Overview
Our center of excellence for cerebrovascular care offers:
- Leading-edge facilities with the ability to care for the most acute and complex patients featuring state-of-the-art cerebrovascular operating suites, neurointerventional angiography and hybrid open-interventional operating suites and the most advanced imaging tools including CT, MRI, duplex ultrasound, biplane neuroangiography, carotid ultrasound and Transcranial Doppler ultrasound.
- A personalized approach to brain aneurysm treatment featuring the latest device technology including flow diversion techniques and new types of coils, stents and support devices for the treatment of complex wide neck aneurysms.
- One of the nation’s largest, and the largest in Northeast Ohio, stroke practices; offering comprehensive, advanced stroke treatments including the latest "clot-busting" medication and endovascular (from within the blood vessel) techniques.
- One of the first Mobile Stroke Treatment Units in the country and the only in Northeast Ohio, bringing advanced hemorrhagic and ischemic stroke care to patients to shorten the time between the onset of stroke-like symptoms and the delivery of "clot-busting" (or thrombolytic) drugs.
- Critical Care Transport services to ensure critically ill and injured patients are quickly and safely transported to Cleveland Clinic via mobile ground intensive care unit (ambulance), helicopter or airplane.
- A multidisciplinary neuro intensive care team that treats the most acute patients utilizing advanced technology for multi-modal monitoring, providing 24/7 coverage and immediate access in a Level I Neuro ICU on Cleveland Clinic's main campus and a Level II Neuro ICU at Cleveland Clinic Akron General.
- Neurological rehabilitation services, including three inpatient rehabilitation hospitals, as well as outpatient occupational, physical and speech therapy services available throughout Northeast Ohio.
What We Treat
Cerebrovascular illnesses include a number of conditions, each requiring a unique, individualized approach to care.
Diseases & Conditions
- Arterial Dissection (carotid and vertebral artery dissection).
- Arteriovenous Malformations (AVM).
- Bowhunters Syndrome.
- Brain Aneurysm.
- Brain Bleed/Intracranial Hemorrhage, Cerebral Hemorrhage & Hemorrhage Stroke.
- Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and other genetic stroke conditions.
- Carotid Artery Disease/Stenosis.
- Cavernous Malformationn-aneurysm.
- Dural Arteriovenous Fistula (Brain and Spine).
- Hemangioblastoma.
- Hereditary Hemorrhagic Telangiectasia (HHT).
- Intracranial Atherosclerosis/Stenosis.
- Ischemic Stroke/Cerebral Infarction.
- Moyamoya Disease.
- Mycotic Aneurysm.
- Scalp and Facial Arteriovenous Malformation.
- Spinal AVMs / Fistulas.
- Subarachnoid Hemorrhage (SAH).
- Subdural Hematoma (SDH).
- Transient Ischemic Attack (TIA).
- Venous Sinus Occlusion.
- Vein of Galen Malformationon.
- Vasculitis/Vasculopathy/Reversible Cerebral Vasoconstriction Syndrome (RCVS).
Diagnostics & Testing
Our state-of-the-art facilities are equipped with the diagnostic tools needed to quickly assess cerebrovascular conditions, including:
- Carotid Artery Duplex Ultrasound.
- Computed Tomography (CT), including:
- CT angiography.
- CT perfusion.
- CT venography.
- Digital Subtraction Angiography, including newest techniques.
- Magnetic Resonance Imaging (MRI), including high field MRI.
- Intraoperative monitoring of intracranial blood flow.
- Transcranial Doppler Ultrasound (TCD), including:
- Transcranial Doppler Emboli Monitoring.
- Transcranial Doppler Bubble Testing (TCB).
- Transcranial Doppler of the posterior circulation (TCP).
- Transcranial Doppler for sickle cell disease.
All examinations are reviewed by board-certified neurologists or neuroradiologists and are performed by registered neurovascular sonographers.
Cleveland Clinic’s Neurovascular Ultrasound Laboratory welcomes referrals from outside physicians. To make an appointment or referral, please call 216.738.5460 or 866.320.4573.
For more information on the Neurovascular Ultrasound Laboratory, please contact Larry Raber, RDMS, RVT, RT(R), clinical manager of the Neurovascular Ultrasound Laboratory at 216.444.9129.
Treatments & Services
- Aneurysm coiling, clipping and flow diversion.
- Brain Bypass/Extracranial to intracranial bypass.
- Carotid and vertebral artery stenting.
- Carotid Endarterectomy.
- AVM Endovascular liquid embolization.
- Epistaxis treatment.
- External Ventricular Drain.
- Gamma Knife radiosurgery.
- Intracranial stenting.
- Mechanical thrombectomy/Intra-arterial thrombolysis for stroke.
- Medical management after a stroke.
- Open microsurgery.
- Reconstructive craniofacial surgery.
- TPA administration for strokes.
- Tumor embolization.
Stroke Program
Cleveland Clinic has one of the highest stroke-related patient practices in North America, with more than 6,800 annual visits. High patient volumes allow our specialists to have vast experience with stroke patients, which results in a team solely dedicated to the comprehensive care and management of strokes, including a team dedicated to preventing and treating stroke in racial and ethnic minorities through our Minority Stroke Program.
Patients who have experienced a stroke are managed by a team of specialists who provide care from onset of the stroke to rehabilitation and management post-stroke. The team of specialists includes:
- Stroke/Vascular neurologists.
- Interventional neurologists and neuroradiologists.
- Vascular neurosurgeons.
- Neurocritical care specialists.
- Psychologists.
- Physiatrists.
- Advanced practice providers.
- Therapists including physical, occupational, speech-language and recreational therapists.
- Pathologists.
- Social workers and case managers.
- Nurse care coordinators.
The team in Cleveland Clinic’s Stroke Program is focused on resolving the cause of the stroke, managing after effects, reducing disability and maintaining/restoring quality of life. For patients and caregivers of patients who have suffered a stroke, members of Cleveland Clinic’s Stroke Program will provide education on:
- Option(s) used in the treatment of stroke (short-term and long-term).
- Stroke rehabilitation.
- Dietary changes after a stroke.
- Emotional and behavioral changes after a stroke.
- Prevention of further strokes.
- Caring for a loved one who has suffered a stroke.
- Stroke resources in the community.
Stroke Center Certification
Comprehensive Stroke Center
The stroke center on Cleveland Clinic's main campus, which also provides care to stroke patients presenting at Cleveland Clinic’s freestanding emergency departments in the Brunswick, Lakewood and Twinsburg family health centers, is a Joint Commission certified Comprehensive Stroke Center. This is the highest level of stroke certification, only earned by an elite group of hospitals across the United States for providing state-of-the-art, leading-edge care for the most complex stroke cases.
Comprehensive Stroke Center certification means that 24 hours a day, 7 days a week, we work with EMS and other stroke centers to deliver advanced stroke care. At Cleveland Clinic's main campus, the Acute Stroke Emergency Response Team meets patients at the door — whether they arrive via EMS, Mobile Stroke Treatment Unit or Critical Care Transport helicopter.
Rapid diagnosis by advanced imaging protocols and highly trained neuroradiologists ensures quick intervention, including Alteplase (tPA) and endovascular interventions including administration of a clot-busting medication (tenecteplase) and endovascular interventions. Our state-of-the-art interventional suites allow our staff to perform advanced diagnostic and endovascular interventional procedures on patients suffering from acute stroke and other cerebrovascular emergencies, including aneurysm coiling, aneurysm clipping, cerebral vessel stenting, clot removal (mechanical thrombectomy) and Pipeline® embolization.
Thrombectomy-Capable & Primary Stroke Centers
The Comprehensive Stroke Center on Cleveland Clinic's main campus serves as the hub in an integrated stroke care network. Cleveland Clinic's health system boasts an additional four Thrombectomy-Capable Stroke Centers, 10 Primary Stroke Centers, 2 DNV Certified Comprehensive Stroke Centers and one regional hospital (Lutheran Hospital) capable of initiating acute stroke treatment. Joint Commission-designated hospitals include:
Thrombectomy-Capable Stroke Centers
Primary Stroke Centers
- Ashtabula County Medical Center.
- Avon Hospital at Richard E. Jacobs Campus
- Euclid Hospital
- Martin North Hospital
- Martin South Hospital
- Marymount Hospital
- Medina Hospital
- Mercy Hospital
- South Pointe Hospital
- Union Hospital
DNV Certified Comprehensive Stroke Centers
American Heart Association/American Stroke Association Get With The Guidelines® Stroke Gold Plus Award
In 2023, Cleveland Clinic's main campus Comprehensive Stroke Center received the American Heart Association/American Stroke Association Get With The Guidelines® award of Stroke Gold Plus with Target: Stroke Honor Roll Elite Plus, Advanced Therapy and Target: Type 2 Diabetes Honor Roll.
Cleveland Clinic's health system boasts an additional 15 hospitals identified for exceptional care through the Get with the Guidelines® award. These achievements recognize Cleveland Clinic's commitment and success in implementing the highest standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations.
Additional hospital awards include:
Stroke Gold Plus with Target: Stroke Honor Roll Elite Plus, Target: Stroke Honor Roll Advanced Therapy and Target: Type 2 Diabetes Honor Roll
Stroke Gold Plus with Target: Stroke Honor Roll Elite and Target: Stroke Honor Roll Advanced Therapy
Stroke Gold Plus with Target: Stroke Honor Roll Elite Plus and Target: Type 2 Diabetes Honor Roll
- Avon Hospital at Richard E. Jacobs Campus
- Hillcrest Hospital
- Martin North Hospital
- Martin South Hospital
- Medina Hospital
Stroke Gold Plus with Target: Stroke Honor Roll, Target: Stroke Honor Roll Advanced Therapy and Target: Type 2 Diabetes Honor Roll
Stroke Gold Plus with Target: Stroke Honor Roll Elite and Target: Type 2 Diabetes Honor Roll
Stroke Gold Plus with Target: Type 2 Diabetes Honor Roll
Rural Stroke Bronze
Cerebrovascular Surgery
Cleveland Clinic performs more than 1,700 cerebrovascular procedures each year. Our team of specialists treat everything from carotid stenosis to complex brain aneurysms. Teamwork and putting patients first are the guiding principles for our multidisciplinary team of:
- Vascular neurosurgeons.
- Interventional neurologists and neuroradiologists.
- Stroke/Vascular neurologists.
- Neurocritical care specialists.
- Psychologists.
- Physiatrists.
- Pathologists.
- Advanced practice providers.
- Therapists including physical, occupational and speech-language therapists.
- Social workers and case managers.
- Nurse care coordinators.
Our team offers extensive expertise and application of novel technologies, like biplane neuroangiography, in surgical and endovascular services like:
- Aneurysm coiling, clipping and flow diversion.
- Arteriovenous malformation treatment.
- Carotid and vertebral artery stenting and endarterectomy.
- Cerebral revascularization surgery (including extra/intracranial brain bypass).
- Epistaxis treatment.
- Gamma Knife radiosurgery.
- Intracranial stenting.
- Minimally invasive clot evacuation for hemorrhages.
- Tumor embolization.
State-of-the-art cerebrovascular operating suites, neurointerventional angiography and hybrid open interventional suites allow our team to customize aneurysm repair using open microsurgery, endovascular surgery or hybrid open-endovascular surgery.
Research
Besides world renowned clinical care, the cerebrovascular and endovascular neurosurgery program at Cleveland Clinic is a world leader in research and innovation. Our program is involved in numerous interventional trials pioneering devices and new techniques from flow diverting stents to minimally invasive intracerebral hemorrhage evacuation.
Neuro ICU
The Level I, 24-bed Neuro Intensive Care Unit (NICU) on Cleveland Clinic’s main campus provides 24/7 critical care for more than 1,300 acute neurology and neurosurgery patients annually. Our multidisciplinary team is comprised of neurocritical care physicians, advanced practice providers, nurse care coordinators, clinical pharmacy specialists; and respiratory, occupational, and physical therapists, as well as providers from many different specialties and subspecialties. Our innovative model of night coverage relies on advanced practice providers with acute care training complemented with remote tele-ICU presence by staff physicians. This novel use of telemedicine enables our team to provide second opinion consultations to patients at other hospitals within Cleveland Clinic’s health system.
Our team provides the whole range of direct bedside care for critically ill patients, rather than just consultative services, and routinely cares for patients with the following neurological conditions:
- Acute ischemic stroke.
- Brain tumor patients who require intensive care.
- Encephalitis.
- Guillain-Barre Syndrome.
- Intracerebral hemorrhage.
- Meningitis.
- Myasthenia Gravis.
- Post-operative neurosurgery patients.
- Spine injury.
- Seizure disorders and status epilepticus (often time refractory).
- Subarachnoid hemorrhage.
- Subdural/epidural hemorrhage.
- Neurology and neurosurgery patients with other critical care needs.
This full service Neuro ICU is equipped to treat any patient with neurological injury, regardless of the severity, and capable of treating any heart, lung or systemic problems that may arise.. We also have specialized equipment designed for the treatment of patients with neurological illnesses, including:
- Brain oxygen sensors.
- External ventricular drains.
- Intracranial pressure monitoring.
- Invasive blood flow monitors.
- Portable head Computed Tomography (CT) scanning.
- Pupillometers.
- Routine continuous EEG monitoring.
We are also in the process of expanding our multimodal monitoring capabilities to include cerebral microdialysis.
Research
Cleveland Clinic’s Neuro ICU team has been at the forefront of early mobility in patients with brain injuries as a means to decrease medical complications and enhance recovery. A funded pilot study of early mobilization therapy and aggressive physical therapy in patients following subarachnoid hemorrhage is being completed and has shown promising preliminary results. Similarly, as part of our comprehensive approach to care, family engagement and patient and family experience are taken very seriously and another funded study is exploring optimal ways to enhance communication between the medical team and families and improve their overall experience during what can be very difficult times.
Our faculty devotes a significant amount of time to research activities that focus on improving the care of patients with brain injuries. We actively participate in (and often times lead) national studies looking at minimally invasive surgical evacuation of brain bleeds as a possible novel treatment strategy, as well as intravenous infusion of experimental medications to ameliorate brain swelling following ischemic stroke. We also have investigator-initiated translational studies that have secured external funding from national organizations that seek to explore the effect of iron-mediated oxidative damage following aneurysmal bleeding.
Other research projects include the analysis of different reversal strategies for warfarin-related coagulopathy in patients with brain bleeds, the use of direct intrathecal administration of medications to minimize vasospasm after aneurysm rupture, and a variety of smaller projects initiated by trainees.
Our staff is regularly invited to give presentations and lectures at major annual meetings. Our national activities include publications in peer-reviewed journals, papers and posters presented at national meetings and a strong annual presence at the Neurocritical Care Society, Society of Critical Care, and international stroke meetings. Members of our staff regularly review manuscript submissions and abstracts for the most relevant journals and meetings associated with neurointensive care.
Our Doctors
View the profiles of our:
Appointments
Make an Appointment
To schedule an appointment with a Cerebrovascular Center specialist, please call 216.636.5860 or 866.588.2264.
Virtual Visits
Whether you're a new or existing patient, you can get an initial evaluation or follow-up care from a cerebrovascular specialist using your phone, tablet or computer. This means there's no travel or parking, less waiting and significant time savings. Call 216.636.5860 to schedule a virtual visit for you or a loved one and get details on cost and set-up instructions.
MyChart
MyChart connects you to your health care team from the comfort and safety of home. With this secure, online tool you can manage your appointments and complete pre-visit tasks, communicate with your providers, and keep track of your test results and medications.
Locations
Clinical Trials & Research
Cerebrovascular Research Programs
The Neurological Institute advances research into diseases of the brain and spine and conducts clinical therapeutic trials to support patients with neurological disorders. Our multidisciplinary research collaboration combines the expertise of clinical principal investigators with state-of-the-art imaging and data analysis to establish and implement new approaches to the treatment of neurological diseases. In addition, the Neurological Institute trains clinical fellows, full-time research fellows and residents as next generation clinical research scientists.
Clinical trials and research are the key to advancing medical knowledge and patient care. They provide hope by testing new drugs, new surgical techniques or other treatments before they are available.
Cleveland Clinic Brain Study
What happens to the brain and body before a neurological disease is diagnosed? Cleveland Clinic's Brain Study will change the landscape of neurodegeneration science. By researching at-risk normal individuals over the course of 20 years, we will learn what is happening to the brain and body before a neurological disease is diagnosed. Help us realize a future without neurological disease.
For Medical Professionals
Refer a Patient
The Cerebrovascular Center offers direct referral lines to ease the process of transferring patients with critical cerebrovascular conditions and non-urgent hospital transfers and referrals for outpatient consults.
For urgent emergency room and hospital transfers and Cleveland Clinic Critical Care Transport autolaunch, please call 800.553.5056 and the press 1. With one phone call to a transfer specialist, all necessary arrangements can be made to receive your patient. If necessary, your patient can be transported to our facility using our Critical Care Transport ambulance or helicopter service, available 24 hours a day, 7 days a week.
For non-urgent hospital transfers, please call 800.553.5056.
For outpatient consults:
- Please call 216.445.8455. An intake coordinator will handle your call directly. If you are unable to reach an intake coordinator, please leave a message and they will return your call within the work day (if left before 1 p.m. ET) or the next work day (if left after 1 p.m. ET).
- To refer a patient to the Neurological Institute via fax, please download and complete our physician referral form and fax to 216.636.2596.
DrConnect
Stay connected to patients you refer to Cleveland Clinic through online updates and electronic medical records.
- Learn More.
- Sign-up or Log in.
Mobile Stroke Treatment Unit
Cleveland Clinic’s mobile stroke treatment unit (MSTU) — one of the first units of its kind in the U.S. — was launched to shorten the time between the onset of a patient’s stroke-like symptoms and the delivery of clot-busting drugs to treat a stroke.
The unit is operated by highly specialized staff who use its advanced equipment to allow Cleveland Clinic stroke physicians to swiftly diagnose stroke and, when appropriate, direct the administration of lifesaving medications while the patient is still en route to an emergency department. Every minute saved before treatment starts is likely to preserve critical brain tissue.
The MSTU, which is integrated into the municipal 911 dispatch system, boasts a critical care team with extensive experience working in and with local rescue squads.
The team includes:
- A critical care nurse.
- A CT technologist.
- A paramedic.
- An emergency medical technician who assists with stroke care and drives the unit.
The team uses the unit’s specialized equipment, including:
- A portable CT scanner to wirelessly transmit brain images in real time to Cleveland Clinic neuroradiologists reviewing the case.
- A two-way videoconferencing consult system connected 24/7 with Cleveland Clinic stroke neurologists.
- Point-of-care lab equipment that allows the team to test blood samples.
- The clot-busting drug tPA, which the team administers intravenously if the stroke physicians determine that the patient is having an ischemic stroke.
To learn more about Northeast Ohio’s only mobile stroke treatment unit or how we can better collaborate with your city, please contact Andrew Russman, DO, Head of Cleveland Clinic’s Stroke Program, at 216.445.1148.
Telestroke Services
The Cerebrovascular Center now offers Telestroke services. The service provides 24x7 coverage by a team including vascular neurologists and neurocritical care specialists, assisting medical centers in the assessment and treatment of their stroke patients.
To facilitate an ongoing, real-time consultation, the Telestroke Network is enabled with a 2-way, portable videoconferencing system as well as a dedicated link between imaging systems. The physician assessment is also supported by Cleveland Clinic's Critical Care Transport services, should the patient need additional care.
The Cerebrovascular Center’s comprehensive treatment approach offers an array of medical and interventional treatment options for acute stroke including t-PA administration, intra-arterial thrombolysis and mechanical revascularization.
How Our Telestroke Service Works
- Call Cleveland Clinic to discuss the patient’s condition.
- Within minutes, the portable 2-way audio/visual system in your ER brings one of our specialty trained physicians into seamless communication with you and your patient.
- Patient CT images taken at your medical center are transferred to our physician to assist in the consultation process.
- Our physician will collaboratively discuss treatment recommendations and options with the ER physician, including the administration of IV tPA. If necessary, patient transfer to Cleveland Clinic for further care can also be coordinated.
To learn more about our Telestroke service and how we can collaborate with your team, please call Dena Brown at 216.445.4446.
Residency & Fellowship
The Cerebrovascular Center has a long-standing tradition of training future leaders in the field of cerebrovascular and endovascular neurosurgery and neurocritical care medicine. Learn more about residency and fellowship opportunities available through Cleveland Clinic’s Cerebrovascular Center:
CME Programs
The Center for Continuing Education is responsible for one of the largest and most diverse CME programs anywhere in the world. We offer live CME courses and free online CME activities.
Resources
Stroke Prevention & Detection
Stroke is the leading cause of serious, long-term disability in the United States, with about 6.5 million stroke survivors alive today. Healthy diet, exercise, controlling blood pressure and not smoking are cornerstones of stroke prevention.
- Control your blood pressure.
- Find out if you have heart disease, especially an irregular heartbeat known as atrial fibrillation.
- Don’t smoke.
- Find out if you have a diseased carotid artery.
- Lower your cholesterol.
- Limit your alcohol intake.
- Control your weight.
- If you have diabetes, manage the disease.
Cleveland Clinic's commitment to stroke care includes education to all on the warning signs of a stroke. In a stroke, every minute counts. Use the BE FAST method to evaluate whether someone may be having a stroke:
- Balance: Watch for a sudden loss of balance.
- Eyes: Is there a sudden loss of vision in one or both eyes? Or double vision?
- Face: Ask the person to smile. Does one side of the face droop?
- Arms: Ask the person to raise both arms. Does one arm drift downward?
- Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
- Time: If you observe any of these signs, call 9-1-1 immediately.
- Make sure you know the signs and symptoms of a stroke and when to call 911.
- Learn more about stroke prevention, detection and management from Shazam Hussain, MD, Director of Cleveland Clinic’s Cerebrovascular Center.
Stroke and Brain Aneurysm Support Group
Stroke and brain aneurysms are serious neurological diseases which can leave a person with a wide variety of deficits affecting them physically, cognitively and/or psychologically. The Cerebrovascular Center at Cleveland Clinic is dedicated to helping those affected by strokes and brain aneurysms by offering a support group that focuses on alleviating the effects of the disease through support and education.
Topics discussed vary by meeting, but may include:
- Rehabilitation challenges.
- Recurrent stroke prevention.
- Updates in stroke treatment.
- Additional support resources.
Participating in a support group allows you to meet others with similar health concerns and issues. It allows you to connect with others in comparable situations and share experiences and coping strategies. Anyone who has suffered a stroke and/or brain aneurysm is welcome to come with or without a family member or support person.
2019 Dates:
- Monday, July 15.
- Monday, September 23.
- Monday, November 11.
Time: 10 am - 11:30 am
Location: Cleveland Clinic Independence Family Health Center
Lower Level Conference Room A
5001 Rockside Road
Crown Center II
Independence, OH 44131
No registration required
For more information: 216.636.0450
