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August 14, 2014 / drrobertcach

Earning Board Certification in Neurosurgery

Dr. Robert Cach is a board-certified neurosurgeon who has been practicing for more than 16 years. In addition to his work as owner and operator of the Idaho Neurological Center, Dr. Robert Cach currently treats patients at Mountain View Hospital and Eastern Idaho Regional Medical Center.

Individuals seeking board certification in the field of neurosurgery must first complete a number of residency training requirements, beginning with 72 months in a training program that has been approved by the Accreditation Council for Graduate Medical Education (ACGME). The bulk of this residency training should be dedicated to areas of core clinical neurosurgery and conclude with 12 months as a chief resident. This training period should include three months of basic neuroscience training within the first year and a half and six months of structured education in general patient care. Residents must follow up on general patient care with three months of critical care training focused on neurosurgery.

Individuals preparing for board certification must also spend two and a half years studying and practicing in a specialty field, such as complex spinal surgery, neuropathology, pediatric neurosurgery, or research. In some cases, work toward a PhD degree may count toward the required 30 months.

August 1, 2014 / drrobertcach

Dr. Robert Cach- Advancements in Neurosurgery

Possessing nearly 20 years of experience in medicine, Dr. Robert Cach owns and operates Idaho Neurosurgical Center in Idaho Falls, Idaho. Also the chief of surgery at Eastern Idaho Regional Medical Center, Dr. Robert Cach stays abreast of the newest advancements in neurosurgery.

In May 2014, neuroscientists and neurosurgeons from the University of Pennsylvania announced a discovery regarding the brain’s reward system and learning process. While performing surgery to treat individuals with Parkinson’s disease, the scientists found a way to approach the substantia nigra. This deep brain structure, named for its dark color, affects addiction, reward, and movement. Dying neurons in this region are the cause of Parkinson’s disease.

The University of Pennsylvania team identified potential benefits to stimulating the substantia nigra, which releases the hormone dopamine, which in turn is associated with reward-seeking behavior. Patients participating in the study played computer games featuring rigged slot machines. When the subjects found an award-producing machine, the doctors would trigger the substantia nigra; they then observed that even when the machine no longer generated winning results, the patients continued to return to it. The conclusion of this research was that stimulation of this zone may encourage people to repeat the same action. This knowledge may help scientists develop better treatments for individuals with substance abuse or gambling issues, as well as people with neurological disorders.

June 24, 2014 / drrobertcach

Disc Nucleoplasty

Dr. Robert Cach, a neurosurgeon in Idaho Falls, practices complex spinal and intracranial procedures at Idaho Neurosurgical Centre. Dr. Robert Cach has over 16 years of experience as a trauma surgeon, and performs procedures such as disc nucleoplasty on patients with neck pain or back pain.

Disc nucleoplasty is a minimally invasive surgical procedure for treating painful conditions such as sciatica that result from spinal disc damage. It is growing in popularity as it is a short outpatient procedure, usually 60 minutes in length, and allows for a return to normal activities much more rapidly than traditional surgical approaches do. The small incision made during disc nucleoplasty reduces the chances of scarring, and allows the patient to resume limited activity shortly after the procedure.

On the day of the procedure, the medical professional administers mild sedation and local anesthetic to the patient. With the guidance of x-ray technology, the doctor inserts a needle into the disc’s sidewall, after which the nucleoplasty device is put through. The device is used to remove a small amount of disc tissue from the disc core in a controlled manner, while heating the surrounding healthy tissue. The removal of disc material results in the relief of pressure. This, in turn, reduces the bulging and the associated irritation.

May 9, 2012 / drrobertcach

Frequently Asked Questions Concerning ADHD

An interview with Dr. Robert Cach, neurosurgeon and owner of Idaho Neurological Center

Q: What is ADHD?

Dr. Robert Cash: A neurobehavioral disorder, attention deficit-hyperactive disorder, more commonly referred to as ADHD, affects a child’s ability to concentrate and demonstrate restraint over inhibitions.

Q: When does one typically develop ADHD?

RC: Most doctors catch ADHD during childhood. In fact, roughly three to five percent of American children have ADHD.

Q: How many types of ADHD exist?

RC: Like many disorders, ADHD comes in several varieties. One type sees children unable to ignore hyperactive tendencies, another emphasizes inattention, and a third combines the two.

Q: How can I tell if a child has ADHD?

RC: Warning signs include symptoms stemming from difficulty concentrating, listening to instructions, and staying on task. For example, a child with ADHD often starts projects like homework or chores, but leaves them unfinished. They also have trouble paying attention to details and tend to fidget constantly when required to stay still.

Q: What treatments exist for ADHD?

RC: First, understand that no cure for ADHD exists. Some children leave it in their childhoods, while others simply learn to work around it as they grow older. Regarding treatment, medications such as Ritalin cut back on impulsive behavior and simultaneously increase attention span. However, medications alone rarely work. Adults in the child’s life, specifically parents and teachers, must collaborate to build a structure for the child that includes tutoring and behavioral therapy, if necessary.

April 29, 2012 / drrobertcach

New Study Supports Surgery for Epilepsy, by Dr. Robert Cach

Neurologist Dr. Robert Cach owns and operates the Idaho Neurological Center in Idaho Falls, Idaho.

A new study conducted by researchers from the University of Rochester in New York suggests that temporal lobectomy surgery may be the best option for certain forms of epilepsy. The study followed patients with temporal lobe epilepsy who did not respond to drugs. The researchers were particularly interested in how the surgery affected quality of life.

Patients who received surgery reported that they were living seizure-free after two years. They showed an increased ability to hold down jobs, have an active social life, and drive vehicles. The patients in the control group, who did not have surgery, had frequent seizures, remained on disability, and were less likely to be able to operate vehicles.

Researchers also compared cognitive abilities between the groups, since the surgery has been shown to reduce some cognitive functions. However, the surgical group experienced no greater decline in mental function than the control group over the course of the study.

While the Rochester study was fairly small, it seems to suggest that neurologists should be more aggressive about offering surgery to patients with uncontrolled temporal lobe epilepsy.