Department Overview

Section of Cerebrovascular Disease and Neurological Critical Care

Faculty:

Shyam Prabhakaran, MD: Section Head	Vivien Lee, MD	Richard Temes, MD
Michael Chen, MD	Sayona John, MD	Pratik V. Patel, MD
Thomas M. Bleck, MD, FCC	Yousef Mohammad, MD, MSC

The Cerebrovascular Disease and Neurologic Critical Care Section provides stroke and neurological critical care, primary and consultative inpatient services, office consultations, and transcranial Doppler and carotid ultrasound studies.

The stroke program was developed at Rush in the mid-1970’s, with a National Institutes of Health (NIH)-funded stroke center focusing on stroke pathophysiology research. In 1991, the Section of Cerebrovascular Disease was established with an inpatient stroke service, an outpatient stroke consultation practice and an expansion of the cerebrovascular ultrasonography lab. Since July 2006, the section has been headed by Shyam Prabhakaran, MD, MS and includes two other stroke neurologists, Vivien Lee, MD and Yousef Mohammed, MD, an endovascular stroke neurologist, Michael Chen, MD, and four neurointensivists: Thomas Bleck, MD, Richard Temes, MD, MS, Sayona John, MD, and Pratik V. Patel, MD.

Certified as a primary stroke center, the stroke program was given the Gold Seal of Approval by the Joint Commission in September 2007. The program continues to grow and also includes a Doppler technician, a stroke research coordinator and data manager, a stroke physician assistant, and ACGME-accredited vascular neurology fellowship and UCNS-accredited neuro-critical care fellowship programs.

The Stroke Program was recently awarded the Gold Performance Achievement Award by the American Stroke Association. Rush has developed a comprehensive system for rapid diagnosis and treatment of stroke patients admitted to the emergency department. This includes always being equipped to provide brain imaging scans, having neurologists available to conduct patient evaluations and using clot-busting medications when appropriate. The award recognizes Rush's commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment for at least 24 months, according to nationally accepted standards and recommendations.

Besides an active inpatient program that treats over 800 patients annually for acute stroke and related cerebrovascular diagnoses, the Stroke Program is proud of its unique outpatient services. In addition to a stroke clinic for routine questions and consultations, a weekly multi-disciplinary outpatient neurovascular clinic was created in May 2007, which draws on expertise from vascular neurologists, vascular neurosurgeons, and endovascular neurologists and neurosurgeons. This specialty clinic aims to provide comprehensive care to outpatients with brain aneurysms, vascular malformations, intracranial stenosis, carotid and vertebral artery stenosis, and rare vascular disorders such as Moya-Moya. These specialists work together to offer high-level diagnosis using modern imaging techniques such as perfusion imaging and quantitative magnetic resonance angiography as well providing state-of-the –art treatments including intracranial and extracranial stents, aneurysm coiling, and embolization of complex arterio-venous malformation.

Current stroke research studies include the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS), A Randomized Multi-center Trial of Unruptured Brain AVMs (ARUBA), Insulin Resistance Intervention after Stroke (IRIS), Septal Occluder for Patent Foramen Ovale (PFO) Closure in Stroke Patients (REDUCE), and Minimally Invasive Surgery plus rtPA for Intracerebral Hemorrhage Evacuation (MISTIE). The Cerebrovascular Disease and Neurologic Critical Care Section also maintains the Rush Stroke Program Prospective Registry, which is an ongoing inpatient database of all patients admitted with ischemic stroke, transient ischemic attack, intracerebral hemorrhage, and subarachnoid hemorrhage.

Faculty Biographies

Shyam Prabhakaran, MD, MS, is an assistant professor of neurological sciences at Rush University Medical Center, director of the Stroke Program, and head of the Section of Cerebrovascular Disease and Neuro-Critical Care. He completed his neurology residency training at New York Presbyterian Hospital, where he also served as Chief Resident, and vascular neurology fellowship training at Columbia University Medical Center. In addition, he received a master’s in epidemiology from the Mailman School of Public Health.

Since joining Rush in 2006, he has overseen tremendous clinical growth while fostering the development of neuro-endovascular and neuro-critical care services at Rush. In addition, his team achieved Joint Commission Primary Stroke Center certification in 2007 and created certified fellowship programs in vascular neurology and neuro-critical care. He also serves on the Rush Associates Board of Trustees and is very active in the Rush Transformation plan. He is a founding member of the Chicago Area Stroke Taskforce (CAST), established in 2007 to improve acute stroke care in the city. Dr. Prabhakaran has published extensively on the topic of cerebrovascular disease, is principal investigator in several multi-center clinical stroke trials, and currently does research in the areas of acute stroke, transient ischemic attack, and intracranial stenosis.

Thomas P. Bleck, MD, FCC, is professor of neurology, neurosurgery, pulmonary and critical care medicine, and anesthesiology at Rush University Medical Center, where he is the associate chief medical officer for critical care. In addition, he is the assistant dean for admissions at Rush Medical College. He serves on the boards of the Society of Critical Care Medicine and the Neurocritical Care Society, is neuroscience editor of Critical Care Medicine, and serves of the editorial boards of Critical Care and Neurocritical Care. Dr. Bleck was the founding president of the Neurocritical Care Society. His research interests include head injury, status epilepticus, infections, stroke, and neuromuscular respiratory failure. He has published over 100 papers and over 135 books and book chapters, and served more than 200 national and international visiting appointments and lectureships. Dr. Bleck is board certified in internal medicine, with subspecialty certification in critical care medicine; neurology, with subspecialty certification in vascular neurology; and clinical neurophysiology.

Michael Chen, MD, is a fellowship-trained neurointerventionalist with an appointment as assistant professor in neurology, neurosurgery and radiology. He received his medical degree in his home state at the University of Hawaii John A. Burns School of Medicine. His training consists of neurology residency at Yale-New Haven Hospital, cerebrovascular disease fellowship at Harvard Medical School/Beth Israel Deaconess Medical Center, and an interventional neuroradiology fellowship at New York Presbyterian Hospital/Columbia College of Physicians & Surgeons. Dr. Chen's practice focuses on minimally invasive treatments of brain and spinal cord vascular disease. Specifically, he is involved in the study and treatment of cerebral aneurysms, arteriovenous malformations of the brain and spine, intracranial atherosclerosis, carotid artery stenosis, acute stroke thrombolysis and preoperative tumor embolization of the brain and spine.

Sayona John, MD, is a fellowship-trained neurointensivist with an appointment as assistant professor in neurology and neurosurgery. She completed her residency in neurology at the University of Mississippi, followed by a 2 year stroke and critical care fellowship at Harvard Medical School/Massachusetts General Hospital. Prior to moving to Rush she worked as assistant professor in the Neuro ICU of University of Texas Medical Center, Dallas. Dr. John's practice focuses on acute brain and spinal cord vascular disease. Her specific interest is in subarachnoid hemorrhage, intracranial hemorrhage, stroke, traumatic brain injury, infections of the brain, status epilepticus, and intracranial pressure management.

Vivien Lee, MD, is an assistant professor in the Department of Neurological Sciences at Rush University Medical Center. She received her medical degree at Pennsylvania State University College of Medicine. Her training consists of a medicine internship and neurology residency at Cleveland Clinic Foundation. She completed a stroke fellowship and neurocritical care fellowship at the Mayo Clinic in Rochester, Minnesota

Pratik V. Patel, MD, is a fellowship-trained neurointensivist with an appointment as assistant professor in the Department of Neurological Sciences at Rush University Medical Center. He received his medical degree at the University of Illinois College of Medicine at Chicago where he also completed an internal medicine internship. He completed his Adult Neurology Residency at the Harvard/Massachusetts General Hospital and Brigham & Women’s Hospitals' program and Neurocritical Care Fellowship at the University of California – San Francisco. His research interests include the use of advanced imaging techniques and multimodal monitoring in acute brain injury, and developing prognostic models for patients with acute brain injury.

Yousef Mohammad, MD, MSC, is an assistant professor in the Department of Neurological Sciences at Rush University Medical Center. He received his medical and master's degrees from the American University of Beirut Faculty of Medicine in 1986 and 1989. Prior to joining to Rush he worked as an assistant professor of neurology, section of Stroke and Cerebrovascular Disease and director of the Stroke Fellowship Program at Ohio State University Medical Center.

His research interests have been in the area of cerebrovascular disease. This includes the clinical areas of acute treatment of stroke, stroke prevention, stroke epidemiology, cerebrovascular imaging, intracranial angioplasty, the mechanism of apoptosis (programmed cell death) in brain ischemia and the molecular mechanism of neuroprotection against apoptosis in brain ischemia. His specific interest is in stroke and migraine headaches.

Richard E. Temes, MD, MS, director of Neurological Critical Care and assistant professor of neurology, neurosurgery and internal medicine is board certified in both internal medicine and neurology. He received his medical degree at the University of Kansas School of Medicine and went on to complete a residency in internal medicine and neurology at the Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin in Milwaukee. Dr. Temes received his mater's degree in epidemiology from Columbia University Mailman School of Public Health in New York and while earning this degree, he served as postdoctoral clinical fellow in stroke and critical care at Columbia-Presbyterian Medical Center in New York.

In 2005, Dr. Temes was awarded the Young Investigator Award from the Neurocritical Care Society. Well published on subarachnoid hemorrhage, Dr. Temes received a prestigious SPORTRIAS (Specialized Program on Translational Research in Acute Stroke) research grant from the National Institute of Neurological Disorders and Stroke. Dr. Temes has research interests in subarachnoid hemorrhage, intracerebral hemorrhage, hypothermia, and multimodality brain monitoring.