A View From Puget Sound ThepracticeofneurologicalsurgerybeganwhenthefirstShamantooktogrindingholeswithobsidianflintsintotheskullsof theirfellows,whoweresometimesimmobilizedbyingestingMandrakeroot.Thereasonsfor thispracticeremainlost inthe conjectureofprehistory,butthemotivationsweresurelytohelptheill.Theobligationtohelpsickpeopleremainstheprimarygoalforourresidentsandfacultytoday,andinthisissueofthenewsletterIamhappytobeabletotellyouaboutsomeoftheirsuccesses. TheUWhasbeenaleaderforyearsinitsdesiretopreventsportsinjuriesinyouth,andwiththefootballseasonunderwaywehappilyreportthatSamBrowd,MD,PhDhasbeennamedUWInvertoroftheYearforhisworkindesigningabetter,saferfootballhelmet.Dr.BrowdandcolleagueshopetheirVICIShelmet’sinnovativedesignwillabsorbmoreenergyinsteadoftransmittingittothebrain.VICIS’snewtechnologiesarefarreachinginapplicationfromsportstothemilitary. MatthewHoward,MDfinishedasChiefResidentatUWin1993andmovedtotheUniversityofIowa,whereheroserapidlyfromassistantprofessortoacademicstarasProfessorandChairman.MatthasbeentheChairatIowaforsomeyears,andreportspassionatelyabouthiscareer,hisfamilyandhisgoaltocombineresearchadvanceswithclinicalproductivity. NewlyappointedAssistantProfessorAliRavanpay,MD,PhD,whose rootsareat theUWwillbeworkingwithMisha Gelfenbyn,MDservingourVeterans.RajivSaigal,MD,PhDhasbeenrecruitedasanewAssistantProfessor, fromUCSFandMiamiandwillaugmentthealreadyworldclassneurosurgicalspineserviceatHMC.Hisspecialtyisthenewlyevolvingfieldofendoscopicandminimallyinvasivespinesurgeryandspinalcordinjuryresearch.RyanMorton,MDwhoalsofinishedthisJune,is staying as aEndovascularFellow for the year under the auspices ofLouisKimand theNeurovascular/EndovascularTeam. RakshithShettywillspendtheyearasResearchFellowintheDepartmentunderDr.Sekhar’stutelage.PhilipMartel,MDhasbeentransplantedfromMontrealtojoinusforayearastheSpineFellowundertheskillfulFangyiZhang,MDandRandyChesnut,MD.NeenaMarapudi,MDfromDetroitisthePediatricNeurosurgicalFellowatChildren’sunderJeffOjemann,MDandteam.AnoopPatel,MDasurgeon/scientistjoinedusfromMGHtobeourCerebrovascular/SkullBaseFellowfortheyear. TheNeurologicalSurgerySummerStudentprogram,anationallyacclaimedprogramdesignedtoinspireunder-representedcollegescholars,topursueneurosciencecareers,isfinishedits9thsuccessfulyear.TheexcitingnewaspectoftheprogramisthatitisnowsupportedbyaR-25NIH/NINDSgrant.Thestudentshavesomethingtosayabouttheirterrificexperiences. ProfessorofNeurologyandNeurologicalSurgeryMikeWilliams,alongwithotherwalkersandrunners,participatedinthe6thannualChildren’sHospitalandHydrocephalusAssociationWalkatMagnusonPark.And,lastlytherearenewclinicsandfacultyatUWMCtotellyouabout,includingtheworldclassmultidisciplinarypituitaryclinic.

Richard G. Ellenbogen, MD, FACSProfessor&Chairman

DepartmentofNeurologicalSurgery

The Montlake Cut

A Publication of the Department of Neurological Surgery

Richard G. EllenbogenM.D., F.A.C.S.

Fall 2016

Sam Browd: Inventor of the YearWhere Are They Now: Matt Howard, MDNew Faculty Welcome New Fellows

Research Fellow/News from UWMC Summer Program 2016Hydrocephalus Walk - 2016Puzzler

In This Issue

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Neurological Surgery’s Culture of Invention and Innovation

TheInventoroftheYearAwardhonorsoutstandingUWresearchscientistswhoseinnovationshavehada

major,positiveeffectonbothhealthcareandourlocaleconomy.In2016theUWSchoolofMedicinerecognizes

Samuel Browd,JonathanPosner,andPerReinhallfortheircollaborativeworkinventinganddevelopingafootball

helmetthatreducestheriskofconcussion.-http://vicis.co/-WeareexceptionallyproudofDr.Browdnotonly

forhisoutstandingclinicalcarebutalsoforinnovationsandmedicaldevicesthatwilldefinethefutureofourfield.

Importantly,Dr.Browdandhiscolleaguesare reachingbeyond theboundariesofour institution tohelpprevent

injuriesinthefirstplace.

Wearealsoproudofthesettinginwhichtheseadvancestakeplace.UW Neurological Surgeryfacultyand

staffcontributetoahighlyinnovativeenvironmentfocusedonscientificdiscoveryandenterprise.Ourfacultyhold

50patentsandhave50patentspending;NeurologicalSurgeryResidentsarenamedon14listedand22filedpatents.

Sevenofourcurrentfacultyhavefounded11activecompaniesdirectedtowardimprovingpatientcareor, inthe

case of Vicis,preventinginjuriestobeginwith.Twoofourfaculty(Drs.BrowdandMourad)havebeennamedUW

PresidentialEntrepreneurialFacultyFellows.Thisisatributetotheingenuityofourfacultyandreflectstheongoing

supportforacultureofinnovationinourDepartmentandtheUW.

Sam Browd: Inventor of the Year

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Where Are They Now: Matt Howard, MD

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I’vebeenkeepingprettybusydoingmostlyfunstuff.JohnVanGilderhiredmetojointhefacultyattheUniversityofIowaanditturnsoutIowaCityisagreatplacetoliveandwork.Itcangetalittlechillyinthewinter,butourfriendsattheMayoClinichaveitmuchworse,nottomentionallthosenicepeoplelivingupinCanada.Dr.VanGilderwasagreatbossandmadeitpossibleformeandmyIowacolleaguestodevelopahumanbrainresearchprogram.TherehavebeentheexpectedupsanddownsbutfortunatelyNIHhasstuckwithusandthisyearextendedsupportforyears20-25oftheprogram.I’mstillchippingawayatmedical deviceinventions.Mostdon’tpanoutbutsomedo.It’salwaysfuntothinkabouthowsuccessfuleachonewillbeuntilitisn’t.

In2001IwasappointedChairmanofthedepartmenthereandthatmadeitpossibletosetupsomeneatthings.IhavethefondestmemoriesoftheUWAtkinsonMorley’srotation,sowesetupanoverseastrainingperiodforourIowatrainees.Theygotodifferentplaces(e.g.Australia,France,Belgium,Japan,etc...)andseemtoenjoytheseexperiencesverymuch.Myfacultycolleaguesarefantastic.EveryoneunderretirementageisNIHfundedorhastheirKawardapplicationscurrentlyunderreview.Wedon’thavemany neurosurgeonsinIowa(ranked50th),andthat’sOKbecausewe’renevershortonpatients.AlthoughmywifeDeliawasinitiallyhorrifiedwhenIsaidIwantedtotakethejobinIowa,nowsheandourdaughtersloveit.Ouroldest,Caroline,isservingwiththePeaceCorpsinWestAfrica.SusannajustfinishedherfirstyearofmedicalschoolattheUniversityofChicagoandLilyisstartinghersenioryearatUVA.

Thinkingback,Ican’tbelievehowluckyIwastomatchintheUWprogram.Thefacultywereall academicsuperstarsandmyfellowresidentswereexactlythekindofteammatesyouwanttobe“inthetrenches”with.Boywasitfun!

New Faculty

Ali C. Ravanpay, M.D., PhD,whocompletedhisresidencyhere,hasbeenappointedtothefacultyas anAssistantProfessor.Hehasoutstandingintellectualandpersonalattributesthatwillenablehimtobecomea successfulacademicneurosurgeoninsupportofourclinicalcare,researchandtrainingmission.Dr.Ravanpay attendedUCBerkley,andgraduatedMagnaCumLaudein1999withdualdegreesinBiochemistryandNear EasternStudies.HethenarrivedattheUWwherehecompletedhisPh.D.inNeurobiologyandBehaviorin2007 andhisM.D.in2009.HedistinguishedhimselfinourResidencyProgrambyanexcellentworkethicandan eagernesstolearn.Inadditiontosuperbclinicalandinterpersonalskills,DrRavanpayhasgreatpromiseasa researcher.Hehasasubstantialrecordofpublicationandsignificantpreandpost-doctoralresearchexperienceatbothUWandUCBerkeley.Dr.Ravanpayhasalonglistofhonorsandawardsthatunderscorehisaccomplishmentsandfuturepromiseasanacademician.Mostrecently,hereceivedaCongressofNeurologicalSurgeonsTumor Fellowship.Healsohasaninterestinresidenteducation,andwilljoinDr.GelfenbeynattheVA,expandingour departmentpresencethere.Heisdedicatedtoanacademicneurosurgerycareerwithalaboratoryfocusinthestudyofbraintumors.

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Ali C. Ravanpay, M.D., PhD

Rajiv Saigal, M.D., PhD

Rajiv Saigal, M.D., PhD,AssistantProfessorofNeurologicalSurgery,isfellowship-trainedinspinal deformityandminimallyinvasivespinetechniques.Hisclinicalinterestsincludecomplexspinesurgery,spinal deformity,spinaltumors,minimallyinvasivetechniques,spinetrauma,anddegenerativedisease.Dr.Saigal completedneurosurgeryresidencyatUCSanFrancisco(UCSF),wherehetrainedwithinternationalleadersin spinaldeformityandspinetumors.HethencompletedanorthopedicspinedeformityfellowshipatScripps,SanDiegoSpineFoundation,inlessinvasivetechniquesforspinaldeformity.HecompletedasecondspinefellowshipattheUniversityofMiami,gainingfurtherexpertiseinminimallyinvasivespinesurgery,includingendoscopicfusion. PriortoUCSF,Dr.SaigalcompletedaPhDinmedicalengineeringattheHarvard-MITDivisionofHealthSciencesandTechnologyandanMDattheTuftsUniversitySchoolofMedicine.HealsohasaB.Sc.inelectricalengineeringfromGeorgiaTechandaM.Sc.inbiomedicalengineeringfromAalborgUniversityinDenmark.Hisclinicalresearchfocusesonoutcomesafterspinesurgeryandhislaboratoryresearchfocusesonuseofbiomaterialsfortreatmentofspinalcordinjuryandtraumaticbraininjury.Heistherecipientofnumerousawardsforresearch,teaching,andleadership,includingtheBoldreyYoungInvestigatorAward,UCSFNeurosurgeryResearchand Rosegayawards,NSFGraduateResearchFellowship,andWhitakerGraduateResearchFellowship.

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Welcome New Fellows

Dr. Marupudi will focus on clinical involvement in the Pediatric Neurosurgery Program at Seattle Children’s Hospital under the supervision of Jeffrey G. Ojemann, MD, Professor and Chief. Dr. Marupudi is a 2005 graduate of Johns Hopkins with dual BA honors degrees in Anthropology and Neuroscience, as wellas an MS in Neuroscience. She did her MD at Penn State and her residency at Detroit Medical Center/Wayne State University. Dr. Marupudi has multiple peer reviewedpublicationsandnationalandinternationalpresentations.

Dr. Martel will work as a Spine Fellow at both UWMC and Harborview Medical Center.Dr.Martel receivedhismedical school andneuroscience training in2003-2009attheUniversityofMontrealinthejointM.D./M.Scprogram(M.Sc.inPharmacology). Following graduation in 2009 he then became a Resident in Neurological Surgery at McGillUniversityfinishingin2015.Dr.Martelthendidaone–yearScoliosisandSpineFellowshipatMcGillbeforecomingtoUW.

Neena Marapudi, MD

Philip Martel, MD

Dr. Morton will work under the supervision and mentorship of Professor of NeurologicalSurgery,LouisKim,M.D. atHarborviewMedicalCenter,with a focuson clinical traininginEndovascularSurgery.Dr.MortoncompletedhisB.ScCumLaudein BiologicalSciencesfromtheUniversityofNotreDamein2005andtheattendedLoyola UniversityStritchSchoolofMedicinewherehegraduatedSummaCumLaudeandValedic-torianJune2009.Dr.MortonenteredtheUniversityofWashingtonNeurologicalSurgery ResidencyProgramin2009andgraduatedinJune,2016.

Ryan Morton, MD

Dr. Patel willworkwithProfessorLaligamSekhar,MD,withafocusonclinicaltraininginSkullBaseandCerebrovascularSurgery.Dr.PatelcompletedhisBSatYalein2005andhisMDatHarvardMedicalSchoolin2009.Hegraduatedfromresidencytrainingat MassachusettsGeneralHospital/HarvardMedicalSchoolinJune2016.Dr.Patelhaswonmanyawardsduringhismedicalschoolandresidencyyears,includingbeingnamedonanNIH/NINDSR25awardin2013tostudysinglecellRNA-seqencesinglioblastoma.

Anoop Patel, MD

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Welcome Research Fellow

Rakshith Kumar Shetty AB, MD

Dr. ShettywillconductoutcomesresearchinthefieldofneurologicalsurgeryunderthesupervisionanddirectionofRichardG.Ellenbogen,MDProfessorandChairmanaswellasLaligamSekhar,MDProfessorandVice-Chairman.HeattainedhisMBBSin2006fromJSSMedicalCollegeinMysoreKarnataka,India,andfinishedasix-yearNeurosurgeryResidencyin2014atNIMHANS,BangaloreHewasthenappointedtobeAssistantProfessorintheDepartmentofNeurosurgeryatKSHegdeMedicalCollegeinMangalore,andConsultantatthatsameinstitution.

News from the UWMC TherehavebeenproductivechangesrecentlyatUWMC.UWChiefofNeurologicalSurgeryAssociate ProfessorDr. Manuel FerreirahastransferredhisnowverylargepituitarypracticethatisacquiringpatientsfromallovertheWWAMIRegiontoUW.Thefeaturethathashelpedtomakethisclinicsoattractivetopatientsaswellasstaffisitsmultispecialtynature.InadditiontoDr.Ferriera,anexpertinminimallyinvasiveendoscopictrans-nasalsurgeryforpituitarytumors,theclinicalsoincludesDr.KrisMoeofENTandDr.CourtneyFrancisfromthe DepartmentofOphthalmology.Allthesefacultymembersarepartoftheteamthatevaluatespatientswith suspectedtumors.ThepituitaryclinicisheldonTuesdays,andappointmentscanbemadebycalling598-5637.

In addition, there has been an augmentation of the neurovascular presence at UWMC. ProfessorLouis Kim, ProfessorDaniel Hallam,andAssistantProfessor Michael Levitthavemovedpart time toUWMC,andareavailableonWednesdaystopreformangiogramsandinterventionsaswellastoseepatientsinclinic.

Assistant Professor Michelle Chowdhary is also nowseeingpatientsatUWMConThursdays from8:30 to4:00pm.

TheNeurological Surgery Summer Student Program successfully concluded its 9th yearwith graduation presentationsonAugust12th2016attheSchoolofMedicineSouthLakeUnion

TodatetheDepartmenthashosted100studentsfrom63differentschools,including10RainierScholars.ThesummerprogrambenefitsfromsubstantialcommitmentsfromawiderangeofDepartmentalresearch,clinical,andsupportstaff.Since2008,wehavehad22differentsummerspeakers,17differentfacultymentors,and14clinicalfacultymemberswhohavehostedobservationsandshadowingopportunities.Oursupportincludesdonationsfrom39differentindividuals,corporationsandfoundations.ThisyearforthefirsttimewereceivedNIHfunding,whichallowedustobroadentheprogramtoinclude5out-of-areastudentswhocouldnothaveotherwiseparticipated.Thisyear15students,arecordnumber,wereplacedin11labs,includingoneatTheAllenInstituteforBrainScienceinthelabofDr.EdLein–anotherProgramfirst.

Theprogramincludesnotonlylaboratory-basedlearning,butalsosocialopportunitiesandpracticalelementssuchassessionsdevotedtovocationalissuesandpathwaystosuccessinneurosciencecareers.Studentsgainvaluableexperienceinpresentingtheirresearchinapublicsettingatgraduation,andthisyeartheysharedtheirresultswithalargeaudienceoffamilymembers,mentors,andpeers.Onestudent’ssummerworkhasalreadybeenacceptedforaposterpresentationatthe2016BlackDoctoralNetworkConferenceConventiontobeheldinAtlanta,Georgia.

Thestudentssayitbest:

-WhatIlikedmostabouttheprogramisthewillingnessofeveryonetoteach.Iaminterestedinenteringacademicmedicine,soseeinghowtheneurosurgeons teachus, their residentsandmedicalstudentsopenedmyeyes to the fascinatingandintellectuallystimulatingcareerthatIhopetopursue.

-Iabsolutelylovedtheobservationopportunities;infact,thesurgeryIobservedthispastMondaywithDr.Browdwassofascinatingthatithascompletelyinspiredmetopursueneurosurgery.Ithinkanyexperiencethatshapesyourlifeinsuchadramaticwayisvaluable,andsomethingtobeappreciatedimmensely.

-Ilovedthecamaraderiethattheprogramparticipantssharedwitheachotherandwiththeprogramadministrators.Everyonegot alongverywell and it helped to amplifyour experience.The administrators truly cared about our well-beingandwerealwaysavailablefortoanswerquestionsorprovideuswithresources.

-IlovedgettingexperienceworkinginalabandIlovedgettingORobservationopportunities

-Ofcourse,theexperienceinthelabwasexceptional,andIlookforwardtocontinuingtohelpwithmylab’sworkelectronicallyevenafterI’veleftSeattle.

Neurological Surgery Summer Student Program 2016

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ProfessorofNeurologyandNeurologicalSurgeryMichaelA.Williams,MD,wasthefeatured

speakeratthe6thAnnualSeattleChildren’sHospital&HydrocephalusAssociationWALKheldatWarren

G.MagnusonPark.Dr.WilliamsleadstheUniversityofWashingtonMedicalCenterprogramforAdultand

TransitionalHydrocephalusandCSFDisorders.NeurologicalSurgeryResidentBrianHanakprovided

introductionsandranaspartoftheevent.Theeventwebsitecontainsvaluableinformationaboutthe

Associationwhosemissionistopromoteacureforhydrocephalusandimprovethelivesofthoseaffected

bythecondition–seehttp://hawalk.kintera.org/faf/home/default.asp?ievent=1156176forfurtherinformation.

Dr.Hanakisnotonlyanoutstandingsixthyearresidentbutalsoaseasonedrunnerwhowontherace

portionoftheday’sevents.Asalong-timerunnerhimself,theEditorcanattesttoDr.Hanak’sexcellentform

havingbeenforcedtorunwithhimbyaccident(butonlyverybriefly).

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Hydrocephalus Walk - August 6, 2016

Michael A. Wiliams, MD Bri-an Hanak, MD &

We remain eager to publish stories and photosabout all aspects and activities of the Department.Pleaseshareyourmemories,ideasandsuggestionsfor stories and news items that expand our commonground.Pleasecontactusattheseemailaddresses:

Editor-in-Chief, RichardG.Ellenbogen,MD,FACS rge@uw.edu

Editor, RichardRapport,MD rappor@uw.edu

Associate Editor, JamesPridgeon,MHA pridgeon@uw.edu

Director, JanaPettit,MBA jmpettit@uw.edu

Publications Specialist, ChristinaBuckman cbuckman@uw.edu

The Puzzler-in-Chief, MinkuChowdhary,MD

Puzzler

New Puzzler

Q:ThisproposedinspirationforIndianaJones,discoveredacitythatreportedlyisthesiteoftheoldestknownproductofthistype,betterknowntoustodayasaproductpopularizedbyapartnershipbetweenaBavarianandaLatvianimmigrant.Whatistheoldproduct?

Previous Puzzler

Question:Insteadofbeingdescribedasasharptongue,thispresidentialwifehadasoretongue,andsomepeculiarhabits.ThemissinglinkthatwillhelpyousolvethispuzzleisafamousCheers bartenderwhocouldn’tquitejump,andaBaywatchbeautywhowasfamousalongsideHoff (notChristof).

Answer:MaryToddLincoln,possiblyhadB12deficiency,whichVegans,likeWoodyHarrelsonandPamelaAnder-sonhavetosupplementtoprevent.

http://www.nytimes.com/2016/07/09/health/mary-todd-lincoln-anemia-vitamin-b12.html?rref=collection%2Fsectioncollection%2Fscience&action=click&contentCollection=science&region=stream&module=stream_unit&version=latest&contentPlacement=3&pgtype=sectionfront&_r=0

Dr. Minku Chowdhary

Director,NeurosurgeryOverlakeHospital

facebook.com/uwmednsi

This publication does not constitute professional medical advice.Although it is intended to be accurate,neitherthepublishernoranyotherpartyassumesliability forlossordamagefromrelianceonthismaterial.Ifyouhavemedicalquestions,consultyourmedicalprofessional.

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