Emergency Medicine, will roll out in early 2015. Offering this capability 24/7 in NYU Langone’s new, state-of-the-art Perelman Center for Emergency Services is just one of the innovative approaches employed by the center’s vascular neurology team. COMPREHENSIVE STROKE CARE CENTER Shaving Minutes, Saving Brain Cells The team also partners proactively with the stroke center’s neurointerventionalists, utilizing the latest research to identify appropriate candidates for mechanical clot extraction or for delivery of tPA directly to the clot in those cases where intravenous tPA is not indicated or isn’t working sufficiently. And they partner closely with the Medical Center’s Neuro ICU on severely ill cases and work with Rusk Rehabilitation’s world-class stroke rehabilitation team on post-acute recovery. Their engagement in community outreach regarding early recognition of stroke symptoms is also designed to help reduce the time-to-tPA by increasing awareness. The center is also actively investigating other aspects of post-stroke care. Its recent selection as one of 25 regional coordinating centers in StrokeNet, the NIH’s new centralized stroke research consortium, ensures that the center will continue to be at the forefront of clinical care and research in the years ahead. “The ultimate outcome we strive for is recovery with minimal or no disability,” notes Dr. Ishida. “We’re trying to get people back to work, and back to their lives.” 2014 Highlights — • 30 percent increase in patient volume since April 2014 • Chosen as one of 25 regional coordinating centers for StrokeNet, the new NIH stroke clinical research consortium Average < 60 minutes “door-to-needle” time Awarded AHA Stroke Gold Plus status for four consecutive years PAGE 12 NYU LANGONE MEDICAL CENTER / NEUROLOGY AND NEUROSURGERY / 2014 With three neurointensivists and a 10-bed unit supervised by an attending physician around the clock, NYU Langone’s Neuro ICU has quickly established itself as a leading facility in the region. In addition to a full array of state-of-the-art technology—including intracranial pressure monitoring, 24/7 EEG brain monitoring capability, transcranial Doppler ultrasound, and noninvasive brain-cooling techniques—the staff also employs innovative, proactive protocols to optimize patient safety and quality of care. “When caring for post-neurosurgery patients, for example, we’ll bypass the PACU and take a handoff straight from the neuro-anesthesiologist,” says Aaron Lord, MD, Neuro-Critical Care division chief, “so there’s a continuous stream of critical care.” The unit’s physicians are complemented by a superb nursing team and highly skilled support personnel. “Whether a patient is dealing with hemorrhagic brain disease, stroke sequelae, traumatic brain injury, hydrocephalus, or post-neurosurgical recovery,” notes Dr. Lord, “this is what we do all day, every day. Our patients require very specific fluids, ventilation, and blood pressure goals—and you need a thorough understanding of both critical care and neurology to do that well.” NEURO-CRITICAL CARE A State-of-the-Art Neuro ICU, Where Quality and Safety Are Paramount 2014 Highlights — • Expanded to take critically ill neurology patients as well as all post-neurosurgery patients • Implemented first-ever neuro-critical care residency rotation Includes access to a 10-bed Neurosurgical Intensive Care Unit, three neurointensivists, a full-time attending neuroradiologist, and four neurointerventional radiologists NYU LANGONE MEDICAL CENTER / NEUROLOGY AND NEUROSURGERY / 2014 PAGE 13 CLINICAL CARE Building on an annual volume that has increased steadily over the past half-decade, NYU Langone’s Brain Tumor Center recorded some impressive numbers in 2014—including several hundred procedures to remove benign and metastatic brain tumors, over 100 skull-base cranial procedures, dozens of trans-nasal endoscopic surgeries, and hundreds more brain tumor patients treated with Gamma Knife® radiosurgery. What these numbers don’t show, however, is the complexity of cases handled by the center’s surgeons—they are among the most complex brain tumor cases in the New York metropolitan area and beyond. “With the team we’ve established, there’s no procedure our department can’t handle,” says John G. Golfinos, MD, chair of neurosurgery and an internationally recognized specialist in open-skull, minimally invasive and Gamma Knife brain tumor surgery. “That includes the surgical treatment of rare brain tumors related to neurofibromatosis type 2, craniopharyngioma, and rare skull base tumors like chordoma.” As Dr. Golfinos notes, by doing these rare, highly demanding procedures on a regular basis, NYU Langone’s neurosurgeons also keep their skills honed for more standard brain surgeries. Despite its focus on challenging brain procedures, with the potential complications these entail, in 2014 the center’s program was ranked number one in the U.S. by the University Hospital Consortium (UHC) in quality and safety for cranial procedures, with top ratings in mortality and most other individual UHC categories. At the same time, the center continues to advance its navigational imaging capabilities, and is teaming with NYU Langone’s neuropsychologists on an innovative initiative to assess patients before and after surgery, in order to better understand