The Emory Cerebrovascular Service Emory MBNA Stroke Center

The Emory Cerebrovascular Service Emory MBNA Stroke Center C. Michael Cawley, MD SNS 2012

Neuroradiology Interventional Neuroradiology Stroke Neurology Neurocritical Care Neurosurgery Cerebrovascular Surgery

Emory MBNA Stroke Center Daniel L. Barrow, MD Director The REAL “Barrow Neurological Institute”

The Emory Stroke Center • Cross-Academic Center of Excellence – Department of Neurosurgery – 2 surgeons – 1 interventionalist – 1 NP – Department of Neurology – – 8 Neurointensivists 7 Stroke Neurologists 2 Interventionalists 3 NPs – Department of Radiology – 2 Interventionalists – 14 Neuroradiologists Department of Rehab Medicine Department of Emeregency Medicine

The Emory Stroke Center • EUH 2011: • 488 hemorrhagic strokes • 597 ischemic strokes • EUHM 2011: (PSC CY 2012) • 67 hemorrhagic strokes • 312 ischemic strokes • GMH 2011 • 83 hemorrhagic strokes • 549 ischemic strokes EJCH (PSC) STHA (PSC)

Emory Stroke Center Research • Basic Science • • • Glutamate Rs NMDA Rs Cell transplant therapy for stroke Neuronal repair Ischemic neuronal death Traynelis, Wei, Yepes, and others…

Emory Stroke Center Research • Clinical – – – – – Coverdell Stroke Registry BIOSIS ERICH PRO-TECT III (+Progesterone) TREVO-2, Penumbra, SWIFT, DAWN SAMMPRIS Aneurysm therapy (Hydrocoil, Pipeline, etc) Computational flow dynamics CREST, COSS • Frankel, Gupta/Nogueira, Nahab, Wright, Dion, Barrow, Cawley, Tong, Samuels

Emory Stroke Center Academic • Stroke Fellowships: 2 – Nahab/Frankel • INR Fellowships: 4 (two each year) – Dion • CV Fellowships: Variable (combined) – Cawley • Resident Access: – 3 month elective (Currently)

Emory Stroke Center: EUH CV Service • Neurosurgery – Daniel L. Barrow, MD FACS • Professor and Chair • Director Emory/MBNA Stroke Center – C. Michael Cawley, MD FACS • Associate Professor • Director Inpatient CV Service and CV Fellowship

Emory Stroke Center: EUH CV Service • Radiology – Jacques E. Dion, MD • Professor, Director INR and INR Fellowship – Frank C. Tong, MD • Associate Professor

Emory Stroke Center: EUH CV Service • Neurology • Owen B. Samuels, MD – Associate Professor, Director Neurocritical Care • Raul G. Nogeuira, MD – Associate Professor, Director GMH Marcus Center Neuroendovascular and Neurocritical Care Services • Rishi Gupta, MD – Associate Professor, Director Multi-Hospital Acute Stroke Network, GMH Marcus Center • Fadi Nahab, MD – Assistant Professor – Director Stroke Programs EUH/EUHM

Emory Stroke Center: EUH CV Service • Hemorrhagic Stroke – 2010: 482 » SAH: 327 • 42% endovascular; 25% Open – 2011: 488 • Aneurysms – 2010: Crani 111; Endo 227 – 2011: Crani 104; Endo 245 • AVM – 2010: Crani 41; Endo 22 – 2011: Crani 38; Endo 19

Emory Stroke Center: EUH CV Service • Inpatient – Split Services • “Gold” Service is the CV Service – Dedicated NS Chief & PGY 2 – 3 INR/CV Fellows; 1 NP – Cawley/Barrow • Morning sign-in and afternoon CV Rounds • Outpatient – Multidisciplinary Clinics • NS/INR/Stroke Neurology

Emory Stroke Center: EUH CV Service • How has it worked? VISION LEADERSHIP SINGLE COST-CENTER ALIGNED INCENTIVES COLLEGIALITY TEAMWORK