Dr. Macellari's predominant specality is clinical neuropsychology, a well established discipline within the field of rehabilitation medicine. He is also an experienced geriatric clinician who was trained at Northwestern University Medical Schools older adult program. Neuropsychologists must be familiar with many aspects of neurology, physiatry, and psychiatry, as well as various interpretations of commonly used psychological tests as they relate to neuropsychology. Since all human behavior is performed through multiple neurophysiological pathways, neuropsychologists strive to find how disruptions in these pathways will effect the behavioral outcome of the patient.
Since many older adults experience problems with their brain functioning, Dr. Macellari's background in geriatrics is extremely beneficial. His education and experience are not, however, limited to the older adults. Dr. Macellari's patients consist of most age groups (with the exception of young pediatrics).
Some of the more common diagnoses Dr. Macellari provides care for include:
Traumatic Brain Injury
Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. The worst injuries can lead to permanent brain damage or death. Symptoms of a TBI may not appear until days or weeks following the injury. Serious traumatic brain injuries need emergency treatment.
Treatment and outcome depend on both the type of trauma and the state of the individual before the injury. TBI can cause a wide range of changes affecting memory, thinking, sensation, language, or emotions. TBI can also be associated with post-traumatic stress disorder. People with severe head injuries usually need rehabilitation.
A stroke or cerebrovascular accident (CVA) happens when blood flow to a specific part of the brain is disrupted. If the blood flow is stopped for longer than a few minutes, the brain is robbed of blood and oxygen. Brain cells can die, causing permanent damage. The symptoms and damage caused from a stroke depend on what part of the brain's blood supply is interrupted.
Frequently, serious pain accompanies many different diagnoses that affect the brain and spinal cord. Since the brain controls all of our physical and sensory functions, it also controls the perception of pain. Understanding how the brain works can help an individual manage and control his or her pain. Instruction in autonomic responsivity, biofeedback, stress inoculation, training and various other neurobehavioral pain management strategies can be extremely helpful in learning how to cope with the various stressors that accompany chronic pain.
Alzheimer's Disease and Other Dementias
Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities. There are many different typs of dementia and each type can initially present different symptoms and challenges to both patients and their loved ones.
Alzheimer's disease often begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or the names of people they know. Over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. This can cause great stress for family members who must care for them.
Alzheimer's disease usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease. While presently there is no treatment that can stop the disease, some drugs may help to keep symptoms from getting worse for a limited time.
Post Traumatic Stress Disorder
You can get Post Traumatic Stress Disorder (PTSD) after living through or witnessing a traumatic life threatening event (e.g. war, hurricane, rape, physical abuse or a bad accident) when you have PTSD you can feel anxious, stressed and afraid after the danger is over. PTSD can seriously affect your life and the people around you.
PTSD can cause problems like:
Flashbacks, or feeling like the event is happening again
Trouble sleeping or nightmares
Feeling alone and isolated
Feeling worried, guilty or sad
PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event or months or even years later. PTSD can happen to anyone, even children.
Medicines can help you feel less afraid and tense. It might take a few weeks for them to work. Talking to a specially trained doctor or counselor also helps many people with PTSD. This is called talk therapy or psychotherapy.
Attention Deficit Disorders
The main features of Attention Deficit Disorder (ADD) are:
No one knows exactly what causes ADD. It sometimes runs in families, so genetics may be a factor. There may also be environmental factors.
A complete evaluation by a trained professional is the only way to know for sure if your child has ADD. Treatment may include medicine to control symptoms, therapy, or both.
Multiple Sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. They can include
Trouble with coordination and balance
Sensations such as numbness, prickling, or "pins and needles"
Thinking and memory problems
At present we are not sure what causes MS. It may be an autoimmune disease, which happens when your body attacks itself. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people can lose the ability to write, speak or walk. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.
Fear and anxiety are part of life. You may feel anxious before you take a test or walk down a dark street. This kind of anxiety is useful - it can make you more alert or careful. It usually ends soon after you are out of the situation that caused it. But for millions of people in the United States, anxiety does not go away, and can get worse over time. They may have chest pains or nightmares. They may even be afraid to leave home. These people have anxiety disorders. Types include:
Post-traumatic stress disorder
Generalized anxiety disorder
Treatment can involve medicines, therapy or both.
Depression is a disorder of mood. There are a variety of causes, including genetic, environmental, psychological, and biochemical factors. Depression usually starts between the ages of 15 and 30, and is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is also one component of a bipolar affective disorder.
The two most common forms of effective treatment for depression include, antidepressants and talk therapy. Most people benefit from both.
Seizures are symptoms of a brain-based problem. They happen because of sudden, abnormal electrical activity in the brain. When people think of seizures, they often think of convulsions in which a person's body shakes rapidly and uncontrollably. However, not all seizures cause convulsions. There are many types of seizures and some have mild symptoms. Seizures fall into two main groups. Focal seizures, also called partial seizures, happen in just one part of the brain. Generalized seizures are a result of abnormal activity on both sides of the brain.
Most seizures last from 30 seconds to 2 minutes and do not cause lasting harm. However, it is a medical emergency if seizures last longer than 5 minutes or if a person has many seizures and does not wake up between them. Seizures can have many causes, including medicines, high fevers, head injuries and certain diseases. People who have recurring seizures due to a brain disorder have epilepsy. Seizure disorders can also cause anxiety, mood, thinking, and memory disorders. Meeting with a neuropsychologist to discuss these kinds of problems can be quite helpful.