Departments
Pediatric Neurosurgery
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.Yale Pediatric Spine Program
The Yale Pediatric Spine program treats children with spinal conditions using the highest level of expertise and care. Because we understand that navigating the treatment options for a child’s spinal condition can be a difficult experience, we focus on bringing our providers together as a team dedicated to delivering cohesive, expert care. The spine team includes anesthesiologists, nurses, advanced practice providers, physical therapists, child life specialists, and fellowship-trained neurosurgeons and orthopaedic surgeons who are experienced in treating the most complex spinal conditions using up-to-date and evidence-based techniques to provide outcomes of the highest quality and value. Our providers tailor spinal deformity treatments to each patient according to their needs. We offer several treatment options, including physical therapy, bracing, growth-friendly solutions for early onset scoliosis, halo gravity traction for complex deformities, and newer fusionless techniques for appropriately selected patients. Nonoperative strategies are almost always utilized as initial treatment, but if surgical care becomes necessary, our team and program provide the technical expertise and rapid surgical recovery pathways to ensure the smoothest recovery possible.Normal Pressure Hydrocephalus Program
The Yale Neurosurgery Normal Pressure Hydrocephalus (NPH) Program is the busiest NPH program in Connecticut and one of the busiest in the region and the nation. Our highly specialized team consists of dedicated physicians, nurses, nurse practitioners, physical therapists, and occupational therapists who care for patients with NPH and are well versed in its presentation, progression, and treatment. NPH is a condition characterized by the buildup of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. It is a condition of “too much water in the brain.” It is not fully understood why this happens, but when this fluid or “water” builds up in the brain, the patient can develop trouble walking, difficulty controlling urine, and have mild memory loss or impairment. Roughly over 700,000 Americans have NPH, although less than 20% are appropriately diagnosed. Diagnosis requires a systematic approach. At Yale, our specialists most often use a 3-day inpatient trial of lumbar drain trial to help determine if symptoms respond to removing the extra fluid in the brain. In addition, while patients are receiving inpatient care, they are evaluated by physical and occupational therapists. If a patient demonstrates improvement we then recommend placement of a permanent drain or shunt, which is most often performed on the same admission. At Yale Neurosurgery we are committed to providing the best care for individuals who have or are suspected of having NPH. We work with patients, their families, and other caregivers to understand the impact the symptoms are having on their life. We look forward to caring for our patients and their family members.Pituitary Program
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.Spine Surgery
Millions of people suffer from the broad range of diseases that can affect the spine. Debilitating pain and impaired function often keep people from working and enjoying normal lives. While spinal conditions and injuries, particularly neck and back pain, are quite common, they can be among the most complex and difficult ailments to treat. This is especially true with patients who have had little improvement with prior spinal surgery or failed medical treatments for such diseases as scoliosis or degenerative disk disease. Our experienced team of highly-skilled neurosurgeons and staff work together to provide the best care possible. Whether the pain is acute or chronic, we are committed to understanding the problem and will work with each patient to determine the best way to treat it. Patients travel from across the Northeast to have our experts treat problems, including spinal cord and nerve compression, spinal deformities, spinal tumors, neck and back pain, and sciatica. Our focus is on helping patients overcome their disability, rather than performing surgery or providing physical therapy. We provide comprehensive diagnostic services for patients whose conditions have not been definitively identified, as well as for those who had unsuccessful treatments, including previous surgeries. Because we are a major referral center for neurosurgical problems of all types and levels of complexity, our patients benefit from our collaborative, interdisciplinary environment that enhances opportunities for advancing care. Our services include: Minimally invasive surgery:Advanced, one-day surgical procedures, including vertebroplasty and disk electrocauterization, are available for appropriate candidates. Vertebroplasty relieves pain among some osteoporosis sufferers with collapsed vertebrae. Surgical bone cement is injected into the affected areas bolstering bone growth. Disk electrocauterization involves the use of a needle to shrink disks by burning them. Complex surgery:Our Spine Center specializes in this type of surgery, which is reserved for cases in which all other treatment options have been considered. Our surgeons can perform spinal reconstructions for severely deteriorated spines or repair damage from trauma or prior surgeries. Cutting-edge techniques, such as discography, make it possible to track electrical activity within the spine with exceptional precision to localize the site of injuries. Support services:Yale New Haven Hospital is a Level I trauma center, fully equipped to handle complex spinal cord injuries. Spine patients who undergo surgery benefit from specially equipped surgical suites. They will recover in the hospital’s Neurosurgical Intensive Care Unit (NICU), the only specialized unit of its kind in the region, staffed with experienced neurocritical care nurses. Our team continuously challenges current practice to ensure our programs reflect the most advanced treatment options delivered in a way that enhances the health and comfort oNeurosurgery
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)Brain Tumor Surgery
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 advanceCraniofacial Program
We provide coordinated management and comprehensive care for children with complex tumors, and congenital, traumatic, and vascular anomalies of the head and neck. We understand that living with a craniofacial defect can present children with challenges. We want to help each child meet and overcome those challenges by exploring what his or her condition means in day-to-day life. Our team includes plastic and reconstructive surgeons, pediatric craniofacial nurse practitioners, and care coordinators who work together to address each child’s needs in managing his or her craniofacial condition. We collaborate with primary care providers and a comprehensive range of multidisciplinary specialists to optimize the child’s health and provide parents with a comprehensive network for all of their child’s care.Pediatric Orthopaedics
We provide a comprehensive, multidisciplinary approach to managing the orthopaedic needs of children and teens, while at the same time attending to their social, emotional, and developmental needs. Ours is one of only two such programs in Connecticut. From diagnosis and treatment, to surgery and follow-up care, our team works with other pediatric specialty clinics to care for young patients with a wide spectrum of orthopaedic conditions, including: Bone deformity Cerebral palsy and other neuromuscular conditions Conditions specific to female athletes Disorders of the hip, including hip dysplasia Fractures, dislocations, and other musculoskeletal injuries Hand and arm disorders Femur fracture Foot and ankle disorders, including clubfoot Leg length discrepancy Scoliosis Overuse and traumatic injuries in the growing athlete Skeletal dysplasia3-D Patient-Specific Surgical Correction Program
The orthopaedic surgery team is dedicated to improving function in patients of all ages who have been injured, developed a problem such as arthritis, or who were born with a bone or joint problem. Although there are standard ways of treating some of these problems, our team can more precisely address many orthopaedic issues with the use of 3-D modeling and virtual surgical planning using 3-D printed, patient-specific surgical guides. To find out more about this program, please fill out a brief survey . We have orthopaedic surgical specialists who are currently using 3-D technology to correct spinal deformity, post-traumatic mal-unions of long bones, congenital upper and lower limb deformities, complex joint replacement surgery (for hips, knees, shoulders, and elbows) and mal-alignment of joints and bones. We work closely with engineers, radiologists, and cutting-edge medical companies who assist in deploying this technology for our patients. Patients that have complex orthopaedic problems are evaluated by our specialists. If the problem is amenable to treatment with custom 3-D surgical correction techniques, a specialized high-resolution CT or MRI scan is obtained focusing on just the injured side (if only bone models are needed) or of the injured and non-injured analogous body part if virtual surgical planning and intra-operative patient specific guides are necessary. Using the data in the CT or MRI scan, a unique 3-D model is built on the computer using specialized image processing software. The 3-D models are then used to study the deformity/injury in detail prior to the actual surgery. The planning is completed with the surgeon and biomedical engineer working together to manipulate the images on a computer to plan the necessary cuts or bone excision to correct the deformity. Surgeons are able to make certain that the bones are corrected and straight, joints can bend and extend, and muscles and nerves are properly positioned. Patient specific guides are then printed in 3-D for use in the operating room during surgery, so that the virtual model can be replicated in the surgery for precise correction of each patient’s problem. These techniques have been shown to decrease surgical time and blood loss, as well as provide a more precise correction of the problem.Fetal Care Center
The Fetal Care Center brings together a team of leading experts in maternal-fetal medicine , neonatology , genetics , pediatric surgery , and an array of other top-ranked pediatric specialties. This network of excellence from throughout our health system comes together to provide an elite level of care. Together, a comprehensive care plan is devised for pregnant patients and their developing babies who require specialized medical and surgical care while in the womb or expected interventions after birth. Our expert physicians and surgeons have ensured successful births for thousands of babies who needed specialized care. As leaders in complex in-utero surgery, we are proud to be the first in Connecticut and the region to perform in utero myelomeningocele repair. Myelomeningocele is a condition in which the baby’s backbone and spinal canal do not close before birth. The condition, a type of spina bifida , is a congenital defect of the spine and spinal cord. The surgery is performed before the baby is born (prior to 26 weeks gestation) as this provides the best outcomes. Provided world-class fetal therapy services at Yale New Haven Health for more than 40 years Pioneered the nation’s first Neonatal Intensive Care Unit at Yale New Haven Health Yale New Haven Health is one of only a few hospitals in the country to offer couplet care, where mothers and their babies are cared for together in the same room Many procedures available to women with high-risk pregnancies were first developed at Yale School of Medicine’s Department of Obstetrics, Gynecology and Reproductive Sciences , including noninvasive fetal anemia assessment, percutaneous umbilical blood sampling (PUBS), in utero fetal blood transfusion, and therapies such as fetoscopy and fetal surgery Physicians are leading researchers in the field of fetal medicine A fetal therapy coordinator is available to help patients through the process. The coordinator is there throughout the patient’s care journey, from pregnancy through delivery, and often beyond. They guide patients through testing, meeting with specialists, scheduling appointments, and coordinating the elements of the care plan based on the patient’s needs. For more information or to request an appointment, please call 855-433-8252 , or submit a Fetal Care Center Information Request . Someone is available to answer your call from Monday through Friday, 8am – 4:30pm. Read our list of frequently asked questions about the Fetal Care Center . Here are some of the common conditions we treat at the Fetal Care Center: Cleft lip/palate Congenital heart defects Fetal anemias Gastroschisis Hydrocephalus Intra-abdominal masses Spina Bifida Twin-to-twin transfusion syndrome View the full list of conditions . Advanced Prenatal Genetic Testing and Counseling Genetic counseling and prenatal testing are among the most valuable tools to help prospective parents make important decisions regarding a current or future pregnancy. Many thingsPediatric Surgery
Pediatric surgeons dedicate their practice to treating children ranging from the neonatal stage through late adolescence. The medical needs of a child differ from those of an adult, requiring pediatric surgeons to have additional education and advanced training. Our pediatric surgeons are recognized as experts in a broad range of specialties, including minimally invasive surgery, pediatric surgical oncology, fetal diagnosis, and treatment of congenital birth defects, pediatric trauma, and surgical procedures for intestinal failure. Through the most current and state-of-the-art surgical techniques, we help treat each child’s condition so he or she can focus on being a kid.Our team has expertise in the latest surgical technologies and the most delicate surgical situations, including neonatal surgery and ECMO (heart and lung bypass for severely ill infants). Our surgeons use advanced, minimally invasive surgical techniques wherever possible to help secure outpatient surgeries or shorter hospital stays, and less postoperative discomfort for the child. All of our team members have extensive experience in working with children, and take extra measures to ensure that each child feels safe and comfortable. Specialized care is offered in the following areas: Mechanical cardiac assist device program Newborn surgery, including repair of severe newborn congenital malformations of the airway, respiratory, gastrointestinal, and genital tracts Operations for inguinal hernias, hydroceles, correction of undescended testicles, and other groin problems Pediatric abdominal surgery Pediatric heart transplant Pediatric thoracic surgery Surgical management of complex solid tumors Thoracoscopic and laparoscopic treatment of such conditions as abdominal and thoracic tumors, congenital lung masses, intestinal atresia, and trachea-esophageal fistula The first pediatric Level I trauma center in Connecticut at Yale New Haven Hospital Six conveniently located outpatient pediatric centers across the state where patients can be evaluated by a pediatric surgeon International recognition for new ways to reduce anxiety and pain in children who need surgery