Laura Ngwenya Profile
Running a Level 1 Neurotrauma Center
Author: Laura B Ngwenya, MD, PhD
I am an Assistant Professor of Neurosurgery and Neurology & Rehabilitation Medicine at the University of Cincinnati. As the Director of the Neurotrauma Center at UC Gardner Neuroscience Institute, to me, neurosurgery means the opportunity to advance the field and help people in their time of greatest need. Neurotrauma is an unexpected and often life-changing event for patients and families. Being able to help others, irrespective of socioeconomic status, is rewarding and a great privilege. UC Health is the only adult Level I trauma center in the Greater Cincinnati area, and I coordinate the neurotrauma care for our hospital system, assuring that our community of 2.9 million people receives comprehensive and excellent clinical care.
One of the challenges I face as Neurotrauma Director is the struggle to provide ongoing medical care to this complex group of patients, many of whom have unaddressed psychosocial needs. I actively work with our neurologists, physiatrists, and therapists to provide multidisciplinary traumatic brain injury (TBI) care. In addition, I am actively engaged with our health system leadership to create sustaining infrastructure to provide social work and addiction services support to neurotrauma patients. As TBI is increasingly being recognized as a chronic disease, patient follow-up is important for prevention and treatment of long-term sequelae of TBI such as cognitive decline, depression, and post-traumatic stress disorder. For many patients, the visit to our trauma bay is their first engagement with the health system. Many do not have a primary care physician, have undiagnosed medical issues, and are overall poor champions of their own health. Helping patients recognize the importance of health and providing outreach and educational resources to help prevent future traumatic event, is a challenging yet rewarding part of my practice.
In addition to patient and community engagement, one of the challenges unique to neurotrauma is the dearth of patient-centered therapies. As a physician scientist, I strive to close the knowledge gap, combining basic science and clinical research for advancements in patient care. I coordinate UC’s involvement in national TBI clinical trials such as Brain Oxygen Optimization in Severe TBI (BOOST-3), Transforming Research and Clinical Knowledge in TBI (TRACK-TBI), and Spreading Depolarizations II. As much remains to be learned about how knowledge gained from these clinical trials can be implemented for successful personalized medicine approaches, my basic science laboratory, currently funded by a NIH/NINDS K08 award, utilizes a rodent model of TBI to better understand how pathology such as spreading depolarizations contributes to secondary injury.
Although my neurosurgical practice is atypical in some regards, my MD, PhD and neurosurgical training has prepared me for the combination of neurotrauma surgery, administrative leadership, clinical research, and laboratory research. Time management and “work-life balance” represent ongoing challenges; the neurosurgery residents often comment that I am always awake when called for middle-of-the-night emergencies. However, my academic neurotrauma practice is fulfilling, supports the mission to improve the lives of patients and the community, and is Neurosurgery.