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      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

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      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

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Forum

Forum: Neurological News from Sweden – the land of EFNS 2012

August 1, 2012

Dawn of a new era: Gösta Hultquist’s thesis of carotid artery disease 1942

by Bo Norrving

A patient with a carotid TIA – emergency diagnosis and neuroimaging – urgent start of medical therapy – carotid ultrasound showing a severe carotid stenosis – carotid surgery: today this chain of care is well embedded in everyday clinical routine. However, only one generation ago none of the elements was known: the clinical features and urgency were not well recognized, diagnostic tools were unavailable, and medical and surgical therapies did not exist.
C. Miller Fisher (who died on 14 April earlier this year at the age of 98) is rightfully credited as the father of modern stroke neurology. His publication in 1951 delineated carotid occlusive disease and included the concept of TIA (a term that he actually coined), possible aethiologies, clinical implications and thoughts on therapeutic possibilities. This was C. Miller Fisher’s 1st seminal publication, which along with his extensive subsequent list of discoveries and writings constitute a core part of modern stroke history.

C. Miller Fisher

Less well known is the contribution on carotid occlusive disease by Gösta Hultquist in 1942 with his dissertation ”Über Thrombose und Embolie der Arteria carotis und hierbei vorkommende Gehirnveränderungen. Pathologisch-Anatomische Studie”. The work was carried out between 1938 and 1942 at the Department of Pathology at St. Göran’s Hospital in Stockholm, under the supervision of Folke Henschen.

The Department of Pathology, Stockholm, 1944. Mural painting by Peter Weiss

Hultquist studied the carotid arteries in 1400 autopsies and found a rate of carotid disease of 3%. He described the clinical presentations in brief, the arterial lesions in extra- and intracranial large arteries, and the brain parenchymal lesions of 88 cases, and discussed symptoms corresponding to TIA, progressive stroke, collateral circulation, and carotid stenosis as well as occlusion. He illustrated the text with schematic drawings of the cerebral circulation and with 60 phothographs of arterial and brain lesions.

Hultquist’s work substantially extended knowledge and concepts on carotid disease. Why was he not more recognized? The occurence of the publication (in German) in 1942, at a critical period of the 2nd world war, likely contributed. Moreover, Hultquist did not himself develop his ideas in further publications and presentations – the thesis apparently marked the end of his scientific career. Even within Sweden, Hultquist’s findings were not further pursued by clinicians during the subsequent few years.

During an office cleaning at the department of neurology in Lund some years ago, Gösta Hultquist’s thesis re-appeared. The dedication indicated that this specific copy had belonged to Gunnar Wohlfart, the 1st chair of Neurology in Lund (see previous article by Sten Fredrikson in this series).

Cover of the thesis with dedication to Gunnar Wolfart

Inside page of the thesis

Gunnar Wohlfart was the opponent at Hultquist’s dissertation in 1942, and the copy is filled with Wohlfart’s remarks and comments. On the inside back cover is glued a type-written piece of paper with his concluding speech in verbatim at the dissertation. Wohlfart praised to the work and indicated the novelty of the findings, but remarked: ”…as a neurologist I must regret that this massive, and from a pathological perspective meticulously examined material, is not equally matched by clinical examinations and details, limiting the possibilities of clinico-pathological correlations”.
Wohlfart continued: ”…it has been very rewarding to read in detail this very extensive thesis…”, wrote a reminder to himself to then make a deep bow, and at the very end (in pencil writing) inserted a personal ”Puh!” with an exclamation mark (the thesis amounted to no less than 400 pages and obviously made tough reading).

Photo from the World Congress of Neurology in London 1955. Archive of the author.

In the history of stroke, Gösta Hultqvist (1910-1993) should certainly be recognized as one of the early pioneers that firmly recognized carotid disease as a cause of TIA and ischemic stroke. The 2012 EFNS congress in Stockholm will mark the 70th anniversary of Hultquist’s contribution.

1 C Miller Fisher. Photo by the author, Boston, July 3, 1985
2 Folke Henschen (right) at the Department of Pathology, Stockholm, 1944. Mural paiting by P Weiss. G Hultguist appears at the left (arrow) by the microscope.
3-4. Illustrations on carotid disease (photo and drawing) from the thesis.
5-6 Cover and inside page of Gösta Hultquist’s thesis 1942. with dedication to Gunnar Wohlfart.
7 John Walton (left) and Gunnar Wohlfart (right) at the World Neurology Congress in London 1955. Archives of the author.

Bo Norrving is Professor of Neurology at Lund University, Sweden. He will present his lecture “Dawn of a new era: Gösta Hultquist’s thesis of carotid artery disease 1942.” during the Special Session on Chapters in the history of Swedish Neuroscience during the EFNS Congress in Stockholm, Sweden.

 

Forum: Neurological News from Sweden – the land of EFNS 2012 was last modified: July 31st, 2012 by Editor
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EAN Guideline: Concomitant use of Cholinesterase Inhibitors and Memantine in Alzheimer’s Disease

May 1, 2015

Roadmap to Istanbul: Election of the Board of the European Academy of Neurology

January 1, 2014

Science from a Tweet: Experimental Ebola drug ZMapp raises big ethical issues, we need to think both ‘carefully & humanistically’

September 1, 2014

Forum: Science from a Tweet: the new era of neuroscience

February 1, 2014

Forum: International Headache Society – Core Curriculum

June 10, 2012

Forum: About Retirement

May 1, 2013

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