Methodist Physicians Neurosurgical Associates of San Antonio

At Neurosurgical Associates of San Antonio (NASA), our expert neurosurgeons have more than 30 years of experience treating disorders of the brain and spine.  We’re proud to provide world-class care right here in our community.

Our team offers the full spectrum of neurosurgical care, combining advanced surgical techniques, state-of-the-art technology, and multidisciplinary collaboration to treat conditions affecting the brain, spine, spinal cord, and peripheral nerves. In addition to providing advanced surgical care, we believe in putting the needs of our patients first by creating individualized treatment plans. Our goal is to answer all questions concerning diagnosis, surgical treatment and recovery.

Brain and cranial neurosurgery

We provide expert care for a wide range of brain and skull-based conditions, including:

• Primary and metastatic brain tumors
• Skull base tumors, including meningiomas and acoustic neuromas
• Pituitary tumors and disorders
• Chiari malformations (Need to verify)
• Hydrocephalus, including shunt placement and management
• Trigeminal neuralgia and cranial nerve compression syndromes
• Congenital abnormalities and traumatic brain injuries
• Colloid cysts
• Hydrocephalous

World class neurosurgical operating suite at Methodist Hospital

Methodist Hospital in San Antonio is home to the only neurosurgical operating suite in South Texas, offering an unparalleled combination of state-of-the-art imaging and surgical technologies. As the only hospital in the region with an intraoperative MRI housed in a hybrid operating suite, Methodist provides neurosurgeons with real-time imaging during procedures— enhancing precision and improving outcomes. of complex, minimally invasive neurosurgical procedures.

Advanced neurosurgical technologies at Methodist Hospital:

• Hybrid operating suite with intraoperative MRI for real-time brain imaging during surgery.  Image guided cranial surgery uses advanced technology that provides surgeons with detailed images of the surgical site on a computer screen. These enhanced images allow for increased accuracy and precision during brain surgery. 
• MRI-guided laser ablation system to treat brain lesions while sparing healthy tissue
• Cranial robotic navigation technology for enhanced precision in complex brain surgeries
• Minimally invasive surgical techniques that reduce recovery time and optimize outcomes
• Exclusive to South Texas, making Methodist Hospital a regional leader in neurosurgical innovation

Endovascular and cerebrovascular neurosurgery

Our endovascular neurosurgeons are highly trained in minimally invasive techniques to treat blood vessel disorders of the brain and spine, including:

• Aneurysms
• Arteriovenous malformations
• Carotid artery disease
• Ischemic and hemorrhagic stroke
• Middle meningeal artery embolization for chronic subdural hematomas

We offer both open surgical and catheter-based interventions using the latest image-guided technologies.

Gamma Knife radiosurgery

We are proud to offer Gamma Knife radiosurgery, a highly advanced, non-invasive treatment that delivers pinpoint, high-dose radiation to targeted areas in the brain with sub-millimeter precision. Gamma Knife is not actually a knife — it’s a form of stereotactic radiosurgery used to treat complex neurological conditions without the need for a traditional surgical incision.

This treatment is especially effective for:

• Metastatic brain tumors
• Benign brain tumors, such as meningiomas and acoustic neuromas
• Trigeminal neuralgia
• Arteriovenous malformations
• Select functional neurosurgery applications, including tremors and movement disorders

We are proud to offer the newest and most advanced Gamma Knife technology available, making us the only center in the San Antonio region with this level of capability. This cutting-edge system allows us to treat the most delicate and difficult-to-reach areas of the brain with unmatched precision and minimal impact on surrounding tissue.

Patients benefit from:

• No surgical incision
• Outpatient treatment
• Minimal recovery time
• Reduced risk of complications

If you’ve been diagnosed with a brain tumor, trigeminal neuralgia, or a vascular or functional brain disorder, our Gamma Knife program offers one of the safest and most effective treatment options available in the region.

Epilepsy surgery

We work closely with neurologists and epileptologists to offer surgical options for patients with medication-resistant epilepsy, including:

• Seizure mapping and resection surgery
• Laser ablation
• Vagus nerve stimulation
• Responsive neurostimulation

Our team is actively involved in multidisciplinary epilepsy case conferences to ensure patients receive the most effective and personalized care.

Movement disorder program highlights

Deep brain stimulation

Deep brain stimulation (DBS) is a surgical procedure that helps patients function with movement disorders, such as essential tremors or Parkinson’s disease. During the procedure, a neurosurgeon will implant a small pacemaker-like device into the area of the brain that controls body movement.

DBS can reduce stiffness and tremors caused by movement disorders, to maximize your quality of life and range of motion.

• Our multidisciplinary care team includes:
• Neurologists
• Neurosurgeons
• Neuropsychologists
• Specialized movement disorder support staff
• Comprehensive treatment for all movement disorders, including::
• Parkinson’s disease
• Essential tremor
• Dystonia
• Other complex movement disorders

• Patient-centered approach
• Collaborative care planning
• Focus on improving quality of life and long-term symptom management

Spine and spinal cord surgery

Our spine surgeons specialize in both traditional and minimally invasive techniques to treat:

• Herniated discs
• Spinal stenosis
• Degenerative disc disease
• Spondylolisthesis
• Spinal deformities, such asscoliosis andkyphosis
• Spinal tumors
• Spinal trauma and fractures

We utilize the latest technologies, including robotic-assisted spine surgery, to improve precision and recovery.

Chronic pain and peripheral nerve surgery

In partnership with pain specialists, we offer surgical solutions for:

• Chronic back and neck pain
• Peripheral nerve entrapments (e.g., carpal tunnel, ulnar neuropathy)
• Spinal cord stimulators for neuropathic pain
• Dorsal root ganglion stimulation

Our team evaluates surgical and non-surgical options tailored to your specific condition and goals.

Multidisciplinary approach and continuum of care

Our model of care is built around the full continuum of treatment. From initial consultation and diagnostics to surgery, rehabilitation, and long-term follow-up, you are supported by a collaborative team that may include:

• Neurologists
• Neuro-oncologists
• Pain management physicians
• Physical medicine and rehabilitation specialists
• Neuro-radiologists
• Advanced practice providers and care coordinators

This integrated approach ensures coordinated, seamless care every step of the way.

If you or a loved one has been diagnosed with a neurological condition, we are here to help you navigate the journey with experience, innovation, and compassion. Our team is committed to providing you with the highest standard of neurosurgical care.

Specialized idiopathic intracranial hypertension clinic

Coordinated care for IIH

Idiopathic intracranial hypertension, or IIH, is a complex neurological condition caused by increased pressure around the brain without an identifiable underlying cause. IIH can produce debilitating headaches, affect your daily functioning and, without appropriate treatment, may threaten your vision.

Our specialized IIH Clinic, led by board certified and fellowship trained Neurointerventional Neurologist Lee Birnbaum, MD, is designed to provide patients with coordinated evaluation, individualized treatment and ongoing management in one comprehensive program.

Recognize the signs and symptoms

Symptoms of IIH may develop gradually or appear suddenly. They can include:

• Frequent or severe headaches
• Headaches that worsen when lying down, bending over, coughing or straining
• Blurred, dimmed or double vision
• Brief episodes of vision loss or “graying out”
• Blind spots or loss of peripheral vision
• A pulsing, rushing or “whooshing” sound in the ears
• Pain behind the eyes
• Nausea, vomiting or dizziness
• Neck, shoulder or back discomfort
• Swelling of the optic nerve, known as papilledema

Because IIH symptoms can resemble migraines and other neurological conditions, a specialized evaluation is important. New or worsening vision changes should be evaluated promptly.

Experience you can trust

Dr. Birnbaum has extensive experience evaluating and treating patients with IIH and other conditions involving the brain’s blood vessels and intracranial pressure.

He understands that IIH is rarely managed through a single visit or one specialty. Patients may need careful neurological assessment, vision monitoring, medical therapy, imaging, lifestyle support and, in selected cases, procedural or surgical treatment.

Dr. Birnbaum works with each patient to develop a treatment plan focused on three essential goals:

• Protecting your vision
• Reducing headaches and other symptoms
• Improving your long-term health and quality of life

Our approach to your health

Through Neurosurgical Associates of San Antonio (NASA) Clinics, Dr. Birnbaum brings together a multidisciplinary team to address the different ways IIH can affect a patient’s health.

Depending on individual needs, the care team may involve specialists in:

• Neurology
• Neurointerventional and cerebrovascular care
• Neurosurgery
• Neuro-ophthalmology or ophthalmology
• Diagnostic imaging
• Headache management
• Nutrition and weight-management services
• Primary care and other medical specialties

This coordinated approach helps reduce fragmented care and allows specialists to work together on diagnosis, treatment decisions, and long-term follow-up for your care.

What patients can expect

Your comprehensive IIH evaluation may include:

• Review of headaches, visual symptoms and medical history
• Complete neurological assessment
• Review or coordination of eye examinations and visual-field testing
• Review of MRI, MRV or other brain imaging
• Evaluation of previous lumbar-puncture findings
• Assessment for conditions that may contribute to increased intracranial pressure
• Development of a personalized medical and lifestyle treatment plan
• Consideration of procedural or surgical options when appropriate
• Continued monitoring of symptoms and vision

Advanced treatment options

Your treatment is personalized based on the severity of symptoms, vision risk, diagnostic findings and overall health. Recommendations may include medication, headache treatment, nutrition or weight-management support and close vision monitoring.

For carefully selected patients whose symptoms or vision remain at risk, our multidisciplinary team can evaluate whether advanced treatment options should be considered.

When to seek immediate care

Please seek urgent medical attention if you are experiencing one or more of the following symptoms:

• Sudden or rapidly worsening vision loss
• A new, severe or unusual headache
• New weakness, numbness, confusion or difficulty speaking
• Fainting or loss of consciousness
• Persistent vomiting with a severe headache

You do not have to navigate IIH alone

Our specialized IIH Clinic provides experienced leadership, coordinated specialty care and an individualized plan focused on protecting your vision and helping you feel better.

To request an appointment or refer a patient, please contact us:

Phone: (210) 614-2453
Fax: (210) 614-2462

4410 Medical Drive, Suite 610
San Antonio, TX 78229

1139 E Sonterra Blvd., Suite 301
San Antonio, TX 78258

A physician referral and medical records may be required. Patients experiencing a medical emergency should call 911 or go to the nearest emergency department.