Neurocritical Care Fellowship Earns Prestigious Accreditation

CINCINNATI—The United Council for Neurologic Subspecialties has accredited the neurocritical care fellowship program at the Neuroscience Institute at the University of Cincinnati (UC) and University Hospital.

The neurocritical care accreditation, achieved by only nine institutions nationally, heightens the stature of UC’s program, which provides advanced training in the focused, specialized care of patients who have sustained a severe neurological injury.

Patients in a neurocritical care setting typically have suffered massive strokes, intracerebral hemorrhages, subarachnoid hemorrhages, severe brain or spinal cord injuries or continuous seizures.

“We are proud to be among the first tier of groups accredited,” says Lori Shutter, MD, associate professor of neurosurgery/neurology and director of neurocritical care. “But the real winners in this development are the residents of Greater Cincinnati. They can rest assured that, should they need the most advanced care for a brain or spinal condition, that care is right here in their own community.”

A neurocritical care program is one that has dedicated physicians—called neurointensivists—who specialize in the care of the neurologic patient and are available to manage the patient in a specialized intensive care unit. The concept is still relatively new. According to the Neurocritical Care Society, which was formed in the late 1990s, only 39 programs in the United States have a separate, recognized neurocritical care division.

“We were one of the earliest centers to recognize the importance of this valuable resource,” says Raj Narayan, MD, professor and chairman of UC’s department of neurosurgery. “And we are fortunate to have been able to attract such an extraordinary team to Cincinnati.”

“Neurocritical care patients must be managed differently from the typical medical patient,” Shutter says. “They have unique requirements for fluids, they have unique conditions, and they suffer unique complications.”

The neurocritical care program forms a backbone of support for patients who are recovering from surgery of the brain or spine, patients of UC Physicians who have undergone airway reconstruction, and patients who have been treated by the Greater Cincinnati/Northern Kentucky Stroke Team.

The UC program graduated its first two neurocritical care fellows this spring. One of the fellows, Opeolu Adeoye, MD, has been successfully retained and will continue working in the division. He and the recently hired Krishna Mohan, MD, are the Neuroscience Institute’s second and third neurointensivists. Shutter, the region’s first neurointensivist, was recruited from Loma Linda University in 2003.

University Hospital’s 20-bed neuroscience intensive care unit (NSICU), which is part of the Neuroscience Institute, is staffed 24 hours a day by highly trained nurses. Its state-of-the-art technology includes:

• A portable CT scanner, which eliminates the risks associated with transporting patients to other parts of the hospital for procedures;
  
• Advanced monitoring of critical values in the brain, such as brain oxygen levels and brain blood-flow levels;
  
• Increased monitoring for seizures. New data suggests that the incidence of seizures in comatose patients is much higher than what was previously expected.

The Neuroscience Institute, a regional center of excellence, is dedicated to patient care, research, education, and the development of new treatments for stroke, brain and spinal tumors, epilepsy, traumatic brain and spinal injury, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, disorders of the senses (swallowing, voice, hearing, pain, taste and smell), and psychiatric conditions (bipolar disorder, schizophrenia and depression).