Brain hemorrhage is due to rupture of blood vessels feeding the brain and accounts for up to 20% of all strokes. Bleeding that occurs inside the brain is called intracerebral hemorrhage (ICH).  Patients with ICH are admitted to our Stroke Team. Patients with bleeding in the spaces covering the brain (e.g., subarachnoid hemorrhage) are managed by our neurosurgical colleagues.

Vision

To provide the highest quality, comprehensive care to all patients with brain hemorrhage, led by an experienced clinical stroke team that partners with the neurocritical care staff and conducts clinical trials testing innovative therapies.

Highlights of our program include:

Comprehensive stroke care certified by the Joint Commission – the only one in Texas

24/7 stroke care provided by vascular neurologists, stroke fellows , and cerebrovascular surgeons
Dedicated stroke coverage of the emergency department 24/7
Dedicated 12 Bed Inpatient Stroke Unit

Strong partnership with neurocritical care team

Patients with brain hemorrhage often require critical care in the neuro-intensive care unit (link ). We work together with our neurocritical care colleagues to provide comprehensive, advanced care to our patients.

Implementing best medical practices and advanced clinical protocols

BP protocol, Hemicrani protocol

State of the Art Rapid Diagnostic Evaluation

Neuroimaging: All patients are evaluated with advanced brain imaging to identify areas of bleeding and potential causes
Neuroradiological Expertise: Radiologists specialized in neuroimaging are available 24/7

Developing home grown, innovative therapies
We are leading or participating in clinical trials testing a range of innovative treatments that we offer to eligible patients.  These approaches include developing medical therapies to reabsorb the blood or minimally invasive surgical approaches to remove the blood

Access to leading stroke doctors and cerebrovascular surgeons

  • Hospitals can call our transfer center line (713-704-2577) to speak with one of our on-call stroke physicians at any time 24/7
  • Patients who require a higher level of care have access to Memorial Hermann Life Flight® or may choose another air ambulance service to be quickly transported to our Comprehensive Stroke Center
  • We accept all patients from our network hospitals, regardless of resource status, in accordance with agreed-upon transfer guideline-based protocols.

Research

Safety of pioglitazone for Hematoma Resolution in Intracerebral hemorrhage (SHRINC):  Based on studies led by stroke scientists, Drs. Aronowski and Zhao, in our program, the diabetic medications pioglitazone enhances reabsorption and clean up of blood debris in ICH.  We recently completed enrollment on an NIH-funded prospective, randomized controlled trial testing the safety of pioglitazone.  We are determining if pioglizatone is safe and increases the rate of hematoma resolution in patients with ICH.
Principal Investigator: Nicole Gonzales

Hi-DEF: We are currently participating in a multicenter, NIH funded study to test whether the iron chelator, desforraxamine.  Principal Investigator: Nicole Gonzales

CLEAR III: A phase III multicenter, international, double-blind, randomized study comparing the use of EVD combined with rt-PA against EVD combined with placebo for the treatment of intraventricular hemorrhage. Principal Investigator: Nicole Gonzales

MISTIE III Trial:  We are participating in a highly-exciting multicenter, NIH funded phase III study to determine if minimally invasive surgery using stereotactic approaches improves outcome in patients with ICH.   Principal Investigator: TBD

nicole-gonzales

Nicole Gonzales, MD
Division Lead, Brain Hemorrhag