Clinical Focus



General Neurosurgery

General neurosurgery Dr. Zünkeler has practiced general adult neurosurgery since first starting in Baltimore in 1997. General neurosurgery encompasses the nonoperative and operative treatment of conditions of the brain, spine, and peripheral nerves. The majority of patients seen by general neurosurgeons do not require a surgical intervention and often improve with nonoperative treatment alone. At this time, Dr. Zünkeler performs small outpatient procedures (including CT-guided epidural steroid injections) to help with the diagnosis and treatment of neurosurgical conditions. In cases in [...]


Brain injury and concussion

Brain injury and concussion Traumatic brain injury (TBI) ranges from very mild to severe and is one of the most common types of injury in the United States. According to the Centers for Disease Control and Prevention (CDC) , about 2.87 million TBI-related emergency department visits, hospitalizations, and deaths occurred in 2014; 837,000 of these were TBIs in children. Concussions are the most common form of TBI and are particularly common in children. Approximately 300,000 TBIs per year are related to [...]


Spine Injury

The spine and the spinal cord The bony spine usually has 24 vertebrae: 7 cervical, 12 thoracic, and 5 lumbar. In the spine model I am holding in the picture above, the yellow pieces are the vertebra, which, together with the tailbone (sacrum), make up the bony spine. Each vertebra supports the load of the portion of the body above it, in addition to any additional weight the person is carrying and any additional stress temporarily placed on the spine during [...]


Age 50 plus Healthy Spine

Effects of aging on the spine Back pain is common and affects almost all people at some time during their lives. Many older individuals have back and neck pain, which is often "nonspecific," meaning that there is no single, easily identifiable cause. Having back or neck pain can be "part of life." Once it has been established that there is no serious underlying cause of the pain, the following tips and tricks may help lessen your pain. Things to avoid: improper [...]


Age 50 plus Healthy Brain

Watercolor of Lake Constance painted by Brigitte Zünkeler, my mother. A healthy brain More than any other organ or part of our body, our brain defines who we are. Our consciousness, thoughts, feelings, intentions, fears, hopes, and intellect are encoded in the many millions of networked nerve cells that make up our brain. Our brain is closely connected through our 24 cranial nerves (12 on each side) and the spinal cord to the rest of our body, which it controls [...]


Second opinions

Care philosophy Whenever possible, nonoperative and less invasive treatments are preferable to surgeries or other invasive procedures. In some cases, surgery is medically necessary and has a better chance of success than ongoing nonoperative treatment. Second opinions A patient who has already consulted a neurosurgeon or an orthopedic spine surgeon and received a recommendation for surgery may feel the need to discuss treatment options with another specialist. Dr. Zünkeler has extensive experience in treating patients both surgically and nonsurgically [...]

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