Craig,
Unfortunately, the best of the best will not necessarily be in your backyard and you will need to travel to be treated by the best. The anausa,org site does provide a list of physicians and facilities that meet their criteria that is categorized by physician's last name and state.
From my research I have found that if you opt for radiosurgery, then Dr Steven Chang at Stanford Medical Center in Palo Alto, CA is at the top of the list if CyberKnife (aka CK) is your treatment choice. The CyberKnife was invented at Stanford and they have done more CK treatments than anyone else worldwide. If you choose Gamma Knife, then the University of Pittsburgh Medical Center will be the top facility because that is where Gamma Knife was first utilized for treatment. If you opt for open surgery, then House in LA is the place to go. Closer to your neck of the woods, I understand Georgetown has an excellent facility.
Before you decide which way to go, it would be in your best interest to do a thorough research of each option, the advantages and disadvantages of each, and what potential side effects you are willing to accept. The anausa.org website will also give you a comprehensive description of each treatment option as well as what you can expect from each. Use the "Overview" pull down menu to find this. Other excellent sources of information are You Tube (Google acoustic neuroma, CyberKnife, Gamma Knife, etc) and you will be presented with a large list of videos by real AN patients detailing their experiences and the consequences of their treatment choice. The postings on this forum are also very informative and reading as many as you can will help you decide what road to follow on your AN journey. Especially read the signature box that most posters on this forum provides because it contains valuable information on what they went through. Some sites that helped me are:
http://www.myacoustic.org/http://www.youtube.com/watch?v=ZbS4K9ENMAghttp://stanfordhospital.org/clinicsmedServices/COE/cyberknife/Watch and wait will be another option you will come across. The most important thing to remember about that option is if you start to develop symptoms like hearing loss, you will not likely regain it even after treatment. AN treatment, whether it be open surgery or radiation, is weird because pretreatment symptoms usually remain despite being treated. Regrowth can also occur even after surgical removal as well as after radiation.
The most important thing to consider when choosing a neurosurgeon and treatment facility is experience, after all, this is brain surgery and it will be your brain that will be worked on so you don't want anyone with little expertise to treat you. You also want to consult with neurosurgeons who do not treat only one way (only radiation or only open surgery) because you will be given biased information. Your AN is classified as small so you have lots of time to do your research. It may be overwhelming at first but take your time and try not to be discouraged by the sheer amount of information you will encounter. Knowledge is power and the more you find out about ANs, the less intimidating your situation will be.
