In 2013, after two years in practice at the regional level I trauma hospital, MetroHealth Medical Center, I joined the Center for Neurological Restoration at the Cleveland Clinic where I now focus on the neurosurgical management of movement disorders, pain, cranial vault reconstruction, spasticity and hydrocephalus in the adult.

In this role, I set the strategic direction for the IFR, establishing partnerships with key stakeholders within industry, foundations, and donors. The IFR works to establish favorable regulatory and reimbursement policies and practices for neuromodulation systems intended to address the needs of orphan markets.

These devices include deep brain stimulator systems, epidural spinal cord stimulators, intrathecal programmable pumps and ventricular shunts. My clinical practice has influenced my clinical research activities. I am studying how implantable neural devices and variations in surgical techniques influence outcomes. In our practice, we have established a model of care designed to improve and optimize outcomes through comprehensive patient evaluation. For example, adult patients with chronic hydrocephalus see a movement disorder neurologist, a neuropsychologist and frequently an expert in neurocognitive impairment.

This multidisciplinary approach has enabled us to tailor and update the care each patient receives as they age. I also currently serve as the Cleveland Clinic site PI for the Adult Hydrocephalus Clinical Research Network. I oversee the post-market analysis of a directional deep brain stimulation lead at the Cleveland Clinic and will be the PI for the forthcoming Placebo-Controlled Effectiveness in INPH Shunting (PENS) Trial. I am also involved in a collaborative effort to test the effect of intradural spinal cord stimulation in spasticity with the University of Iowa in addition to my role as a co-investigator in several other clinical trials based at the Cleveland Clinic main campus.

Publications (Select)

Entire publication list can be found here.

  • Angelov L, Mohammadi AM, Bennett EE, Abbassy M, Elson P, Chao ST, Montgomery JS, Habboub G, Vogelbaum MA, Suh JH, Murphy ES, Ahluwalia MS, Nagel SJ, Barnett GH. Impact of 2-staged stereotactic radiosurgery for treatment of brain metastases >/= 2 cm. J Neurosurg. 2018 Aug;129(2):366–382. doi: 10.3171/2017.3.JNS162532 Pubmed PMID: 28937324
  • Kwiecien GJ, Rueda S, Couto RA, Hashem A, Nagel S, Schwarz GS, Zins JE, Gastman BR. Long-term Outcomes of Cranioplasty: Titanium Mesh Is Not a Long-term Solution in High-risk Patients. Ann Plast Surg. 2018 Jul 27; doi: 10.1097/SAP.0000000000001559 Pubmed PMID: 30059381
  • Frizon LA, Hogue O, Achey R, Floden DP, Nagel S, Machado AG, Lobel DA. Quality of Life Improvement Following Deep Brain Parkinson’s Disease: Development of a Prognostic Model. Neurosurgery. 2018 Jul 12; doi: 10.1093/neuros/nyy287 Pubmed PMID: 30010975
  • Frizon LA, Nagel SJ, May FJ, Shao J, Maldonado-Naranjo AL, Fernandez HH, Machado AG. Outcomes following deep brain stimulation lead revision or reimplantation for Parkinson’s disease. J Neurosurg. 2018 Jun 22;1–6. doi: 10.3171/2018.1.JNS171660 Pubmed PMID: 29932378
  • Herring EZ, Frizon LA, Hogue O, Mejia JU, Rosenquist R, Bolash RB, Machado AG, Nagel SJ. Long-term Outcomes Using Intrathecal Drug Delivery Systems in Complex Regional Pain Syndrome. Pain Med. 2018 Jun 7; doi: 10.1093/pm/pny104 Pubmed PMID: 29889241
  • Xiong DD, Ye W, Xiao R, Miller JA, Mroz TE, Steinmetz MP, Nagel SJ, Machado AG. Patient-reported allergies predict postoperative outcomes and psychosomatic markers after spine surgery. Spine J. 2018 May 22; doi: 10.1016/j.spinee.2018.05.032 Pubmed PMID: 29800707
  • Shao J, Frizon L, Machado AG, McKee K, Bethoux F, Hartman J, Nagel SJOcclusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report. Anesth Pain Med. 2018 Apr;8(2):e65312. doi: 10.5812/aapm.65312 Pubmed PMID: 30027067
  • Xu J, Nault RJ, Maldonado-Naranjo A, Frizon LA, John K, Holman K, Nagel SJDisseminated cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia. J Clin Neurosci. 2018 Apr;50:127-128. doi: 10.1016/j.jocn.2018.01.057.  Epub 2018 Feb 7. PubMed PMID: 29428267.
  • Abbatemarco JR, Willis MA, Wilson RG, Nagel SJ, Machado AG, Bethoux FA. Case Series: Intrathecal Baclofen Therapy in Stiff Person Syndrome. Neuromodulation. 2018 Mar 13. doi: 10.1111/ner.12765.[Epub ahead of print] PubMed PMID: 29532593.
  • Achey RL, Yamamoto E, Sexton D, Hammer C, Lee BS, Butler RS, Thompson NR, Nagel SJ, Machado AG, Lobel DA. Prediction of depression and anxiety via patient-assessed tremor severity, not physician-reported motor symptom severity,  in patients with Parkinson’s disease or essential tremor who have undergone deep brain stimulation. J Neurosurg. 2018 Feb 23:1-10. doi: 10.3171/2017.8.JNS1733. [Epub ahead of print] PubMed PMID: 29473781.
  • Nagel SJ, Reddy CG, Frizon LA, Chardon MK, Holland M, Machado AG, Gillies GT, Howard MA 3rd, Wilson S. Spinal dura mater: biophysical characteristics relevant to medical device development. J Med Eng Technol. 2018 Feb;42(2):128-139. doi: 10.1080/03091902.2018.1435745. Epub 2018 Mar 23. PubMed PMID: 29569970.
  • Matias CM, Frizon LA, Nagel SJ, Lobel DA, Machado AG. Deep brain stimulation outcomes in patients implanted under general anesthesia with frame-based stereotaxy and intraoperative MRI. J Neurosurg. 2018 Jan 26:1-7. doi: 10.3171/2017.7.JNS171166. [Epub ahead of print] PubMed PMID: 29372880.
  • Lang M, Habboub G, Moore NZ, Recinos VMR, Mohammadi AM, Nagel S, Bhimraj A, Silva D, Recinos PF. Neuroendoscopic evacuation of intraventricular empyema using a side-cutting aspiration device. J Clin Neurosci. 2018 Jan;47:323-327. doi: 10.1016/j.jocn.2017.09.029. Epub 2017 Oct 21. PubMed PMID: 29066241.


Cleveland FES Center

Staff Physician, Neurological Surgery, Center for Neurological Restoration
Cleveland Clinic

Assistant Professor, Department of of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University


Program Contact
Sean Nagel

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