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    S. Andrew Josephson, MD

    TitleAssociate Professor
    SchoolUCSF School of Medicine
    DepartmentNeurology
    Address505 Parnassus Ave, Moffitt
    San Francisco CA 94143
    Phone415-476-9211

       Overview 
       Overview
      Dr. S. Andrew Josephson is a neurologist who specializes in neurovascular and other neurologic disorders. At UCSF, he cares for general neurology and stroke patients in the hospital as well as in clinic. He is the Director of the UCSF Neurohospitalist Program and Fellowship, and Medical Director of Inpatient Neurology. He holds the Carmen Castro Franceschi and Gladyne K. Mitchell Neurohospitalist Distinguished Professorship.

      After graduating from Stanford University, Dr. Josephson earned his medical degree at Washington University in Saint Louis. He completed an internship in internal medicine and a residency in neurology at UCSF, where he was chief resident. He also completed fellowships in neurovascular neurology (stroke) and behavioral neurology at UCSF. He is an associate professor of neurology and Vice-Chairman of the Department of Neurology.

      Dr. Josephson's research interests include improving models of inpatient neurologic care, quality and safety in hospitalized patients, neurologic education, delirium, and the contribution of stroke to dementia.

      Dr. Josephson has won numerous teaching awards from medical students and residents at UCSF including being selected to present the keynote speech for the School of Medicine Commencement; the Henry J. Kaiser Award for Excellence in Teaching; the Academic Senate Distinction in Teaching Award, and the Robert Layzer Golden Toe Award for resident teaching.


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       Bibliographic 
       Publications
      Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
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      1. Chiong W, Kim AS, Huang IA, Farahany NA, Josephson SA. Inability to consent does not diminish the desirability of stroke thrombolysis. Ann Neurol. 2014 Aug; 76(2):296-304.
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      2. Chiong W, Kim AS, Huang IA, Farahany NA, Josephson SA. Inability to consent does not diminish the desirability of stroke thrombolysis. Ann Neurol. 2014 Aug; 76(2):296-304.
        View in: PubMed
      3. Chiong W, Kim AS, Huang IA, Farahany NA, Josephson SA. Testing the presumption of consent to emergency treatment for acute ischemic stroke. JAMA. 2014 Apr 23-30; 311(16):1689-91.
        View in: PubMed
      4. Singhal NS, Josephson SA. A practical approach to neurologic evaluation in the intensive care unit. J Crit Care. 2014 Aug; 29(4):627-33.
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      5. Sheth SA, Hausrath D, Numis AL, Lawton MT, Josephson SA. Intraoperative rerupture during surgical treatment of aneurysmal subarachnoid hemorrhage is not associated with an increased risk of vasospasm. J Neurosurg. 2014 Feb; 120(2):409-14.
        View in: PubMed
      6. Hauser SL, Johnston SC, Ferriero DM, Josephson SA, Lowenstein DH, Messing RO, Oksenberg JR. Quo vadis? - peering into the future. Ann Neurol. 2013 Dec; 74(6):A5-7.
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      7. Kamel H, Betjemann JP, Navi BB, Hegde M, Meisel K, Douglas VC, Josephson SA. Diagnostic yield of electroencephalography in the medical and surgical intensive care unit. Neurocrit Care. 2013 Dec; 19(3):336-41.
        View in: PubMed
      8. Johnston SC, Ferriero DM, Josephson SA, Lowenstein DH, Messing RO, Oksenberg J, Stewart A, Hauser SL. Have the Annals editors added value? Ann Neurol. 2013 Nov; 74(5):A7-9.
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      9. Kriseman YL, Lee H, Chung S, Josephson SA. A 67-year-old man with headaches, gait changes, and altered mental status. Neurohospitalist. 2013 Oct; 3(4):221-7.
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      10. Rabe IB, Schwartz BS, Farnon EC, Josephson SA, Webber AB, Roberts JP, de Mattos AM, Gallay BJ, van Slyck S, Messenger SL, Yen CJ, Bloch EM, Drew CP, Fischer M, Glaser CA. Fatal transplant-associated west nile virus encephalitis and public health investigation-california, 2010. Transplantation. 2013 Sep 15; 96(5):463-8.
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      11. Betjemann JP, Nguyen I, Santos-Sanchez C, Douglas VC, Josephson SA. Diagnostic yield of electroencephalography in a general inpatient population. Neurodiagn J. 2013 Sep; 53(3):207-16.
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      12. Josephson SA, Johnston SC, Hauser SL. Blockbusters for cheap? The difficulties surrounding generic biologics. Ann Neurol. 2013 Sep; 74(3):A7-8.
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      13. Douglas VC, Hessler CS, Dhaliwal G, Betjemann JP, Fukuda KA, Alameddine LR, Lucatorto R, Johnston SC, Josephson SA. The AWOL tool: derivation and validation of a delirium prediction rule. J Hosp Med. 2013 Sep; 8(9):493-9.
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      14. Conwell WD, Josephson SA, Li H, Saint S, Janssen WJ. Clinical problem-solving. Weak in the knees. N Engl J Med. 2013 Aug 1; 369(5):459-64.
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      15. Josephson SA. Inpatient neurologic care: continued challenges of a neurohospitalist model. JAMA Neurol. 2013 Jul; 70(7):825-6.
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      16. Josephson SA, Johnston SC, Hauser SL. The neurologic revolving door: time to pay attention to readmissions. Ann Neurol. 2013 May; 73(5):A5-6.
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      17. Rubenstein JL, Wong VS, Kadoch C, Gao HX, Barajas R, Chen L, Josephson SA, Scott B, Douglas V, Maiti M, Kaplan LD, Treseler PA, Cha S, Hwang JH, Cinque P, Cyster JG, Lowell C. CXCL13 plus interleukin 10 is highly specific for the diagnosis of CNS lymphoma. Blood. 2013 Jun 6; 121(23):4740-8.
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      18. Betjemann JP, Nguyen I, Santos-Sanchez C, Douglas VC, Josephson SA. Diagnostic yield of electroencephalography in a general inpatient population. Mayo Clin Proc. 2013 Apr; 88(4):326-31.
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      19. Hauser SL, Josephson SA, Johnston SC. Multiple sclerosis: monotherapy rules. Ann Neurol. 2013 Mar; 73(3):A5-6.
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      20. Scott BJ, Douglas VC, Tihan T, Rubenstein JL, Josephson SA. A systematic approach to the diagnosis of suspected central nervous system lymphoma. JAMA Neurol. 2013 Mar 1; 70(3):311-9.
        View in: PubMed
      21. Johnston SC, Josephson SA, Hauser SL. Are relative value units hurting healthcare? Ann Neurol. 2013 Feb; 73(2):A5-6.
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      22. Nash KB, Josephson SA, Sun K, Ferriero DM. Should there be pediatric neurohospitalists? Neurology. 2013 Mar 5; 80(10):957-62.
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      23. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, Whetstone WD, Josephson SA, Johnston SC, Kim AS. The use of neuroimaging studies and neurological consultation to evaluate dizzy patients in the emergency department. Neurohospitalist. 2013 Jan; 3(1):7-14.
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      24. Hirsch KG, Josephson SA. An update on neurocritical care for the patient with kidney disease. Adv Chronic Kidney Dis. 2013 Jan; 20(1):39-44.
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      25. Josephson SA, Johnston SC, Hauser SL. Electronic medical records and the academic neurologist: when carrots turn into sticks. Ann Neurol. 2012 Dec; 72(6):A5-6.
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      26. Kamel H, Navi BB, Elijovich L, Josephson SA, Yee AH, Fung G, Johnston SC, Smith WS. Pilot randomized trial of outpatient cardiac monitoring after cryptogenic stroke. Stroke. 2013 Feb; 44(2):528-30.
        View in: PubMed
      27. Hauser SL, Josephson SA, Johnston SC. Deciphering the signature injury. Ann Neurol. 2012 Nov; 72(5):A5-6.
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      28. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, Whetstone WD, Josephson SA, Johnston SC, Kim AS. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc. 2012 Nov; 87(11):1080-8.
        View in: PubMed
      29. Vasa M, Baudendistel TE, Ohikhuare CE, Grace EM, Yan W, Josephson SA, Tierney LM. Clinical problem-solving. The eyes have it. N Engl J Med. 2012 Sep 6; 367(10):938-43.
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      30. Douglas VC, Scott BJ, Berg G, Freeman WD, Josephson SA. Effect of a neurohospitalist service on outcomes at an academic medical center. Neurology. 2012 Sep 4; 79(10):988-94.
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      31. Waung MW, Grossman AW, Barmada SJ, Josephson SA, Dillon WP, Ralph JW. Pearls & Oy-sters: the use of CT venography in Hirayama disease. Neurology. 2012 Jul 31; 79(5):e38-40.
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      32. Hauser SL, Josephson SA, Johnston SC. Florbetapir: knowing one's future. Ann Neurol. 2012 Jun; 71(6):A6.
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      33. Marcus JF, Goodin DS, Harris CA, Josephson SA. Acute hypercalcemia following excessive calcium supplementation in a dehydrated patient with progressive multiple sclerosis: vitamin d supplementation is a red herring-reply. Arch Neurol. 2012 Jun 1; 69(6):793-4.
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      34. Toossi S, Josephson SA, Hetts SW, Chin CT, Kralik S, Jun P, Douglas VC. Utility of MRI in spinal arteriovenous fistula. Neurology. 2012 Jul 3; 79(1):25-30.
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      35. Navi BB, Kamel H, Shah MP, Grossman AW, Wong C, Poisson SN, Whetstone WD, Josephson SA, Johnston SC, Kim AS. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Stroke. 2012 Jun; 43(6):1484-9.
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      36. Josephson SA, Engstrom JW. Residency training: developing a program of quality and safety to train resident neurologists for the future. Neurology. 2012 Feb 21; 78(8):602-5.
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      37. Toossi S, Lomen-Hoerth C, Josephson SA, Gropper MA, Roberts J, Patton K, Smith WS. Organ donation after cardiac death in amyotrophic lateral sclerosis. Ann Neurol. 2012 Feb; 71(2):154-6.
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      38. Rodríguez-Hernández A, Josephson SA, Lawton MT. Bypass surgery for the prevention of ischemic stroke: current indications and techniques. Neurocirugia (Astur). 2012 Feb; 23(1):5-14.
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      39. Marcus JF, Shalev SM, Harris CA, Goodin DS, Josephson SA. Severe hypercalcemia following vitamin d supplementation in a patient with multiple sclerosis: a note of caution. Arch Neurol. 2012 Jan; 69(1):129-32.
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      40. Stewart AF, Ferriero DM, Josephson SA, Lowenstein DH, Messing RO, Oksenberg JR, Johnston SC, Hauser SL. Fighting decision fatigue. Ann Neurol. 2012 Jan; 71(1):A5-A15.
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      41. Edwards NJ, Kamel H, Josephson SA. The safety of intravenous thrombolysis for ischemic stroke in patients with pre-existing cerebral aneurysms: a case series and review of the literature. Stroke. 2012 Feb; 43(2):412-6.
        View in: PubMed
      42. Rodríguez-Hernández A, Josephson SA, Josephson AS, Langer D, Lawton MT. Bypass for the prevention of ischemic stroke. World Neurosurg. 2011 Dec; 76(6 Suppl):S72-9.
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      43. Dasilva KB, Josephson SA. Patient management problem-preferred responses. Continuum (Minneap Minn). 2011 Oct; 17(5 Neurologic Consultation in the Hospital):1178-85.
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      44. Douglas VC, Josephson SA. Altered mental status. Continuum (Minneap Minn). 2011 Oct; 17(5 Neurologic Consultation in the Hospital):967-83.
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      45. Dasilva KB, Josephson SA. Patient management problem. Continuum (Minneap Minn). 2011 Oct; 17(5 Neurologic Consultation in the Hospital):1173-7.
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      46. Kamel H, Dhaliwal G, Navi BB, Pease AR, Shah M, Dhand A, Johnston SC, Josephson SA. A randomized trial of hypothesis-driven vs screening neurologic examination. Neurology. 2011 Oct 4; 77(14):1395-400.
        View in: PubMed
      47. Douglas VC, Neuhaus J, Johnson JK, Racine CA, Miller BL, Josephson SA. Dementia=(MC)2: a 4-item screening test for mild cognitive impairment and dementia. Alzheimer Dis Assoc Disord. 2011 Jul-Sep; 25(3):220-4.
        View in: PubMed
      48. Josephson SA, Lowenstein DH. Medical student learning in the preclinical curriculum: many steps behind a rapidly moving world. Ann Neurol. 2011 Jul; 70(1):A9-A10.
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      49. Freeman WD, Dawson SB, Raper C, Thiemann K, Josephson SA, Barrett KM. Neurohospitalists reduce length of stay for patients with ischemic stroke. Neurohospitalist. 2011 Apr; 1(2):67-70.
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      50. Poisson SN, Josephson SA. Quality measures in stroke. Neurohospitalist. 2011 Apr; 1(2):71-7.
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      51. Wilkins EG, Kamel H, Johnson EC, Shalev SM, Josephson SA. Ischemic stroke of the pyramidal decussation causing quadriplegia and anarthria. J Stroke Cerebrovasc Dis. 2012 Oct; 21(7):620.e1-2.
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      52. Freeman WD, Josephson SA. The birth of neurohospitalists. Neurohospitalist. 2011 Jan; 1(1):5-7.
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      53. Douglas VC, Josephson SA. A proposed roadmap for inpatient neurology quality indicators. Neurohospitalist. 2011 Jan; 1(1):8-15.
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      54. Josephson SA, Hauser SL. Neurologic education 2011: new challenges and opportunities. Ann Neurol. 2010 Dec; 68(6):A9-10.
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      55. Dhand A, Zhang X, Josephson SA. Increasing aerobic exercise in the community: the adult playground in Beijing, China. Arch Neurol. 2010 Oct; 67(10):1283; author reply 1283-4.
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      56. Josephson SA, Hauser SL, Johnston SC. Malignant middle cerebral artery stroke: Where ischemia meets the scalpel. Ann Neurol. 2010 Oct; 68(4):A6-8.
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      57. Barazangi N, Wintermark M, Lease K, Rao R, Smith W, Josephson SA. Comparison of computed tomography angiography and transesophageal echocardiography for evaluating aortic arch disease. J Stroke Cerebrovasc Dis. 2011 Sep-Oct; 20(5):436-42.
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      58. Burnett MM, Hess CP, Roberts JP, Bass NM, Douglas VC, Josephson SA. Presentation of reversible posterior leukoencephalopathy syndrome in patients on calcineurin inhibitors. Clin Neurol Neurosurg. 2010 Dec; 112(10):886-91.
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      59. Gelfand AA, Josephson SA. Substantial radiation exposure for patients with subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2011 Mar-Apr; 20(2):131-3.
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      60. Easter JS, Josephson SA, Vinton DT, Saint S, Edlow JA. Clinical problem-solving. All in the family. N Engl J Med. 2010 Jun 3; 362(22):2114-20.
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      61. Toossi S, Hess CP, Hills NK, Josephson SA. Neurovascular complications of cocaine use at a tertiary stroke center. J Stroke Cerebrovasc Dis. 2010 Jul-Aug; 19(4):273-8.
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      62. Ambrose JB, Bennett HD, Lee HS, Josephson SA. Cerebral vasculopathy after 4-bromo-2,5-dimethoxyphenethylamine ingestion. Neurologist. 2010 May; 16(3):199-202.
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      63. Josephson SA, Gillum LA. An intervention to teach medical students ankle reflex examination skills. Neurologist. 2010 May; 16(3):196-8.
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      64. Douglas VC, Josephson SA. Delirium. Continuum (Minneap Minn). 2010 Apr; 16(2 Dementia):120-34.
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      65. Josephson SA, Moheet AM, Gropper MA, Nichols AD, Smith WS. Ventilator-associated pneumonia in a neurologic intensive care unit does not lead to increased mortality. Neurocrit Care. 2010 Apr; 12(2):155-8.
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      66. Kamel H, Cornes SB, Hegde M, Hall SE, Josephson SA. Electroconvulsive therapy for refractory status epilepticus: a case series. Neurocrit Care. 2010 Apr; 12(2):204-10.
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      67. Josephson SA. Predicting neurologic outcomes after cardiac arrest: the crystal ball becomes cloudy. Ann Neurol. 2010 Mar; 67(3):A5-6.
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      68. Josephson SA, Douglas VC, Lawton MT, English JD, Smith WS, Ko NU. Improvement in intensive care unit outcomes in patients with subarachnoid hemorrhage after initiation of neurointensivist co-management. J Neurosurg. 2010 Mar; 112(3):626-30.
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      69. Poisson SN, Johnston SC, Josephson SA. Urinary tract infections complicating stroke: mechanisms, consequences, and possible solutions. Stroke. 2010 Apr; 41(4):e180-4.
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      70. Hauser SL, Johnston SC, Ferriero DM, Lowenstein DH, Josephson SA, Messing RO, Oksenberg JR, Stewart AF. Status report: the Annals in 2010. Ann Neurol. 2010 Jan; 67(1):A5-12.
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      71. Gelfand JM, Wintermark M, Josephson SA. Cerebral perfusion-CT patterns following seizure. Eur J Neurol. 2010 Apr; 17(4):594-601.
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      72. Mekuria S, Ching EC, Josephson SA, Tavee J, Harte BJ. The third time's the charm. J Hosp Med. 2009 Oct; 4(8):515-20.
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      73. Ghoshal N, Cali I, Perrin RJ, Josephson SA, Sun N, Gambetti P, Morris JC. Codistribution of amyloid beta plaques and spongiform degeneration in familial Creutzfeldt-Jakob disease with the E200K-129M haplotype. Arch Neurol. 2009 Oct; 66(10):1240-6.
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      74. Dubal DB, Mueller S, Ruben BS, Engstrom JW, Josephson SA. T-cell lymphoproliferative disorder following mycophenolate treatment for myasthenia gravis. Muscle Nerve. 2009 Jun; 39(6):849-50.
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      75. Elijovich L, Josephson SA, Fung GL, Smith WS. Intermittent atrial fibrillation may account for a large proportion of otherwise cryptogenic stroke: a study of 30-day cardiac event monitors. J Stroke Cerebrovasc Dis. 2009 May-Jun; 18(3):185-9.
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      76. Hills NK, Josephson SA, Lyden PD, Johnston SC. Is the NIHSS certification process too lenient? Cerebrovasc Dis. 2009; 27(5):426-32.
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      77. Ho EL, Josephson SA, Lee HS, Smith WS. Cerebrovascular complications of methamphetamine abuse. Neurocrit Care. 2009; 10(3):295-305.
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      78. Josephson SA, Saver JL, Smith WS. Comparison of mechanical embolectomy and intraarterial thrombolysis in acute ischemic stroke within the MCA: MERCI and Multi MERCI compared to PROACT II. Neurocrit Care. 2009; 10(1):43-9.
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      79. Geschwind MD, Tan KM, Lennon VA, Barajas RF, Haman A, Klein CJ, Josephson SA, Pittock SJ. Voltage-gated potassium channel autoimmunity mimicking creutzfeldt-jakob disease. Arch Neurol. 2008 Oct; 65(10):1341-6.
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      80. Josephson SA, Sidney S, Pham TN, Bernstein AL, Johnston SC. Higher ABCD2 score predicts patients most likely to have true transient ischemic attack. Stroke. 2008 Nov; 39(11):3096-8.
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      81. Racine CA, Lawton MT, Hetts SW, Josephson SA. Neuropyschological profile of reversible cognitive impairment in a patient with a dural arteriovenous fistula. Neurocase. 2008; 14(3):231-8.
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      82. Mueller S, Dubal DB, Josephson SA. A case of paraneoplastic myelopathy associated with the neuromyelitis optica antibody. Nat Clin Pract Neurol. 2008 May; 4(5):284-8.
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      83. Josephson SA, Engstrom JW, Wachter RM. Neurohospitalists: an emerging model for inpatient neurological care. Ann Neurol. 2008 Feb; 63(2):135-40.
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      84. Carey CL, Kramer JH, Josephson SA, Mungas D, Reed BR, Schuff N, Weiner MW, Chui HC. Subcortical lacunes are associated with executive dysfunction in cognitively normal elderly. Stroke. 2008 Feb; 39(2):397-402.
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      85. Josephson SA, Sidney S, Pham TN, Bernstein AL, Johnston SC. Factors associated with the decision to hospitalize patients after transient ischemic attack before publication of prediction rules. Stroke. 2008 Feb; 39(2):411-3.
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      86. Roy S, Josephson SA, Fridlyand J, Karch J, Kadoch C, Karrim J, Damon L, Treseler P, Kunwar S, Shuman MA, Jones T, Becker CH, Schulman H, Rubenstein JL. Protein biomarker identification in the CSF of patients with CNS lymphoma. J Clin Oncol. 2008 Jan 1; 26(1):96-105.
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      87. Josephson SA, Papanastassiou AM, Berger MS, Barbaro NM, McDermott MW, Hilton JF, Miller BL, Geschwind MD. The diagnostic utility of brain biopsy procedures in patients with rapidly deteriorating neurological conditions or dementia. J Neurosurg. 2007 Jan; 106(1):72-5.
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      88. Johnston SC, Nguyen-Huynh MN, Schwarz ME, Fuller K, Williams CE, Josephson SA, Hankey GJ, Hart RG, Levine SR, Biller J, Brown RD, Sacco RL, Kappelle LJ, Koudstaal PJ, Bogousslavsky J, Caplan LR, van Gijn J, Algra A, Rothwell PM, Adams HP, Albers GW. National Stroke Association guidelines for the management of transient ischemic attacks. Ann Neurol. 2006 Sep; 60(3):301-13.
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      89. Josephson SA, Hills NK, Johnston SC. NIH Stroke Scale reliability in ratings from a large sample of clinicians. Cerebrovasc Dis. 2006; 22(5-6):389-95.
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      90. Josephson SA, Pillai DR, Phillips JJ, Chou D. Neurolisteriosis presenting as cervical myelitis in an immunocompetent patient. Neurology. 2006 Apr 11; 66(7):1122-3.
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      91. Josephson SA, Kirsch HE. Complex visual hallucinations as post-ictal cortical release phenomena. Neurocase. 2006 Apr; 12(2):107-10.
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      92. Josephson SA, Dillon WP, Smith WS. Incidence of contrast nephropathy from cerebral CT angiography and CT perfusion imaging. Neurology. 2005 May 24; 64(10):1805-6.
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      93. Josephson SA, Johnston SC. Multiple stable fusiform intracranial aneurysms following atrial myxoma. Neurology. 2005 Feb 8; 64(3):526.
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      94. Josephson SA, Bryant SO, Mak HK, Johnston SC, Dillon WP, Smith WS. Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA. Neurology. 2004 Aug 10; 63(3):457-60.
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      95. Josephson SA, Dillon WP, Dowd CF, Malek R, Lawton MT, Smith WS. Continuous bleeding from a basilar terminus aneurysm imaged with CT angiography and conventional angiography. Neurocrit Care. 2004; 1(1):103-6.
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      96. Josephson SA, Whelan AJ. A new first-year course designed and taught by a senior medical student. Acad Med. 2002 Dec; 77(12 Pt 1):1207-11.
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      97. Josephson SA, Schmidt RE, Millsap P, McManus DQ, Morris JC. Autosomal dominant Kufs' disease: a cause of early onset dementia. J Neurol Sci. 2001 Jul 15; 188(1-2):51-60.
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