The neurovascular clinic is one of the busiest clinics of its kind in Ontario, treating patients with a range of neurovascular diseases. Experts in neurosurgery, neuroradiology, neurocritical care and neurovascular science provide highly specialized neurovascular services, including endovascular neurosurgery, aneurysm coiling and clipping, carotid stenting and vascular malformation management. The clinic sees over 200 hemorrhagic stroke patients per year.
St. Michal’s Hospital is one of 11 regional stroke centres across the province and one of three within Toronto. We provide rapid assessment, diagnostics and treatment for patients experiencing an acute stroke to maximize the potential for life- and function-saving advanced stroke care. The stroke unit is supported by the Stroke Assessment and Treatment Team, which is comprised of a stroke neurologist, case manager, physiotherapist, occupational therapist, speech language pathologist, dietitian and a clinical nurse specialist, all of whom have expertise in the care and management of stroke patients. As part of the South East Toronto Regional Stroke Network of the Ontario Stroke System, we provide leadership to the region in the development, implementation and co-ordination of Best Practice Stroke Care across the continuum, including stroke prevention, acute care, rehabilitation and community re-engagement. Every year, approximately 300 patients with an acute ischemic stroke are admitted to St. Michael’s Hospital, and over 1,000 patients are assessed in the stroke prevention clinic.
The St. Michael’s Hospital Head Injury Clinic was established in 1987 to manage and treat patients with persisting symptoms following traumatic brain injury. The Head Injury Clinic is the largest of its kind in Ontario, servicing over 1,900 patients per year, many of whom have mild cases of traumatic brain injury. The clinic is comprised of an interdisciplinary team of experts, including a neurorehabilitation specialist, a physiatrist, a neuropsychologist, a neuro-otolaryngologist, a psychiatrist, a clinical nurse specialist/case manager, a social worker and research personnel. Beyond its commitment to patient care, the Head Injury Clinic is dedicated to conducting extensive clinical research to improve patient outcomes after TBI. Research ranges from investigating effective and innovative interventions for common physical symptoms of traumatic brain injury (headaches, dizziness, depression), and developing improved assessment tools for the identification of mild traumatic brain injury.
St. Michael’s has a 19-bed intensive care unit which treats critically ill patients with trauma and neurosurgical diseases. This unit supports a regional trauma program, a neurovascular program and a major provincial referral network for neurosurgical patients. It is an academic unit with an international teaching program for medical students, residents and fellows and with multiple, ongoing clinical trials.
This outpatient clinic provides assessment for patients with memory concerns that interfere with their day-to-day function. It is staffed with a nurse clinician, a geriatric psychiatrist and a behavioural neurologist, in addition to students and research staff. The clinic sees about 150 new cases of dementia and related cognitive disorders a year in addition to 300 follow-ups, with an extremely heterogeneous group of patients, something that is unique to St. Michael’s. These patients are from a variety of socioeconomic status groups, making St. Michael’s ideally suited to study lifestyle-associated factors on brain cognitive reserve.
The Movement Disorders Clinic at St. Michael’s Hospital has been in operation since August 2010. One of the mandates of this academic clinic is to provide education to University of Toronto Neurology residents. The clinic evaluates a full spectrum of movement disorders, including atypical Parkinsonism, Parkinson’s disease, chorea and dystonia. All forms of dystonia are treated in the clinic, with a special interest in task-specific dystonias, such as writer’s cramp and musician’s dystonia that typically require more detailed evaluations and electromyography-guided injections of botulinum toxin.
Established in 1981, the Multiple Sclerosis (MS) clinic is one of 22 centres across Canada dedicated to the treatment of and research in MS. The MS clinic has become one of the largest of its kind in North America. Staffed by six specialists, the clinic sees over 6,000 patients who come for regular and urgent follow-ups. The clinic offers medical and nursing care services in one location, and provides referrals for services provided within the hospital and in other health centres. The clinic helps with the diagnosis of MS and treatment of relapses, symptom management, disease modification, psychosocial support, rehabilitation and referral to appropriate services. A multidisciplinary approach to care allows for the expertise of allied health professionals who provide occupational therapy consultation, social work services and speech-language therapy.
