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 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.