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 physician (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.

• The Medicines Company

Representative Publications
Olson DM, Thoyre SM, Bennett SN, Stoner JB, Graffagnino C. Effect of mechanical chest percussion on intracranial pressure: a pilot study. Am J Crit Care. 2009 Jul;18(4):330-5. (2009) Abstract

Olson DM, Thoyre SM, Peterson ED, Graffagnino C. A randomized evaluation of bispectral index-augmented sedation assessment in neurological patients. Neurocrit Care. 2009;11(1):20-7. (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. J Neuroimaging. 2009 Apr;19(2):144-9. (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). Am J Cardiol. 2008 Nov 15;102(10):1285-90. (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. Neurocrit Care. 2008;9(1):8-12. (2008) Abstract

Bennett SS, Graffagnino C, Borel CO, James ML. Use of high frequency oscillatory ventilation (HFOV) in neurocritical care patients. Neurocrit Care. 2007;7(3):221-6. (2007) Abstract

Olson D, Lynn M, Thoyre SM, Graffagnino C. The limited reliability of the Ramsay scale. Neurocrit Care. 2007;7(3):227-31. (2007) Abstract

Olson DM, Thoyre SM, Turner DA, Bennett S, Graffagnino C. Changes in intracranial pressure associated with chest physiotherapy. Neurocrit Care. 2007;6(2):100-3. (2007) Abstract

Bushnell CD, Griffin J, Newby KL, Goldstein LB, Mahaffey KW, Graffagnino C, Harrington RA, White HD, Simes R J, Califf RM, Topol EJ., Easton JD. Statin Use and Sex-Specific Stroke Outcomes in Patients With Vascular Disease. Stroke. 2006; 37: 1427-1431. (2006)

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. J Neurosurg. 2006 Nov;105(5):671-4. (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. Neurocrit Care. 2005;3(3):246-8. (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 Sep;36(9):2024-6. (2005) Abstract

Olson DM, Graffagnino C, King K, Lynch JR. Toward solving the sedation-assessment conundrum: bi-spectral index monitoring and sedation interruption. Crit Care Nurs Clin North Am. 2005 Sep;17(3):257-67. (2005) Abstract

Olson DM, Graffagnino C. Consciousness, coma, and caring for the brain-injured patient. AACN Clin Issues. 2005 Oct-Dec;16(4):441-55. (2005) Abstract

Olson DM, Graffagnino C. Managing temperature in brain-injured patients. Nursing. Jul 2005;35(7):32cc31-32. (2005)

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 May;36(5):1089-90. (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 Aug;62(2):143-50. (2004) Abstract

Kassem-Moussa H, Mahaffey KW, Graffagnino C, Tasissa G, Sila CA, Simes RJ, White HD, Califf RM, Bhapkar MV, Newby LK, . Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome. Am Heart J. 2004 Sep;148(3):439-46. (2004) Abstract

Neurocritical Care Fever Reduction Trial Group. Treatment of fever in the neurologic intensive care unit with a catheter-based heat exchange system. Critical Care Medicine. 2004; 32(2): 559-64. (2004)

(2003) 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 Neurol Scand. 2003 Feb;107(2):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, . Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease. Circulation. 2003 Jul 29;108(4):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 Jan-Feb;21(1):18-21. (2002) Abstract

Alberts MJ, McCarron MO, Hoffmann KL, Graffagnino C. Familial clustering of intracerebral hemorrhage: a prospective study in North Carolina. Neuroepidemiology. 2002 Jan-Feb;21(1):18-21. (2002) Abstract

Bulsara KR, Alexander MJ, Villavicencio AT, Graffagnino C. De novo cerebral arteriovenous malformation: case report. Neurosurgery. 2002 May;50(5):1137-40; discussion 1140-1. (2002) Abstract

Bulsara KR, Alexander MJ, Villavicencio AT, Graffagnino C. De novo cerebral arteriovenous malformation: case report. Neurosurgery. 2002 May;50(5):1137-40; discussion 1140-1. (2002) Abstract

Kassem-Moussa H, Graffagnino C. Nonocclusion and spontaneous recanalization rates in acute ischemic stroke: a review of cerebral angiography studies. Arch Neurol. 2002 Dec;59(12):1870-3. (2002) Abstract

Kassem-Moussa H, Graffagnino C. Nonocclusion and spontaneous recanalization rates in acute ischemic stroke: a review of cerebral angiography studies. Arch Neurol. 2002 Dec;59(12):1870-3. (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 Sep;32(9):2033-5. (2001) 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 Sep;32(9):2033-5. (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 Aug 15;102(7):728-35. (2000) 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 Aug 15;102(7):728-35. (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. Am Heart J. 2000 Jun;139(6):927-33. (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. Am Heart J. 2000 Jun;139(6):927-33. (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 May 11;99(18):2371-7. (1999) 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 May 11;99(18):2371-7. (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. Ann Neurol. 1997 May;41(5):683-6. (1997) 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. Ann Neurol. 1997 May;41(5):683-6. (1997) Abstract

Gasecki AP, Graffagnino C, Hachinski V. Tissue plasminogen activator in a vertebral artery dissection. Can J Neurol Sci. 1997 May;24(2):151-4. (1997) Abstract

Gasecki AP, Graffagnino C, Hachinski V. Tissue plasminogen activator in a vertebral artery dissection. Can J Neurol Sci. 1997 May;24(2):151-4. (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. Arch Neurol. 1996 Apr;53(4):303-8. (1996) 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. Arch Neurol. 1996 Apr;53(4):303-8. (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 Aug 26;346(8974):575. (1995) Abstract

Alberts MJ, Graffagnino C, McClenny C, DeLong D, Strittmatter W, Saunders AM, Roses AD. ApoE genotype and survival from intracerebral haemorrhage. Lancet. 1995 Aug 26;346(8974):575. (1995) Abstract

Alberts MJ, Quinones A, Graffagnino C, Friedman A, Roses AD. Risk of intracranial aneurysms in families with subarachnoid hemorrhage. Can J Neurol Sci. 1995 May;22(2):121-5. (1995) Abstract

Alberts MJ, Quinones A, Graffagnino C, Friedman A, Roses AD. Risk of intracranial aneurysms in families with subarachnoid hemorrhage. Can J Neurol Sci. 1995 May;22(2):121-5. (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 Nov;26(11):2190-3. (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 Nov;26(11):2190-3. (1995) Abstract

Graffagnino C, Gasecki AP, Doig GS, Hachinski VC. The importance of family history in cerebrovascular disease. Stroke. 1994 Aug;25(8):1599-604. (1994) Abstract

Graffagnino C, Gasecki AP, Doig GS, Hachinski VC. The importance of family history in cerebrovascular disease. Stroke. 1994 Aug;25(8):1599-604. (1994) Abstract

Graffagnino C, Herbstreith MH, Roses AD, Alberts MJ. A molecular genetic study of intracerebral hemorrhage. Arch Neurol. 1994 Oct;51(10):981-4. (1994) Abstract

Graffagnino C, Herbstreith MH, Roses AD, Alberts MJ. A molecular genetic study of intracerebral hemorrhage. Arch Neurol. 1994 Oct;51(10):981-4. (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 Jun;24(6):909-10. (1993) 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 Jun;24(6):909-10. (1993) Abstract

Alberts MJ, Graffagnino C. Ulcerated plaques in the aortic arch in patients with stroke. N Engl J Med. 1992 Jul 9;327(2):128-9. (1992) Abstract

Alberts MJ, Graffagnino C. Ulcerated plaques in the aortic arch in patients with stroke. N Engl J Med. 1992 Jul 9;327(2):128-9. (1992) Abstract