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The Stroke and Neurovascular Program at the Medical College of Wisconsin and Froedtert Hospital, in Milwaukee, is a comprehensive, interdisciplinary center for stroke medicine. The program encompasses an acute stroke team, a neuro-intensive care unit, a stroke care unit, and a stroke rehabilitation program. The staff includes specialists with fellowship training in stroke, neurocritical care, neurointerventional therapy, vascular neurosurgery, interventional neuroradiology, and stroke rehabilitation. Fellowships are offered in interventional neurology, neurocritical care, and vascular neurology. In addition to clinical service and education, the faculty are actively engaged in research. The program is certified by the Joint Commission as a Primary Stroke Center.
The Medical College of Wisconsin & Froedtert Stroke and Neurovascular Program includes a multidisciplinary team of stroke neurologists, interventional neurologists, neurointensivists, neurosurgeons, emergency medicine specialists and rehabilitation specialists (Figure 1) with subspecialty training and a primary clinical focus in the field of cerebrovascular disease. This program is the first full-service, Joint Commission-certified Primary Stroke Center in Wisconsin. Our mission is to provide the best available clinical care for the devastations of stroke and neurovascular illness. Certification by The Joint Commission provides patients and referring physicians with objective evidence of ongoing excellence in quality stroke care.
The Neurovascular Program is located at Froedtert Hospital in Milwaukee, Wisconsin, the only academic hospital in Milwaukee. It is the premier neuroscience center in the state of Wisconsin, accounting for 15–20% of overall hospital admissions. It is one of the largest stroke centers in the nation with eight fellowship trained vascular neurologists on the staff. It is the only hospital in Wisconsin with a dedicated Neuroscience Critical Care Unit staffed with fellowship trained neurointensivists.
Neurons die rapidly after stroke onset and limiting the extent of damage requires urgent, expert evaluation and treatment. The Froedtert & the Medical College of Wisconsin Acute Stroke Team (FAST; Figure 2) implemented rigorous protocols in 1996 for treating ischemic stroke patients with tPA in the first 3 hours after stroke, and has over 30 years of combined experience applying these protocols to hundreds of patients. In addition, they offer intra-arterial thrombolysis and mechanical clot extraction using endovascular methods in the 3–8 hour window after stroke onset in suitable patients.
Specialized care continues in a dedicated Neuroscience Intensive Care Unit (NICU) where stroke patients receive coordinated care and expert intervention. The NICU is equipped with state-of-the-science monitoring equipment and is the only NICU in Wisconsin staffed by full-time fellowship-trained neuro-intensivists, as well as an experienced team of nurses, therapists, pharmacists and other health professionals.
The Vascular Neurosurgery Program offers a complete range of treatment options for cerebrovascular disorders, including cerebral vascular malformations (cavernous angiomas and arteriovenous malformations), cerebral aneurysms, cerebral insufficiency, and carotid stenosis. Treatment options range from minimally invasive radiosurgery (gamma knife), neuro-endoscopy, and microsurgery, to complex skull base approaches.
The fellowship trained neurointerventionalists (Figure 3) are supported by nurses and technicians with specialty training in interventional neuroradiology. Endovascular stroke therapy encompasses a wide range of up-to-date advances in intra-arterial treatment of stroke, including thrombolysis in acute ischemia, prevention of recurrent ischemic stroke in the setting of extracranial or intracranial stenosis, treatment of cerebral aneurysms, and non-surgical management of arteriovenous malformations (AVMs). The volume of cases in their interventional neurology practice has significantly increased over the last three years to approximately triple its original volume (Figures 3 and and4).4). Their clinical outcomes are collectively among the best in the nation.
The Acute Stroke Unit is a dedicated inpatient service run by fellowship trained stroke neurologists and staffed by nurses with specialized training in stroke care. Diagnostic, stroke prevention, and risk management protocols consistently exceed national standards of care for stroke established by The Joint Commission and the University Health System Consortium.
MCW-Froedtert hospital is involved with cutting edge treatments for ischemic and hemorrhagic stroke.
The Neurovascular Program at the MCW-Froedtert Hospital offers fellowship training for neurologists in five pathways.
Jeffrey Binder, MD
Diane Book, MD
Brian-Fred M. Fitzsimmons, MD
Ann Helms, MD, MS
John R. Lynch, MD, FAHA
John McGuire, MD
Conrad Nievera, MD, DABPN, FPNA
Grant Sinson, MD
Michel Torbey, MD, MPH, FAHA
Osama O. Zaidat, MD, MS