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Neurovascular Center at MGHmGH Neurosurgical Service
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For patients with aneurysms and arteriovenous malformations (AVMs) as well as other neurovascular problems of the brain and spinal cord. Including the Neurovascular News; - A newsletter with information regarding carotid endarterectomy to prevent stroke, transient ischemic attack or TIA; brain aneurysms; arteriovenous malformations and other vascular lesions affecting the brain and spinalcord with information on the MGH Brain AVM and Aneurysm Center.
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Program Offering
HARVARD MEDICAL SCHOOL

MASSACHUSETTS GENERAL HOSPITAL
Neurosurgical Service

MINUTES COUNT: UPDATE ON NEW TECHNIQUES AND REVIEW OF ESTABLISHED PRINCIPLES OF MANAGEMENT OF CEREBROVASCULAR EMERGENCIES

FRIDAY, NOVEMBER 1, 1996
at the
SWISSOTEL, BOSTON

Under the Direction of:
THE MGH BRAIN ANEURYSM / AVM CENTER,
THE MGH NEUROINTENSIVE CARE UNIT,
AND MGH EMERGENCY SERVICES
COURSE DESCRIPTION
    This course will focus on the early management and diagnosis of neurovascular emergencies. With the advent of many new techniques (medical, surgical and endovascular), physicians are left questioning old practices. Determination of appropriate therapy can be confusing for specific patients during the first few minutes and hours after an acute neurovascular event. This symposium will be directed at clarifying current techniques and decision making strategies. In addition to medical considerations, legal issues of neurovascular emergencies will be discussed. The symposium will be directed to emergency room personnel (physicians, nurses, physician assistants), neurologists and primary care physicians who deal with neurovascular emergencies. The format will be lectures and case discussion. CME credit will be available.
COURSE INFORMATION
    Registration Information:
      Tuition Fee: $150.00. Reduced fee for Residents/Fellows in Training/Nurses/Physician Assistants - $75.00. Lunch will be provided. Please make check payable to the MGH Brain Aneurysm / AVM Center and mail with application to:
        MGH Brain Aneurysm / AVM Venter
        VBK 710
        Fruit Street
        Boston, MA 02114.
    Other Information:
      Inquiries should be directed to the above address or phone:
        (617)-726-3303 or (617) 726-5531
      For specific question about the course, call DeDe Buckley, RN at (617)726-5531 or E-mail buckley@helix.mgh.harvard.edu
HARVARD FACULTY
  • JONATHAN ADLER, M.D.,
      Instructor in Medicine, Harvard Medical School, Assistant in Emergency Medicine, Associate Director of Emergency Medicine Residency Program, Massachusetts General Hospital, Boston, MA
  • WILLIAM BUTLER, M.D.,
      Assistant Professor of Surgery (Neurosurgery), Harvard Medical School, Assistant in Neurosurgery, Massachusetts General Hospital, Boston, MA
  • BOB CARTER, M.D., Ph.D.,
      Neurosurgical Service and Emergency Medicine, Massachusetts General Hospital, Boston, MA
  • IN SUP CHOI, M.D.,
      Associate Professor of Radiology, Harvard Medical School, Director, Interventional Neuroradiology, Co-Director of the MGH Brain Aneurysm/ AVM Center, Massachusetts General Hospital, Boston, MA
  • ALASDAIR CONN, M.D.,
      Assistant Professor of Surgery, Harvard Medical School, Chief of Emergency Services, Massachusetts General Hospital , Boston, MA
  • STEVEN FESKE, M.D.,
      Instructor in Neurology, Harvard Medical School, Director, Neurology Emergency Services, Brigham and Women's Hospital, Boston, MA
  • R. GILBERTO GONZÁLEZ, M.D.Ph.D.,
      Associate Professor of Radiology, Harvard Medical School , Director of Neuroradiology, Massachusetts General Hospital, Boston, MA
  • STEVEN GREENBERG, M.D., Ph.D.,
      Assistant Professor of Neurology, Harvard Medical School, Assistant Neurologist, Massachusetts General Hospital, Boston, MA
  • WALTER KOROSHETZ, M.D.,
      Assistant Professor of Neurology and Internal Medicine, Associate Director, Stroke Service, Associate Director, Neurology Clinical Service, Massachusetts General Hospital, Boston, MA
  • MARILYN McMAHON, J.D.,
      Risk Manager, Massachusetts General Hospital, Boston, MA
  • CHRISTOPHER S. OGILVY, M.D.,
      Associate Professor of Surgery, Associate Visiting Neurosurgeon, Director of Cerebrovascular Surgery, Co-Director of the MGH Brain Aneurysm/AVM Center, Massachusetts General Hospital, Boston, MA
  • GUY RORDORF, M.D.,
      Instructor in Neurology, Harvard Medical School, Assistant in Neurology, Massachusetts General Hospital, Boston, MA
  • LEE SCHWAMM, M.D.,
      Instructor in Neurology, Harvard Medical School, Assistant in Neurology, Massachusetts General Hospital, Boston, MA
  • GREGORY SORENSON, M.D.,
      Instructor of Radiology, Harvard Medical School, Director, Quantitative Therapeutic Visualization, Massachusetts General Hospital, Boston, MA
  • SUSAN WEDEL, M.D., FACP,
      Executive Medical Director, New England Life Flight ,Inc., Boston, MA
  • PROGRAM OUTLINE
    FRIDAY, OCTOBER 18, 1996

      Registration ~ 7:30- 8:30

      Welcome and Introduction ~

      Christopher S. Ogilvy, M.D., Walter Koroshetz, M.D. and Alasdair K. Conn, M.D. ~ 8:30-8:40

      General management of patients with a presumed neurovascular event (ischemic or hemorrhagic) ~ Moderator: A. Conn, M.D.

        Critical care transport of patients with acute neurologic conditions ~ S. Wedel, M.D. ~ 8:40-9:00

        Airway and blood pressure control with presumed and confirmed diagnosis ~ J. Adler, M.D. ~ 9:00-9:20

      Intervening in Acute Ischemic Stroke ~ Moderator: W. Koroshetz, M.D.

        Confirming and documenting the diagnosis:New techniques in radiologic evaluation ~ G Sorenson, M.D. ~ 9:20-9:40

      Coffee Break ~ 10:05-10:25

      Emergency institution of therapy: Thrombolytic therapy -

        <>Timing and administration of therapy <>Risks and efficacy of treatment:

        Intra-arterial ~ In Sup Choi, M.D. ~ 10:10-10:40

        Intravenous rt--PA - The NINDS rt-PA and the E CASS study ~ L.Schwam, M.D. ~ 10:40-11:10

        Other medical therapies: Hypertension, Heparin - Rationale and experience ~ G. Rordorf ~ 11:10-11:30

        A rationale approach to treatment of acute stroke ~ W.Koroshetz, M.D. ~11:30-11:50

        Surgical therapy -Emergency endarterectomy, hemicraniectomy ~ B. Carter ~ 11:50-12:10

      DISCUSSION ~ W. Koroshetz, S. Feske, M.D. ~ 12:10- 12:30


      LUNCH ~ 12:30-2:00

      Special topic: Legal issues in emergency management of cerebrovascular disease. ~ C. Ogilvy, M.D., W. Koroshetz, M.D.


      Hemorrhagic disease: Subarachnoid and intraparenchymal hemorrhage ~ . Moderator: C. Ogilvy, M.D

        SAH: Making the diagnosis and emergency treatment

          Patients in good neurologic condition ~ G. Rordorf, M.D ~ 2:00-2:20

          Patients in poor neurologic condition ~ C. Ogilvy, M.D ~ 2:20-2:40

        Intraparenchymal Hemorrhage: Radiologic clues regarding the eitology of hemorrhage G. Gonzalez, M.D. 2:40- 3:00

      Coffee Break ~ 3:00-3:30

      Emergency treatments:

        Hypertensive hemorrhage- treatment and results ~ W. Butler, M.D ~ 3:30-3:50

        Amyloid angiopathy ~ S. Greenberg, M.D ~ 3:50-4:10

        Vascular malformations ~ C. Ogilvy, M.D ~ 4:10-4:30

      DISCUSSION ~ C. Ogilvy, M.D. ~ 4:30-5:00


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