Advancing Neuroscience and Clinical Applications for:

Brain Injury, Recovery, Rehabilitation, and Restoration

CDC: Centers for Disease Control and Prevention Handouts

Our team was involved in helping create the following links regarding discharge instructions, recovery tips, and return to work instructions.


Discharge Instructions

 

Recovery Tips

 

Return to Work Instructions

 

Pac-12 Student-Athlete Health & Well Being Initiative

The Pac-12 Initiative is a collective effort between the Conference and member universities to find ways to reduce injuries, share current best practices and latest studies, and conduct research to uncover new ways to keep student-athletes as safe as possible. In 2019, the Pac-12 Grant Program committed funding to Dr. Angela Lumba-Brown for leading a study, "The Subtypes of Concussion - Classification and Recovery Trajectories in Pac-12 Student Athletes," aimed at advancing the science of concussion care and changing how concussions are diagnosed and managed.

 

Brain Trauma Evidence-Based Consortium (B-TEC)

Launched in 2014 with funding by the U.S. Department of Defense to Stanford University, and subcontracted to the Brain Trauma Foundation, B-TEC brings together brain injury experts from the Brain Trauma Foundation, Stanford University, Oregon Health and Sciences University, and Portland State University. The Consortium's aim is to develop an evidence-based classification for the spectrum of traumatic brain injury, including concussion, and to model post-injury trajectories and outcomes.

Core Objectives:

1. To establish evidence for concussion subtypes, describing their prevalence in head injured patients, and informating how each subtype recovers. Goals of this work are to lead to targeted management strategies to effect better care.

2. To maximize the utility of scientific effortrs to-date that address the epidemic of concussion and brain trauma, for the purpose of deriving a clinically useful classification system, and evidence-based guidelines for diagnosis, prognosis, treatment, and outcomes. 

3. To create a consortium among the neurotrauma community that will inspire a commitment to the principles of evidence-based medicine in the design and conduct of brain trauma research.

4. To continue updating the Brain Trauma Foundation traumatic brain injury guidelines.

Key Research Areas:

  • Concussion Subtypes
  • Sports-related Concussion
  • Head Injury in Children
  • Classification of Severe Traumatic Brain Injury
  • Pediatric Management of Severe Traumatic Brain Injury
  • Adult In-Hospital Management of Severe Traumatic Brain Injury
  • Pre-Hospital Management of Severe Traumatic Brain Injury in Adults and Children
  • Brain Injury Algorithm Development

Founded by Center Director, Dr. Jamshid Ghajar, in 1986, the Brain Trauma Foundation was created to provide ongoing support for research on TBI. In the three decades since its founding, the Foundation continues to focus on conducting innovative clinical research, updating evidence-based guidelines, and working towards improving outcomes for the millions of people who suffer from traumatic brain injuries every year.

    Featured Faculty Research

    Odette Harris, MD, MPH
    Paralyzed Veterans of America Professor of Spinal Cord Injury Medicine

    Publications

    • Rationale and Methods for Updated Guidelines for the Management of Penetrating Traumatic Brain Injury. Neurotrauma reports Hawryluk, G. W., Selph, S., Lumba-Brown, A., Totten, A. M., Ghajar, J., Aarabi, B., Ecklund, J., Shackelford, S., Adams, B., Adelson, D., Armonda, R. A., Benjamin, J., Boone, D., Brody, D., Dengler, B., Figaji, A., Grant, G., Harris, O., Hoffer, A., Kitigawa, R., Latham, K., Neal, C., Okonkwo, D. O., Pannell, D., Rosenfeld, J. V., Rosenthal, G., Rubiano, A., Stein, D. M., Stippler, M., Talbot, M., Valadka, A., Wright, D. W., Davis, S., Bell, R. 2022; 3 (1): 240-247

      Abstract

      Penetrating traumatic brain injury (pTBI) affects civilian and military populations resulting in significant morbidity, mortality, and healthcare costs. No up-to-date and evidence-based guidelines exist to assist modern medical and surgical management of these complex injuries. A preliminary literature search revealed a need for updated guidelines, supported by the Brain Trauma Foundation. Methodologists experienced in TBI guidelines were recruited to support project development alongside two cochairs and a diverse steering committee. An expert multi-disciplinary workgroup was established and vetted to inform key clinical questions, to perform an evidence review and the development of recommendations relevant to pTBI. The methodological approach for the project was finalized. The development of up-to-date evidence- and consensus-based clinical care guidelines and algorithms for pTBI will provide critical guidance to care providers in the pre-hospital and emergent, medical, and surgical settings.

      View details for DOI 10.1089/neur.2022.0008

      View details for PubMedID 35919507

      View details for PubMedCentralID PMC9279118

    • Rationale and Methods for Updated Guidelines for the Management of Penetrating Traumatic Brain Injury NEUROTRAUMA REPORTS Hawryluk, G. W. J., Selph, S., Lumba-Brown, A., Totten, A. M., Ghajar, J., Aarabi, B., Ecklund, J., Shackelford, S., Adams, B., Adelson, D., Armonda, R. A., Benjamin, J., Boone, D., Brody, D., Dengler, B., Figaji, A., Grant, G., Harris, O., Hoffer, A., Kitigawa, R., Latham, K., Neal, C., Okonkwo, D. O., Pannell, D., Rosenfeld, J., Rosenthal, G., Rubiano, A., Stein, D. M., Stippler, M., Talbot, M., Valadka, A., Wright, D. W., Davis, S., Bell, R. 2022; 3 (1): 240-247

      View details for DOI 10.1089/neur.2022.0008

      View details for Web of Science ID 000813892800001

    • Sex differences in cortical thickness and diffusion properties in patients with traumatic brain injury: a pilot study. Brain injury Adamson, M. M., Main, K., Harris, O. A., Kang, X. 1800: 1-15

      Abstract

      OBJECTIVE: Cortical thickness and diffusion properties are important measures of gray and white matter integrity in those with traumatic brain injury (TBI). Many studies show that healthy adult females have greater cortical thickness than males across numerous brain sites. In this study, we explored this sex difference in patients with TBI.METHOD: Participants consisted of 32 patients with TBI and 21 neurologically healthy controls. All were scanned by magnetic resonance imaging (MRI). Differences in cortical thickness and diffusion properties were examined between groups (i.e., TBI/control, male/female).RESULTS: Patients with TBI had more cortical thinning (both hemispheres) compared to controls. They also showed decreased fractional anisotropy (FA) for several major white matter tracts. Healthy females had significantly greater cortical thickness compared to healthy males. However, this difference was smaller among the patients with TBI. We found no sex differences in diffusion properties. There were moderate correlations between cortical thickness, diffusion properties, and cognitive performance, as measured by the Trail Making Test B.CONCLUSION: These findings contribute to a growing discussion on sex differences in cortical thickness and diffusion properties. Sexual dimorphism could necessitate different clinical profiles, targets, and rehabilitation strategies in patients with TBI.

      View details for DOI 10.1080/02699052.2022.2034046

      View details for PubMedID 35113752

    Ashwin Ramayya, MD, PhD
    Assistant Professor of Neurosurgery

    Publications

    • Bilateral subdural empyema diagnosed after middle meningeal artery embolization: illustrative case. Journal of neurosurgery. Case lessons Lear, B., Ahmed, S., Taiwo, R., Levinson, S., Lamano, J., Dodd, R., Harris, O., Ramayya, A. G. 2026; 12 (13)

      Abstract

      Middle meningeal artery (MMA) embolization has emerged as an effective adjunctive treatment for chronic subdural hematomas (SDHs) and is generally associated with a favorable safety profile. As utilization increases following recent randomized trials, uncommon complications are increasingly being recognized. The authors present a case of bilateral subdural empyema following bilateral MMA embolization.A 67-year-old man underwent bilateral MMA embolization for acute-on-chronic SDHs. Three weeks after an initially uncomplicated procedure, he developed progressive confusion, dysarthria, facial weakness, and hemiparesis. Serial CT and MRI demonstrated stable bilateral subdural collections without definitive radiographic evidence of empyema. Surgical evacuation was pursued because of persistent neurological deficits despite correction of alternative metabolic abnormalities. Intraoperatively, purulent material was encountered in both epidural and subdural spaces bilaterally, with cultures growing Klebsiella pneumoniae. Following bilateral evacuation and 6 weeks of intravenous antibiotics, the patient achieved complete neurological recovery.Subdural empyema should be considered in patients with neurological deterioration following MMA embolization, even in the setting of stable interval imaging and the absence of classic laboratory markers of infection. Although the temporal association with embolization raises the possibility of a procedure-associated mechanism, the route of infection may not always be apparent, and clinicians should maintain a broad differential diagnosis. https://thejns.org/doi/10.3171/CASE26631.

      View details for DOI 10.3171/CASE26631

      View details for PubMedID 42804802

      View details for PubMedCentralID PMC13618027

    • Percutaneous Cervical Cordotomy for Refractory Cancer Pain With General Anesthesia and Neuromonitoring: A Case Report. Pain practice : the official journal of World Institute of Pain Ahmed, S., Huang, Y., Polat, M., Chang, F., Lopez, J. R., McGeoch, P. D., Buch, V. P., Heidari, S. N., Wu, A., Neugarten, C., Carroll, I., Brose, W. G., Lanzman, B., Ramayya, A. G. 2026; 26 (7): e70193

      Abstract

      Cancer-related pain remains one of the most debilitating symptoms in patients with advanced malignancy, with a significant proportion experiencing pain refractory to standard medical therapy. Percutaneous cordotomy is an established intervention targeting the spinothalamic pathway and can provide meaningful relief in appropriately selected patients; however, its use has declined and is typically performed in awake patients.A 54-year-old woman with metastatic gallbladder carcinoma presented with severe, unilateral, nociceptive abdominal pain refractory to medical and interventional treatments. Given her limited life expectancy and persistent symptoms, she underwent percutaneous cervical cordotomy. At the patient's request, the procedure was performed under general anesthesia. We achieved excellent localization for safe ablation using intraoperative CT and neuromonitoring guidance. Postoperatively, she reported complete resolution of her primary pain (8-10/10 to 0/10) on postoperative Day 1. She developed expected contralateral "mirror pain," which was less severe and manageable. Pain relief was sustained during early follow-up, although later recurrence was attributed to disease progression rather than procedural failure.This case demonstrates that percutaneous cordotomy can be performed safely and effectively under general anesthesia with the aid of intraoperative CT and neuromonitoring. This approach may expand the applicability of cordotomy in carefully selected patients with refractory cancer pain, particularly when patient comfort is a priority.

      View details for DOI 10.1111/papr.70193

      View details for PubMedID 42613854

      View details for PubMedCentralID PMC13486940

    • Rapid stereo-EEG network mapping enables personalized multinodal stimulation for refractory facial pain. Brain stimulation Huang, Y., McGeoch, P. D., Kaboodvand, N., Liu, T. X., Reid, B., Chibukhchyan, A., Vesuna, S., Patron, K., Yamada, L., Fogarty, A., Cho, E. Y., Taha, A., Rolle, C., Polat, M., Park, J. J., Ramayya, A., Rodríguez, C. I., Nuyujukian, P., Deisseroth, K., Buch, V. P. 2026: 103176

      View details for DOI 10.1016/j.brs.2026.103176

      View details for PubMedID 42532258

    Irene L. Llorente
    Assistant Professor of Neurosurgery

    Publications

    • Patient-derived glial enriched progenitors repair functional deficits due to white matter stroke and vascular dementia in rodents SCIENCE TRANSLATIONAL MEDICINE Llorente, I. L., Xie, Y., Mazzitelli, J. A., Hatanaka, E. A., Cinkornpumin, J., Miller, D. R., Lin, Y., Lowry, W. E., Carmichael, S. 2021; 13 (590)

      Abstract

      Subcortical white matter stroke (WMS) accounts for up to 30% of all stroke events. WMS damages primarily astrocytes, axons, oligodendrocytes, and myelin. We hypothesized that a therapeutic intervention targeting astrocytes would be ideally suited for brain repair after WMS. We characterize the cellular properties and in vivo tissue repair activity of glial enriched progenitor (GEP) cells differentiated from human-induced pluripotent stem cells, termed hiPSC-derived GEPs (hiPSC-GEPs). hiPSC-GEPs are derived from hiPSC-neural progenitor cells via an experimental manipulation of hypoxia inducible factor activity by brief treatment with a prolyl hydroxylase inhibitor, deferoxamine. This treatment permanently biases these cells to further differentiate toward an astrocyte fate. hiPSC-GEPs transplanted into the brain in the subacute period after WMS in mice migrated widely, matured into astrocytes with a prorepair phenotype, induced endogenous oligodendrocyte precursor proliferation and remyelination, and promoted axonal sprouting. hiPSC-GEPs enhanced motor and cognitive recovery compared to other hiPSC-differentiated cell types. This approach establishes an hiPSC-derived product with easy scale-up capabilities that might be effective for treating WMS.

      View details for DOI 10.1126/scitranslmed.aaz6747

      View details for Web of Science ID 000642350100002

      View details for PubMedID 33883275

    • Customized Brain Cells for Stroke Patients Using Pluripotent Stem Cells STROKE Kokaia, Z., Llorente, I. L., Carmichael, S. 2018; 49 (5): 1091-1098

      View details for DOI 10.1161/STROKEAHA.117.018291

      View details for Web of Science ID 000430662100020

      View details for PubMedID 29669871

      View details for PubMedCentralID PMC5916498

    • Hydrogel-delivered brain-derived neurotrophic factor promotes tissue repair and recovery after stroke JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM Cook, D. J., Nguyen, C., Chun, H. N., Llorente, I. L., Chiu, A. S., Machnicki, M., Zarembinski, T. I., Carmichael, S. T. 2017; 37 (3): 1030-1045

      Abstract

      Stroke is the leading cause of adult disability. Systemic delivery of candidate neural repair therapies is limited by the blood-brain barrier and off-target effects. We tested a bioengineering approach for local depot release of BDNF from the infarct cavity for neural repair in chronic periods after stroke. The brain release levels of a hyaluronic acid hydrogel + BDNF were tested in several stroke models in mouse (strains C57Bl/6, DBA) and non-human primate ( Macaca fascicularis) and tracked with MRI. The behavioral recovery effects of hydrogel + BDNF and the effects on tissue repair outcomes were determined. Hydrogel-delivered BDNF diffuses from the stroke cavity into peri-infarct tissue over 3 weeks in two mouse stroke models, compared with 1 week for direct BDNF injection. Hydrogel delivery of BDNF promotes recovery of motor function. Mapping of motor system connections indicates that hydrogel-BDNF induces axonal sprouting within existing cortical and cortico-striatal systems. Pharmacogenetic studies show that hydrogel-BDNF induces the initial migration of immature neurons into the peri-infarct cortex and their long-term survival. In chronic stroke in the non-human primate, hydrogel-released BDNF can be detected up to 2 cm from the infarct, a distance relevant to human functional recovery in stroke. The hydrogel can be tracked by MRI in mouse and primate.

      View details for DOI 10.1177/0271678X16649964

      View details for Web of Science ID 000394660400024

      View details for PubMedID 27174996

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