2024 Department of Neurological Surgery Annual Report : simplebooklet.com

DEPARTMENT LEADERSHIP TEAM5IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '244Dear Colleagues and Supporters,2024 was a landmark year for the Indiana University Schoolof Medicine Department of Neurological Surgery as wecelebrated our 75th anniversary. Reecting on our journey,we are lled with pride and excitement for the future. Ourtraditions of academic and clinical excellence, medicaleducation and transformative research continue to thrive,and we are poised to elevate our reputation even further.Since 1949, when Robert Heimberger introduced theultrasound to our department, we have been pioneersin the eld. Our previous ve department chairs havebeen leaders, hosting national meetings and serving asocers of national organizations. We played a key role indeveloping the Neuroscience Institute and had the privilegeof treating notable individuals such as John Mellencamp,Lance Armstrong, Andre Watts — a famous pianist — andnumerous IndyCar drivers.We have developed and have been early adopters ofnumerous surgical procedures or technologies for minimallyinvasive skull base, spine and endovascular therapies. Ourcontributions to major clinical trials and registries aresignicant, and we are prolic in education. Notably, oneof our faculty members developed a powerful web-basedvideo platform, The Neurosurgery Atlas. We boast some ofthe highest rates of medical students entering neurosurgerytraining and provide six subspeciality fellowships for internaland external candidates.2024 HighlightsFaculty Expansion: This year, we welcomed ve new faculty members, nearly completing the build-out of severaldivisions, including pediatric neurosurgery, functionalneurosurgery and skull base surgery. Thomas Larrew, MD,and Jason Chu, MD, MSc, joined our pediatric neurosurgeryfaculty this past fall. Jason Schwalb, MD, and David Purger,MD, PhD, who are both part of the IU Health FoundationLETTER FROM THE CHAIRAngela M. Richardson, MD, PhDVice Chair of Strategic EngagementMisty Kirby-Nolan, NPAdvanced Practice ProviderManagerDavid W. Stockwell, MDVice Chair of Clinical AairsBradley N. Bohnstedt, MDVice Chair of EducationLaura Hamm, MBAService Line AdministratorMary GallagherDirector of EducationBronson Troyer, MBAVice Chair, Clinical &Academic AdministrationLaurie L. Ackerman, MDVice Chair of Faculty AairsMaster Clinician program, will transform the elds of functionalneurosurgery in the department. We also welcomed João Paulo AlmeidaMD, PhD, as the Robert L. Campbell Scholar in Neurological Surgery anddirector of our skull base surgery program.Research Growth: Our researchers received $3.2 million in total grant funding — a 6% growth from 2023. We also tripled the number of high-impact publications, including articles published in the New EnglandJournal of Medicine and JAMA Neurology. We onboarded seven newclinical trials and will be a collaborating site within the TRACK-TBINetwork’s Multi-Arm Multi-Stage (MAMS) Adaptive Platform Trial forAcute Treatment of traumatic brain injury. Jignesh Tailor, MD, PhD, one ofour four surgeon-scientists, received a Clinical Scientist Research CareerDevelopment Award for elucidating the role of neuroepithelial stem cells inNF2 Tumorigenesis. We also welcomed the rst MD-PhD graduate studentto be trained in our department.Lectureships: We welcomed international leaders in neuro-oncology and functional neurosurgery for the Campbell and Mealey lectureships. Forthe rst time, we showcased our functional program to luminaries, AndresLozano, MD, PhD, and Helen Mayberg, MD, at our joint lectureship withthe Department of Psychiatry. We have invested in the development of aninterventional psychiatry program as part of the Neuroscience Institute.Leadership: Charles Stevenson, MD, from Cincinnati Children’s Hospital, agreed to join the faculty as the new Pediatric Neurosurgery Divisionsection head. Jamie Bradbury, MD, was named Interim Director of theCenter for Neurotrauma within the IU School of Medicine-IU HealthNeuroscience Institute. Laurie Ackerman, MD, Brad Bohnstedt, MD, andAngela Richardson, MD, PhD, have begun their new roles as Vice Chairfor Faculty Aairs, Education, and Strategic Engagement, respectively.Clinical Growth: We continue to excel in the care of complex neurosurgical disorders. We performed more than 3,000 surgeries, including a record212 thrombectomies. We grew our spinal surgery volume by 14.6% andskull base case volume by 11%.Technological Advancements: Our neurology collaborators introduced magnetoencephalography (MEG) technology to non-invasively evaluateseizures in patients, working in tandem with our pediatric and adultneurosurgeons. IU-Bloomington neurosurgeons are also advancing patientcare with state-of-the-art augmented reality tools. We are investigating therole of 3D printing, AR/VR platforms and low-intensity focused ultrasound(FUS) for our clinicians, scientists and educators. We have formalized aplan to build out a new cadaveric surgical skills lab to perform both cranialand spinal procedures in the new IU School of Medicine Medical Educationand Research building set to open this summer.Thank you for your continued support and dedication to our mission.Together, we can ensure that the IU School of Medicine Department ofNeurological Surgery remains at the forefront of medical innovation andpatient care.Sincerely,Mitesh V. Shah, MDChair, Department of Neurological SurgeryPaul B. Nelson Chair of Neurological SurgeryCo-director, Neuroscience InstituteIU School of Medicine

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DEPARTMENT LEADERSHIP TEAM5IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 4Dear Colleagues and Supporters,2024 was a landmark year for the Indiana University School of Medicine Department of Neurological Surgery as we celebrated our 75th anniversary. Reecting on our journey, we are lled with pride and excitement for the future. Our traditions of academic and clinical excellence, medical education and transformative research continue to thrive, and we are poised to elevate our reputation even further.Since 1949, when Robert Heimberger introduced the ultrasound to our department, we have been pioneers in the eld. Our previous ve department chairs have been leaders, hosting national meetings and serving as ocers of national organizations. We played a key role in developing the Neuroscience Institute and had the privilege of treating notable individuals such as John Mellencamp, Lance Armstrong, Andre Watts — a famous pianist — and numerous IndyCar drivers.We have developed and have been early adopters of numerous surgical procedures or technologies for minimally invasive skull base, spine and endovascular therapies. Our contributions to major clinical trials and registries are signicant, and we are prolic in education. Notably, one of our faculty members developed a powerful web-based video platform, The Neurosurgery Atlas. We boast some of the highest rates of medical students entering neurosurgery training and provide six subspeciality fellowships for internal and external candidates.2024 HighlightsFaculty Expansion: This year, we welcomed ve new faculty members, nearly completing the build-out of several divisions, including pediatric neurosurgery, functional neurosurgery and skull base surgery. Thomas Larrew, MD, and Jason Chu, MD, MSc, joined our pediatric neurosurgery faculty this past fall. Jason Schwalb, MD, and David Purger, MD, PhD, who are both part of the IU Health Foundation LETTER FROM THE CHAIRAngela M. Richardson, MD, PhDVice Chair of Strategic EngagementMisty Kirby-Nolan, NPAdvanced Practice Provider ManagerDavid W. Stockwell, MDVice Chair of Clinical AairsBradley N. Bohnstedt, MDVice Chair of EducationLaura Hamm, MBAService Line AdministratorMary GallagherDirector of EducationBronson Troyer, MBAVice Chair, Clinical & Academic AdministrationLaurie L. Ackerman, MDVice Chair of Faculty AairsMaster Clinician program, will transform the elds of functional neurosurgery in the department. We also welcomed João Paulo Almeida MD, PhD, as the Robert L. Campbell Scholar in Neurological Surgery and director of our skull base surgery program.Research Growth: Our researchers received $3.2 million in total grant funding — a 6% growth from 2023. We also tripled the number of high-impact publications, including articles published in the New England Journal of Medicine and JAMA Neurology. We onboarded seven new clinical trials and will be a collaborating site within the TRACK-TBI Network’s Multi-Arm Multi-Stage (MAMS) Adaptive Platform Trial for Acute Treatment of traumatic brain injury. Jignesh Tailor, MD, PhD, one of our four surgeon-scientists, received a Clinical Scientist Research Career Development Award for elucidating the role of neuroepithelial stem cells in NF2 Tumorigenesis. We also welcomed the rst MD-PhD graduate student to be trained in our department. Lectureships: We welcomed international leaders in neuro-oncology and functional neurosurgery for the Campbell and Mealey lectureships. For the rst time, we showcased our functional program to luminaries, Andres Lozano, MD, PhD, and Helen Mayberg, MD, at our joint lectureship with the Department of Psychiatry. We have invested in the development of an interventional psychiatry program as part of the Neuroscience Institute.Leadership: Charles Stevenson, MD, from Cincinnati Children’s Hospital, agreed to join the faculty as the new Pediatric Neurosurgery Division section head. Jamie Bradbury, MD, was named Interim Director of the Center for Neurotrauma within the IU School of Medicine-IU Health Neuroscience Institute. Laurie Ackerman, MD, Brad Bohnstedt, MD, and Angela Richardson, MD, PhD, have begun their new roles as Vice Chair for Faculty Aairs, Education, and Strategic Engagement, respectively.Clinical Growth: We continue to excel in the care of complex neurosurgical disorders. We performed more than 3,000 surgeries, including a record 212 thrombectomies. We grew our spinal surgery volume by 14.6% and skull base case volume by 11%.Technological Advancements: Our neurology collaborators introduced magnetoencephalography (MEG) technology to non-invasively evaluate seizures in patients, working in tandem with our pediatric and adult neurosurgeons. IU-Bloomington neurosurgeons are also advancing patient care with state-of-the-art augmented reality tools. We are investigating the role of 3D printing, AR/VR platforms and low-intensity focused ultrasound (FUS) for our clinicians, scientists and educators. We have formalized a plan to build out a new cadaveric surgical skills lab to perform both cranial and spinal procedures in the new IU School of Medicine Medical Education and Research building set to open this summer.Thank you for your continued support and dedication to our mission. Together, we can ensure that the IU School of Medicine Department of Neurological Surgery remains at the forefront of medical innovation and patient care.Sincerely,Mitesh V. Shah, MDChair, Department of Neurological SurgeryPaul B. Nelson Chair of Neurological SurgeryCo-director, Neuroscience InstituteIU School of Medicine

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21%New Patient11%Surgeries51%Publications6%Total ResearchFunding 33%Clinical Trials Visits 7IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 6David A. Purger, MD, PhDAssistant Professor of Neurological SurgeryDr. Purger is an assistant professor of neurological surgery, an adjunct assistant professor of psychiatry and an IU Health Foundation Master Clinician. Dr. Purger’s clinical practice focuses on stereotactic, functional, epilepsy, and peripheral nerve neurosurgery, with a special emphasis on brain stimulation for psychiatric disorders. Dr. Purger is the principal investigator of the Indiana University Center On Novel Investigations of Consciousness (ICONIC), where his research focuses on elucidating the neural mechanisms of consciousness and understanding patient-specic network dysfunction to develop personalized neuromodulation strategies for psychiatric disorders. Together with his colleagues in the Department of Psychiatry, Dr. Purger is working to establish Indiana’s rst psychedelic-assisted treatment center and to understand the mechanisms underlying the eects of psychedelic-assisted therapy. Dr. Purger studied brain and cognitive sciences at the Massachusetts Institute of Technology before moving to California to complete his MD and PhD at the Stanford University School of Medicine.Jason M. Schwalb, MDBetsey Barton Professor of Neurological SurgeryDr. Schwalb is the Betsey Barton Professor of Neurological Surgery, the director of functional neurosurgery and an IU Health Foundation Master Clinician. Author of more than 15 chapters and 110 peer-reviewed papers, Dr. Schwalb is an active clinical trials investigator and nationally sought advisor to industry on stereotactic and functional neurosurgery. His research also focuses on quality improvement and health care delivery, including health equity and access to underutilized, eective surgical procedures by disadvantaged populations. Dr. Schwalb obtained his bachelor’s degree in Classical Greek from CUNY Brooklyn College, spurring a lifelong interest in how language inuences thought. He obtained his MD from Yale University, where he was named a Farr Scholar, one of ve recipients of the medical school’s highest thesis award. He completed his surgical internship at Johns Hopkins University and his neurosurgical residency at the University of Pennsylvania, with an enfolded fellowship in spine surgery. Dr. Schwalb next completed a fellowship in functional neurosurgery at the University of Toronto, during which time he also obtained additional training in peripheral nerve surgery.reviewed papers and ve book chapters. His research interests lie in translational neuroscience, functional neuroimaging in brain development and improving clinical outcomes for his patients. Originally from Toronto, Ontario, Canada, Dr. Chu is a graduate of Saint Louis University School of Medicine and completed his neurosurgery training at Emory University School of Medicine in Atlanta. Dr. Chu nished his pediatric neurosurgery fellowship at Texas Children’s Hospital. Prior to joining IU, he was an assistant professor of neurological surgery at the University of Southern California. Thomas W. Larrew, MDAssistant Professor of Neurological SurgeryDr. Larrew is an assistant professor of neurological surgery and a pediatric neurosurgeon. His clinical practice includes treating pediatric patients with neurosurgical diseases such as hydrocephalus, brain tumors, epilepsy, congenital cranial and spinal disorders, and traumatic brain and spinal injuries. Dr. Larrew has extensive experience in neuroendoscopy, providing a minimally invasive, implant-free approach to treat hydrocephalus in appropriate patients. His clinical research interests span a wide variety of topics in pediatric neurosurgery, and Larrew serves as the site principal investigator for the Cerebral Palsy Research Network at the IU School of Medicine and Riley Children’s Health. Dr. Larrew earned his medical degree from the Medical University of South Carolina, where he went on to complete his residency in neurological surgery and obtain a Master of Science degree in clinical research. He completed a fellowship in pediatric neurosurgery at Cincinnati Children’s Hospital Medical Center.João Paulo Cavalcante de Almeida, MD, PhDRobert L. Campbell Scholar in Neurological Surgery Dr. Almeida is an associate professor of neurological surgery, the Robert L. Campbell Scholar in Neurological Surgery and the director of skull base surgery. He has a strong commitment to academic neurosurgery, and his main areas of clinical care and research are open and endoscopic skull base surgery, neuro-oncology and microsurgical anatomy. Dr. Almeida has authored and co-authored more than 110 peer-reviewed papers, 75 neurosurgical meeting presentations and 29 book chapters, in addition to collaborations in microsurgical courses and academic teaching activities at international centers. Dr. Almeida obtained his medical degree at The School of Medicine of The Universidade Federal do Ceará in Brazil and completed his neurosurgery residency at State University of Campinas. After residency, he worked at the Institute of Neurological Sciences in São Paulo. In 2017, Dr. Almeida relocated to North America and underwent training at the Toronto Western Hospital / University of Toronto as a clinical fellow in neuro-oncology and skull base surgery and cerebrovascular surgery. He also completed an advanced endoscopic and open skull base surgery fellowship at the Cleveland Clinic. From 2021-2024, Dr. Almeida was a faculty member at the Mayo Clinic Florida.Jason Chu, MD, MScAssistant Professor of Neurological Surgery Dr. Chu is a board-certified pediatric neurosurgeon and an associate professor of neurological surgery. He serves as a surgical director for pediatric epilepsy at Riley Children’s Health, working closely with providers in the Comprehensive Epilepsy Program. He also serves as the director of fetal neurosurgery and has formed a close partnership with the Indiana University Maternal-Fetal Medicine and the Riley Children’s Health Spina Bida teams to perform in utero surgery for patients with myelomeningocele. Dr. Chu has authored more than 60 peer-IU School of Medicine Department of Neurological Surgery welcomes new facultyDEPARTMENT NEWS2024DepartmentGrowthTotal Patient Visits – 18,068New Patient Visits – 5,358Surgeries – 3,094Clinical Faculty – 19Basic Scientists – 5Advanced Practice Providers - 23

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9IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 8Pictured is 2024 Campbell Lecture Keynote Speaker, Dr. Andres Lozano and the Inaugural Breier Lectureship in Psychiatry Keynote Speaker Dr. Helen MaybergPictured is 2024 Frew Lecture Keynote Speaker, Dr. Laura Ngwenya (middle)3rd Annual Kalsbeck LectureshipMarch 20, 2024Edward R. Smith, MD, MBA Professor, R. Michael Scott Endowed Chair in NeurosurgeryBoston Children’s Hospital/Harvard Medical School “Pediatric Moyamoya: Learning from Tumors to Treat Stroke” Dr. Smith serves as the co-director of the Cerebrovascular Surgery and Interventions Center, vice-chair of the No. 1 ranked department of pediatric neurosurgery in the United States and leads a translational research laboratory in the Vascular Biology Program, focusing on development of non-invasive biomarkers and novel therapies for brain tumors and stroke. Dr. Smith heads one of the largest pediatric cerebrovascular programs in the country, and innovations from his research and clinical eorts have been incorporated in current national guidelines, with the goal of improving patient outcomes.27th Annual Campbell Lectureship October 9, 2024Andres M. Lozano, MD, PhDUniversity ProfessorDan Family Chair in NeurosurgeryDepartment of SurgeryUniversity of Toronto“Treating Dysfunctional Brain Circuits with Neurosurgery”Dr. Lozano has an active laboratory dedicated to the study of neurodegeneration and functional neurosurgery. He has published more than 450 manuscripts, 90 chapters and edited five books. He has the unique distinction of being named the most highly cited neurosurgeon in the world (Thompson Reuters, 2002-2012). Dr. Lozano is best known for electrical recording and stimulation mapping of hitherto unexamined brain areas and for the identication and testing of novel therapeutic targets for deep brain stimulation (DBS). He and his team have pioneered the “rst in man” applications of DBS in dystonia, Huntington’s, depression, anorexia and Alzheimer’s disease and locomotor brainstem areas in Parkinson’s disease. He is currently leading a large multicenter trial of DBS for Alzheimer’s disease.21st Annual Frew LectureshipMay 16, 2024Laura B. Ngwenya, MD, PhDAssociate ProfessorDepartments of Neurosurgery & Neurology and Rehabilitation MedicineUniversity of Cincinnati College of MedicineDirector, Neurotrauma Center, UC Gardner Neuroscience Institute “Spreading Depolarizations in Traumatic Brain Injury: From Bedside to Bench” Dr. Ngwenya is a neurosurgeon scientist with a clinical and research focus on traumatic brain injury (TBI). Dr. Ngwenya participates in national and international initiatives to improve TBI patient care such as Transforming Research and Clinical Knowledge in TBI (TRACK-TBI), Co-Operative Studies on Brain Injury Depolarizations (COSBID), and the International Initiative for TBI Research (InTBIR-2). Dr. Ngwenya is involved in clinical trials research, comparative effectiveness research and basic science research. Her NIH-funded neurotrauma laboratory explores cellular and molecular mechanisms underlying poor recovery after TBI, with a focus on spreading depolarizations. Dr. Ngwenya’s clinical and research eorts focus on identifying novel therapeutic targets, improving patient management strategies and improving the quality of life for patients with TBI.10th Annual Mealey Lectureship November 20, 2024Gelareh Zadeh, MD, PhDChairDepartment of NeurosurgeryMayo Clinic, Rochester, Minnesota"Predicting Brain Tumor Behaviour Using Genomic Signatures to Guide Surgical Decisions”Dr. Zadeh, chair of the Department of Neurosurgery at the Mayo Clinic in Rochester, Minnesota, has a dedicated skull base and neuro-oncology practice, with several multidisciplinary specialized programs including a skull base clinic, brain metastases, pituitary clinic and neurofibromatosis clinics. Dr. Zadeh has an active research laboratory focusing on integrated multi-platform molecular analysis of brain tumors, together with a focus on understanding molecular response to targeted therapies, such as anti-angiogenesis and metabolic inhibitors. She has published impactful investigative research in Cancer Cell, Nature Communication, Nature, Nature Medicine and her research has translated to direct advances in clinical care.LECTURESHIPSohn

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11IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 10IU Health Medical Group - Ball IU Health Medical Group - ArnettS. Kathleen Bandt, MDAssistant Professor of Neurological SurgeryKarl W. Janich, MDAssistant Professor of Neurological SurgeryDavid J. Hart, MDAssociate Professor of Neurological SurgeryIppei Takagi, MDAssistant Professor of Neurological SurgeryGarrett J. Jackson, MDAssistant Professor of Neurological SurgeryKenneth A. Moore, MDAssistant Professor of Clinical Neurological SurgeryGordon Mao, MDAssistant Professor of Neurological SurgeryBrandon C. Lane, MDAssistant Professor of Clinical Neurological SurgeryJames C. Miller, MDAssociate Professor of Clinical Neurological SurgeryMatthew W. Pease, MD Assistant Professor of Neurological SurgeryMitesh V. Shah, MDChair, Professor of Neurological SurgeryBradley N. Bohnstedt, MDAssociate Professor of Neurological SurgeryJoão Paulo Almeida, MD, PhDAssociate Professor of Clinical Neurological SurgeryJamie L. Bradbury, MDAssistant Professor of Clinical Neurological SurgeryLaurie L. Ackerman, MDProfessor of Clinical Neurological SurgeryRabia Qaiser, MDAssociate Professor of Neurological SurgeryJason Chu, MD, MSc Associate Professor of Clinical Neurological SurgeryJignesh Tailor, MD, PhDAssistant Professor of Neurological SurgeryThomas W. Larrew, MDAssistant Professor of Neurological SurgeryIU Health Medical Group - Riley Hospital for ChildrenIU Health Medical Group - Neuroscience Center IndianapolisTodd A. Eads, MDAssistant Professor of Neurological SurgeryBryan J Wohlfeld, MDAssociate Professor of Neurological SurgeryJason M. Voorhies, MDAssistant Professor of Neurological SurgeryIU Health Medical Group -BloomingtonClinical FacultyDavid A. Purger, MD, PhDAssistant Professor of Neurological SurgeryAngela M. Richardson, MD, PhDAssistant Professor of Neurological SurgeryDavid W. Stockwell, MDAssociate Professor of Clinical Neurological SurgeryJason M. Schwalb, MDProfessor of Neurological SurgeryThomas C. Witt, MDAssociate Professor of Neurological Surgery

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13IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 12Marking its vibrant history of academic and clinical excellence.of Neurosurgery at the Celebrating 75 years Neurosurgery Residents and Sta 1965-1966. 1st row (Sta): Dr. John Mealey, Jr., Dr. John Kalsbeck, Dr. Robert L. Campbell, Dr. Robert F. Heimburger. 2nd row: (Residents) Dr. Andrieu Dzenitis, Dr. C.C. Kas, Dr. Paul Kramer, Dr. Alan Kaufman, Dr. Arthur Hockey. 3rd row: (Residents) Dr. John Joyner, Dr. Julius Good-man, Dr. Maxwell Arata. IU Indianapolis University Library Special Collection and ArchivesA devoted pursuit of knowledge and innovationENDURING LEGACYThe rich tradition of excellence in clinical care, education and research in the Department of Neurological Surgery goes back to 1949 when Robert Heimburger, MD, was asked to form the neurosurgery service and residency program at the Indiana University Medical Center.As the rst director of the Division of Neurological Surgery in the Department of Surgery, Heimburger recruited neurosurgeons and residents to Indianapolis over the course of the next decade-and-a-half — including department legends Robert Campbell, MD; John Mealey, MD; and John Kalsbeck, MD — and launched the ACGME-approved residency program. The division continued to blossom and grow under the leadership of Campbell as director for nearly three decades, from the 1960s to the 1990s. Over the course of the next 35 years, four directors and chairs have led the division through its establishment as a full department and the development of a neuroscience hub of clinical care and research. These leaders advanced the department into a new age of leading-edge neurosurgery technology. With 75 years of world-class neurosurgery expertise, the department has continued to be at the forefront among national and international leaders in how they treat patients, investigate new therapeutics and train the next generation of neurosurgeons.IU School of MedicineA novel transducer designed and built by William Fry (shown), Frank Fry, and coworkers combined four individual transducer elements to create a highly localized, intense ultrasound spot. Physics Today, 2015

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17IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 16Heimburger wrote that he read a paper in a medical journal about better patient outcomes if the newborns had their spinal canals closed surgically soon after birth, so he began performing early surgical closure of their spinal defects. Heimburger told Advance Local in a May 2015 interview that Mellencamp’s spina bifida birth defect would have likely been fatal. “Family physicians hearing of my willingness to do so would occasionally phone in the middle of the night to say, ‘Get the OR ready; I′m bringing one to you!’ The babies arrived held gently in the arms of a nurse or relative, often in the family physician’s car,” Heimburger wrote. “The family physicians liked to scrub in with me and a surgical resident for these operations.”Mellencamp told CBS News that he didn’t know about the operation until elementary school when a student behind him pointed out to him a large scar on the back of his neck."And I said, 'What scar?' My parents had never told me anything had ever happened to me,” Mellencamp recounted during his Rock and Roll Hall of Fame induction speech on March 10, 2008. “I'm lucky. And my Grandma, my entire life, from a little kid until she died, would always come up to me and whisper. She called me Buddy. And she'd go, 'Buddy, you're the luckiest boy in the world.' And I am."In September 2014, Mellencamp finally met the 97-year-old Heimburger at Riley Hospital for the rst time since the operation in 1951. Mellencamp saw an image of his spinal column at just nine days old during the visit and spoke with Heimburger about the surgery and faith."I'm 62 years old now," Mellencamp told CBS News in the 2014 interview. "I just for the rst time saw the growth in the back of my neck. And it was just like 'Why didn't you guys show this to me earlier? 'Cause I woulda seen how lucky I am to even be here.'... I mean it was really an epiphany moment for me. And you just couldn't thank the guy enough."Mellencamp, a longtime resident of Bloomington, dedicated the last stop of his tour in 2015 to Heimburger and Riley Hospital. Proceeds from the August concert went to Riley Children’s Foundation, which supports Riley Hospital. Heimburger died two months before the concert.Nearly two years after Robert Heimburger, MD, established the neurosurgery service at Indiana University Medical Center, the neurosurgeon performed a highly risky and experimental surgery on a newborn from Seymour, Indiana, born with spina bida — a likely fatal birth defect.That child was John Mellencamp — the Rock and Roll Hall of Fame singer-songwriter best known for rock hits in the 1980s like “Hurts so Good,” “Pink Houses” and “Small Town.” Spina bifida is a birth defect that occurs when the spine doesn’t fully develop. This can cause damage to the spinal cord, nerves and brain. Heimburger, who performed the surgery on Mellencamp for 18 hours at Riley Hospital for Children in 1951, said in a journal article published in “Surgical Neurology International” about his career in neurosurgery, that medical experts at the time advised physicians to leave the defects in their back alone for six months. "Most of the babies succumbed to meningitis in spite of extensive care provided by mothers, families, and experts," Heimburger wrote. "The normal faces and intelligent eyes of the babies who were brought for my examination caused me to think that they deserved better than to wait six months for surgery."Mellencamp was one of three babies with spina bifida in 1951 at Riley Hospital."They did three operations," Mellencamp told CBS News in 2014. "One died on the table. Another girl lived I think 'til she was 14, and then she died — and then me. So they basically cut my head ... laid it open, cut that thing o and then put all the nerves into my spine."Saving the life of an American heartland rock iconPIONEERING SURGERYJohn Mellencamp and Dr. Robert Heimburger, after more than 60 years, finally meet photo credit: Advanced LocalJohn Mellencamp performs at Farm Aid Farm Aid’s annual music and food festival

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19IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 18“My 120-mile drives to Champaign-Urbana to visit the Fry brothers′ ultrasound laboratory became almost monthly,” Heimburger wrote. “With the help of relatives, I brought several patients with malignant brain tumors to the University of Illinois to receive HIFU (high-intensity focused ultrasound) in an attempt to diminish the spread of their malignant brain tumors. We found that chemotherapy and radiation treatments seemed to be enhanced by the HIFU treatments so that the patients had considerably longer than expected survivals.”In addition to treating patients with Parkinson’s disease, cerebral palsy and cerebrovascular disorders, Heimburger and the Fry brothers were interested in the focused ultrasound device’s potential to treat brain tumors. In 1968, Heimburger took a patient who was referred to him who had a brain tumor in the center of her brain where physicians said couldn’t be reached by surgery. The young woman and her parents traveled to Champaign-Urbana to learn about the Fry’s laboratory and see if they would be interested in this experimental technique.Heimburger used the ultrasound equipment to see the woman’s tumor more precisely, and he was able to remove the mass in the right temporal lobe of her brain, which he said, “contained all we could identify of her glioblastoma multiforme.” At a neurosurgical meeting in the 1950s, Robert Heimburger, MD, heard a presentation from research scientists William and Frank Fry on the development of the rst focused ultrasound device that pinpointed brain lesions and destroyed selected tissue without damaging surrounding tissue in animals. Heimburger wrote about this meeting in a journal article about his career in neurosurgery, published in “Surgical Neurology International.”“The idea of using the technique and other stereotactic surgery procedures to treat Parkinsonism and other conditions intrigued me,” Heimburger wrote.Heimburger later connected with the Fry brothers at the University of Illinois Urbana-Champaign, about his interest in collaboration. The Frys had already started working with Russell Meyers, MD, a professor of neurosurgery at the University of Iowa, in Iowa City to create a high-intensity focused ultrasound apparatus to “make very discrete brain lesions in patients.” The Frys had done extensive animal testing of their technology to that point.In 1957, Meyers successfully conducted the first ultrasonic surgery on a human brain, which was covered in Time magazine later that year, according to a 2015 article in Physics Today written by William O’Brien and Floyd Dunn. For the focused ultrasound to reach the target in the brain, a section of a patient’s skull had to be removed to pinpoint the lesion. Heimburger visited the university to see these procedures and the research of the Frys.Advancing techniques for over 50 yearsFOCUSED ULTRASOUNDDr. Robert Heimburger performs a stereotactic brain surgery. IU Indianapolis University Library Special Collection and Archives“We took her back to Champaign-Urbana several times for HIFU therapy while her parents became increasingly impressed by the Fry brothers and their innovation,” Heimburger wrote. “We found that HIFU signicantly improved the treatment results of the few malignant brain tumors we treated with ultrasound in addition to chemotherapy and radiation.”The patient’s parents, Robert and Elizabeth Fortune gifted the university more than $250 thousand to move the Fry’s laboratory from the University of Illinois to Indianapolis, naming it the Fortune-Fry Research Laboratory."Moving the Fry Laboratory to IUMC (Indiana University Medical Center) enabled years of fruitful service and research on ultrasound uses in the brain, including imaging research, which was eclipsed by the invention of the computed tomography (CT) scan in the 1970s," Heimburger wrote.During much of the 1970s, Heimburger led the use of focused ultrasound equipment developed by the Fortune-Fry lab on neurosurgical pediatric patients at Riley Hospital for Children with acute head injuries. The team used the equipment for diagnostic imaging of patients, while the researchers in the lab continued studying the eect of sonication of intracranial areas in animals.Looking to the present, the Department of Neurological Surgery are still pioneers in stereotactic and functional neurosurgery. Faculty neurosurgeons have led the development of deep brain stimulation, a minimally invasive surgical treatment that involves placing ne stimulating electrodes into specic areas of the brain that control movement, and a more modern approach to focused ultrasound, spearheading both initiatives in the early 2020s.Focused ultrasound thalamotomy is a cutting-edge, non-invasive operation, that’s a treatment for patients experiencing movement disorders who have not responded to medications. Advancing on the early surgeries of Heimburger and Meyers in the 1950s and 1960s, the current procedure has no incisions, drilling or burr holes. It instead directs ultrasonic waves to a small part of the brain that is responsible for the patient’s movement disorders condition.Patients will usually see immediate improvement after multiple rounds of the ultrasonic waves. Throughout the procedure the amount of energy from the ultrasonic waves increases the heat needed to form a lesion to eliminate brain tissue that’s causing the tremor.An operating room technician adjusts the settings on a stereotactic head mobilization device to prepare for surgery. IU Indianapolis University Library Special Collection and Archives

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Lance Armstrong receiving treatment from Dr. Scott A. Shapiro after undergoing surgery to remove brain lesions at the Indiana University Medical Center in Indianapolis. gettyimages21IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 20Lance Armstrong during the Amstel Gold Race 99. gettyimagesWhen Lance Armstrong was diagnosed with testicular cancer in 1996, he was referred to the IU School of Medicine for treatment by renowned oncologist Larry Einhorn, MD, a pioneer in cancer re-search who developed a successful treatment for testicular cancer. The cancer also spread to other parts of Armstrong’s body, inclu-ding his brain. Twenty-ve years old in 1996 and at the start of his ca-reer in competitive cycling, Armstrong met with Scott Shapiro, MD, a neurosurgeon specializing in neuro-oncology and spinal disorders.Shapiro, who earned his medical degree and completed his neuro-surgery residency program at the IU School of Medicine, often wor-ked with Einhorn and Craig Nichols, MD, on consultations. He was their “go-to guy” for patients who had brain metastases or spine cancer from testicular cancer.“Einhorn invented the treatment that cured testicular cancer, but there are a lot of other great oncologists in the oncology section at the school of medicine, so we would get lots of tumor patients,” Sha-piro said. “People wouldn’t keep sending them to us if they we didn’t do a good job for them, and we did a good job.”Shapiro performed the surgery that removed two metastases from Armstrong’s brain. IU was one of just a handful of places in the 1990s that had image guidance and brain mapping that made it possible to conduct simultaneous bilateral craniotomies, Shapiro said. The treatment, designed by Nichols, destroyed cancer cells in Armstrong without hurting his lungs allowing him to return to being a professio-nal and successful athlete.At the time, Armstrong had only won a few professional races – he later won seven consecutive Tour de France titles between 1999 and 2005.Shapiro said, he removed brain metastases nearly every week in patients. It was integral to his surgical work and for many other neu-rosurgeons at IU. “We were implementing relatively new technology,” Shapiro said, “but the basic concept of the surgery I had done a lot of, so for me it was just another day in the operating room.”Neurosurgery faculty performing brain metastases tumor removals were able to improve patient outcomes with the assistance of inter-operative CAT scans and MRI scans to image a tumor and verify its removal while a patient was still in the operating room.“That was a tremendous advance for us,” Shapiro said." It made sur-gery safer for patients.”Forefront of brain cancer treatmentA SYMBOL OF PERSEVERANCE AND HOPE

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23IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 22NEUROSURGERY TRAININGAt the IU School of Medicine, the largest medical school in the country, neurosurgery training is historically one of the top medical specialties that students pursue when entering residency.Paul Nelson, MD, chair of the department from 1992 to 2011, said many medical students at the IU School of Medicine were drawn to the neurosurgery program because of its breadth of clinical and research opportunities. Many medical schools, Nelson said, organize their clerkships to include only a neurology rotation; but at IU, students can spend their time in a neurology rotation or neurosurgery rotation, and in some cases can split between both groups. “Students who interacted with us I think saw that we tried to make it pleasant for them and tried to give them plenty of experience both in and out of the operating room,” Nelson said.Scott Shapiro, MD, the Robert L. Campbell Professor Emeritus of Neurological Surgery, earned his medical degree at the IU School of Medicine and later matched at the school for his neurosurgery residency. After training, Shapiro joined department faculty and later became the residency program director, serving in that role for more than 30 years. Top destination for neurosurgery education“All the faculty that I trained under were not only outstanding neurosurgeons, but they were good people and a joy to work with,” Shapiro said, “and I followed in their footsteps.”Shapiro said the department developed an environment that was inclusive and supportive for medical students and residents. Each month, third-year medical students would rotate in the department, and fourth-year students spent most of the year in the department. They participated in lectures and assisted surgeons and residents in the operating room and clinic. During Nelson’s tenure with the department he mentored between 80-85 medical students at IU who pursued a neurosurgery residency, many of whom stayed at the university.“We’re trying to get the spark there,” Nelson said. “Mentoring is something that I enjoyed doing, and I think everybody else enjoyed doing it as well.”Shapiro said the breadth of neurosurgery gave students, and eventually residents, an opportunity to learn something new each day, whether that was about complex brain tumors and cerebrovascular conditions, spinal disorders, functional neurosurgery, pediatric neurosurgery or neurotrauma.“We're one of the better programs teaching you how to do neurosurgery,” Shapiro said. “We were really good at letting residents operate, under appropriate supervision, and as they got better and better, turn them loose. That’s how you truly train people to become great themselves.”

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25IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '2424of the state-of-the-art outpatient IU Health NeuroscienceCenter, which later opened in 2012. Following Nelson’s reti-rement in 2011, he received the President’s Medal for Excel-lence from then IU President Michael McRobbie in 2014 forhis dedication to the Department of Neurological Surgeryand the IU School of Medicine as a top tier institution forneurosciences education, research and clinical care.Nicholas Barbaro, MD(2011-2019)Barbaro joined the IU School ofMedicine faculty in 2011 as theChair of the Department of Neu-rological Surgery and as a leaderof the Goodman Campbell Brainand Spine academic mission.Barbaro performed surgery re-lated to pain, peripheral nerveprocedures and epilepsy surge-ries on adults, and he conducted clinical trial research de-signed to improve surgical procedures in epilepsy. Barbarocame to Indianapolis from the University of California, SanFrancisco. As the medical director of the IU Health Neuro-science Center, Barbaro oversaw the six-level IU Health out-patient neurosciences facility, which in 2014, was connec-ted to the IU School of Medicine Neurosciences ResearchBuilding.Shelly Timmons, MD, PhD(2019-2022)Timmons came to the IU Schoolof Medicine as the rst woman tolead the Department of Neurolo-gical Surgery and only the fourthwoman at the time to serve aschair of a neurosurgical depart-ment at a U.S. medical school. Timmons, who had completed aterm as president of the Ameri-can Association of Neurological Surgeons, began as chairwhile IU Health and Goodman Campbell Brain and Spineended their 10-year agreement to sta surgeons from thephysician-owned private practice at IU Health facilities.Timmons, an expert in neurotrauma, was also named asa co-director of the new IU Health-IU School of MedicineNeuroscience Institute.Robert L. Campbell, MD(1965-1992)
Campbell, one of the rst resi-dents to complete neurosurgerytraining at the IU School of Me-dicine, served as the Director ofNeurological Surgery for nearly30 years. Campbell joined thedepartment faculty after his resi-dency in 1957. An outstanding cli-nician and surgeon, Campbell trai-ned an entire generation of neurosurgeons, many of whomare still practicing across the country. Campbell faithfullyattended nearly all the department’s annual lectureships,including one in his honor, the Robert L. Campbell Lecture,which began in 1994. His areas of specialization includedacoustic neuromas, cranial vascular neurosurgery and cer-vical spine neurosurgery. In 1999, the Robert L. CampbellProfessorship in Neurosurgery was established to recogni-ze and honor him for his extraordinary contributions to theIU School of Medicine and the eld of neurological surgeryand to support resident education and research. He servedon the faculty until 2006 when he retired as professor eme-ritus. Campbell died in 2018.Paul B. Nelson, MD(1992-2011)Nelson was named the rst Chairof the Department of Neurologi-cal Surgery in 1992, coming tothe IU School of Medicine facultyfrom the University of Pittsburgh.Under the leadership of Nelson,Neurological Surgery became itsown department at the IU Schoolof Medicine after being a divisionwithin the Department of Surgery. Nelson, whose clinicalinterests include pituitary disease and spinal disorders, wasa mentor to dozens of residents in the department. Nelsonset the tone on the importance of neurological surgeryeducation at the school, which at one point, under Nelson’sdirection, generated more students entering neurosurgicaltraining than any other medical school in the country. Nel-son successfully led the merger of the surgical, researchand academic expertise of the Indianapolis NeurosurgicalGroup and the IU School of Medicine Department of Neu-rological Surgery, creating Goodman Campbell Brain andSpine in 2010. He also helped spearhead the developmentRobert F. Heimburger, MD(1949-1965)
Heimburger was invited tospend a few months at IndianaUniversity Medical Center (theIU School of Medicine) while theuniversity was recruiting for aneurosurgeon to establish theirneurological surgery serviceand residency program. A fewmonths turned into 40 yearsas Heimburger became the rst Director of the Division ofNeurological Surgery in the Department of Surgery in 1949— the same year the residency program began — a posi-tion he held until 1965. Heimburger's major contributionsto neurosurgery at the IU School of Medicine included earlyrepair of congenital spinal defects and spinal cord tether-ing, ultrasound imaging of and high-intensity focused ultra-sound treatment in the brain, stereotactic neurosurgery fora variety of disorders, and neurosurgical capacity-buildingin Asian countries. Heimburger also performed a life-savingand high-risk surgery on musician John "Cougar" Mellen-camp at Riley Hospital for Children when Mellencamp, a na-tive of Seymour, Indiana, was a newborn, correcting a con-genital myelomeningocele (spina bida). An accomplishedacademician, his research, surgical, and teaching career re-sulted in 62 publications. Heimburger spent the nal yearsof his career, 1983-1988, at Chang Gung Memorial Hospitalin Taipei, Taiwan, training neurosurgeons near the land ofhis birth, while maintaining his faculty appointment at theIU School of Medicine before retiring in 1988. Heimburgerdied at the age of 97 in Birmingham, Alabama.Leading the wayDEPARTMENT CHAIRSMitesh Shah, MD(2023-present)Shah joined the IU School of Me-dicine faculty in 1994 as the onlyfellowship-trained skull basesurgeon — specializing in thetechnique that are now widelyapplied for treating brain tumors.Shah, the Paul B. Nelson Endo-wed Chair, was recruited to theschool to grow the subspecialityof neurovascular and skull base surgery. He became chairof the department in 2023. Shah, who previously served asthe director of education for the Department of Neurologi-cal Surgery, demonstrated a passion for education — ser-ving as a mentor for medical students, residents, fellows,undergraduates and nursing students. Shah also servesas the co-director of the IU Health-IU School of MedicineNeuroscience Institute.During Shah's tenure the department ’smultidisciplinary approach to the care ofcomplex skull base tumors has becomenationally recognized.

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25IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 24of the state-of-the-art outpatient IU Health Neuroscience Center, which later opened in 2012. Following Nelson’s reti-rement in 2011, he received the President’s Medal for Excel-lence from then IU President Michael McRobbie in 2014 for his dedication to the Department of Neurological Surgery and the IU School of Medicine as a top tier institution for neurosciences education, research and clinical care.Nicholas Barbaro, MD (2011-2019)Barbaro joined the IU School of Medicine faculty in 2011 as the Chair of the Department of Neu-rological Surgery and as a leader of the Goodman Campbell Brain and Spine academic mission. Barbaro performed surgery re-lated to pain, peripheral nerve procedures and epilepsy surge-ries on adults, and he conducted clinical trial research de-signed to improve surgical procedures in epilepsy. Barbaro came to Indianapolis from the University of California, San Francisco. As the medical director of the IU Health Neuro-science Center, Barbaro oversaw the six-level IU Health out-patient neurosciences facility, which in 2014, was connec-ted to the IU School of Medicine Neurosciences Research Building.Shelly Timmons, MD, PhD (2019-2022)Timmons came to the IU School of Medicine as the rst woman to lead the Department of Neurolo-gical Surgery and only the fourth woman at the time to serve as chair of a neurosurgical depart-ment at a U.S. medical school. Timmons, who had completed a term as president of the Ameri-can Association of Neurological Surgeons, began as chair while IU Health and Goodman Campbell Brain and Spine ended their 10-year agreement to sta surgeons from the physician-owned private practice at IU Health facilities. Timmons, an expert in neurotrauma, was also named as a co-director of the new IU Health-IU School of Medicine Neuroscience Institute.Robert L. Campbell, MD (1965-1992) Campbell, one of the rst resi-dents to complete neurosurgery training at the IU School of Me-dicine, served as the Director of Neurological Surgery for nearly 30 years. Campbell joined the department faculty after his resi-dency in 1957. An outstanding cli-nical and surgeon, Campbell trai-ned an entire generation of neurosurgeons, many of whom are still practicing across the country. Campbell faithfully attended nearly all the department’s annual lectureships, including one in his honor, the Robert L. Campbell Lecture, which began in 1994. His areas of specialization included acoustic neuromas, cranial vascular neurosurgery and cer-vical spine neurosurgery. In 1999, the Robert L. Campbell Professorship in Neurosurgery was established to recogni-ze and honor him for his extraordinary contributions to the IU School of Medicine and the eld of neurological surgery and to support resident education and research. He served on the faculty until 2006 when he retired as professor eme-ritus. Campbell died in 2018.Paul B. Nelson, MD (1992-2011)Nelson was named the rst Chair of the Department of Neurologi-cal Surgery in 1992, coming to the IU School of Medicine faculty from the University of Pittsburgh. Under the leadership of Nelson, Neurological Surgery became its own department at the IU School of Medicine after being a division within the Department of Surgery. Nelson, whose clinical interests include pituitary disease and spinal disorders, was a mentor to dozens of residents in the department. Nelson set the tone on the importance of neurological surgery education at the school, which at one point, under Nelson’s direction, generated more students entering neurosurgical training than any other medical school in the country. Nel-son successfully led the merger of the surgical, research and academic expertise of the Indianapolis Neurosurgical Group and the IU School of Medicine Department of Neu-rological Surgery, creating Goodman Campbell Brain and Spine in 2010. He also helped spearhead the development Robert F. Heimburger, MD (1949-1965) Heimburger was invited to spend a few months at Indiana University Medical Center (the IU School of Medicine) while the university was recruiting for a neurosurgeon to establish their neurological surgery service and residency program. A few months turned into 40 years as Heimburger became the rst Director of the Division of Neurological Surgery in the Department of Surgery in 1949 — the same year the residency program began — a posi-tion he held until 1965. Heimburger's major contributions to neurosurgery at the IU School of Medicine included early repair of congenital spinal defects and spinal cord tether-ing, ultrasound imaging of and high-intensity focused ultra-sound treatment in the brain, stereotactic neurosurgery for a variety of disorders, and neurosurgical capacity-building in Asian countries. Heimburger also performed a life-saving and high-risk surgery on musician John "Cougar" Mellen-camp at Riley Hospital for Children when Mellencamp, a na-tive of Seymour, Indiana, was a newborn, correcting a con-genital myelomeningocele (spina bida). An accomplished academician, his research, surgical, and teaching career re-sulted in 62 publications. Heimburger spent the nal years of his career, 1983-1988, at Chang Gung Memorial Hospital in Taipei, Taiwan, training neurosurgeons near the land of his birth, while maintaining his faculty appointment at the IU School of Medicine before retiring in 1988. Heimburger died at the age of 97 in Birmingham, Alabama.Leading the wayDEPARTMENT CHAIRSMitesh Shah, MD (2023-present)Shah joined the IU School of Me-dicine faculty in 1994 as the only fellowship-trained skull base surgeon — specializing in the technique that are now widely applied for treating brain tumors. Shah, the Paul B. Nelson Endo-wed Chair, was recruited to the school to grow the subspeciality of neurovascular and skull base surgery. He became chair of the department in 2023. Shah, who previously served as the director of education for the Department of Neurologi-cal Surgery, demonstrated a passion for education — ser-ving as a mentor for medical students, residents, fellows, undergraduates and nursing students. Shah also serves as the co-director of the IU Health-IU School of Medicine Neuroscience Institute.During Shah's tenure the department ’s multidisciplinary approach to the care of complex skull base tumors has become nationally recognized.

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27IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 26John Linczer, MD, MSMedical School, Indiana University School of MedicineMartin A. Arhin, MDMedical School, University of North Carolina at Chapel Hill School of MedicineAlexei Christodoulides, MDMedical School,Indiana University School of MedicineRyan Cloyd, MD, PhDMedical School, University of Kentucky College of MedicineSamantha Palma, MDMedical School, Indiana University School of MedicineSarah A. Merrill, MD, MSMedical School, Mayo Clinic Alix School Of MedicineWeston C. Troja, MDMedical School, Indiana University School of MedicineChiara A. Flores, MDMedical School, Drexel University College of MedicineHailey C. Budnick, MDMedical School, Texas Tech University Health Sciences Center School Of MedicineJosue Ordaz, MDMedical School, Indiana University School of MedicineAhmed M. Belal, MD, MSMedical School, Alexandria Faculty of MedicineAjay Patel, MDMedical School, Indiana University School of MedicineAndrew Huh, MDMedical School, Indiana University School of MedicineMatthew K. Tobin, MD, PhDMedical School, University of Illinois College of MedicineScott Mitchell, MDMedical School, University of Vermont Collegeof MedicinePiiamaria Virtanen, MDMedical School, Indiana University School of MedicineJae Hyun Kwon, MDMedical School, Indiana University School of MedicineKyle J. Ortiz Rodriguez, MDMedical School, University of Puerto Rico School of MedicineAndy Witten, MDMedical School, Indiana University School of Medicine2024 RESIDENTS & FELLOWSPGY 6PGY 3PGY 1 PGY 2 PGY 4PGY 7PGY 5

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29IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '2428“It is not common for aneurosurgery residency graduateto receive such intense training inboth cranial and spine, and I owethis to my mentors’ dedication tomy training at IU.”spine and cranial. During his one-yearenfolded fellowship, Zaazoue trainedunder Aaron Cohen-Gadol, MD, arenowned cranial neurosurgeon.“It is not common for a neurosurgeryresidency graduate to receive suchintense training in both cranial andspine, and I owe this to my mentors’dedication to my training at IU,”Zaazoue said.Once his spine deformity fellowshipconcludes, Zaazoue will start hisacademic medicine career as anassistant professor of neurologicalsurgery at the University of Wisconsin-Madison.Neurosurgeons, Zaazoue said, arelife-long learners, actively involved inadvancing the eld.“I anticipate that I will continue tolearn and evolve so I can better servemy patients until I retire in light of therapid technological advancementswe witness in neurosurgery,” he said.“There is so much work to be done inneurosurgery, and I am excited aboutall the research and innovation I willget to engage in at the University ofWisconsin. Looking back, I know thatIU has played a tremendous role inshaping my career and the kind ofsurgeon I am today.”Through six years as a resident and oneyear as an enfolded neuro-oncology fellow,Zaazoue, who graduated residency in2024, said he enjoyed the department’sculture of collegiality and camaraderie.Because of the unparalleled clinical volumeat IU Health, neurosurgery trainees at theschool get exposed to the operating roomearly in the seven-year program.“It takes a lot of time, eort and dedicationto create such a culture,” Zaazoue said.“I am glad that the residency programdirectorship has been handed to facultymembers who have the same approach asDr. Shapiro, including James C. Miller, MD,Brandon C. Lane, MD, and Rabia Qaiser, MD.As I transition into academic spine surgery,I hope I will carry forward such compassionand dedication to the future trainees I willhave the privilege to work with.”Born into a family of physicians — his fatherand grandfather were surgeons — Zaazoueknew he would become a physiciansomeday. After initially joining medicalschool with the thought of becoming acardiothoracic surgeon, Zaazoue laterbroadened his surgical interests andeventually landed on neurosurgery aftergetting “hooked” during his rotation.“The amount of training it requiresand attention to detail got meintrigued,” Zaazoue said. “A distanceof a few millimeters can mean thedierence between alleviating pain orcuring cancer and causing paralysisor even death. Not many specialtiescan claim that this is their day-to-day work, and while it can sounddaunting, I appreciate challenges.”Over the course of his seven years at theIU School of Medicine, Zaazoue was ableto translate his “hands-on” approach to lifeinto the operating room — performing morethan 1,800 surgeries, many of which wereWhenever Mohamed Zaazoue, MD, MS,MBA, would see his name assigned tothe operating room schedule of ScottShapiro, MD, during the rst few years of hisneurosurgery residency at the IU School ofMedicine, he knew the day would be good —no matter the surgery.“He is the kind of mentor who makes youenjoy waking up every day and going towork,” Zaazoue said. “Dr. Shapiro ensuredto create and maintain a culture whereneurosurgery residents can thrive.”Zaazoue, currently a an orthopedicspine deformity fellow at the WashingtonUniversity School of Medicine in St. Louis,matched as a resident in the IU Schoolof Medicine Department of NeurologicalSurgery in 2017 when Shapiro was theresidency program director, a role he servedfor decades before retiring in 2021 after 34years as a department faculty member.Reecting on residencyculture, breadth ofexperience at the IUSchool of MedicineDepartment ofNeurosurgeryNEUROSURGERYALUMNIMohamed A. Zaazoue, MD, MS, MBA

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33IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 32tumorBattling brain Patient gets dream car as motivation to ghtRyleigh Taylor, a 17-year-old from Jeerson City, Tennessee, loves dirt biking. However, when doctors found a large skull-base tumor after she went to the emergency room for a bad headache, that life-long passion appeared dim.Her doctor in Tennessee referred Ryleigh to IU Health for treatment — saying the expertise of Mitesh Shah, MD, chair of the Department of Neurological Surgery at the IU School of Medicine, and the team of skull base surgeons was the top place in the region to receive leading-edge clinical care from a multi-disci-plinary group of skull base specialists. IU Health, in partnership with the IU School of Medi-cine, is the largest academic healthcare system in the Midwest and is nationally recognized for research and treatment of spontaneous cerebrospinal uid leaks, acoustic neuromas and pituitary adenomas.Ryleigh had a very large tumor that arose from the base of the skull, Shah said, occupying over a third of the volume of what is called the infratentorial compartment — it's about the size of a plum. Shah collaborated with Satyan Sreenath, MD, assistant professor of otolaryngology — head and neck sur-gery at IU School of Medicine — on the complex skull base case.“My whole life I've had headaches,” Ryleigh said. “I was scared because I didn't know what was going to happen. I've never had a surgery before, and this major of a surgery was very s c a r y.”They decided to perform the surgery through the mouth and nose — an endonasal approach with endoscopic guidance. Sreenath handles the visuali-zation of the tumor through a camera in one nostril while Shah is working to remove the tumor that was near the brain stem in the other nostril.“We were very happy with the resection, but the real challenge then is the gap. We could see from the top of the brain stem all the way down to the bottom,” Shah said. “If you don't use vascularized tissue that we have in the nasal septum, that area won't heal. If you get a spinal uid leak, then you can get meningi-tis and that can lead to death if it's untreated.”A few days after the initial surgery, Ryleigh showed evidence that she had a spinal uid leak. They repai-red it using harvested tissue from her leg to re-bol-ster the area.Two to three weeks later, when Ryleigh was back in Tennessee, she started experiencing meningitis due to another spinal uid leak. Sreenath connec-ted with Avinash Mantravadi, MD, associate pro-fessor of clinical otolaryngology — head and neck surgery at the IU School of Medicine — to use a method where surgeons took healthy vasculari-zed muscle from Ryleigh’s back to completely seal o the area at the base of the skull, giving the area more robust tissue.“What's really good about a team like ours is that we can take on adversity,” Shah said. “We don’t give u p.”Following this second intervention to stop the spinal uid leak, Shah said he was concerned with the stability of the region where the skull joins with the spine. It looked like the bone eroded, which could lead to Ryleigh needing a fusion to connect the skull to the upper part of the cervical spine. If they had to do that, she would lose the ability to turn, potenti-ally making it dicult for her to ride motor bike.Ryleigh’s father, Joseph, said his daughter needed a “motivator” to get through the tough road ahead. She had wanted a Nissan 370Z sports car for years. They looked at a few, and she found one she liked.“I love it. I love every second of it,” Ryleigh said. “I drive it all the time. Sometimes I just sit in it.”When Shah received Ryleigh's post-operative ima-ging and x-rays of her spine, he found everything to be stable. As a result, they were able to get her out of her collar and avoid having to perform a fusion.“That's amazing to me,” said Tammy, Ryleigh’s mother. “That's a miracle.”Joseph said the surgeons at IU Health are “on a dif-ferent level.” “There were moments in time where there were a lot of unknowns, and this is a 17-year-old girl,” Sree-nath said. “You think about your own family, your own kids, your own friends. When I got a picture of Ryleigh in her new car, it's almost indescribable what that kind of feeling gives you and what we've been able to accomplish and achieve. This is a case that I will not forget for the rest of my career.”Source: Indiana University HealthRyleigh receiving treatment from Dr. Mitesh V. Shah after undergoing surgery to remove brain lesion at the IU Health Neuroscience Center.

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35IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 34Riley Hospital for Children in Indianapolis, is designing a space for new cutting-edge magnetoencephalography technology that oers a visually calming environment for patient scans.MAGNETOENCEPHALOGRAPHYFrom research to patient care, pediatric neurologists and neurosurgeons at Riley Children’s Health and the IU School of Medicine are multifaceted innovators who work diligently to pursue new thera-pies for children. The team has introduced new magnet-oencephalography (MEG) technology into their program, a state-of-the-art modality used to evaluate seizures in patients. This novel, non-invasive test is a promising presurgical evaluation and represents a signicant milestone for patients experiencing medically intrac-table focal epilepsies, especially children with epilepsy.“We are proud to bring the latest techno-logical innovations to Riley Children’s, including the MEG, but also robotic-assisted surgery, minimally invasive neu-rosurgical techniques, and intracranial neuromodulation,” said Jason Chu, MD, associate professor of clinical neurologi-cal surgery. “With these recent advance-New MEG technology delivers hope for medically refractory epilepsyJason Chu, MD, MSc Associate Professor of Clinical Neurological Surgeryments, nearly every single medically refractory patient could have a surgical option to treat their epilepsy.”With its ability to detect brain signals using a specialized helmet, MEG monitors both normal and abnormal brain activity while patients are at rest or engaged in specic tasks. The advan-ced technology, available for both adults and children, provides a whole-head view of brain activity by using sensors and advanced com-puting, allowing neurologists and neurosur-geons to identify the exact location of seizures. Such detailed mapping is crucial for planning complex surgical treatment and ongoing medi-cal management.“Several studies have demonstrated the MEG can provide signicant presurgical information to improve surgical outcomes in patients,” Chu said.Riley Children’s, a Level 4 Epilepsy Center, sees the most complex and diculty medically ref-ractory epilepsy patients in Indiana. Beyond brain mapping, MEG provides structured information and detailed functional insights through magnetic eld recordings — an advan-tage that sets it apart from the traditional MRI and other diagnostic technologies.“Data from MEG renes the accuracy of intracranial EEG recordings, facilitating presurgical workup,” said Makram M. Obeid, MD, assistant professor of neurology. “Our multidisciplinary team of experts will be able to take care of the most dicult epilepsies more eciently.”Neurologists and neurosurgeons collaborate in a weekly, comprehensive Epilepsy Surgical Conference to identify patients that may benet from MEG testing, review MEG data for surgical patients and formulate individualized surgical plans to best benet our patients.While MEG remains a transformative resource for pin-pointing brain activity, the technology is a major step-pingstone for patients nationwide. Specialists at Riley Children’s will continue integrating the tool, improving the overall quality of care for patients with epileptic con-ditions.Pediatric neurologists and neurosurgeons at Riley Children’s oer a range of surgical evaluations and treatments to manage seizures. Particularly, the Com-prehensive Epilepsy Program at Riley Children’s, com-prised of enhanced technologies and clinical experts, is actively involved in research to treat medically refractory epilepsy.Source: Riley Children’s Health

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37IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '2436One in 1,000 people in the Uni-ted States are estimated to haveChiari malformation, a conditionwhen the brain’s cerebellumbulges through the bottom ope-ning of the skull where it meetsthe spinal canal. This can causesevere headaches, neck painand balance issues.Three brothers, Lincoln, Norrinand Remley Niece, of Green-eld, Indiana, were each diagno-sed with Chiari malformationand underwent brain surgeryat Riley Children’s Health in thesame year. Although the condi-tion is common, it’s unusual forit to occur in all children in one family, said the family’s surgeon,Laurie Ackerman, MD, John E. Kalsbeck Professor of PediatricNeurosurgery at the IU School of Medicine.“When our oldest had really bad headaches for years, we tookhim to several dierent doctors and everything came out cle-ar,” said Whitney Niece, the mother of the Niece boys. “Whenwe were back and the emergency room doctor noticed thathis pupils were not equal in size, he had a CT scan and wasdiagnosed with Chiari malformation.”Over the following months after the rst diagnosis, the twoyounger Niece children went through similar experiences. Theextra brain matter that comes down at the base of the skull canpush on parts of the brain and spinal canal and cause blockageof cerebral spinal uid, Niece said. For her children, it causedthem severe headaches, vomiting and balance issues.Three brothers go through brain surgeryin one year due to rare brain abnormalityCHIARI MALFORMATIONLaurie L. Ackerman, MDProfessor of ClinicalNeurological SurgerySince the boys each had multiple symp-toms, surgery was the best option, she said.“What are the odds that all three of our boysnot only have the Chiari but also need tohave the surgery?” Niece said.Ackerman told the Greeneld Daily Repor-ter newspaper that many people go undia-gnosed with Chiari malformation due tobeing asymptomatic. The Department ofNeurological Surgery is part of a large studywith the Park Reeves Foundation to evaluatecare of children with the condition. Anothergroup is investigating the genetics of Chiarimalformation, where they take cheek swabsand test them to see if there any commona-lities between those with the malformation.The surgery removes a small piece of theback part of the skull and takes out a 3-by-3-centimeter piece of bone. Ackerman saidshe opens the covering over the brain calledthe dura mater and sews a patch in there.“The goal of all of these things is to sort ofdisimpact the area, to allow uid to movearound there normally,” Ackerman said inan interview with the newspaper.Lincoln has frequently been to Riley Chil-dren’s due to his congenital heart defects.He’s had three open heart surgeries andwas under anesthesia nearly 30 times in 10years, Niece told the newspaper.“Sending my kids into surgery — itnever gets easier — it's always oneof those things that you kind of holdyour emotions back because youdon't want to cry in front of your kids,”Niece said.Niece said she’s grateful to have Ackermanas the surgeon for each of the boys. Nor-rin and Remley had an external ventriculardrain (EVD) placed for 10 days after theoperation to treat hydrocephalus — an ab-normal buildup of cerebrospinal uid in thebrain — and relieve the pressure of the uidin the brain by draining it from the body, Nie-ce told the newspaper.“She makes the kids laugh, she makes thekids smile, and when you're stuck here on anEVD, it's a big thing for a kid to have a doctorcome in and not be so scary, and we're be-yond thankful for her,” Niece said.Source: Riley Children’s HealthThe Niece Brothers;Lincoln, Norrin, andRemley

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37IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 36One in 1,000 people in the Uni-ted States are estimated to have Chiari malformation, a condition when the brain’s cerebellum bulges through the bottom ope-ning of the skull where it meets the spinal canal. This can cause severe headaches, neck pain and balance issues.Three brothers, Lincoln, Norrin and Remley Niece, of Green-eld, Indiana, were each diagno-sed with Chiari malformation and underwent brain surgery at Riley Children’s Health in the same year. Although the condi-tion is common, it’s unusual for it to occur in all children in one family, said the family’s surgeon, Laurie Ackerman, MD, John E. Kalsbeck Professor of Pediatric Neurosurgery at the IU School of Medicine.“When our oldest had really bad headaches for years, we took him to several dierent doctors and everything came out cle-ar,” said Whitney Niece, the mother of the Niece boys. “When we were back and the emergency room doctor noticed that his pupils were not equal in size, he had a CT scan and was diagnosed with Chiari malformation.”Over the following months after the rst diagnosis, the two younger Niece children went through similar experiences. The extra brain matter that comes down at the base of the skull can push on parts of the brain and spinal canal and cause blockage of cerebral spinal uid, Niece said. For her children, it caused them severe headaches, vomiting and balance issues.Three brothers go through brain surgery in one year due to rare brain abnormalityCHIARI MALFORMATIONLaurie L. Ackerman, MDProfessor of Clinical Neurological SurgerySince the boys each had multiple symp-toms, surgery was the best option, she said.“What are the odds that all three of our boys not only have the Chiari but also need to have the surgery?” Niece said.Ackerman told the Greeneld Daily Repor-ter newspaper that many people go undia-gnosed with Chiari malformation due to being asymptomatic. The Department of Neurological Surgery is part of a large study with the Park Reeves Foundation to evaluate care of children with the condition. Another group is investigating the genetics of Chiari malformation, where they take cheek swabs and test them to see if there any commona-lities between those with the malformation.The surgery removes a small piece of the back part of the skull and takes out a 3-by-3-centimeter piece of bone. Ackerman said she opens the covering over the brain called the dura mater and sews a patch in there.“The goal of all of these things is to sort of disimpact the area, to allow uid to move around there normally,” Ackerman said in an interview with the newspaper.Lincoln has frequently been to Riley Chil-dren’s due to his congenital heart defects. He’s had three open heart surgeries and was under anesthesia nearly 30 times in 10 years, Niece told the newspaper. “Sending my kids into surgery — it never gets easier — it's always one of those things that you kind of hold your emotions back because you don't want to cry in front of your kids,” Niece said. Niece said she’s grateful to have Ackerman as the surgeon for each of the boys. Nor-rin and Remley had an external ventricular drain (EVD) placed for 10 days after the operation to treat hydrocephalus — an ab-normal buildup of cerebrospinal uid in the brain — and relieve the pressure of the uid in the brain by draining it from the body, Nie-ce told the newspaper.“She makes the kids laugh, she makes the kids smile, and when you're stuck here on an EVD, it's a big thing for a kid to have a doctor come in and not be so scary, and we're be-yond thankful for her,” Niece said.Source: Riley Children’s HealthThe Niece Brothers; Lincoln, Norrin, and Remley

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39IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 38radiation with GammaTile placement at the time of surgery to remove brain tumor, or those who receive standard of care external radiation.For internal radiation patients, a neurosurgeon removes the tumor and implants small collagen tiles that contain radiation seeds to slowly deliver radiation into the cavity over the next 90 days. For external radiation patients, a neurosurgeon removes the tumor and sends the patient for external radiation within three to four weeks with a radiation oncologist. External radiation, the current standard of care, requires daily visits to the radiation treatment center for radiation therapy for usually six weeks. The two groups will be monitored to assess the safety and ecacy of the two treatment approaches. The goal is to determine outcomes that allow for longer survival with delayed tumor recurrence and to evaluate the most ecient way to protect healthy brain tissue.Na Tosha Gatson, MD, PhD, FAAN, professor of neurology and director of the Center for Neuro-Oncology in the IU School of Medicine-IU Health Neuroscience Institute, said the 100th patient milestone is of special signicance as it is a testament to the team’s continued dedication to the delivery of leading-edge brain tumor care. “All clinical trial enrollment is done with close patient assessment and is in line with strict institutional and trial guidelines. It is the best pathway toward drug development and innovations in cancer care,” Gatson said. “It speaks volumes about our excellent research staff and clinical providers who have earned the patient’s trust to move their treatment forward.”Brain metastases are the most common malignancy found in the brain — more than 200,000 people are diagnosed with this form of tumor annually in the United States. These growths spread to the brain from other sites in the body, most often from lung, breast, colon, kidney and melanomas, and are a sign of aggressive tumor behavior.The Radiation One and Done Study (ROADS), a clinical trial now in Phase 3, is a randomized control trial comparing an FDA-cleared device called GammaTile with brachy radiotherapy, after the removal of a brain metastasis tumor. The clinical trial began in 2021.IU School of Medicine is one of 23 institutions in the clinical trial, and the university, in conjunction with its health partner IU Health, enrolled the 100th patient in the study, according to the trial’s sponsor, GT Medical Technologies, Inc.“Our dedication to the ROADS trial is fueled by our mission to furnish the highest caliber of clinical evidence through randomized trial research. The ROADS trial will help determine the most efficient and effective treatments after surgical resection,” said Angela Richardson, MD, PhD, assistant professor of neurological surgery and the principal investigator of the trial.Patients enrolled in the ROADS clinical trial are randomized to one of two treatment groups: those who receive internal IU School of Medicine enrolls 100th patient in 23-site brain tumor radiation therapy clinical trialENROLLMENT MILESTONE Angela Richardson, MD, PhD, Neurosurgical Oncologist at Indiana UniversityAngela M. Richardson, MD, PhDAssistant Professor of Neurological Surgery

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41IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 40This study combined data from multiple smaller studies of mild and moderate TBI adult patients with early post-traumatic seizures who received seizure prophylaxis in the rst seven days. The meta-analysis showed that these types of medications had a small, yet signicant eect on reducing seizures, Pease said.An estimated 1 million people experience a mild TBI each year in North America. According to the study, 167 patients need to be treated to prevent one seizure."Those are thousands of people who are having seizures after mild TBI that you can prevent every single year," Pease said. "This research is setting a standard that there is evidence to support giving people anti-seizure medication."Pease said by conducting a meta-analysis, this showed a more effective outcome of anti-seizure medication compared to the data found in each smaller study with fewer patients."When you combine the results across multiple studies, it increases the power of your study because you're not limited by having one institution or one particular study," Pease said. "You're looking at multiple studies that have multiple strengths and weaknesses and those strengths and weaknesses can balance each other out to leave you with a more powerful result."Pease collaborated with the IU School of Medicine faculty members and co-authors of the paper Flora Hammond, MD, chair of the Department of Physical Medicine and Rehabilitation, and Sergiu Abramovici, MD, assistant professor of clinical neurology."These findings support consideration of early seizure prevention among mild and moderate TBI patients at highest risk for seizure," Hammond said. "Further research of the costs and benets of early seizure prevention after mild and moderate TBI is needed to refine treatment recommendations."The IU School of Medicine has multiple grants and clinical trials in TBI research, which includes the Traumatic Brain Injury Model Systems Center, the CARE Consortium and TRACK-TBI."TBI has such a large impact on the U.S. and the world," Pease said. "At IU, we're some of the leaders in guring out better ways to treat TBI and limit the downstream consequences. We're spanning multiple disciplines to try to create the best treatment for patients." Administering anti-seizure medications to patients after they experience a mild or moderate traumatic brain injury (TBI) could reduce their risk of having a seizure in the first seven days post injury, according to a new study by IU School of Medicine researchers recently published in JAMA Neurology.The team of investigators conducted a meta-analysis of smaller observational studies of mild and moderate TBI, comparing rates of early post-traumatic seizures among patients who received treatment to prevent seizures with anti-seizure medication to those who didn't receive that treatment. "Although seizures are much less likely in mild and moderate TBI, the risk reduction of post-traumatic seizures is still signicant," said Matthew W. Pease, MD, assistant professor of neurological surgery at the IU School of Medicine and rst author of the paper. "We're able to show that people who get anti-seizure medicines are less likely to have seizures in the short term."Traumatic brain injury is a major cause of death and disability worldwide. In the United States, there were 214,000 TBI-related hospitalizations in 2020 and more than 69,000 TBI-related deaths in 2021, according to the U.S. Centers for Disease Control and Prevention.Post-traumatic seizures contribute to secondary brain damage after TBI and exacerbate the injury, leading to a longer hospital stay, worse functional outcomes and increased chance of death.Pease said physicians often administer anti-seizure medication within the first seven days of injury to patients with severe TBI, leading to a less than 5% chance of having a seizure. But for patients with mild and moderate TBI, anti-seizure medications are not generally prescribed since the data hasn't shown whether the medications should be used as a preventative treatment.Early administration of anti-seizure medication may improve traumatic brain injury patient outcomesNEUROCRITICAL CAREMatthew W. Pease, MD Assistant Professor of Neurological Surgery

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43IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 42A STORY OF RESILIENCENearly four years ago, Laura Burdick’s life changed in a matter of seconds.In May 2020, Burdick sustained a traumatic brain injury and a spinal cord injury when a drunken driver drove erratically o Interstate 94 in Chicago, sailed through the air and landed on top of Burdick’s car on an access road next to the highway. The driver died. Burdick survived.Burdick awoke two months later in the ICU with no memory of the crash or her stay at the Chicago hospital. Constrained to a bed, she had zero motor function below her shoulders, and doctors didn’t know the extent of her injuries. And under strict COVID-19 visitor restrictions, Burdick’s family couldn’t see her in the hospital until at least two weeks after the accident.Despite these uncertainties and isolation, Burdick persevered.Her brain has fully healed, and Burdick has spent the last few years rehabilitating at facilities in Chicago, Omaha and Indianapolis. Burdick now has more mobility with her hands and arms, which allows her to eat on her own, operate her wheelchair and do daily tasks.Spinal cord injury survivor now spinal research ambassador thanks to IU School of Medicine researcherBurdick’s story has been an inspiration to many — and it connected her to Lingxiao Deng, PhD, assistant professor of neurological surgery and a primary member of Stark Neurosciences Research Institute at the IU School of Medicine. Deng investigates neural plasticity following spinal cord injury with the hopes of discovering promising new therapies.“Laura’s message of strength, courage and resilience has been an inspiration to us all,” Deng said.Deng connected Burdick with Spinal Research, the leading charity in the United Kingdom funding spinal cord research and one of the largest organizations of its kind internationally. Burdick was recently chosen as one of their ambassadors. She meets monthly on a call with researchers and fellow ambassadors across the world to discuss their work and advocacy.“It would be wonderful if we could cure paralysis, but there are a lot of other issues that need research and help,” Burdick said. “Even if you could solve some of those issues, that can make a tremendous dierence in someone’s life whether or not they ever walk again.”Deng, who has been researching spinal cord injuries at the IU School of Medicine for nearly a decade, said it’s mutually benecial for researchers to meet with people living with the injury or disease they study.“We need to listen to what the spinal cord injury population needs,” Deng said. “They may help us translate some of our strategies in the lab to their daily lives.”Burdick, an Indianapolis resident and Terre Haute native, attended Notre Dame for her undergraduate education and later earned a master’s degree in public health from Saint Louis University. With a budding career in the wellness eld, Burdick became general manager of The Hot Room, an Indianapolis-based hot yoga and Pilates studio. It was through her role there that led her to Chicago in May 2020 to visit The Hot Room’s Chicago location, where she was helping deliver virtual health and tness during the early weeks of the COVID-19 pandemic.It was also through The Hot Room that she met Kristen Cohen, a research assistant in the Deng lab. Burdick has known Cohen for more than 10 years, as both a yoga student and yoga client. Shortly after Burdick returned to Indianapolis following several months of rehabilitation out of state, her friendships with Cohen and a group of other women from the studio deepened. Cohen introduced Burdick to Deng and he shared information about their research in the lab.“Dr. Deng’s research is at top of mind for people living with a spinal cord injury,” Burdick said.Deng’s work explores three translational themes: the plasticity of neural circuitry mediating the recovery of bladder function after spinal cord injury; a pharmacological approach to protect the spinal cord from contusive injury; and cell transplantation combined with locomotor exercise to improve the motor and bladder functional recovery after spinal cord injury.Bladder function recovery is a top priority among people with spinal cord injuries, and Deng and his team are investigating rehabilitation approaches to improving this function through locomotor exercise. The lab is also investigating the use of a Food and Drug Administration-approved drug that has been effective in reducing function deficit of spinal cord injury in animal models.“Researchers, the public and the spinal cord injury population should have a similar goal, and we should work together,” Deng said.After being discharged from the ICU, Burdick rst sought care during a short stay at Shirley Ryan AbilityLab in Chicago for acute care needs, which included relearning how to swallow food and water with the help of speech-language pathologists. Burdick next traveled to the QLI rehabilitation center in Omaha, Nebraska, for nine months to work with physical therapists, occupational therapists, speech-language pathologists, vocational specialists and other experts to help her improve and progress in her physical health and wellness.Burdick continues to rehabilitate in Indianapolis at NeuroHope, and she even oers nutrition coaching at the wellness center. While at QLI, Burdick led in-person and virtual yoga classes. She’s also back working at The Hot Room, teaching yoga classes and conducting teaching training classes for new yoga teachers and coaching wellness and nutrition classes.Through the ambassadorship program with Spinal Research, Burdick is tasked with spreading the word about spinal cord injury research to a broader audience and helping fundraise. Prior to her injury, Burdick said she didn’t know much about spinal cord injuries. A few months after, Burdick started researching how scientists and clinicians are trying to treat and cure paralysis.“It did heighten my awareness that there are people out there who are dedicating their research to try and help us improve,” Burdick said. “In doing a clinical trial, I understand that things may never improve for me in my life. But if I can help the next set of people with spinal cord injuries, then that’s worth it for me.” Always with a smile on her face, Burdick said she attributes her positive attitude to the strength of her friends and family who have stood by her side through the highs and lows.“I have hope,” Burdick said. “I think a lot of people don’t have that same hope. I’m a faithful person, but I just know that good things can happen, and we could be on the precipice of something big all the time. I’m going to continue to work hard at improving my health, so who knows what can happen. I’m not resigned to the fact that it’s all over, and that makes me still want to get up in the morning and say, ‘What can happen today?’”Above: Burdick works with a rehabilitate therapist in Indianapolis at NeuroHope.Laura Burdick and Lingxiao Deng, PhD, at the Stark Neurosciences Research Institute at the IU School of Medicine.

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47IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 46Over the past 75 years, the IU School of Medicine Department of Neurologi-cal Surgery has been a leader in excel-lent medical care, competitive and engaging residency and fellowship edu-cation opportunities and groundbreak-ing neuroscience research that impacts everyday people. Our department faculty, national and international leaders, are among the nest surgeons in the coun-try, and thousands of patients entrust their care here in Indianapolis. One of the reasons we have been able to build such a strong program since 1949 is because of philanthropic contributions from people like you.Gifts from our alumni, patients and friends help us to train our sta in the latest surgical techniques, to make advances in surgery through research and to achieve the best possible outco-mes for patients. When you make a gift to the IU School of Medicine Depart-ment of Neurological Surgery, you enable our team to provide the most advanced care, conduct research and educate the next generation of neurosurgeons. Our department, through the eorts of the IU Foundation and the IU School of Medicine Gift Development team has multiple ways your giving can impact the department and school.Our department supports distinguished professorships and endowed chairs as we recruit and retain experts in neurosur-gery. We also oer educational lectures-hips for our faculty and trainees named after renowned faculty physicians at IU School of Medicine.Continuing the legacy of the Department of Neurological SurgerySUPPORTINGOTHERS THROUGHGIVINGJoseph Maroon, MD, was honored in fall 2024 by his alma mater, Indiana University, with the establishment of the Joseph C. Maroon Professorship in Neuroscience Innovation. The award recognizes Dr. Maroon for his many contributions to neuroscience, sports medicine, neuro-oncology and neuro traumatology.There are many ways to support the Department of Neurological Surgery, including annual giving, creating endowed funds and gifts of assets. If you would like to discuss how you can be part of this critical work, please contact any or all the representatives.IU Foundation: Andrea Spahn-McGraw at anspahn@iu.eduor 317-278-2124IU Health Foundation: Eric Statler at estatler@iuhealth.orgor 317-962-2207Riley Children’s Foundation: Kate Cohen at kcohen@rileykids.orgor 317-634-4474The new IU Health Hospital and IU School of Medicine Medical Education and Research Building in downtown Indianapolis will combine adult services into one location with inpatient and observation beds, a full-service outpatient center, on-site faculty oces and a state-of-the-art medical education facility. We are creating a new model of care for our community.This will enhance ongoing collaboration with the Indiana Univer-sity School of Medicine and support the mission of clinical care, research and education.

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49IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 48ALUMNI2024Miracle C. AnokwuteMohamed A. Zaazoue2023Vincent J. AlentadoJonathan WeyhenmeyerChristopher Wilson2022Jacob ArcherAndrew KoivuniemiStephen Mendenhall2021Wei HuNicolas Villelli2020Thomas GianarisBrandon LaneGina Monaco2018Shaheryar F. AnsariTimothy Kovanda2017Kashif ShaikhIan White2016Andrea G. SchererCharles G. Kulwin2015John R. EdwardsNeal B. PatelTodd D. Vogel2014Bradley N. BohnstedtDavid Lewis2013Daniel L. KimJason M. Voorhies2012Zachary H. DoddJessica Wilden2011Gregory M. HelbigTodd A. Eads2010Jamie L. BradburyShannon P. McCanna2009Daniel H. Fulkerson2008Philip Yoder SmuckerThomas J. Altstadt2007Jordan JudeJames C. Miller2006Robert Blake Sloan2005Richard B. RodgersScott Hoyle Purvines2004Patrick J. ConnollyKevin M. Jackson2003Francesca D. Tekula2002Jill W. DonaldsonTodd B. Abel2001Rajesh K. BindalSubrata Ghosh2000Carl Gorman Bevering IIIJames K. Kaufman1999David P. FritzKen SatoWilliam E. Snyder1998Richard V. Chua1997Christopher E. WolaRobin M. Bowman1995James D. CallahanKimball N. Pratt1994Thomas B. ScullyThomas C. Witt1993Steven Goodwin1992Timothy K. PuttySteven Sanders1991Constance Kayser1990Carl J. SartoriusTariq Javed1989Joel C. Boaz1988John CummingsJoseph L. Voelker1987Christopher L. MarquartScott A. Shapiro1986Luis Rodriquez1985Mark C. GlazierRobert Yount1984David Hall1982Jack DeckardRalph C. Loomis1981Thomas LuerssenMichael Turner1979Alonzo DeSousa1978Thomas Keucher1977Peter HallRobert Schultz1976 Malcolm Snell1975Terry HornerLarry Schulhof1974Michael BurtBertil Loftman1973Daniel CooperRobert M. Worth1972Henry FeuerRichard Gilmor1971Joseph C. Maroon1970James Franco1968C. Courtney Whitlock1967John E. Joyner1966Carl KaoAndrievs Dzentis1965Sam Assam1959Eldon Hann1957Robert L. CampbellJoseph Maroon, MD1959 Indiana University FootballBloomington, Indiana

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51IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 | | IU DEPARTMENT OF NEUROLOGICAL SURGERY ANNUAL REPORT '24 50Neurosurgery Alumni ConnectionStay ConnectedThe legacy of the Department of Neurological Surgery at the IU School of Medicine lives on through our alumni. We’ve seen countless residents and fellows step into the clinic and ope-rating room at IU Health hospitals, learning the latest techno-logy and techniques from our leading neurosurgery faculty. The training experienced in our department extends across the nation — and world — and we couldn’t be prouder of the careers of our residents.As the department continues to grow and develop new opportunities for collaborations in science and academic medicine, we’d like to keep in contact with our alumni. Each year we have events that we encourage alumni to attend — lectureships, symposiums, get-togethers at national con-ferences and even golf outings. We want to stay connected, reminisce and discover new ways to partner together. Many alumni have returned to the IU School of Medicine as faculty members, have given keynote lectures at department events or endowed large gifts.If you are an alum of the Department of Neurological Surgery, contact Mary Gallagher, director of education, at mjgallag@iu.edu, with your name and most recent contact information so we can stay in touch.@NEUROSURGERY_IU@IU_NEUROSURGERYIU SCHOOL OF MEDICINE DEPARTMENT OF NEUROLOGICAL SURGERY

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2024 Department of Neurological Surgery Annual Report

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