Research on telestroke (telemedicine) shows improved access and clinical care in Oregon

If you're a neurologist, you're probably in San Diego at the American Academy of Neurology’s 65th Annual Meeting. Last Friday, researchers at UPenn revealed how telemedicine programs in Oregon are pushing stroke coverage into previously uncovered, less populated areas and expanding coverage by approximately 40 percent. The study shows that, by employing telemedical systems in concert with in-person care, nearly 80 percent of residents had access to expert stroke care within one hour.

The study evaluated all hospitals in Oregon, finding that 43 percent of the population could reach a stroke center in person within 60 minutes, 76 percent had telemedical access, 40 percent had access to both, and 20 percent had no access to stroke care within an hour.

You can read the full press release here.

Speaking of telemedicine - make sure you don't miss the early bird registration deadline for the upcoming ATA (American Telemedicine Association) conference in May. Registration fees go up on April 1. You won't want to miss ATA given that there is so much happening in telemedicine right now!

FDA approves cPAX Aneurysm Treatment System

The U.S. Food and Drug Administration has approved the cPAX Aneurysm Treatment System for surgery on brain aneurysms that are difficult to manage because of their size and shape.

An aneurysm is a bulge in the wall of a blood vessel, which can rupture as it increases in size, causing hemorrhage or death. Brain aneurysms often produce no symptoms until they grow and press on nerves in the brain, or until they begin to leak blood or rupture.

Aneurysms can be repaired in two ways: surgeons can close the base of the aneurysm with a surgical clip, or use a technique commonly known as coiling, in which surgeons use a catheter to thread metallic coils through a blood vessel in the groin and into the blood vessel in the brain that contains the aneurysm. Surgeons then fill the aneurysm with the detachable coils, which block it from circulation and cause blood to clot, effectively destroying the aneurysm.

ELANA (Excimer Laser Assisted Non-Occlusive Anastamosis)

The next patient who requires neurosurgery to repair a brain aneurysm may receive the ELANA during the operation. Here's the press release from the FDA:

FDA approves device to maintain blood flow during artery bypass brain surgery
Option for those at greater risk for stroke during standard bypass surgery

The U.S. Food and Drug Administration today approved a surgical kit that allows neurosurgeons to reroute blood flow around an aneurysm or a tumor in the brains of patients at greater risk of stroke during standard bypass surgery.

The ELANA (Excimer Laser Assisted Non-Occlusive Anastamosis) Surgical Kit allows neurosurgeons to create a bypass without shutting off the blood flow. It consists of a small platinum ring and a hand piece connected to a surgical laser and suction tubing.

Standard bypass surgery in the brain requires clipping the artery to halt blood flow during the procedure. The surgery is not considered safe for about 1,000 patients annually in the United States because temporarily shutting off their blood flow would put them at high risk of stroke. The group includes patients ages 13 and older who have an enlarged, weak area in a brain artery (cerebral aneurysm), tumors at the base of the skull that could impact blood flow in brain arteries, or other issues that could complicate conventional surgery.

Physicians and medical dreams

What type of medical dreams do you think physicians have at night? Do you think surgeons dream about surgery?

So my wife (who is a family physician) had a dream where she was performing surgery. However, she was performing a very unusual surgery (I won't get into the details right now) and she was puzzled that she was performing such a strange procedure. In the dream, she was finishing the surgery and she wanted to make the incision look really clean. She was surprised at the minimal amount of bleeding. So you may be wondering: why was the surgery so unusual? She was performing brain surgery (even though she's not a neurosurgeon).

So I wonder how often physicians have dreams that are unrelated to their specialty. I should conduct a survey...

Dr. Sanjay Gupta - Won't be the Next Surgeon General

Dr. Sanjay Gupta is the chief medical correspondent on CNN. He had been approached for the position of the US Surgeon General. However, he recently announced that he will not be pursuing this position and he will focus his time on neurosurgery and on his family. I'm sure he finds his current lifestyle fun and exciting - he gets to practice surgery at Emory and he travels the world to report for CNN. He has done an excellent job blending the clinical and non-clinical worlds.

The current Acting Surgeon General is Rear Admiral Steven K. Galson, M.D., M.P.H. and the Acting Deputy Surgeon General is Rear Admiral Robert C. Williams, P.E., DEE. John Maynard Woodworth (1871-1879) was the first Supervising Surgeon of the Marine Hospital Service.