Thursday, November 3, 2016

Seven minutes in stroke – Andreas Charidimou MD PhD MSc (Clinical Neurology)

Dr Andreas Charidimou is currently a post-doctoral clinical research fellow in Stroke at the Hemorrhagic Stroke Research Program,JPK Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA
Twitter: @microbleeds

1. What inspired you towards neuroscience?
The mystery of the brain intrigued me since I was a medical student. The ‘fetishism’ of studying and trying to understand the most ‘complex structure in the universe’ was sparked by three books that I came across in the 2nd year of medical school: Eric Candel’s Principles of Neural Science, Vilayanur S. Ramachandran’s Phantoms in the Brain and Oliver Sacks’ Awakenings. I got my first taste of clinical neurology during my Neurology rotation in the 5th year of medical school at the Eginition Hospital, University of Athens, Greece. We had a great Lecturer of Neurology (Constantin Potagas) who had an amazing talent for bringing the subject to life. I knew that this was my sort of ‘calling’ and from that moment I couldn’t really see how anything in medicine could have ever been more interesting!

2. Why stroke?
Stroke, because it is such a common and devastating disease, but with so many things that could be done to further our knowledge and help patients - I am really hoping to contribute in some ways towards this direction. When I started my acute neurology rotations, one of the first patients admitted was an elderly lady with an MCA stroke. I felt really frustrated by the general nihilistic approach at the time, with so few things to offer for stroke patients, especially compared to other acute syndromes, including acute coronary disease. Some months later, and largely by chance, I had the opportunity to do a clinical attachment to the only comprehensive state-of-the-art stroke unit in Athens, at the Alexandra hospital, Greece, under Konstantinos Vemmos. It was there that I realised the exciting combination of different medical disciplines involved in acute and chronic stroke pathophysiology and clinical care of stroke patients, including neurology, neuroimaging, internal medicine etc. It was also encouraging and inspiring to see how clinical stroke research is truly intertwined with stroke medicine and how far this approach can get us.

3. What have been the highs so far?
There have been so many highs. Perhaps the most life-changing one was moving from Greece to London, UK to continue pursuing my research career at Queen Square, UCL, which led be to a PhD in cerebral small vessel disease and intracerebral haemorrhage. Well, during these years the satisfying moments have been many, both academically and personally. Becoming part of the wider small vessel disease community and the smaller cerebral amyloid angiopathy family has been amazing. Equally life-changing, was then moving from London to Boston, USA to my current position as post-doctoral fellow at the Hemorrhagic Stroke Research Program in Massachusetts General Hospital. The best part of this adventure is of course meeting so many interesting people around the world and making good friends, which, at the end of the day, it’s all that matters.

4. What have been the lows?
Occasionally, some rejection letters from journals! The slow progression in prevention and treatment of small vessel disease and vascular dementia. Also, the realization that working in research can occasionally be incredibly competitive, and the inherent flaws resulting from how the research academic system is structured which to a certain extend can prevent progress. But this a big topic for a lengthy discussion!

5. How do you balance work life with the needs of home life?
Achieving such a balance is really challenging and almost a lifelong exercise! It is always useful to put things into perspective and enjoy time with family and friends. I am very lucky because my family members are very supportive, especially my partner.

6. Who are your most important mentors and how did you find them?
Real mentorship is a complex matter. I am grateful to many generous and interesting people, whom I was lucky enough to encounter in my professional life. Among them, my primary PhD mentors, David Werring at Queen Square, UCL who have generously provided me with professional opportunities that were important steps in my career and shaped me as a researcher. My secondary PhD advisor, Rolf Jager, also at Queen Square, UCL who trained me in clinical neuroimaging and . I am grateful to both for their support and trust. My academic life wouldn’t have been the same if I wasn’t lucky enough to meet Jean-Claude Baron, a great mentor generously sharing his ideas, experience and passion for cerebrovascular disease. My current mentors here at MGH, especially Steven Greenberg, is an amazing source of advice, knowledge and inspiration and it’s a unique experience being part of this group.

7. What are your most important collaborations and how have you built them?
During the last few years I have had the pleasure to collaborate on multiple projects with amazing and very generous colleagues in the field of small vessel disease and intracerebral haemorrhage.

My research has always been very clinically-oriented, and collaborations grown around key clinical questions in our field. Currently, important collaborations include those within the cerebral amyloid angiopathy community in building large multicentre cohorts to definitely address relevant clinical questions. Building and being part of these collaborations has been among the most fulfilling experiences.

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