Division of Neurocritical Care
In the Division of Neurocritical Care, part of NYU Langone Health’s Department of Neurology, we treat critically ill patients who have conditions that affect the brain, spine, and nervous system. Our physicians oversee more than 50 intensive care unit (ICU) beds—34 at NYU Langone’s Kimmel Pavilion and multiple flex beds at NYU Langone Hospital—Brooklyn. Care is provided 24 hours a day, 7 days a week by our division’s neurologists, who are all fellowship trained and board certified in neurocritical care.
Conditions we treat include hemorrhagic stroke, including intracerebral hemorrhage, subarachnoid hemorrhage, and brain aneurysm rupture; traumatic brain injury; large ischemic stroke; brain infections; acute spinal cord injury; status epilepticus; and neuromuscular diseases, such as Guillain-Barré syndrome and myasthenia gravis.
We are highly integrated with NYU Langone’s Center for Stroke and Neurovascular Diseases and the Comprehensive Stroke Center, where we care for people who have had a stroke and coordinate care from stroke risk identification through treatment and recovery. We work closely with the Division of Epilepsy to treat patients requiring epilepsy surgery and for treatment of status epilepticus, and we also collaborate with the Department of Neurosurgery to manage their most complex patients as a team.
Our advanced neurological technical capabilities include brain oxygen monitoring with the Licox® Brain Tissue Oxygen Monitoring System, intracranial pressure monitoring, 24-hour continuous video electroencephalographic monitoring, therapeutic temperature modulation, and advanced hemodynamic monitoring.
Our division is composed of the following physicians:
Harpaul S. Bhamra, MD
Leah Dickstein, MD
Jennifer A. Frontera, MD
David E. Kahn, DO
Sok W. Lee, MD
Ariane Lewis, MD
Jessica Lin, MD
Aaron S. Lord, MD
Kara R. Melmed, MD
Rajanandini Muralidharan, MD
Ting Zhou, MD
A unique feature of our division’s capabilities at NYU Langone Hospital—Brooklyn is our ability to use telemedicine to consult on stroke cases with outside facilities via secure, high-definition videoconferencing. Using state-of-the-art hardware and software, our physicians can examine stroke patients, read CT scans, and coordinate further care—extending the highest-quality specialty care to patients in neighboring Brooklyn communities.
Neurocritical Care Research
Our division members take part in investigator-initiated research. Through ongoing research meetings, we discuss research topics and best practices for data sharing.
NYU Langone is also a participation site for the National Institute of Health’s StrokeNet, a network of more than 200 hospitals across the United States that serves as the infrastructure and pipeline for potential new treatments for people who have had a stroke and those at risk for stroke. Through StrokeNet, we are able to conduct research studies and clinical trials at NYU Langone to provide better outcomes for people with neurocritical illnesses.
Neurological Emergencies Outcomes at NYU
A highlight of our division’s research is our prospective database, Neurological Emergencies Outcomes at NYU (NEON), which tracks patients with intracerebral and subarachnoid hemorrhages.
Neurological injury is sometimes associated with permanent physical, intellectual, and emotional problems that affect basic activities of daily living and long-term quality of life. Through NEON, we can identify specific findings during hospitalization and before injury that may be linked to hospital-acquired infections in patients who have recently had a neurological injury, and determine the impact of hospital-acquired infections in patients with neurological injury on life satisfaction and objective quality of life. This information may lead to the development of improved treatments and rehabilitation interventions that specifically address the needs of patients with neurological injury.
We are currently a StrokeNet site participant in the AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke (ARCADIA) trial. ARCADIA is a multicenter, biomarker-driven, randomized, double-blind, active-control, phase 3 clinical trial comparing apixaban and aspirin in patients who have evidence of atrial cardiopathy and a recent stroke of unknown cause.
At NYU Langone Hospital—Brooklyn, we are participating in the phase 3 Safety and Efficacy of NA-1 in Subjects Undergoing Endovascular Thrombectomy for Stroke (ESCAPE-NA1) trial. The ESCAPE-NA1 trial has a randomized, multicenter, blinded, placebo-controlled, parallel group, single-dose study design. It will determine the safety and efficacy of the neuroprotectant NA-1 in reducing global disability in patients who have had a major acute ischemic stroke with a small, established infarct core and with good collateral circulation who are selected for endovascular revascularization.
We also participated in the Intracerebral Hemorrhage Deferoxamine Trial (iDEF). As a prospective, multicenter, double-blind, randomized, placebo-controlled, phase 2 clinical trial, iDEF sought to determine whether treatment with deferoxamine mesylate improves the outcome of patients with brain hemorrhage. Results from this trial are pending.
Neurocritical Care Education
We help train medical students, neurology residents, and vascular neurology fellows. Residents in their junior year spend a month caring for patients in the neurological ICU under the guidance of our experts. Senior residents provide night coverage for the ICU and mentor junior residents.
Vascular neurology fellows spend two weeks rotating through our division, running rounds and monitoring patients in the ICU.
Continuing Medical Education
We participate in stroke continuing medical education (CME) events, including the Department of Neurology’s Annual Stroke Update. We also help teach a Foundations of Critical Care Medicine course for physician assistants and nurse practitioners throughout NYU Langone.
At NYU Langone Hospital—Brooklyn, our division members teach the Emergency Neurological Life Support (ENLS) course. ENLS helps healthcare professionals improve patient care and outcomes during the critical first hours of a neurological emergency.
A multiyear brain internship in the Division of Neurocritical Care is available for NYU undergraduates who are interested in the neurosciences and medicine and want to learn more about neurocritical care. Interns help manage the NEON database and gain exposure to medical documentation and terminology. The internship is offered to two to three undergraduates each year. For more information about our internship, please contact Dr. Lewis at email@example.com.
To learn more about the Division of Neurocritical Care, please contact Dr. Lewis, division director, at firstname.lastname@example.org, or Dr. Lord, chief of neurology at NYU Langone Hospital—Brooklyn, at email@example.com.