Neuroscience Outlook Spring 2015 Newsletter

VOL. 12 | ISSUE 1

NEUROSCIENCE OUTLOOK

NEWS AND RESEARCH FROM THE DEPARTMENTS OF NEUROLOGY AND NEUROSURGERY AT GEORGIA REGENTS NEUROSCIENCE CENTER

WORLD-CLASS CARE

The department of neurosurgery’s International Program fosters global partnerships

FROM THE CHAIRMEN

DEPARTMENT NEWS

Cargill H. Alleyne Jr., MD, and David C. Hess, MD

Welcome to the 24th issue of Neuroscience Outlook, the newsletter of the departments of neurology and neurosurgery. This issue marks the second decade of its publication, and we are proud of the significant accomplishments we have made in the last decade. In the Department News section, we are delighted to report that our institution was named one of the top 25 for Best Practices in Patient and Family Engagement.

In the same section, we welcome Dr. Kurek, a neurologist specializing in movement and cognitive disorders, and provide an update on our Comprehensive Stroke Center, the first in Georgia to be certified by The Joint Commission. In the Clinical Spotlight, we focus on the expanding International Program in the neurosurgery department and the advances in neurocritical care in our combined unit. We complete this issue with a list of our philanthropic donors to whom we are deeply grateful, faculty accomplishments, and publications and presentations in our combined departments. As always, we hope these pages give our readers insight into the progress we have made as we strive to maintain excellence in our tripartite missions.

Cargill H. Alleyne Jr., MD Professor and Marshall Allen Distinguished Chair of Neurosurgery calleyne@gru.edu

David C. Hess, MD Professor and Presidential Distinguished Chair of Neurology dhess@gru.edu

NEUROSCIENCE OUTLOOK A publication of the Georgia Regents University Departments of Neurology and Neurosurgery Editor-in-chief: Cargill H. Alleyne Jr., MD Editor: Phil Malkinson Illustrations: Colby Polonsky, MS Contributors: Haroon F. Choudhri, MD, Kim Bolodosky, CMTP, Cargill H. Alleyne Jr., MD, Subhashini Ramesh, MD, K. Alfredo Garcia, MD

2

NEUROSCIENCE OUTLOOK  Volume 12 | Issue 1

Comprehensive Stroke Care

GRMC is a regional leader in stroke care, fostering innovative treatments and delivering state-of-the-art patient care

Georgia Regents Medical Center (GRMC) houses the region’s only Comprehensive Stroke Center (CSC), providing acute and complete stroke care to Augusta, the Central Savannah River Area, and rural counties throughout Georgia and into South Carolina. The CSC consists of the GRMC Emergency Department (ED), an 18-bed neurointensive care unit staffed by fellowshiptrained neurointensivists, and an adjacent 16-bed medical/surgical stroke ward.

In-house neurology and neurosurgery coverage is available 24/7/365.

Through the use of telemedicine via the Remote Evaluation for Acute Ischemic Stroke (REACH) network, GRMC provides telestroke and teleneurology consults to 26 hospitals in Georgia and South Carolina. Having a vascular neurologist virtually at the bedside facilitates decisions regarding rt-PA administration and acute management. Patients can then be transferred to a higher level of care or hub if needed for neurointensive care, endovascular therapy, or neurosurgical intervention.

Last year, 254 stroke patients were admitted to GRMC through the ED (211 ischemic strokes and TIAs, GRMC was the first Joint 10 SAH, and 33 ICH) and another 279 stroke patients were transferred Commission-certified CSC in from other hospitals, mostly from in Georgia. Recent accolades REACH referrals (178 ischemic strokes include American Heart and TIAs, 30 SAH, and 71 ICH).

Association Target Stroke Thirty-three (16 percent) received rt-PA Honor Roll Elite and Get in the GRMC ED, and REACH with the Guidelines– recommended the administration of rt-PA 182 times. Among the 163 Stroke Gold Plus recognition ischemic stroke patients transferred from for 2014. an outside ED, 34 (21 percent) were treated with rt-PA over REACH. Subarachnoid hemorrhage cases are managed collaboratively by specialists with expertise in endovascular neurosurgery and neurointensive care.

GRMC was the first Joint Commission-certified CSC in Georgia. Recent accolades include American Heart Association Target Stroke Honor Roll Elite and Get with the Guidelines–Stroke Gold Plus recognition for 2014. Target Stroke Honor Roll Elite status is awarded to facilities with a door-to-needle time of less than 60 minutes in 75 percent or more of patients treated with rt-PA. Guidelines–Stroke Gold Plus recognition is the highest award given to stroke centers that consistently adhere to stroke treatment quality measures for a timeframe greater than 24 months. GRMC is dedicated to being the regional leader in stroke care by providing exceptional, state-of-the-art quality and expertise in patient care; by educating our patients, community, health care partners, and trainees in stroke prevention and treatment; and by fostering research into innovative treatments for stroke patients.

Jeffrey Switzer, DO, and William Todd, MSN, FNP

FACULTY & STAFF UPDATES Cargill H. Alleyne Jr., MD, (department of neurosurgery) submitted a patent application (Patent filed 9/22/14).

Alleyne CH, Dhandapani KM, Wen K, Ma M, Hu W, with Georgia Regents University.

Protective effects of curcumin against hemorrhagic stroke injury GRU 2007-048.

Figure 1. Ischemic strokes and TIAs by county; FY 2014

Krishnan M. Dhandapani, PhD, (department of neurosurgery) chaired the American Heart Association Brain 2 Study Section and the VA Neurobiology C (NURC) Study Section. He was also an ad hoc reviewer for the Henry M. Jackson Foundation. In addition, he submitted a patent with Dr. Alleyne (see above).

Ian Heger, MD, (department of neurosurgery) was recently inducted into the Alpha Omega Alpha Honor Medical Society.

David C. Hess, MD, (department of neurology) was moderator and session organizer at the session on “Peripheral to Central Signaling,” Brain Edema 2014 and 2nd Preconditioning Conference, Huntington Beach, California, in September 2014. He was also an NIH study section reviewer at the NSD-K Study Section and the Udall Study Section in November and December, respectively.

Sergei A. Kirov, PhD, (department of neurosurgery) was awarded an R01 grant (R01NS083858); PI, “Synaptic Circuitry in Stroke” National Institute of Neurological Disorders and Stroke.

Sept 14, 2014–May 31, 2018; Percentile: 6.0; Impact score: 20; Funding: $1,438,360. He was also an American Heart Association Grant Reviewer for the National Innovative Research Grant (IRG) Vascular Sciences (Brain) BSc1in October 2014.

Welcome…

Figure 2. SAH by county; FY 2014

Julie Kurek, MD, joined the department of neurology Nov. 1, 2014, as Assistant Professor in the movement and cognitive disorders section.

Julie completed her neurology residency at Columbia in NYC and a Movement Disorder fellowship at North Shore Long Island Jewish Medical Center. Dr. Kurek is interested in deep brain stimulation, Parkinson’s disease, and movement disorders.

Patient-Centered Care

Figure 3. ICHs by county; FY 2014

Georgia Regents Medical Center was named to a list of 25 of the Nation’s Best Practices in Patient and Family Engagement by Caregiver Action Network (one of the nation’s leading family caregiver organizations).

Only nine U.S. hospital systems were recognized, and GRMC was the only one in Georgia so named. Our neuroscience unit was the first adult service at GRU to adopt a patient-centered care approach and was featured on the PBS home video “Remaking American Medicine—Healthcare for the 21st Century” in 2006. Formerly the National Family Caregivers Association, CAN is a nonprofit organization providing complimentary education, peer support, and resources to family caregivers across the nation.

Volume 12 | Issue 1 gru.edu/neuro

3

CLINICAL SPOTLIGHT

Connect the dots

The department of neurosurgery’s International Program at GRU fosters partnerships around the globe Haroon F. Choudhri, MD, Kim Bodolosky, CMPT, and Cargill H. Alleyne, Jr., MD

The department of neurosurgery at GRU has a long history of collaboration with colleagues throughout the United States and around the world. These ties have grown exponentially in recent years and are reflected in all aspects of our tripartite mission.

TEACHING In addition to publications in a variety of international journals, our faculty members have been invited to speak at many international meetings and to be visiting professors at prestigious institutions around the world. We have hosted medical students, residents, and consultant faculty from many countries who have come to observe surgeries here at GRU. The “Neurosurgery Board Review” textbook (first edition) by Dr. Cargill H.

4

NEUROSCIENCE OUTLOOK  Volume 12 | Issue 1

Alleyne Jr., has been translated into Mandarin and is available throughout China. Also, Dr. Scott Y. Rahimi, Alleyne, and several neurosurgery residents have contributed a chapter (to be translated into Greek) on intracranial aneurysms in a neurosurgical text being published by the neurosurgery department at University of Thessaly, Greece.

RESEARCH The cerebrovascular lab with Alleyne and Dr. Krishnan Dhandapani conducts a variety of translational research projects, including investigations into mechanisms of neuroprotection from stroke from curcumin, a component of turmeric that is a key ingredient in curry powder.

The lab was the first to show beneficial results of curcumin in a murine SAH model. The

compound also works well in ischemia models and ICH models. Our lab has collaborated with scientists at East China Normal University to increase the bioavailability and efficacy of curcumin by modifying its chemical structure.

This collaboration has led to the discovery of novel curcumin analogues for which a patent application has been filed.

Additionally, Dr. Haroon F. Choudhri has mentored students in Saudi Arabia and Egypt in the preparation of grant applications and the ensuing basic science research.

PATIENT CARE Colleagues throughout the United States and around the globe have availed themselves of our Case Review program. Both physicians and patients have sent hundreds of cases to GRU neurosurgical specialists for their opinion. Choudhri has been coordinating this effort and accepts referrals at hchoudhri@gru.edu. In addition to answering questions and sharing opinions, we have been honored that patients from many foreign countries have traveled to GRU to receive their neurosurgical care. The large number of international patients we receive prompted us to hire a concierge in 2012 (see sidebar below). Kim Bodolosky, a certified Medical Tourism Professional, coordinates their arrivals and travel/housing logistics, provides guidance on obtaining U.S. visas, and helps to obtain quotations for medical care. Our Cultural and Linguistically Appropriate Services (CLAS) program provides certified medical translators for a large number of languages and facilitates our guests by recognizing cultural needs such as dietary restrictions and houses of worship. In 2014, the International Neurospinal Program was launched to organize patient care, fellowship training for some international trainees, and charitable outreach.

INTERNATIONAL CONNECTIONS Lecturing by GRU Faculty Canada China Egypt France Germany Greece Guyana Italy Kingdom of Saudi Arabia Kuwait Morocco Pakistan Puerto Rico Tunisia United Arab Emirates Medical Students, Residents, and Consultant Faculty visiting GRU China Egypt El Salvador Ghana Greece Haiti India

Kim Bodolosky, CMPT

Research Partnerships China Egypt Kingdom of Saudi Arabia Charity Missions Involving GRU Faculty Algeria Egypt Morocco Pakistan International Patients coming to GRU for Care Afghanistan Algeria Canada Egypt Greece Kingdom of Saudi Arabia

Kuwait Lebanon Mexico Pakistan United Arab Emirates Internet Consultations Afghanistan Australia Canada China Greece Egypt France Germany Iran Italy Kingdom of Saudi Arabia Kuwait Morocco Nigeria Oman Pakistan Puerto Rico Russia Sudan Tunisia United Arab Emirates United Kingdom

In addition to publications in a variety of international journals, our faculty members have been invited to speak at many international meetings and to be visiting professors at prestigious institutions around the world. We have hosted medical students, residents, and consultant faculty from many countries who have come to observe surgeries here at GRU.

International Patient Concierge From the time of arrival to the completion of care at Georgia Regents Medical Center, the International Patient Concierge is here to assist our international patients.

Travel to another country for health care can be overwhelming. The concierge greets patients, presents them with a welcome binder written in their language, and guides them through the challenges of being in an

Japan Kingdom of Saudi Arabia Kuwait Pakistan Scotland Syria Turkey United Arab Emirates

unfamiliar environment.

The concierge is a contact person available to the patient 24 hours a day, seven days a week.

Our International Patient Concierge specializes in and provides many services to our international patients, including:

`` Familiarizing our

international patients with the hospital and areas of treatment

`` Assisting with

housing and meal accommodations `` Assisting with air and ground travel `` Assisting with translation needs `` Assisting with pharmacy needs and obtaining prescriptions `` Familiarizing our international patients with local customs and culture `` Being familiar with the cultural differences

and religious needs and ensuring the proper respect and observations `` Escorting patients to appointments for tests, lab work, etc.

The International Patient Concierge visits with our international patients and their families daily to provide comfort and assess additional needs and expectations.

Volume 12 | Issue 1 gru.edu/neuro

5

CLINICAL SPOTLIGHT

Neurocritical Care Managing the unique needs of patients requiring neurocritical care is a rapidly expanding specialty Subhashini Ramesh, MD, and K. Alfredo Garcia, MD

6

Neurocritical care is the intensive care management of patients with lifethreatening neurosurgical and neurological illnesses such as stroke, bleeding in and around the brain (subarachnoid hemorrhage, intracerebral hemorrhage, subdural hematoma, intraventricular hemorrhage), brain tumors, brain trauma, status epilepticus, nerve and muscle diseases (myasthenia gravis, Guillain-Barré syndrome), spinal cord disorders, and the cardiopulmonary complications of brain injury.

Neurocritical care units specialize in managing the unique needs of such critically ill patients. In a neuro ICU, specialized nurses and physicians care for critically ill patients with diseases of the brain, spinal cord, and nerves that often have associated medical problems complicating their care.

Neurological intensive care is one of the newest and fastest-growing specialties in medicine today. The first modern academic neuro ICUs in the United States were established in the early 1980s. At the present time, there are approximately 50 academic neuro ICUs directed by full-time staff in North America, and this number is growing rapidly.

Neuro ICUs are unique in that they bring together specially trained physicians and nurses and advanced technology, all focused on treating life-threatening neurological diseases. Neurological diseases tend to be complex and relatively uncommon and are best treated by specialists who have experience in applying neuroimaging and critical care techniques to the specific needs of neurological patients. Another major advantage to care in a neuro ICU is the constant observation and

NEUROSCIENCE OUTLOOK  Volume 12 | Issue 1

Specially trained physicians and nurses at neuro ICUs use advanced technology to treat serious neurological diseases.

immediate action that is required to detect and treat neurological deterioration. Constant surveillance by neuro-nurses and the immediate availability of neuroimaging, on-call physicians, and specialized interventions make it possible to act immediately to correct or reverse worsening medical conditions that might otherwise lead to permanent brain damage.

HISTORY OF NEUROCRITICAL CARE While the beginnings of the neurosciences ICU — defining it as a combined neurology and neurosurgery ICU — are largely unknown and difficult to tease out, some important developments in the evolution of neurocritical care should be recognized. Many of these first units were either for neurosurgical or neurologic patients. In a broader sense, little is known about the triage of patients with acute neurologic conditions in those days.

Historically, neurosurgeon Walter Dandy has been credited with opening the first neurosurgical ICU at Johns Hopkins Hospital in 1932. Indeed, Dandy had the insight to understand that some neurosurgical patients needed special care, and he chose a ward that he dedicated to the care of the sicker postoperative neurosurgical patients.

In London, the Batten Respiratory Unit at the Institute of Neurology and National Hospital for Nervous Diseases opened in 1954 to treat mostly patients with acute neuromuscular disease, as well as those with stroke and spinal cord disorders who required mechanical ventilation. The development of the Neurosciences ICU at Mayo Clinic at Saint Mary’s Hospital was one of the first newly built combined neurosciences ICUs in the United

States. It started as a unit with predominantly neurosurgical patients, and most of the expertise was developed in the care of these patients. Soon, acutely ill neurologic patients were admitted. A new culture of neurosciences was nurtured with specific attention to the care of the neediest patients.

In the United States, most neurosciences ICUs combined neurosurgical and neurologic patients. This would seem logical because acutely ill neurologic patients could need neurosurgical intervention (e.g., cerebral hematoma), and acutely ill neurosurgical patients could benefit from neurologic expertise (e.g., seizure management).

Because of the open nature of the neurosciences ICU, physicians from multiple disciplines would closely cooperate in patient management. Often, a close cooperation between neurology and neurosurgery consultants in the neurosciences ICU was needed. There was a renewed interest in closely studying and treating acute neurologic and neurosurgical conditions, and this led to a better understanding of the risks for deterioration.

Several other landmark developments should be noted. First, neurologists became interested in acute neurologic conditions (e.g., coma) after patients survived as a result of more advanced resuscitation.

Neurologists often were asked to judge the severity of injury and to prognosticate. Neurologists Fred Plum, Raymond Adams, and C. Miller Fisher were the first to describe causes of coma and other acute conditions (e.g., brain death, locked-in syndrome, anoxicischemic encephalopathy). A better understanding of neurologic complications of critical illness soon followed, and consultations in ICUs increased.

Second, with the emergence of neurosciences ICUs, coverage was needed. In the 1980s, neurologists would be stationed in these units.

The presence of a neurologist in the neurosciences ICU provided a major benefit to neurosurgeons who would not always have the opportunity to immediately go to the bedside (e.g., during a long and complex neurosurgical procedure). Neurologists became more knowledgeable in management of acute neuromuscular respiratory failure, treatment of increased intracranial pressure, and systemic complications specific for acute neurologic disease.

Neurologists would join intensivists (mostly anesthesiologists) and developed sufficient hands-on training that would allow them to fully manage these complicated patients.

Third, a flurry of scientific publications followed that would further define the field and its boundaries. Better understanding of causes of deterioration and recognition of opportunities of early intervention would lead to more complex and specialized care.

CREATION OF THE NEUROCRITICAL CARE SOCIETY There had been several attempts to form neurocritical care organizations throughout the world prior to the formation of the Neurocritical Care Society.

In the U.S. alone, there are critical care sections in the American Academy of Neurology, American Association of Neurological Surgeons, and Society of Neuroscience in Anesthesiology and Critical Care, as well as a neuroscience section of the Society of Critical Care Medicine. In Europe, there is the Neuro-Intensive Care Section of the European Society of Intensive Care Medicine. Perhaps the oldest neurocritical care society is the DGNI: Deutschen Gesellschaft für Neurointensiv-und Notfallmedizin (German Society for Neuro-Intensive Care and Emergency Medicine), which marked its 30th anniversary in 2013. Other multidisciplinary organizational attempts had been started as well, but it wasn’t until 1999 when seven neurointensivists (founding members: Bill Coplin, Jeff Frank, Claude Hemphill, Ed Manno, Stephan Mayer, Wade Smith, and Gene Sung) decided to collaborate that an independent, international, multidisciplinary organization was started — the Neurocritical Care Society. Each member donated their own money and time to begin the process of starting a nonprofit organization, and after several planning meetings, the first official annual meeting was held in Phoenix in 2003.

The founding members recused themselves from leadership positions and the first officers were elected: Tom Bleck, president; Michael Diringer, vice president; Raj Narayan, secretary; and Thorsten Steiner, treasurer. Since then, the Neurocritical Care Society has continued to grow steadily with increased membership, increased meeting attendance, improved journal circulation and impact score, increasing NCS projects, and increased revenue and reserves.

The physical presence of a neurointensivist in a neurosciences ICU should improve care and outcomes. Multiple — albeit retrospective — studies have shown that outcomes in certain conditions can be improved with an attending neurointensivist. Benchmarks can be defined such as mortality, morbidity, length of stay, number of consultations, and actual costs.

Mayo Clinic Neuro ICU at St. Mary’s Hospital circa 1958.

This Neuro ICU was one of the first newly built combined neurosciences ICUs in the U.S.

Volume 12 | Issue 1 gru.edu/neuro

7

CLINICAL SPOTLIGHT

The Mayo Clinic ICU circa 1958 started with neurosurgical patients, and then added acutely ill neurologic patients.

8

GEORGIA REGENTS MEDICAL CENTER NEUROSCIENCES ICU The Neurosciences ICU at Georgia Regents University Medical Center was renovated and opened its doors in December 2003. In September 2009, another major renovation was completed, the floor was separated from the ICU, and the number of ICU beds increased from 14 to 18 universal ICU beds in 2010. The Neurosciences ICU at Georgia Regents University is one of the largest dedicated Neuro intensive care units in the region. It is an 18-bed ICU that cares exclusively for patients with strokes, cerebral aneurysms, brain tumors, trauma, and neuromuscular failure, as well as status epileptics, treating some of the region’s most critically ill patients. Our services include two fellowship-trained dedicated neurointensivists, a nurse-patient ratio of 1:2, and an integrated and patient/family-focused approach to care. We have strong neurology and neurosurgical residency programs, and in-house residents cover the ICU. We also have the capability of performing 24/7 neurointerventional procedures by two dually trained, fellowship-trained cerebrovascular neurosurgeons. We are also able to provide 24/7 continuous VEEG monitoring. Our Neuro ICU was recently cited as one of several services key to our designation as an Advanced Comprehensive Stroke Center by the Joint Commission — one of only 15 hospitals in the nation to be so named at the time of designation in 2013.

In today’s changing health care landscape, family members of critically ill patients are taking a more active, hands-on role in the care and recovery of their loved ones. Families not only provide patients with vital emotional and social support during critical illness, they themselves benefit from enhanced connectivity. The growing trend toward patient- and family-centered care (PFCC) in the

NEUROSCIENCE OUTLOOK  Volume 12 | Issue 1

intensive care unit invites families to participate more fully in the care of their loved ones, while helping to bring wholeness to the patient through partnerships with the critical-care team and personalized care that respects the values, beliefs, and experiences of the individual.

A particular focus on departmental changes — such as the elimination of restricted visiting hours — is helping transform the perception of family members from visitors to full participants.

In relation to the built environment, PFCC is often expressed through the expansion and differentiation of facilities for family members, including sleeping accommodations in patient rooms and amenities on nursing units — all measures that serve to break down barriers between clinician and family.

Georgia Regents Medical Center is a pioneer in the concept of patient- and family-centered care, an approach that removes the barriers to having collaborative partnerships between health care providers, patients, and families. This means that we put patients and families first. We believe that families are an extension of the patient, not an imposition. The more involved a family is, the more our quality and safety improve along with your satisfaction. We don’t just have visitors in our hospitals, we have health care partners, and they are an integral part of the health care team.

Patient satisfaction scores are also increasing for the new Neuroscience Center. This nursing unit recently enjoyed some of its highest scores since tracking began over three years ago. Results are being closely monitored to determine the full impact of the new unit. Three years of quality improvement data for the Georgia Regents Adult Center for Excellence in Neuroscience reveal the following: `` Patient satisfaction increased from 10th to 95th percentile. `` Neurosurgery length of stays decreased by 50 percent. `` Medical errors were reduced by 62 percent. `` The number of patients discharged increased by 15.5 percent.

This is an exciting time in neurosciences and especially in neurocritical care. The brain is the great and final frontier in medicine. We at GRMC Neuro ICU look forward to providing excellence in critical care to patients with devastating neurological and neurosurgical injuries in the years to come.

PUBLICATIONS & PRESENTATIONS

Sept–Dec 2014 PUBLICATIONS Alleyne CH Comment on validation of the supplemented Spetzler-Martin grading system for brain arteriovenous malformations in a multicenter cohort of 1009 surgical patients.

Neurosurgery 76:31, 2014 Hoda MN, Fagan SC, Khan MB, Vaibhav K, Chaudhary A, Wang P, Dhandapani KM, Waller JL, Hess DC A 2 × 2 factorial design for the combination therapy of minocycline and remote ischemic perconditioning: efficacy in a preclinical

trial in murine thromboembolic stroke model.

Exp Transl Stroke Med. 2014 Oct 9;6:10. doi: 10.1186/2040-7378-6-10. eCollection 2014 Khan MB, Hoda MN, Vaibhav K, Giri S, Wang P, Waller JL, Ergul A, Dhandapani KM, Fagan SC, Hess DC Remote ischemic postconditioning: Harnessing endogenous protection in a murine model of vascular cognitive impairment.

Transl Stroke Res. 2014 Oct. 29. [Epub ahead of print, PMID:25351177]

Patel C, Narayanan SP, Zhang W, Xu Z, Sukumari-Ramesh S, Dhandapani KM, Caldwell RW, Caldwell RB Activation of the endothelin system mediates pathological angiogenesis during ischemic retinopathy.

Am J Pathol 11:304051, 2014 (doi: 10.1016/j. ajpath.2014.07.012.

Epub 2014 September 6) Heck CN, King-Stephens D, Massey AD, Nair DR, Jobst BC, Barkley GL, Salanova V, Cole AJ, Smith MC, Gwinn RP, Skidmore C, Van Ness PC, Bergey GK, Park YD,

Miller I, Geller E, Rutecki PA, Zimmerman R, Spencer DC, Goldman A, Edwards JC, Leiphart JW, Wharen RE, Fessler J, Fountain NB, Worrell GA, Gross RE, Eisenschenk S, Duckrow RB, Hirsch LJ, Bazil C, O’Donovan CA, Sun FT, Courtney TA, Seale CG, Morrell MJ Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: Final results of the RNS System Pivotal trial.

Epilepsia 55:432-441, 2014

Riccio CA, Pliego, Cohen M, Park YD Executive function performance for children with epilepsy localized to the frontal or temporal lobes.

Applied Neuropsychology: Child (DOI:10.1080/216 22965.2014.923774), 2014

UCLA, Los Angeles, Calif., November 2014

depolarization-induced dendritic beading.

The 44th SFN Annual Meeting, Washington D.C., November 2014 (abstract)

Viers A, Smith JA, Alleyne CH, Allen MB Neurosurgery at Medical College of Georgia, Georgia Regents University in Augusta (1956-2013).

Neurosurgery 75:295305, 2014

PRESENTATIONS Hess DC Remote ischemic conditioning in stroke and intracranial atherosclerosis.

7th International Congress of Intracranial Atherosclerosis (ICAS 2014), Chengdu, China, September 2014

impact on the integrity of synaptic circuitry.

Albany Medical College, Center for Neuropharmacology and Neuroscience (CNN) Seminar Series, Albany, N.Y., September 2014

Hess DC Remote ischemic conditioning. Session on peripheral to central signaling.

Brain Edema 2014 and 2nd Preconditioning Conference, Huntington Beach, Calif., September 2014

Kirov SA Window into the injured brain: live imaging of brain injury depolarizations and their impact on the integrity of synaptic circuitry.

University of Alabama at Birmingham, Neurobiology Seminar Series, Birmingham, Ala., October 2014

Kirov SA Window into the injured cerebral cortex: live imaging of pathological depolarizations and their

Kirov SA Neuronal and astroglial structural integrity during cortical spreading depolarization.

16th Annual Cooperative Studies on Brain Injury Depolarizations (COSBID) Meeting, Boston, Mass., October 2014 Sukumari Ramesh S, Alleyne CH, Dhandapani KM Suberoylanilide hydroxamic acid (SAHA) attenuates neurodegeneration and glial activation after intracerebral hemorrhage.

Congress of Neurological Surgeons Annual Meeting, Boston, Mass., October 2014 Hess DC Remote ischemic conditioning: Is it time for clinical trials?—debate.

UCLA-NIH Conference on Collateral Circulation.

Hess DC Multistem (MASTERs) clinical trial.

Presentation to Japanese Neurologists and Neurosurgeons.

Okayama, Japan, November 2014 Kirov SA Mechanisms underlying spreading depolarization-induced dendritic beading.

The 44th SFN Annual Meeting, Washington D.C., November 2014 (poster) Steffensen AB, Sword J, Croom D, Kirov SA, MacAulay N Mechanisms underlying spreading

Giller CA Surgery for essential tremor.

Updates for best medications and strategies, Georgia Regents University, December 2014 Shakir B, Choudhri HF, Solares A C1 lateral mass reconstruction after nerve sheath tumor resection.

Georgia Neurosurgical Society Fall Meeting, Greensboro, Ga., December 2014

Names in blue indicate faculty members or residents in the Georgia Regents University neurosurgery or neurology departments.

Volume 12 | Issue 1 gru.edu/neuro

9

THANKS TO OUR DONORS A & A Minit Mart A.R. Staulcup Foundation Joseph Abstance Aiken County Board of Education Nettie N. Albrecht Allergan Inc. ALS Association of Georgia Inc. Thomas Amerson Janet B. Amoss Charles Angstadt Pamela Apple Nancy Aquino Joan C. Arazie Elissa P. Armstrong Susan A. Asbill Miriam Y. Atkins Augusta Office Solutions Diane Azzarano Wendy Baggott Steve Bailey Scott Ball Sankar Bandyopadhyay Alfred F. Barefield Tina Barham Jeanette R. Barker Amanda G. Barnes Rosa Barnett Mandy Battle Wayne Battle Battle Lumber Co. Inc. Beat Feet For ALS Marivic Beebe Charles H. Bennett Sara Bennett Josh Bernstein Barbara Berton Best Friends Child Care Herman Bingham Carroll Binns Janet Black John A. Black Tara Black Kathleen Blaine Nancy Blanchard Patricia A. Blanco Debbie Blatt Ernest Blizzard Shannon M. Blizzard Joanne M. Blount Richard D. Blume Bob Hagen Insurance Agency Inc. April Boham Jean Bolick Criscelina Boo Sarah Boozer Melissa C. Borders Marcella Borelli Janice Boswell Julie Bower Heather Bowman Kasey Bozeman

10

Melba Bradford Eric V. Bradley James R. Bradley Caroline B. Brady Eileen V. Brandon Shirley Branson Donald C. Bray Beth K. Brett Brigance Brigade Foundation Inc. Ruth L. Brinson Barandy Brock Arthur L. Brooke Bonnie Brooks Marques Brooks Virginia F. Brown William Brown Jason Bruder Bulloch Fertilizer Co. Inc. Lisa Bunch Kim A. Burdeshaw Burke County High School Claire T. Burkelman Eddie Burns Corinne Burstein Brenda K. Butts Brian Byler Edmund G. Byne Jeanne Calabrese Joann Carroll Beth Carter David W. Cartledge Rebecca Casey Ruth Castillo Daniel Chapman Cynthia Chappell Charmed Spa LLC Charlotte A. Chatto Margaret E. Cheney Melissa S. Chesser Jonathan Christenbury Tammy Claxton Preston Clay Douglas P. Clepper John Coleman Michelle R. Coleman Kelli Collins Frances Combs Community Foundation of Greenville Inc. Craig Condon Kristyn Coogler Kathy Cooper Keri Cooper Peggy Cooper Karel K. Copenhaver Gregory T. Coursey Donna L. Cowan Brian Cozart Laura R. Craft Ruth Ann Crider Doris Crouse Denise Crowe

NEUROSCIENCE OUTLOOK ď ˝ Volume 12 | Issue 1

Your support is essential to advancing the research and community care goals of the neurosurgery and neurology departments.

Angela Dams William L. Daniel Deborah R. Davis Hillary Deering Jane DeLoach Charles A. Denney Robert E. Dicks III Donald H. Bailie Agency Inc. Kimberly V. Donaldson Dorchester School District Two Amber A. Dowdy Jerry Dowdy Pamela Drake Brenda S. Durant Judith B. Dutterer DWC Solutions LLC Ed Dismukes Plumbing Inc. Allen W. Edmunds Cynthia Eiring Michael S. Ekre Bonnie Ellinger Elliott Sons Funeral Home Emily Hudgens Design LLC Lynne A. Entrekin Gabriella Epperly Grace Eubanks L. Janet Eubanks Tremain Eunice Ellen Evans Jo A. Evans Michelle R. Evans Evans Middle School Pia M. Ferrario Matthew Fincher Ashton Finley Joseph Fischbein Jennifer Fisher Judith Fleenor James K. Floyd Kelley Flynn Ernest Fokes Naeemah Foster Russell E. Foster Mary Fowler Lee K. Fox Richard Frame Barbara Frazier Kevin B. Frazier Christopher A. Fulmer September D. Fulmer David J. Fulton Valerie Furman Paul R. Gage Janet Garman Stacey Garner Tammy Garner Renae Gasser Douglas L. Gatchell Francy M. Geiger Luciana Geiselhofer Gregory Gerlach

Billy (Dan) Gibson Harry M. Gillam Martha Gilmartin Charlotte L. Gilmore Thomas E. Glass Dale Godby Carole E. Goff Kimberly Goldman Barry J. Goldsmith Gordy Sidetrack Company Inc. Jeffrey Gorelick Miriam Graham Mary Gregg Betsy Griffeth Nancy E. Griffis Caitlin Groeber Sylvia Gross GRU College of Nursing BSN 2015 SGA David L. Gunnels Rose Haas Myrna W. Hackett Leisa Hadden Tamalia Hairr Catherine Hale Cynthia T. Hale James Hale Gaye O. Hall Kathy Hall William Hallmon Patsy Hammond Elise Hannigan Thomas Harper Roger Harris Harris Foundation Mary Hart Sarah J. Hartung Hajra M. Hasan Havre De Grace High School Leah Haworth Navicent Health Edwina F. Heath Glenn Heffner Carol C. Henderson William A. Henshall David Hewitt Linda Higgins Mildred L. Hobbs Sally C. Holland Ron Honeycutt Donna S. Hood Kim Hooks Thomas Hoover Manton Horton Richard Horton James M. Houser Helen S. Hughes David Huskey Gina P. Hutto Ben Inabinet Ashlee H. Inman Janet Inman

Integrity Medical Barbara B. Jackson Marlee Jamison Reynolds G. Jarvis Cheryle L. Jennings Kay Jesse John L. Armstrong Inc. Daniel L. Johnson Matthew Johnson Maxine G. Johnson Meredith D. Johnson Sheri Johnson Theodore S. Johnson Amanda Johnston Rebecca Johnston Manja F. Jonas Anthony Jones Dallas Jones Randall Jones Robert H. Jones Walter R. Jones Wendy Jordan Journeys of Wesley United Methodist Church Just Scott Designs Inc. d/b/a Frills & Fancies Toni Justus Peter Kaeding Dennis Kase Kathy Hodge Oakbrook Elem. School Anne Katzer Julie S. Kelley Nancy Kiernan C.L. Kight Kenneth R. Kimberly Kimberly-Clark Corporation–Beech Island Mill Kimberly-Clark Foundation Pamela W. King Sandra J. King Philip Kinzer Diane Kirk Geri Klein-Shank Bernard Kost Catherine Kottyan Jason Kozel Philip J. Kraker Judith L. Kriegel Jeanette Kroger Deanna Kwan Lando Church of God Molly Lane Frank T. Lanier Russell Larcombe Doreen Larimer Amanda Lawrence Stanley Lawrence Ki H. Lee Natalie H. Lee Carolyn Leggio Jodi W. Lerman

Susan K. Lesshafft Cameron Lewis Carolyn Liebau Matthew Liebman Alton L. Lightsey Lesley Lightsey Lindblom Class of 1974 Brad Lindsey Janis Lindsey Martha Livesay Janie Livingston Lance Logan Julie E. Logue Laura S. Logue Louisville & Wadley Railway Company Timothy B. Lumpkin Lundbeck LLC Candace Lydakis William L. Macuch Rebecca J. Magnotta-Easley Khalid Malik Lisa Mallory Carol G. Mann Mark Mansfield Wade J. Marchman Mark C. Marcum Mary Markle James Marthaller Cynthia Martin Angela M. Maskey Lisa Matfess Carol Mavity Jill Maxwell Amber Mayo Carol F. Mays F.L. Mays Maria A. Mays Shanna H. McBride Ashlie McClellan Kathryn McCoy Dionne H. McCracken Michael McDargh Barbara McDougald Michelle E. McGee Herbert E. McGinty Lisa McGrath Pamela C. McGraw Donny B. McKellar Daniel McKeon Kathleen M. McKie Nancy L. McNair Kenneth McPherson Medical Services of America Inc. Medtronic Annice Meeler Lauren Megill-Milton Lin Mei Ashley Melton Cliff Melton Catherine Merrills Mary Merz Meybohm Realtors LLC Iris Middleton

Kathleen Mihalyak Grace Milford Barbara Miller Linda Miller Stacie Miller Brian W. Mitchell Rebecca C. Mobley Judith A. Montgomery Alan Morris Brenda Morris Morris Marketing Karl J. Munschy Merv Murdock Lynn B. Murray Tammy Murrell Christine Nelson Raymond Nelson Tommy New Laura B. Newton Jaidyn Nguyen William L. Nichols Anne Norviel Sherryl Norviel D. Kevin Nusbaum Dean E. Nusbaum Heidi Oates Susan O’Brien Patricia S. Odom Billie S. Oldham Patricia O’Neill Randie Osgood Melissa Padgett Francesco Palumbo Holly Papstein PAR Fore Parkinson’s Inc. Nancy M. Parks Sonja Parks David Paterson Ryan Patrick Susan Payne PCS Administration Inc. Richard H. Peacock Artince Pearson Yelena Pecheny Carol L. Peters Brad Petersen Judy Peterson Jayne Petrak Jane S. Petro Marilyn Petty Phi Mu-Kappa Chapter Photography by Anna Bowick Pierson Property LLC Ann M. Pittel Planters First Bank–Perry Kevin D. Plummer Robert J. Pollock Donna W. Posey Chera L. Poulin Cheryl P. Pounds Alison B. Powell Karen Powell Precision Pallet Joyce P. Presby Barbara Pressey

Jeffrey Privett Christine Probert Dagmara Pychynski Brandy M. Quarles Sheryl J. Quick Mary Sue Rachels Keith Radick Catherine Ramsey Donna K. Rayner Cathy Reece Marian D. Reeves Suzanne N. Reeves Gary A. Reitz Janice Repetske ResMed Resolute Forest Products James Reynolds Frederick W. Ricketson Betty Ricketts Ann Riley Felix Rivera Michael H. Rivner Roger Rivner Anne T. Rizzo Genevieve Rizzo Donald N. Roberson Idelle H. Roberson Jody C. Rocker King Rocker Rockwood Trust (The) Sandra Roe Kimberly B. Rogers Jane N. Rohrbaugh Philip Rosche Roundstone International Inc. Stephanie Rountree Barbara A. Rowe Stacey L. Rucker Linda Rushing Debra Russell Matt Russo Amy Ryan Mihaela Saler Jone Salter Juan Sanchez Betty J. Sanders Kara Sanders Daisy Sandlin Jennifer B. Sandlin Sarah Saunders Stephanie Scangas Pearl Schmitz Roger P. Schurig Paula L. Schwartzman Carroll I. Scott Maree M. Seigler Elizabeth A. Sekul Erin Selby Roseanne M. Selby Edouard J. Servy Kapil D. Sethi Dana Seymore Hemang H. Shah Jeanne K. Sharpe Patricia Shea

Cindy Shehee Barbara R. Shelley Chengyong Shen Cindy W. Sheppard Jack Sheppard Susan M. Sheppard Gloria D. Shivers Barbara W. Sims Carleen D. Skiles Wallace L. Slater SLB Management Group Inc. Gloria Smith Laurie O. Smith Mary M. Smith Melody Smith Walter B. Smith Dana Soule Southeastern Medical Brokers Inc. d/b/a Integrity Medical Deanna Sowa Connie Spann Larry Spencer Stephanie Spinks Sportscuts of Sportscuts of Augusta W.H. Spratling Jeana Stanfield Andrew Stash Joan H. Steinberg Anne K. Still Thomas Still Yvonne O. Stone Marjorie M. Story Pamela Strickler Alicia Stroble Robert Sullivan Supernus Pharmaceuticals Inc. Annie Swan Carolyn L. Swan Laura B. Swan Kim Swigart T. W. Josey High School Takosushi, Inc. Cathy C. Tankersley James D. Tarver Melanie A. Taylor Nancy C. Taylor Robert L. Thatcher Teresa H. Thirkell Dominee Thomas Thomas Jefferson Academy Jon Thompson William R. Thompson Mae S. Timmerman Eve Tomberlin Tonya J. Torek Rita Torner Martin B. Travis Mark Tribby Bonnie M. Troiano Chris Tuck James Turner

Varena M. Turner Henderson C. Upchurch Thomas Vandell Nitzmari M. Vazquez ViaCord Sydnee Voigt W O W Camp #1436 Anthony E. Wagner James L. Wagner Joann Walden Jerri Wall Tammy L. Wallace (No First Name) Walter Rebecca B. Ward Corrina Warner Warren Baptist Church Vanessa L. Washington-Griffin Sherry A. Waters Clifford Watson Alan W. Watts Kaye W. Weathers Carrie Weaver Holly B. Weaver Marsha Weaver Kim Webb Denise R. Webster Dianne G. Weeks Richard Weiers Tina Weinstein Bethany L. Welsh Edward J. Westbrook Ronni Whitebook Margaret O. Wilkes Amy Williams Harry Williams Susan M. Williams Gene Willich Rhonda Willis Andrew Wilson Jim Wilson Julie A. Wilson Mary E. Wingate Michael Wofford Christopher Wolfe Womble Carlyle Sandridge & Rice LLP Courtney Wood Robert Wood Deborah Wright Louise M. Wright Roy Wright Theresa Wright James Wyant Roger L. Yancey Nicole Yarab Annetta York Linda Youmans Shirley H. Youngsman Robert K. Yu James H. Zamora Joshua Ziolkowski

Volume 12 | Issue 1 gru.edu/neuro

11

Georgia Regents University 1120 15th St., T101 Augusta, GA 30912

NON-PROFIT US POSTAGE

PAID

GEORGIA REGENTS UNIVERSITY

GRU-015

January–April 2015

CONFERENCE SCHEDULES

Neurosurgery Jan. 2 No Conference

March 13

Jan. 9 Interviews 10 a.m.

Jan. 16 11 a.m.

Case Conference

10 a.m.

Oral Board Neuro 101 — Dr. Shakir Case Conference

Oral Board Review

9 a.m.

Resident Meeting

Business

10 a.m.

Pathology — Dr. Sharma

11 a.m.

Journal Club

10 a.m.

March 27

noon

Case Conference

10 a.m.

Pathology — Dr. Sharma

noon

M&M

Journal Club

11 a.m.

Radiology

noon

Case Conference

10 a.m.

Gamma Knife

April 3

noon

M&M

11 a.m.

Radiology

noon

Case Conference

11 a.m.

Gamma Knife

noon

Case Conference

noon

Case Conference

10 a.m.

Board Review

10 a.m.

Anatomy

April 10 11 a.m.

April 17 11 a.m.

Neuro 101 — Dr. Yowtak

Business

Neuro 101 — Dr. Woodall

noon

Case Conference

noon

Case Conference

9 a.m.

Pathology — Dr. Sharma

10 a.m.

Resident Meeting

10 a.m.

Resident Meeting

11 a.m.

Journal Club

noon

M&M

Feb. 20 11 a.m.

Feb. 27 11 a.m.

March 6

noon

noon

Case Conference

Jan. 30 11 a.m.

Feb. 13

Radiology

March 20 11 a.m.

Gamma Knife

noon Jan. 23 11 a.m.

Feb. 6

Anatomy

11 a.m.

Journal Club

noon

M&M

11 a.m.

Anatomy

noon

Case Conference

April 24

Neurology

Meeting Schedule AANS/CNS Section on Cerebrovascular Surgery, Feb. 9–10, Nashville, Tenn.

International Stroke Conference, Feb. 11–13, Nashville, Tenn.

AANS/CNS Section on Disorders of the Spine & Peripheral Nerves, March 4–7, Phoenix, Ariz.

Southern Neurosurgical Society, March 25–28, Naples, Fla. Comprehensive Stroke Management Update 2015, April 10–12, Hilton Head, S.C. American Academy of Neurology, April 18–25, Washington, D.C. American Association of Neurological Surgeons, May 2–6, Washington, D.C.

Jan. 1 No Grand Rounds: Holiday

March 5 Dr. Suzanne Smith

Multiple Sclerosis

Jan. 8 Dr. Ned Pruitt

March 12 Dr. Tom Swift

Case Presentation

Jan. 15 Dr. Yong Park

Epilepsy

March 19 Dr. Jeff Switzer

Stroke

Jan. 22 Dr. Klepper Garcia

Neuro Critical Care

March 26 Dr. Michael Rivner

Neuromuscular

Jan. 29 Dr. Askiel Bruno

Resident Rank Meeting

April 2 Dr. Nancy McNair

Feb. 5 Dr. Anthony Murro

Epilepsy

April 9 No Grand Rounds: Masters Week

Feb. 12 Dr. Tom Swift

Case Presentation

April 16 Dr. Debra Moore-Hill

Epilepsy

Feb. 19 Dr. John Morgan

Movement Disorders

April 23 No Grand Rounds: AAN Meeting

Feb. 26 Dr. Elizabeth Sekul

Child Neurology

April 30 Dr. Subhashini Ramesh

All neurology conferences are held from 8-9 a.m.

Neuro Critical Care