Preliminary Program AONeuro Course — Controversies in ......8 AONeuro Course — Controversies in Neurotrauma: Brain and Spinal Cord September 3 – 5, 2015 AONeuro Course — Controversies

AONeuro Course — Controversies in Neurotrauma: Brain and Spinal Cord

September 3 – 5, 2015Westin BellevueBellevue, Washington

Preliminary Program

Directly Provided by

Table of Contents

CME Mission 4 Statement

Course Overview 5

Target Audience 5

Learner Objectives 6

Accreditation 6

Designation 6 Statement

Faculty 7 – 8

Preliminary 9 – 13 Program

Presentation 14 Information

Course Tuition 15 and Registration

Hotel and Travel 16 – 17

Welcome

Welcome to AONeuro! In AO North America’s continued commitment to surgeon education:

It is our distinct pleasure to announce a special educational offering for Neurotrauma which represents a collaborative effort between AOSpine North America and AONeuro North America.

This unique course will provide participants with an outstanding opportunity to advance their knowledge and surgical skills in brain, spine and spinal cord trauma through didactic lectures and case-based discussions. Faculty selection includes recognized Neurotrauma leaders who are eager to share their knowledge and experience with you. We hope that you will consider registering for this course and sharing this opportunity with your colleagues.

Course Chairs

Randall M. Chesnut, MD, FCCM, FACS

Richard G. Ellenbogen, MD, FACS

Message from the Program Coordinator

On behalf of AO Foundation and your local and international faculty, I would like to welcome you to this AONeuro educational event.

AONeuro is a unique worldwide multi-specialty community that includes cranial Neurosurgeons, Neurologists, Neurointensivists, Neuro anesthesiologists, Neuro Traumatologists and Neurological professionals who are involved in cranial neurological trauma, cranial oncologic and cerebrovascular surgery, cranial reconstruction and cranial congenital anomalies surgery.

Our organization creates a forum for specialists from all over the world who have common interests and enthusiasm in these fields. It is our goal to encourage and inspire residents, fellows, and experienced practitioners by means of education, academic stimulation instruction and international communication to pursue more fulfilling, rewarding and productive careers in these fields.

Education has always been a major pillar in the AO Foundation. Currently, more than 46,000 surgeons participate in over 750 AO educational events worldwide per year. AONeuro is committed to communicating the latest advances, treatment information, protocols in education, equipment and new developments as we strive to improve your educational experience by providing you education at the forefront of your specialty.

Your cranial neurological colleagues are working diligently to bring you the latest in cranial neurological education, and most specifically have initiated programs in the area of traumatic brain injury. Cranial AO Neurosurgeons collaborate with their AOSpine colleagues to bring you the latest developments in combined brain and spinal cord trauma. For years, cranial neurological surgeons have cooperated with craniomaxillofacial colleagues in the areas of facial and cranial trauma, congenital craniofacial anomalies, and skull base trauma and surgery to provide the multidisciplinary perspective necessary to manage these areas.

AONeuro is a project of the AO Foundation, established to learn the needs and educational structure which cranial neurologists require to improve their worldwide educational efforts. AONeuro cooperates with AOSpine and AOCMF (Craniomaxillofacial) to provide multidisciplinary course education, and seeks to add a cranial dimension to existing AO Education in the present specialty areas of Orthopedics, Spine, Craniomaxillofacial and Veterinary surgery.

We hope that your experience with us over the next few days will result in the acquisition of new knowledge, skills and understanding that can directly translate into improved care for your patients.

We also hope that, as a result of this educational event, you will develop a longer term relationship with AOSpine and AONeuro, become a member of our communities, take advantage of our website www.AOFoundation.org, explore our comprehensive online medical reference tool and phone app AO Surgery Reference (www.AOSurgery.org), take up AO Membership, and participate in AONeuro and AOSpine courses and educational opportunities. You may also even wish to acquaint yourself with AOCMF educational events in the areas of congential anomalies surgery, craniofacial trauma and skull base surgery.

Make these organizations yours by bringing your opinions, ideas and contributions. Enjoy the camaraderie of our unique network, and help us maintain and expand the preeminent educational position that the AO Foundation enjoys worldwide.

Yours sincerely,

Paul Manson, MD Coordinator, AONeuro Pilot Program

4 AONeuro Course — Controversies in Neurotrauma: Brain and Spinal Cord September 3 – 5, 2015

AONeuro Course — Controversies in Neurotrauma: Brain and Spinal Cord 5 September 3 – 5, 2015

CME Mission StatementThe Continuing Medical Education (CME) mission of AO North America (AONA®) is to provide comprehensive multidisciplinary needs based education to surgeons, fellows, and residents in the specialties of orthopedic, hand, craniomaxillofacial, spine, neurosurgery, and veterinary surgery in the areas of trauma (i.e.), operative reduction and fixation), degenerative disorders, deformities, tumors, and reconstruction.

Expected results of AONA’s CME activities for surgeons, fellows, and residents are to:– Increase their knowledge base and surgical skill level– Improve competence by applying advances of knowledge in patient care in

the areas of trauma, degenerative disorders, deformities, tumors, and reconstructive surgical techniques

– Address practice performance gaps by improving management of all aspects of musculoskeletal injuries and disorders (i.e., pre-operative planning to post-operative care)



Course OverviewManaging neurotrauma patients in an evidence-based manner is challenging for even the most experienced clinician. Choosing the best available operative and nonoperative treatment options requires balancing numerous parameters and coordinating care between multiple disciplines. Formulating optimized, cooperative treatment plans requires understanding of the complex underlying pathophysiology, limitations of current monitoring systems, evolution of the injury over time and with treatment, and limitations in the available literature.

This course is designed to provide participants with a unique opportunity to advance their evidence-based knowledge and surgical skills in brain and spinal cord trauma through didactic lectures and case-based discussions with renowned neurotrauma thought leaders. Systematic, surgical, and critical care considerations in managing patients with traumatic brain and spinal cord injuries will be addressed.

Target AudienceNeurological Surgeons, Neurointensivists, Neurologists, Orthopedic Spine Surgeons, Registered Nurses, Physician Assistants, Nurse Practioners, and specialists involved in the care of the neurotrauma patient will benefit from attending this course. Residents and Fellows will especially find this course to be of interest as this will be geared towards their education, as well.



Learner Objectives

Accreditation

Designation Statement

At the conclusion of this Course, the participant should be able to:– Apply evidence-based decision making to the management of the

neurotrauma patient– Recognize the clinically relevant pathophysiology underlying traumatic

brain and spinal cord injuries– Discuss the utility and limitations of currently available neurological

monitoring systems and their interactions– Recognize indications and opportunities for individualizing and fine tuning

treatment of traumatic brain and spinal cord injuries– Describe the utility and limitations of current guidelines in directing

neurotrauma management– Coordinate the acute management of neurological trauma with the overall

care of the polytrauma patient.– Outline the available methods and distinguish the advantages, and

disadvantages of various methods of managing traumatic cerebrospinal fluid leaks

– Identify the priorities and techniques that influence coordination of the surgical management of cranial neurological and maxillofacial injuries

AO North America is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

AO North America designates this live educational activity for a maximum of 18.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For Canadian Based Physicians Attending AONA CoursesAll live conferences or live courses held outside of Canada can be reported as accredited group learning activities under Section 1 of the MOC Program if they are developed by a university, academy, college, academic institution or physician organization.

Courses sponsored by AO North America meet the criteria of the Royal College of Physicians and Surgeons for accredited group learning activities.

This course meets the CME external trauma-related requirements of the American College of Surgeons, Committee on Trauma (ACS COT).

This course meets the requirements of the American Board of Neurological Surgery (ABNS) for Part II of Maintenance of Certification: Lifelong Learning and Self-Assessment.


FacultyCourse Chairs

Faculty

Randall M. Chesnut, MD, FCCM, FACSIntegra Endowed Professor of Neurotrauma

Department of Neurological Surgery

Department of Orthopaedic Surgery

Professor, School of Global Health

Harborview Medical Centre

University of Washington

Seattle, Washington

Richard G. Ellenbogen, MD, FACSProfessor and Chairman


University of Washington School of Medicine

Harborview Medical Center

University of Washington Medical Center

Seattle Children’s Hospital

Seattle, Washington

Rocco A. Armonda, MDDirector, Neurointerventional Surgery

Department of Neurosurgery

MedStar – Georgetown University and

Washington Hospital Center

Washington, District of Columbia

Neeraj Badjatia, MD, MSAssociate Professor

Chief of Neurocritical Care, Program in

Trauma Departments of Neurology,

Neurosurgery, Anesthesiology

University of Maryland School of Medicine

Baltimore, Maryland

Eileen M. Bulger, MD, FACSProfessor of Surgery

and Chief of Trauma


Seattle, Washington

Jefferson Chen, MD, PhD, FAANS, FACS, FCCMNeurological Surgeon

Director of NeuroTrauma


University of California, Irvine

Orange, California

Education AdvisorCarlo Bellabarba, MDProfessor, Departments of Orthopaedic &

Neurological Surgery

University of Washington School of Medicine

Acting Chief of Orthopaedics


Seattle, Washington



Faculty (continued)

Joseph Gruss, MD, FRCSCMarlys C. Larson Professor Craniofacial Surgery

Division of Plastic and Craniofacial Surgery

Childrens Hospital & Medical Center

Seattle, Washington

Richard Hopper, MD, MSChief, Division of Pediatric Plastic Surgery

Surgical Director

The Craniofacial Center

Professor

Department of Surgery


Seattle, Washington

Peter Le Roux, MD, MBBCh, FACSProfessor


Thomas Jefferson University

Philadelphia, Pennsylvania

Geoffrey T. Manley, MD, PhDProfessor and Vice-Chairman of

Neurological Surgery

Chief of Neurosurgery,

San Francisco General Hospital

Co-Director, UCSF Brain & Spinal Injury Center

San Francisco, California

Kris S. Moe, MD, FACSProfessor and Chief, Division of

Facial Plastic Surgery

Department of Otolaryngology – Head & Neck


Seattle, Washington

David O. Okonkwo, MD, PhDProfessor and Executive Vice Chair


University of Pittsburgh

Pittsburgh, Pennsylvania

Nino Stocchetti, MDMilan University

Neuro Intensive Care

Milan, Italy

Shelly D. Timmons, MD, PhD, FACS, FAANSDirector of Neurotrauma, Geisinger Health System

Neurosurgery Residency Program Director,

Geisinger Health System

Associate Director for Neurosciences Adult ICU

Geisinger Medical Center

Clinical Associate Professor, Temple University


Danville, Pennsylvania

Miriam Treggiari, MD, PhD, MPHPortland, Oregon

Jennifer M. Zumsteg, MDAssistant Professor

Medical Director, TBI Rehabilitation

Fellowship Director, Brain Injury Medicine

Investigator, TBI Model System


Department of Rehabilitation Medicine

Seattle, Washington

Faculty list subject to change.


Preliminary Program

Thursday, September 3, 2015

Time Agenda Item

1700 – 1800 Registration / Buffet Dinner

18:00 – 18:15 Classification of Traumatic Brain Injury (TBI)

18:15 – 18:25 Discussion

18:25 – 18:40 What’s Wrong with Current Management


18:50 – 19:05 Concussion/Return to Play


19:15 – 19:30 Practical Multimodality Monitoring


19:40 – 19:55 Guidelines


20:05 – 20:15 Neurotrauma Practice in the Real World


20:25 – 21:30 Case Discussions



Preliminary Program

Friday, September 4, 2015

Time Agenda Item

08:00 – 08:10 Introduction

08:10 – 08:25 What is AONeuro

08:25 – 08:40 TBI Pathophysiologic Mechanisms

08:40 – 08:55 Intracranial Pressure (ICP) and Cerebral Compliance

08:55 – 09:10 Cerebral Blood Flow (CBF) and Autoregulation

09:10 – 09:25 Measuring and Treating Cerebral Ischemia

09:25 – 10:00 General Discussion

10:00 – 10:15 Coffee Break

10:15 – 10:30 Resuscitating the Polytrauma Patient with TBI

10:30 – 11:15 Principle Discussion Based on Patient Cases: Case 1 – TBI Patient Direct to Operating Room (OR) with General SurgeryCase 2 – Herniating Patient Needing Direct Transport to ORCase 3 – Timing of Non-emergent Surgery in TBI

11:15 – 11:30 Penetrating TBI


11:40 – 11:55 Pediatric TBI


12:05 – 12:20 TBI Rehabilitation


12:30 – 13:15 Lunch

13:15 – 13:30 Decompressive Craniectomy


13:40 – 13:55 Difficult Cranioplasty Management


Preliminary Program

Friday, September 4, 2015 (continued)

Time Agenda Item


14:05 – 14:25 Bifrontal Injury But High Glasgow Coma Score (GCS)

14:25 – 14:45 Normal ICP, No PbrO2 Desaturations, DI III CT

14:45 – 15:05 Difficult ICP Control, No PbrO2 Desaturations

15:05 – 15:25 Difficult ICP Control With PbrO2 Desaturations

15:25 – 15:45 Normal ICP But PbrO2 Desaturations

15:45 – 16:05 Refractory ICP


16:25 – 16:45 Principle Discussion Based on Patient Cases: Case 1 – Subdural Hematoma (SDH)Case 2 – No Subarachnoid Hematoma (SAH)Case 3 – Minimal Mass EffectCase 4 – Good GCS

16:45 – 17:05 SDH, Moderate Swelling at End of Evacuation

17:05 – 17:25 Gun Shot Wound with Bifrontal Injury, Alert, CSF Leak

17:25 – 17:45 Diffuse Swelling High ICP Needs Decompression

17:45 – 18:05 Pediatric Patient with High ICP

18:05 – 18:25 Severe TBI with Unstable Spine

18:25 – 18:45 Devastating TBI, Family Wants Everything Done




Preliminary Program

Saturday, September 5, 2015

Time Agenda Item

08:00 – 08:20 Principle Discussion Based on Patient Cases: Case 1 – 14 Year Old Football Player with Concussion – Loss of Consciousness (LOC) on Field

08:20 – 08:40 Principle Discussion Based on Patient Cases: Case 1 – 24 Year Old NFL Player with > 1 Concussions in One Season

08:40 – 09:00 Status Post Discharge with Hydrocephalus

09:00 – 09:20 Status Post Cranioplasty with Large Hygroma Under Flap

09:20 – 09:40 Status Post Discharge, Ready for Rehabilitation at 3 Weeks



10:15 – 10:25 Anticoagulants

10:25 – 10:35 Cerebral Spinal Fluid (CSF) Leak Management

10:35 – 10:45 Endoscopic Options for CSF Rhinorrhea

10:45 – 10:55 Cranioplasty Following Decompressive Craniectomy (DC)

10:55 – 11:15 Principles of Craniofacial Reconstruction

11:15 – 11:30 Principle Discussion Based on Patient Cases: Case 1 – CSF Rhinorrhea

11:30 – 11:45 Post DC Needing Cranioplasty – Scalp Problems

11:45 – 12:00 Patient with Combined Facial and Frontal Skull Defects Requiring Surgery

12:00 – 12:10 Pick up Boxed Lunch

12:10 – 12:25 Pathophysiology of Spinal Cord Injury

12:25 – 12:35 Blood Pressure Management

12:35 – 12:40 Emergent Decompression – Always

12:40 – 12:45 Emergent Decompression – Conditional



Preliminary Program

Saturday, September 5, 2015 (continued)

Time Agenda Item

12:55 – 13:00 Steroids – Pro

13:00 – 13:10 Steroids – Con


13:20 – 13:50 Principle Discussion Based on Patient Cases: Case 1 – Incomplete Spinal Cord Injury (SCI) with Jumped Facets

13:50 – 14:00 Course Evaluations and Adjourn

Preliminary program subject to modification.



Faculty DisclosureIt is the policy of AO North America to abide by the Accreditation Council for Continuing Medical Education Standards for Commercial Support. Standard 2: “Disclosures Relevant to Potential Commercial Bias and Relevant Financial Relationships of Those with Control over CME Content,” requires all planners, including course directors, chairs, and faculty, involved in the development of CME content to disclose their relevant financial relationships prior to participating in the activity. Relevant financial relationships will be disclosed to the activity audience. The intent of the disclosure is not to prevent a faculty with a relevant financial or other relationship from teaching, but to provide participants with information that might be of importance to their evaluation of content. All potential conflicts of interest have been resolved prior to the commencement of this activity.

Conflict of Interest Resolution StatementWhen individuals in a position to control or influence the development of the content have reported financial relationships with one or more commercial interests, AO North America utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias.

Off-Label / Experimental DiscussionsSome medical devices used for teaching purposes and/or discussed in AO North America’s educational activities may have been cleared by the FDA for specific uses only or may not yet be approved for any purpose. Faculty may discuss off-label, investigational, or experimental uses of products/devices in CME certified educational activities. Faculty have been advised that all recommendations involving clinical medicine in this CME activity are based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported or used in this CME activity in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection and analysis.

Liability Statement AO North America faculty and staff assume no personal liability for the techniques or the use of any equipment and accessories used for teaching purposes in the laboratory. The certificate provided pertains only to the participants’ completion of the course and does not, in any way, attest to the proficiency of the participants’ clinical experience.

DisclaimerThe opinions or views expressed in this live continuing medical education activity are those of the faculty and do not necessarily reflect the opinions or recommendations of AO North America or any commercial supporter. The certificate provided pertains only to the participants’ completion of the course.

Presentation Information


Course Tuition and RegistrationTuition: $375.00 U.S.D.

Course, breakfasts, coffee breaks and lunch will be provided.

Registration is available online only at www.aona.org

We encourage early registration, as seating is limited.Upon receipt of your online registration you will be sent via email a confirmation of your registration in the Course, along with hotel and travel information to assist you in making your arrangements.

PLEASE NOTE: Registration deadline is August 13, 2015.

ADA StatementAO North America fully intends to comply with the legal requirements of the Americans with Disabilities Act. If any registrant is in need of accommodation, please do not hesitate to submit a written request at least one month prior to this activity.

Until an email confirmation is received, please do not consider yourself registered in this Course.

For Information:Contact AONA Customer Service DepartmentPhone: (800) 769-1391 (610) 695-2459 Fax: (610) 695-2420Email: [email protected]



Hotel and TravelHotel Information: Westin Bellevue600 Bellevue Way, Bellevue, WA. 98004

Hotel Concessions: Complimentary internet in guestrooms.Complimentary local calls and 1-800 toll calls from guestrooms. Complimentary 2 bottles of water in each guestroom.

Travel We recommend flying into Seattle-Tacoma International Airport (SEA). SeaTac Airport is the gateway to Bellevue, Seattle and the Pacific Northwest. The Westin Bellevue is just an 18 mile drive north of SeaTac on Interstate 405, roughly a 25 minute drive. There are several ways to reach the hotel from the airport. You can catch a cab, rent a car, arrange for a private car service, or take the airport shuttle. To travel throughout the Bellevue area and beyond, we recommend hailing a taxi outside the hotel. If you’re heading to Seattle, take advantage of public transit at the city bus station, just three blocks from the hotel.

Port of Seattle Travel Distance: Approximately 20.92 km/13.0 miles

Options for getting to and from the hotel include:By TaxiFee: 40 USD Hours: hours

By ShuttleFee: 61 USD Hours: 24 hours

Airport Seattle/Tacoma International Airport (SEA) Travel Distance: Approximately 28.97 km/18.0 miles

Hertz Car Rental Travel Time: 25 minutes Contact: (425) 453-6097; Reservation Required

Budget Car Rental Travel Time: 25 minutes Contact: (425) 455-3653

Enterprise Rent A CarTravel Time: 25 minutes Contact: (425) 455-1660; Reservation Required

Green CabFee: 45 USD; One way, additional passenger fees apply Hours: 24 hours

Travel Time: 25 minutes Contact: (206) 575-4040; Reservation Required About: Green Cab taxis are readily available outside of the airport. Green Cab offers the only all-hybrid fleet of enviromentally friendly taxi cabs in Puget Sound. Learn more at www.greencab.com.

Alamo Rent A CarHours: 24 hours Travel Time: 25 minutes Contact: (800) 462-5266; Reservation Required

Thrifty Car RentalTravel Time: 25 minutes Contact: (425) 453-1857; Reservation Required

Avis Rent A CarTravel Time: 25 minutes Contact: (425) 462-9373


National Car RentalTravel Time: 25 minutes Contact: (800) 328-4567; Reservation Required

Shuttle ExpressFee: 19 USD; Fee is one way, per person Hours: 24 hours Travel Time: 25 minutes Contact: (206) 981-7000; Reservation Required About: Shuttle Express buses depart regularly from the airport. Call in advance for airport pickup reservations, or book online. For more information visit www.shuttleexpress.com.

Bayview TransportationFee: Varies by vehicle type Hours: 24 hours

Travel Time: 25 minutes Contact: (206) 824-6200; Reservation Required About: Bayview Transportation offers a fleet of private cars that can be reserved for aiport pick-up. For more information or to make a reservation visit www.bayviewlimo.com.

• Complimentary Self-Parking on Friday and Saturday nights • $25 per night for Self-Parking on Sunday – Thursday nights • $29 per night for overnight Valet Parking Rates do not include taxes.

Valet Parking is available at the front door of The Westin Bellevue Hotel. Should you choose Self-Parking, you will be directed to the Lincoln Square parking garage by the doorman. Please park on level P4 or P5 near the south elevators and take the elevator up to the hotel lobby. Directional signage is posted.

Covered, lit parking is directly connected to hotel via elevators and indoor walkways. This is not a hotel-owned parking facility although parking fees can be added to your hotel bill. Rates are subject to change.

Please visit our website: www.aona.org to register for this Course

and for other course offerings.

Hotel and Travel (continued)

Options for getting to and from the hotel include:

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Documents

Preliminary Program AONeuro Course — Controversies in ......8 AONeuro Course — Controversies in Neurotrauma: Brain and Spinal Cord September 3 – 5, 2015 AONeuro Course — Controversies