Our Neuro Network

Our Neuro Network Content is not medical advice. My dedication to this field is deeply personal. We operate as one 'ohana, united in our pursuit of homeostatic betterment for all.

🧠Our Neuro Network🧠

Honor, hope, and homeostasis for those with acute, chronic, and complex conditions, including neurometabolic, cerebral venous, and cerebrospinal fluid variations. Aloha Ohana Mana Network,

I am a doctorally prepared, board-certified Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC), Stroke Certified Registered Nurse (SCRN), and Certified Neuroscience Registered Nurse (CNRN) based in Honolulu, HI. My professional passion centers on providing exceptional care to individuals navigating acute, chronic, and complex neurological conditions. My expertise encompasses a wide range of neurological challenges, with a particular emphasis on neurometabolic, cerebral venous, and cerebrospinal fluid (CSF) disorders, as well as related conditions such as hypermobile connective tissue diseases, mast cell activation syndrome, melanocortin-4 receptor deficiency, chronic migraine, headache, and facial pain. These conditions have directly impacted my family, fueling my commitment to patient advocacy and specialized expertise. This personal connection drives my unwavering pursuit to destigmatize these often-misunderstood conditions. I believe in empowering patients through advocacy, fostering supportive networks, providing comprehensive education, advancing research, and delivering compassionate clinical practice. The rapid pace of scientific discovery is illuminating the intricate cellular and metabolic pathways underlying these diseases, offering new insights into their foundations, manifestations, and potential treatment options. By fostering collaborative partnerships with experts and patients who share genetically or neurometabolically related conditions, we can amplify our collective efforts. This collaborative approach accelerates our progress, enabling us to better serve affected individuals, families, and communities. To further this vision, I founded the Ohana Mana Network for Neurometabolic Wellness LLC and host its dedicated podcast. This platform serves as a vital resource and supportive community for our 'ohana of neurometabolic, cerebral venous, and CSF disorders patients, advocates, and experts. Through the power of storytelling, active listening, and mentorship, we honor each individual's journey. Our work is grounded in compassionate, holistic, and evidence-based content, providing hope for a brighter tomorrow. By working together, we can improve the quality of life for those impacted by these challenging neurometabolic conditions. Tiffany Hoke DNP, RN, RNP, APRN-RX, AGACNP-BC, SCRN, CNRN

Ohana Mana Network for Neurometabolic Wellness LLC

Founder & CEO | Medical Director | Neuroscience and Neurovascular Nurse Practitioner

Cancer Survivor Living with Familial Neurometabolic Syndrome, Cerebral Venous, and CSF Disorders

04/03/2026

A word about intracranial pressure, our biases, and important considerations to guide our mission honoring truth and our journey toward healing.

Nine years ago today, I woke up with a facial (VII) nerve palsy from a congested, laterally positioned right jugular bul...
04/02/2026

Nine years ago today, I woke up with a facial (VII) nerve palsy from a congested, laterally positioned right jugular bulb eroding into my stylomastoid foramen.

It was accompanied by severe great auricular neuralgia and trigeminal neuralgia in the setting of intracranial hypertension from cerebral venous congestion. At the time, I thought my cancer had metastasized. I am grateful I was wrong.

Here, you can appreciate another cranial neuropathy that can accompany venous congestion: spinal accessory nerve (XI) palsy.

Left-sided scapular winging with preserved shoulder elevation due to trapezius compensation is consistent with partial spinal accessory nerve dysfunction, which is often missed unless you directly visualize or palpate the scapula as it moves.

I have also had right vagal (X) nerve dysfunction with a leftward-deviated uvula and spasmodic dysphonia.

Cranial nerve VII at the stylomastoid foramen, and cranial nerves X and XI at the jugular foramen and carotid sheath, can all be affected in intracranial hypertension with jugular venous compression.

These are localizing neurological signs. It is not a mystery.

Would you spot it, if it happened to your patient, if it happened to you?

When you adapt, you facilitate recruitment of novel neural reserves and stimulate neuroplasticity. In other words, thos...
03/31/2026

When you adapt, you facilitate recruitment of novel neural reserves and stimulate neuroplasticity. In other words, those who have encountered more resistance develop the skill of persistence. This is how people with significant neurological impairment and disability do amazing and incredible things.

To adapt requires commitment to a goal, vision, flexibility, courage, and patience. It can take you some time to learn how to accomplish your mission in your own way, but where there is a will, there is a way.

Do I wish to work recumbent? No, but I can, I will, and it will be worth my while because my effort, applied over time, makes it so. It does not happen overnight, arrival; but the journey has already begun. Life is now, and with gratitude, I live it to the fullest of my ability.

Check out Our Neuro Network’s Latest Podcast on Apple and Spotify. Video episodes are now on You Tube!!! Mast Cell Acti...
02/21/2026

Check out Our Neuro Network’s Latest Podcast on Apple and Spotify. Video episodes are now on You Tube!!!

Mast Cell Activation Syndrome, Chemical Sensitivity, and Jugular Venous Congestion: A Big Picture Perspective

In this episode, host and Our Neuro’ Networks CEO, Neuroscience, and Neurovascular Nurse Practitioner Tiffany Hoke, DNP, RN, RNP, APRN-RX, AGACNP-BC, SCRN, CNRN addresses a common question: Is MCAS caused by jugular venous congestion, and will improving drainage fix it?

LINKS IN BIO & BELOW

https://www.youtube.com/

https://podcasts.apple.com/us/podcast/our-neuro-network/id1841175096

https://open.spotify.com/show/6bsa3fcXUetNqPD0wkAW1a?si=906d503445834c44

High-performing, driven, perfectionistic people are often the most vulnerable to cerebral venous, CSF, and migraine diso...
02/02/2026

High-performing, driven, perfectionistic people are often the most vulnerable to cerebral venous, CSF, and migraine disorders when rest and recovery are neglected. I learned this the hard way.

Healing required more than procedures. It required regulation.

Rest is not indulgence.

Self-care is not optional.

This is physiology.

This is homeostasis.

🧠 New blog post:
High Performance, Overextension, and the Physiology of Healing

I share the science, lived experience, and the framework that transformed my recovery, along with the daily affirmation that anchors my self-care practice.

🔗 Read here:
https://ourneuronetwork.org/high-performance-overextension-and-the-physiology-of-healing (link in Bio and Story)

Daily Affirmation:

All is as it should be.

My worth is inherent. It requires no achievement, no striving, no proof.

I am whole. I am complete. Everything else is abundance.

I am free to pause, to breathe, to recover in ways that honor my body, mind, and spirit.

I need no permission to care for myself with intention and love.

This is homeostasis.

01/28/2026

🔬 Optic Nerve Ultrasound & Intracranial Pressure (ICP)

Bedside ultrasound of optic nerve sheath diameter (ONSD) and optic disc elevation (ODE) provides rapid, non-invasive screening for intracranial pressure abnormalities.

• ONSD: ~90% sensitivity, ~85% specificity; cutoff 5.0–5.7 mm
• ODE ≥0.6 mm detects papilledema (~82% sensitivity)
• Combined ONSD + ODE: 93% sensitivity, 92% specificity
• Intracranial hypotension: ~10% ONSD reduction supine→upright (AUC ≈ 0.87)

Accuracy depends on standardized technique and training.

⸻

References

Koziarz, A., Sne, N., Kegel, F., et al. (2019). Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure: A systematic review and meta-analysis. Annals of Internal Medicine, 171(12), 896–905. https://doi.org/10.7326/M19-0812

Janitschke, D., Stögbauer, J., Lattanzi, S., Brigo, F., & Lochner, P. (2023). B-mode transorbital ultrasonography for the diagnosis of idiopathic intracranial hypertension: An updated systematic review and meta-analysis. Neurological Sciences, 44(12), 4313–4322. https://doi.org/10.1007/s10072-023-07016-z

Malky, I. E., Aita, W. E., Elkordy, A., et al. (2025). Optic nerve sonographic parameters in idiopathic intracranial hypertension: A case-control study. Scientific Reports, 15(1), 1788. https://doi.org/10.1038/s41598-024-85033-4

Berhanu, D., Ferreira, J. C., Abegão Pinto, L., et al. (2023). The role of optic nerve sheath ultrasonography in increased intracranial pressure: A systematic review and meta-analysis. Journal of the Neurological Sciences, 454, 120853. https://doi.org/10.1016/j.jns.2023.120853

Intracranial Hypertension can be devastating, especially when standard treatments fail.A new study may be changing what’...
01/10/2026

Intracranial Hypertension can be devastating, especially when standard treatments fail.

A new study may be changing what’s possible.

I break down the River Study, what it found, and what it could mean for patients living with IH.

👉 Read more: https://zurl.co/6JsiJ

01/08/2026

If you are alive, the tables can still turn for you.

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Honolulu, HI

Opening Hours

Monday 9am - 5pm
Tuesday 8am - 4pm
Wednesday 9am - 5pm
Thursday 8am - 4pm
Friday 9am - 5pm

Website

http://ourneuronetwork.org/, https://podcasts.apple.com/us/podcast/ohana-mana-networ

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