Year In Review 2010 The Department of Neurological Surgery at UCSF University of California San Francisco Neurological Surgery is a true example of how Contents technology will continue to improve our lives in the Brain Tumor Center 2 years to come. California Center Among the many honors for Pituitary Disorders 6 given to our faculty in 2010, I would like to recognize Brain & Spinal Injury Center 7 Dr. Nicholas Barbaro’s appointment as President of Adult Epilepsy Surgery 10 the Neurosurgical Society of America and Dr. Lawrence Epilepsy Research 11 Pitts’ appointment to Provost Movement Disorders and Executive Vice President Program 12 of Academic Affairs at the University of California, Vascular Neurosurgery Offi ce of the President. Program 16 I am exceedingly proud to have been chairman during Neurospinal Disorders a year marked by signifi cant Program 18 Letter from the Chair ingenuity and progress Pediatric towards understanding Since its inception in to train the future generation Neurological Surgery 22 and treating neurosurgical 1947, the Department of of academic neurosurgeons. disorders, and to work with Neurological Surgery at In this review, we highlight Pediatric Epilepsy Center 24 such a highly talented and UCSF has grown from a some of the major dedicated group of faculty UCSF Nerve Injury Clinic 24 division of the Department accomplishments and staff. of Surgery into one of the and fi ndings from the UCSF Neurological Surgery premier neurosurgical Department in 2010. Pain Management Program 24 programs in the world. In In one of the more exciting 2010, we have neurosurgery developments, this month Center for Neural Engineering services at all major hospitals we launched the Center & Prostheses 25 in the Bay Area and we were for Neural Engineering and again ranked in the top fi ve Prostheses (CNEP, page 25) neurosurgery programs on – a collaboration between US News & World Report’s UCSF and UC Berkeley. annual list of Best Hospitals. Mitchel S. Berger, Department of While bionics that meld mind We also ranked fi rst in MD, FACS, FAANS Neurological Surgery and machine have long been funding for neurosurgery the stuff of science fi ction, Kathleen M. Plant University of California, from the National Institutes this new program will build Distinguished Professor San Francisco of Health for the fi fth on current technologies that and Chairman consecutive year. Our central 505 Parnassus Ave., are already allowing patients mission is to give the best Department of Room 779 M to move artifi cial limbs with care possible to our patients; Neurological Surgery thought. By bridging the gap San Francisco, CA to improve therapies for between neuroscience and Director, UCSF 94143-0112 neurosurgical disorders; and Brain Tumor Center cognitive science, CNEP Phone: (415) 353-7500 Fax: (415) 353-2889 neurosurgery.ucsf.edu Design & layout: Victoria Maier Magbilang Illustration: Kenneth Xavier Probst Photography: Noah Berger, John Branscombe, Susan Merrell, Kaz Tsuruta The Brain Tumor Center at UCSF The Brain Tumor Center at UCSF is one of the largest and most comprehensive programs for brain tumor treatment in the United States. It includes the Division of Neuro-oncology, the Brain Tumor Research Center, and the Division of Translational Research. 2 Top: Susan Chang MD, Jennifer Clarke MD, Nicholas Butowski MD Bottom: 5-ALA causes tumor tissue to fl uoresce during surgery Clinical Trial Highlights in the United States as an will be to create a virtual • The UCSF Helen Diller investigational new drug at a tissue bank to prospectively Family Comprehensive • The Department of handful of select institutions, identify patient subgroups Cancer Center has been Neurological Surgery is and UCSF is the only who will be candidates for chosen as one of fi ve cancer participating in a Phase II institution on the West Coast clinical trials done at time of centers in the United States study of 5-aminolevulinic to offer this cutting-edge tumor recurrence. to participate in the Merck acid (5-ALA) to enhance neurosurgical treatment. Oncology Collaborative • The Department of visualization and resection Trials Network (OncoNet), a • The Ben and Catherine Ivy Neurological Surgery is of malignant brain tumors. global clinical trials network Foundation has funded a currently offering a Phase The prodrug 5-ALA taken focusing on the development new clinical trials consortium II clinical trial for a novel orally before surgery causes of Merck drug and of fi ve institutions across the vaccine to treat glioblastoma, fl uorescent porphyrins to vaccine candidates being United States, led by Michael led by Andrew Parsa accumulate in tumor tissue investigated for the treatment Prados MD, director of the MD, PhD. Once a tumor and can be visualized under and prevention of cancer, Division of Translational is removed, a vaccine fl uorescent light during including brain tumors. surgery to identify tumor Research. The main is created from proteins cells and facilitate a more objective of the consortium specifi c to that tumor and Collaboration provides complete resection. will be to perform small, a heat-shock protein, and funding for infrastructure, enriched-patient clinical trials injected back into the patient fast-track access to It has previously only been for recurrent glioblastoma. over time. This prepares the compounds and drugs for used outside the United The goals will be to screen immune system to produce clinical trials, and a scientifi c States, and the European promising molecularly T cells that fi nd and kill new educational exchange. Every data show that it improves targeted agents and to cancerous cells with proteins year, the network will enroll extent of resection and validate drug distribution, matching those extracted approximately 1,200 patients leads to longer progression- pharmacokinetics, and from the tumor. in 30 to 40 investigator- free survival for patients. pharmacodynamics in tumor initiated or company- 5-ALA is now being tested tissue. Another objective sponsored trials. Faculty Adult Clinical Oncolytic viral therapies; Nalin Gupta MD, PhD Russ Pieper PhD vascular biology of glioma Neuro-Oncology Pediatric brain tumors; Signal transduction; models cell-cell interactions of human gliomagenesis and Susan Chang MD Arturo Alvarez-Buylla PhD drug resistance Developmental neuroscience; Daphne Haas-Kogan MD Nicholas Butowski MD stem-cell neurobiology Apoptosis and genetic William Weiss MD, PhD Jennifer Clarke MD Krys Bankiewicz MD, PhD mutations; therapeutic Mouse models of irradiation enhancement human brain tumors Michael Prados MD Convection drug-delivery systems; gene therapy C. David James PhD Adult Brain Tumor John Wiencke PhD Surgery Mitchel S. Berger MD Molecular biology of CNS Biomarker development cancer; analysis of mutant and application in brain Brain mapping; molecular Mitchel S. Berger MD epidermal growth factor tumor etiology genetic basis, biology, and Manish Aghi MD receptors in malignant therapy of brain tumors gliomas; rodent model Margaret Wrensch Edward Chang MD MPH, PhD Gabriele Bergers PhD testing of experimental Sandeep Kunwar MD therapies Genetic and molecular Angiogenesis; epidemiology of adult glioma Michael McDermott MD tumor invasion Andrew Parsa MD, PhD Andrew Parsa MD, PhD Shichun Zheng PhD Soonmee Cha MD Immunotherapy Molecular neuroepidemiology Neuropsychology Perfusion magnetic Claudia Petritsch PhD resonance imaging Caroline Racine PhD Brain cancer stem cells; Joe Costello PhD asymmetric stem cell BTRC Laboratories division; novel tumor Functional genomics suppressor genes Manish Aghi MD, PhD UCSF Neuro-Oncologists and prognostic markers Several new research studies of convection Have Highest Patient and improving classifi cation projects were initiated in enhanced delivery into the Satisfaction Scores and grading schemes for 2010, while many of our program’s overall focus on brain tumors. Dr. Phillips ongoing investigations neuroimaging. The Neuro-Oncology also directs the Molecular yielded signifi cant results. Partnering with veterinarians Service was awarded the Morphology Laboratory, • California Institute for at UC Davis, P01 investigator UCSF Medical Center which is a core resource Regenerative Medicine Krystof Bankiewicz MD, PhD Pinnacle Award for the to assist investigators in (CIRM) Disease Team Award: used convection-enhanced third consecutive year. This optimizing techniques for Funded by a $19 million delivery of nanoliposomal award recognizes the UCSF immunohistochemistry, grant from CIRM, the BTRC CPT-11 to treat dogs with medical service with the best molecular in situ studies, and will lead studies with other spontaneous brain tumors, patient satisfaction scores for laser capture microdissection. outpatient care. California institutions to which are very similar to Brain Tumor genetically engineer stem tumors that arise in humans. Brain Tumor Center Research Center cells that deliver therapeutic CPT-11 was infused directly Welcomes New agents to selectively kill into the brain tumors via Neuropathologists Continuously funded by glioblastoma cells. If convection-enhanced grants from the National approved by the FDA, it will delivery, and its distribution Neuropathologists Joanna Institutes of Health (NIH) be tested fi rst in patients with was monitored in real time Phillips MD, PhD and Arie since 1972, the Brain Tumor recurrent glioblastoma. using intraoperative MRI. Perry MD have joined the Research Center (BTRC) Three years later, many of the • NIH Program Project Brain Tumor Center