Clemens M. Schirmer, MD, PhD, FAANS, FAHA
Chair, AANS/CNS Communications and Public Relations Committee
Geisinger
Wilkes Barre, PA

Our vascular neurosurgery focus ends and with it a sweeping overview of the field of vascular neurosurgery. We began in May in coordination with the efforts of Rep. Joyce Beatty (D-Ohio), who introduced a resolution, H. Res. 366, designating May 2019 as “Stroke Awareness Month.” Over the ensuing weeks, our posts have ranged far and wide, incorporating many aspects of the field of #vascularneurosurgery, including:

  • Our introduction set the stage for a guest blog from Christine J. Buckley, the Executive Director of the Brain Aneurysm Foundation who reminded us that it is time to give researchers and scientists the funding to reduce the harm caused by a ruptured brain aneurysm.
  • Additionally, we featured several video blogs (under the hashtag #strokemonth). These contributions are thanks to the efforts of neurosurgeons working in the trenches to treat strokes, who shared what stroke month meant to them and their communities. We also received a detailed overview of the signs and symptoms of a stroke. It is important to increase public education on these signs as early detection and treatment will save more lives than all of our best surgical techniques.
  • Jonathan J. Stone, MD, MSe and Michael P. Wilson, PhD, authored a wonderful piece illustrating how work at the bench is translated into improvements at the bedside in stroke care. The development of 3-D printed training phantoms for cerebrovascular simulation enhances training and education for learners of all stages and prepares them better for their work on patients.
  • Timed with the finale of HBO hit show Game of Thrones (if you don’t know what this refers to we won’t judge…) we featured a cross-blog post about the battle one of the stars of the show Emilia Clarke faced when she suffered from a ruptured aneurysm. Emilia’s poignant and personal story highlights the need for more research to find a cure for brain aneurysms.
  • From our focus on the current state of vascular neurosurgery, we turned to the future of the specialty with the help of two leaders in the field. It is always a fool’s errand to attempt to predict the future, but Babu G. Welch, MD, FAANS, and H. Hunt Batjer, MD, FACS, FAANS, shared their insights of the current cutting edge of vascular neurosurgery to emphasize the important issues for the specialty moving forward.
  • High-level evidence informs what we do in contemporary cerebrovascular neurosurgery, and clinical trials pave the way for new techniques and improved outcomes in patient care. A fortunate coincidence during our vascular focus was Neurosurgery’s release of results from one of the long-awaited clinical trials concerning the management of intracerebral brain hemorrhages. The results of the Minimally Invasive Surgery Plus Rt-PA for ICH Evacuation (MISTIE) III Trial were published in 2019. This represents the first study to identify specific surgical goals for the treatment of an intracerebral hemorrhage — the deadliest and most disabling type of stroke. The multi-institutional team of researchers found that at least 70 percent of the hemorrhage has to be removed for patients to make a meaningful recovery.
  • In a tribute to our colleagues who serve America’s heroes, Randy S. Bell, MD, FAANS, tells the story about a young West Point graduate and neurosurgery resident from Walter Reed Medical Center, COL (ret) Rocco A. Armonda, MD, FAANS. The very earliest stages of his career saw tremendous opportunity in studying the field of endovascular neurosurgery, and he became one of the early, dually trained practitioners. His skills and experience treating American soldiers in recent combat has not only saved lives but also advanced the fields of endovascular and trauma neurosurgery.
  • Tyler Martin Schmidt, DO and Kristopher T. Kimmell, MD, shared a patient story from a brain arteriovenous malformation survivor, which allowed us to appreciate communication as an integral aspect of the patient-centered care model.
  • Curated by expert guest editors, and enhanced by color images and video clips, Neurosurgical Focus covers a different neurosurgery-related topic in-depth online each month. A cross-post blog spotlights the February issue theme:  Cerebral Revascularization. It houses 16 free articles covering a variety of vascular neurosurgery topics.
  • Sandi K. Lam, MD, FAANS shared a compelling story about our youngest, smallest, and bravest patients. Stroke spares no age group, and pediatric victims of stroke, although rarer, demand our best efforts to research cures and improve care and outcomes for these diseases.

There are doubtless many more aspects of cerebrovascular neurosurgery, breakthroughs, and patient stories deserving of our attention. We are amazed at how this field has truly transformed before our eyes. We are privileged both to bear witness to this amazing improvement of our capabilities to help our patients and also see neurosurgeons from all areas coming together to contribute to advancing this field forward. Although vascular neurosurgical diseases are complex, and the therapies that will conquer them will be equally intricate, the formula for progress in the field is simple. We start by putting patients (and their families) first. To this, we add our own efforts, through improving clinical care, advocating for improved access for patients and more efficient systems of care, as well as innovating the latest scientific breakthroughs in the field. The sum of this mathematic formula is the best possible outcomes for our patients.  

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