Meeting Highlights

AANS Annual Meeting Highlights

April 26 | April 27 | April 28 | April 29 | April 30

Saturday, April 26

Practical Courses

8:00 - Noon

Anterior and Lateral Approaches to Skull Base
Co-Directors: Ossama Al-Mefty, MD; Chandranath Sen, MD
Faculty: Ryojo Akagami, MD; Helmut Bertalanffy, MD; Chun Siang Chen, MD; William T. Couldwell, MD, PhD;  Evandro De Oliveira, MD, PhD; Kadir Erkmen, MD; Paulo Abdo Kadri, MD; Wesley A. King, MD; Sandeep M. Kunwar, MD; Anil Nanda, MD, FACS; Thomas C. Origitano, MD, PhD; Raj K. Shrivastava, MD

Skull base approaches will be taught by recognized experts in the field through
lectures and hands-on cadaver dissections.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe the surgical anatomy of approaches to the skull base
• Evaluate advantages/disadvantages of approaches for specific pathologies
• Discuss minimizing morbidity of tumor resection in the skull base

1:00 - 5:00 pm

3-D Anatomy and Approaches to the Supratentorial Area and Anterior Skull Base
This clinic is free to Residents, Fellows and Medical Students.
Director: Albert L. Rhoton, Jr., MD

This course will provide three-dimensional microsurgical instruction on routes through the anterior and posterior cerebrum and temporal lobe; anatomy and approaches to the lateral and third ventricles and pineal region;  anterior skullbase and cavernous sinus; and transsphenoidal, transmaxillary and transoral approaches.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe the routes to and through the anterior and posterior cerebrum and temporal lobe
• Discuss anatomy and approaches to the lateral and third ventricles and pineal Region
• Discuss anterior and middle skull base including the orbit and cavernous sinus
• Discuss transsphenoidal, transmaxillary and transoral approaches

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Sunday, April 27

8:00 - 5:00 pm

Practical and Technical Aspects of Transsphenoidal Surgery
Co-Directors: William T. Couldwell, MD, PhD; Gail L. Rosseau, MD
Faculty: Helmut Bertalanffy, MD; William F. Chandler, MD, FACS; Matthew G. Ewend, MD, FACS; Carl Barnes Heilman, MD; John A. Jane, Jr., MD; Amin Kassam, MD; Daniel F. Kelly, MD; Edward R. Laws, Jr., MD; Ian E. McCutcheon, MD; Basant Kumar Misra, MD; Edward H. Oldfield, MD; Jean Regis, MD; Warren R. Selman, MD; Jonas M. Sheehan, MD

This clinic will review traditional transsphenoidal approaches and present contemporary modifications of the technique, including endoscopic approaches. This clinic will also update the neurosurgeon on current medical and radiosurgical adjuncts to transsphenoidal surgery.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe the transsphenoidal approach and contemporary modification
• Cite the advantages of the endonasal, endoscopic technique
• Outline current approaches to transsphenoidal surgery
• Evaluate adjunctive therapies for patients with pituitary tumors

Update on Tumors for the General Neurosurgeon
Director: Jeffrey N. Bruce, MD, FACS
Faculty: Ossama Al-Mefty, MD; Frederick G. Barker, II, MD, FACS; Mitchel S. Berger, MD, FACS; Michael W.  McDermott, MD; Thomas C. Origitano, MD, PhD; Joseph M. Piepmeier, MD; Corey Raffel, MD, PhD; James T. Rutka, MD, PhD; Raymond Sawaya, MD

This clinic will provide the practicing clinician with an up-to-date overview of current management strategies for all types of benign and malignant brain tumors. This seminar includes current research topics but emphasizes practical management issues.

Learning Objectives
After completing this educational activity, participants should be able to:
• Identify the state-of-the-art management of benign and malignant brain tumors including glial tumors, meningiomas, acoustic neuromas and skull base tumors
• Discuss current concepts in glioma management
• Apply current updates about brain tumors to daily clinical practice decision making

1:00 - 5:00 pm

Local Delivery Methods for Adjuvant Treatment of Brain Tumor Patients
Co-Directors: Russell R. Lonser, MD; Andrew Thomas Parsa, MD, PhD
Faculty: Arun Paul Amar, MD; Edward A. Neuwelt, MD; Edward H. Oldfield, MD; Timothy C. Ryken, MD; Stephen B. Tatter, MD, PhD; Kevin A. Walter, MD

Local delivery methods for adjuvant therapy of intrinsic brain tumors have evolved from experimental studies into standard of care treatment. In this practical update a wide range of local delivery modalities will be discussed including polymers, convection, blood brain barrier disruption, endovascular techniques and local delivery of radiation. Practical examples of clinical applications for each of these methods will be reviewed, and the current status of experimental therapies in clinical trial will be discussed. At the conclusion of the course, participants will be able to explain what delivery methods are currently available for standard of care treatment, and what methods are currently in later stages of clinical development. A review of clinical trial results, ongoing
clinical trials and centers of participation will be provided as well.

Learning Objectives
After completing this educational activity, participants should be able to:
• Explain the basic physiologic principles behind local delivery methods
• Discuss the utility and limitations of local delivery methods for brain tumor patients
• Discuss the most recent results of clinical trials testing local delivery methods

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Monday, April 28

Breakfast Seminars

7:30 - 9:30 am

Open vs. Endoscopic Surgical Strategies and Approaches to the Anterior Skull Base
Moderator: William T. Couldwell, MD, PhD
Panelists: Joshua B. Bederson, MD; Fred Gentili, MD; Hae-Dong Jho, MD, PhD; Sandeep M. Kunwar, MD

This seminar will review the pathologic conditions affecting the anterior cranial base and surgical strategies employed for extradural, intradural and combined compartment lesions. Panelists will discuss steps in avoidance and management of complications, demonstrate specialized (expert) surgical approaches and indicate the appropriate application of emerging technology to anterior cranial base problems.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe the various approaches to the anterior skull base
• List pathologies that would indicate use of an anterior skull base approach
• Explain various approaches to the anterior skull base
• List the advantages of using the endoscope for anterior skull base approaches

Surgical Approaches to the Lateral Skull Base
Moderator: Jeffrey J. Olson, MD
Panelists: Jeffrey N. Bruce, MD, FACS; John G. Golfinos, MD; Takeshi Kawase, MD; Chandranath Sen, MD

This seminar will address contemporary surgical approaches to the lateral skull base and how to avoid complications.

Learning Objectives
After completing this educational activity,participants should be able to:
• Discuss the pathologic processes best addressed by lateral skull base surgical approaches
• Describe the technical aspects of standard and unusual lateral skull base approaches
• Identify the most common complications to the lateral skull base and how to avoid them

Platform Presentations

10:40–10:54 AM

Conventional Surgery Versus Stereotactic Radiosurgery in the Treatment of Single Brain Metastases: A Prospective Study with Both Randomized and Nonrandomized Arms
Authors: Frederick F. Lang, MD, FACS; Dima Suki, PhD; Moshe Maor, MD; Eric Chang, MD; Kenneth Hess, PhD; Susan Graham, RN; Stephen Hentschel, MD; Raymond Sawaya, MD

2:45–3:15 PM

Pre-Clinical Trials in Genetically Engineered Mouse Models of Brain Tumors
Speaker: Eric C. Holland, MD

3:16–3:30 PM

A Phase I/II Clinical Trial Evaluating RNA-Loaded Dendritic Cells Targeting Human Cytomegalovirus in Patients with Newly-Diagnosed GBM
Authors: John H. Sampson, MD, PhD; Duane A. Mitchell, MD, PhD; Gary E. Archer, PhD; Sharon McGehee-Norman; Beth A. Perry, RN; Denise Lally-Goss, ANP-C; Robert Schmittling, PhD; Darell D. Bigner, MD, PhD; Allan H. Friedman, MD; Henry S. Friedman, MD; David A. Reardon, MD; James J. Vredenburgh, MD; James E. Herndon, PhD; Peter E. Fecci, MD, PhD

3:31–3:45 PM

Association of Uncontrolled Hyperglycemia with Perioperative Mortality, Length of Hospitalization and Healthcare Cost for Resection of Supratentorial Brain Neoplasms
Authors: Matthew J. McGirt, MD; Frank Attenello, MS; Muraya Gathinji, MS; Khoi Than, MD; Kaisorn L. Chaichana, BS; Ghazala Datoo, BS; Alessandro Olivi, MD; Jon D. Weingart, MD; Henry Brem, MD; Alfredo Quinones-Hinojosa, MD

3:46–4:00 PM

Synthes Skull Base Award
The Natural History of Untreated Acoustic Neuromas: A Comprehensive Meta-Analysis
Authors: Michael Sughrue, MD; Derick Aranda, MD; Isaac Yang, MD; Steven Cheung, MD; Andrew Parsa, MD, PhD

4:01–4:15 PM

Association of Preoperative Depression and Survival After Primary Resection of Malignant Brain Astrocytoma
Authors: Matthew J. McGirt, MD; Frank Attenello, MS; Muraya Gathinji, MS; Khoi Than, MD; Kaisorn L. Chaichana, BS; Ghazala Datoo, BS; Alessandro Olivi, MD; Jon D. Weingart, MD; Henry Brem, MD; Alfredo Quinones-Hinojosa, MD

4:16–4:30 PM

National Brain Tumor Foundation Mahaley Award
Prolific CD8 T Cell Infiltrate in Newly Diagnosed Glioblastoma Patients Correlates with Long Term Survival
Authors: Andrew T. Parsa, MD, PhD; Tarik Tihan, MD; Margaret Wrensch, PhD

4:31–4:45 PM

Long-Term Recurrences of Cushing’s Disease After Initial Successful Transsphenoidal Surgery
Authors: Chirag G. Patil, MD; Daniel M. Prevedello, MD; Shivanand P. Lad, MD, PhD; Mary Lee Vance, MD; Michael O. Thorner, MD; Laurence Katznelson, MD; Edward R. Laws, Jr., MD

4:46–5:00 PM
Differential Proteomic Signatures Detected by MALDI Mass Spectrometry in Glioblastoma Multiforme
Authors: John R. Floyd, MD; Reid Thompson, MD; Richard Caprioli, PhD; Mahlon Johnson, MD

5:01–5:15 PM
The Value of Fiber Tractography with the 3-Tesla MRI System for Brainstem Surgery
Authors: Ugur Ture, MD; Ahmet Hilmi Kaya, MD; Geysu Karlikaya, MD; Zeynep Firat, PhD; Hatice Ture, MD; Canan Aykut Bingol, MD; Ilhami Kovanlikaya, MD

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 Tuesday, April 29

Breakfast Seminar

7:30 - 9:30 am

How I Do It: Acoustic Tumors
Moderator: Frederick G. Barker, II, MD, FACS
Panelists: Ossama Al-Mefty, MD; L. Dade Lunsford, MD; Sanjay N. Misra, MD; Kalmon D. Post, MD; Craig Andrew Van Der Veer, MD

The principles of selecting suitable approaches, techniques and tactics of multimodality treatment of acoustic neuromas will be described.

Learning Objectives
After completing this educational activity, participants should be able to:
• Identify the indications for operative treatment, radiation treatment and observation
• Apply technical details of acoustic tumor surgery
• Discuss how to avoid complications and study the outcome of surgery, radiation treatment and observation

Pituitary Tumors
Moderator: Gail L. Rosseau, MD
Panelists: William T. Couldwell, MD, PhD; Daniel F. Kelly, MD; Edward R. Laws, Jr., MD; Jean Regis, MD

Participants will obtain a state-of-the-art update on pituitary tumors, including optimal medical, surgical and adjunctive therapies.

Learning Objectives
After completing this educational activity, participants should be able to:
• Discuss optimal management of prolactinomas
• Describe approach advances in and extensions of transsphenoidal surgery
• Construct appropriate adjunctive treatment algorithms for patients

Malignant Brain Tumors: State-of-the-Art Treatment
Moderator: Joseph M. Piepmeier, MD
Panelists: Ennio Antonio Chiocca, MD, PhD; Francesco DiMeco, MD; Andrew Thomas Parsa, MD, PhD
This seminar will discuss new advances in the management of malignant gliomas including gene therapy, convection enhanced drug and immunotherapy. These advances will be discussed in the context of tumors managed by the neurosurgeon.

Learning Objectives
After completing this educational activity, participants should be able to:
• Examine drug delivery using convection based interstitial diffusion
• Review the tumor biology with gene and vaccine therapy

Platform presentations

10:15–10:29 AM

Journal of Neuro-Oncology Award
Impact of Surgery on the Leptomeningeal Dissemination (LMD) of Supratentorial Brain Metastasis (SBM)
Authors: Raymond Sawaya, MD; Dima Suki, PhD; Mustafa Aziz Hatiboglu, MD; Akash J. Patel, MD; Weiming Shi, MD; Anita Mahajan, MD; Jeffrey Weinberg, MD; Morris D. Groves, MD

Symposium

2:45–3:30 PM

An Expert Panel Discussion on Suprasellar Meningiomas: Thoughts and Strategies for Microscopic Versus Endoscopic Surgical Resection

Learning Objectives:
After completing this educational activity, participants should be able to:
• Explain the pros and cons of minimally invasive surgery
• Discuss the anatomical barriers to suprasellar meningiomas
• Discuss safe optic foramenotomy and dissection around the encased optic nerve and/or the internal carotid artery branches
• Discuss the importance of dural repair
• Discuss operative time, cosmetics and postoperative recovery

2:45–2:59 PM

Endoscopic Resection of Suprasellar Meningiomas
Speaker: Amin Kassam, MD

3:00–3:14 PM

Microscopic Resection of Suprasellar Meningiomas
Speaker: Ossama Al-Mefty, MD

3:15–3:30 PM

Endoscopic Assisted Microsurgical Resection of Suprasellar Meningiomas
Speaker: Harry R. van Loveren, MD

4:21–4:30 PM

American Brain Tumor Association Young Investigator
Identification of Inhibitor for Brain Tumor Stem Cells
Author: Ichiro Nakano, MD, PhD

4:31–4:40 PM

Persistent Outpatient Hyperglycemia is Independently Associated with Decreased Survival After Surgical Resection of Malignant Brain Astrocytoma
Authors: Matthew J. McGirt, MD; Muraya Gathinji, MS; Frank Attenello, MS; Khoi Than, MD; Kaisorn L. Chaichana, BS; Amado Jimenez Ruiz, BS; Alessandro Olivi, MD; Jon D. Weingart, MD; Henry Brem, MD; Alfredo Quinones-Hinojosa, MD

4:41–4:50 PM

Convection Enhanced Delivery of a Highly Specific Ras Inhibitor: Salirasib
Authors: Liat Goldberg, MSc; Aharon Ocherashvilli, PhD; Dianne Daniels, MSc; David Last, PhD; Zvi Cohen, MD; Gregory Tamar, BSC; Yoel Kloog, PhD; Yael Mardor, PhD

4:51–5:00 PM

Gamma Knife Surgery for Cushing’s Disease: Long-Term Outcomes
Authors: Jason P. Sheehan, MD, PhD; Jay Jagannathan, MD; Nader Pouratian, MD, PhD; Edward Laws, MD; Ladislau Steiner, MD, PhD; Mary Lee Vance, MD

5:01–5:10 PM

Preuss Award
Interleukin-13 Receptor Alpha2 Expression in Glioblastoma Multiforme
Authors: John K. Park, MD, PhD; John Jarboe, BS; Russell Lonser, MD; Kory Johnson, PhD; Yong Choi, PhD

5:11–5:20 PM

Factors Related to Failed Vestibular Schwannoma Radiosurgery
Authors: Bruce E. Pollock, MD; Michael J. Link, MD; Robert L. Foote, MD

5:21–5:30 PM

Quantitative Comparison of Kawase’s Approach Versus Retrosigmoid Approach
Authors: Steven W. Chang; Anhua Wu, MD; Pushpa Deshmukh, PhD; Mark Preul, MD; Robert F. Spetzler, MD; Nicholas Bambakidis, MD

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Wednesday, April 30

Breakfast Seminars

7:30 - 9:30 am

Suprasellar and Juxtasellar Tumors Moderator
Michael W. McDermott, MD
Panelists: William T. Couldwell, MD, PhD; Theodore H. Schwartz, MD; Juraj Steno, MD, PhD; Harry R. van Loveren, MD

This seminar will concentrate on explaining the approaches and indications for surgical therapy of lesions in the suprasellar region in adults and children. Appropriate preoperative evaluation and surgical decision making will be discussed. Innovative surgical techniques will be presented. Management of the most common lesions arising in this area will be discussed.

Learning Objectives
After completing this educational activity, participants should be able to:
• Review the options for surgical approaches to tuberculum sellae meningiomas
• Review the bifrontal extended frontal approach
• Review visual outcomes following surgery for tuberculum sellae meningiomas
• Review outcomes for children after surgery for craniopharyngiomas
• Review outcomes after minimally invasive endoscopic approaches

Intramedullary Spinal Cord Tumors
Moderator: Paul C. McCormick, MD
Panelists: Albino P. Bricolo, MD; Volker K. H. Sonntag, MD

This seminar will focus on the clinical evaluation and the current surgical management of intramedullary focus of the spinal cord.

Learning Objectives
After completing this educational activity, participants should be able to:
• Evaluate methods and strategies to reduce peri-operative complications
• Identify operative techniques to optimize safe achievement of optimal outcome

Low-Grade Gliomas
Moderator: Joseph M. Piepmeier, MD
Panelists: Mitchel S. Berger, MD, FACS; Hugues Duffau, MD; Linda M. Liau, MD, PhD

This seminar will provide an update on current evaluation and management of lowgrade gliomas. The panel will address the variety of tumors and compare outcomes from different treatment strategies.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe the range of pathologies included in low-grade gliomas
• Distinguish between different management strategies for low-grade gliomas

The Spectrum of Adjuvant Therapy for Brain Tumors
Moderator: Raymond Sawaya, MD
Panelists: Jeffrey N. Bruce, MD, FACS; Amy B. Heimberger, MD; Randy Lynn Jensen, MD, PhD; James M. Markert, Jr., MD

This seminar will provide a state-of-the-art review of the different treatment options available for patients with malignant brain tumors. These treatment options influence radiation therapy, including radiosurgery and chemotherapy.

Learning Objectives
After completing this educational activity, participants should be able to:
• Describe current scientific advances used to diagnose and treat brain tumors
• Discuss current problems with the design of effective therapies and recommend appropriate treatment options
• Design the best treatment programs based on current data for patients with brain tumors

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