Departments

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

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

We use radiation therapy to treat central nervous system (CNS) tumors, and to prevent or significantly delay their recurrence. CNS tumors include both low- and high-grade gliomas, meningiomas, ependymomas, germ cell tumors, and pituitary adenomas. All of our patients, both adult and pediatric, receive individualized consultations from a radiation oncologist. Our multidisciplinary team then employs a variety of state-of-the-art technologies to pinpoint, plan, and precisely deliver radiation therapy, based on each patient’s needs. We also work in collaboration with Yale Cancer Center’s Brain Tumor Program. Our Stereotactic Radiosurgery/Gamma Knife programat the YaleGamma Knife Center is the only radiosurgery unit in Connecticut dedicated to the treatment of head and neck conditions.A technique discovered more than 50 years ago, stereotactic radiosurgery remains the most accurate way to use radiation to destroy tumors in and around the brain. In our Spine Radiosurgery Program, our goal is to provide long-lasting control of pain and local disease for patients with spinal metastases. We treat patients using radiotherapy, a noninvasive, painless technique that delivers high doses of radiation to destroy tumors within or near the spine.

The Yale Pediatric Neuro-Oncology Program provides advanced care for children, adolescents, and young adults with brain tumors. Our multidisciplinary clinic brings together a team of experts to offer the latest treatments and support for both patients and their families. Our team includes specialists in pediatric oncology, neurosurgery, neurology, endocrinology, and radiation oncology who work alongside experienced psychosocial practitioners to provide truly multidisciplinary care. We ensure that your child receives a comprehensive approach to their medical needs and overall well-being. With clinic locations in New Haven, Trumbull, and Greenwich, we offer accessible care to families across the state. We are committed to supporting your child throughout the entire treatment process, from diagnosis to recovery. We use the latest research and clinical trials to provide the most advanced treatments available. Our on-site labs and “bench to bedside“ approach mean your child can access cutting-edge therapies in state-of-the-art facilities. The Yale Pediatric Neuro-Oncology Program is proud to serve families from New England and the surrounding areas. Our focus is on your child's health and happiness, helping them thrive during and after their treatment.

The Pituitary Program is a destination center for the clinical management of pituitary, parasellar, and anterior skull base disease delivering state-of-the-art, multidisciplinary care. It is the referral center for the state of Connecticut for treatment of complex pituitary and sellar-parasellar pathology using the expertise of minimally invasive endoscopic skull base surgery jointly performed by neurosurgery and ENT. Patient cases are reviewed by a multidisciplinary pituitary tumor board, with intraoperative hormone monitoring, intraoperative MRI, and whole exome sequencing of tumors for potential genomic-based diagnosis and treatment. The Yale endocrinology team and other supporting subspecialties follow each patient during the hospitalization for uninterrupted endocrine care. We aim to maximize the quality of care and the ultimate outcome of each patient. To ensure the best care possible, we co-manage the pituitary disorder with each patient’s primary care physician, and actively seek second opinions, exploring dynamic testing and pituitary hormone replacement therapy options. Yale New Haven Hospital is a regional center for pituitary surgery, and our physicians have specific expertise in treating a variety of neuroendocrine diseases, including Cushing's disease and adult growth hormone deficiency syndrome. We also evaluate and treat reproductive disorders in collaboration with the sections of Reproductive Endocrinology and Infertility. Additionally, we work closely with colleagues in neurosurgery, surgical endocrinology, therapeutic radiology, and other departments to make sure patients benefit from our patient-centered, team-based approach. Combined with first-rate technology at Yale New Haven Hospital, the Yale Cancer Center and the Department of Neurosurgery’s Gamma Knife Center, the Pituitary Program is uniquely positioned to offer every diagnostic and treatment option available, including: Dynamic pituitary magnetic resonance imaging (MRI), an enhanced diagnostic imaging technique Inferior petrosal sinus sampling to sample hormones from the veins that drain the pituitary gland 3-D conformal radiotherapy to better target tumors Intensity-modulated radiation therapy, an advanced high-precision technique Transphenoidal surgery performed through the nose and sphenoid sinus Gamma Knife surgery (stereotactic radiosurgery) performed at the Gamma Knife Center, the only dedicated Gamma Knife facility in Connecticut. At Yale New Haven Children's Hospital, our longstanding pediatric endocrinology clinic provides the same services and excellence of care that adults receive.

From consultations with parents-to-be, to follow-up appointments with young adult patients, our pediatric neurosurgery specialists offer the most advanced medical care available, along with compassionate understanding and support for patients with pediatric neurosurgical conditions. Our reputation for surgical excellence combined with our understanding of the special needs of children and families who live with neurological diseases rank us among the finest Pediatric Neurosurgery sections in the country. In addition, the Yale New Haven Children's Hospital is the only hospital in the state to have a dedicated Pediatric Intensive Care Unit (PICU), providing the highest level of care to children with neurological conditions. We provide comprehensive services to infants, toddlers, school-age children, adolescents, and young adults for common problems including: Hydrocephalus Brain and spinal cord tumors Spina bifida Craniofacial disorders (i.e., craniosynostosis) Brain or spine trauma Our pediatric neurosurgeons work closely with each other, as well as with an interdisciplinary team that includes orthopaedists, urologists, neurologists, radiation oncologists, neuropathologists, adult neurosurgeons, physical therapists, occupational therapists, and social workers. Our full-time pediatric advanced practice nurse participates in all aspects of the child’s care and carefully coordinates evaluation and treatment appointments to make the process as convenient and timely as possible. Our operating facilities are designed for children, and our nursing units are arranged by age. Often, a family’s first contact with us takes place when they learn their unborn baby has a congenital abnormality of the central nervous system such as hydrocephalus or spina bifida. We provide counseling for these parents to help them understand how these conditions might affect the lives of children and their family members. Yale pediatric neurosurgeons were pioneers in the use of endoscopes (tiny fiber optic cameras) to treat hydrocephalus surgically, making it possible to bypass the obstruction and restore normal fluid flow. The procedure, called endoscopic third ventriculostomy, is a safe and effective treatment option. Our pediatric neurosurgeons also team with plastic surgeons to treat craniosynostosis, which affects the shape of the head. We re-contour the bones of the skull and re-secure them in such a way that symmetrical growth can occur. For brain tumors, we offer such specialized treatments as stereotactic radiosurgery (Gamma Knife surgery). We also offer electrocorticography and cortical mapping. These are techniques to identify areas of the brain that are critical to movement, feeling, memory, and speech so surgeons can remove as much of the tumor as possible without disturbing critical areas of the brain.