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The Alan and Barbara Mirken Department of Neurology oversees stroke and neurocritical care services through Beth Israel Medical Center’s emergency department, the hospital’s intensive care units (ICU), and in the hospital’s dedicated post-ICU units. Neurological critical care cases include:
- Stroke – Beth Israel Medical Center’s Betty and Morton Yarmon Stroke Center is a New York State-Designated Stroke Center, with a stroke team available 24 hours a day, seven days a week
- Brian tumors
- Hydrocephalus
- Neurosurgical post-operative patients
- Seizures
- Spinal cord compression
- Brain trauma, including subdural hematoma
The emergency department has its own equipment for computed tomography (CT) scan and access to magnetic resonance imaging (MRI) to aid in fast and accurate diagnosis. Additionally, the Neurology Department offers the following diagnostic and monitoring capabilities: continuous electroencephalography (EEG) monitoring, portable EEG monitoring in the ICU and step-down unit setting, and transcranial ultrasound. Diagnostic angiography and carotid duplex ultrasonography are available within the Department of Radiology.
Treating Stroke and Critical Care Patients
The stroke team is able to administer intravenous thrombolytic therapy on an emergency basis with very good response times, meeting all the Joint Commission standards of care for strokes. Transcranial ultrasound performed in the acute setting can assist in determining stroke etiology and may have a potential therapeutic role in enhancing thrombolytic therapy.
The hospital also has a designated stroke unit/step-down unit used for both stroke and non-stroke neurological patients. This unit offers expert nursing care, intracranial pressure monitoring, full cardiac and respiratory monitoring, and dialysis capability.
Furthermore, the department is able to seamlessly transfer those patients in need of endovascular treatment (clot retrieval, intra-arterial thrombolysis, arterial stenting, or management of ruptured aneurysms) or neurosurgical intervention within either Beth Israel Medical Center or the larger Continuum health system.
After emergent critical care is delivered, the department supervises ongoing medical treatments for patients. The range of care can include:
- Medication
- When appropriate, inclusion in clinical trials for new medications and protocols
- Educating a patient on lifestyles changes, for instance, improving diet and exercise regimes
- Physical therapy to improve and retain function
- Speech language pathology
- Occupational therapy to give patients adaptive living skills
- Practical and emotional support for the patient, caregivers and family, including various support groups and input from the department’s social workers
- Collaborative psychological and psychiatric counseling and evaluation when necessary to help patients with conditions (depression, anxiety) that can accompany the rehabilitation process
- Referrals to other medical disciplines as needed (surgeons or cardiologists, for example)
- Ongoing care and follow-up.
The department coordinates stroke prevention and screening outreach to the general community, and to the Asian and Latino communities in particular. In fact, all the department’s stroke prevention materials have been translated into Spanish and Chinese.
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