Leading the Way: Neurocritical Care at Phoenix Children’s

Varina Boerwinkle, MD
Medical Director, Neurocritical Care

As the medical director of Barrow Neurological Institute at Phoenix Children’s Hospital dedicated (full-time) Neurocritical Care Program, I’m extremely proud of what we offer here. We’re the only one of this kind in the Southwest and one of only a handful across the nation to have this type of program. I am responsible for the acute care of children with serious neurological illness or injury such as:

  • Pediatric stroke
  • Encephalitis
  • Anoxic brain injury
  • Traumatic brain injury (the leading cause of disability and death in children and adolescents in the U.S.)
  • Status epilepticus (ongoing/long seizures)
  • Brain hemorrhages (on or around the brain)
  • Brain tumors
  • Autonomicinstability
  • Spinal cord disorders
  • Toxic exposure effecting brain function
  • Loss of cardiac function affecting the brain
  • Heart disorders affecting the brain
  • Acute presentations of myasthenia gravis and Guillain-Barre Syndrome
  • Neonatal (difficult birth affecting brain function/increasing the risk for seizures)

The Most Common Neurocritical Complications

Difficult births are the most common neurocritical care cases. Neurologic diseases or injuries present at birth can have a lasting impact on your child’s growth and development. However, these symptoms with newborns are under-recognized, especially because signs with an infant are very subtle. The good news is that birth complications can be mitigated with proper treatment when they’re recognized quickly. For instance, it wasn’t long ago, that most babies who needed cooling therapies for neurocritical complications would come to PCH, however, the addition of a dedicated, on-site neurocritical care program puts us in a class of our own when it comes to babies’ brain care.

High-risk births need to have brain care available. So a key question for moms- and dads-to-be is, ‘Does your birthing center refer high-risk babies to Phoenix Children’s Hospital?’ Without dedicated neurocritical care for a high-risk birth, babies are at higher risk for seizures, hydrocephalus or brain damage that can manifest in any number of ways.

A baby's brain has the remarkable ability to heal. You should entrust your baby’s brain care to our dedicated Neurocritical Care Program.

Symptoms of Neurocritical Complications

Outside of neonatal neurocritical cases, there are symptoms of pediatric neurocritical complications such as:

  • Loss of walking function, cognitive/motor abilities, mental status – these are very alarming symptoms and must be addressed immediately
  • Child is more irritable than usual
  • Child is unresponsive to first-line interventions like rehydration
  • Child has a tough time staying awake (more exhausted than you would expect for a normal cough, cold or other minor illness)
  • Child says he/she has pain, which is not easily explained. It’s abnormal for a child to have pain

Pediatric Stroke

Hundreds of children suffer strokes every year. Stroke is the sixth leading cause of death in children. The risk of stroke is highest during the first year of life, but stroke may occur any time throughout childhood or adolescence. The good news, again, is that children tend to recover from stroke better than adults, due mostly to the plasticity of their brains and the fact their brains are still developing.

So the addition of a dedicated neurocritical care program and team to our multidisciplinary Pediatric Stroke Program, Barrow Neurological Institute at Phoenix Children’s Hospital is a leader in the most advanced acute pediatric stroke care with rapid evaluation, intervention and monitoring.

The program brings together the services of a variety of health care specialists involved in a child's care. Treatment includes neuroprotective measures, which include maintaining adequate blood pressure and supplying fluids and appropriate medication. The patient may also need aggressive physical rehabilitation. Phoenix Children's team of physicians, nurses, therapists, social workers, and education coordinators is available to help children with stroke and their families every step of the way.

Really, what it comes down to is no matter what the problem, we can handle it – whatever it is, no matter how rare, we can handle it here at Barrow Neurological Institute at Phoenix Children’s Hospital - all under one roof.

Physicians may refer a patient to our Neurocritical Care Program using One Call at 602-933-DOCS (3627).

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