The WFNS 100 Webinar series was the brainchild of Professor Nasser El-Ghandour (Egypt), current treasurer of the WFNS, president of MANS (Mediterranean Association of Neurological Surgery), and past president of CAANS (Continental Association of African Neurosurgical Society). The impetus for this format was to mitigate the isolation imposed by the COVID-19 pandemic on the global neurosurgical community. Now that the series has reached “maturity”, webinar #74 has been selected as an example of this series of webinars because of the importance of neurotraumatology for neurosurgeons worldwide.
The first webinar of this series, held on May 29, 2020, was fittingly entitled “Is Covid-19 a Neurotropic Virus?”. The three eminent speakers were Professors Tito A. Perilla-Cepeda (Colombia), Maged Abdel Naseer (Egypt), and Mohamed Amin Roshdy (Egypt). Since then the gamut of neurosurgical topics has been covered by expert speakers worldwide. This series rapidly became the exemplary model for other virtual learning platforms with typically over one thousand participants zooming in to the bi-weekly sessions. Its popularity has persisted post- pandemic and is now a fixture of global neurosurgical education. The entire series is endorsed by the WFNS Education Committee, currently led by Professor Luis Borba (Brazil).
Each 3-hour long webinar is usually divided into 3 sessions. The moderator introduces the 3 or 4 expert speakers who share their experiences, answer questions both virtually in the chat box and in person during the question-and-answer sessions; the moderator then directs the post-talk discussions. Lively debates between the speakers often ensue. To best accommodate the time differences across the globe, these webinars start at 14:00 Egypt time (12 noon GMT). Professor Nasser El Ghandour is ably assisted by a technology team headed by Dr Manal Hassan.
The focus of the webinars varies among neurosurgical topics and is often directed to regional needs. Neurotrauma webinars have been held with societies in Latin America (La Federación Latinoamericana de Sociedades de Neurocirugía – FLANC), Asia (Asian Australasian Society of Neurological Surgeons – AASNS), Africa (Continental Association of African Neurological Surgeons – CAANS), and the Asian Congress of Neurological Surgeons (ACNS).
All participants including speakers and audience members receive certificates of participation and, most importantly, all have continued access to the entire webinars which are posted online (YouTube) for reference and subsequent review. For Webinar #74, held on June 16, 2023, the focus was Neurotrauma Research, both clinical and bench.
Webinar #74 was a joint effort of the WFNS, MANS and CAANS, and organized by WFNS Neurotrauma Committee Chair, Andrew Reisner (USA) of Emory University and Children’s Healthcare of Atlanta, and Professor Nasser El-Ghandour – and smoothly presented thanks to Dr Manal Hassan and her technology team in Cairo. Nearly 1000 participants logged in.
The first session was co-moderated by Eve Tsai (Canada), Department of Neurosurgery, The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa and Wilco Peul (The Netherlands), Department of Neurosurgery, Universiteit Leiden. The first speaker was
Michael Fehlings (Canada), Department of Neurosurgery, Robert Campeau Family Foundation, Dr. C.H. Tator, Chair in Brain and Spinal Cord Research, Spine Program, and McLaughlin Scholar in Molecular Medicine, University of Toronto. His talk was "Time is Spine: State of the Art and Future Directions of the Management of Traumatic Spinal Cord Injury." Professor Fehlings summarized the international guidelines on three topics related to SCI. This work was jointly sponsored by AO Spine and the PRAXIS Institute and endorsed by the WFNS. The three topics: 1) role and timing of surgical intervention for acute SCI, 2) optimal hemodynamic management of acute SCI, 3) prevention, diagnosis, and management of intraoperative SCI. The first topic, an update of the 2017 AO Spine-CSRS guidelines that strengthens recommendations regarding early surgery for acute SCI, is currently under review at the Global Spine Journal.
The next speaker was Jack Jallo (USA), Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania. He spoke about “Frailty Index in Spinal Trauma”, the key point being the Frailty Index’s value when prognosticating outcomes of spine surgery.
The third speaker was Nader Hejrati (Switzerland), Eastern Switzerland Spine Center, Department of Neurosurgery Cantonal Hospital St. Gallen, who spoke on “Clinical Trial for Neurodegenerative Therapies: Challenges and Opportunities”. Professor Hejrati stressed the roadblocks to implementing evidence-based guidelines into clinical care, especially in lower and middle-income countries (LMICs).
This session concluded with Elham Rostami (Sweden), Department of Neurosurgery, Uppsala University, discussing “TBI: Current State of the Art and Future Perspectives”. An excellent review was given on guidelines for severe TBI, including important pointers for performing an adequate decompressive craniectomy. Professor Rostami concluded her talk with a fascinating discussion of advanced translational research.
The second session was moderated by Niklas Marklund (Sweden), Department of Clinical Sciences, Lund University. The first talk, by Uzma Samadani (USA), President and CEO, US Neurosurgery Associates, Staff Neurosurgeon Minneapolis Veterans Administration, Associate Professor of Bioinformatics and Computational Biology, University of Minnesota, was “Brain Injury and the Digital Neurological Examination”. She described mechanisms to measure brain function, including her innovations to monitoring brain function in a non-invasive manner, that are applicable to TBI patients ranging from concussion to coma.
This was followed by Ramesh Grandhi (USA), University of Utah, Surgical Co-Director, University of Utah Stroke Center, Salt Lake City, Utah, who spoke on "Blood-based Biomarkers: A New Era for Care and Research of Patients with TBI”. He presented a comprehensive review of current TBI biomarker investigation and how this may influence future TBI management.
The final talk, by Firas Kobaissy (USA), Department of Neurobiology, Associate Director, Center for Neurotrauma, Bioinformatics and Computational Biology, Morehouse School of Medicine, Atlanta, Georgia, was "The Promise of Mitoquinone in Ameliorating Behavioral Deficits and Neuropathological Changes in an Experimental Model of TBI Journey”. This summary of the biochemical and pathophysiological changes that occur following TBI focused on the changes ameliorated in an animal model of TBI by mitoquinone and other medications.
The final session was moderated by Russell Andrews (USA), Medical Advisor at National Aeronautics and Space Administration (NASA) Ames Research Center, California. The first speaker, Ryan Kitagawa (USA), Director of Neurotrauma/Associate Professor, Vivian L Smith Department of Neurosurgery, University of Texas Health Sciences Center, Houston, Texas, spoke on “Blood Thinners Before and After TBI”. His summary, peppered with pertinent case reports, included when, how, and why to reverse anticoagulants in various scenarios.
Jacob Lepard (USA), Emory University and Children's Healthcare of Atlanta, gave a fascinating talk on the “Differences in Outcomes of Mandatory Motorcycle Helmet Legislation by Country Income Level: A Systematic Review and Meta-analysis”. He stressed how this project could serve as a model for other preventative neurotrauma initiatives worldwide and be used to train neurosurgeons to better meet the currently overwhelming demand for neurosurgery care globally.
The session was closed by Christopher Bonfield (USA), Director, Global Neurosurgery Program, Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee. His talk, “Asking Practical Questions in Neurotrauma Research: Neurological Injuries in All-terrain Vehicle (ATV) Accidents", highlighted the socioeconomic factors associated with helmet use (or not) in ATV and bike accidents. These are important considerations in TBI prevention efforts.
The YouTube link to this entire 3-hour WFNS Neuro-Traumatology Symposium webinar #74 can be found at https://youtu.be/cqsGd_SdpEQ
A follow up e-mail from Professor El-Ghandour to the speakers stated “It was a great honor to work with all of you in this great event. We received lots of emails & messages from all continents that the program was outstanding, all presentations were great, and the discussion was very interesting.” I agree and would extend an additional thanks to Nasser El-Ghandour from the entire 33 member WFNS Neurotrauma Committee, who hail from 29 different countries. We are all grateful for Professor El-Ghandour’s expertise and generosity in allowing us to disseminate important aspects of neurotrauma to such a wide and diverse global neurosurgical audience.
As this webinar series marches on to #100, we wonder what the topic for Symposium #100 will be? Regardless of the subject, we know at least what 4 keywords (co-incidentally, all beginning with the letter “e”) will be - education, El-Ghandour, Egypt and excellence. Shukrn.
Andrew Reisner, MD, FACS, FAAP, 1, 2, 3, 4 Laura Lippa, MD, 1,5 Andrés M Rubiano, MD 1,6,7
1 Neurotrauma Committee, World Federation of Neurological Societies (WFNS); 2 Department of Neurosurgery, Emory University; 3 Department of Pediatrics, Emory University; 4 Children’s Healthcare of Atlanta, Atlanta, GA USA ; 5 Department of Neurosurgery, ASST Ospedale Niguarda, Milano, Italy; 6 INUB/ MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia; 7 MEDITECH Foundation, Clinical Research, Calle 7-A # 44-95, Cali 760036, Colombia.
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