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In 2015 Dr. Carroll collaborated With Stanford's Neuroradiology and Neurology Headache divisions to create the Stanford CSF Leak Headache Program after his daughter suffered through an initially-undiagnosed CSF leak. This experience left him with a passion for helping patients experiencing CSF leaks around the world. He is board-certified in four different specialties: Headache Medicine by the United Council for Neurologic Subspecialties; Addiction Medicine by the American Board of Addiction Medicine; Pain Medicine by the American Board of Anesthesiology; and Anesthesiology by the American Board of Anesthesiology. His primary focus is on spinal cerebrospinal fluid (CSF) leaks. He has spoken at numerous national meetings on CSF leaks, management of the pain from nerve injuries, and factors influencing opioid cessation. He has conducted visiting professorships at Johns Hopkins University, Vanderbilt University, Yale University, University of California at Davis Medical Center, and others. Dr. Carroll graduated summa cum laude and Phi Beta Kappa from Columbia University, and then graduated with an M.D. from Columbia University. He was a Research Fellow at the Experimental Immunology Branch at the National Cancer Institute at the National Institutes of Health in Bethesda Maryland. He completed his internship in Internal Medicine, residency in Anesthesiology, fellowship in Pain Medicine, and was elected Chief Resident of Anesthesiology from 2001-2002 at Stanford University Medical Center. He joined Stanford's Department of Anesthesiology as a primary teaching and research faculty in the Pain Management clinic in 2004. Dr. Carroll completed Stanford's two-year Clinical Research training program earning a M.S. degree in clinical epidemiology from Stanford in 2006. He has published over 50 original articles including research funded by the Foundation for Anesthesia Education and Research (FAER); the National Institute for Drug Abuse (NIDA); and the Stanford Institute for Neuro-Innovation & Translational Neurosciences (SINTN).In addition to his clinical and research responsibilities, Dr. Carroll helps select and train Stanford Anesthesia residents, Pain Management Fellows and Neurology Headache Fellows.
Cerebrospinal fluid (CSF) leaks are a treatable disease that can cause a myriad of symptoms including chronic head pain, headache, migraine, neck pain, nausea, vomiting, ringing in the ears (tinnitus), difficulty concentrating, difficulty with memory, and fatigue. One of the cardinal features of cerebrospinal fluid leaks is that symptoms tend to be worse depending on the posture of the body-with headaches being more prominent when upright, and relieved when lying down (orthostatic headaches). Among people who are leaking chronically, a person may need to be upright or flat for a protracted period of time in order for symptoms to be exacerbated or relieved. Therefore, many patients with cerebrospinal fluid leaks experience a typical daily pattern in which the mornings are better-especially before arising from bed, but things get progressively worse as the day goes on with prolonged upright activity.<br/><br/>Because patients with cerebrospinal fluid leaks often feel significantly worse when they are upright, patients with cerebrospinal fluid leaks may be misdiagnosed with an alternative diagnosis associated with increased symptoms depending on body posture such as postural orthostatic tachycardia syndrome (POTS). In addition because of reduced spinal fluid pressure the brain may sag resulting in a misdiagnosis of Chiari malformation. Other patients have been diagnosed with New Daily persistent Headache (NDPH), Chronic migraine, Occipital Neuralgia,and Chronic Fatigue Syndrome.<br/><br/>Cerebrospinal fluid leaks should be considered as a diagnostic possibility in any patient who has previously undergone an injection into the spine, or the placement of a needle into the spinal fluid and is then experiencing symptoms that are worse when the patient is upright and relieved when the patient is flat. In addition, it is well recognized that spine surgery can precipitate cerebrospinal fluid leaks related to the surgery. <br/><br/>CSF leaks are understood to be much more frequent among people with genes that make their connective tissue less strong. These patients may be notably flexible, unusually tall or unusually short, may appear to be double-jointed, or have unusually stretchy skin. Clinically, these patients often have multiple joint dislocations, or joint sprains at different times of their life, may have early arthritis in multiple joints, and may have multilevel spine pain from degenerative joint disease or degenerative disc disease. Subsequently many patients have been misdiagnosed as having fibromyalgia, chronic fatigue syndrome, and other conditions. Some hereditary disorders of connective tissue are named such as Marfan syndrome, or Ehlers-Danlos syndrome (EDS), but other people may have a number of signs and symptoms associated with hereditary disorders of connective tissue, and are more likely to experience spinal fluid leaks, but don't have these named syndromes. <br/><br/>Dr. Carroll's current clinical and research work are oriented towards ensuring that all patients with cerebrospinal fluid leaks receive prompt diagnosis and effective treatment.<br/><br/>Patients and physicians may find the following lecture on cerebrospinal fluid leaks helpful and informative:<br/><br/>https://www.youtube.com/watch?v=QyvWxobqKrc<br/><br/><br/>Giving: Gifts to support innovative patient care, research and education programs will make a difference in the lives of patients now and in the future. If you need assistance or more information on giving options such as a gift of securities or a planned gift, please call Medical Center Development at (650) 725-2504 or email us at firstname.lastname@example.org. In the memo line indicate For Dr. Ian Carroll CSF Leak Research.
[18F]FTC-146 PET/MRI in Healthy Volunteers and in CRPS and Sciatica
Chronic pain can result from injured or inflamed nerves, as occurs in people suffering from
sciatica and CRPS. These nerve injuries or regions of nerve irritation are often the cause of
pain in these conditions, but the current diagnostic tools are limited in pinpointing the
area of origin. Several studies have implicated involvement of sigma-1 receptors in the
generation and perpetuation of chronic pain conditions, others are investigating anti sigma-1
receptor drugs for the treatment of chronic pain. Using the sigma-1 receptor (S1R) detector
and experimental radiotracer [18F]FTC-146 and positron emission tomography/magnetic resonance
imaging (PET/MRI) scanner, the researchers may potentially identify the source of pain
generation in patients suffering from complex regional pain syndrome (CRPS) and chronic
sciatica. The ultimate goal is to assist in the optimization of pain treatment regimens using
an [18F]FTC-146 PET/MRI scan.
The study is not designed to induce any physiological/pharmacological effect.
Stanford is currently not accepting patients for this trial.
For more information, please contact Sandip Biswal, MD, 650-725-8018.
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Stanford Accelerated Recovery Trial (START)
The goal of this study is to determine whether administering Gabapentin prior to surgery
affects duration of pain and opioid use post-surgery. The investigators aim to compare
gabapentin to placebo in a prospective, randomized clinical trial in which patients will be
followed post-surgery until pain resolves and opioid use ceases.
Stanford is currently not accepting patients for this trial.
For more information, please contact Debra Clay, 650-724-1753.
Use of PET/MR Imaging in Chronic Pain
The investigators are studying the ability of PET/MR imaging (using the PET tracer [18F]FDG)
to objectively identify and characterize pain generators in patients suffering from chronic