Editor: Roland Torres, MD, FAANS, FACS Spring 2012  
In this Issue...
Message from the Chair
Neurotrauma and Critical Care Web Page Update
Sports Medicine Committee
Clinical Research Update:
ProTECT III
When the Cameras All Are On You
  Message from the Chair

Shelly D. Timmons, MD, PhD, FAANS, FACS

At the 2011 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting, the AANS publicized a Position Statement on Traumatic Brain Injury, drafted by the AANS/Congress of Neurological Surgeons (CNS) Section on Neurotrauma and Critical Care. This statement was developed, in part, as a response to the overwhelming attention this subject has gained in the public eye. While neurosurgeons have been at the forefront of treatment, research and public-policy development regarding this issue, it is key at this time to reinforce that role and provide our membership with tools to evolve in this leadership role.

To that end, the position statement has been widely publicized, including through a press release at the AANS meeting. The Section on Neurotrauma and Critical Care also has participated in the development of slide sets for education on concussion to be provided to AANS members and section members, spearheaded by Drs. Gail Rosseau and Martina Stippler, respectively. An afternoon session on concussion in sports is planned for the CNS’ upcoming annual meeting. The Council of State Neurosurgical Societies (CSNS) Neurotrauma and Emergency Neurosurgery Committee has sponsored a resolution to develop a toolkit for neurosurgeons regarding this topic, to include reference lists, legislation lists, existing grading scales and evidence-based guidelines. Section members are involved actively with the development of prevention programs such as ThinkFirst and the development of evidence-based guidelines. The fourth International Sport Concussion Consensus (to be held in November of 2012 in Zurich) will address the evidence basis for recommendations. It is clear that more research and surveillance data collection regarding this problem will help to formulate more effective education and prevention strategies in the future.

Another issue that continues to be addressed by the Section, the AANS and the CNS is the provision of neurocritical care by neurosurgeons. It is the position of the Section, the AANS, the CNS, the Society of Neurological Surgeons and the American Board of Neurological Surgery (ABNS), that the performance of neurocritical care by neurosurgeons is integral to the practice of neurosurgery. (Click here to see the full position statement issued on March 3, 2009.) Moreover, neurosurgeons are trained and qualified to provide critical care, although some may choose to limit these activities due to practice considerations. All residency programs accredited by the Accreditation Council on Graduate Medical Education (ACGME) are required to provide substantial training in critical care for matriculating residents, and certification by the American Board of Neurological Surgery includes the provision of neurocritical care. Collaborative approaches with our critical-care colleagues from other disciplines will continue to enhance the care we provide our patients, but neurosurgeons remain uniquely qualified to provide many aspects of critical care to both our surgical and non-surgical patients.

The Section’s executive committee has enjoyed active involvement from a number of long-term and new members. Several projects are underway, including the development of transfer guidelines for mild traumatic brain injury patients. Together with the CSNS, we are looking at the evidence basis for transfer, repeat imaging, use of telemedicine, and socioeconomic implications of over-triage and under-triage. Such an examination of the current state of the literature on this ubiquitous population will aid in future directions for research and quality improvement projects, and help to shape the dialogue with our emergency room, trauma surgery and pre-hospital colleagues. The Section remains engaged in disaster and mass casualty preparedness initiatives, led by Dr. Jamie Ullman, and our military colleagues remain engaged in Section activities, for which we certainly are grateful. Several civilian neurosurgeons also have been able to lend support as visiting surgeons in Landstuhl, Germany. Opportunities for involvement abound, and we welcome input from all of our members as we work to further the field of neurotrauma and critical care.


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