Outpatient Services

• Overview
• Cerebrovascular Disorders
• Clinical Programs
• Staff

Overview

Stroke encompasses three distinct type of brain injury:

• Ischemic stroke (blockage of a blood vessel)
• Hemorrhagic stroke (bleeding into the brain)
• Aneurysmal subarachnoid hemorrhage (rupture of a brain aneurysm)

Our out-patient services are designed to diagnose, prevent, and manage the complications of stroke. Our Service has a multidisciplinary approach to exploring innovative therapies for stroke recovery, as well.

Patients are referred from around the world to the MGH and can recieve comprehensive evaluation by a team of specialists that includes stroke neurologists, vascular neurosurgeons, interventional neuroradiologists, and rehabilitation physicians. Patient services are coordinated through the Stroke Prevention Clinic.

Cerebrovascular Disorders

We diagnose and manage an array of cerebrovascular conditions including:

Ischemic Stroke & Transient Ischemic Attack (TIA) Treatment and Prevention Heart disease Cardioembolism Carotid or vertebral artery disease Small vessel intracranial or lacunar disease White matter disease Dissection of a cerebral artery Intracranial Hemorrhage Intracerebral hemorrhage Aneurysmal subarachnoid hemorrhage Cerebral venous sinus thrombosis

Stroke in the Young (Age < 55) or Due to Other Rare Causes Congenital heart defects (ASD, PFO) Pregnancy Migraine or vasoconstriction Moya moya Cancer Fabry’s disease, CADASIL or other genetic causes Fibromuscular dysplasia Cerebral vasculitis Drug-induced stroke (e.g. cocaine, amphetamines) Hypercoagulability associated stroke syndromes Stroke Recovery

Clinical Programs

The MGH Stroke Service supports the following outpatient programs:

• Stroke Clinic
• Vascular Center Neurology: Waltham Campus
• Genetic Causes of Stroke
• Vascular Cognitive Impairment
• Interventional Neurovascular Surgery
• Clinical Vascular Laboratory: Cerebrovascular Ultrasound
• Cardio Neurology

Stroke Clinic

State-of-the-art evaluation and intervention for individuals with a history of or at increased risk for ischemic and hemorrhagic stroke.

Stroke Prevention Clinic

The Stroke Prevention Clinic improves the transition of inpatient to outpatient care for patients with stroke. It allows rapid access to a stroke specialist within 2 weeks of discharge to follow-up on outstanding laboratory tests, monitor response to therapy, and ensure that an optimal stroke prevention regimen is in place. There is unique subspecialty interest in hemorrhagic stroke and a specialized clinic focusing on prevention of intracerebral hemorrhage.

Vascular Center Neurology: Waltham Campus

Genetic Causes of Stroke

MGH is on the cutting edge of stroke genetics research and can offer comprehensive assessment for individuals with known or suspected inherited causes of stroke.

Vascular Cognitive Impairment

Diagnosis and management of cognitive dysfunction caused by "silent" strokes and "white matter disease".

Interventional Neurovascular Surgery

For embolization of complex intracranial and spinal vascular malformations and tumors, ceregral angioplasty, and intra arterial thrombolysis.

Clinical Vascular Laboratory: Cerebrovascular Ultrasound

In partnership with the MGH Clinical Vascular Laboratory and the MGH Vascular Center, we employ sophisticated tools for the detection of ischemia by carotid duplex ultrasound, transcranial Doppler ultrasound, and TCD embolus and vasospasm detection in the OR, ICU, and endovascular procedure suite.

Cardio Neurology

The purpose of the Cardio Neurology Stroke Clinic is to provide comprehensive evaluation and care of patients with cerebrovascular disorders related to the heart.

This clinic offers specialized evaluation of cerebrovascular disorders directly or indirectly related to the heart. These disorders may relate to congenital heart conditions in adult patients [e.g., septal defects, patent foramen ovale (PFO)], strokes related to dilated cardiomyopathies or cardiac valvular diseases, as well as to conditions and arteriopathies relating to both the heart and the vascular system.

Given also the special relationship between PFO and paradoxical embolism (often related to venous thrombosis), we also specialize in peripheral venous thrombotic disorders (e.g., May-Thurner syndrome) as well as cranio-cerebral venous sinus thromboses, the evaluation of which involves specialized, in-depth evaluation of clotting dysfunction (thrombophilia).

There are also other cerebrovascular disorders related to the heart, which are not stroke related. To see these other disorders, visit the MGH Neurology Service's Cardio-Neurology Clinic webpage.

Staff

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