurosurgery today. Possibly the most egregious example of that is the use of the hand-crank drill for emergency ventriculostomies,” said Qadir. “At first glance, I thought the hand-crank drill looked medieval. So you can imagine my surprise when that turned out to be true. Hand-crank drills almost exactly like the ones used today have been used to form holes in the skull since the Middle Ages.”

In a graduate-level course called NUvention Medical offered by The Farley Center for Entrepreneurship and Innovation, Qadir was challenged to develop and commercialize her own medical technology through the creation of a startup. In 2017, she teamed up with her classmates to form Hubly Surgical, and got to work to modernize the cranial drill.

“The biggest problem with hand-powered drills is they do not contain an automatic stop feature,” said Qadir. “We know from one study that 66% of physicians experience plunging, which carries a 12% risk of death or permanent neurological morbidity. Another study shows that even in the hands of an experienced neurosurgeon, the risk for complication from manually drilling is 2%.”

To address these issues, Qadir and her team developed a battery-powered drill with a variety of safety features. An auto-stop mechanism shuts off power to the motor as soon as the drill breaks through the skull. A cone-shaped drill bit also guards against over-penetration.

On the back of the device, a colored LED light turns green to let users know they are applying the correct amount of force, then changes to red when the device comes to a halt.

While the hand-crank drill requires two hands to operate, the Hubly Drill enables surgeons to use the device single-handedly, allowing surgeons to place their free hand on the patient’s shoulder to stabilize them while drilling.

“This drill offers greater levels of control and stability, and its ease of use is especially beneficial for our residents and fellows who are still learning the procedure,” said Dr. Potts. “In addition to how innovative this technology is, I think it’s wonderful to see Northwestern students and residents coming together to create something that, years later, is now poised to have a huge impact on the field of neurosurgery.”

“It’s incredibly meaningful that being founded out of Northwestern, Northwestern also got to be the first place where we had impact on the patient population and the users that inspired us to fix the problem in the first place,” said Qadir. “And then specifically, Dr. Potts – to have someone so highly regarded in the field as our first user is incredibly powerful in setting us up for a great future.”

The Northwestern Medicine Neurosurgery Teams are committed to providing comprehensive, multidisciplinary care for patients with neurological conditions, using advanced technologies and innovative approaches to care. For more information about Northwestern Medicine Neurosurgery, visit nm.org.

DeBartolo bounced his idea off Linda Egan, the Parkinson’s disease program coordinator at Northwestern Medicine Lake Forest Hospital, who in turn served up an instructional table tennis exercise program. Parkinson’s Players Ping Pong, now offered at Northwestern Medicine Lake Forest Health & Fitness Center twice a week and once a week at Edgewater Fitness Center in Chicago, is taught by certified exercise physiologists with additional Parkinson’s-specific training.

“Many of us grew up playing Ping-Pong in our basements not even realizing we were exercising or improving brain function,” said Egan. “Research has shown table tennis is uniquely beneficial for those with Parkinson’s disease because of its focus on balance, hand-eye coordination, rhythmic movements and concentration.”

The program begins with warm-ups and drills to maximize the benefits of Ping-Pong. Dynamic warm-ups help participants get familiar with the paddle. Drills include dual tasks, such as walking or lateral steps while bouncing the ball. Partner drills include counting aloud how many times you hit the ball, which activates the voice and encourages socialization.

Then the real fun starts with single and dual Ping-Pong matches, which can become very competitive.

“Ping-Pong is great because of the social aspect. The participants are having fun while moving in a variety of ways that will benefit daily life,” said Logan Sinnett, certified exercise physiologist at Northwestern Medicine Lake Forest Health & Fitness Center. “Ping-Pong requires agility and axial mobility, which is the twisting motion of your torso, along with lateral stepping. In addition to physical skills, Ping-Pong also involves a cognitive element as players must remember and announce the score during their serves.”

A study by the Fukuoka University School of Medicine in Fukuoka, Japan found that people with Parkinson’s who participated in a Ping-Pong exercise program once a week for six months showed improvement in their Parkinson’s symptoms. Study participants experienced significant improvements in speech, handwriting, getting dressed, getting out of bed and walking.

“The evidence supporting the potential benefits in quality of life and motor scores from a regular Ping-Pong program for people with Parkinson's is not surprising given the coordination, planning, and anticipation of movement involved in the sport,” said Neil Shetty, MD, movement disorders specialist at Northwestern Medicine Lake Forest Hospital. “The built-in cues of Ping-Pong play may be particularly helpful in facilitating motor training for people with Parkinson's. In addition to these physical and cognitive elements, ping pong also provides a strong social element of stimulation that we know is very important for the brain.”

The Ping-Pong program is an extension of Parkinson’s Players, an idea DeBartolo launched with Northwestern Medicine to host golf and tennis clinics.

“The two things central to Parkinson’s Players are play and friendship,” said DeBartolo. “One of the few known things to slow the progression of Parkinson’s is exercise. Play takes it to another level. There is an isolating nature to Parkinson’s disease. Playing together gives us an opportunity to smile, laugh and let our hair down while staying active.”

The program is for Level 1 and Level 2 Parkinson’s patients that can stand for an hour without support. For information about the Lake Forest Hospital program, contact Linda Egan at legan@nm.org. For the Edgewater Fitness program, contact Katie Fagan at movementdisorders@nm.org.

In June, the 20-year-old from Geneva, Ill., was diagnosed with an extremely rare and catastrophic epilepsy condition called FIRES (febrile infection-related epilepsy syndrome), caused by inflammation in the brain after fevers, which can lead to severe neurologic and cognitive injury. One in a million kids are affected by FIRES, and only 15-20% of FIRES patients return to a normal life.

“The odds are incredible; I’m literally one in a million,” said Hinchman. “You never think something like this will happen to you, and when it does, it’s really scary.”

In early June, Hinchman developed headaches and high fevers, which led to multiple seizures per day. When she stopped following commands and conversing intelligibly between seizures, Hinchman was intubated and sedated in the Neuro Intensive Care Unit at Northwestern Memorial Hospital. Test results came back consistent with FIRES – a rarity for the neurology team.

“I have taken care of patients who had previously been diagnosed with FIRES, but this was truly the first time where we made the diagnosis and had to make that decision to implement therapy,” said Ayush Batra, MD, neuro critical care specialist at Northwestern Medicine. “These are one in a million type cases that present every now and then, and many of our residents and fellows will just see one or two throughout their training.”

The medical team started Hinchman on an off-label medication called anakinra, which has been shown to be effective in small case series to control the devastating disease. After receiving the medication, Hinchman was able to communicate and function normally within 48 hours. She was discharged from the hospital on July 2 and received medical clearance to return to volleyball practice with her teammates.

“Grace is doing phenomenally well, and she’s stopped having seizures,” said Stephen VanHaerents, MD, epilepsy specialist at Northwestern Medicine. “These novel treatment options weren’t available 10 to 15 years ago, but thanks to active research, we can now treat FIRES very differently. Grace has responded beautifully to these medications, and her story is important for the epilepsy community because it shows you can get control of your seizures and get your life back.”

Hinchman will also follow the ketogenic (or keto) diet to help lower her risk of seizures. Research shows, after three months on the keto diet, 87% of patients with epilepsy report an improved quality of life. Hinchman hopes her comeback story inspires others.    

“Before this happened to me, I knew nothing about FIRES,” said Hinchman. “By sharing my story, I want to help doctors and researchers learn more about the disease, and hopefully lead to more successful outcomes. Thanks to my medical team at Northwestern Medicine, I’m able to return to my volleyball team and play the sport I love. I will forever be grateful.”

“I thought maybe I had Lyme disease, COVID-19 or walking pneumonia; I just wasn’t sure,” said 48-year-old Keller.

By September, he developed horrible headaches, and was admitted to Northwestern Memorial Hospital for testing. Blood work showed Keller had endocarditis (an infected heart valve) from Streptococcus mutans (oral bacteria) that can cause cavities.

“We’re all exposed to little bits of bacteria from the mouth, but Jay’s stuck to his valve because he had a congenital heart abnormality – he was born with two aortic valve leaflets instead of three, called a bicuspid aortic valve. It’s associated with a higher risk of cardiovascular complications, including endocarditis,” said Karen Krueger, MD, infectious diseases specialist at Northwestern Medicine.

“Because of the two-leaflet valve, the flow across that valve was not normal, and it lent to the valve getting infected more easily. Jay developed an infection of that valve, which then caused a stroke,” said Duc Thinh Pham, MD, cardiac surgeon at Northwestern Medicine.

Each time Keller’s heart would beat, it would push blood through the infected valve and flick pieces into his brain, causing an infected mycotic brain aneurysm, which is a very dangerous condition. Due to the important blood vessels involved, Babak Jahromi, MD, PhD, neurosurgeon at Northwestern Medicine, had to open Keller’s skull, cut the aneurysm out, and sew the affected brain blood vessels to other unaffected brain blood vessel segments. It was the first time Dr. Jahromi performed a double bypass for a mycotic aneurysm. The rare, 8-hour procedure preserved Keller’s important blood vessels.

“It’s basically redoing the plumbing of the brain by cutting out the part that’s bulging out and getting the remaining tubes to connect to each other,” said Dr. Jahromi. “Having a fusiform brain aneurysm is very uncommon and having that be related to a heart infection is even more uncommon. Jay came to the right place because Northwestern Medicine had the right team to deal with potential simultaneous disasters.”

Just a few days following brain surgery, Keller was already up and walking the hospital hallways. He logged seven miles in one day and couldn’t believe how much better he felt.

Two months later, Keller was back in the operating room with Dr. Pham who fixed the infected heart valve on April 21, 2022. Surgeons also found a small hole in Keller’s heart that they were able to fix. 

Keller recently finished cardiac rehabilitation and he’s ready to get back to running, biking, swimming, and spending quality time this Father’s Day with his wife, Grace, and their 7-year-old son, Hudson.

 “Obviously, it takes on a little more appreciation when you go through something like this,” said Keller. “You go back and re-visit your priorities.”

CHICAGO – A new study published in Annals of Clinical and Translational Neurology* looked at the evolution of neurologic symptoms in non-hospitalized COVID-19 long-haulers at the Northwestern Medicine Neuro COVID-19 Clinic and discovered most long-haulers continue to experience symptoms such as brain fog, numbness/tingling, headache, dizziness, blurred vision, tinnitus and fatigue on average of 15 months after disease onset. Researchers analyzed patients 6-9 months after their initial visit to the Neuro COVID-19 Clinic and discovered heart rate, blood pressure variation and gastrointestinal symptoms increased in long-haulers, while loss of taste and smell decreased overall. The findings are a follow-up to the Northwestern Medicine research team’s March 2021 study that discovered 85% of long-haulers experience four or more neurologic symptoms which impact their quality of life, and in some patients, their cognitive abilities.

“This new study is novel and reports the longest follow-up period of neurologic symptoms impacting non-hospitalized patients suffering from long-COVID anywhere in the world,” said Igor Koralnik, MD, chief of Neuro-infectious Diseases and Global Neurology at Northwestern Medicine, who oversees the Neuro COVID-19 Clinic. “We were surprised by the persistence of most of the debilitating neurologic symptoms of our patients, and by the late appearance of symptoms that suggest dysfunction of the autonomic nervous system.”

Researchers focused this study on patients evaluated initially between May and November 2020 who had mild initial COVID-19 symptoms (ex: transient cough, sore throat) and never required to be hospitalized for pneumonia or low oxygen levels. Of the 52 patients who completed the follow-up study:

- Average age was 43

- 73% were female

- 77% received the COVID-19 vaccine

- Most continued to experience neurologic symptoms, fatigue, and compromised quality of life 11-18 months after disease onset, an average of 15 months

Overall, there was no significant change in the frequency of most neurologic symptoms between first and follow-up appointments including brain fog (81 vs 71%), numbness/tingling (69 vs 65%), headache (67 vs 54%), dizziness (50 vs 54%), blurred vision (34 vs 44%), tinnitus (33 vs 42%) and fatigue (87 vs 81%).

While loss of taste (63 vs 27%) and smell (58 vs 21%) decreased overall, heart rate and blood pressure variation (35 vs 56%) and gastrointestinal symptoms (27 vs 48%) increased at follow-up.

Patients reported improvements in their recovery, cognitive function, and fatigue, but quality of life measures remained lower than the average population of the United States. Seventy-seven percent of the patients had been vaccinated for COVID-19, but the vaccine didn’t have a positive or detrimental impact on cognitive function or fatigue.

“Vaccination didn’t cure long COVID symptoms, but didn’t worsen them either, which is a reason given by some long-haulers for not getting vaccinated,” said Dr. Koralnik. “As new variants emerge and the number of patients impacted by long COVID rises, we’re now focusing our research on understanding the root cause of long COVID. We’re also devising interventions to improve the management of those patients and find the best treatment options for them.”

To date, the Northwestern Medicine Neuro COVID-19 Clinic has treated nearly 1,400 long-haulers from across the U.S. For more information, visit nm.org and to schedule an appointment, please call 312.695.7950.