In a neurological emergency – such as acute stroke, cardiac arrest (when the heart stops), or traumatic brain or spinal injury – the first 48 hours can make the difference between life and death. Without swift and advanced care, the initial damage to the brain can set off a cascade of related complications – such as increased pressure inside the skull, seizures, and fever – which heighten the injury and reduce the patient's chance of a full recovery. Getting the most advanced and comprehensive care available within the first 48 hours of an injury can halt this cascade and raise the patient's chance of achieving the best possible recovery.
NewYork-Presbyterian has a world-renowned neurocritical care program providing the most advanced care in the region. Both NewYork-Presbyterian/Columbia University Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center have Neurological Intensive Care Units (Neuro-ICUs) offering specially trained medical staff, round-the-clock surveillance, state-of-the-art brain monitoring, and specialized medical and surgical treatments to minimize immediate and delayed brain damage and maximize each patient's chance for a full recovery. There is a New York State-designated Level 1 Adult Trauma Program at NewYork-Presbyterian/Weill Cornell, and Level 1 Regional Pediatric Trauma Programs at both the NewYork-Presbyterian/Weill Cornell and NewYork-Presbyterian/Columbia campuses.
Our world-renowned neurocritical care programs offer the most advanced services in the region, including:
- A "mobile ICU" for patient transfer. Physicians who wish to transfer a patient to NewYork-Presbyterian Hospital for stroke, trauma, or other neurocritical care can call us at 1-800-NYP-STAT (1-800-697-7828) to arrange for a transfer, 24/7.
- Clot-busting treatment for ischemic stroke. We offer t-PA (tissue plasminogen activator), the clot-dissolving drug that is the FDA-approved therapy of choice for stroke. To be effective, t-PA must be given within four and a half hours of the onset of symptoms.
- Acute stroke "revascularization." This approach is used to remove the stroke-causing clot from the blocked artery in the brain. This emergency therapy is the only way to extend the treatment window for acute stroke.
- Brain cooling ("therapeutic hypothermia"). Cooling the brain can prevent tissue damage, reduce brain swelling, and significantly improve the likelihood of a good recovery in patients with cardiac arrest. Our Neuro-ICU program is a national leader in the application of therapeutic hypothermia for these patients.
- Advanced monitoring and imaging. Continuous monitoring enables our Neuro-ICU specialists to prevent, detect, and treat secondary brain injuries that often develop after a stroke. Our Neuro-ICUs are among the few in the world with dedicated scanners within each unit for immediate neuro-imaging. To monitor seizure activity (an important cause of secondary damage after brain injury), we provide continuous electroencephalography (EEG) monitoring with EEG technicians on-site 24/7.Our Neuro-ICUs are the only units in the New York region with this capability.
- Depth of experience. Many studies have shown that stroke patients treated at high-volume centers have the best rates of survival and recovery, and that outcomes for patients with life-threatening brain injuries are improved when care is delivered in a specialized neuro-ICU. Our Neuro-ICUs are also home to one of the largest and most successful neurocritical care fellowship training programs in the country.
- Family-centered care. NewYork-Presbyterian is spearheading an effort to establish family-centered care, allowing families to play an active role in decision-making about strategies to improve care on critical care units. We consider the patient and his/her family to be an important part of our care team and encourage their participation in decisions about treatment in all phases of the recovery process.
- Early integration of rehabilitation. Beginning rehabilitation as early as is safely possible is an essential part of NewYork-Presbyterian's approach to neurocritical care, as it promotes each patient's transition from critical illness to recovery.
Patients with the following diseases and conditions may benefit from urgent transfer to a Neuro-ICU:
- Brain aneurysms
- Subarachnoid or intracerebral hemorrhage (bleeding in the brain)
- Acute ischemic stroke (a clot blocking blood flow to the brain)
- Traumatic brain injury
- Brain arteriovenous malformations
- Dural sinus thrombosis
- Status epilepticus
- Cardiac arrest (heart attack)
- Guillain-Barre syndrome
- Myasthenia gravis