Neuroscience outlook vol 12 issue 3 by Augusta University

A Triannual Publication of GRHealth

NEUROSCIENCE OUTLOOK News and Research from the Departments of Neurology and Neurosurgery

VOL. 12 | ISSUE 3

VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

FROM THE CHAIRMEN

DEAR READERS, This is the 26th issue of Neuroscience Outlook. Our

newsletter was initiated in 2004 as an instrument to dis-

seminate the newsworthy clinical and research items from the Department of Neurosurgery.

In 2013 the contributions of both the Neurology and

Neurosurgery departments were combined, consistent with our common clinical, research and teaching goals and our

close working relationship. We are immensely proud of our collective contributions.

We continue to treat the sickest and most complicated From left: Cargill H. Alleyne, Jr., M.D. Professor and Marshall Allen Distinguished Chair of Neurosurgery David C. Hess, M.D. Professor and Presidential Distinguished Chair of Neurology

patients as indicated by our increasing case mix index.

Our clinical expertise is evidenced by the fact that 8 of our collective faculty have received the â&#x20AC;&#x153;Best Doctorâ&#x20AC;? designation, one afforded to only 10 percent of U.S.

physicians. We remain committed to improving the health of our future patients

by working tirelessly in our clinics and research laboratories to innovate new therapies and delivery mechanisms for common and uncommon diseases.

This issue is replete with examples of this commitment such as the REACH

telemedicine system cited as the top 25 breakthroughs in Georgia and reaccredita-

tion of our Advanced Comprehensive Stroke Center (news from our department), innovative minimally invasive spine procedures (clinical spotlight) and multiple hippocampal subpial transections as a treatment for epilepsy (clinical spotlight). Our commitment to education can be seen in our academic pro-

ductivity including the 42 presentations (many international) given in a short 4-month reporting period.

We hope you find this issue both informative and enjoyable.

IN THIS ISSUE VOL. 12 | ISSUE 3

faculty & staff update________________4

Neuroscience Outlook is produced triannually by the Medical

College of Georgia Departments of Neurology and Neuro-

Resident Update______________________5

surgery and the Georgia Regents University Division of Communications and Marketing. Please direct comments or

department news_____________________6

questions to marketing@gru.edu.

Schedules____________________________7

Editor-in-Chief: Cargill H. Alleyne, Jr., M.D.

clinical spotlight: Minimally Invasive Spine Surgery________________8

Illustration: Colby Polonsky, M.S.

clinical spotlight: Multiple Hippocampal subpial transections___10

Contributors: Jonathan A. Tuttle, M.D., C. Arturo Solares, M.D., Cole Giller, M.D., Ph.D., M.B.A., Anthony Murro, M.D., Yong Park, M.D.

publications & presentations_________12 Thank you, Donors___________________13 the clinical team_____________________15 upcoming meetings___________________16

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VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

FACULTY & STAFF UPDATE Cargill H. Alleyne, Jr., M.D. (Department of Neurosurgery) was selected as one of the Best Doctors in America for 2015-16. He was also the moderator of “Topic Updates in Neurology and Neurosurgery” at the National Medical Association Meeting in Detroit, Michigan in August 2015. James E. Carroll, M.D. (Department of Neurology) was selected as one of the Best Doctors in America for 201516.

Cole Giller, M.D., Ph.D. (Department of Neurosurgery) was selected as one of the Best Doctors in America.

David C. Hess, M.D. (Department of Neurology) was selected as one of the Best Doctors in America. He was awarded an NIH/NINDS R21 grant “Remote ischemic conditioning for neuroprotection in vascular cognitive impairment” (R21NS081143-01, $500,000 direct costs July 1, 2015-June 30, 2017). He was also the principal investigator awarded a NOA NINDS/ SBIR grant with NeuroFx “Development of a stroke therapy targeting both neuroregeneration and protection” (1R43NS092167-01A1with NeuroFx, November 2015 to June 2016) and awarded an intramural UGA/GRU Program Award “A porcine model for vascular cognitive impairment” with Franklin West (UGA). In addition, he served on the NIH Review Panel NIH-NIBIB “Medical Technologies to Reduce Health Disparities” (SBIR, R43/ R44) on June 24, 2015. Sergei A. Kirov, Ph.D. (Department of Neurosurgery) was the discussion leader/session co-chair of Targeting Spreading Depolarizations in Injured Brain: Triggers, Modulators and Causation at the XXVIIth International Symposium on Cerebral Blood Flow, Metabolism and Function (Brain 2015) in Vancouver, Canada, in June 2015.

S. Dion Macomson, M.D. (Department of Neurosurgery) was selected as one of the Best Doctors in America for 2015-16.

Lin Mei, Ph.D., and Michael Rivner, M.D. (Department of Neurology) were awarded an NIH grant “Characterization of Agrin/LRP4 antibody-positive myasthenia gravis” (NIH 1 R01 NS090083-01A1, July 1, 2015 – June 30, 2020, Direct Cost: $394,612 per year). J. Ned Pruitt, M.D. (Department of Neurology) was the course director of “Seizures, Shakes and Spells: Neurology for the Non-Neurologist”, a GRU CME course hosted by the Department of Neurology in July in Kiawah Island, South Carolina. Elizabeth A. Sekul, M.D. (Department of Neurology) was selected as one of the Best Doctors in America for 2015-16.

Kapil D. Sethi, M.D. (Department of Neurology) was selected as one of the Best Doctors in America for 2015-16.

Jonathan A. Tuttle, M.D. (Department of Neurosurgery) was co-director of the Annual GRU Spine Conference in May.

John R. Vender, M.D. (Department of Neurosurgery) was selected as one of the Best Doctors in America for 2015-16.

RESIDENT UPDATE Farewell

Welcome Basheer Shakir, M.D., was honored at the annual neurosurgery graduation ceremony in June. Dr. Shakir is currently completing a fellowship in complex spine at the University of Miami, Florida.

This July, we welcomed our new PGY-1 neurosurgery resident Christopher Banerjee, M.D. Dr. Banerjee graduated from the University of Miami.

Four new PGY-1 neurology residents and four PGY-2 were also welcomed.

Residents completing the neurology program in June were: Brandi Fleenor, M.D., who is now completing a clinical neurophysiology fellowship at GRU

PGY-1 residents: Lydia Searcy from Georgia Regents University Belachew Arasho from Addis Ababa University Michael Nahhas from University of Damascus

Feroze Afzal, M.D., completing a vascular neurology fellowship at GRU

Uttam Verma from Dayanand Medical College. PGY-2 residents: Karl Knights, M.D., from Georgia Regents University

Jennifer Davis, M.D., completing a movement disorders fellowship at GRU

Abraham Chileuitt, M.D., from American University of the Caribbean

John Edry, M.D., who joined a private practice group in Athens, Georgia

Brian Cravanas, M.D., from University of South Alabama

Makambo Tshionyi, M.D., from the University of Illinois.

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VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

NEWS from the DEPARTMENTS (January-April)

Advanced Comprehensive Stroke Center reaccredited After a rigorous recertification process by the Joint Commission our Advanced Comprehensive Stroke Center was reaccredited effective May 6. Our center was the first comprehensive stroke center in Georgia and the second in the Southeast to be accredited by the Joint Commission in 2013. Comprehensive Stroke Center Certification was developed in collaboration with the Brain Attack Coalition and the American Heart Association/American Stroke Association. There are roughly 80 centers in the U.S. equipped with the resources, including neurological critical care and 24-hour availability of endovascular neurosurgeons, to deal with the most severe strokes. Georgia Research Alliance cites REACH as one of the 25 breakthroughs in Georgia The REACH telemedicine system pioneered by Dr. David Hess (Department of Neurology) and his team (Grant Kohler, Sam Wang, Bill Hamilton, Hartmut Gross and Fenwick Nichols) in the early 2000s was listed as No. 12 of 25 breakthroughs in Georgia by the Georgia Research Alliance (GRA) as it celebrates its 25th year. The specialized telemedicine program enables neurologists to diagnose a potential stroke remotely utilizing a flexible in-room camera through which patients can be interviewed and examined. The software integrates CT images, diagnostic tools, dosage recommendations and decision support, minimizing wasted time. Hospitals using the system successfully administered t-PA at a rate of nearly 35 percent, compared to under 10 percent nationally. REACH Access has expanded well beyond its roots in rural Georgia to serve hundreds of hospitals nationwide. It is also now used outside the stroke arena and currently used to treat patients in need of psychiatric evaluations, intensive care, pulmonology and general neurology consultations. REACH was launched with the support of GRA, which expands research and commercialization capacity in Georgia’s universities to launch new companies, create high-value jobs and transform lives. Neurology and Neurosurgery faculty cited to Best Doctors list Four neurologists and four neurosurgeons were named one of the Best Doctors in America for 2015-2016 (see Faculty update). This designation is given to the top 10 percent of U.S. doctors. 6

Neurology chairman edits book Dr. David Hess edited the book, “Cell Therapy in Brain Injury” published by Springer Verlag. In addition he was appointed as Associate Editor of “Translational Stroke Research” and to the editorial board of “Brain Circulation.” Neurosurgery chairman publishes second educational children’s book Dr. Cargill Alleyne recently published “Bart’s Heart” a second in his series of educational children’s texts designed to present facts about the human body in an entertaining, colorful manner from the perspective of a child. The first, “Ned’s Head,” won an Honorable Mention at the Royal Dragonfly

Books Awards in 2012. The books consist of 16 verses in limerick form. “Bart’s Heart” was illustrated by Colby Polonsky and “Ned’s Head” by Mike Jensen (now assistant professor in the Department of Medical Illustration) and Karen Bradley. All three illustrators graduated from GRU’s Department of Medical Illustration (in the College of Allied Health Sciences), one of only four accredited such departments in the world. Future books planned include “Joan’s Bones,” “Nellie’s Belly,” “Malachi’s Eye” and “Russell’s Muscles.”

Neurosurgery Conference Schedule September-December 2015 September 4 10 a.m. Anatomy 11 a.m. Business (Dr. Giller) 12 p.m. Case Conference September 11 10 a.m. Oral Board Review 11 a.m. Neuro 101 (Dr. Macomson) 12 p.m. Case Conference September 18 10 a.m. Radiology 11 a.m. Functional (Dr. Giller) 12 p.m. Case Conference September 25 10 a.m. Resident Meeting 11 a.m. Journal Club 12 p.m. M&M October 2 10 a.m. Anatomy 11 a.m. Business (Dr. Giller) 12 p.m. Case Conference

October 9 10 a.m. Oral Board Review 11 a.m. Neuro 101 (Dr. Rahimi) 12 p.m. Case Conference October 16 10 a.m. Radiology 11 a.m. Functional (Dr. Giller) 12 p.m. Subarachnoid Hemorrhage (Dr. Alleyne) October 23 10 a.m. Resident Meeting 11 a.m. Journal Club 12 p.m. M&M October 30 12 p.m. Faculty Meeting November 6 10 a.m. Anatomy 11 a.m. Business (Dr. Giller) 12 p.m. Case Conference

November 13 10 a.m. Oral Board Review 11 a.m. Neuro 101 (Dr. Vender) 12 p.m. Case Conference November 20 Resident Applicant Interviews November 27 Holiday December 4 10 a.m. Anatomy 11 a.m. Business (Dr. Giller) 12 p.m. Case Conference December 11 Resident Applicant Interviews December 18 10 a.m. Resident Meeting 11 a.m. Journal Club 12 p.m. M&M December 25 Christmas

NEUROLOGY GRAND ROUNDS SCHEDULE September-December 2015

2015 September 3 September 10 September 17 September 24 October 1 October 8 October 15 October 22 October 29 November 5 November 12 November 19 November 26 December 3 December 10 December 17 December 24 December 31

Dr. Ed Hartmann: Neuromuscular Dr. Jeff Switzer: Stroke Dr. David Hess: Stroke Dr. Fallaw: ICD 10 Training Dr. Debra Moore-hill: Epilepsy Dr. Tom Swift: Case Presentation Dr. Nancy McNair Dr. Tom Swift: Case Presentation Dr. Fenwick Nichols: Stroke Dr. Kapil Sethi: Movement Disorders Dr. Michael Rivner: ALS Dr. Julie Kurek: Movement Disorders No Grand Rounds: Holiday Dr. Alfredo Garcia:: Neuro Critical Care Dr. Tom Swift: Case Presentation Dr. Mary Gregory: Child Neurology No Grand Rounds : Holiday No Grand Rounds: Holiday 7

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VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

CLINICAL SPOTLIGHT

minimally invasive spine surgery Minimally invasive spine surgery has been show in studies to be equivalent in long-term follow-up to open spinal surgery. Advances in instrumentation and retractors have allowed for these approaches. Patient selection is at the heart of spine surgery and is a key factor in outcomes, a measure that is increasingly important for reimbursement. We would like to highlight two recent cases.

case 1

A 37-year-old female presented nearly two years prior with basilar impression and a retroverted dens (figure 1a). She complained of a history of migraines, lower facial numbness and upper cervical pain but was not myelopathic on examination. She returned a month later complaining of progressively worsening hand clumsiness and right hand numbness that prevented her from crocheting. At the time of her return, she had seen three different spine surgeons and wanted to move forward with an occipital to cervical fusion. She underwent an uncomplicated occipital to the fifth cervical fusion (figure 1b). Initial postoperative follow-up visits were rewarding as she had improvement in the hand clumsiness and headaches as well as some decreased hand numbness. These benefits seemed to be tempered by paraspinal muscular pain requiring continued muscle relaxant use for relief. Nine months later, she returned with significant right upper extremity numbness and weakness after a manual labor task required by her workplace. Although our prior discussions included the potential for an odontoidectomy, we treated her conservatively, and she made significant improvement. The acute worsening was enough, however, to prompt her to request delayed surgery as the work-related task could have presented itself again.

Jonathan A Tuttle, M.D. and C. Arturo Solares, M.D.

Traditional odontoidectomy is performed via a transoral approach. Fortunately, a newer and less morbid option has been reported. Goldschlager et al1 had published a series of nine patients, which illustrated a significant reduction in time to extubation and time to feeding (0.3 and 1 day, respectively), when an endoscopic endonasal odontoidectomy was utilized. This compares favorably to the transoral approach-related time to extubation and feeding of 3.5 and 5.2 days, respectively. The endoscopic endonasal approach is limited by the eustachian tubes, nasal bones and the soft and hard palates. The anatomy was favorable for this approach in our case. The procedure, which was the first endoscopic endonasal odontoidectomy at GRU, was performed jointly with Dr. Arturo Solares (Department of Otolaryngology) utilizing Stealth navigation to augment the endoscope. The operative time, including septectomy, was 4 hours and 6 minutes. Estimated blood loss was 50 cc. Figures 1c, d, e, and f show an intraoperative endoscopic view and postoperative images. The patient was extubated postoperative day 1. Speech therapy cleared her for a diet on the same day. She was discharged postoperative day 3. At two-and-a-half months after surgery, the patient had with increased facial sensation and was pleased with the result. She continued to complain of neck stiffness and muscular soreness.

Figure 1a

Figure 1c

Figure 1e

Figure 1b

Figure 1d

Figure 1f 8

case 2

minimally invasive spine surgery

A 74-year-old gentleman presented with a complaint of progressive neurogenic claudication recalcitrant to conservative treatment. He had history of a minimally invasive discectomy followed by a unilateral L4-S1 percutaneous fusion (figures 2a and b). His X-rays did not reveal dynamic instability. An MRI of the lumbar spine revealed significant stenosis from L1-4 (figure 2e).

Jonathan A Tuttle, M.D.

He was offered a minimally invasive lateral transpsoas interbody fusion for indirect decompression versus an open posterior decompression and extension of hardware. He chose the minimally invasive approach. Postoperatively, his leg pain resolved, and he was ambulating further compared to his preoperative status.

Figure 2a

Figure 2c

Figure 2e

Figure 2b

Figure 2d

Figure 2f

Figure legendS Figure 1a: Preoperative MRI (sagittal T2-weighted image) shows the basilar impression and a retroverted dens.

Figures 2a and b: Lateral and AP radiographs show the preoperative instrumentation.

Figure 1b: Preoperative CT (sagittal image) shows the O-C5 fusion

Figures 2c and d: Intraoperative lateral and AP images show the interbody cages in place.

Figures 1c and d: Intraoperative views are seen via the endoscopic endonasal approach.

Figure 2e: Preoperative lumbar MRI (lateral view) shows significant lumbar stenosis at L1-2, L2-3 and L3-4.

Figures 1e and f: Postoperative CT (sagittal and coronal views) show the odontoidectomy.

Figure 2f: Postoperative lumbar MRI (lateral view) shows L1-4 interbody cages with impressive indirect decompression of the spinal canal and improved lumbar lordosis. The L5-S1 disc space has been stable for years and was included in his previous percutaneous L4-S1 fusion.

1. Goldschlager T, Hartl R, Greenfield JP, Anand AK and Schwartz TH: The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding. J Neurosurg 122:511-518, 2015.

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CLINICAL SPOTLIGHT

multiple hippocampal subpial transections case Report

Cole Giller, M.D., Ph.D., Anthony Murro, M.D. and Yong Park, M.D.

A 44-year-old woman presented with intractable partial complex seizures that had worsened over 10 years and now occurred twice each month despite maximal medical therapy. They were typified by an indescribable aura followed by lip smacking, hand automatisms, right arm extension and right versive head movements. She worked as a secretary and depended on her memory and other cognitive skills. Her Phase I evaluation included video/EEG monitoring that confirmed complex partial seizures arising from the left temporal area. An MRI was normal, and a PET scan showed decreased uptake in the left temporal lobe. An ictal SPECT scan showed increased activity in the left temporal lobe. A Wada study showed left-sided language dominance with preservation of memory during both right and left injections. The estimated risk of significant verbal memory decline after a left temporal lobectomy was 90 percent. These data showed that the risk of a disabling decline in verbal memory after resection would be high but that she was otherwise a candidate for a left temporal lobectomy. Invasive monitoring was therefore recommended to determine whether seizure onset was limited to the lateral temporal lobe, so that the mesial temporal lobe structures – those serving memory

Discussion

Temporal lobe epilepsy is the most common form of partial epilepsy in adults. Since the 1950’s, temporal lobectomy has been widely applied to temporal lobe epilepsy, and there is Class I data showing that it is superior to medical therapy alone2. However, memory deficits are not uncommon after temporal lobectomy in the absence of hippocampal sclerosis or atrophy. Multiple subpial transection (MST) was designed by Morrel in 1989 to surgically treat neocortical seizures arising from eloquent cortex3. In this procedure, a series of slices perpendicular to the long axes of the involved gyri are made in order to disrupt the horizontal interneuronal connections while minimizing damage to the underlying columnar structure supporting cortical function. Although the cytoarchitecture of the hippocampus is different from that of the cortex, the principles of MST are the same. In a pioneering study, Shimizu followed 17 patients after hippocampal MST. After one year, 82 percent were seizure-free, 12 percent had rare seizures and 6 percent had a significant reduction in seizures1. Rey Auditory Verbal Learning Test scores 10

– could be spared. Three depth electrodes were stereotactically placed to traverse the lateral temporal lobe before reaching the hippocampus, followed by placement of surface grids over the lateral surface of the left temporal lobe through the craniotomy (Figure 1). The monitoring unfortunately confirmed that her seizures arose from both the posterolateral temporal lobe as well as the mesial structures, including the hippocampus. Because a standard temporal lobectomy could not be offered, a procedure was designed to preserve function in two ways. First, the craniotomy was performed with the patient awake so that her language centers could be identified and spared. Second, instead of resecting the hippocampus, multiple subpial transections (MST) were performed in which a series of incisions were made at 3 to 4 mm intervals along the hippocampus to disrupt its seizure pathways (Figures 2, 3 and 4). Pioneered in Japan in the early 2000s1, hippocampal MST can often effectively treat epilepsy without complications of memory impairment. The patient is seizure-free one year after surgery, and a medication wean is planned. Her memory remains intact. She reports improvements in her social function and energy, and she has successfully resumed employment. were at baseline or rose in all but one patient four weeks following surgery. After a follow-up of up to three years, none of the patients showed MRI changes in the transected hippocampus. More recently, Patil and Andrews followed 15 patients after hippocampal MST for at least two years4. Each patient received additional surgery: all received neocortical MST; 11 underwent resection of the temporal tip; and 10 received an amygdalectomy. The results are therefore not solely those of hippocampal MST, but 14 of the 15 patients were seizure-free, and the remaining patient had rare seizures. Neuropsychological studies showed preservation of verbal memory.

Summary

While only a few centers currently offer this new surgical method, hippocampal MST has been found to effectively control seizures while preserving hippocampal function for patients with mesial temporal lobe epilepsy without hippocampal atrophy. This technique is particularly useful to those patients requiring temporal lobectomy for seizure control who are at high risk for memory impairment.

multiple hippocampal subpial transections

Figure 1

Figure 3

Figure 2

Figure 4

Figure legend Figure 3. Composite MRI reconstruction showing hippocampus (blue) after temporal lobectomy. Orientation is that of Figure 2.

Figure 1. Composite reconstruction from preoperative MRI and postoperative CT scan showing grids placed on the neocortical surface (yellow), subtemporal strips (green) and hippocampal SEEG electrodes (blue).

Figure 4. Operative photo of anatomy depicted in Figure 3 with the same orientation. Arrow points to hippocampus. Inset is a magnified view of the hippocampus showing a few of the subpial transections.

Figure 2. Diagram showing surgical exposure (red).

1. Shimizu H, Kawai K, Sunaga S, Sugano H, Yamada T. Hippocampal transection for treatment of left temporal lobe epilepsy with preservation of verbal memory. J Clin Neuroscience. 2006;13:322-328. 2. Wiebe S, Blume WT, Girvin JP, Eliasziw M. A randomized controlled trial of surgery for temporal lobe epilepsy. N Engl J Med. 2001;345:311-318. 3. Morrell F, Whisler WW, Bleck TP. Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. J Neurosurg. 1989;70:231-239. 4. Patil AA, Andrews R. Long term follow-up after multiple hippocampal transection (MHT). Seizure. 2013;22:731-734.4.

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VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

PUBLICATIONS & PRESENTATIONS

Members of the GRU Neurology and Neurosurgery departments are shown in bold

(May-August 2015) Presentations: Choudhri HF: Osteotomies for spinal deformity correction. 16th Dubai Spine Conference/1st Arab Spine Society, Dubai, UAE, April 2015. Choudhri HF: New strategies for spine tumor resection. 16th Dubai Spine Conference/1st Arab Spine Society, Dubai, UAE, April 2015. Choudhri HF: MIS vs. open approaches for degenerative scoliosis (Debate). 16th Dubai Spine Conference/1st Arab Spine Society, Dubai, UAE, April 2015. Alleyne CH, Hoda MN, Dhandapani KM: Remote ischemic conditioning improves neurovascular outcomes after intracerebral hemorrhage in mice. Georgia Neurosurgical Society Meeting, Sea Island, GA, May 2015. Giller CA: What condensed matter physics tells us about seizure spread. American Association of Neurological Surgeons, Washington D.C., May 2015. Giller CA: The Arc-Quadrant principle of stereotaxis: used, forgotten, rediscovered and inspired by warfare. American Association of Neurological Surgeons, Washington D.C., May 2015.

Hess DC: Remote ischemic conditioning. 2nd Hypoxia and Preconditioning Conference, Xuanwu Hospital/Beijing Capitol University, Beijing, China, June 2015. Kirov SA: Role of cotransporters in spreading depolarization-induced neuronal swelling. XXVIIth International Symposium on Cerebral Blood Flow, Metabolism and Function (Brain 2015), Vancouver, Canada, June 2015. Steffensen AB, Sword J, Croom D, Kirov SA, MacAulay N: Mechanisms underlying spreading depolarization-induced dendritic beading. 47th Sandbjerg Meeting on Membrane Transport, Sønderborg, Denmark, June 2015. Hess DC: Brain death, minimally conscious and the persistent vegetative state. Critical Care Medicine Symposium, GRU, Kiawah Island, SC, July 2015. Hess DC: Treatment of acute ischemic stroke. Critical Care Medicine Symposium, GRU, Kiawah Island, SC, July 2015. Hess DC: Case studies of dizziness. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Hess DC: New therapies in acute stroke management. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

Hess DC: Cell therapy and preconditioning. University of Miami Department of Neurology Grand Rounds, Miami, FL, May 2015. Kirov SA: Cortical spreading depolarizations: Emerging pathophysiologic mechanisms in the acutely injured brain. University of Helsinki, Neuroscience Center Seminar Series, Helsinki, Finland, May 2015. Rahimi SY: Postoperative pain management with intravenous acetaminophen after craniotomy. American Association of Neurological Surgeons Meeting, Washington, D.C., May 2015. Rahimi SY, Alleyne CH: Complication management and avoidance: Vascular malformations. American Association of Neurological Surgeons Meeting, Washington, D.C., May 2015. Todnem N, Heger I, Tuttle J: Pediatric occipital condyle fixation: Case report and review of the literature. 16th Annual GRU Spine Conference, May 2015 Zaenger D, Rabatic BM, Mourad W, Kaminski J, Vender JR, AlBasheera A, Schulz R, Ryckman J: The potential role of radiosurgical rhizotomy for intractable facetogenic pain: A review of the literature for efficacy and safety. American Association of Neurological Surgeons Meeting, Washington, D.C., May 2015. Woodall MN, Hamilton C, Vender J: Gamma Knife radiosurgery for trigeminal neuralgia at the Medical College of Georgia. American Association of Neurological Surgeons Meeting, Washington, D.C., May 2015. Woodall MN, Macomson SD, Alleyne CH, Rahimi SY: Craniocervical vessel sacrifice using the Amplatzer vascular plug. American Association of Neurological Surgeons Annual Meeting, May 2015.

Moore-Hill D: Differential diagnosis of episodic loss of consciousness. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Moore-Hill D: Case studies of seizure disorders. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Morgan JC: Tremors – Differential diagnosis and management. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Morgan JC: Concussion management and chronic traumatic encephalopathy. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Pruitt JN: Neurological examination: Live demonstration. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Pruitt JN: Doc, I’m weak. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Pruitt JN: Headache – Diagnosis and management. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Pruitt JN: Neurological complications of medical illness - case studies. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Sekul E: Common neurological problems in children. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

Yowtak J, Tuttle J: Thoracolumbar mass: Case report. 16th Annual GRU Spine Conference, May 2015. Yowtak, J: Pediatric temporal lobe epilepsy: Review of the literature. GRU Epilepsy Conference, May 2015.

Sekul E: Attention deficit and hyperactivity disorder. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

publications and presentations Sethi KD: Case studies in Parkinsonism. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

Publications:

Sethi KD: Case studies in Parkinsonism. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

Park JM, Hess DC: Breaking out from the neuroprotective logjam: combined treatment with remote ischemic conditioning and minocycline in the prehospital setting. Neural Regen Res 10:537-9, 2015.

Sethi KD, Moore-Hill D: Psychogenic problems in Neurology. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015.

Alleyne CH: Bart’s Heart. North Charleston, SC, CreateSpace Independent Publishing Platform, July 2015. Kim KJ, Iddings JA, Stern JE, Blanco VM, Croom D, Kirov SA, Filosa JA. Astrocyte contributions to flow/pressure-evoked parenchymal arteriole vasoconstriction. J Neurosci 35(21), 8245-8257, 2015.

Sethi KD: Neurobowl quiz show for the non-neurologist. Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Switzer JA: Diagnosis and management of acute stroke 2015 – the first 3 hours – the first 3 days: Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Switzer JA: Secondary stroke prevention: Seizures, Shakes and Spells: Neurology for the Non-Neurologist, Kiawah Island, SC, July 2015. Alleyne CH: Hemorrhagic stroke from vascular malformations of the central nervous system. National Medical Association Meeting, Detroit, MI, August 2015. Giller CA, Murro A: Epilepsy Surgery. Neurology Grand Rounds, GRU, August 2015.

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VOL. 12 | ISSUE 3 NEUROSCIENCE OUTLOOK

Dr. Rahimi and Dr. Todnem (resident) in the state-of-the-art Philips Allura Xper biplanar angiography suite. 14

The clinical TEAM ALS CLINIC Michael H. Rivner, MD EPILEPSY CENTER Cole A. Giller, MD, PhD Debra Moore-Hill, MD Anthony M. Murro, MD Yong Park, MD Gregory Lee, PhD GAMMA KNIFE CENTER Cargill H. Alleyne, Jr., MD Cole A. Giller, MD, PhD John R. Vender, MD MEMORY DISORDERS John C. Morgan, MD, PhD MOVEMENT DISORDERS Cole A. Giller, MD, PhD Julie A. Kurek, MD John C. Morgan, MD, PhD Kapil D. Sethi, MD MULTIPLE SCLEROSIS CENTER Suzanne H. Smith, MD

NEUROLOGISTS Askiel Bruno, MD James Carroll, MD K. Alfredo Garcia, MD J. Edward Hartmann, MD David C. Hess, MD Julie A. Kurek, MD Gregory Lee, PhD Debra Moore-Hill, MD John C. Morgan, MD, PhD Anthony M. Murro, MD Fenwick T. Nichols III, MD Yong Park, MD J. Ned Pruitt II, MD Michael H. Rivner, MD Elizabeth Sekul, MD Kapil D. Sethi, MD Suzanne H. Smith, MD Thomas Swift, MD Jeffrey A. Switzer, DO NEUROMUSCULAR DISEASES J. Edward Hartmann, MD J. Ned Pruitt II, MD Michael H. Rivner, MD NEUROSURGEONS Cargill H. Alleyne, Jr., MD Haroon F. Choudhri, MD J. Dan Dillon, MD Cole A. Giller, MD, PhD Ian Heger, MD S. Dion Macomson, MD Scott Rahimi, MD John Tuttle, MD John R. Vender, MD

NEURO CRITICAL CARE K. Alfredo Garcia, MD PEDIATRIC NEUROSCIENCES James Carroll, MD Morris Cohen, EdD Ian Heger, MD Yong Park, MD Elizabeth Sekul, MD SKULL BASE TUMOR CENTER Cargill H. Alleyne, Jr., MD John R. Vender, MD SLEEP MEDICINE Anthony M. Murro, MD Yong Park, MD SPINE CENTER Cargill H. Alleyne, Jr., MD Haroon F. Choudhri, MD Ian Heger, MD S. Dion Macomson, MD Scott Rahimi, MD John Tuttle, MD John R. Vender, MD STROKE AND CEREBROVASCULAR CENTER Cargill H. Alleyne, Jr., MD Askiel Bruno, MD David C. Hess, MD Fenwick T. Nichols III, MD Scott Rahimi, MD Jeffrey A. Switzer, DO

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UPCOMING MEETINGS (September-December 2015) September 26-30: Congress of Neurological Surgeons, New Orleans, LA September 27-29: American Neurological Association, Chicago, IL October 14-17: North American Spine Society, Chicago, IL October 16-18: American Academy of Neurology Fall Session, Las Vegas, NV October 24-31: Research Update in Neuroscience for Neurosurgeons, Woods Hole, MA November 9-11: American Board of Neurological Surgery (Orals), Houston, TX December 5-6: Georgia Neurosurgical Society, Greensboro, GA December 8-11: AANS/CNS Section on Pediatric Neurological Surgery, Seattle, WA