Neurology

Peter O’Donnell Jr. Brain Institute

Stroke/Cerebrovascular

The Stroke and Cerebrovascular Diseases and Stroke section focuses on the diagnosis and treatment of vascular-mediated damage to the central nervous system (CNS). While ischemic and hemorrhagic strokes are the most common condition managed by the Stroke and Cerebrovascular Diseases and Stroke section, we have a long history of caring for patients with conditions such as Moyamoya disease, carotid/vertebral artery dissections, intracranial cerebral atherosclerosis and CNS vasculitis.

Clinical 

The Cerebrovascular Diseases and Stroke program has been in practice since 1988. Our team cares for patients in the inpatient and outpatient services at Parkland Memorial Hospital and William P. Clements, Jr. University Hospital within the UT Southwestern system. 

Stroke Transfer and Consult Hotline

Stroke Consultation Process

  • Phone: 214-645-FAST (3278) to reach the consultant.
  • Discussion of the case with hospital staff.
  • Timely review of findings and treatment recommendations to the requesting physician.
  • If the patient is to be transferred to UT Southwestern, the consultant will assist with the coordination of the transfer and arrange telephone consultation with other specialists to include neurosurgery, neurocritical care, and radiology, as needed. We offer timely follow-up to hospital staff about the outcome of the transferred patient.

Neurosurgery Hotline (Monday-Friday, 8 a.m.-5 p.m.)

  • Phone: 214-648-0360 | Fax: 214-648-2204

Hospital-to-Hospital Stroke Transfers

  • Phone: 214-645-FAST (3278)
  • UT Southwestern’s transfer service provides a seamless transition of care, including emergency and complex cases.

Research

The Cerebrovascular Diseases and Stroke section conducts local and national clinical trials, registry, and outcomes research, including landmark studies in the care of patients with stroke and cerebrovascular diseases.

Lone Star Stroke Research Consortium


Lone Star Stroke (LSS) Research Consortium is a novel collaboration among leading medical research institutions in Texas to improve the health of Texans affected by stroke and cerebrovascular disease. The mission of LSS is to a state-wide network for patient-centered stroke research and therapeutic trials within Texas that links academic health institutions with proven in stroke research to community stroke centers. Our are to find better therapies and prevention strategies to improve cerebrovascular health for Texans throughout our state. The LSS Research Consortium has established a robust, geographically diverse, network of sites that has the capability and infrastructure to implement studies quickly throughout Texas. This is crucial for providing the game-changing breakthroughs that are needed now by people who have or may soon develop a stroke.

Brain Oxygen Optimization in Severe TBI Phase-3


Registered with ClinicalTrials.gov: NCT03754114

NIH Project Number: 1U01NS099046-01A1

Status: Enrolling

Traumatic brain injury (TBI) is a major cause of death and disability in developed societies. Every year, approximately 3.5 million Americans sustain a TBI, of which 50,000 die, and another 300,000 are hospitalized and survive the injury. BOOST3 is a randomized clinical trial to determine the comparative effectiveness of two strategies for monitoring and treating patients with traumatic brain injury (TBI) in the intensive care unit (ICU). The study will determine the safety and efficacy of a strategy guided by treatment goals based on both intracranial pressure (ICP) and brain tissue oxygen (PbtO2) as compared to a strategy guided by treatment goals based on ICP monitoring alone. Both of these alternative strategies are used in standard care. It is unknown if one is more effective than the other. In both strategies the monitoring and goals help doctors adjust treatments including the kinds and doses of medications and the amount of intravenous fluids given, ventilator (breathing machine) settings, need for blood transfusions, and other medical care. The results of this study will help doctors discover if one of these methods is more safe and effective. Click below to read about Phase II of BOOST in the Critical Care Medicine Journal or click here for the latest press release.

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Curing Coma Campaign


The focus of the Curing Coma Campaign ACute cOma PragMatic Prospective ObSErvational (COMPOSE) Study is to: 1) accurately define the natural history of coma recovery in the acute phase of neurological injury, 2) establish a prototype hub-spoke based research network with central governance utilizing database infrastructure under the Curing Coma Campaign, and 3) explore the variability in care influencing patient outcomes. We propose a prospective, pragmatic, multicenter study to recruit 425 patients with acute coma to detail the natural history of coma recovery. Our study is the first step towards addressing several of the critical research gaps identified by the Curing Coma Campaign. Ours will be the first study to evaluate recovery in coma from a variety of etiologies, in a global diverse population utilizing standardized, pragmatic outcome measures. We plan to incorporate comorbidities as well as secondary hospital complications that can influence patient outcomes, thereby providing a real-world roadmap of phenotypic coma recovery under each etiology. Our work hereby creates a platform upon which future studies can develop a biomarker overlay to define coma endotypes.

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Education

For decades, our faculty has actively been teaching medical students and fellows in the acute care of stroke patients 24/7 coming to our institutions of care from the DFW and North Texas areas. Our teaching has included the management of complex cerebrovascular disorder and the prevention of recurrent stroke. 

Fellowship Training

 The Vascular Neurology Fellowship offers one-year, ACGME-accredited program that emphasizes a comprehensive approach to patient care, didactic learning, and clinical/translational research.

Vascular Neurology Fellowship Page

Stroke Education for Providers and Nurses

Physicians, Faculty, and APPs from several sections have recorded self-study lecture series. Participants will learn about best practices in stroke care. Topics include:

  • Acute Stroke Care
  • Cerebral Venous Sinus Thrombosis
  • Cognitive Function & Communication
  • Pain Management
  • Palliative Care
  • Prehospital Care
  • Social Determinants
  • and more

Lecture Series

Conditions Treated

The Cerebrovascular Diseases and Stroke section is committed to providing comprehensive, compassionate, efficient, high-quality care to our patients and their families. We are consulted for the assessment of acute stroke patients and the care of other conditions including:

  • Stroke
  • CNS Vasculitis
  • Fibromuscular Dysplasia
  • CADASIL
  • Moyamoya disease
  • Extracranial Carotid and Vertebral Atherosclerotic Disease
  • Intracranial Atherosclerotic Disease (ICAD)
  • Carotid and Vertebral Dissections
  • Stroke in patients with cardiac conditions of PFO and Atrial Fibrillation
  • Cerebral Venous Sinus Thrombosis  

Primary and Collaborative Services

The Cerebrovascular Diseases and Stroke section offers Transcranial and Carotid Duplex in the diagnostic assessment of patients with stroke. We often collaborate with departments including Cardiology, Hematology, Neurosurgery, Neurointerventional, Rheumatology, and Physical Medicine and Rehabilitation in the patient care continuum.   

Co-Section Heads

Mark Johnson, M.D. & Ying Xian, M.D., Ph.D.

Providers