Find A Physician
Return to Stroke and Cerebrovascular Disease Overview
More on Stroke and Cerebrovascular Disease
Hospital News
Return to Stroke and Cerebrovascular Disease Overview
More on Stroke and Cerebrovascular Disease
Research and Clinical Trials
Return to Stroke and Cerebrovascular Disease Overview
More on Stroke and Cerebrovascular Disease
Health Library
Return to Stroke and Cerebrovascular Disease Overview
More on Stroke and Cerebrovascular Disease
Clinical Services
Return to Stroke and Cerebrovascular Disease Overview
More on Stroke and Cerebrovascular Disease
Stroke and Cerebrovascular Disease
Stroke is caused by a blockage, usually a blood clot, in the brain's blood vessels.
NewYork-Presbyterian Hospital is one of the major centers nationally for endovascular treatment of congenital and acquired cerebrovascular diseases. Our excellence rests on the dedication and expertise of our physicians, as well as the extensive state of the art medical technology available at the Hospital.
Diagnostic Innovation
NewYork-Presbyterian Hospital's Cerebrovascular Disease Centers work in conjunction with the Hospital's Neurological Intensive Care Units (NICU) to provide highly specialized treatment for patients who are hospitalized as a result of a sudden cerebrovascular event. After such an emergency, outcome may depend solely on the resources, monitoring, and action taken in the first 24 to 72 hours. NewYork-Presbyterian Hospital has the only multidisciplinary, academic, neurocritical care facilities in the greater New York area. Our NICU offers the most advanced diagnostic technologies, including brain mapping and imaging modalities, which give greater detail of the brain's functional status and allow surgeons to direct treatment to a specific area of the brain.
Therapeutic Excellence
The Cerebrovascular Disease Centers of NewYork-Presbyterian Hospital are among the largest and busiest centers in the country. With the access to the latest devices, we have a long history of innovations in diagnosis and treatment of stroke and cerebrovascular disease. Our multidisciplinary team of neurologists, neurosurgeons, neuropsychologists and interventional neuroradiologists treats a broad range of diseases, including stroke and transient ischemic attacks (TIAs), arteriovenous malformations (AVMs), and aneurysms.
The NewYork-Presbyterian Cerebrovascular Disease Centers offer an endovascular approach to the treatment of aneurysms, AVMs, and blocked carotid arteries that may lead to stroke. This minimally invasive technique involves inserting a thin, flexible catheter into a leg artery, and under X-ray guidance, moving it through the body to the area in need of treatment. With the catheter in place, our team of neuro-interventionalists can employ the most advanced methods of treating AVMs, aneurysms, and other conditions that may lead to stroke or neurological damage.
Treatments for stroke have been constrained by a relatively short time window of a few hours during which intervention is most effective. Neuroendovascular treatments for stroke at NewYork-Presbyterian Hospital focus on two approaches.
- The first involves infusion of anti-clotting medication called tissue plasminogen activator (t-PA) directly to the area of the brain in which the stroke is occurring. The medication must be administered within six hours of the stroke onset, and can salvage brain tissue from irreversible damage.
- The second approach, developed more recently by one of our neuro-interventionalists, Y.P. Gobin, MD, involves using a mechanical retrieval device (the Merci Retriever) to extract blood clots from the brains of patients experiencing an acute ischemic stroke, and reopen the blood vessel. This pioneering device may be used up to eight hours after stroke onset, and can therefore extend the time window during which therapy for stroke is most effective.
Neurological Rehabilitation
The staff of the Cerebrovascular Disease Centers works in collaboration with the neurological rehabilitation team to review each patient's case and develop an individualized plan that will yield the best outcome. Our rehabilitation specialists provide comprehensive services for patients with cerebrovascular disease. NewYork-Presbyterian Hospital/Weill Cornell Medical Center offers specialized rehabilitation programs such as
- Physiatry evaluation
- Spasticity management (including botulinum toxin and intrathecal baclofen treatment)
- Vestibular and visual rehabilitation
- Cognitive assessment and treatment
- Wheelchair and brace evaluation and prescription, as well as
- Physical, occupational and speech therapies.
Patients recovering from stroke may suffer neurological damage and require stroke rehabilitation, which is offered at the renowned Rehabilitation Center at NewYork-Presbyterian Hospital/Columbia University Medical Center. NewYork-Presbyterian Hospital/Columbia also provides comprehensive rehabilitation services for patients in all stages of cerebrovascular disease, from acute in-patient care to outpatient rehabilitation.
Research
NewYork-Presbyterian Hospital is a leader in research and clinical trials. Our surgeons pioneered a new therapy, known as cardiac arrest surgery, for the treatment of giant aneurysms. We are currently participating in three National Institutes of Health-sponsored studies to advance diagnosis and treatment of AVMs. Our Centers are also involved in ongoing clinical studies to determine the efficacy of new devices developed to assist in the treatment of a variety of diseases.
NewYork-Presbyterian Hospital is involved in a groundbreaking NIH-sponsored clinical trial called CREST (Carotid Revascularization: Endarterectomy versus Stent Trial), which compares a procedure called Carotid Endarterectomy, the standard surgical treatment for stroke prevention in which the neck is opened and the atheromatous plaque is removed from the carotid arteries, with a neuroendovascular procedure that inserts a stent into the diseased portion of the carotid artery to open the blockage caused by atherosclerosis.
NewYork-Presbyterian Hospital's neuro-interventionalists are also developing a technique for treating aneurysms with the use of bioactive coils. Coils are inserted inside the aneurysm to effectively cut off the blood supply to it and thus prevent it from bursting. This technique, called embolization, is also used to treat other cerebrovascular conditions such as tumors and AVMs.
