Physicians

Department / Division
Medicine / Medicine-Neurology

Address
DUMC 2900
Durham, NC 27710

Appointment Telephone
919-668-7600

Office Telephone
919-684-8969

Fax Telephone
919-684-6514

Training

• MD, University of Western Ontario Schulich School of Medicine & Dentistry (Canada), 1985

Residency

• Internal Medicine, University of Western Ontario (Canada), 1986-1988
• Neurology, University of Western Ontario (Canada), 1988-1991

Fellowship

• Stroke Clinical Fellowship, University of Western Ontario (Canada), 1991
• Stroke Molecular Genetics, Duke University Medical Center, 1992-1994
• Vascular Neurology, University of Western Ontario; Duke University Medical Center, 1990-1991
• Neurosonology, Duke University Medical Center, 2005
• Neurocritical Care, University of Western Ontario, Duke University Medical Center, 1991-1994

Other Training

• Fellow, Royal College of Physicians (Canada)
• Board Certifications, Neurology and Vascular Neurology

Clinical Interests
Stroke, neurocritical care

Research Interests
As an neurointensivist with subspecialty training in cerebrovascular disease and neurocritical care my research focus is on the application of neurocritical care interventions to help patients with acute strokes and head injuries. My clinical research has focused on exploring methods to control body temperature in order to mitigate the detrimental effects of hyperthermia following acute neurological injury. Clinical trials utilizing novel intravascular thermoregulatory devices have demonstrated highly effective new methodoligies.

Current research studies include the use of therapeutic hypothermia to treat patients with acute traumatic brain injuries as well as following cardiac arrest. Out group at Duke is collaborating with other investigators to evolve the field of therapeutic hypothermia to be able to deliver this therapy in the field by EMS-paramedic personel.

Our research interests in intracerebral hemorrhage include the acute managment of hypertension, as well as the control of intracebral hypertension. We are collaborating in multiple NIH based studies involving patients with ICH.

Industry Relationships and Collaborations (What's this?)

This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• Novella Clinical, Inc.

Representative Publications
Olson, DM; Thoyre, SM; Bennett, SN; Stoner, JB; Graffagnino, C. Effect of mechanical chest percussion on intracranial pressure: a pilot study. American Journal of Critical Care. 2009;18:330-335. (2009) Abstract

Olson, DM; Thoyre, SM; Peterson, ED; Graffagnino, C. A randomized evaluation of bispectral index-augmented sedation assessment in neurological patients. Neurocritical Care. 2009;11:20-27. (2009) Abstract

Zaidat, OO; Ionita, CC; Hussain, SI; Alexander, MJ; Friedman, AH; Graffagnino, C. Impact of ruptured cerebral aneurysm coiling and clipping on the incidence of cerebral vasospasm and clinical outcome. Journal of Neuroimaging. 2009;19:144-149. (2009) Abstract

Aronow, HD; Califf, RM; Harrington, RA; Vallee, M; Graffagnino, C; Shuaib, A; Fitzgerald, DJ; Easton, JD; Van de Werf, F; Diener, HC; Ferguson, J; Koudstaal, PJ; Amarenco, P; Theroux, P; Davis, S; Topol, EJ. Relation between aspirin dose, all-cause mortality, and bleeding in patients with recent cerebrovascular or coronary ischemic events (from the BRAVO Trial). American Journal of Cardiology. 2008;102:1285-1290. (2008) Abstract

Ionita, CC; Graffagnino, C; Alexander, MJ; Zaidat, OO. The value of CT angiography and transcranial doppler sonography in triaging suspected cerebral vasospasm in SAH prior to endovascular therapy. Neurocritical Care. 2008;9:8-12. (2008) Abstract

Bennett, SS; Graffagnino, C; Borel, CO; James, ML. Use of high frequency oscillatory ventilation (HFOV) in neurocritical care patients. Neurocritical Care. 2007;7:221-226. (2007) Abstract

Olson, D; Lynn, M; Thoyre, SM; Graffagnino, C. The limited reliability of the Ramsay scale. Neurocritical Care. 2007;7:227-231. (2007) Abstract

Olson, DM; Thoyre, SM; Turner, DA; Bennett, S; Graffagnino, C. Changes in intracranial pressure associated with chest physiotherapy. Neurocritical Care. 2007;6:100-103. (2007) Abstract

McGirt, MJ; Blessing, R; Alexander, MJ; Nimjee, SM; Woodworth, GF; Friedman, AH; Graffagnino, C; Laskowitz, DT; Lynch, JR. Risk of cerebral vasopasm after subarachnoid hemorrhage reduced by statin therapy: A multivariate analysis of an institutional experience. Journal of Neurosurgery. 2006;105:671-674. (2006) Abstract

Ionita, CC; Ferrara, J; McDonagh, DL; Grossi, P; Graffagnino, C. Systemic hemostasis with recombinant-activated factor VII followed by local thrombolysis with recombinant tissue plasminogen activator in intraventricular hemorrhage. Neurocritical Care. 2005;3:246-248. (2005) Abstract

Lynch, JR; Wang, H; McGirt, MJ; Floyd, J; Friedman, AH; Coon, AL; Blessing, R; Alexander, MJ; Graffagnino, C; Warner, DS; Laskowitz, DT. Simvastatin reduces vasospasm after aneurysmal subarachnoid hemorrhage: results of a pilot randomized clinical trial. Stroke. 2005;36:2024-2026. (2005) Abstract

Olson, DM; Graffagnino, C. Consciousness, coma, and caring for the brain-injured patient. AACN Advanced Critical Care. 2005;16:441-455. (2005) Abstract

Olson, DM; Graffagnino, C; King, K; Lynch, JR. Toward solving the sedation-assessment conundrum: bi-spectral index monitoring and sedation interruption. Critical Care Nursing Clinics of North America. 2005;17:257-267. (2005) Abstract

Zaidat, OO; Slivka, AP; Mohammad, Y; Graffagnino, C; Smith, TP; Enterline, DS; Christoforidis, GA; Alexander, MJ; Landis, DM; Suarez, JI. Intra-arterial thrombolytic therapy in peri-coronary angiography ischemic stroke. Stroke. 2005;36:1089-1090. (2005) Abstract

Al-Senani, FM; Graffagnino, C; Grotta, JC; Saiki, R; Wood, D; Chung, W; Palmer, G; Collins, KA. A prospective, multicenter pilot study to evaluate the feasibility and safety of using the CoolGard System and Icy catheter following cardiac arrest. Resuscitation. 2004;62:143-150. (2004) Abstract

Kassem-Moussa, H; Mahaffey, KW; Graffagnino, C; Tasissa, G; Sila, CA; Simes, RJ; White, HD; Califf, RM; Bhapkar, MV; Newby, LK; SYMPHONY and 2nd SYMPHONY Investigators. Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome. American Heart Journal. 2004;148:439-446. (2004) Abstract

McCarron, MO; Weir, CJ; Muir, KW; Hoffmann, KL; Graffagnino, C; Nicoll, JA; Lees, KR; Alberts, MJ. Effect of apolipoprotein E genotype on in-hospital mortality following intracerebral haemorrhage. Acta Neurologica Scandinavica. 2003;107:106-109. (2003) Abstract

Topol, EJ; Easton, D; Harrington, RA; Amarenco, P; Califf, RM; Graffagnino, C; Davis, S; Diener, HC; Ferguson, J; Fitzgerald, D; Granett, J; Shuaib, A; Koudstaal, PJ; Theroux, P; Van de Werf, F; Sigmon, K; Pieper, K; Vallee, M; Willerson, JT; Blockade of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion Trial Investigators. Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease. Circulation. 2003;108:399-406. (2003) Abstract

Alberts, MJ; McCarron, MO; Hoffmann, KL; Graffagnino, C. Familial clustering of intracerebral hemorrhage: a prospective study in North Carolina. Neuroepidemiology. 2002;21:18-21. (2002) Abstract

Bulsara, KR; Alexander, MJ; Villavicencio, AT; Graffagnino, C. De novo cerebral arteriovenous malformation: case report. Neurosurgery. 2002;50:1137-1140. (2002) Abstract

Kassem-Moussa, H; Graffagnino, C. Nonocclusion and spontaneous recanalization rates in acute ischemic stroke: a review of cerebral angiography studies. Archives of Neurology. 2002;59:1870-1873. (2002) Abstract

Schwab, S; Georgiadis, D; Berrouschot, J; Schellinger, PD; Graffagnino, C; Mayer, SA. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke. 2001;32:2033-2035. (2001) Abstract

Harrington, RA; Armstrong, PW; Graffagnino, C; Van De Werf, F; Kereiakes, DJ; Sigmon, KN; Card, T; Joseph, DM; Samuels, R; Granett, J; Chan, R; Califf, RM; Topol, EJ. Dose-finding, safety, and tolerability study of an oral platelet glycoprotein IIb/IIIa inhibitor, lotrafiban, in patients with coronary or cerebral atherosclerotic disease. Circulation. 2000;102:728-735. (2000) Abstract

Topol, EJ; Easton, JD; Amarenco, P; Califf, R; Harrington, R; Graffagnino, C; Davis, S; Diener, HC; Ferguson, J; Fitzgerald, D; Shuaib, A; Koudstaal, PJ; Theroux, P; Van de Werf, F; Willerson, JT; Chan, R; Samuels, R; Ilson, B; Granett, J. Design of the blockade of the glycoprotein IIb/IIIa receptor to avoid vascular occlusion (BRAVO) trial. American Heart Journal. 2000;139:927-933. (2000) Abstract

Mahaffey, KW; Harrington, RA; Simoons, ML; Granger, CB; Graffagnino, C; Alberts, MJ; Laskowitz, DT; Miller, JM; Sloan, MA; Berdan, LG; MacAulay, CM; Lincoff, AM; Deckers, J; Topol, EJ; Califf, RM. Stroke in patients with acute coronary syndromes: incidence and outcomes in the platelet glycoprotein IIb/IIIa in unstable angina. Receptor suppression using integrilin therapy (PURSUIT) trial. The PURSUIT Investigators. Circulation. 1999;99:2371-2377. (1999) Abstract

Alberts, MJ; Davis, JP; Graffagnino, C; McClenny, C; Delong, D; Granger, C; Herbstreith, MH; Boteva, K; Marchuk, DA; Roses, AD. Endoglin gene polymorphism as a risk factor for sporadic intracerebral hemorrhage. Annals of Neurology. 1997;41:683-686. (1997) Abstract

Gasecki, AP; Graffagnino, C; Hachinski, V. Tissue plasminogen activator in a vertebral artery dissection. Canadian Journal of Neurological Sciences. 1997;24:151-154. (1997) Abstract

Hachinski, V; Graffagnino, C; Beaudry, M; Bernier, G; Buck, C; Donner, A; Spence, JD; Doig, G; Wolfe, BM. Lipids and stroke: a paradox resolved. Archives of Neurology. 1996;53:303-308. (1996) Abstract

Alberts, MJ; Graffagnino, C; McClenny, C; DeLong, D; Strittmatter, W; Saunders, AM; Roses, AD. ApoE genotype and survival from intracerebral haemorrhage. Lancet. 1995;346:575. (1995) Abstract

Alberts, MJ; Quinones, A; Graffagnino, C; Friedman, A; Roses, AD. Risk of intracranial aneurysms in families with subarachnoid hemorrhage. Canadian Journal of Neurological Sciences. 1995;22:121-125. (1995) Abstract

Graffagnino, C; Herbstreith, MH; Schmechel, DE; Levy, E; Roses, AD; Alberts, MJ. Cystatin C mutation in an elderly man with sporadic amyloid angiopathy and intracerebral hemorrhage. Stroke. 1995;26:2190-2193. (1995) Abstract

Graffagnino, C; Gasecki, AP; Doig, GS; Hachinski, VC. The importance of family history in cerebrovascular disease. Stroke. 1994;25:1599-1604. (1994) Abstract

Graffagnino, C; Herbstreith, MH; Roses, AD; Alberts, MJ. A molecular genetic study of intracerebral hemorrhage. Archives of Neurology. 1994;51:981-984. (1994) Abstract

Graffagnino, C; Alberts, MJ. Restriction fragment length polymorphism of the apoprotein A-I-C-III gene cluster in control and stroke-prone white and black subjects: racial differences. Stroke. 1993;24:909-910. (1993) Abstract

Alberts, MJ; Graffagnino, C. Ulcerated plaques in the aortic arch in patients with stroke. New England Journal of Medicine. 1992;327:128-129. (1992) Abstract