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Dr. Garni Barkhoudarian, MD
Neurological Surgeon
7 years of experience
Accepting new patients
Video profile


Education ?

Medical School Score Rankings
University of Michigan Medical School (2005)
Top 25%
UCLA Medical Center (2011) *
Neurological Surgery
Brigham and Women's Hospital (2012) *
Neurological Surgery
* This information was reported to Vitals by the doctor or doctor's office.

Awards & Distinctions ?

John Wayne Cancer Institute (2012 - Present)
Faculty Neurosurgeon
Congress of Neurological Surgeons
Pituitary Network Association
American Association of Neurological Surgeons

Affiliations ?

Dr. Barkhoudarian is affiliated with 2 hospitals.

Hospital Affiliations

  • Saint John's Health Center
    1328 22nd St, Santa Monica, CA 90404
  • St. John's Hospital & Health Center *
  • Publications & Research

    Dr. Barkhoudarian has contributed to 9 publications.
    Title The Molecular Biology and Novel Treatments of Vestibular Schwannomas.
    Date December 2011
    Journal Journal of Neurosurgery

    Vestibular schwannomas are histopathologically benign tumors arising from the Schwann cell sheath surrounding the vestibular branch of cranial nerve VIII and are related to the NF2 gene and its product merlin. Merlin acts as a tumor suppressor and as a mediator of contact inhibition. Thus, deficiencies in both NF2 genes lead to vestibular schwannoma development. Recently, there have been major advances in our knowledge of the molecular biology of vestibular schwannomas as well as the development of novel therapies for its treatment. In this article the authors comprehensively review the recent advances in the molecular biology and characterization of vestibular schwannomas as well as the development of modern treatments for vestibular schwannoma. For instance, merlin is involved with a number of receptors including the CD44 receptor, EGFR, and signaling pathways, such as the Ras/raf pathway and the canonical Wnt pathway. Recently, merlin was also shown to interact in the nucleus with E3 ubiquitin ligase CRL4(DCAF1). A greater understanding of the molecular mechanisms behind vestibular schwannoma tumorigenesis has begun to yield novel therapies. Some authors have shown that Avastin induces regression of progressive schwannomas by over 40% and improves hearing. An inhibitor of VEGF synthesis, PTC299, is currently in Phase II trials as a potential agent to treat vestibular schwannoma. Furthermore, in vitro studies have shown that trastuzumab (an ERBB2 inhibitor) reduces vestibular schwannoma cell proliferation. With further research it may be possible to significantly reduce morbidity and mortality rates by decreasing tumor burden, tumor volume, hearing loss, and cranial nerve deficits seen in vestibular schwannomas.

    Title The Molecular Pathophysiology of Concussive Brain Injury.
    Date March 2011
    Journal Clinics in Sports Medicine

    Concussion or mild traumatic brain injury (mTBI) is a condition that affects hundreds of thousands of patients worldwide. Understanding the pathophysiology of this disorder can help manage its acute and chronic repercussions. Immediately following mTBI, there are several metabolic, hemodynamic, structural, and electric changes that alter normal cerebral function. These alterations can increase the brain's vulnerability to repeat injury and long-term disability. This review evaluates current studies from the bench to the bedside of mTBI. Acute and chronic effects of concussion are measured in both animal and clinical studies. Also, the effect of repeat concussions is analyzed. Concussion-induced pathophysiology with regards to glucose metabolism changes, mitochondrial dysfunction, axonal injury, and structural damage are evaluated. Translational studies such as functional magnetic resonance imaging, magnetic resonance spectroscopy and diffusion tensor imaging prove to be effective clinical tools for both prognostic and treatment parameters. Understanding the neurobiology of concussion will lead to development and validation of physiological biomarkers of this common injury. These biomarkers (eg, laboratory tests, imaging, electrophysiology) will then allow for improved detection, better functional assessment and evidence-based return to play recommendations.

    Title Intravenously Administered Abciximab in the Management of Early Cerebral Ischemia After Carotid Endarterectomy: Case Report.
    Date September 2006
    Journal Neurosurgery

    Cerebral ischemia is the most worrisome perioperative complication of carotid endarterectomy (CEA). The stroke rate occurring with CEA is estimated to range from 2.3 to 6.3%. Numerous treatment options are available to the neurosurgeon in this scenario, although no "gold standard" exists.

    Title Propionibacterium Infection Associated with Bovine Pericardium Dural Allograft. Case Report.
    Date September 2005
    Journal Journal of Neurosurgery

    Propionibacteria are known to play a part in postneurosurgical infections, primarily those involving ventricular shunts. Nevertheless, little is known about the association between dural allografts and propionibacterium infections. Two patients underwent craniotomy for supratentorial meningiomas and each received a dural allograft. Both patients subsequently presented with delayed epidural fluid collections several weeks after surgery. Propionibacterium species was cultured in samples from both patients. The allografts were removed and the patients were treated with appropriate antibiotic agents; one patient underwent an interval craniectomy. Both patients demonstrated neuroimaging and clinical improvement after surgery and antiobiotic therapy. These cases demonstrate the association of propionibacterium infections with dural allografts. Furthermore, in patients with latent and indolent infections, Propionibacterium spp. should be suspected and treated appropriately.

    Title Progression of a Posterior Communicating Artery Infundibulum into an Aneurysm in a Patient with Alagille Syndrome. Case Report.
    Date November 2004
    Journal Journal of Neurosurgery

    The authors present a case in which a posterior communicating artery (PCoA) infundibulum progressed into an aneurysm in a patient with Alagille syndrome (arteriohepatic dysplasia). The 3-mm PCoA infundibulum had been noted on angiography studies obtained 5 years earlier, prior to clip occlusion of a basilar tip aneurysm. Recently, the patient presented to the emergency department with the sudden onset of headache and decreased mental status. A computerized tomography scan of the head with three-dimensional angiography revealed no gross subarachnoid hemorrhage, but did demonstrate a 5-mm PCoA aneurysm. Lumbar puncture demonstrated xanthochromia and a large quantity of red blood cells. The patient underwent open surgery for aneurysm clip occlusion and obtained a good recovery. This case illustrates the small but growing number of examples of infundibulum progression. It also indicates the need for a close follow up in patients with congenital abnormalities that may pose an increased risk for what has traditionally been considered a benign lesion.

    Title Fiber Size and Myosin Phenotypes of Selected Rhesus Lower Limb Muscles After a 14-day Spaceflight.
    Date November 2000
    Journal Journal of Gravitational Physiology : a Journal of the International Society for Gravitational Physiology

    Muscle biopsies were taken from the rhesus (Macaca mulatta) soleus (Sol, a slow ankle extensor), medial gastrocnemius (MG, a fast ankle extensor), tibialis anterior (TA, a fast ankle flexor), and vastus lateralis (VL, a fast knee extensor) muscles in vivarium controls (n=5) before and after either a 14-day spaceflight (Bion 11, n=2) or a 14-day ground-based flight simulation (n=3). Myosin heavy chain (MHC) composition (gel electrophoresis), fiber type distribution (immunohistochemistry), and fiber size were determined. Although there were no significant changes, each muscle showed trends towards adaptation.

    Title Fiber Size and Myosin Phenotypes of Selected Rhesus Hindlimb Muscles After a 14-day Spaceflight.
    Date June 2000
    Journal Journal of Gravitational Physiology : a Journal of the International Society for Gravitational Physiology

    Open muscle biopsies were obtained from Rhesus soleus (slow ankle extensor), medial gastrocnemius (fast ankle extensor) and tibialis anterior (fast ankle flexor) muscles before and after either a 14-day spaceflight (BION 11, n=2) or ground-based flight simulation (n=3) and in time-matched controls (n=5). Fiber type distribution (immunohistochemistry), myosin heavy chain (MHC) composition (gel electrophoresis) and fiber size were determined. There was a large amount of inter-animal variability and there were no significant pre-post differences for any variable under any condition for any muscle studied. However, each muscle showed trends towards adaptation. Based on the immunohistochemical analyses, the percentage of type I fibers in the soleus was 68 and 86% in pre and 43 and 70% in post biopsies of the simulation and flight groups. The number of hybrid (containing both fast and slow MHC) fibers increased in both groups. MHC composition changed in a similar direction. Type I and hybrid fibers were 23 and 31% smaller after than before flight. In the medial gastrocnemius, type I fibers were 16, 14 and 32% smaller in post compared to pre biopsies in control, simulation and flight Rhesus. In the tibialis anterior, type I fibers were approximately 14% smaller in post- than pre-flight biopsies. As expected the soleus, a slow anti-gravity muscle, was most affected after 14 days of weightlessness. Further, slow fibers in each muscle were more responsive to microgravity than fast fibers. All changes, however, were smaller than those observed in rats after the same duration of flight. This differential effect may be related to the partial restraint of Rhesus in the chaired position compared to the free-floating position of rats in the cage and/or to differences in the contractile protein turnover rates between species.

    Title A Role of Diffusion Tensor Imaging in Movement Disorder Surgery.
    Journal Acta Neurochirurgica

    The safe and reversible nature of deep brain stimulation (DBS) has allowed movement disorder neurosurgery to become commonplace throughout the world. Fundamental understanding of individual patient's anatomy is critical for optimizing the effects and side effects of DBS surgery. Three patients undergoing stereotactic surgery for movement disorders, at the institution's intraoperative magnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography were determined on preoperative magnetic resonance imagings using the Schaltenbrand-Wahren atlas for definition in the BrainLab iPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate nucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the x/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. Diffusion tensor imaging tractography allowed reliable and reproducible visualization and correlation between frontal eye field, premotor, primary motor, and primary sensory cortices via corticospinal tracts and corticopontocerebellar tracts. There is an apparent increase in the number of cortical regions targeted by the fiber tracts as the region of interest is enlarged. This represents a possible mechanism of the increased effects and side effects observed with higher stimulation voltages. Currently available diffusion tensor imaging techniques allow potential methods to characterize the effects and side effects of DBS. This technology has the potential of being a powerful tool to optimize DBS neurosurgery.

    Title Molecular and Physiological Responses to Juvenile Traumatic Brain Injury: Focus on Growth and Metabolism.
    Journal Developmental Neuroscience

    Traumatic brain injury (TBI), one of the most frequent causes of neurologic and neurobehavioral morbidity in the pediatric population, can result in lifelong challenges not only for patients, but also for their families. Survivors of a brain injury experienced during childhood - when the brain is undergoing a period of rapid development - frequently experience unique challenges as the consequences of their injuries are overlaid on normal developmental changes. Experimental studies have significantly advanced our understanding of the mechanisms and underlying molecular underpinnings of the injury response and recovery process following a TBI in the developing brain. In this paper, normal and TBI-related alterations in growth, development and metabolism are comprehensively reviewed in the postweanling/juvenile age range in the rat (postnatal days 21-60). As part of this review, TBI-related changes in gene expression are presented, with a focus on the injury-induced alterations related to cerebral growth and metabolism, and discussed in the context of existing literature related to physiological and behavioral responses to experimental TBI. Increasing evidence from the existing literature and from our own gene microarray data indicates that molecular responses related to growth, development and metabolism may play a particularly important role in the injury response and the recovery trajectory following developmental TBI. While gene expression analysis shows many of these changes occur at the level of transcription, a comprehensive review of other studies suggests that the control of metabolic substrates may preferentially be regulated through changes in transporters and enzymatic activity. The interrelation between cellular metabolism and activity-dependent neuroplasticity shows great promise as an area for future study for an optimal translation of experimental data to clinical TBI, with the ultimate goal of guiding therapeutic interventions.

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