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)

Yale neurointerventional radiologists are specialists who perform and interpret brain scans, and help guide endovascular neurosurgical procedures. Using only the highest-quality magnetic resonance and CT scanners, our doctors have both the expertise and advanced technology needed to quickly and accurately diagnose and treat conditions—both common and rare—that affect the brain.

The Yale Medicine Interventional Radiology (IR) program is one of the leading programs in the nation. Our interventional radiologists, recognized as pioneers in the field of minimally invasive medicine, work with nursing and technologist staff to offer image-guided, non-surgical treatments for vascular and non-vascular disease with excellent outcomes for pediatric and adult patients. Our interventional radiology procedures are performed for a broad range of conditions spanning gastrointestinal/hepatobiliary, gynecology, infectious disease, oncology , pediatrics, pain management, urology, and venous and arterial disease. Interventional radiologists use advanced imaging modalities including ultrasound, fluoroscopy, computed tomography, and magnetic resonance imaging to perform procedures through tiny pinholes, thereby avoiding surgery and long recovery times. IR advances enable minimally invasive treatment of many conditions on an outpatient basis, allowing patients to recover in the comfort of their own home. We also offer comprehensive care dedicated to the treatment of pediatric patients, including vascular malformations, biopsy service with sedation, feeding tube maintenance, and expert care in hepatobiliary, urological, gastrointestinal, and musculoskeletal disorders. Our team at Yale New Haven Hospital was the first in Connecticut and among the first in the nation to perform transcatheter pulmonary embolectomy, a procedure for the removal of a blood clot from the pulmonary arteries. Such patients are initially evaluated by a multidisciplinary Pulmonary Embolism Response Team (PERT) , and a comprehensive treatment plan is then developed. We also have one of the world’s leading hereditary hemorrhagic telangiectasia (HHT) and vascular malformation programs. Founded in 1994, both serve as role models for other programs around the world. We offer a wide range of minimally invasive Interventional Radiology treatments, all available at Yale New Haven Hospital. Heart and vascular Angiography, angioplasty, and stenting for arterial disease Embolization for acute, traumatic gastrointestinal and genitourinary bleeding Endovascular treatment of aneurysms and pseudoaneurysms Inferior vena cava filter placement and removal Non-surgical dialysis fistula creation and repair Pulmonary embolectomy to remove pulmonary embolism (blood clot in the lungs) Treatment of arteriovenous malformations Venography, venous stenting, and related procedures for venous occlusion and clot Venous ablation for varicose veins Gastrointestinal/Hepatobiliary Gastrojejunostomy placement and gastrostomy for nutrition Transjugular intrahepatic portosystemic shunt (TIPS) placement for upper GI bleeding and refractory ascites Treatment of benign and malignant bile duct obstructions Treatment of fluid collections in the abdomen, chest, and pelvis Gynecology Fallopian tube recanalization for infertility Uterine fibroid embolization for fibroids and uterine artery embolization fo

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

Our neurosurgeons provide excellence in general neurosurgery care. While some conditions require a subspecialized neurosurgeon, others actually benefit from a more general approach to managing disease. As a result, patients can receive care closer to home and in a community setting. A dedicated neurovascular surgeon is on call and ready to mobilize a team at a moment’s notice—24 hours a day, 7 days a week. In addition to providing emergency treatments for conditions such as acute stroke and brain bleeds, we are readily available for elective treatments for aneurysms and other vascular lesions that are discovered incidentally. We streamline access to emergency neurovascular care for referring physicians, guaranteeing patients will receive the timeliest and best care anywhere. Our state-of-the-art VISIUS Surgical Theater is equipped with a powerful MRI that provides highly detailed images, and an integrated, bi-plane X-ray angiography system that allows our experts to better visualize arteries and vessels. The ability for a patient to receive preoperative diagnostic imaging, open microsurgery, percutaneous, catheter-based endovascular treatments, and post-operative checks all in the same room, while remaining in one place, is unique in the tri-state area and a model system in North America and the world. This advanced technology makes it possible to tackle the most complex neurovascular conditions with the highest degree of safety.

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

With the latest microsurgical and endovascular technologies, we offer unparalleled treatment to patients with all types of neurovascular disease affecting blood vessels in the brain and spinal cord. This includes aneurysms, vascular malformations, and artery and venous stenosis, or blockages. Our cutting-edge research also allows for more refined, personalized medicine. Our expert clinicians specialize in managing all types of brain, neck, and spinal cord vascular disorders. Our therapeutic treatment strategies include: Open microsurgery Less invasive endovascular (interventional) treatment Stereotactic radiation (Gamma Knife radiosurgery) Rehabilitation

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.

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.

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.