Vol. 10 - Neuroscience Outlook
We are delighted to present an expanded version of Neuroscience Outlook in which the contributions of both the Neurosurgery and the Neurology departments are presented.
outlook NEUROSCIENCE News and research from the Departments of Neurology and Neurosurgery Early treatment of craniosynostosis Patients can receive minimally invasive, endoscopic-assisted cranial vault remodeling to treat craniosynostosis at an early age page 4 VOL. 10 ISSUE 1 } FACULTY UPDATES 2 + MOVEMENT DISORDERS PROGRAM 8 + Presentations and publications 10 FROM THE CHAIRMEN DEPARTMENT NEWS Cargill H. Alleyne Jr., M.D. David Hess, M.D. Neuroscience Outlook, the Department of Neurosurgery newsletter, was initially launched in summer 2004. We are delighted to present an expanded version of Neuroscience Outlook in which the contributions of both the Neurosurgery and the Neurology departments are presented. This merger is a reflection of the close working relationship that our two departments continue to share. In addition, the newsletter has undergone a makeover, which we hope you will enjoy. In this issue we feature news items from our departments, including the recent Advanced Comprehensive Stroke Center certification from The Joint Commission. This certification is the first in Georgia and only the second in the Southeast. We also focus on craniosynostosis and highlight the movement disorders program (the only center designated as a National Parkinson Disease Center of Excellence in Georgia or South Carolina). As always, we list the honors and awards as well as the presentations and publications from our departments. Cargill H. Alleyne Jr., M.D. Professor and Marshall Allen Distinguished Chair of Neurosurgery calleyne@ gru.edu gru.edu/neurosurgery David Hess, M.D. Professor and Presidential Distinguished Chair of Neurology dhess@ gru.edu gru.edu/neurology Neuroscience Outlook A publication of the Georgia Regents University Departments of Neurology and Neurosurgery Editor-in-chief: Cargill H. Alleyne Jr., M.D. Editor: Phil Malkinson Illustrations: Colby Polonsky, M.S. Contributors: Ian Heger, M.D., David C. Hess, M.D., Cargill H. Alleyne Jr., M.D., Kapil D. Sethi, M.D., F.R.C.P., John Morgan M.D., Ph.D., Shyamal Mehta M.D., Ph.D., Cole A. Giller, M.D., Ph.D., M.B.A., and Jill Trumble M.D. 2 NEUROSCIENCE OUTLOOK Volume 10 | Issue 1 We’re Growing Georgia Health Sciences University is now Georgia Regents University The Georgia Board of Regents recently voted to approve the consolidation of Augusta State University and Georgia Health Sciences University. The new name of our expanded institution is Georgia Regents University Augusta. The new university includes nine colleges: Medical College of Georgia; College of Dental Medicine; College of Graduate Studies; College of Nursing; College of Allied Health; College of Education; College of Science and Mathematics; College of Business; and College of Arts, Humanities, and Social Sciences. The medical school class recently expanded to 230 students, making it the 6th largest medical school in the nation. With an expected economic impact of nearly $1.3 billion, the expanded university will have 10,000 students, more than 650 acres of campus, nearly 150 buildings, more than 1,000 full-time faculty, approximately 5,600 staff, an integrated health system, and an intercollegiate athletics program. The university’s clinical arm, Georgia Regents Health System, includes the 478-bed Medical Center and the 154-bed Children’s Hospital of Georgia (formerly Children’s Medical Center). FACULTY & STAFF UPDATES Accomplishments and recognition Cargill H. Alleyne Jr., M.D., (Department of Neurosurgery) served as President of the Georgia Neurosurgical Society, May 2012 to present. He also continued his duties as Chair of the Neurology/ Neurosurgery section of the National Medical Association at its annual meeting in August 2012 in New Orleans, where he moderated the Don H. Wood, M.D., postgraduate resident forum, and the Clarence S. Greene, Sr., M.D., Stroke Symposium. In addition, he was listed as one of the Best Doctors in America in 2013. Finally, his educational children’s book “Ned’s Head” received an “Honorable mention” in the fall 2012 Royal Dragonfly children’s book award competition. Krishnan Dhandapani, M.D., (Department of Neurosurgery) was an ad hoc reviewer for the Veterans Affairs (VA)—Neurobiology A (NURA) Study Panel, the NIH Brain Injury and Neurovascular Pathologies (BINP) Study Section, and the NIH, ZNS1 SRB-E (54) Special Emphasis Panel “Translational Research Review,” (U44 award mechanism). In addition, he was a scientist reviewer for the United States Army Medical Research and Materiel Command and a panelist at the Second Augusta Research Symposium on Advances in Warrior Care (Augusta Wounded Warriors Project). Top Honors Neurosurgeons Cargill H. Alleyne Jr., M.D., Cole Giller, M.D., Ph.D., M.B.A., and John Vender, M.D., were recognized as being among the Best Doctors in America for 2013. They have previously been cited for this honor. Neurologists David C. Hess, M.D., and Kapil D. Sethi, M.D., were included in a list of America’s Top Doctors and US News Top Doctors in 2012. All five physicians have previously received these awards. THANKS TO OUR DONORS TRANSITIONS We are delighted to welcome Ian Heger, M.D., into the Department of Neurosurgery as Assistant Professor and section Chief of Pediatric Neurosurgery. Dr. Heger completed his medical training at SUNY Downstate in Brooklyn, N.Y., and his pediatric neurosurgery fellowship at the Children’s Hospital of Philadelphia. He held previous positions at Wolfson’s Children’s Hospital in Jacksonville, Fla., and Joe DiMaggio Hospital in Miami. He has been named as one of America’s Top Surgeons in 2008, 2009, and 2012. Dr. Heger will work to expand the pediatric neurosurgical service at the Children’s Hospital of Georgia (formerly Children’s Medical Center), Georgia Regents University. Donations received from January–June 2012 Neurosurgery Marshall B. Allen Jr., M.D. Cargill H. Alleyne, M.D. Haroon F. Choudhri, M.D. Dr. Ernest C. Fokes Jr. Marilyn E. Montgomery The Staulcup Foundation John R. Vender, M.D. Neurology ALS Association of Georgia Mark Antebi Baker and Baker Foundation Dr. Christopher Brandon Mrs. Eileen Brandon Dr. David Butler Mr. & Mrs. John Cisar Dr. Barbara Cohen The Comfort Keepers 429 Frederick Deutsch, M.D. Mr. & Mrs. Dale Godby Mr. Michael Goldstein Mrs. Diane Grimsley Elliott G. Gross, M.D. Mr. Fred Hunt Integrity Medical Jim and Janet Ivett Dr. Gregor W. Jason Ms. Mary Losikoff Mark Loomus, M.D. Dr. David Loring Dr. Jose Maestre-Moreno David A. Nye, M.D. Ms. Gloria Pitt Bridglal Ramkissoon, M.D. Mr. & Mrs. Asher Rivner Michael H. Rivner, M.D. The Rockwood Trust Ignacio Rodriguez, M.D. The Sanctuary of Augusta Kapil D. Sethi, M.D., F.R.C.P. Saeed S. Shahidsalles, M.D., Ph.D. Michael Stein, M.D. T. Rowe Price Associates, Inc. Kenneth Vatz, M.D. Ms. Janet L. Voight Dr. Michelle C. Winston Cole A. Giller, M.D., Ph.D., M.B.A., (Department of Neurosurgery) was an ad hoc reviewer for Neurosurgery. In July he was nominated to the medical advisory board of the International Essential Tremor Foundation. In addition he was cited as one of the Best Doctors in America for 2013. award and the Georgia Health Sciences Research Institute Distinguished Research Award in 2012. co-investigator Darrell Brann, Ph.D.) entitled “Mechanisms of neuregulin 1 protection of excitatory neurons in stroke models.” Its major goal is to study whether neuregulin 1 protects excitatory neurons in stroke indirectly by regulating GABAergic neurons. The second grant was a Muscular Dystrophy Association grant (MDA240849, 8/1/2012–7/31/2015) entitled “Mechanisms of LRP4 autoantibodies in myasthenia gravis.” The major goal of this proposal is to study pathogenic mechanisms of LRP4 autoantibodies in myasthenia gravis. The third grant was a VA grant (1/01IBX001020A, 7/1/2013–6/30/2017) entitled “Mechanisms of Erbin regulation of remyelination.” The goal of this grant is to investigate roles of Erbin in nerve regeneration and underlying mechanisms. Jeffrey Switzer, D.O., (Department of Neurology) was awarded an American Heart Association Southeast Affiliate Grant in Aid for “Minocycline in acute intracerebral hemorrhage,” 2012–2014. David C. Hess, M.D., (Department of Neurology) was cited as one of America’s Top Doctors in 2012 and was also named a US News Top Doctor. In addition, he won an Outstanding Faculty member Sergei A. Kirov, Ph.D., (Department of Neurosurgery) was on an NIH Special Emphasis Panel (ZGM1 TWD-7 SC) Review of SCORE Grant Applications in December 2012. Lin Mei, Ph.D., (Department of Neurology) was awarded three grants. The first was an NIH R21 grant (NS078774, 8/1/2012–7/31/2014 with Kapil Sethi, M.B.B.S., (Department of Neurology) was named one of America’s Top Doctors and a US News Top Doctor in 2012. John Vender, M.D., (Department of Neurosurgery) was cited as one of the Best Doctors in America for 2013. Volume 10 | Issue 1 gru.edu/neuro 3 CLINICAL SPOTLIGHT Artistâ€™s depiction of unilateral coronal synostosis being treated via an endoscopic-assisted, minimally invasive orbital advancement technique. This procedure has numerous advantages over the standard open procedure. 4 NEUROSCIENCE OUTLOOK ď ˝ Volume 10 | Issue 1 Early treatment of craniosynostosis Patients can receive minimally invasive, endoscopic-assisted cranial vault remodeling to treat craniosynostosis at an early age by Ian Heger, M.D. Craniosynostosis is the premature fusion of away from the affected side. Lamdoidal synosone or more cranial sutures. It occurs in 1 out tosis results in flattening of the occipital bone, of 2,500 births and can present in an isolated which is uncommon and needs to be differentifashion (non-syndromic) or associated with ated from positional plagiocephaly. other congenital abnormalities (syndromic). Most commonly, the different types of synosTreatment options tosis present with an identifiable, reproducible The traditional treatment has been to allow the pattern. The most common is sagittal synostochild to grow and build up a circulating blood sis, which has a slight male predominance. The volume so the child can safely withstand an typical pattern of the fused sagittal suture is operation to reconstruct the cranial vault and elongation of the longitudinal axis and narattendant blood loss. Essentially, these procerowing of the width of the head leading to what dures involve degloving the skull so that multiple is termed a scaphocephalic shape (figure 1). osteotomies can be made to remove the calvarMetopic synostosis has a slight female preium. The calvarium can then be reshaped and dominance and is characterized by fusion of the reconstructed in such a fashion as to aesthetimetopic suture, which results in flattening and cally return the skull to a more normocephalic retrusion of the frontal bones and narrowing of appearance as well as enlarge the cranial vault to the intracanthal distance (hypotelorism), leading allow more room for the growing skull. Although to a triangular forehead shape or trigonecephaly these procedures are quite successful, they are (figure 2). Coronal synostosis associated with significant blood leads to ipsilateral forehead loss and a very large cranial scar. Here at Georgia To circumvent these problems, flattening and elevation of the superior orbital rim along with minimally invasive techniques Regents, we contralateral frontal bone bossintend to study have recently been developed ing (figureÂ 3). These changes are to perform these procedures the neurobehav- through smaller incisions using also projected along the skull base and result in the nasal ioral effects of the endoscopic assistance (figureÂ 4). bridge deviating to the affected minimally invasive Using these techniques has been side and the tip of the nose shown to reduce transfusion craniosynostosis rates, operating time, and hospiprojecting away. In more severe cases, the mandible deviates release surgery. tal length of stay. Figure 1. Scaphocephalic shape Figure 2. Trigonecephaly Volume 10 | Issue 1 ď ˝ gru.edu/neuro 5 CLINICAL SPOTLIGHT To circumvent these problems, minimally invasive techniques have recently been developed to perform these procedures through smaller incisions using endoscopic assistance (figure 4). Using these techniques has been shown to reduce transfusion rates, operating time, and hospital length of stay. Figure 3. Elevation of the superior orbital rim along with contralateral frontal bone bossing Figure 4. Minimally invasive techniques using endoscopic assistance 6 NEUROSCIENCE OUTLOOK ď ˝ Volume 10 | Issue 1 Identifying the optimal age for treatment Although there are clear benefits from the minimally invasive, endoscopic-assisted cranial vault remodeling procedures, it is unclear whether or if there is any benefit to the developing brain to have these procedures done at an early age. We do know that early operations can lead to less strabismus and astigmatism in patients with coronal synostosis. Additionally, it has been demonstrated that if the brain develops under pressure, such as with untreated hydrocephalus, there is a negative impact on cognitive development. Although there has not been a clear demonstration in the literature that earlier treatment of craniosynostosis leads to an improved cognitive outcome, no studies have been undertaken in children undergoing minimally invasive, endoscopic-assisted cranial vault remodeling procedures. Here at Georgia Regents, we intend to study the neurobehavioral effects of the minimally invasive craniosynostosis release surgery. Children will be evaluated before and after the To speak with Ian surgery to see how Heger, M.D., or to the surgery affects refer a patient, please email their development as iheger @gru.edu or call 706.721.9386. To learn more well as their materabout pediatric neurosurnal bonding so these gery at Georgia Regents questions can finally Medical Center or Childrenâ€™s be answered. Hospital of Georgia, visit gru.edu/neuro. FACILITY SPOTLIGHT Highest Designation JCAHO awards stroke center its highest designation— Advanced Comprehensive Stroke Center The multidisciplinary stroke center at Georgia Regents Medical Center (GRMC) was awarded an Advanced Comprehensive Stroke Center designation after a rigorous two-day review in January by The Joint Commission on the Accreditation of Healthcare Organizations. The stroke center comprises stroke neurology, emergency medicine, neuroradiology, cerebrovascular and endovascular neurosurgery, neurointensive care, nursing, pharmacy, physical therapy, occupational therapy, and speech therapy, among other disciplines. This makes our center the first in the state of Georgia, the second in the Southeast, and only the 16th in the entire nation to be given this highest designation of stroke care. “This means we provide high-level care for patients with the most severe and challenging types of strokes and cerebrovascular disease, and we help set the national standards in highly-specialized stroke care,” says David S. Hefner, CEO of the medical center. “It’s not any one thing that we do here; it’s a myriad of best-practices performed by specially-trained staff from a variety of health care disciplines, all working together to provide better outcomes for our stroke patients.” Expanding Capabilities During a rigorous two-day onsite review, Joint Commission experts examined the medical center’s compliance with Comprehensive Stroke Center standards and requirements, including 24/7 availability of specialized treatments, staff who possess the unique education and competencies to care for complex stroke patients, and advanced imaging capabilities. Georgia Regents Medical Center recently opened a second interventional radiology suite, enabling the hospital to treat more than one complex patient at a time. The state-of-the-art biplanar angiography machines (Phillips Allura Xper model) produce clear 3-D pictures of the arteries in the brain and neck. Surveyors also looked at post-hospital care coordination for patients and patient-centered stroke research efforts. Physician scientists at GRMC are currently researching how stem cell therapy and insulin administration methods affect stroke recovery. Collaborative Care Comprehensive Stroke Center certification was developed in collaboration with the Brain Attack Coalition and the American Heart Association/American Stroke Association. The AHA/ASA awarded GRMC with its second consecutive Get With The Guidelines® Stroke Gold Plus Quality Achievement Award in 2012, and the hospital was named to the AHA/ASA Target: Stroke Honor Roll for excellence in emergency stroke care in December. GRMC is the only truly comprehensive stroke center in the region with the expertise and technical skills needed to offer 24/7 care for acute cerebrovascular events. For this reason, GRMC extends quality stroke care to rural patients throughout the region through REACH Health, Inc. This hub-and-spoke network allows stroke specialists at GRMC to diagnose and treat stroke patients remotely at more than a dozen rural hospitals and a few larger community hospitals. GRMC also collaborates with neighboring EMS teams by providing pre-hospital and interventional stroke care education. Congratulations to the many individuals who prepared for our review, especially the Stroke Program Coordinator, Holly Hula, R.N., B.S.N., C.N.R.N. The Phillips Allura Xper biplanar angiography suite produces clear 3-D pictures. It was the first in the South to feature VasoCT imaging that enables the hospital’s neurosurgery team to more precisely pinpoint and open blockages. If you have questions about the Stroke Program, please visit us at gru.edu/stroke, call 706.721.4581 or email firstname.lastname@example.org. For more information on The Joint Commission and American Heart Association’s Advanced Certification for Comprehensive Stroke Center, visit jointcommission.org or heart.org/myhospital. Volume 10 | Issue 1 gru.edu/neuro 7 CLINICAL & RESEARCH SPOTLIGHT Evidence-based care for movement disorders The interdisciplinary team at the Movement Disorders Center delivers evidencebased, family-centered care for patients and families with Parkinson’s disease and related disorders by Kapil D. Sethi, M.D., F.R.C.P., John Morgan M.D., Ph.D., Shyamal Mehta M.D., Ph.D., Cole Giller, M.D., Ph.D., M.B.A., and Jill Trumble, M.D. The Movement Disorders Center at Georgia Regents Health System is focused on state-ofthe-art, evidence-based interdisciplinary care for patients and families suffering with Parkinson’s disease (PD) and related disorders such as tremor, dystonia, chorea, restless legs syndrome, gait and balance problems, and drug-induced movement disorders. Our center is the only Our center is the only center center designated as a National Parkinson designated as a National Disease Center of Parkinson Disease Center Excellence in Georgia of Excellence in Georgia or or South Carolina. Our physicians Kapil South Carolina. D. Sethi, M.D., FRCP, John Morgan, M.D., Ph.D., Shyamal Mehta, M.D., Ph.D., and Jill Trumble, M.D., are board-certified neurologists with training and expertise in diagnosing and treating common and complex movement disorders. We offer cutting-edge medical therapies, including botulinum toxin therapy, for disorders characterized by excessive muscular activity. Figure 1. Coronal MRI image showing DBS electrode inserted on left. The dark, rounded objects are the four electrical contacts of the electrode and appear larger due to metal artifact. 8 NEUROSCIENCE OUTLOOK Volume 10 | Issue 1 We strongly believe in family-centered care and we work with the entire family to empower the patient and caregiver in making educated decisions regarding the choice of medical or surgical therapy. We achieve these goals with a strong interdisciplinary team consisting of a social worker, a neuropsychologist, nurses, and physical, occupational, and speech therapists in order to provide optimal care and educational resources for patients and caregivers. We are intimately involved in outreach and have close working partnerships with support groups throughout Georgia and South Carolina. Communication with referring primary care physicians and neurologists is a priority, and as a result, patients are routinely sent to our center from all over Georgia, South Carolina, and beyond. Figure 1. Coronal MRI image Surgical Therapy Surgery is a mainstay for the treatment of medicationresistant Parkinson’s disease, essential tremor, and other movement disorders, and we offer a full range of surgical options. Our experience with these operations began almost 30 years ago and our Deep Brain Figure 2. Operative view of stereotactic frame holding guiding electrode through a bur hole to the chosen target. Clear drapes facilitate neurologic monitoring of the patient. Figure 2. Operative view of stereotactic frame Stimulation (DBS) program has been active for almost two decades. These procedures have been shown to improve many of the disabling symptoms of movement disorders, as well as to increase the major quality of life indices. The neurosurgical team, led by Cole Giller, M.D., Ph.D., M.B.A., collaborates closely with the Movement Disorders Program physicians during patient selection and treatment. Programming of the DBS device is individualized, and can be done either by our physicians or the referring physician. We have performed more than 220 procedures for movement disorders in the past four years with excellent results and low morbidity. Research While clinical care is our primary focus, we realize that basic and clinical research is the only way to identify disease-slowing therapies for these diseases in the future. Therefore, we are actively involved in clinical and basic research. The Movement Disorders Center has a long history of leading and participating in clinical research trials in Parkinson’s disease, restless legs syndrome, cervical dystonia, Huntington’s disease, and other movement disorders. We have received funding for conducting numerous clinical trials in PD from Figure 3. Lateral skull film showing DBS electrode prestigious funding sources such as the National Institutes of Health, the Parkinson Study Group, and the National Parkinson Foundation (NPF). We have studied or are currently studying drugs that attack PD on all fronts: drugs that may slow down disease progression, drugs that ameliorate dyskinesias related to levodopa therapy, drugs that help treat neuropsychiatric and cognitive effects of the disease, and drugs that improve motor function. Dr. Sethi has been involved in clinical trials in PD since the early 1990s, has designed national trials in PD, and has served on the steering committees of important clinical trials of dopamine agonists and other therapeutics. He serves as the local Principal Investigator on the largest potential disease-slowing trial in PD to date, looking at creatine versus placebo in PD (funded by NIH). Dr. Morgan has initiated numerous clinical trials in PD and serves as Co-Principal Investigator (with Tanya Simuni, M.D.) on a study of pioglitazone in early PD to see if this medication actually has disease-slowing properties in PD. This study is funded by NIH and is a multi-center trial across the United States. We have been funded by NPF for multiple investigator-initiated studies (initiated by Dr. Nathan Herz, O.T.) in PD, including a study of occupational therapy in PD and a study of “Wiihab” with the Nintendo Wii in PD. Figure 3. Lateral skull film showing DBS electrode. Note the four contacts at the tip of the electrode and the connection to the wire that will attach to the DBS generator. The Georgia Regents Movement Disorders/ Parkinson’s Disease Center offers exceptional clinical diagnosis, treatment, and care for Parkinson’s disease and other movement disorders. If you have questions regarding movement disorders, please call 706. 721.2798 or email email@example.com. Refer a patient online at gru.edu/ referral or call 706.721.4581. Volume 10 | Issue 1 gru.edu/neuro 9 PUBLICATIONS & PRESENTATIONS July–December 2012 PUBLICATIONS Viers A, Allen MB, Alleyne CH Historical vignette: George Smith (1916-1964). J Neurosurg 117:800-803, 2012 Risher WC, Croom D, Kirov SA Persistent astroglial swelling accompanies rapid reversible dendritic injury during stroke-induced spreading depolarizations. Glia 60:1709-1720 [Epub ahead of print; (2012) Jul 20], 2012 Dreier JP, Isele T, Reiffurth C, Kirov SA, Dahlem M, Herreras O, for the COSBID study group Is spreading depolarization characterized by an abrupt, Presentations Alleyne CH Introduction to neurosurgery. Surgery 5000 lecture series, Medical College of Georgia, July 2012 Giller C New and old aspects of deep brain stimulation for Parkinson’s disease. Augusta Parkinson’s Disease Support Group, Augusta, Ga., July 2012 massive release of Gibbs free energy from the human brain cortex? Neuroscientist 19:25-42 [Epub ahead of print; (2012) Aug 20], 2013 Woodall MN, Alleyne CH Nail gun head trauma: A comprehensive review of the literature. Journal of Trauma and Acute Care Surgery 73:993-6, 2012 Alleyne CH Ned’s Head. North Charleston, SC, CreateSpace, 2012 Alleyne CH Comment on Microsurgical anatomy of the carotid cave. Neurosurgery 70, ons311, 2012 Kirov SA, Sword J In vivo 2-photon imaging of acute injury to synaptic circuitry in the peri-contusional cortex. 8th Forum of European Neuroscience, Barcelona, Spain, July 2012 (Abstract) Alleyne CH Subarachnoid hemorrhage and unruptured intracranial aneurysms. National Medical Association Meeting, New Orleans. La., August 2012 Alleyne CH Comment on Use of a Yasargil mirror as an adjunct to indocyanine green angiography to evaluate the patency of elusive posterior communicating arteries during aneurysm clipping: case report. Neurosurgery 71:onsE197, 2012 Alleyne CH, Hughes D Review of Cavernous malformations of the nervous system. Neurology 79:1837, 2012 Sukumari-Ramesh S, Alleyne Jr CH, Dhandapani KM Astrogliosis: a target for intervention in intracerebral hemorrhage? Translational Stroke Research 3:80-87, 2012 Kimbler DE, Shields J, Yanasak NE, Vender JR, Dhandapani KM Activation of P2X7 promotes cerebral edema and neurological injury after traumatic brain injury in mice. PLoS ONE, 7:e41229, 2012 NEUROSCIENCE OUTLOOK Volume 10 | Issue 1 Chutkan N, Tuttle J Cervicothoracic fractures and dislocations Anderson and Vaccaro, eds, Decision Making in Spinal Care, second ed, p55-58. Thieme, New York, 2012 Zhang QG, Laird MD, Han D, Dhandapani KM, Brann DW Critical role of NADPH oxidase in neuronal oxidative damage and microglial activation following traumatic brain injury. PLoS ONE 7:e34504, 2012 Sukumari-Ramesh S, Alleyne Jr CH, Dhandapani KM Astrocyte-specific expression of survivin after intracerebral hemorrhage in mice: a possible role in reactive gliosis? J Neurotrauma 29:2798-2804, 2012 Borlongan CV, Glover LE, Sanberg PR, Hess DC Permeating the blood brain barrier and abrogating the inflammation in stroke: implications for stroke therapy. Curr Pharm 18:3670-6, 2012 Alleyne CH Subarachnoid hemorrhage and unruptured intracranial aneurysms: diagnosis and management. Neurology Residents Noon Conference, Georgia Health Sciences University, September 2012 Alleyne CH, SukumariRamesh S, Dhandapani KM Astrocyte-specific expression of survivin mediates reactive gliosis after intracerebral hemorrhage. Congress of Neurological Surgeons Meeting, October 2012 (poster) Hess DC Stem cells in stroke: Hype or hope. World Stroke Congress, Brasilia, Brazil, October 2012 Alleyne CH Central nervous system vascular malformations. University Hospital Noon Conference, Augusta, Ga., October 2012 Giller C Surgery for Parkinson’s disease. Southeastern Parkinson’s Conference, Atlanta, Ga., October 2012 Names in blue indicate faculty members in the Georgia Regents University Neurosurgery or Neurology department. 10 Hester SM, Fisher JF, Lee MR, Macomson S, Vender JR Evaluation of salvage techniques for infected baclofen pumps in pediatric patients with cerebral palsy. J Neurosurg Pediatr 10:548-54, 2012 Hess DC Telestroke in stroke systems of care. World Stroke Congress, Brasilia, Brazil, October 2012 Shields J, Dhandapani KM The effect of traumatic brain injury on the circadian clock. Advances in Warrior Care Conference, Augusta, Ga., October 2012 Switzer JA, Rocker J, Mohorn P, Waller JL, Hughes D, Bruno A, Nichols FT, Hess DC, Natarajan K, Fagan SC Clinical experience with three-factor prothrombin complex concentrate to reverse warfarin anticoagulation in intracranial hemorrhage. Stroke. 2012 Jul 17. [Epub ahead of print]PMID: 22811449 Hoda MN, Siddiqui S, Herberg S, Periyasamy-Thandavan S, Bhatia K, Hafez SS, Johnson MH, Hill WD, Ergul A, Fagan SC, Hess DC Remote ischemic preconditioning is effective alone and in combination with intravenous tissue-type plasminogen activator in murine model of embolic stroke. Stroke. 2012 Aug 21. [Epub ahead of print] PMID: 22910893 Sukumari Ramesh S, Alleyne CH, Vender JR, Dhandapani KM Nrf2-ARE signaling augments glioma proliferation and chemoresistance. Society for Neuroscience Annual Meeting, New Orleans, La., October 2012 Kirov SA Astrocytes, microglia and neurons in early stroke and traumatic brain injury. University of Alabama at Birmingham Mini Symposium “Physiology and Pathophysiology of Astroglia,” Birmingham, Ala., October 2012 Switzer JA, Sikora A, Ergul A, Waller JL, Hess DC, Fagan SC Minocycline prevents IL-6 increase after acute ischemic stroke. Transl Stroke Res 3:363-368, 2012. Epub 2012 Mar 15 Meador KJ, Baker GA, Browning N, Cohen MJ, et al Effects of fetal antiepileptic drug exposure: outcomes at age 4.5 years. Neurology 78:1207-1214, 2012 Davis, KL, Murro, AM, Park, YD, Lee, GP, Cohen, MJ, Smith, JR Posterior quadrant epilepsy surgery: predictors of outcome. Seizure 21:722-728, 2012 Sethi KD, Mehta SH A clinical primer on restless legs syndrome: what we know, and what we don’t know. Am J Manag Care 18:S83-8, 2012 Switzer JA, Demaerschalk BM Overcoming challenges to sustain a telestroke network. J Stroke Cerebrovasc Dis21:535-40, 2012 Chong RK, Lee KH, Morgan J, Mehta SH, Hall P, Sethi K Diagnostic value of the rapid assessment of postural instability in Parkinson’s disease (RAPID) questionnaire. Int J Clin Pract66:718-21, 2012 Carroll JE Human cord blood for neonatal brain damage. Ped Research 71:459-63, 2012 Bruno A, Shah N, Akinwuntan AE, Close B, Switzer JA Stroke size correlates with functional outcome on the simplified modified rankin scale questionnaire. J Stroke Cerebrovasc Dis21:659-661, 2012 Choudhri HF New strategies for spinal tumor surgery. Emirates Neuroscience Society Meeting, Dubai, UAE, November 2012 Giller C Some neurosurgical viewpoints of anesthesia for functional neurosurgery. Anesthesia Grand Rounds GHSU, November, 2012 Dhandapani KM Neuro-immune interactions after TBI: a role in the development of cerebral edema. Department of Physiology, Georgia Health Sciences University, Augusta, Ga., November 2012 Shakir B, Choudhri HF Resection of alveolar soft part sarcoma. Georgia Neurosurgical Society Meeting, Atlanta, Ga., November 2012 Alleyne CH Introduction to neurosurgery. Surgery 5000 lecture series, Medical College of Georgia, December 2012 Akinwuntan AE, Devos H, Stepleman L, Casillas R, Rahn R, Smith S, Williams M Predictors of driving in Dhandapani KM Neuro-immune interactions after TBI: a role in the development of cerebral edema. Brain and Behavior Discovery Institute, Georgia Health Sciences University, Augusta, Ga., December 2012 individuals with relapsingremitting multiple sclerosis. Mult Scler July 3, 2012 (Epub ahead of print) Akinwuntan AE, O’Connor C, McGonegal E, Turchi K, Smith S, Williams M, Wachtel J Prediction of driving ability in people with relapsingremitting multiple sclerosis using the stroke driver screening assessment. International Journal of MS Care 14:65-70, 2012 En bloc resection with reconstruction is important in the surgical management of certain spinal tumors. This illustration shows a large alveolar soft part sarcoma of the cervical-thoracic junction, which was resected in one piece with clean margins (Choudhri HF, New strategies for spinal tumor surgery). Volume 10 | Issue 1 gru.edu/neuro 11 Georgia Regents University 1120 15th St., 1114 Augusta, GA 30912 NON-PROFIT US POSTAGE PAID GEORGIA REGENTS UNIVERSITY GRU-001 January–April 2013 CONFERENCE SCHEDULES Neurosurgery Feb. 1 Feb.8 Feb. 15 Feb. 22. Mar. 1 Mar. 8 Mar. 15 Mar. 22 Evaluations Apr 12 Apr. 19 Apr. 26 Jan. 3 Dr. Ed Hartmann: Myasthenia Gravis 10:00–11:00 am Gamma Knife–Giller Jan. 10 Dr. Tom Swift: Case Presentation 11:00 am–noon Anatomy Jan. 17 Dr. Tom Swift: Case Presentation noon–1:00 pm Case Conference 10:00–11:00 am Radiology Jan. 24 Dr. Shyamal Mehta: Deep Brain Stimulation, A Brave New World 11:00 am–noon Neuro 101 Jan. 31 Dr. Tom Swift: Case Presentation noon–1:00 pm Case Conference 10:00–11:00 am Journal Club 11:00 am–noon Hours/Case Log Meeting noon–1:00 pm M&M 10:00–11:00 am Business–Giller 11:00 am–noon Oral Board noon–1:00 pm Case Conference 10:00–11:00 am Radiology 11:00 am–noon Neuro 101 noon–1:00 pm Case Conference 11:00 am–noon Anatomy noon–1:00 pm Case Conference 10:00–11:00 am Journal Club 11:00 am–noon Hours/Case Log Meeting noon–1:00 pm M&M Mar. 29 Apr. 5 Neurology No Conference 10:00–11:00 am Gamma Knife–Giller 11:00 am–noon Anatomy noon–1:00 pm Case Conference 10:00–11:00 am Radiology 11:00 am–noon Neuro 101 noon–1:00 pm Case Conference 11:00 am–noon Oral Board noon–1:00 pm Case Conference 10:00–11:00 am Journal Club 11:00 am–noon Hours/Case Log Meeting noon–1:00 pm M&M Feb. 7 Feb. 14 Feb. 21 Feb. 28 Mar. 7 Dr. Anthony Murro: Epilepsy All conferences are held from 8:00–9:00 am. Dr. Tom Swift: Case Presentation Dr. Elizabeth Sekul: Child Neurology Dr. Askiel Bruno: Stroke Dr. Nancy McNair: VA General Neurology Mar. 14 Dr. Tom Swift: Case Presentation Mar. 21 TBA Mar. 28 Dr. David Hess: Stroke Apr. 4 Masters Week Apr. 11 Dr. Tom Swift: Case Presentation Apr. 18 Dr. John Morgan: Movement Disorders Apr. 25 AAN Meeting Upcoming meetings AANS/CNS Section on Cerebrovascular Surgery, Feb. 3–6, Honolulu, Hawaii American Academy of Neurology, Mar. 16–23, San Diego, Calif. International Stroke Conference, Feb. 6–8, Honolulu, Hawaii Comprehensive Stroke Management Update 2013, Apr. 6–8, Hilton Head, S.C. Southern Neurosurgical Society, Feb. 20–23, Sarasota, Fla. AANS/CNS Section on Disorders of the Spine & Peripheral Nerves, Mar. 6–9, Phoenix, Ariz. Neurosurgical Society of America, Apr. 7–10, Sea Island, Ga. American Association of Neurological Surgeons, Apr. 27– May 1, New Orleans, La. As a regional referral center for the Southeastern U.S., the Georgia Regents Neuroscience Center of Excellence includes the area’s largest, most diverse team of adult and pediatric neurologists and neurosurgeons, including renowned experts in Parkinson’s disease, stroke, ALS, MS, functional and cerebrovascular neurosurgery, and complex spine surgery. To make an online referral, visit gru.edu/referral.