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.

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.

We evaluate and treat all neurological conditions, and make sure patients are seen by appropriate subspecialists within the Department of Neurology to provide the best possible care. The Yale Headache and Facial Pain Center specializes in the diagnosis and treatment of headaches and facial pain in adolescents and adults. The Lumbar Puncture Clinic provides analysis to physicians for conditions related to spinal fluid abnormalities. We perform routine testing of cerebral spinal fluid, as well as more specialized testing for demyelinating disease, neoplasms, inflammatory conditions, and infections. We also provide large-volume spinal taps for the diagnosis of normal pressure hydrocephalus. The Neurology Urgent Access Clinic provides expedited evaluation of patients seen in the emergency room as well as those referred from physicians requiring an urgent assessment.