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Department of Neurology

Directors' Message

Wade Smith, MD, PhD, Director, Neurovascular Service
S. Claiborne Johnston, MD, PhD, Director, Stroke Service

 

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Our philosophy is that the brain should be the target organ of resuscitation. More than the heart, the lung, the kidneys—avoiding death of brain cells most often saves the patients from the devastating cognitive and physical losses than can follow a critical injury. Wade Smith, MD, PhD

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The UCSF Neurocritical Care and Stroke Service is a major referral center for patients with acute brain injuries, treating 600 inpatients and 1000 outpatients per year. The UCSF Neurointensive Care Unit applies the advanced techniques of intensive care medicine to the treatment of neurological disorders.

At UCSF, stroke patients are aggressively treated with advanced clinical protocols, including tPA (tissue plasminogen activator). tPA is a highly effective treatment in many cases. Because of its risks of bleeding, and the relatively short window of time it must be used, tPA is applied in only 3% of all stroke cases nationally.  At UCSF we treat nearly 20% of stroke patients. Yet, we strive to treat an even broader group of patients. A revolutionary new intervention used at UCSF is mechanical clot retrieval, in which a tiny device is threaded to the brain through the patients arteries. The device carefully snares the clot and pulls it free, clearing the arterial obstruction. Combining the treatments of tPA and these advanced catheter-based treatments gives patients the best chance of making a neurological recovery. Since UCSF helped pioneer these treatments, we are among the most experienced in the world to treat stroke.

UCSF is one of the busiest cerebral aneurysm treatment centers in the US, employing two state-of-the-art interventions, "clipping" and "coiling." The clipping procedure is performed by placing a metal clip over the neck of the aneurysm. This delicate procedure is done by one of the most experienced neurosugeons in America, Dr. Michael Lawton. Coiling of an aneurysm is performed by placing metal coils within the aneurysm through a catheter (small tube). This procedure was pioneered in part at UCSF, making UCSF the most experienced center nationally to have this done. Our UCSF researchers are advancing neuroimaging techniques as diagnostic tools for stroke and aneurysm and pursuing the role of genetics in causes and outcomes of stroke.

Stroke and aneurysm patients can expect a safe and effective arsenal of treatments at UCSF Medical Center. Mechanical retrieval options for stroke treatment are available, as are interventions for cerebral hemorrhage. Advanced neuroimaging technologies are employed for diagnosis and treatment.
 
UCSF also specializes in the care of children with stroke, vascular malformations, and aneurysms through the UCSF Benioff Children's Hospital Stroke and Cerebrovascular Disease Center. One of only a handful of pediatric stroke centers nationwide, this is the only one with two neurologists board certified in both Child Neurology and Vascular Neurology, Dr. Heather Fullerton and Dr. Christine Fox.

 

 

 

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