• Three Full-day Symposia Highlight Advances, Innovation, and Challenges

    Authors: Peter Kan, MD
    Nader Pouratian, MD PhD

    Part of the CNS Annual Meeting's tradition is a coming-together of some of the best minds in neurological surgery for full-day symposia. In the spirit of Transformation and Celebration, we will continue this legacy and enhance the experience at the 2017 CNS Annual Meeting with three day-long symposia that explore the innovation, advances, and challenges within various neurosurgical subspecialties.

    Symposium 1: Functional Neurosurgery Update

    October 7, 8:00 am-5:00 pm

    This full-day symposium provides a forum for attendees to obtain a comprehensive, yet succinct, update on the most current and emerging science, tools, and clinical evidence for functional neurosurgery. The course is designed for both young and established functional neurosurgeons, as well as general neurosurgeons interested in integrating functional neurosurgery into their practice. Discussions will include neurosurgical techniques and approaches to treat movement disorders, psychiatric disease, and epilepsy as well as emerging indications such as obesity, neuropsychiatric diagnoses, and cognition. In addition to neurosurgeons, the course is designed for neurologists, psychiatrists, physician assistants, and nurse practitioners involved in the multidisciplinary care of these patients. The symposium will be delivered as six one-hour modules.

    The first module begins with expert-led discussions of the various approaches to implanting deep brain stimulators (DBS), including frame versus frameless technique and awake versus asleep implantation. A focus on outcomes, efficiency, and limitations will help guide participants in tailoring their own practice to best meet the needs and expectations of their patient population. The second module will evaluate key controversies and emerging concepts in movement disorders, including the advantages of different deep brain targets for movement disorder surgery, advanced imaging techniques to enhance visualization of deep brain targets, and the value of directional leads and current steering, which have recently been introduced into markets around the world. In the third module, which will conclude the morning session, topic experts will discuss the lessons learned from the increasing use of central neuromodulation for Tourette syndrome (TS), obsessive compulsive disorder (OCD), and chronic pain.

    The afternoon session will begin with a comprehensive discussion of the advantages and pitfalls of lesioning in the era of neuromodulation, and whether ablation should be considered a first-line approach. Techniques discussed will include high-intensity focused ultrasound (HiFU), stereotactic radiosurgery (SRS), and laser ablation. The second afternoon module will survey surgical techniques in epilepsy surgery beyond resective surgery, including brain stimulation, minimally invasive lesioning, and stereo-EEG with the use of a robot. In the final session, key opinion leaders will survey emerging therapies and applications, including the current state of gene and cellular therapies, and investigational DBS application in psychiatry, obesity, and cognition, with a concluding discussion of how to build a comprehensive practice.

    By the end of the symposium, attendees will have a comprehensive overview of the modern-day transformation that has occurred in functional neurosurgery. Sponsored breakout sessions will be hosted by industry leaders who have helped to shape the technological landscape critical to the field of functional neurosurgery.

    Symposium 2: Neurovascular Update: Evidencebased Guidelines in Ischemic and Hemorrhagic Stroke for the Practicing Neurosurgeon

    October 8, 8:00 am-4:00 pm

    This symposium is a full-day forum delivering the latest information on cerebrovascular surgery, endovascular neurosurgery, and management of ischemic and hemorrhagic stroke by a panel of national experts. Designed for the busy general neurosurgeon, physicians will obtain a concise update on relevant topics and controversies in cerebrovascular surgery. Throughout the course, we will review recent literature regarding patient selection and outcomes for endovascular treatment of acute ischemic stroke as well as emerging technologies such as mobile stroke units. New topics for 2017 include neuroprotective strategies and stem cell therapy in acute ischemic stroke.

    We will also discuss the management of intracranial atherosclerotic and vaso-occlusive disease. Areas covered include surgical revascularization (EC-IC bypass) for Moyamoya disease and the controversies around endovascular revascularization (balloon angioplasty and stenting) for intracranial atherosclerotic and extracranial vertebral origin diseases. Based on current evidence and guidelines, we'll move to a discussion about endovascular and surgical revascularization (CAS versus CEA) for extracranial atherosclerotic diseases with a focus on new and ongoing trials such as CREST2.

    The course also covers optimal treatment of intracranial aneurysms, including surgery (clip reconstruction and bypass), traditional endovascular techniques (primary and assisted-coil embolization), flowdiversion, and other new technologies such as intrasaccular devices and novel stents and coils. Attendees will hear a lecture on current management of cerebral vasospasm. Finally, a comprehensive panel discussion on multimodal treatment options (surgery, embolization, and radiosurgery) for intracranial arteriovenous malformations will be presented, and the day concludes with evidence-based management and emerging minimally invasive surgical techniques on the management of intracerebral hemorrhage.

    Symposium 3: Neurocritical Care and Neurosurgical Emergencies Update

    October 8, 8:00 am-4:00 pm

    This full-day symposium is dedicated to the latest information on the current management of neurosurgical emergencies and common neurocritical care scenarios. This forum will allow attendees to discuss course content with colleagues and interact with faculty. Using a case-based approach, the management of brain and spine injuries, spinal tumors, infections, and other related scenarios will be thoroughly reviewed.

    The first didactic session will cover seizures, intracranial hypertensions, neuromonitoring tools, and a selection of related cases for discussion. The second didactic session, preceded by a beverage break, will continue the case-based learning with discussions about head injury in polytrauma, pulmonary complications, and a unique support group session about on-call experiences of attendees.

    After lunch, a representative from our international partner association, the Neurological Society of India, will discuss the neurotrauma environment in his home country. There will also be focus on prehospital management of TBI, spine trauma, complications including infection, and the latest spinal instrumentation.

    Upon completion of this symposium, attendees can expect to be current in their knowledge of recommended treatment of traumatic brain injury, the latest literature on spinal tumor and infection management, common systemic complications after neurological injury, and more. This course is intended to be an exhaustive review to keep attendees up-to date, confident, and prepared for the scenarios discussed.

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