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
- "Autonomic dysfunction syndromes after acute brain injury" Handbook of clinical neurology / edited by P.J. Vinken and G.W. Bruyn 2015
- "Manifestations of the hyperadrenergic state after acute brain injury" Current Opinion in Critical Care April 2012
- "Reduced cardiovascular fitness and ambulatory function in black and white stroke survivors" Ethnicity and Disease September 2007
- "Neuroanatomical basis of paroxysmal sympathetic hyperactivity" Brain Injury April 1 2015
- "Management of intraventricular hemorrhage" Current Neurology and Neuroscience Reports March 2010
- "Blurred lines" Resuscitation July 1 2015
- "Association of intraprocedural blood pressure and end tidal carbon dioxide with outcome after acute stroke intervention" Neurocritical Care 2014
- "Blowing the whistle on sports concussions" Neurology October 27 2015
- "Hypertonic saline and mannitol therapy in critical care neurology" Journal of Intensive Care Medicine January 2013
- "Clinical evidence of inflammation driving secondary brain injury" Journal of Trauma and Acute Care Surgery January 13 2015
- "Pathophysiology and clinical management of moderate and severe traumatic brain injury in the ICU" Seminars in Neurology 2015
- "The use of lacosamide in refractory status epilepticus" Neurocritical Care June 2011
- "Rescue Therapy for Refractory Vasospasm after Subarachnoid Hemorrhage" Current Neurology and Neuroscience Reports 2015
- "Drainage efficiency with dual versus single catheters in severe intraventricular hemorrhage" Neurocritical Care 2012
- "Anti-NMDA receptor encephalitis with paroxysmal sympathetic hyperactivity" Clinical Autonomic Research April 2013
- "Delirium and confusion" January 1 2014
- "Timing of deep vein thrombosis formation after aneurysmal subarachnoid hemorrhage" Journal of Neurosurgery October 1 2015
- "Safety and efficacy of intravenous glyburide on brain swelling after large hemispheric infarction (GAMES-RP)" The Lancet Neurology October 1 2016
- "Early Fever As a Predictor of Paroxysmal Sympathetic Hyperactivity in Traumatic Brain Injury" Journal of Head Trauma Rehabilitation January 5 2017
- "Curiosity killed the cat (scan)" Resuscitation April 1 2017
- "Early Fever after Trauma" Journal of Trauma and Acute Care Surgery June 20 2017
- "Medical Management of the Severe Traumatic Brain Injury Patient" Neurocritical Care June 1 2017
- "Hemodynamic and neuro-monitoring for neurocritically ill patients" Journal of Critical Care June 1 2017
- "Paroxysmal sympathetic hyperactivity in hemispheric intraparenchymal hemorrhage" Annals of Clinical and Translational Neurology March 1 2014
- "Future Directions for Hypothermia following Severe Traumatic Brian Injury" Seminars in Respiratory and Critical Care Medicine December 1 2017
- "Long-Term Outcomes in Patients Aged â‰¤70 Years With Intravenous Glyburide From the Phase II GAMES-RP Study of Large Hemispheric Infarction" Stroke June 1 2018
- "The procoagulant molecule plasminogen activator inhibitor-1 is associated with injury severity and shock in patients with and without traumatic brain injury" Journal of Trauma and Acute Care Surgery November 1 2018
- "Effect of IV glyburide on adjudicated edema endpoints in the GAMES-RP Trial" Neurology December 4 2018
- "Cheap, fast, or reliable" Resuscitation January 1 2019
- "EAST Multicenter Trial on targeted temperature management for hanging-induced cardiac arrest" Journal of Trauma and Acute Care Surgery July 1 2018