UH Neurology Chair Aids Stroke Patients Locally and Nationally

UH Clinical Update | April 2025

Cathy Sila grew up in Highland Heights, where her father was a carpenter at Parker-Hannifin for 40 years, and her mom worked from home. It wasn’t the typical environment that would get a 10-year-old planning to become a physician.

Cathy Sila, MD

But one day her fifth-grade teacher – realizing her pupil was very smart – asked what she wanted to be when she grew up. “A teacher like you,” said Cathy. Her teacher said, “Oh honey, that’s not going to work because you don’t have the patience to be a teacher,” which Cathy had to agree with. The teacher asked for some other ideas, and eventually suggested, “A doctor?” and while Cathy wasn’t entirely sure what doctors did, she decided immediately that yes, that was it.

“From then on, that’s what I was going to be,” she says. “I never questioned the goal after that. That’s what I focused on.”

But what kind of doctor? The answer came when, as a pre-teen, her mother needed Cathy’s physical help to get her father to doctor’s visits, because of extreme pain in his back and legs. The doctor showed Cathy the model of a spine in his office and explained how her father’s nerves were being pinched, triggering the sharp pain.

“I was so excited by the problem-solving aspect of this - it made sense to ‘junior high school’ me,” she says. So she planned to become a neurosurgeon.

After graduating from high school and Miami University, she went on to the Case Western Reserve University School of Medicine. Early on, she observed general surgery. “And I hated it,” she says. “The cold, the smell of burning flesh, I was just nauseated, and I thought, “I picked this?”

But one of her mentors said, “Don’t worry - just be a neurologist.”

“It was an offhand comment, but it had such an effect on me. It was true - neurologists and neurosurgeons do similar work, but there’s no surgery with neurology.”  

Dr. Sila then had a fellowship in cerebrovascular research at the Cleveland Clinic and a residency in neurology at the Mayo Graduate School of Medicine in Rochester, Minn.

Today, Dr. Sila is chair of the UH Department of Neurology and Gilbert W. Humphrey Professor of Neurology, and the research and innovations she has led and contributed to have saved and changed lives for stroke patients everywhere.

One of her first efforts after joining University Hospitals was looking at quality improvements in stroke treatment. At that time, national certification standards for stroke centers were expanding from academic medical centers to include community hospitals, recognizing that emergency squads would take patients to the UH hospital closest to their home, where the chain of treatment would begin. Many patients’ stroke needs could be met in the community if there was a high-quality program there with their families nearby to offer support. But patients with more complex strokes needed other treatments offered at hub hospitals, or at UH Cleveland Medical Center.

But how could we improve that chain of care and ensure that all hospitals in the UH system have the same protocol? “My goal was to develop a stroke system program, where we would train emergency squads to evaluate patients in the field; improve our immediate brain imaging in the emergency room, and use the clinical and CT scan information to predict who would need what kind of care, and launch transport when needed to the appropriate medical center,” says Dr. Sila. “We began to use MRIs instead of CT scans, even though CT scans are easier – we chose the harder path to gain the essential information that advanced to what we now use in triage.”  

Dr. Sila says putting that infrastructure in place was critical to the next leap - a number of clinical trials. “Those allowed us to determine the next treatment paradigm,” she says. “All the caregivers taught each other – we worked together to create a system that allows us to deliver innovative treatments to the most complicated cases.”

That led directly to Project DAWN, a landmark trial with UH as a major participant, which had its results published in the New England Journal of Medicine in 2017. It showed that selected patients with acute ischemic stroke caused by a blood clot could be effectively treated up to 24 hours after the onset of stroke symptoms with a mechanical procedure – a thrombectomy - to remove the clot. Prior to this, patients were considered if their symptoms started within six hours, which rendered many patients ineligible for treatment.

Throughout her career, Dr. Sila also has maintained a devoted interest in intercranial stenosis, which is the narrowing of small blood vessels. She’s been involved in a series of clinical studies that looked at this subset of vascular disease, which is not due to atherosclerosis. Instead it is a result of such conditions as sickle cell anemia, moyamoya, vasculitis or autoimmune disorders, among others.

“The population of people who have intracranial stenosis is a little younger, so it is a stroke population with a different anatomy,” she says. “I’ve always found that very challenging and it is still a problem we need to solve. There have been small breakthroughs, but in many ways it remains a frontier and it may continue to be for many years. But there is always a possibility a new door will open and provide some kind of insight.”

A few months ago, Dr. Sila was one of 11 physicians recognized with a “Cliff Appreciates/Dinner with the Doc” honor, bestowed by UH CEO Cliff A. Megerian, MD, FACS, Jane and Henry Meyer Chief Executive Officer Distinguished Chair. She was lauded for “Demonstrating Professionalism,” for the outstanding care she regularly provides to patients, including one patient who wrote about the kindness and compassion Dr. Sila displayed while she was hospitalized at UH Ahuja Medical Center.

To nominate a physician for this honor, click here for the Dinner with the Doc Nomination Form. The next deadline is June 17.