Cerebrovascular & Comprehensive Stroke Center

The Stony Brook Difference

US News - High Performing Hospital emblem US News - High Performing Hospital emblem America's Best 100 Stroke Care: 2016 - 2024

The outlook for people who have had a stroke is more hopeful than ever today due to advances in stroke awareness, prevention, treatment, education and rehabilitation. However, stroke remains the fifth-leading cause of death for both men and women in the United States.

While we hope that you or someone you love never experiences a stroke, it's important to know that you have the most advanced level of stroke care just minutes away at Stony Brook University Hospital.

We also invite you to watch our livestream, "When Stroke Happens: What to Do," featuring our co-directors of the Cerebrovascular and Comprehensive Stroke Center, Dr. David Fiorella and Dr. Michael Guido.

Certified Comprehensive Stroke Center

TJC Comprehensive Stroke CertificationIn May 2018, Stony Brook University Hospital became the first hospital in Suffolk County to achieve Comprehensive Stroke Center (CSC) certification by The Joint Commission, the nation's oldest and largest standards-setting and accrediting body in health care. This is the highest level a stroke center can achieve, and involves a rigorous screening process.

The advanced Comprehensive Stroke Center designation indicates our ability to receive and treat the most complex stroke cases. As a certified comprehensive stroke center, Stony Brook provides nationally recognized best practices and a level of care few hospitals anywhere can match.

Nationally approximately only 200 hospitals out of 5,800 have earned this certification.

To be eligible, hospitals must first demonstrate compliance with stroke-related standards.  Stony Brook Cerebrovascular and Stroke Center had been a New York State Department of Health designated Stroke Center since 2005 and a Joint Commission-certified Advanced Primary Stroke Center since 2004. Additional requirements include:

  • Advanced imaging capabilities (Stony Brook offers magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography (DSA), and transcranial doppler ultrasound (TCD)
  • 24/7 availability of specialized treatments, operating room and endovascular facilities and staff with the unique education and competencies to care for complex stroke patients (training in vascular neurology, neurosurgery and endovascular procedures)
  • Experience and expertise in treating volume of patients with large ischemic strokes, intracerebral hemorrhage and subarachnoid hemorrhage
  • Ability to deliver physical, occupational and speech therapy every day of the week
  • Follow up with patients on their outpatient care
  • Community education outreach to local residents about preventing and recognizing strokes
  • Tracking performance and defined quality improvement programs to maximize positive outcomes of stroke patients, especially for the most complicated cases

All of these requirements and measures are designed to help hospital teams create a loyal and cohesive clinical team, establish a consistent approach to care, reduce the variation and risk of error, and demonstrate a commitment to a higher standard of clinical service.

Suffolk County's Only Mobile Stroke Unit Program 

Suffolk County residents have one more reason to look to Stony Brook Medicine for the highest level of stroke care. In April 2019, Stony Brook launched Long Island's first mobile stroke unit program, designed to provide specialized, life-saving care to people within the critical moments of stroke before they even get to the hospital. This revolutionary pre-hospital process markedly accelerates the time to making an accurate stroke diagnosis, allows for time-sensitive stroke therapies to be administered earlier, and allows for the transport of stroke patients directly to the most appropriate hospital for the level of care they require, the first time. By May 2024, just five years into the program, our mobile stroke units had already reached a milestone of responding to nearly 8,000 calls! The result has been and continues to be,  more lives saved, and better outcomes through earlier interventions. While new to Long Island, mobile stroke units have successfully reduced stroke disability and have improved survival rates in other major metropolitan areas across the country.

Understanding Cerebrovascular Disease

Cerebrovascular disease is a term that describes disorders in which an area of the brain is temporarily or permanently deprived of blood and oxygen (ischemia) or bleeds profusely (hemorrhage). It involves one or more of the blood vessels that feed the brain or are located in the brain or the spine. Conditions include arterial narrowing (stenosis), arteriovenous malformations, aneurysms, and strokes.

Our Cerebrovascular and Comprehensive Stroke Center uses a multidisciplinary, team-based approach, state-of-the-art facilities and equipment, and the latest surgical and minimally invasive techniques to accurately diagnose your cerebrovascular disorder and design a treatment plan that is individualized to your unique circumstances.

Our dedicated, multidisciplinary team consists of neurologists, interventional neuroradiologists, and cerebrovascular neurosurgeons who have the expertise needed to diagnose and treat a wide range of cerebrovascular diseases, including arteriovenous malformations, arteriovenous fistulas, hemorrhagic strokes, ischemic strokes, atherosclerosis, and carotid stenosis. 

As part of an academic medical center, our Cerebrovascular and Comprehensive Stroke Center is also home to active clinical trials supported by three clinical research coordinators and a National Institute of Health (NIH) funded hemodynamics laboratory. The clinical and translational research is funded by more than two dozen research grants and we participate in virtually all of the major cerebrovascular clinical trials that are currently underway in the U.S. As a result, our patients have access to all of the newest devices and procedures as more and more advanced minimally invasive technologies become available.

Our state-of-the-art facilities, which include high-speed computed tomographic (CT), MRI, biplane angiography equipment and a new $14 million cerebrovascular biplane suite, enable us to make quick and accurate diagnoses so that critical treatment can begin as soon as possible. Our practitioners are supported by a full complement of state-of-the art treatment rooms, including two neurointerventional procedure rooms, a neurological suite, and advanced operating rooms.

Our support staff of physician assistants and administrative assistants will keep in contact with you through your follow-up imaging or treatments.

We also offer two Stroke Support Groups where you'll receive encouragement and feedback from others who can relate to your situation; gain more knowledge from experts speakers; and learn about many programs and resources that can help. Our Stroke Caregiver Support Group meets on the second Tuesday of every month from 7 to 8 pm. And our Stroke Survivor Support Group meets on the last Tuesday of every month from 7 to 8 pm. If interested, call (631) 638-2638 for information on how to join our virtual support group meetings.

Our Neurology Stroke Program

Led by Michael Guido, MD, our Neurology Stroke Program provides rapid response in diagnosing and treating stroke patients. For example, advanced radiologic techniques are available to aid in quick and accurate diagnosis. In addition, our highly specialized team of stroke experts collaborates at all stages of treatment using state-of-the-art research and technology. Therapies include medication, advanced neurosurgical techniques, and interventional neuroradiology procedures. We provide specialized diagnostic imaging for analyzing patient's blood flow in the brain and delivery of clot-busting medications as well. These unique capabilities are essential to the realization of our ultimate goal -- to provide outstanding stroke care to our patients and our community.

Our Neurology Stroke program features the highest standard facility for the acute care and management of stroke patients. Our Stroke team includes stroke neurologists; stroke nurse practitioners; a physician assistant; stroke nurse coordinators and researchers; physical, speech and occupational therapists. Our Stroke ICU and Acute Care Units are staffed with specially trained nurses for the acute management of stroke and vascular patients. Our Stroke Team works with the dedicated and highly skilled Emergency Department staff and EMS, providing immediate care to stroke patients.

Our Cerebrovascular Program

Begun in 2007, our Cerebrovascular Program is led by David Fiorella, MD, PhD, an expert in interventional neuroradiology who has pioneered new diagnosis and treatment methods for complex cerebrovascular disorders. These include mechanical thrombectomy as treatment of acute ischemic
stroke due to large vessel occlusions (blockage). About 87 percent of all Cerebrovascular teamstrokes are ischemic strokes, in which blood flow to the brain is blocked.
And it is estimated that 20 to 30 percent of acute ischemic strokes are due to large vessel blockage.

Stony Brook University Hospital is the only institution on Long Island using the Apollo® procedure, a minimally invasive intervention for intracranial hemorrhage that can extract blood from the brain using a tiny hole in the skull to relieve pressure in a matter of minutes with very little trauma to the surrounding brain.

For aneurysms, our treatments include open surgery, such as clipping, which involves placing a clamp on the neck of the aneurysm and also minimally invasive endovascular treatments such as coiling. During coiling the surgeon advances a catheter (long, thin tube) through blood vessels to the site of the aneurysm. Once in place, coils are injected through the catheter and into the aneurysm, blocking blood flow. We also use minimally invasive methods to inject clot-dissolving drugs or place instruments, such as stents, stent grafts, and embolic agents. Our expertise with less invasive treatments allows for shorter stays and more efficient treatment.