Neurocritical Care Division

The Neurocritical Care Division focuses on patient care, research, and training related to the acutely ill neurological patient.  The division conducts research to improve the understanding of these conditions and patient outcomes.  In addition, the division trains nurses, medical students, residents, fellows and nurse practitioners in the principles and practices of neurocritical care.

Academic Overview

The division offers a Neurocritical Care fellowship, a two-year long program that trains physicians in the acute care of critically ill patients with an underlying neurological process. Specific diseases and conditions include but are not limited to: cerebrovascular disorders, neurotrauma, neuro-oncology, refractory seizures, neuromuscular diseases, infections, disorders of consciousness, and perioperative neurosurgical care.

Our Team

Our Neurocritical Care Division has one of the largest faculties in the country of attending physicians board certified in Neurocritical Care. At present there are nine board certified neurointensivist physicians and five nurse practitioners with advanced training in neurocritical care.  Our neurocritical care physicians come from a variety of medical backgrounds including Neurology, Emergency Medicine, and Internal Medicine. 

Areas of Expertise

UC neurocritical care physicians have expert level knowledge about life threatening neurological and neurosurgical disorders as well as medical conditions common in the critically ill.

Our specific areas of expertise include cerebrovascular disorders (such as ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage), traumatic brain injuries of all types, brain tumors, uncontrolled seizures, encephalitis, meningitis, coma and disorders of consciousness, spinal cord injuries, and neuromuscular disorders causing weakness such as myasthenia gravis and Guillain-Barre. 

Our Neuroscience ICU has numerous capabilities including:

• Multimodality Intracranial Neuromonitoring:
  • Intracranial pressure monitorning
  • Brain tissue oxygen monitoring
  • Implanted electrodes to record seizures and spreading depolarizations
  • Continuous brain blood flow measurements at the bedside
• Bedside data integration of brain monitoring data using the Moberg Component Neuromonitoring System with advanced full-band EEG capabilities
• Continuous non-invasive video/EEG monitoring 24/7 and bedside quantitative EEG for rapid review and detection
• Continuous non-invasive cardiac output monitoring

Our Facility

We work exclusively at the University of Cincinnati Medical Center which is a 605 bed hospital in Cincinnati. UCMC is the only Level I trauma center and the only JCAHO-certified Comprehensive Stroke Center in the region. We work in a 20 bed Neuroscience Intensive Care Unit with state of the art neuromonitoring capabilities. A neurocritical care trained attending physician, fellow, or advanced nurse practitioner is on duty in our Neuroscience ICU 24 hours a day. Our ICU admits over 1500 patients per year with transfers coming to us from hospitals throughout our region.

Research Activity

Our UC Neurocritical Care physicians and staff play an important role in brain injury research and the establishment of evidence-based treatment for stroke, ruptured aneurysms, brain bleeds, severe seizures and traumatic brain injuries.  The Collaborative for Research on Acute Neurological Injuries (CRANI) forms a programmatic home for clinical and translational research scientists across UC and its affiliates, crossing the boundaries of individual disease and allowing for novel multidisciplinary approaches to dealing with severe brain and spinal cord injuries. Our team joins with other institutions across the country and world to advance our understanding of the most severe brain injuries. We believe clinical research offers patients the opportunity to be a part of the most cutting-edge care available first at UC.

UC Neurocritical Care is involved in federal-, defense-, and industry-funded clinical research, including:

1. Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) – an NIH-funded multicenter observational clinical effort led by the University of California, San Francisco that aims to improve our understanding of traumatic brain injury and its outcome. TRACK-TBI also supports a specific substudy to examine the impact of intracranial pressure on cognitive outcome following severe TBI.
2. Critical Care EEG Monitoring Research Consortium – a multicenter and international observational research infrastructure including partners at Yale, Columbia, the Massachusetts General Hospital and others that specifically.
3. The Epilepsy Bioinformatics Study (EpiBioS4Rx) – an NIH-funded multicenter observational project to understand the development of epilepsy after traumatic brain injury and to design treatment to prevent it.
4. Development of a Transcranial Ultrasonographic Exam for the Management of Acute Traumatic Brain Injury – a DOD-funded study examining the use of non-invasive measurements to detect elevated intracranial pressure.
5. Spreading Depolarizations II – a DOD-funded study that leverages the TRACK-TBI infrastructure and incorporates cutting-edge electrocorticography and scalp EEG to detect and understand the incidence of spreading depolarizations across the spectrum of traumatic brain injury.
6. CHARM – an industry-funded phase III study that will examine a novel infusion of glibenclamide to reduce brain swelling starting during the first day after large stroke.