Departments

We are dedicated to excellence in patient care through the study of the cognitive and behavioral changes that can result from medical and brain injuries. We are experts in identifying a patient’s pattern of cognitive and emotional functioning and how this relates to expected brain function. A neuropsychological evaluation combines tests of cognition, behavior, and emotional functioning. This comprehensive evaluation will help to determine whether cognitive changes are related to symptoms of a medical or neurological illness, a psychological condition, or a normal part of aging. This evaluation is also part of the gold-standard workup for neurosurgery candidates. We provide neuropsychological evaluations for a wide array of medical and neurological disorders, as well as neurosurgery-specific candidacy evaluations. In addition, our bilingual neuropsychologists are able to provide evaluations in Spanish. We have expertise in the following areas. Epilepsy Memory disorders & dementia Multiple Sclerosis Oncology Parkinson’s disease Stroke Traumatic brain injury What to expect at your appointment A neuropsychological evaluation consists of an interview and testing, and lasts approximately three to six hours. During the interview, you will be asked about your cognitive and emotional symptoms, health history and medications, and other important background information. Neuropsychological Testing : Cognitive testing is designed to assess domains of thinking including attention, processing speed, memory, language, visual spatial abilities, and problem solving. Tests include paper-and-pencil as well as computerized methods. Emotional functioning is evaluated during the clinical interview and supplemented with self-report measures. We often request information from a close relation (family member or caregiver) about the individual’s functioning in daily life. The results from testing will aid your providers in diagnosis, treatment planning, and recommendations to improve your overall well-being. The neuropsychological evaluation typically includes administration of standardized tests to determine cognitive functioning in the following areas: General/baseline intellectual ability Attention Processing speed Visuospatial abilities Language Memory Executive functioning (problem solving) Motor skills Behavioral and emotional functioning What to bring to your appointment We are very attentive to our patients’ needs. We work with each patient so that they feel as comfortable as possible. We encourage patents to get a good night’s sleep and eat a good breakfast before the appointment. Please bring the following: Glasses and hearing aids Water and a small snack, if needed Reports from any prior neuropsychological testing previously completed A family member, friend, or caregiver so they can provide insights into your abilities Please call us at 203-785-4085 if you have any questions about your appointment.

At the Yale New Haven Stroke Center, we offer safe, effective, patient-centered, timely, efficient, and equitable care to patients with strokes. In collaboration with the hospital’s emergency medical service and emergency department teams, we deliver rapid diagnosis and treatment of acute stroke 24 hours each day. Our center is a Joint Commission Primary Stroke Center, a national recognition of our expertise in providing the highest level of care to stroke patients. From prevention to treatment to recovery, we have the most experienced doctors and the latest diagnostic tools, techniques, and treatments. Our patients receive rapid access to treatment by a highly experienced team that includes experts in vascular neurology, endovascular surgical neuroradiology, neurovascular surgery, neurocritical care, physical medicine and rehabilitation, emergency medicine, and other medical subspecialties. Our multidisciplinary team works together to diagnose and determine the most appropriate treatment for our patients. Timely, effective treatment can make a significant difference in quality of life following recovery. We follow best practices to try to preserve brain function and prevent serious injury. Our services include: Dedicated neuro-intensive care unit Stroke consult service with a patient- and family-centered approach to the treatment and rehabilitation of patients with cerebrovascular disease. Specialized stroke clinics for community physician referrals, stroke consults, and for primary and secondary stroke prevention.

The Yale Neurotrauma section was started in July 2019 to deliver the best care possible to patients with traumatic brain and spinal cord injuries. Our team oversees each patient’s care from the moment of injury to outpatient follow-up. This longitudinal care is critical, especially for our patients who need long-term management plans. We also conduct cutting-edge research into the molecular basis of traumatic and spinal cord injuries to develop better techniques for diagnosing and treating these conditions. We work with state and national community outreach programs and partner with the Yale Neurocritical Care program and the Yale Trauma Surgery Program to provide comprehensive and compassionate care to all of our patients.

We cover all of the components critical to successfully managing patients with brain tumors. This includes comprehensive evaluation and diagnosis, genomic profiling of the tumor, leading-edge treatment options, follow-up, and psychosocial support. We welcome newly diagnosed patients as well as those who have already received extensive treatment elsewhere, along with patients in need of second surgeries or follow-up biopsies. We work closely with other Yale Medicine brain tumor doctors to provide a comprehensive, multidisciplinary approach that is patient-focused. Using advanced microsurgical techniques, including intraoperative neurophysiological monitoring and awake craniotomy (when appropriate), our brain tumor surgeons strive to achieve the maximum extent of tumor removal while preserving neurological function. Often, what is often deemed "inoperable" by some surgeons is considered operable at Yale with successful outcomes. We are the only hospital in the region to have MRI and angiography capabilities in our operating room. Yale New Haven Hospital also banks all tumor samples and performs genomic profiling to better understand tumor mutations. We use this information to help direct postsurgical therapy. Our state-of-the-art neurosurgical operating rooms in Smilow Cancer Hospital are the only in the regionto offer intraoperative MRI, intraoperative angiography, stereotactic surgical guidance, and operative brain mapping to precisely pinpoint brain tumors during surgery.These technologies, combined with our surgical expertise allow for the best in surgical care for patients. A team of experts dedicated to caring for patients with brain tumors, including specialized brain tumor surgeons, radiation oncologists, neuroradiologists, medical neuro-oncologists, neuropathologists, and other specialists meets weekly to arrive at the most advanced and appropriate treatment plan for each individual. Yale is one of the few centers capable of offering even more personalized and precise oncologic care, when appropriate, based on the genetic makeup of the individual’s tumor. Inquiries from referring physicians or directly from patients or their families are welcome. All inquiries are handled expeditiously by our team of experienced patient coordinators. Their role includes ensuring that appropriate appointments are made in a timely fashion, and coordinating with the various medical specialists involved in each treatment plan. New patients with brain tumors are usually seen within two or three days. Our patient coordinators also act as patient advocates, communicating with the various medical specialists contributing to the treatment plan. Through Yale’s strong tradition of and commitment to research, practitioners are well acquainted with the most advanced treatment methods and have access to clinical trials. Patients also benefit from the specialized resources at Smilow Cancer Hospital and Yale New Haven Hospital, such as an advance

Sport-related concussion is a frequent injury in athletes of all ages. Although important steps have been taken to improve sports safety and reduce the incidence of concussion, there are still over 1 million sport-related concussions per year in youth athletes in the United States. The Sports Medicine specialists at Yale Medicine Orthopaedics & Rehabilitation are dedicated to providing the highest quality treatment of all athletic injuries, and helping youth athletes recover and safely return to their sports. To find out more about this program, please fill out a brief survey . Our multidisciplinary team includes a dedicated and compassionate group of concussion specialists including Sports Medicine physicians, pediatric neurosurgery providers, physical therapists with special expertise in concussion and vestibular treatment, nurses, and social workers to address all the components of an athlete’s well-being after a diagnosis of concussion. In addition, our patients benefit from access to the expert providers in pediatric neurology, neuropsychology, and behavioral health at Yale New Haven Children’s Hospital and Yale Medicine. Our patients benefit from a comprehensive initial visit, which includes a review of their history and a thorough concussion examination, including all domains of concussion symptoms and signs. Our doctors and physical therapists help our patients and their parents to understand their symptoms and outline steps for recovery based on the latest evidence and best clinical practices, tailoring treatments to each patient’s set of symptoms. If any musculoskeletal injuries occurred at the same time as a concussion, our Sports Medicine specialists are also experts in the diagnosis and treatment of athletic injuries and joint pain. Often, follow-up doctor visits can be done via telemedicine, which is convenient for patients and their parents. If a specific need arises, patients with sport-related concussion may benefit from consultation with another expert Yale clinician to discuss headaches, sleep disturbances, mood symptoms including anxiety and depression, cognitive symptoms affecting school performance, visual symptoms, or concerns about the long-term risks of concussions. Our Sports Medicine specialists work with patients’ schools and athletic trainers to facilitate their returning to the learning environment and to physical activities in a gradual and supervised progression.

For patients at other Connecticut hospitals who present with acute stroke symptoms, our Stroke Telemedicine Program allows local providers to consult with our neurologists via video- and image-sharing technology. Within minutes of making an initial call to the Stroke Telemedicine Program, the on-call neurologist can examine a patient at the remote hospital to help diagnose and make recommendations for treatment. Yale New Haven Hospital is the only hospital in Connecticut to offer stroke telemedicine services. Some patients who present with the opportunity for treatment with IV tPA may be transferred to Yale New Haven Hospital. tPA is the only FDA-approved treatment for strokes caused by blocked blood vessels, which account for the vast majority of them. Stroke telemedicine programs throughout the country have demonstrated that telemedicine conferencing between outlying hospitals and trained stroke neurologists can improve outcomes for stroke patients, enhancing the use of tPA at hospitals that do not have on-site neurologists 24/7.

At Yale Medicine Neurosurgery, we care for adults and children with neurological disorders of the central and peripheral nervous system. These types of conditions affect the brain, spinal cord, and nerves which send messages from brain to the rest of your body. Our team is comprised of highly trained surgeons, researchers, and clinicians who are all focused on delivering expert care for conditions related to the brain and spine. Each neurosurgeon on our team has extensive training in their respective areas of neurosurgery. Conditions we treat include: All types of primary brain tumors, including gliomas, glioblastomas, and meningiomas Brain and spine trauma Cerebrospinal fluid disorders (such as normal pressure hydrocephalus) Epilepsy Metastatic brain, spine, and spinal cord tumors Movement disorders (including Parkinson's disease and tremors) Neurovascular disease (aneurysms, arteriovenous malformations, ischemic and hemorrhagic stroke, and carotid artery stenosis) Pain disorders (such as trigeminal neuralgia) Pediatric and congenital disorders (including hydrocephalus, craniosynostosis, spina bifida, and congenital spine deformities Peripheral nerve syndromes (such as carpal tunnel syndrome) Pituitary tumors (adenomas) Spasticity (including multiple sclerosis) Spinal disorders (such as herniated disks, stenosis, and scoliosis)

The Chênevert Family Brain Tumor Center at Smilow Cancer Hospital and Yale Cancer Center is an internationally recognized leader in comprehensive and multidisciplinary clinical care, and a hub of excellence for brain tumor research. Our team of specialists is dedicated exclusively to the care of patients with all types of brain tumors, and has extensive experience with: Primary brain tumors, such as glioblastomas, astrocytomas, oligodendrogliomas, primary CNS lymphomas, and others Brain metastases and leptomeningeal metastases, which originate from other cancers in the body Other primary tumors, such as meningiomas and schwannomas Rare brain tumors including craniopharyngiomas, medulloblastomas, ependymomas pineal tumors, pituitary tumors, and others All types of neurological complications of cancer and their treatments Our expertise covers all critical components for successful care for patients with brain tumors, from comprehensive diagnostic evaluation and state-of-the-art genomic tumor profiling, to innovative treatment options and cutting-edge clinical trials. We treat all patients, whether they are newly diagnosed or have already received extensive treatment. Our expert physicians are readily available to offer second opinions for patients from all over the country, and rapidly accommodate our patients for prompt evaluation and initiation of care. We also offer an extensive program to improve patients’ quality of life before, during, and after treatment, including psychosocial support, rehabilitation for memory impairment, and other resources. Diagnosis Our experts use state-of-the-art technology to diagnose brain tumors with detailed accuracy. Three Tesla MRIs offer highly sophisticated testing, such as functional MRI, MR spectroscopy, and positron emission tomography (PET). Experienced neuroradiologists read all brain scans and evaluate the images for diagnosis. Importantly, all brain tumors that are biopsied or removed at our program undergo whole exome sequencing, the most advanced technique available for tumor characterization, which can target the vulnerabilities of individual tumors. Medical Oncology Many brain tumors require chemotherapy, targeted therapies, or other medical treatments, often combined with radiation therapy and surgery. Our team of neuro-oncologists have extensive expertise in delivering oncology treatments, with a focus on achieving optimal efficacy and safety. Each patient receives an individualized and coordinated treatment plan, taking into consideration the tumor type, molecular and genomic information on the tumor, and the patient’s own needs and choices. Additionally, our patients have access to cutting-edge Yale clinical trials exploring multiple novel strategies to fight brain cancer. Radiation Oncology Established in 1958 as one of the first Radiation Oncology departments in the country, the Yale Department of Therapeutic Radiology has played a foundational role in the national development of