Dr. Jonathan Citow Performs “The Ultimate in Minimally Invasive Surgery” on Patient

Chicago Hospital News

A year ago, Edward O'Neill was losing his ability to communicate, suffering from headaches and incontinence, losing his mobility, had difficulty walking and balancing, and had memory disturbances. A year later, O'Neill,69, has made a remarkable recovery due to an unusual surgical procedure performed by Jonathan Citow, M.D., a neurosurgeon on staff at Saint Francis Hospital in Evanston.

The story began when O'Neill was taken to Saint Francis Hospital Emergency Department after falling at the indepent living facility where he resided. O'Neill's daughter, Deborah, explains that she noticed he was continuing to have trouble balancing and his speech and mobility were deteriorating. “One time when we went to visit him, they wouldn't allow him to walk at all and he needed to be in a wheelchair. He had deteriorated in a month.”

After a series of diagnostic procedures including an MRI (Magnetic Resonance Imaging) and CT (Computerized Tomography) Scan, the family met with O'Neill”s doctors for a neurology consult – of which Citow was included. It was concluded that the only treatment option for O'Neill was neurosurgery. Daughter Deborah recalls that many of the doctors didn't think he'd make it through the surgery.

“But Dr. Citow came forward and said. If there's a tumor I can help. He told us if we didn't do anything the tumor would grow.” said Deborah. “I couldn't do that. I wanted a better quality of life for my dad. He was already wheelchair bound, lost most of his motor skills, was incontinent, and words together.

So when Dr. Citow came and told my brothers and me that he could help and take out the tumor, we knew we had to try. Except we weren't sure if dad would agree to surgery.”

O'Neill recalls, “Despite my fears and concerns. Dr. Citow excuded a calm and confidence that I could feel each time we met to discuss my treatment.” In fact, O'Neill cancelled the surgery once, but the family made him realize that he was getting worse and convinced him to have the surgery.

Citow diagnosed O'Neill with Hydrocephalus (water on the brain) caused by a large cyst in the pineal (center) region of the brain. “The choices of surgical approach included a ventriculoperitoneal shunt and possibly an open resection of the pineal cyst,” said Citow. “We performed a more modern and unusual technique by using an endoscope to go through  the ventricular system and remove the cyst through a tiny hole the length of a thumbnail on the top of Mr. O'Neill's head.”

Also through the same incision, Citow was able to direct the endoscope through another ventricle to create a new pathway for the cerebrospinal fluid and thus resolve O'Neill's hydrocephalus.

“This is the ultimate in minimally invasive surgery.” says Citow. “He went home one day after surgery and has had significant improvement in all of his symptoms.”

“The recuperation time was unbelievable,” said Deborah. “One day dad had a mass in the middle of the brain and two days later, he was sitting up, ate his whole tray of food and pushed away the walker because it was interfering.”

O'Neill did not need any therapy pr rehabilitation after the surgery. The only indication that he had any type of surgery was the shaved part of his head, about the size of a silver dollar.

Now a resient of Highland Park Health Care Center. O'Neill no longer uses a walker, he's no longer incontinent, and his memory and mobility have improved.

“There were several naysayers suggestions that he should not have surgery and that it would not very helpful.” says Citow. “Fortunately, he made the right decision”.

“The doctor was amazing”, says Deborah. O'Neill says he is just happy to still be alive.

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Dr. Jonathan Citow, Chief of Neurosurgery, Condell Medical Center