Neurocritical Care

Description

Neurocritical Care is a multidisciplinary team that offers treatment for adults suffering from various neurological disorders such as acute head and spinal injuries, coma, cerebral vascular problems, tumors, intracranial pressure problems and infectious diseases.

As a joint venture, the disciplines of Neurology, Neurosurgery, Neuroradiology and Critical Care at London Health Sciences Center manage the largest group of critically ill patients from all medical and surgical disciplines in Canada. A significant proportion of care involves patients with primary neurological or neurosurgical diseases or other disorders with a high incidence of neurological complications.

The two-tertiary/quaternary care intensive care units at the London Health Sciences Centre is suitable for intensive monitoring procedures including automated blood pressure, oxygen saturation, electrocardiographic, intracranial pressure and EEG. The adult neurocritical care program provides numerous opportunities for improved patient management and outcomes, teaching, research and new technology assessment.

The neurocritical care department is committed to providing an unparalleled training experience for medical students, residents and fellows and offers allied health trainees, nurses, nursing students, respiratory therapists, physiotherapists, nutritionists and other health professionals to an integrated, multidisciplinary educational experience.

Training Opportunities

Residents

CNS Neurology residents can complete a rotation in neurocritical care. Upon completing this rotation residents will be proficient in recognizing, assessing, investivating, and managing  patients with life-threatening disorders of the nervous system including:

  • Comatose states
  • Raised intracranial pressure
  • Status epilepticus
  • Acute myelopathy
  • Neurogenic respiratory failure
  • Acute peripheral nerve disease including Guillain Barre syndrome
  • Failure to wean from the ventilator
  • Severe head injury
  • Intracranial hemorrhage
  • CNS infections
  • Neurological consequences of systemic illness, including transplant-related neurological syndromes

Residents will also learn:

  • Utilization and efficacy of continuous EEG monitoring in critically ill patients who are at high risk of developing seizures; impact on length of stay and outcome
  • Use of Somatosensory evoked potentials in the prognostication of neurological outcome following anoxic brain injury
  • Assessment of new technology: Continuous modular EEG monitoring at the bedside - industry support from Datex-Ohmeda
  • Innovative electrophysiological assessment methods in traumatic brain injury. Canadian Institutes of Health Research - $130,000 grant received August 2001, in collaboration with Dr. John Connolly, Dalhousie University, Halifax

Learn more about CNS Residency programs.

Neuro Intensive Care Unit Fellowship

Main Contact: Teneille Gofton - MD, FRCPC

phone: 519-663-3672
fax: 519-663-3982
London Health Sciences Centre
University Hospital
339 Windermere Road
London Ontario Canada
N6A 5A5

Fellowship application information.

Research Opportunities

If you are interested in conducting research on neurocritical care or are interested in assisting in ongoing research by our faculty, visit their bio pages for information on their specific research interests and how to get in touch.

Recent Neurocritical Care Publications

Norton L, Gibson RM, Gofton T, Benson C, Dhanani S, Shemie SD, Hornby L, Ward R, Young GB. Electroencephalographic Recordings During Withdrawal of Life-Sustaining Therapy Until 30 Minutes After Declaration of Death. Can J Neurol Sci. 2017 Mar;44(2):139-145. doi: 10.1017/cjn.2016.309. PMID: 28231862

Weijer C, Bruni T, Gofton T, Young GB, Norton L, Peterson A, Owen AM. Ethical considerations in functional magnetic resonance imaging research in acutely comatose patients. Brain. 2016 Jan;139(Pt 1):292-9. doi: 10.1093/brain/awv272. Epub 2015 Sep 15. No abstract available. PMID: 26373606

Melinyshyn AN, Gofton TE, Schulz V. Supernumerary phantom limbs in ICU patients with acute inflammatory demyelinating polyneuropathy. Neurology. 2016 May 3;86(18):1726-8. doi: 10.1212/WNL.0000000000002541. Epub 2016 Mar 11. PMID: 26968516

Program Faculty

Neurologists