RENOwNEd NEUROSURGEON jOiNS HCMC ANd U OF M StAFF

Fall 2015
A quarterly publication for friends of the Department of Neurosurgery
Adding insight to
injury
Following is a teaser of a 2014 TEDMED
talk given by Uzma Samadani, MD, PhD.
“Every eight seconds someone in
the United States gets a serious
blow to the head and we can’t
even tell how badly they are hurt.
Sometimes we can’t tell if they are
hurt at all... A collaborator said to
me... ‘why don’t you try tracking
their eye movements?’”
Leaping on that suggestion,
Samadani and her team
wrote software that tracks eye
movements as people follow
action on a screen. A video
camera records the movements.
“If one eye lagged behind the
other, even for a fraction of a
second, it could be tracked,”
Samadani said in the video. The
results shocked her. “It was clear
that normal people moved their
eyes differently than people who
had swelling in their brains. Their
eyes even indicated where in
the brain the injury might have
occurred.”
For Samadani, using the eyes
as “a window to the brain” adds
insight into brain injury.
Learn more: http://tedmed.com/
talks/show?id=299432
Excellence
Renowned neurosurgeon joins HCMC and
U of M staff
Uzma Samadani, MD, PhD, recently joined Hennepin
County Medical Center (HCMC) as the Rockswold
Kaplan Endowed Chair for Traumatic Brain Injury
Research. She is also Associate Professor of
Neurosurgery at the University of Minnesota.
Samadani splits her time between clinic and research.
In addition, she spends one day a week each at the
Minneapolis Veteran’s Hospital and teaching at the
Uzma Samadani,
university. She sees a variety of neurosurgical patients. MD, PhD
“Trauma is exciting because you never know what will
come in the door and you have a chance to dramatically
change a patient’s outcome for the better,” she said. “But I also enjoy
operating on tumors in the brain and spine.”
Samadani received her MD/PhD from the University of Illinois and
completed neurosurgery residency training at the Hospital of the
University of Pennsylvania. She also completed a Van Wagenen
Fellowship in Goettingen, Germany.
Most recently Chief Neurosurgeon at Manhattan Veterans Hospital,
Samadani also held academic appointments at New York University and
New York University School of Medicine. She co-directed the Steven and
Alexandra Cohen Center for Veteran Traumatic Brain Injury and Post
Traumatic Stress at NYU Langone Medical Center.
The offer to come back to the Midwest was one that Samadani couldn’t
refuse. “I have fivefold the access to trauma than I did in New York City,”
she said. “The hospital made a huge commitment to helping me get my
lab set up and get the resources I need to do the work I want to do.”
Her first surgery rotation at Cook County Hospital in Chicago showed
her what a neurosurgeon could do. “I was completely blown away that
a neurosurgeon’s intervention could have such immediately gratifying
results for the patient,” she said. “Since then, I’ve been hooked.”
Education
Residents’ time at HCMC
enables them to learn,
collaborate
According to Chief of Neurosurgery
Tom Bergman, one of the things
that distinguishes brain-injured
patient care at Hennepin County
Medical Center (HCMC) is the
neurosurgical residents.
The U’s residency program calls
for six months at HCMC by both
the Chief Resident and a thirdyear resident. At this time, those
roles are filled by Zoe Zhang, MD,
and David Darrow, MD, MPH,
respectively.
“At HCMC, there is a lot of
opportunity to learn about traumatic
brain injury (TBI) because of the
sheer volume of patients that
come through a Level 1 trauma
center,” said Zhang. “We see all
sorts of TBI, including head and
spine trauma resulting from car
accidents, falls, gunshot wounds,
stabbings, and assaults.”
Zhang appreciates that she gets
to work with several different
teams at HCMC. “There is a lot of
collaboration on behalf of patients
who have TBI, as well as other
injuries,” she said. “It’s been a
really good experience in terms of
exposure, volume, education, and
team collaboration.” She added
that HCMC has specific hospital
protocols for taking care of braininjured patients.
Zhang believes all these factors
enable the residents to “take good
care of patients with many different
severities of TBI.”
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HCMC recognized throughout country
for traumatic brain injury care
Imagine this. Your elderly neighbor is cleaning leaves
from his gutter. You see him fall from his ladder,
striking his head on the sidewalk below. You call 911
immediately and he is transported to the emergency
department of Hennepin County Medical Center
(HCMC) in Minneapolis, Minn. Several trauma teams
spring into action, including emergency room staff,
surgery, and orthopedics. A neurosurgery resident is
there when he arrives to initially assess brain and spine
trauma.
Tom Bergman,
MD
This is business as usual for one of the busiest traumatic brain injury
(TBI) centers in the upper Midwest. “The neurosurgical service does a
comprehensive assessment and offers a variety of treatments based on
the patient’s symptoms,” noted Uzma Samadani, MD, PhD, Rockswold
Kaplan Chair for Traumatic Brain Injury Research at HCMC. “It’s the
current state of the art.”
HCMC hones its TBI practice by staying at the cutting edge of patient
care techniques. “We’re one of the very few major trauma facilities
that routinely evaluates the latest innovations in severe traumatic brain
injury,” said Chief of Neurosurgery Tom Bergman, MD. “We are also in
the process of incorporating Dr. Samadani’s revolutionary eye tracking
evaluation for concussion.”
One of the things that Bergman feels distinguishes HCMC’s traumatic
brain injury care is the presence of U of M neurosurgical residents. “They
are dedicated 24/7 and are with the patient from the very beginning,”
Bergman said. “Having them as part of our team increases everyone’s
ability to care for our brain-injured patients.”
Active research is another way that HCMC stays at the top of its game.
“Our development of brain injury management is known throughout the
country,” said Bergman. “The hardest part of TBI for anyone is that it’s
difficult to diagnose because it’s difficult to measure,” added Samadami.
“With our research, we’re hoping to change that because we’re
developing objective measures, particularly with eye tracking.”
There may be difficulties treating TBI patients, but there are also
rewards. “I love taking a severely injured, multi-trauma patient, working
with them sometimes from six months to a year and then having them
walk into the clinic and shake my hand,” Bergman said. “It makes it all
worth it.”
Traumatic brain injury research to “affect
lives of people everywhere”
Lab team keeps
Samadani on top of
things
Sometimes the answer is simple, even though getting there may have
been complex. That’s what Uzma Samadani, MD, PhD, learned when
she led a team of New York researchers. They discovered that tracking
a person’s eyes helps determine a concussion’s existence and extent.
She believes that eye tracking will do for concussion what EEG did for
seizures.
When it comes to staffing
her lab, “My strategy is to
identify the best and brightest
people who are motivated
to work hard,” said Uzma
Samadani, MD, PhD. “If you
don’t surround yourself with
young people who are much
smarter than you, you run the
risk of not staying current.”
Samadani recently brought that spirit of discovery to her role as
the Rockswold Kaplan Chair for Traumatic Brain Injury Research at
Hennepin County Medical Center (HCMC). “Gaylan Rockswold is
phenomenal,” she said. “He dedicated his life to treating brain injury
at HCMC. And Elliot and Eloise Kaplan have experienced brain injury
treatment firsthand. It’s a huge honor to have their support.”
One of the things that Samadani and her team (pictured below) want
to create is a multi-modal assessment for brain-injured patients that
will lead to clearer TBI classifications. “Brain injury studies often fail
because we can’t classify participants well,” she noted. The assessment
will include serum biomarkers, radiographic imaging, eye tracking, and
physiologic evaluations.
In addition, Samadani will help continue Rockswold’s efforts to treat brain
injury with hyperbaric oxygen. She also has an ongoing study looking at
atrophy patterns over time in more than 10,000 brain-injured veterans.
Samadani is setting up collaborations with U of M researchers, Ann Parr,
MD, PhD (spinal cord repair); and Andrew Grande, MD (stroke recovery).
Her work is currently funded through VA Merit Awards and several
foundation grants.
“When I do my clinical work, I affect the lives of people I meet and treat,”
she said. “But with research, I can potentially affect the lives of people
everywhere.”
Samadani’s fulltime lab team
at Hennepin County Medical
Center includes Abdullah Bin
Zahid, MD, and David Balser,
MD, who are working on
outcomes after traumatic brain
injury in veterans and preventing
and treating chronic subdural
hemorrhage. Lab Manager
Vikalpa Dammavalam, BS, is
working on eye tracking as a
means to classify brain injuries.
Volunteers also do important
work in the lab. Sam Daly, BS,
is a recent addition. Samadani
asked him to make a list of all
serum biomarkers considered
indicative of brain injury, thinking
he would come up with 50 or
so. “He started looking through
the literature and told me he
was up to more than 200. I was
blown away,” she said. “His
efforts in multimodal brain injury
classification are invaluable!”
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version of this newsletter by calling
612-624-3122 or emailing [email protected].
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Traumatic brain
injury resources
Minnesota Brain Injury Alliance premiere
partner for those with TBI
If you or a loved one has suffered
a traumatic brain injury and need
help or answers to questions, here
are a few resources:
National
Americans with Disabilities Act
Information Line: 1-800-514-0301
Brain Injury Alliance of America:
www.biausa.org
Brain Trauma Foundation: www.
braintrauma.org
Center for Disease Control and
Prevention: http://www.cdc.gov/
TraumaticBrainInjury/
Center for Medicare & Medicaid
Services: 1-800-633-4227
Family Caregiver Alliance: www.
caregiver.org
National Rehabilitation Information
Center: www.naric.com
National Stroke Association: www.
stroke.org
Think First National Injury
Prevention Foundation: www.
thinkfirst.org
Traumatic brain injury doesn’t discriminate. “It’s one of
the very few chronic illnesses for which everyone is at
risk, from babies to senior citizens,” said David King. He
should know. King is Executive Director of the Rosevillebased Minnesota Brain Injury Alliance (MNBIA), the
largest organization of its kind in the nation. Its goal is
to raise awareness about brain injury and enhance the
quality of life for anyone in the state affected by it.
David King
The nonprofit organization looks at its work through
several lenses, including prevention, treatment, and advocacy. Most of
their work involves navigation of some kind. “We help people navigate
the system to see what’s available to them,” said King.
Here are a few of the ways they do that:
• Working with hospitals under a program called Resource
Facilitation to help educate staff members about what’s
available for their patients with brain injury
• Using a HIPAA-compliant external firm that monitors the
Minnesota Department of Health’s TBI Registry to follow up
with patients about six weeks after being discharged from the
hospital and make sure they’re getting what they need
• Partnering with homeless shelters under a Bush Foundation
Community Innovation grant to educate staff about TBI
symptoms and services
• Providing case-management services to the state to ensure
that about 800 people with TBI get the support and services
they need to live as independently as possible.
Minnesota
Minnesota Brain Injury Alliance:
www.braininjurymn.org
“Our role is to stay in contact with our clients, to see what’s working and
what’s not and make sure that either we provide a service or connect
them with someone who can,” said King.
Wisconsin
Brain Injury Alliance of Wisconsin:
www.biaw.org
He loves his work. “You get to work with schools and athletes, senior
citizens, the corrections system, the homeless,” King said. “These are
very diverse populations that add variety to our work and keep it so
interesting and rewarding.”
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