Stephen Figueroa, M.D.

Neurocritical Care Specialist in Dallas

As a neurocritical care specialist in UT Southwestern’s Neuro Intensive Care Unit, Stephen Figueroa, M.D., sees patients with acute brain injuries such as status epilepticus, ischemic stroke, traumatic brain injury (TBI), intracerebral hemorrhage, and rare conditions such as autoimmune encephalitis, in which the body’s own antibodies attack the brain.

These conditions are extremely serious and often life-threatening. Dr. Figueroa applies his expertise while working with a multidisciplinary team to find the best possible treatments for each patient.

“Neurocritical care is an extremely collaborative service,” he says. “The more eyes on a patient, the better, and care that is brought to the bedside in a truly multidisciplinary way benefits all of our patients.”

Some patients with these injuries can recover, but others will not. It’s important to Dr. Figueroa that he balances the science of medicine with feelings of empathy for his patients and their family members.

“Being able to help families accept when there is likely to be no recovery ­– or to keep hope alive when there is a possibility – takes a very special disposition. It was that combination of the art of medicine and the personal interactions with patients and their families that drew me to neurocritical care.”

Collaborative Care

A strong component of care in UT Southwestern’s Neuro ICU is a bedside rounding model that brings together physicians, nurses, pharmacists, case managers, nutritionists, respiratory therapists, and medical trainees.

“This way everyone knows the medical status of each patient, and what our goals are for the day,” Dr. Figueroa says. “With everyone present at the same time, we ensure that we are all on the same page.”

Dr. Figueroa’s team even invites the patient’s family members to daily rounds so that they can participate in the bedside discussion of their loved one.

“We are the only center in the Dallas area to invite families to bedside rounds,” he notes. “Those who choose to participate say they greatly appreciate the opportunity to be part of the team and have all of their questions answered. It enables them to know that nothing is hidden from them and that the care their family member is receiving is truly transparent.”

Hope and Perseverance

While the initial outlook for comatose patients with severe brain injuries can look dire, Dr. Figueroa says that one of the things he likes best about neurocritical care is that there are always surprises.

“Doctors sometimes approach a patient who has suffered a severe traumatic brain injury with pessimism,” he says. “But the more patients I see, the more reserved I’ve become in my expectations of how well patients can recover.”

To illustrate, Dr. Figueroa recalls treating a man who was brought to the ICU after hitting his head hard when he fell off his roof.

“It was a severe injury; the early signs were not encouraging,” he says. “But we kept treating him with the best tools and techniques we have to help manage severe traumatic brain injury. After a week, he started waking up and following commands. Ultimately, he went to rehab and now is back at home and functioning close to his baseline prior to the injury.”

Such success stories, even in grievously injured patients, are what keep Dr. Figueroa and his colleagues going.

“We often have patients who are brought back by family members to visit us in the Neuro ICU,” he says. “The patient may not remember us, but it's great for the team when a patient who initially was in poor health comes back looking so good. It helps us keep going everyday.”