Karl Schaller

Dear friends and colleagues,

I am proud to hold the mandate to serve as President of the EANS for the two years ahead of us.

Be assured that I am taking this task seriously, and that I am committed to serve the interests of our entire community – be they purely clinical or academic neurosurgeons, old or young, and of whatever background and origin. That same commitment applies to all members of our Board, who are dedicated to continuing to build on our legacy and to bring the EANS further ahead.

For the time being, I have identified four axes of action, where I would like to focus on with our team:

Research With education and training having been established as our main common denominator for many years, I believe it is timely to develop a stronger base in research across all our membership.

It is my goal to assist Peter Hutchinson to grow our Research Fund and to develop a stronger liaison with our industrial partners. That should allow the offer of a greater variety of research grants and dedicated funding schemes for young neurosurgeons across our membership countries.

Publication There is an abundance of European neurosurgical journals, many of them written in their respective national language. That prevents them from becoming accessible to a wider readership. They represent the common European neurosurgical canon, however.

As bibliometrics, e.g. IF, are of utmost importance when it comes to grant applications and to academic promotions, it must be our goal to strengthen the visibility and impact of our European projects and achievements in neurosurgical innovation and research. We will work on improving the visibility and the accessibility of this work, and to strive for a better organization of scientific vs. educational content – through the website of the EANS. That will take time, but I am optimistic that we will achieve that goal.

Transparency During the congress in Dublin I was approached on various occasions: for numerous (mainly younger) colleagues it doesn’t always seem clear how our organization is structured, and how they may engage themselves with respective Task Forces, Committees and Sections. In addition, some groups, including female neurosurgeons, have the feeling of being excluded from activities and from decision-making. The current Board is taking these concerns seriously. We will thus provide a clearer description of the Bylaws of our organization through our website. In addition to that, a new task Force on Diversity in Neurosurgery will be launched.

Legacy John Garfield was an excellent example of how our activities were documented. This is beautifully illustrated in his books, e.g. on EANS Cities. There are gaping holes in our knowledge and our common memory about the History of the EANS, however. These shall be filled, and André Grotenhuis as our Historian will be endorsed to collect all relevant information, ideally assisted by a student collaborator.

Technical & Adminstrative The last year has brought many changes with regard to the management of the EANS. Together with the new office team we could stabilize the situation, and we will continue to professionalize our organization: That will include improved website management, data storage and protection, and the accessibility of administrative data. Ultimately, that should lead to better interaction with our members and across our sections and committees.

Threats and Opportunities

The subjects, which may have motivated me and my peers to become a neurosurgeon (i.e. classical micro-neurosurgery for neurovascular disorders) are continuously replaced or expanded upon by other pathologies and by new technologies, due to ongoing changes of paradigms: i.e. neuro-restoration, pre-habilitation instead of re-habilitation, neural enhancement procedures, CNS-computer interfaces, access provision for neuro-biological tissue, IT in training and in surgery, and many others.

All that requires our attention and our constant presence and participation in those fields. That goal may be attained by education and training through the channels of the EANS. But, it needs scientific open-mindedness and participation in respective research consortia as well.

It is our obligation to keep interpretational authority in these fields. That includes awareness and taking a stand on ethically relevant issues, and to keep an eye on the activities of multi-national companies, which intend to build BCI-devices and to have them implanted by robots. That is only one example, which illustrates our responsibility toward society.

Economical constraints and bureaucracy are prominent in our daily work. As individual neurosurgeons we have to strive to provide the best care for our patients. As an organization we have to create opportunities for our individual members and for our membership societies to express themselves and to assist each other in attaining that goal. That works through clinical education and training, through our various committees and sections, through our meetings, and through the manifold opportunities, which we have created throughout the years. Meanwhile we enjoy enormous outreach and connectivity across our community.

That works through lobbying and political influencing as well. That’s why we have (re)connected with the European Brain Council (EBC), for instance, with whom we are sharing an office in Brussels since recently. Negotiations with the European Academy of Neurology (EAN) concerning the creation of joint research axes are underway. Recently issued MDRs (Medical Device Regulations) at the European level are jeopardizing our existing fruitful collaboration with the medical device industry. As important technological developments will continue to have an impact on our field, we are obliged to explain our needs to the political stakeholders at the highest possible level.

As you see, there are many issues which require our attention and our constant presence in various arenas, from research to clinics to politics! I thus ask all individual members to actively participate in our organization. There is room for everybody, and for everybody’s interests, be it in one of our existing sections or committees, or in one of our newly founded task forces, i.e. on Frontiers in Neurosurgery, on Diversity in Neurosurgery, or on CSF disorders. Your energy is clearly needed!

Please feel free to contact me and the office should you have suggestions or questions regarding our organization, or should you like to participate in our activities and you don’t know how to proceed.

I look forward to seeing you soon – somewhere in our arena.

Sincerely yours,

Karl Schaller

The main interest of our lab is to better understand the neuro-glia-vascular physiology in the normal and pathological brain. Our research focuses on the 3 most important cell types in the brain: neuron, astrocyte and endothelial cell. These cells are affected after stroke or brain trauma. Our aim is to investigate how these cells interacts using in vitro and in vivo models. This understanding is important for the development of new neuroprotective and restorative therapies. The group of Prof K. Schaller is comprised of three teams working on specific aspects of the neuro-glio-vascular unit.

Dr Bijlenga's team has an interest for intracellular calcium modifications in neurones and glia during ischemia. One currently investigated target is T-calcium channels. His team is now testing the effect of inhibiting those channels during or after ischemia (in global and focal brain ischemia) with the aim to protect the brain tissue or reduce damage. http://www.projectdb.snf.ch/webforms/frameset.aspx Dr Badaut's team has an interest on the role of the astrocyte in the brain water and energy homeostasis. His group is developing an original research on the role of the AQP in normal and pathological brain. Dr da Silva's team interest is the role of L-arginine/arginase pathway in the autocrine and paracrine regulation of the cell types present in the neurovascular unit. Cell interactions, at physiological and pathological conditions, will be investigated in vitro and in vivo. Dr Schatlo investigates molecular mechanisms of brain damage following cerebral vasospasm following subarachnoid hemorrhage and stroke. Points of interest include blood brain barrier integrity, endogenous radical oxygen species production and the exploitation of the nitric oxide pathway for therapeutic purposes. Selected Publications:

Schatlo B, Gläsker S, Zauner A, Thompson BG, Oldfield EH, Pluta RM: Continuous neuromonitoring using transcranial Doppler reflects blood flow during carbon dioxide challenge in primates with global cerebral ischemia. Neurosurgery. 2009 Jun;64(6):1148-54 Hirt L, Ternon B, Price M, Mastour N, Brunet JF, Badaut J: Protective role of early aquaporin 4 induction against postischemic edema formation. J Cereb Blood Flow Metab. 2009 Feb;29(2):423-33.Epub 2008 Nov 5. Thacher TN, Silacci P, Stergiopulos N and da Silva RF: Autonomous effects of shear stress and cyclic circumferential stretch regarding endothelial dysfunction and oxidative stress: an ex-vivo arterial model. Journal of Vascular Res. (accepted for publication, 2009) Contact: Geneva University Hospital Service de neurochirurgie Email: Karl (dot) Schaller (at) hcuge (dot) ch