Departments of Neurology and Neurosurgery



Departments of Neurology and Neurosurgery

Treatment Programs

Maryland Brain Attack Center

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Members of the UM Brain Attack Team.

The Maryland Brain Attack Center at the University of Maryland Medical System was created to provide the most advanced and innovative treatments to stroke and TIA patients throughout the state of Maryland.

The hub of the Center's strategy for acute stroke treatment is the Brain Attack TeamSM (BAT), a highly specialized team of neurologists, neurosurgeons, nurses and other health professionals who provide the rapid evaluation and initiation of treatment for brain attack patients, using the most advanced approaches and technologies.

For More Information

• Physicians: In case of stroke emergency, please call 410-328-1234. See services to physicians.

• UM Stroke Center and Brain Attack Team top national ranking.

• UM Medical Center earns Primary Stroke Center designation.

• TIA Rapid Assessment of Transient Ischemic Attack Etiologies (RATE)

• Stroke warning signs.

• This short video explains how a stroke can occur.

Requires Quicktime.

• To contact the Brain Attack Center, please call (410) 328-3793.

The team offers immediate patient contact by a neurologist with specialized training in stroke care 24 hours a day, seven days a week. No other medical center in the state offers this kind or level of service. Patients can be transported or transferred to the University of Maryland Medical Center from other hospitals using our Maryland ExpressCare ambulances or helicopter transport via MIEMSS.

The Brain Attack Team's cerebrovascular specialists ensure that diagnosis and treatment of stroke patients occurs immediately upon arrival to the medical center.

The focus of the Brain Attack Team is on the coordinated efforts of:

• pre-hospital neurological consultation

• critical care transport

• Emergency Department evaluation

• rapid initiation of the most advanced therapies and diagnosis

• neurosurgery

• vascular surgery

• interventional neuroradiology

• rehabilitation therapy

Special Programs

Another component of The Maryland Brain Attack Center is the Rapid Assessment of Transient Ischemic Attack Etiologies (RATE), which was developed to evaluate patients with TIA and to identify risk factors and potential stroke causes and then quickly treat them to prevent an actual stroke. This rapid evaluation is performed within 24 hours and patients are provided secondary stroke prevention and follow-up.

The Rapid Assessment and Treatment of TIA Etiology (RATE) is an ultrafast emergency department workup and treatment program for patients who experience transient ischemic attack.

More rapid work-up and intervention result in less disability and more rapid advancement to rehabilitation and post-acute care services, which are provided through the University Rehabilitation Network. All levels of post-acute care are provided through the Network, ranging from home health services to subacute and acute rehabilitation as well as long term care.

Training Programs

The Maryland Brain Attack Center offer fellowships in cerebrovascular neurology with an emphasis on brain attack for physicians, nurse practitioners and physician assistants.

Clinical Trial Research

Clinical trial research has resulted in the first FDA approved therapy for acute brain attack called Activase, (or t-PA, tissue plasminogen activator) which has been shown to reduce the chance of permanent disability following a stroke. However, the treatment must be administered within a golden time window, similar to that for a trauma victim.

Due to the highly specialized and efficient operation of the Brain Attack Team, Activase can be administered rapidly after careful evaluation to appropriate patients at The Maryland Brain Attack Center. Many promising therapies in clinical trials are also offered at the medical center for both ischemic and hemorrhagic types of stroke. The goal of the Brain Attack Team includes giving every patient the opportunity to have a new, innovative approach to their care.

Stroke Risk Assessment and Prevention

Still, the best way to reduce the disability from stroke is to prevent the stroke from occurring. A new plan for stroke risk assessment and prevention has been developed through The Maryland Brain Attack Center. This far-reaching plan includes a program for educating both health professionals and the public, and provides members of the community with free stroke risk assessment and follow-up for identified stroke risk factors.

This plan of prevention is provided by a collaboration of multiple disciplines at the medical center. Specialized surgical techniques such as carotid endarterectomy under regional anesthesia and other specialized endovascular procedures are performed after careful evaluation and consultation with surgical colleagues. As a result of these comprehensive pioneering efforts, patients of The Maryland Brain Attack Center have a shorter length of stay and lower cost for care as compared to years prior to the Center's initiation. The gains are measured best in reduced disability of those patients treated with these innovative therapies and inpatient satisfaction results (100% very good or exceptionally satisfied).

Signs of Stroke

Stroke is an emergency. Call 911 if you are experiencing signs of a stroke:

Severe headache and/or sudden loss of:

• Vision

• Speech

• Strength

• Balance

• Sensation

Patient Conditions

• Brain attack and ischemic stroke

• Transient ischemic attacks

• Vasculitis

• Carotid and vertebral dissection

• Cerebral venous thrombosis

• Subarachnoid hemorrhages, including aneurysms

• Intracerebral hemorrhage

• Primary prevention of stroke in high risk patients, (asymptomatic carotid stenosis and sickle cell disease)

Comprehensive Evaluations

• CT and CT angiography

• MRI, including perfusion and diffusion sequences, and MRI angiography

• Neuroangiography

• Carotid duplex sonography

• Transcranial doppler ultrasonography

• Xenon-CT

• SPECT

Specialized Treatments

• Acute thrombolytic therapy with TPA

• Gamma Knife

• Interventional neuroradiology

• Surgical treatment of carotid stenosis, aneurysms, and arteriovenous malformations

• Dedicated intensive and intermediate care units

• Comprehensive rehabilitation evaluation

Research Activities

• Telemedicine for Brain Attack Consultation

• Technologies for rapid evaluation, diagnosis and treatment of Brain Attack

• Identification of new genetic and environmental risk factors for stroke

• Studies of stroke in young adults

• Mobile telemedicine for accelerated prehospital evaluation

• Clinical trials of investigational drugs for acute stroke, and of strategies to prevent recurrent stroke and to improve recovery from stroke

• Studies of outcome after stroke, including predictors of return to work after stroke

• Studies of the role of exercise in recovery after stroke, including exercise-induced brain neuroplasticity

Services to Physicians

• Brain Attack Team Consultation with acute stroke specialist 24 hours/day, 7 days per week, at Maryland ExpressCare, 410-328-1234

• Specialty consultation for patients with complicated cerebrovascular disease

• Multidisciplinary patient care conferences with medical, surgical and interventional radiology specialists

• Coordinated stroke care from prevention through acute presentation rehabilitation and long term recover

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