Cheryl Carcel - Stroke Society Australasia

Cheryl Carcel - Stroke Society Australasia

CT-Angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study (BASICS)

CT-Angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study (BASICS)

Seven minutes in Stroke - Veronica Olavarria

What inspired you towards neuroscience?

The complexity of the brain with its potential and its connections to the rest of the body. It is very interesting the pathophysiology of the neurological diseases that we know so far.

2. Why stroke?

Because it is a devastating disease with so many consequences and I think that I would like to contribute in some way to its knowledge and to help patients with stroke.

3. What have been the highs so far?

Fortunately there have been several highs in the past years, more for ischaemic stroke like the use of intravenous thrombolysis, the performance of decompressive craniectomy for malignant infarction and recently the use of thrombectomy and the organization of stroke units for all types of strokes.

4. What have been the lows?

The slow progression in prevention, in decreasing the incidence of stroke and better accessibility to neurorehabilitation, that also need to be improved, especially in low income countries.

5. How do you balance work life with the needs of home life?

It is always a challenge, sometimes you have to make some sacrifices. At this moment I try to work part time at the hospital and outpatient clinic, and also working on night shifts, so I can share more time with my family, with full support from my husband to work this way.

6. Who are your most important mentors and how did you find them?

While I did my fellowship in neurovascular and neurointensive care programme at the Instituto de Neurocirugía Dr. Asenjo in Santiago, Chile, I met Dr. Pablo M. Lavados, who is my mentor and he encourage me to do research in the stroke field, and after some years he introduced me to Dr. Craig S. Anderson from The George institute, Sydney, Australia, who taught me to simplify when is possible the way to do research at patient level and the importance of pragmatic clinical trials.

7. What are your most important collaborations and how have you built them?

The most important collaboration have been the Head Position and Stroke trial between The George Institute for Global Health, Sydney, Australia and our stroke team at Clínica Alemana de Santiago, Chile. Some years ago (2011) in Chile we invited Dr. C.S. Anderson to a Conference and with my mentor we presented to him the idea of the trial about the best position of the head in the acute phase of stroke, and he supported the idea. We applied at a local level to get funds to do a pilot study and together we also applied to a research grant from the Australian MRC to do a phase 3, the main phase of the trial, which is ongoing and will finish this year, to answer a simple but a relevant question. This collaboration has meant a contribution also to our knowledge as a group about conducting clinical trials in stroke at large scale.

1 year on, AVERT trial results

1 year on, AVERT trial results

Seven minutes in stroke - Tim Vanbellingen

Dr. Tim Vanbellingen is a neuroscientist at Head Motor Therapies

Neurology and Neurorehabilitation Center, Luzern in Switzerland and the Postdoc Departments of Neurology and Clinical Research at the

University Hospital, Inselspital Bern

tim.vanbellingen@dkf.unibe.ch

1. What inspired you towards neuroscience?

Understanding how our brain actually works, and how this is related to different kinds of human behavior is really fascinating to me and inspired me to become a clinical neuroscientist. Still a lot is unknown, many research questions are open. What is also important to me is how to translate the knowledge derived from basic neuroscience into clinical neuroscience.

2. Why stroke?

Stroke affects many people worldwide, leading to strong disability, reduced quality of life (QoL). The last decade some well performed randomized trials have shown positive effects of exercise therapy improving gait, upper limb function, consequently QoL. Already in the very acute stage of a stroke, early mobilization is important and effective for long term functional outcome. Still, the exact dosage of an specific intervention to improve, for example hand function, in a single stroke patient is difficult to determine.

The effects of exercise therapy on structural and functional brain functioning, plasticity, needs to be much better explored in stroke and is very interesting to me.

3. What have been the highs so far?

Not research related:

-       To met my wife back in 2005. Having two kids together ;-))

Research related:

-       To win an important research award in 2014.

-       Obtaining a peer reviewed research grant just recently

4. What have been the lows?

A close rejection of a revised paper in a high ranked journal.

5. How do you balance work life with the needs of home life?

I try to manage this with a very strict time schedule, to be well organized. I do a lot of conference calls, e-mail checks on the road (in the train) etc… It is also very important to have, at certain time points, a complete, I called it, ‘Offline modus’. No cell-phone, laptop, television ; just family, wife, kids, and the beautiful surroundings of Switzerland, my second home country (besides Belgium off course, as a native Belgian).

I also percieve my ability to engage in research as a ‘privelege’. For example I like to analyse data, or to finalyze a paper, for example in our garden in the evening at sun set. It is a kind of passion, and in fact it is not exhausting to me. I call it a kind of addiction, finishing a nice paper draft, hopefully to get published. And at the end, importantly, to have a certain impact in research community and clinical pratice.

6. Who are your most important mentors and how did you find them?

Prof. Dr. Willy De Weerdt: He was my supervisor for my master thesis and was a great inspiration to me back at that time. ‘The sky is the limit’ he always said to me; he is right !

Prof. Dr. Stephan Bohlhalter: I met him 10 years ago at work and he is my closest collaborator and guided me throughout my PhD. He is great!

Prof. Dr. Thomas Nyffeler: He is my direct chief at work and besides Prof. Bohlhalter my closest collaborator. We share many common interests and has given me new inputs paving my way for the future.

Prof. Dr. Gert Kwakkel and Dr. Erwin van Wegen: I had the opportunity the visit them as a postdoctoral research fellow. They have so much experience, are very well connected. We will continue to work together in the future.

7. What are your most important collaborations and how have you built them?

I closley work together with the NIH, Bethesda (Dr. Mark Hallett), with the University of Vienna (Dr. Thomas Foki), Prof. Dr. Jan Mehrholz (SRH Gera, Kreischa) and the University of Amsterdam (Prof. Dr. Gert Kwakkel and Dr. Erwin van Wegen). All of them I met at international congressess.

Seven minutes in stroke - Sara Mazzucco

Dr Sara Mazzucco is a clinical scientist at the Centre for Prevention of Stroke and Dementia

Nuffield Department of Clinical Neurosciences, Oxford UK.

What inspired you towards neuroscience?

The mystery of the brain! In the late 90s, as a medical student in my pre-clinical years, I was fascinated by how little we knew about how the brain works. There was so much to discover. When I went on to my clinical training and started seeing patients, I was struck by how different, and special, neurological patients were. I had the feeling that some diseases affecting the brain had the power to build a wall of incommunicability and estrangement between the affected patient and the rest of the world. I wanted to understand what that wall was, and I wanted to be able to knock it down.

Why stroke?

I have always been interested in blood circulation, and of course cerebral circulation is even more fascinating as it is different from the rest of the body. The brain is special even in the way it regulates its own perfusion. From a clinical point of view, cerebrovascular diseases are largely preventable and treatable, and I still feel the enthusiasm of being able to make a difference for each individual patient, helping to prevent strokes or offering acute-phase treatments.  

What have been the highs so far?

Finding a non-invasive tool that allows me a glimpse into cerebral haemodynamics, using ultrasound. This tool is called “Neurosonology”. I discovered it in the late 90s and since then I have started from scratch a neurosonology lab first in Italy (in Verona, where I worked for over 10 years) and now in Oxford, UK.

What have been the lows?

When I started my training, I felt very frustrated by the nihilistic attitude of some colleagues towards strokes patients, especially when compared with the enthusiasm for acute coronary reperfusion and endovascular treatments. Nearly twenty years later, we are finally getting there!

How do you balance work life with the needs of home life?

Working hard on both sides, and having great colleagues and a very understanding and helpful family.  

Who are your most important mentors and how did you find them?

I am indebted to many generous and clever people, whom I was lucky enough to meet in my professional life.  Among them, the neuroscientist who lead me through the fascination of Neurology was Nicolo’ Rizzuto, head of Neurosciences in Verona University Hospital when I was a medical student and a young doctor, who nurtured and encouraged my interest for stroke and Neurosonology. He also introduced me to Gian Paolo Anzola, who taught me so much, and has always supported me with his advice and practical help.  Peter Rothwell, whom I met during my PhD in Neurosciences when he was just starting the Oxford Vascular study, has always been a guide and reference for me in understanding and treating cerebrovascular diseases. I have moved from Italy to Oxford to be able to work with him, and he is a continuous source of inspiration. And lastly, my father, who is a cardiac surgeon and an academic, to whom I have always turned in my professional life when in doubt, and from whom I suspect I have inherited my interest in haemodynamics.

What are your most important collaborations and how have you built them?

I have always worked with cardiologists, radiologists and vascular surgeons. More recently, I have developed an interest in paediatric stroke and Sickle Cell Disease, and new collaborations with Paediatric haematologists have started. My research has always been very clinically oriented, and collaborations in research have always grown around clinical questions.

sara.mazzucco@ndcn.ox.ac.uk

Seven minutes in stroke - Han-Gil Jeong

1. What inspired you towards neuroscience?

It’s the attraction. When I was preparing to apply to a residency program, I asked myself; “Which organ is most important and interesting in human life?” The answer was easy to find; “Brain.”  

2. Why stroke?

During my rotation in ER, I met a patient with global aphasia with left MCA occlusion. The patient completely recovered after recanalization treatment. My heart pounded with excitement. That moment was I decided to go deep into stroke.

3. What have been the highs so far?

The highs so far was when I finally helped my patient with never-giving-up mind;

A 73-year-old woman presented to our clinic with drowsiness and generalized edema. She had had a left medullary stroke 7 months earlier. She was diagnosed with decompensated right heart failure but the cause was unknown even with a cardiology consultation. I had cared her day and night (even not going home!), and finally noticed that she was hypopneic/apneic when asleep. Yes, it was central hypoventilation syndrome after medullary stroke. She started nocturnal biPAP and fully recovered. After 3 months, the heart suffering at night was also normalized. I felt really great about successfully having treated the patient. The details are here! (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60682-1/abstract)

4. What have been the lows?

I think I’m still too young to talk about the lows of my career as a doctor or a researcher. :) 

5. How do you balance work life with the needs of home life?

I always tried to finish my work in time and according to priorities, although sometimes failed. But I can survive with a beautiful and fully supportive wife at home.

   

6. Who are your most important mentors and how did you find them?

I have been lucky to be mentored by many people. Dr. Kiwon Lee, who is always passionate and full of energy, have taught me how to be confident and successful in life. Dr. Beom Joon Kim, who inspired my interest in clinical research and have taught me how to conduct a reproducible and meaningful clinical research; Dr. Seung-Hoon Lee, who has the great pioneer spirit and has led me to the field of nanomedicine and stroke; Dr. Sang-Bae Ko, who was a model of clinical excellence and great teaching during my training; Dr. Byung-Woo Yoon, who was a model of patient rapport and generosity in a clinic.

7. What are your most important collaborations and how have you built them?

Currently, I have had the chance of collaborating with great researchers in the field of nanomedicine to develop nanotherapeutics for stroke (Dr. Seung-Hoon Lee & Dr. Jaeyun Kim). And I also collaborate with Dr. Beom Joon Kim focusing on post-recanalization treatment strategies for acute ischemic stroke. I’m always open to new opportunity and diligent in doing my research, which helps me to build healthy collaborations with other researchers.