Clinical and basic cerebrovascular research within the Department of Neurological Surgery is done in collaboration with the Department of Anesthesia and Perioperative Care and the Center for Cerebrovascular Research (CCR) (http://avm.ucsf.edu/). The CCR is a multi-disciplinary group of investigators conducting a wide range of research aimed at directly improving clinical outcomes and care for patients with cerebrovascular disorders.
Clinical research emphasizes vascular malformations of the brain. The Department of Neurological Surgery is an integral part of the UCSF Brain Arteriovenous Malformation Study Project, which tracks treatment results and patient outcomes. This program includes a prospective registry of AVMs and other vascular malformations of the brain. A parallel project is the Brain Vascular Malformation Consortium, a recently funded multi-center effort that is studying the clinical behavior and genetics of three cerebrovascular disorders: cavernous malformations, Sturge-Weber Syndrome and Hereditary Hemorrhagic Telangiectasia. The consortium is part of the Rare Disease Clinical Research Network program administered by the NIH Office of Rare Disease Research and NINDS (http://rarediseasesnetwork.epi.usf.edu).
The Department of Neurological Surgery is also home to cutting-edge surgical anatomy laboratory that is focused on developing more effective surgical strategies for complex cerebrovascular and skull base lesions. Surgical anatomist and principal investigator Arnau Benet MD performs surgical simulations in postmortem specimens and produces digital 3-D anatomic images for surgical planning, development of novel surgical approaches, and educational activities.
Current areas of study include:
• Epidemiology and clinical course of brain arteriovenous malformations to identify risk factors for disease susceptibility or spontaneous intracranial hemorrhage
• Genomic studies, including genome-wide SNP and expression, to help identify genes involved in brain arteriovenous malformation or hemorrhage
• Risk stratification algorithms for predicting surgical outcomes
• Vascular biology of cerebrovascular malformations
• Development of gene and cell based therapy for the treatment of ischemic stroke
• Development of clinically relevant animal models of cerebrovascular disorders:
o Animal models combining manipulation of genetic background and growth factor stimulation to induce brain arteriovenous malformations
o Animal models of intracranial aneurysm used to study the influence of hemodynamics and inflammatory pathways on lesion progression