Report from the 2021-2023 WFNS Neurotraumatology Committee Convention Center Ágora Bogotá



Report from the 2021-2023 WFNS Neurotraumatology Committee
Convention Center Ágora Bogotá

Andrew Reisner, Laura Lippa and Andrés Rubiano

The WFNS Neurotraumatology Committee (NTC; 2021-2023) held its first meeting at the World Federation of Neurosurgical Societies Meeting XVII in Bogotá, Colombia on March 15, 2022.

e had great representation from around the world. A total of 31 participants attended (14 inperson and 17 virtually). It was wonderful to meet and discuss the important issues of TBI once again in an atmosphere of professionalism and friendship.

Attendees

n-person attendees included: Andrew Reisner (chair; USA), Andrés Rubiano (co-chair; Colombia), Corrado Iaccarino (Italy), Niklas Marklund (Sweden), Marcelo Zenteno (Bolivia), Anthony Figaji (South Africa), Russell Andrews (USA), Kostas Fountas (Greece), Eve Tsai (Canada), Amos Adeleye Ibadan (Nigeria), and Massimiliano Visocchi (Italy). Honorary in-person guests included: Tariq Kahn (Pakistan), David Adelson (USA), and Nicolo Marchesini (Italy).

Virtual attendees included: Laura Lippa (co-chair; Italy), Alfonso Lagares (Spain), Eiichi Suehiro (Japan), Andrés Buki (Hungary), Virendra Deo Sinha (India), Wilco Peul (Netherlands), Bruno Splavski (Croatia), Faiqa Filza Khan (Pakistan), Ahmed El-Fiki (Egypt), Martin Schumann (Germany), Elham Rostami (Sweden), Opara Oluwamayowa (Nigeria), and Hiroshi Karibe (Japan). Honorary virtual guests included: Franco Servadei (Italy), Peter Hutchinson (UK), Maximillian Mehdorn (Germany), and Amit Chakraboty (India).

Welcome and Opening Agenda Items

Andrew Reisner welcomed everyone to the meeting and asked for a moment of silence to remember the colleagues, family, and patients that did not survive COVID-19. He then thanked the 2019-2021 NTC for their hard work, especially during the pandemic and pledged to continue its work through the 2021-2023 period.

The theme for the 2021-2023 NTC tenure is “Recover and Restore.” Andrés Rubiano and Laura Lippa were thanked for their outstanding efforts as 2021-2023 co-chairs.

Minutes of the last WFNS NTC meeting, held in Peshawar, Pakistan on November 13, 2019 were slightly amended (to better reflect attendees) and approved unanimously.

Neurotrauma Fellowship Program
Andrés Rubiano provided an update on the Neurotrauma Fellowship Program, started in 2015 to formalize training for basic and advanced neurotrauma care, particularly outside high-income countries (HICs). Centers participating in the one-year program are in Colombia, Brazil, USA, and UK. David Adelson and Andrés Rubiano handed out the certificates to Santiago Morales (Colombia) and Diana Sanchez (Colombia), who both thanked their mentors.

Research Updates

Peter Hutchinson (Cambridge, UK) gave a virtual update on two ongoing projects that remain open to WFNS members. Interested members may reach out to Peter Hutchinson directly.
(pjah2@cam.ac.uk )

The Global Epidemiology and Outcomes after Traumatic Brain Injury
The Global Epidemiology and Outcomes after Traumatic Brain Injury (GEO-TBI) registry is a global collaborative neurotrauma registry. Its main objectives are to enable high-quality data collection, data sharing, and collaborative auditing and research efforts across multiple institutions. Any center treating TBI patients is eligible to join. Please enlist your center through e-mailing geotbi@orion.net or through www.geotbi.org

Global Neurotrauma Outcomes Study: Spine
Over seven months of recruitment, the Global Neurotrauma Outcomes Study: Spine enrolled 222 institutions with great diversity between LMICs and HICs across almost all continents. To date, 84 centers obtained local approval and are either collecting data or about to begin. To join, form a team (up to four individuals) and register your institution on http://tinyurl.com/RegisterGNOSSpine with next step being obtaining local approval for the study to be conducted at your institution. For more information, including accessing the study protocol, please visit, or contact the central study team at info@globalspinetrauma.com.

Other International Study Updates from Peter Hutchinson

  • Cranial Reconstruction Registry remains open across all neurosurgical centres in the UK.
  • Two-year results of the RESCUEicp study were recently accepted by JAMA Neurology.
  • RESCUE-ASDH is finalizing a paper and plans to submit to a major journal.
  • Results of the CPPopt Guided Therapy: Assessment of Target Effectiveness (COGiTATE) multicenter randomized phase II clinical trial (Holland, Belgium, Italy, UK), were published last year.
  • Two MAST trials (UK) aim to define the best practice for the use of antiepileptic drugs (AEDs) following TBI.

Endorsement of the BOOTstrap Study for spinal trauma
Nico Marchesini presented Spine BOOTstrap (Beyond Only One Treatment option – A Stratified Approach) study. The rationale for the study was that existing guidelines require resources that may be lacking in some regions of the world. The BOOTstrap was done in a modified Delphi process. If the results are positive, efforts will be made to extend the protocols to different scenarios. Please see photo below.

Nicolo Marchesini requested the committee endorse this document. Andrew Reisner agreed and put it to the vote. It passed unanimously.

Research Encouraging Collaboration Between Low-, Middle, and High-Income Countries

  • Kostas Foutas presented a proposed multicenter study examining posttraumatic hydrocephalus. There was a discussion on lowering the age to include children. Once the protocol is developed, Kostas Foutas will present to the NTC. .
  • Ayodanola Atun and Opara Oluwamayowa presented a plan for TBI in a tertiary care center in Nigeria. The study would collect clinical and epidemiological data to examine predictors of clinical outcome and the effect of emergency department training on clinical outcomes. Anthony Figaji warned about mixing prospective and retrospective data.
  • In Andreas Demetriades' absence, Nicolo Marchesini presented an international multicenter, prospective observational study on concomitant cranial and spinal injuries. Andrew Reisner assured them that the committee supported this project.

Corrado Iaccarino presented several research projects, including:

  • Embolization of middle meningeal artery for the treatment of subdural hematomas.
  • A study of hemostasis and TBI.
  • Survey on the elderly in TBI.

The NTC applauded these ongoing efforts and are willing participants, if needed.

 

WFNS Webinars or Grand Rounds
A focus of the 2021-2023 NTC is to develop a Grand Rounds and Guidelines section on the WFNS website. It is proposed that the committee will curate, index, and host webinars, grand rounds, and guidelines that will live as a well-categorized compendium or index of neurotrauma topics. Each will be linked (with permission and acknowledgements, of course) to the many outstanding webinars and lectures that already exist through neurosurgery organizations such as Global Neuro, ThinkFirst, WHO, and others.
It is planned that two committee members are needed to sign off on each topic to maintain the quality. Details of this process, as well as topics and appropriate legal disclaimers will be drafted by Andrew Reisner, Peter Nakaji, and Takao Hiroyuki.
Laura Lippa, co-chair of NTC, has a keen interest in education and agreed to spearhead this project. If you are willing to assist, please email her at laura.lippa@gmail.com. She will also send out a poll to get NTC members' input.

Global Courses and Conferences
Two courses in the planning stages:

  • One will be directed to African continent in conjunction with CAANS. Organizers include Laura Lippa, Nasser El-Ghandour, and Franco Servadei. This will be a virtual course on June 10, 2022. ALL WFNS NTC members will be asked to participate once an agenda and syllabus are developed with our African colleagues.
  • A Southeast Asia course is in the planning stage under the direction of Franco Servadei. There will likely be an in-person component with the possible involvement of Global Neuro.

Timing and location for several international conferences were discussed:

  • Berlin is hosting the 15th International Neurotrauma Society meeting in 2022 and Cambridge is hosting the 16th International Neurotrauma Society meeting in 2024.

ICRAN (International Congress in Recent Advances in Neurotraumatology).

  • Tariq Khan reminded us that the last in-person ICRAN meeting was in Peshawar, Pakistan in 2019. Subsequent planned meetings in India and Indonesia were postponed or canceled.

Discussion included whether there should be one or two meetings a year, possibly on different continents. No decision was made, but future meeting venues were discussed with excellent presentations by:

  • Marcello Zentino and colleagues from Bolivia (Santa Cruz)
  • Sinha Virendra and Amit Chakrabaraty, from India (Jaipur)
  • Wilco Peul from the Netherlands (Leiden and The Hague)

The proposal to hold ICRAN meeting in Santa Cruz, Bolivia (2023); Jaipur, India (2024); and the Leiden, the Netherlands (2025) was approved with no objections. Details including exact dates still to be determined. Anthony Figaji and David Adelson raised the good question of considering the timing of the 2025 meeting in the Netherlands if the 2025 WFNS meeting is to occur in Europe. To be discussed further once details are known.

Abusive Head Trauma Consensus Statement
Abusive head trauma is an international problem that was exacerbated during the pandemic. No clear-cut guidelines or consensus statements exist that encompass HICs and LMICs. This is something the WFNS can develop. While there was insufficient time in this meeting to discuss the details of the proposed consensus statement, Andrew Reisner made a brief presentation and asked for a yes or no vote as to whether it was worth proceeding. It was unanimously agreed that this should be a goal for the current committee to be completed within two years.

Next Meetings
It was proposed that the next WFNS NTC meeting be held at National Neurotrauma Society meeting, Atlanta GA, June 26-29, or the International Neurotrauma Society, Berlin, July 17-22.

Closure
Dr Reisner thanked all participants and closed the meeting. Lunch was served.

BOOTstrap Study for spinal trauma

August 2022
SunMonTueWedThuFriSat
31123456
78910111213
14151617181920
21222324252627
28293031123
45678910