Stroke-Neurocritical Care

1
Neurology Divisions

• Stroke-Neurocritical Care
• Epilepsy
• Movement Disorders
• Dementia
• Neuromuscular Disorders
• Multiple Sclerosis
• Neuro-oncology
• Headache
• General Neurology
• Pediatric Neurology

2
Neurology Divisions

• Stroke-Critical Care-NeuroIntervention
• Epilepsy
• Neuromuscular Disorders
• Dementia
• Movement Disorders
• Multiple Sclerosis
• Neuro-oncology
• Child Neurology
• Sleep
• Headache

3
Stroke-Neuro Critical Care
Stanford TIA Clinic
TIA gt 50 strokes within 30 days
4
Mismatch Good outcome following repurfusion
Before tPA
65 cc
3 cc
After tPA
Improved
6 cc
0 cc
5
No Mismatch Poor outcome following repurfusion
Before tPA
Before tPA
215 cc
105 cc
After tPA
77 cc
6
MERCI Retrieval System
7
Neuro-critical Care
Dr. Christine Wijman hypothermia therapy
MRI-ADC color map good vs. poor outcome post
cardiac arrest
Poor outcome
Good neurologic recovery
8
Stroke Summary

• TIA Clinic
• Assessment of stroke risks
• Post stroke prevention

9
Epilepsy Level 4 Center

• Diagnosis
• EEG Telemetry
• New generation medications
• Electrical stimulation therapy
• Surgical treatment

10
Epilepsy Electrical Stimulation Therapy
Dr. Robert Fisher Medtronic SANTE Trial Dr.
Martha Morrell Neuropace Trial
11
Movement Disorders

• Parkinsons disease (dx, meds vs DBS)
• Dystonia (Botox)
• Tremor
• Huntingtons disease

12
Deep brain stimulation
Stereotactic functional neurosurgery- a team
approach
13
Parkinsons Deep Brain Stimulation
14
Stanford Human Motor Control and Balance
Laboratory
Dr. Helen Bronte-Stewart
Motion Monitoring Angular Velocity Sensors
Computerized Dynamic Posturography
Quantitative Digitography (QDG)
15
Stanford Center for Memory Disorders
Mild cognitive impairment
Alzheimers disease
16
Conventional MRI scan
17
Stanford Resting State fMRI
Healthy elderly
Early Alzheimers

Drs. Michael Greicius and Vinod Menon
18
Alzheimer trials
clinicaltrials.gov Interventional
San Francisco
Bapineuzumab (antibody) T-817MA
(antibody) LY2062430 (antibody) CAD-106
(immunization) ACC-001 (immunization) LY450139
(?-secretase) PF-04494700 (neuroprotective-RAGE)
SB-742457 (5HT7 antagonist)
Total 633 Open 242 Treatment 205 CA 47 San
Francisco 12 SF New Treatment 8
19
Alternative treatments?
20
Neuromuscular Disorders

• Peripheral neuropathies
• Muscular disorders

21
Multiple Sclerosis
Dr. Larry Steinman Natalizumab (Tysabri)
22
Neuro-oncology
Dr. Larry Recht
Treatment options and quality of life issues
23
Neurology Clinic Contacts
New Pt Referrals 650 725-5792 Fax 650
723-6002 dl-neurocoordinators_at_stanfordmed.org
Main Clinic 650 723-6469
Clinic Mgr Alison Kerr 650 498-6180
Frank Longo longo_at_stanford.edu