Explore This Treatment Program

Overview

Our multidisciplinary team uses the most advanced therapies available to treat both the physical and emotional impact of acute brain injury on patients and support their families through the illness and recovery process.

Our physicians, nurse practitioners, and nurses care for patients and their families in the Neuroscience Intensive Care Unit, the Emergency Department, and in emergency departments throughout New England through our extensive telemedicine network. We treat patients with traumatic brain injury, spinal cord injury, stroke, intracerebral hemorrhage, subarachnoid hemorrhage, subdural hemorrhage, encephalitis, and refractory seizures, as well those who have undergone complex neurosurgical and neuro-interventional procedures. A combination of world-class training and integration of cutting-edge technology allows us to deliver the best and most advanced care to our patients.

A Collaborative Multidisciplinary Approach

Our patient and family-centered care involves close collaboration with neurosurgery, interventional neuroradiology, physiatry, psychiatry, epilepsy and other consulting services that offer complementary expertise in the care of complex critically ill patients. In addition, we work within a multidisciplinary team of nurses, case managers, pharmacists, nutritionists, occupational therapists, physical therapists, respiratory therapists, social workers and speech-language pathologists.

What to Expect

Whether in the Emergency Department, in the Intensive Care Unit, or in the recovery phase, our staff knows that families have a significant impact on the way patients respond to health and illness. We recognize that the Intensive Care Unit experience can be very stressful. Our staff is committed to supporting patients and families during their stay. In the Neuro ICU, physician team rounds occur every morning and generally last until midday. During rounds, physicians may have time for a brief “check in” with family members.  Longer meetings between families and the care team are typically scheduled for the afternoons. Families provide an important form of support that is distinct from what the patient care team provides. We believe healing is optimized when clinicians and patients/families partner to support our patients’ values and preferences.

Clinical Services We Provide

Our clinical team includes physicians, nurse practitioners, and nurses. Our Neurocritical Care services include continuous electroencephalography (cEEG), invasive neuromonitoring, neurotrauma consultation in ED and other ICUs. We also provide consultative support to other ICUs outside of Mass General using an innovative TeleNeurocritical Care system. Our treatment and commitment to patients with acute brain injury does not end when they leave the NeuroICU, and we also see patients during their recovery in our NeuroRecovery outpatient clinic.

About This Program

The care delivered in the Neurosciences Intensive Care Unit (NeuroICU) at Massachusetts General Hospital is unique. Patients who are critically ill due to arrhythmia, respiratory failure, trauma, and sepsis are complicated by the presence of neurologic disease. In addition to hemodynamic monitoring, the neurologic assessment can require monitoring of intracranial pressure or cerebral oxygen demand. Problems of fluid balance are complicated by problems of cerebral edema and endocrine abnormalities. Injury to the nervous system affects the mind, body, and spirit. Changes in our ability to communicate, move, and feel often result in drastic life changes. Confusion, delirium, and aphasia contribute to already stressful situations. Therefore, collaboration within our multidisciplinary team is crucial in transitioning patients to general care and providing informational and emotional support to both patients and their loved ones.

Supporting patients’ families is an important aspect of our care. Families are vital to our patient's progress and recovery, and we provide a wide array of resources for their support and education. As an example, the innovative Attending Nurse program has introduced a single nurse as a point person for patients and families throughout their hospital stay, including the complex transfer of care from the NeuroICU to the Neurosciences General Care Units. Please be sure to reach out to your attending nurse.

Our Mission

The Mass General Neuroscience Intensive Care Unit provides expert, compassionate care to individuals with serious conditions of the brain and nervous system. Our goal is to strengthen resiliency and enhance recovery.  Bringing together a multidisciplinary team of individuals with the broadest range of medical, humanistic and scientific expertise, we seek to be the world’s pre-eminent Neuroscience Intensive Care Unit.

The components of our mission are to:

  • Deliver patient and family-centered care that is both the most compassionate and most technologically advanced care available
  • Adhere to the highest standards of patient safety
  • Work together as a collaborative, respectful and synergistic multidisciplinary team of outstanding nurses, physicians, therapists and hospital staff
  • Provide an outstanding training and practice environment that nurtures the best hearts and minds in medicine, nursing and science
  • Produce the scientific advances essential for improving the fate of tomorrow’s patients

History of the Mass General Neuroscience Intensive Care Unit

Created in 1969, the Neuroscience Intensive Care Unit was founded by two Mass General neurosurgeons, Dr. Robert Ojemann and Dr. Nicholas Zervas, with the close collaboration of an eminent neurologist, Dr. J. Phillip Kistler. From the initial efforts of these two pioneers, the NeuroICU has grown from four beds to the current state-of-the-art 22 bed unit.

There have been many milestones along the way. In 1978, a neurologist, Dr. Allan Ropper and an anesthesiologist, Dr. Sean Kennedy became the first Co-Directors of the NeuroICU, and ushered in what was then a first-of-its-kind critical care collaboration. During this time period, the NeuroICU developed the first neuroscience nursing training rotation, quickly developing what has become one of the world’s most talented pool of NeuroICU nursing staff.

In 1993, under the direction of Dr. Walter Koroshetz, the NeuroICU expanded into an 18 bed unit on Blake 12 and became known as a hub for the treatment of acute stroke and the growth of acute stroke therapies. Under the leadership of Dr. Lee Schwamm, the Mass General Telestroke Network was created, which allows for acute remote consultation for neurologic emergencies in more than 20 hospitals in three states. This pioneering telestroke network has become the largest in the country and remains so today.

The training of neurointensivists and vascular neurologists has always been a core feature of the Mass General NeuroICU. From its origins the fellowship training programs have trained more leaders in the field. From 2002 to 2011, under the leadership of Dr. Jonathan Rosand, the fellowship training program expanded dramatically, evolving into our current Neurocritical Care and Vascular Neurology fellowship programs, which together represent the largest training program of its kind in the world.

In 2010, Dr. Jonathan Rosand was named Chief of the Division of Neurocritical Care and Medical Director of the NeuroICU, positions that he held until 2018. In 2011, the NeuroICU moved into a new 22 bed, state-of-the-art facility in the Lunder Building. In addition to expanding our space for patients and families, the Lunder 6 NeuroICU contains numerous technological advances, which enable us to continue to serve our patients with the latest generation of cutting-edge monitoring and treatments.

Today, the Division of Neurocritical Care is led by Division Chief Dr. W. Taylor Kimberly. He is joined by NeuroICU Medical Director Dr. Eric Rosenthal, Dr. Aman Patel as the Neurosurgical Director, and Associate Medical Director Dr. Sahar Zafar. Tara Tehan, RN, MSN, MBA serves as the NeuroICU Nursing Director, and the Clinical Nurse Specialist is Mary Guanci, RN, MSN, CNRN. The NeuroICU continues its commitment to excellence and innovation in patient care.

Education

The Department of Neurology sponsors these and other educational programs for health care professionals:

Neurocritical Care Fellowship
The Neurocritical Care fellowship is a two-year UCNS-accredited program for general and neurologic critical care training.

Vascular Neurology Fellowship
The Vascular Neurology one-year fellowship at Massachusetts General Hospital offers clinical, neuro-imaging, and rehabilitation training, and opportunities for vascular research projects.

Partners Neurology Residency
The joint Partners Neurology Residency Program of the Massachusetts General and Brigham and Women’s hospitals provides a uniquely rich residency training experience.

Neuro ICU Observership
The Division of Neurocritical Care offers observership opportunities for visiting physicians and neurologists who are interested in informal educational exposure in the field of Neurocritical Care. Programs typically range from one day to three months. Topics can be customized to the needs and goals of the physician observer, and include direct observation of clinical care, Neuro ICU team model assessments, administrative and Neurocritical Care unit operations, and research operations.

Clinical Trials

Our faculty are involved in a wide range of basic science and patient-oriented research that is aimed at improving outcomes in patients with brain injury. Some examples of the work we do include: