Neurology - Division

The Stroke Department is a dedicated unit providing comprehensive care for patients with acute stroke, from their arrival at the Emergency Department, throughout hospitalization, and until discharge home or transfer to rehabilitation.

A stroke, also known as a cerebrovascular accident (CVA), is a sudden disruption of brain function caused by impaired blood flow to the brain. In most cases, a stroke results from the blockage of a cerebral blood vessel (ischemic stroke). Less commonly, it is caused by the rupture of a blood vessel, leading to bleeding within the brain (hemorrhagic stroke).

Stroke is the third leading cause of death in the Western world, after cancer and heart disease, and a major cause of disability among older adults. Risk factors include hypertension, diabetes, elevated blood lipid levels (high cholesterol), smoking, obesity, atrial fibrillation, and an unhealthy lifestyle.

The Stroke Department at Ichilov was the first dedicated stroke department established in Israel. Since its establishment in 2016, the Department has been committed to excellence in medical care, placing patients at the center of treatment while maintaining the highest professional standards.

In recent years, stroke care has undergone a global process of increasing specialization, similar to developments in the treatment of heart disease.

Today, the Stroke Department at Ichilov has the most extensive experience in stroke treatment in Israel. The Department is staffed by a senior team of experienced vascular neurologists and integrates intensive care, advanced imaging, endovascular brain procedures, vascular surgery, and rehabilitation.

The Department treats the full spectrum of stroke-related conditions, from transient ischemic attacks (TIA) to the most complex and challenging stroke cases.

The Stroke Department includes a Neurological Intensive Care Unit, a dedicated facility for stroke patients requiring close observation and continuous monitoring. The Unit is equipped with advanced intensive care beds that enable continuous monitoring of patients' vital signs, as well as sophisticated medical equipment for ongoing medication administration and support of impaired bodily functions during the first hours and days following a stroke.

The Unit treats patients with the most severe strokes who require intensive monitoring and medical support, both for the neurological injury itself and for associated medical complications that may develop during the first days following a severe stroke.

In addition, Ichilov's Stroke Department is the only department in Israel with a dedicated rehabilitation facility located within the inpatient department.

The Department includes two specialized medical units:

Doppler Laboratory

The Doppler Laboratory performs noninvasive examinations of the neck arteries and intracranial blood flow. Doppler testing uses ultrasound technology, does not involve invasive procedures, and does not expose patients to radiation.

Cerebral Embolism Prevention Center

Cerebral embolism is a medical condition in which foreign material, such as a blood clot or air bubble, blocks a blood vessel in the brain and disrupts oxygen supply to brain tissue.

Cerebral emboli may originate in the heart (cardioembolic), most commonly due to atrial fibrillation, or from the arteries (artery-to-artery embolism). They may also be associated with coagulation disorders and other conditions.

Emboli that reach and obstruct cerebral blood vessels are responsible for more than 50% of ischemic strokes.

The Cerebral Embolism Prevention Center brings together vascular neurologists, interventional cardiologists, cardiac electrophysiologists, cardiothoracic surgeons, and hematologists specializing in coagulation disorders.

The Center provides coordinated multidisciplinary care under one roof, including arranging all necessary diagnostic tests, conducting joint consultations, and maintaining direct communication between the specialists involved throughout the patient's treatment.

The Epilepsy and EEG Unit specializes in the diagnosis, treatment, and follow-up of patients with all types of epilepsy and other paroxysmal disorders that mimic epileptic seizures. The Unit is also involved in teaching and research in these fields.

The multidisciplinary team includes neurologists specializing in epilepsy, a psychiatrist, a psychologist, and a coordinating nurse.

The Unit provides the following services:

• Epilepsy Clinic: Specializes in the diagnosis and treatment of all types of epilepsy and seizure disorders, with particular emphasis on drug-resistant epilepsy. The clinic performs presurgical evaluations for patients being considered for surgical treatment of drug-resistant epilepsy. It also investigates new antiepileptic medications and experimental diagnostic devices.
• Pediatric Epilepsy Unit: Operates within the Neurology Institute at Dana-Dwek Children's Hospital.
• Epilepsy Neurostimulation Clinic: A specialized clinic providing consultation and seizure management using neurostimulation devices, including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS).
• Epilepsy in Pregnancy Clinic: A dedicated clinic providing comprehensive care for women with epilepsy, from preconception planning through pregnancy, childbirth, and the postpartum period.
• Initial Psychological Assessment: For patients with epilepsy or conditions that mimic epileptic seizures.
• Living with Epilepsy Therapeutic Group: A support and therapy group for patients with epilepsy, facilitated by a psychiatrist and a psychologist.
• EEG Laboratory: Performs electroencephalography (EEG) examinations to record the brain's electrical activity during wakefulness and sleep.

The Neurology Day Care Unit provides services for patients requiring short neurological diagnostic evaluations, such as lumbar punctures or assessments lasting several hours, as well as intravenous treatments or injections into the subarachnoid space.

The Unit was established in response to the growing need for diagnostic and therapeutic lumbar punctures and repeated or prolonged intravenous treatments for patients with complex neurological conditions.

This service helps reduce hospitalization time, minimizes the risk of hospital-acquired infections associated with prolonged inpatient stays, and improves the efficiency and cost-effectiveness of treatment and follow-up. It also enables continuity of care while minimizing disruption to patients' daily routines.

The main services provided include intravenous treatments, chemotherapy administration, and diagnostic procedures that do not require hospitalization for more than a few hours.

Various diagnostic tests can be performed during a day care visit, with some results available on the same day. Laboratory results are sent by mail and are generally received within 3–4 weeks.

The head nurse of the Neurology Day Care Unit monitors laboratory results, and any abnormal findings are reported to the physician who referred the patient for testing.

The Unit's team includes registered nurses and physicians specializing in neurology, who accompany patients from the time of admission to the Day Care Unit.

Upon completion of treatment, patients receive a medical discharge summary describing the care provided, which should be submitted to their treating physician at their health maintenance organization (HMO).

When further treatment is required, the Unit's administrative staff arrange follow-up appointments according to the treating physician's recommendations.

Headaches are among the most common conditions affecting people worldwide.

The Headache Clinic at Ichilov Hospital provides specialized care for a large number of patients suffering from headaches from across Israel. The clinic aims to achieve the best possible diagnosis and treatment for each patient by making optimal use of the department's expertise while considering available resources. Treatment is based on the principles of evidence-based headache medicine.

The clinic accepts patients referred exclusively by neurology specialists, accompanied by a detailed explanation of the reason for referral. Each referral is reviewed by the clinic's physicians to assess the patient's suitability before an appointment is scheduled.

Follow-up appointments are scheduled exclusively by the clinic's physicians, usually within three months of the initial visit.

LEMON is a research laboratory within the Neurology Division and part of the Center for the Study of Gait and Mobility. The laboratory's research aims to identify and quantify early markers of neurodegeneration and aging.

The research contributes to a better understanding of the pathological processes underlying neurodegeneration by investigating clinical, biological, and neurophysiological markers using sensitive assessment methods, including MRI, functional MRI (fMRI), EEG, functional near-infrared spectroscopy (fNIRS), and wearable sensors.

The extensive knowledge gained from identifying these markers and understanding their relationship to disease onset and progression helps predict patients' risk levels and guide personalized treatment strategies that may modify the processes of neurodegeneration and aging.

The laboratory's team includes senior researchers, neurologists, engineers, and neuroscience students.

The EEG Laboratory performs electroencephalography (EEG) tests to record the brain's electrical activity during wakefulness and sleep in both adults and children. The Laboratory also performs EEG recordings following sleep induction, EEG tests under general anesthesia in children, and prolonged EEG monitoring.

An EEG is a noninvasive and painless examination. The test is performed while the patient lies on a bed or sits in an adjustable chair.

The technician performing the examination attaches electrodes to the scalp using a special paste or adhesive. The electrodes are then connected to the recording system.

Most EEG recordings are performed while the patient is awake. In some cases, EEG monitoring is performed during sleep following sleep deprivation to increase the likelihood of detecting abnormal brain activity.

The Electromyography and Clinical Neurophysiology Laboratory at Tel Aviv Sourasky Medical Center (Ichilov) performs thousands of neurophysiological examinations each year.

These tests provide an objective assessment of peripheral nervous system and muscle function. They are performed by neurologists who have undergone specialized training in this field, together with medical equipment technicians, using advanced computerized equipment.

The Laboratory is also involved in research activities and the training of medical residents.

The Encephalitis and Brain Inflammation Center includes the Autoimmune Encephalitis Clinic and the Neuroinfectious Diseases Clinic. These clinics specialize in a relatively new field of neurology, providing advanced and comprehensive diagnosis and treatment.

Through the appropriate use of new and specialized laboratory tests, these dedicated clinics aim to significantly improve diagnosis, treatment, and recovery outcomes for patients with these conditions.

Autoimmune encephalitis is a serious disease that can cause significant and sometimes irreversible damage to brain tissue within a short period, potentially leading to severe illness and even death. Early diagnosis and treatment are critical to stopping the inflammatory process and preventing brain damage.

The Encephalitis Center at Ichilov also operates a unique, first-of-its-kind clinic dedicated to infectious diseases of the nervous system: the Neuroinfectious Diseases Clinic.

The clinic provides care for patients with neurological manifestations of infectious diseases or inflammatory conditions suspected to have an infectious origin.

Its activities range from managing critically ill patients with meningitis and encephalitis to treating acute and chronic neurological complications of viral infections, such as HIV and varicella-zoster virus, and investigating the potential infectious causes of inflammatory and neurodegenerative neurological diseases.

The Neuroimmunology Clinic specializes in the diagnosis and treatment of a wide range of diseases caused by immune-mediated damage to the nervous system.

These conditions primarily include autoimmune diseases affecting the nervous system, such as multiple sclerosis, myasthenia gravis, optic neuritis, myelitis (inflammation of the spinal cord), primary central nervous system vasculitis, and Susac syndrome.

The clinic also treats neurological conditions associated with systemic autoimmune diseases, including neurological involvement in connective tissue disorders (neuro-rheumatological diseases) such as lupus, Sjögren's syndrome, and sarcoidosis.

Additional conditions treated include neurological disorders that develop following immune stimulation, such as responses to viral infections or vaccinations, as well as autoimmune encephalitis. Some of these conditions may occur as immune responses associated with cancer (paraneoplastic syndromes).

The clinic's multidisciplinary team includes neurologists specializing in neuroimmunology, a senior nurse, a psychologist, a neurological rehabilitation specialist, researchers, a research assistant, and administrative staff.

The team also conducts joint outpatient follow-up with specialists in neurological rehabilitation, rheumatology, and neuroradiology (MRI).

When necessary, patients receive additional care through the Neurology Inpatient Department and Day Care Unit, the Rehabilitation Department and Rehabilitation Day Care Unit, and the medical center's apheresis services.

The Cognitive Neurology Unit operates within the Neurology Division at Tel Aviv Sourasky Medical Center (Ichilov) and provides evaluation and care for individuals with suspected cognitive decline.

Cognitive decline refers to a deterioration in a person's cognitive abilities, which may affect concentration, memory, language functions, and executive functions.

The term dementia describes a condition in which cognitive impairment significantly interferes with a person's ability to perform daily activities and maintain independence.

Cognitive decline and dementia may result from neurodegenerative brain diseases, such as Alzheimer's disease, cerebrovascular diseases, including stroke or cerebral hemorrhage, head injuries, and other conditions.