As a clinician in the Neurosciences Intensive Care Unit, I strive to provide cutting-edge care for severely brain-injured patients. In my relatively young field of neurocritical care, many of our treatment paradigms lack the mature evidence base of other fields. As a clinician-scientist it is my goal to conduct clinical trials to enhance understanding of underlying pathophysiology, and to test novel mechanism-based treatments to aid the maturation of our subspecialty.
Through clinical encounters with challenging patients during my fellowship, I developed a strong interest in autonomic dysfunction after acute brain injury. I became dissatisfied with mere symptom management, and desired to understand the pathophysiology underlying the clinical manifestations we observed in the ICU. Since joining the faculty at OHSU, my interests have broadened to include other types of autonomic dysfunction, specifically hyperthermia or fever, after severe brain injury. To address this clinically relevant issue, I designed an observational study to test the hypothesis that early fever after severe TBI was associated with neurologic deterioration, and/or promoted the production of pro-inflammatory cytokines. I was awarded the Oregon Multidisciplinary Training Program for Emergency Medicine Clinical Research K12 for my projected, entitled "Fever and Inflammation in Neurotrauma (FAINT)."
2010—Abstract Dual Catheters in Severe Intraventricular Hemorrhage selected for presentation in Critical Care and Emergency Neurology Section Highlights in the Field at the 62nd American Academy of Neurology Annual Meeting, Toronto, Canada.
2010—Awarded a fellowship to attend NINDS sponsored Clinical Trial Methods Course in August 2010 for Dysautonomia in Traumatic Brain Injury protocol.
2011—Abstract Anatomical basis of paroxsysmal sympathetic hyperactivity chosen to be featured as a daily highlight among the best abstracts accepted for presentation at the 24th Annual Congress of the European Society of Intensive Care Medicine.
2012—Winner of the American Academy of Neurology Practice Research Training Fellowship Grant 2012 for Quantifying Paroxysmal Sympathetic Hyperactivity in Traumatic Brain Injury.
2013—Session entitled "Weathering the Storm: Brain Injury & the Autonomic Nervous System" selected as the members submitted session for the 11th annual NCS meeting.
2014—American Heart Association Young Investigator Award for abstract, "Differences in Inflammatory Dysregulation in TBI versus Major Trauma" submitted to the 2014 Resuscitation Science Symposium, Chicago, IL.Read more
- B.A., Rice University, Houston Texas 2001
- M.D., University of Texas Health Science, San Antonio Texas 2005
- M.C.R., Oregon Health & Science University 2016
- Intern, Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, 2006
- Fellow, neurologic critical care, Department of Neurology, anesthesiology and critical care medicine and neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, 2011
- American Board of Psychiatry and Neurology, 2009
Memberships and associations
- 2004–present American Academy of Neurology, member
- "Future Directions for Hypothermia following Severe Traumatic Brian Injury." Seminars in Respiratory and Critical Care Medicine In: , Vol. 38, No. 6, 01.12.2017, p. 768-774.
- "Early Fever after Trauma : Does it Matter?" Journal of Trauma and Acute Care Surgery In: , 20.06.2017.
- "Medical Management of the Severe Traumatic Brain Injury Patient." Neurocritical Care In: , 01.06.2017, p. 1-17.
- "Hemodynamic and neuro-monitoring for neurocritically ill patients : An international survey of intensivists." Journal of Critical Care In: , Vol. 39, 01.06.2017, p. 40-47.
- "Curiosity killed the cat (scan)." Resuscitation In: , Vol. 113, 01.04.2017, p. A1.
- "Early Fever As a Predictor of Paroxysmal Sympathetic Hyperactivity in Traumatic Brain Injury." Journal of Head Trauma Rehabilitation In: , 05.01.2017.
- "Safety and efficacy of intravenous glyburide on brain swelling after large hemispheric infarction (GAMES-RP) : a randomised, double-blind, placebo-controlled phase 2 trial." The Lancet Neurology In: , Vol. 15, No. 11, 01.10.2016, p. 1160-1169.
- "Blowing the whistle on sports concussions." Neurology In: , Vol. 85, No. 17, 27.10.2015, p. 1442-1443.
- "Timing of deep vein thrombosis formation after aneurysmal subarachnoid hemorrhage." Journal of Neurosurgery In: , Vol. 123, No. 4, 01.10.2015, p. 891-896.
- "Blurred lines : Reduced discrimination of gray white junctions observed on CT in out-of-hospital cardiac arrest (OHCA) portends poor prognosis." Resuscitation In: , Vol. 92, 01.07.2015, p. A1.
- "Neuroanatomical basis of paroxysmal sympathetic hyperactivity : A diffusion tensor imaging analysis." Brain Injury In: , Vol. 29, No. 4, 01.04.2015, p. 455-461.
- "Clinical evidence of inflammation driving secondary brain injury : A systematic review." Journal of Trauma and Acute Care Surgery In: , Vol. 78, No. 1, 13.01.2015, p. 184-191.
- "Autonomic dysfunction syndromes after acute brain injury." Handbook of Clinical Neurology In: , Vol. 128, 2015, p. 539-551.
- "Pathophysiology and clinical management of moderate and severe traumatic brain injury in the ICU." Seminars in Neurology In: , Vol. 35, No. 1, 2015, p. 42-49.
- "Rescue Therapy for Refractory Vasospasm after Subarachnoid Hemorrhage." Current Neurology and Neuroscience Reports In: , Vol. 15, No. 2, 2015.
- "Paroxysmal sympathetic hyperactivity in hemispheric intraparenchymal hemorrhage." Annals of Clinical and Translational Neurology In: , Vol. 1, No. 3, 01.03.2014, p. 215-219.
- "Delirium and confusion." Imaging Acute Neurologic Disease: A Symptom-Based Approach. Cambridge University Press, 2014. p. 19-33.
- "Association of intraprocedural blood pressure and end tidal carbon dioxide with outcome after acute stroke intervention." Neurocritical Care In: , Vol. 20, No. 2, 2014, p. 202-208.
- "Anti-NMDA receptor encephalitis with paroxysmal sympathetic hyperactivity : An under-recognized association?" Clinical Autonomic Research In: , Vol. 23, No. 2, 04.2013, p. 109-111.
- "Hypertonic saline and mannitol therapy in critical care neurology." Journal of Intensive Care Medicine In: , Vol. 28, No. 1, 01.2013, p. 3-11.
- "Manifestations of the hyperadrenergic state after acute brain injury." Current Opinion in Critical Care In: , Vol. 18, No. 2, 04.2012, p. 139-145.
- "Drainage efficiency with dual versus single catheters in severe intraventricular hemorrhage." Neurocritical Care In: , Vol. 16, No. 3, 2012, p. 399-405.
- "The use of lacosamide in refractory status epilepticus." Neurocritical Care In: , Vol. 14, No. 3, 06.2011, p. 348-353.
- "Management of intraventricular hemorrhage." Current Neurology and Neuroscience Reports In: , Vol. 10, No. 2, 03.2010, p. 73-82.
- "Reduced cardiovascular fitness and ambulatory function in black and white stroke survivors." Ethnicity and Disease In: , Vol. 17, No. 4, 09.2007, p. 682-685.