Neurocritical Care Society Podcast

In this episode of the NCS Podcast Hot Topics series, host Rich Choi, MD, is joined by Chiara Robba, MD, PhD, to discuss the article "The Effects of Milrinone Systemic Administration on Cerebral Perfusion as Measured with Computed Tomography in Aneurysmal Subarachnoid Hemorrhage Patients," published in Neurocritical Care. Their conversation explores the complex, multifactorial pathophysiology of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage and the potential role of intravenous milrinone as a rescue therapy. They discuss how milrinone may influence both systemic and cerebral hemodynamics, as well as the role of CT perfusion imaging in evaluating cerebral blood flow and perfusion heterogeneity. They also review findings from the retrospective study, including milrinone's association with increased cardiac index but not a consistent increase in cerebral blood flow. Among patients who did not develop delayed cerebral ischemia, cerebral perfusion became more spatially homogeneous as the milrinone dose increased. Dr. Robba explains why the distribution of cerebral blood flow may be more informative than its average value, the potential of perfusion heterogeneity as a marker of treatment response and why larger prospective studies are needed before these findings can inform changes in clinical practice. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Gisele Sampaio Silva about the Currents article, "Breaking Barriers: How Brazil's RESILIENT Trials Redefined Stroke Research in Latin America." Sampaio Silva discusses how the RESILIENT trial demonstrated that mechanical thrombectomy can be delivered safely and effectively within Brazil's public health system. She explains why researchers needed to evaluate the treatment in a middle-income country with significant regional differences in hospital resources, prehospital transportation, imaging access and stroke care infrastructure. The conversation also explores the partnerships and advocacy required to conduct the multicenter trial, including support from Brazil's Ministry of Health, international researchers and industry collaborators. Silva reflects on how the trial helped pave the way for the approval of mechanical thrombectomy within Brazil's public health system, the persistent gaps in access across the country and the importance of expanding international research partnerships to improve stroke care in resource-limited settings. To read the full article, visit NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Shraddha Mainali, Sahar Zafar and Brooke Murtaugh about their Currents article, "Neurocritical Care Disorders of Consciousness: Do We Have the Education We Need to Provide Care?" The guests discuss the clinical spectrum of disorders of consciousness and the importance of accurately assessing patients using standardized bedside examinations, neuroimaging and other multimodal tools. They also examine the role of neuroprognostication in guiding conversations with families and ensuring that patients are given appropriate opportunities for recovery. The conversation explores findings from a pilot survey on educational needs related to disorders of consciousness. The panel discusses barriers to care and education, including limited access to centralized resources, time constraints and knowledge gaps in assessment, diagnosis, prognosis and treatment. They also highlight the Curing Coma® Campaign's efforts to expand access to evidence-based education through webinars, online resources, World Coma Day and interdisciplinary global collaboration. To read the full article, visit NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Rich Choi, DO, is joined by Eric Rosenthal, MD, to discuss the article "Surgical Intervention for Super-Refractory Status Epilepticus," a systematic review published in Neurocritical Care. Their conversation explores why super-refractory status epilepticus can become increasingly difficult to control, the limited evidence guiding treatment after standard medical therapies have failed and how surgical approaches may fit into care for selected patients. They also discuss the review's findings across 114 reported cases, including high rates of status epilepticus termination after surgical intervention, the distinction between terminating status and achieving long-term freedom from disabling seizures and the potential role of earlier multidisciplinary collaboration with epilepsy and neurosurgery teams. Dr. Rosenthal also emphasizes the importance of matching the intervention to the patient's underlying etiology, seizure localization and goals of care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Rich Choi, MD, is joined by Alejandro Rabinstein, MD, Shraddha Mainali, MD, and Krishna Rajajee, MD, to discuss the article "Guidelines for Neuroprognostication in Critically Ill Adults With Acute Ischemic Stroke," published in Neurocritical Care. Their conversation explores the development of the guideline, including the need for a more structured, evidence-based approach to prognostication in critically ill patients with acute ischemic stroke. The guests discuss why early prognostication is especially high-stakes, how uncertainty and the risk of self-fulfilling prophecy shaped the recommendations and why no single clinical variable or prediction model is reliable enough to guide individual decisions about poor outcomes. They also review the role of early neurological improvement as a moderately reliable predictor of good outcomes, the limitations of existing prediction models in the era of reperfusion therapy, and the importance of multimodal assessment, ongoing family conversations, long-term outcome counseling and shared decision-making rooted in each patient's values. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, host Nicholas Morris, MD, and co-host Tom Lawson, PhD, ACNP-BC, FNCS, speak with Molly McNett, PhD, RN, CNRN, FNCS, FAAN, about her career in neurocritical care and the role of implementation science in translating research evidence into routine clinical practice. Dr. McNett reflects on her early experiences as an ICU nurse, the disconnect she observed between published evidence and bedside care and how those experiences shaped her work in research, guideline development and implementation science. The conversation explores the distinction between implementation science and quality improvement, common barriers to practice change and the importance of identifying local facilitators, workflows and organizational needs. Dr. McNett discusses examples such as automated pupillometry and fall-prevention practices, highlighting how implementation strategies and hybrid research designs can help healthcare teams adopt and sustain evidence-based care. The discussion also examines interdisciplinary collaboration, mentorship and opportunities for nurses and advanced practice providers interested in research. Dr. McNett shares practical advice for clinicians seeking to address evidence-to-practice gaps, including finding mentors, participating in research teams and developing a deeper understanding of individual and organizational behavior change. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Vanessa Abraham, MS, CCC-SLP,  and Jared Rosen, MD, about Vanessa's Story of Hope and the lasting connection they formed during her neurocritical care journey. Vanessa shares how a sudden illness progressed from flu-like symptoms to respiratory failure and paralysis, ultimately requiring mechanical ventilation, an prolonged ICU stay and inpatient rehabilitation. She discusses the uncertainty surrounding her eventual diagnosis of a rare pharyngeal-cervical-brachial variant of Guillain-Barré syndrome, as well as the fear of being unable to communicate, care for her daughter or return to the life she knew before her illness. The conversation also explores the profound impact of compassionate, patient-centered care. Vanessa reflects on how Dr. Rosen, then a medical student completing an ICU rotation, became a reassuring presence for both her and her husband. Together, they discuss the importance of recognizing intubated patients as active participants in their care, providing accessible communication tools and taking time to listen. They also emphasize how small acts of empathy and human connection can reduce anxiety and potentially lessen the long-term effects of post-intensive care syndrome. To read Vanessa's full Story of Hope, visit NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the Neurocritical Care Society Podcast Masterclass series, hosts Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, are joined by Richard Wunderink, MD, professor of medicine at Northwestern University Feinberg School of Medicine and pulmonary critical care intensivist, to discuss the diagnosis and management of respiratory infections in the ICU.  Dr. Wunderink highlights why ventilator-associated pneumonia and suspected respiratory infections are common challenges across critical care settings, particularly among patients with acute neurologic injury, aspiration risk and prolonged mechanical ventilation. The discussion focuses on practical, bedside approaches to pneumonia management, including the limitations of tracheal aspirates and the risks of antibiotic overuse. The group also examines the role of bronchoalveolar lavage and the value of adjunctive diagnostic tools such as quantitative cultures, cell counts, Gram stains, amylase testing and molecular panels.  They further explore how rapid diagnostics can help clinicians make more targeted antibiotic decisions, support earlier de-escalation when appropriate and prompt consideration of non-pulmonary causes of fever or clinical instability when pneumonia is unlikely. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the Neurocritical Care Society Podcast Masterclass series, hosts Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, are joined by Seemant Chaturvedi, MD, professor of neurology and director of the Stroke Division at the University of Maryland, for an in-depth discussion on carotid disease, stroke prevention and the role of revascularization in clinical practice. The episode explores the historical impact of NASCET, key findings from the CREST-2 trial and the role of intensive medical management for patients with asymptomatic carotid stenosis. Dr. Chaturvedi also shares practical guidance for neurointensivists caring for patients with symptomatic carotid disease, including intervention timing, risk stratification and emerging diagnostic tools such as MRI plaque imaging and TCD microemboli monitoring. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, host Nicholas Morris, MD, leads a roundtable discussion with neurocritical care fellowship directors Jenna Ford, MD; Rishi Malhotra, MD; Fiona Lynch, MD; and Matt Bevers, MD, on the current state of neurocritical care fellowship training. The panel discusses what distinguishes their programs, how fellowship leadership roles evolve and the ways Accreditation Council for Graduate Medical Education (ACGME) accreditation has shaped training programs. The conversation also examines key challenges in fellowship education, including recruitment, changing learner expectations, wellness, faculty development and collaboration with neurosurgery, APPs and other critical care teams. The group also shares practical advice for fellowship applicants, including what programs look for in strong candidates and the questions applicants should ask when evaluating potential programs. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Ryan Hakimi, DO, MS, a neurointensivist at Prisma Health and member of the Neurocritical Care Society Board of Directors, about his Currents article, "The Business of Neurocritical Care: Understanding Physician Benefits." Dr. Hakimi explores the often-overlooked financial side of physician compensation, focusing on how retirement benefits can meaningfully shape the overall value of an employment offer. He explains the differences between 401(a), 403(b), 401(k), and 457(b) plans, including employer contributions, tax advantages, vesting periods and expense ratios. He also discusses why a lower base salary may sometimes be offset by a stronger overall benefits package. The conversation highlights why physicians should request and review benefits information during contract negotiations rather than focusing only on salary, title and work expectations. This episode offers practical guidance for physicians seeking to better understand the long-term financial impact of their benefits package and make more informed career decisions. To read the full article that inspired this conversation, visit "The Business of Neurocritical Care: Understanding Physician Benefits" on NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Tommy Thomas, MD, PhD, and Aimee Aysenne, MD, MPH, co-directors of the Henderson Equity and Research on Disparities (HEARD) Center, about the center's origins and its mission to advance equity in neurocritical care. Drs. Thomas and Aysenne reflect on the legacy of Galen Henderson, MD, whose mentorship, leadership and commitment to systems-level change inspired the establishment of the HEARD Center. They discuss how disparities in neurocritical care are shaped by factors such as access, geography, education, socioeconomic conditions, as well as the broader systems that influence whether patients receive high-level care. The conversation also highlights the center's three core pillars: mentorship, research and community outreach, including efforts to support early-career professionals, fund solutions-focused disparities research  and partner with communities to identify needs from the ground up. The episode concludes with practical insights on how clinicians can begin addressing disparities in their daily practice, from listening more closely to patients' lived experiences to recognizing gaps in who reaches the ICU and strengthening partnerships with community and rural providers to improve access to neurocritical care. To read the full article that inspired this conversation, visit "Honoring Through Action: The HEARD Center Story" on NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Eric Lawson, MD, is joined by Adam Arthur, MD, neurosurgeon at the University of Tennessee and Semmes Murphey Clinic in Memphis, Tennessee, to discuss the article "Minimally Invasive Surgery Versus Medical Management Alone for Intracerebral Hemorrhage: The MIND Clinical Trial," published in JAMA Neurology. Their conversation explores the MIND trial's evaluation of minimally invasive hematoma evacuation compared with best medical management for patients with intracerebral hemorrhage. Dr. Arthur reviews the trial's design, primary outcomes and early termination, and explains how findings from the ENRICH trial influenced enrollment and feasibility considerations. He also explores key considerations such as the importance of hematoma location, evacuation thresholds and timing, while reflecting on what the trial's negative primary outcome may still reveal about the future of surgical intervention and more individualized approaches for ICH patients. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society. 

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, is joined by Katharina Busl, MD, MS, to discuss the article "Infratentorial Pressure Monitoring in Cerebellar Stroke: Feasibility and Prognostic Utility," recently published in Neurocritical Care. Their conversation examines why pressure in the posterior fossa may differ from supratentorial measurements in patients with cerebellar stroke and why that distinction may matter clinically. They discuss the physiologic basis for compartmentalized intracranial pressure, the challenges of posterior fossa management and the potential implications for monitoring and treatment. Dr. Busl reviews the study's design and key findings, including evidence of a significant pressure gradient between infratentorial and supratentorial compartments and an early signal that higher infratentorial pressures may be associated with worse outcomes. She also discusses important limitations, including the study's small sample size, single-center nature and unanswered questions about surgical variables such as decompression size. The discussion further considers how this proof-of-concept work could inform future studies on monitoring, prognostication and treatment selection in cerebellar stroke. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, is joined by Melissa Dang, PharmD, BCCCP, neurocritical care pharmacist at MedStar Franklin Square Medical Center, to discuss the article "Levetiracetam Dosing Optimization in Neurocritical Care Population: Neuro-ARC Study", recently published in Neurocritical Care. Their conversation explores how augmented renal clearance may reduce levetiracetam exposure in neurocritical care patients and the implications for seizure management in clinical practice. Dr. Dang breaks down the study's pharmacokinetic modeling, highlights key dosing findings and reviews the patient factors most strongly associated with increased drug clearance. She also discusses the study's limitations and emphasizes the need for caution when applying its findings across broader clinical settings. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the Neurocritical Care Society Podcast Masterclass series, hosts Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, are joined by Hooman Kamel, MD, MS, professor of neurology at Weill Cornell Medicine, to discuss how clinical trials take shape in practice. Dr. Kamel reflects on his path into research, the importance of strong mentorship and what it takes to grow from early-stage projects to large multicenter trials. Their conversation explores practical aspects of trial design in neurocritical care, including building robust data sets, leveraging EMR-based tools, designing pragmatic studies and fostering collaboration across institutions. They also discuss the Arcadia trial and the broader mindset required to stay engaged in research, even when results do not go as expected. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, is joined by Wendy Ziai, MD, professor of neurology and critical care medicine at Johns Hopkins University, to discuss the article "Prophylactic Anti-Seizure Medication in Patients with Lobar Intracerebral Hemorrhage", recently published in Neurocritical Care. Their conversation explores the ongoing debate surrounding prophylactic antiseizure medication use in patients with lobar intracerebral hemorrhage. They review current guideline recommendations, highlight limitations in the existing evidence and consider the challenge of balancing seizure prevention with the risk of adverse effects. Dr. Ziai reviews key findings from prior trials as well as the featured study, which demonstrated lower rates of early seizures among patients who received prophylaxis. She also addresses questions related to patient selection, nonconvulsive status epilepticus and long-term cognitive outcomes. The discussion further considers the role of continuous EEG monitoring in the first 48 hours and how future study designs may help clarify which patients, if any, are most likely to benefit. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society. 

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, welcomes Tom Lawson, PhD, ACNP-BC, FNCS, lead advanced practice provider at The Ohio State University, as a recurring co-host who will bring APP perspectives to future NCS podcast discussions. Lawson reflects on his path into neurocritical care and explains how the specialty's unique blend of neurologic focus and broad ICU medicine continues to keep him engaged. He also discusses persistent gaps in APP onboarding and mentorship, highlighting why the NCS Advanced Practice Orientation Bundle is a key resource for programs integrating new APPs into neurocritical care teams. Lawson previews upcoming APP-focused education initiatives, including planned masterclasses on EEG and MRI interpretation, and shares insights on balancing the need for standardized practices with the flexibility required  across different institutions.He closes with a call for deeper APP engagement within NCS, from membership to committee involvement, to further strengthen collaboration across the field. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the Neurocritical Care Society Podcast Hot Topics series, host Richard Choi, DO, FNCS, joins Melissa Dang, PharmD, BCCCP, a neurocritical care pharmacist at MedStar Franklin Square Medical Center, to discuss the article Real-World Antiseizure Medication Prophylaxis and Outcomes in Hospitalized Adults with Acute Brain Injuries, recently published in Neurocritical Care. Together, they examine the real-world use of antiseizure medication prophylaxis in patients with acute brain injury, including ischemic stroke, hemorrhagic stroke and traumatic brain injury. Dr. Dang highlights variability in current practice, key factors influencing prophylaxis decisions and the balance between seizure prevention and medication-related risks. She also reviews the study's limitations and underscores the ongoing importance of risk stratification in guiding patient care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Claude Hemphill, MD, MAS, FNCS, professor of neurology and neurological surgery at the University of California, San Francisco, and chief of neurology and director of neurocritical care at Zuckerberg San Francisco General Hospital. Hemphill reflects on the patient encounters that shaped his career, his longstanding focus on intracerebral hemorrhage and the clinical gaps that led to development of the ICH score. He discusses how the score was intended to support communication and risk stratification rather than precise prognostication, and shares insights on early care limitations, ICU culture and the importance of aligning teams around thoughtful, aggressive care when appropriate. The conversation also explores the origins and progress of the Curing Coma® Campaign, including its role in advancing research, driving culture change and fostering collaboration across the continuum of care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Charlie Gagliardo, a physician assistant and former medical student, about his journey through autoimmune encephalitis, refractory status epilepticus and long-term recovery — and how those experiences continue to shape his clinical practice. Charlie shares the story of his sudden decline from a thriving pre-clinical medical student to  weeks of uncontrollable seizures and medically induced coma. He reflects on the intensive immunotherapy and critical care course that followed, as well as the months of rehabilitation that ultimately paved the way for his return to medicine. The conversation also explores the challenges of resuming medical training after prolonged illness, his decision to transition from residency to clinical practice as a physician assistant and how living with chronic illness has shaped his approach to patient care and empathy. The episode highlights the emotional and professional resilience required to rebuild life after severe neurocritical illness, and the support systems — both clinical and personal — that make healing possible. To read the full article that inspired this conversation, visit Story of Hope: Charlie on NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in August 2023. Listen to the fifth episode of the NCS INSIGHTS series focused on intracerebral hemorrhage. The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Ceribell. Time is brain when it comes to seizures. Ceribell point-of-care EEG empowers the bedside team to detect or rule out seizure activity in minutes. To learn more, visit ceribell.com. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in December 2023. Listen to an episode of the NCS INSIGHTS series focused on meningitis and encephalitis. The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Ceribell. Time is brain when it comes to seizures. Ceribell point-of-care EEG empowers the bedside team to detect or rule out seizure activity in minutes. To learn more, visit ceribell.com. The NCS Podcast is the official podcast of the Neurocritical Care Society. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Charlie Gagliardo, a physician assistant and former medical student, about his journey through autoimmune encephalitis, refractory status epilepticus and long-term recovery — and how those experiences continue to shape his clinical practice. Charlie shares the story of his sudden decline from a thriving pre-clinical medical student to  weeks of uncontrollable seizures and medically induced coma. He reflects on the intensive immunotherapy and critical care course that followed, as well as the months of rehabilitation that ultimately paved the way for his return to medicine. The conversation also explores the challenges of resuming medical training after prolonged illness, his decision to transition from residency to clinical practice as a physician assistant and how living with chronic illness has shaped his approach to patient care and empathy. The episode highlights the emotional and professional resilience required to rebuild life after severe neurocritical illness, and the support systems — both clinical and personal — that make healing possible. To read the full article that inspired this conversation, visit Story of Hope: Charlie on NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the Neurocritical Care Society Podcast Hot Topics series, host Richard Choi, DO, FNCS, speaks with Wendy Ziai, MD, MPH, professor of neurology and critical care medicine at Johns Hopkins University, about the article The Association Between Hourly Systolic Blood Pressure Variability and Outcomes in Patients With Intracerebral Hemorrhage Is Time-Dependent: A Post Hoc Analysis of the ATACH-2 Trial, recently published in Neurocritical Care. Their discussion explores why blood pressure variability — not just absolute blood pressure targets — may play a critical role in outcomes following acute intracerebral hemorrhage. Dr. Ziai reviews key findings from ATACH-2 and INTERACT trials, the physiologic mechanisms that may link variability to hematoma expansion and neurologic deterioration and why the timing of variability within the first 8 to 12 hours appears especially important. They also examine the unresolved question of causation versus association, implications for antihypertensive management in the ICU and how emerging trials focused on variability may shape future practice. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Theresa Human, PharmD, a critical care pharmacist whose career spans clinical practice at the University of Virginia and Washington University in St. Louis, followed by a transition into the pharmaceutical industry with Cumberland Pharmaceuticals. Dr. Human shares the winding path that led her to neurocritical care pharmacy and explains why the field's limited evidence base can create both autonomy and urgency to collaborate on better research. She discusses the role pharmacists play on neuro ICU teams — from providing therapeutics expertise and bedside teaching to ensuring continuity amid rotating physician teams — and reflects on burnout, moral injury and the realities of being "always on." Dr. Human also offers candid insights into industry partnerships, explaining how medical science liaisons can support research and education, and connects these efforts back to the goals and momentum of the Curing Coma® Campaign, framing it as a unifying "moonshot" for data collection, collaboration and progress. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in August 2023.  Listen to the fourth episode of the NCS INSIGHTS series on acute ischemic stroke (part 2 of 2). The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Biogen. Science that transforms patient lives. Science that seeks to solve societal problems. Science that acts with purpose. Science that is inspired by the diversity and passion of our people. Discover where science meets humanity at Biogen. The NCS Podcast is the official podcast of the Neurocritical Care Society. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in August 2023.  Listen to the third episode of the NCS INSIGHTS series on acute ischemic stroke (part 1 of 2). The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Biogen. Science that transforms patient lives. Science that seeks to solve societal problems. Science that acts with purpose. Science that is inspired by the diversity and passion of our people. Discover where science meets humanity at Biogen. The NCS Podcast is the official podcast of the Neurocritical Care Society. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in July 2023.  Listen to the second episode of the NCS INSIGHTS series on status epilepticus (part 2 of 2). The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Ceribell. Time is brain when it comes to seizures. Ceribell point-of-care EEG empowers the bedside team to detect or rule out seizure activity in minutes. To learn more, visit ceribell.com. The NCS Podcast is the official podcast of the Neurocritical Care Society. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This INSIGHTS episode revisits a core topic from Neurocritical Care ON CALL®, originally released in July 2023.  Listen to the first episode of the NCS INSIGHTS series on status epilepticus (part 1 of 2). The INSIGHTS series is hosted by Casey Albin, MD, and Salia Farrokh, PharmD, and covers topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource dedicated exclusively to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Ceribell. Time is brain when it comes to seizures. Ceribell point-of-care EEG empowers the bedside team to detect or rule out seizure activity in minutes. To learn more, visit ceribell.com. The NCS Podcast is the official podcast of the Neurocritical Care Society. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Ryan Hakimi, DO, MS, NVS, RPNI, CPB, FNCS, FCCM, FAAN, a neurointensivist at Prisma Health, about his Currents article on billing in neurocritical care. Their conversation explores why billing and documentation education is often absent from medical training, how staffing models and split/shared billing affect physician productivity and key considerations when working with advanced practice providers. Dr. Hakimi also shares practical insights on aligning documentation and billing practices with institutional metrics to support sustainable neurocritical care programs. To read the full article, visit Business of Neurocritical Care: Billing Under the Attending Physician or APP—Which One is Right For You? The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Nilufer Yalcin, MD, a neurointensivist at Boston Medical Center, about her Currents article on the use of virtual reality in neurorehabilitation. Together, they explore the neuroscience behind virtual reality–based therapies, including multisensory engagement, cortical reorganization and the role of motivation and reward pathways in recovery. Their conversation also examines different VR modalities, the current evidence supporting motor and cognitive rehabilitation and emerging applications in the ICU setting. Dr. Yalcin further highlights practical considerations such as feasibility and standardization, as well as future directions for the field, including brain-computer interfaces and tele-rehabilitation. To read the full article, visit Currents: Virtual Reality for Neurorehabilitation: Mechanisms, Modalities, and Clinical Applications. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, host Nicholas Morris, MD, speaks with Cherylee Chang, MD, division chief of neurocritical care and professor of neurology, neurosurgery and medicine at Duke University. Dr. Chang reflects on her journey from an early interest in cardiothoracic surgery to neurology, and ultimately, to the "intersectional" work that drew her to neurocritical care. She discusses her early training in the field, efforts to establish certification and fellowship accreditation pathways and the challenges of defining the essential components of what constitutes neurocritical care. Dr. Chang also shares insights from Duke's advanced practice provider model, her work to broaden multidisciplinary inclusion within NCS and her current focus on leadership development, workforce shortages and strategies to better attract the next generation to the field. Dr. Chang recommends the following books for those interested in developing their leadership potential:Difficult Conversations by Douglas Stone, Bruce Patton and Sheila HeenExtreme Ownership by Jocko Williams Leadership and Self-Deception by The Arbinger InstituteThe Fearless Organization by Amy EdmonsonThe Leader's Guide to Mastering Feedback by Joan HibdonThe Let Them Theory by Mel Robbins The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, speaks with Katharina Busl, MD, MS, FNCS, division chief of neurocritical care at the University of Florida and assistant editor for Neurocritical Care journal, about transfusion strategies in patients with acute brain injury. They discuss recent randomized trials and a new systematic review examining restrictive versus liberal red blood cell transfusion thresholds across traumatic brain injury, intracerebral hemorrhage and subarachnoid hemorrhage. Their conversation highlights the physiologic rationale behind transfusion, challenges in interpreting trial and meta-analysis data, and how overlapping hemoglobin ranges complicate bedside decision-making. Dr. Busl also shares how this evolving evidence is influencing clinical practice and the importance of individualized transfusion decisions. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, speaks with Katharina Busl, MD, MS, FNCS, division chief of neurocritical care at the University of Florida and assistant editor for Neurocritical Care journal. They explore new research on cerebrospinal fluid (CSF) clearance after aneurysmal subarachnoid hemorrhage. They also discuss the study Prospective Trial of Cerebrospinal Fluid Filtration After Aneurysmal Subarachnoid Hemorrhage: The Lumbar Catheter Extension (PILLAR XT) Trial, which evaluates a dual-lumen intrathecal catheter designed to filter CSF and accelerate removal of red blood cells and inflammatory byproducts. Their conversation highlights the rationale behind CSF drainage, how prior work like the Early Drain trial shaped the field, and what this early-phase device trial reveals about feasibility, safety, and reductions in CSF RBC and protein levels. Dr. Bussel and Dr. Choi also touch on implementation challenges and the need for larger trials before this approach can move into broader clinical use. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Masterclass series, hosts Jon Rosenberg, MD, and Stephan Mayer, MD, speak with Jamie Odell, MD, assistant professor of neurocritical care and emergency medicine at the University of Maryland School of Medicine. Together, they explore paroxysmal sympathetic hyperactivity – how it develops after brain injury, why symptoms differ among patients and what current research suggests about its underlying neural networks. Dr. Odell offers practical guidance on recognizing patterns, avoiding anchoring bias and distinguishing PSH from other causes of instability. The conversation also covers common treatment approaches, scoring tools used at the bedside and areas of ongoing study. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Werner Hacke, MD, PhD, DSc (hon. mult.), FAHA, FESC, senior professor of neurology at Heidelberg University and a major leader in vascular neurology and neurocritical care. Professor Hacke reflects on his path from psychiatry and psychology to helping establish Germany's early neurological intensive care units and advancing modern acute stroke care. He discusses his contributions to thrombolytics, intra-arterial therapy and the DESTINY trials in decompressive surgery. Professor Hacke also shares perspectives on the evolution of neurocritical care training in Europe, ethical challenges in randomized trials and the importance of collaboration among neurology, neurosurgery and neuroradiology. He touches on individualized decision making, standard-of-care gaps and the ongoing need for progress in hemorrhagic stroke research. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.    

In this episode of the NCS Podcast Masterclass series, host Jon Rosenberg, MD, is joined by Harald Sauthoff, MD, ICU Director at Westchester Medical Center and a leader in point-of-care ultrasound (POCUS). They explore how POCUS has transformed bedside evaluation and management in the ICU, from rapid shock assessment to informed fluid management. Dr. Sauthoff shares how ultrasound can quickly identify shock etiology, assess fluid responsiveness and tolerance and detect pulmonary congestion. He also discusses using Doppler and the VExUS score to refine hemodynamic understanding and tailor treatment to individual patients. The conversation closes with insights on building sustainable ultrasound training programs, from boot camps and image portfolios to pathways toward critical care echocardiography certification. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Andrew Kofke, MD, emeritus professor of anesthesiology and critical care at the University of Pennsylvania. Dr. Kofke reflects on his remarkable path from a teenage ambulance volunteer to a pioneering leader in neuroanesthesia and neurocritical care. He discusses the origins of Penn's neuro ICU program, his collaborations with influential figures like Peter Safar and Alan Ropper and his research on cerebral blood flow and opioid neurotoxicity. Dr. Kofke also shares insights on the evolution of multimodal neuroprotection, the future of noninvasive cerebral monitoring and how curiosity and physiology have guided his decades-long career. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, is joined by Eelco Wijdicks, MD, PhD, professor of neurology at Mayo Clinic and chair of the Division of Critical Care Neurology. A pioneer of neurocritical care, Dr. Wijdicks reflects on training in Rotterdam, fellowship at Mass General under Allan H. Ropper, MD, and the creation of Mayo Clinic's neuro ICU in the 1990s. Wijdicks shares the story behind the FOUR Score Coma Scale and lessons from subarachnoid hemorrhage, hyponatremia and cerebral salt wasting, including how early fluid-restriction practices shaped outcomes. The conversation also explores building a new specialty, the role of neurologists in the ICU, the history of medicine and “neuro cinema,” as well as compassion fatigue and the future of global neurocritical care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Dr. Nicholas Morris speaks with Dr. Wendy Ziai, professor of neurology at Johns Hopkins and senior editor for Neurocritical Care, and Dr. Richard Choi, neurointensivist at MedStar Franklin Square and social media editor for the journal. This episode also introduces Dr. Richard Choi as the new host of the NCS Podcast Hot Topics series, which will continue to feature high-impact articles from Neurocritical Care. They discuss a new study, Postoperative Monitoring After Elective Intracranial Surgery in a Postanesthesia Care Unit is Safe, Efficient and Cost-Effective, by Arthur Wagner and colleagues in Munich, Germany. The conversation examines the 10-year experience with more than 5,500 patients, complication rates and how PACU-based pathways may ease ICU demand while supporting safe outcomes. Dr. Ziai and Dr. Choi also share perspectives on ICU capacity and the importance of collaboration across departments, showing how this research connects to real-world practice. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Camilo Espinosa-Jovel, MD, and Clio Rubinos, MD, MS, FACNS, about their recent Currents article on the Seizure Code strategy. They share how their collaboration began across continents, the origins of the seizure code and the importance of recognizing and treating urgent epileptic seizures before they progress. The discussion covers barriers faced in lower-resource settings, the steps involved in creating and implementing a protocol and the measurable improvements in treatment times and patient outcomes. They also reflect on how similar approaches could be adapted within U.S. hospitals to improve care for patients with seizures. To read the full article, visit Currents: Seizure Code Strategy: Improving Treatment Times and Clinical Outcomes in Patients With Urgent Epileptic Seizures The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Swarna Rajagopalan, MD, MS, associate professor of neurology Cooper University Health Care about her recent co-authored Currents article on the role of ultrasound guidance in performing lumbar punctures in the neuroscience ICU. They discuss the limitations of the landmark-based technique, when ultrasound can improve safety and accuracy, and how point-of-care training supports providers. Dr. Rajagopalan also describes why neurointensivists should consider increasing their use of ultrasound in daily practice outside of traditional critical care procedures. To read the full article, visit Currents: The Role of Ultrasound Guided Lumbar Puncture in the Neuroscience Intensive Care Unit: A Review and Case Presentation The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.  

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, is joined by Chere Chase-Gregory, MD, MHS, senior vice president and chief health equity officer at Novant Health and a practicing neurointensivist. Dr. Chase-Gregory, also an adjunct faculty member at the University of North Carolina and founding member of the Women in Neurocritical Care Committee, shares her path into leadership, the origins of the committee and her ongoing work to advance health equity, mentorship and community partnerships. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Masterclass series, hosts Jon Rosenberg, MD, and Stephan A. Mayer, MD, FCCM, FNCS, are joined by Carolina B. Maciel, MD, MSCR, and Katharina Busl, MD, MS, professors of neurology at the University of Florida. They explore the evolution of opioid-sparing pain management strategies in patients with subarachnoid hemorrhage and acute brain injury. The conversation highlights Dr. Maciel and Dr. Busl's work with sphenopalatine ganglion nerve blocks and the design of a phase 2 clinical trial investigating this novel technique. The guests also discuss the limitations of traditional analgesic options, the complexities of headache mechanisms in neurocritical care and how targeted interventions may improve outcomes and quality of life for patients in the neuro ICU. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Tara Wall and her husband, Ron, whose journey through cardiac arrest and recovery offers a deeply personal look at the realities of critical illness, caregiving and hope. Tara, a former NICU nurse, recounts the terrifying moment her husband collapsed at home and the life-saving measures she took, while Ron shares his fragmented but remarkable memories from the event and his long road back to health. Together, they reflect on the emotional weight of medical decision making, the importance of support from health care teams and how connection, care and determination can shape recovery. Read the accompanying article: Part 1: Story of Hope – Life After Cardiac Arrest The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.  

In this episode of the NCS Podcast Perspective series, Nicholas Morris, MD, is joined by Immediate Past-President of NCS, Paul Vespa, MD, a professor of neurology and neurosurgery at UCLA. Dr. Vespa shares his path into neurocritical care, as well as his views on the growth of neuro ICUs and advances in continuous EEG monitoring and microdialysis. He discusses the future of AI in EEG, the value of patient stories and the importance of clinician-investigators, mentorship, and teamwork. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.  

In this episode of the NCS Podcast Masterclass series, Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, welcome renowned neurointensivist Chiara Robba, MD, Ph.D., to discuss the concept of brain protective ventilation. Drawing from her experience across both pulmonary and neurocritical care, Dr. Robba explores the physiological nuance of ventilating patients with brain injury, including how to balance positive end-expiratory pressure (PEEP), tidal volume and CO₂ levels to protect both lung and brain. The trio also dives into findings from the VENTIBRAIN study and practical strategies for tailoring care using multimodal monitoring. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, speaks with Clio Rubinos, MD, MS, and Rommel Morel, MD, about the urgent need to improve pre-hospital neurocritical care in low- and middle-income countries. They explore disparities in emergency response, the reality of patients arriving via family or bystanders and community-driven solutions like Colombia's Bootstrap consensus and Uganda's MOTOR trial. The conversation highlights how global collaboration, data-driven strategies and shared passion are essential to improving outcomes and reducing inequities in neurocritical care. Read the accompanying article:Traumatic Brain Injury in a Resource-Limited Setting: A Reflection on the Importance of Timely Interventions in Neurocritical Care Have questions or interested in collaborating?Contact the authors directly: crubinos@unc.edu rommellmorel121@gmail.com The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of Perspectives, Dr. Nicholas Morris is joined by neurocritical care fellows Dr. Diana Alsbrook, Dr. Sonja Darwish and Dr. Scott Sparks to discuss the future of the field. They share insights on choosing a fellowship, the challenges of training and what it takes to become a well-rounded neurointensivist. From clinical autonomy and mentorship to wellness and preparing for life after fellowship, this conversation provides valuable perspectives for both aspiring fellows and experienced practitioners. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, welcomes Ray and his wife, Kathleen, who authored a recent Currents "Stories of Hope" feature. Ray shares his journey of recovery after sustaining a traumatic brain injury in an accident while traveling in Aruba. Kathleen offers her perspective on navigating medical care abroad, the challenges of intensive rehabilitation and the resilience that carried them forward. Tune in to hear their inspiring story of determination, love and recovery. You can read Ray's story in Currents at Part 1: Ray's Story of Hope. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.