Thanks to everyone who joined us on November 11, 2023, for our inaugural Bridging the Gap conference! Please see below for video replays of presentations from the event.
Opening Remarks, Dr. Andrew Callen
November 11, 2023
Today at the first inaugural Spinal CSF Leak Bridging the Gap symposium, we come together not just in the spirit of learning, but in the spirit of understanding.
Our assembly is unique. We gather as clinicians, researchers, and patients, all driven by a shared commitment to shed light on the accurate diagnosis and effective treatment of this condition. Today we inaugurate a new chapter in medicine with this conference. We are a unique confluence of patients and healthcare providers, all propelled by a shared dedication to demystifying and treating CSF leaks.
We’ve all been enthralled by the recent advances in radiology, which have provided us with a visual evidence of these leaks, opening new vistas and diagnosis and care. Yet, let us not overlook the profound clinical insights that are woven into the very fabric of our patients’ experiences. The stories they share are not mere narratives.
They are rich with vital information that can enhance our clinical acumen and our understanding of this disease. We stand united in the face of a condition that has for too long left many feeling isolated within the very system meant to heal them. Today we turn a new leaf. We are not just sharing space: we are actively weaving a tapestry of trust and respect, where the courage of our patients to share their narratives is met with the profound respect and earnest attention it deserves. In the echoes of their experiences, we find more than stories. We discover the beating heart of medicine. Let us channel the spirit of Sir William Osler, who famously said, “Listen to the patient. They are telling you the diagnosis.”
Today, we listen not only to diagnose, but to learn, to connect, and reaffirm our oath to do no harm. I ask that as providers, we acknowledge the uniqueness of today’s CME opportunity to listen to and learn from our patient lectures.
Many of these patients have felt vulnerable and unheard during their diagnosis, treatment, or aftercare. And today as providers, we are inverting the power structure embedded in the patient-doctor relationship and listening to what they, our patients, have to teach us about living with this disease. This conference is a testament to our collective resolve to foster an environment where every voice is heard, every story is honored, and every experience is a step towards enlightenment.
On behalf of all providers speaking and in attendance today, I ask that we pledge to embrace the vulnerability of our patient speakers, both today and moving forward, with the dignity and earnestness it warrants. I’m confident that by the end of this conference, we will have nurtured a deeper, more empathetic understanding of this condition, one that resonates with the shared humanity at the core of our practice.
So, with a commitment to both learn and support, I warmly welcome you all. Thank you for your presence, your courage, and your invaluable contributions.
SIH: ARRIVING AT A DIAGNOSIS
Patient Talk: Journey to a Diagnosis (Nick Stevens)
Transcript
Provider Talk: Challenges in the Diagnosis of Intracranial Hypotension (Dr. Marius Birlea)
Slides | Transcript
Provider Talk: Clinical Mimics of SIH (Dr. Deborah Friedman)
Transcript
Patient Talk: Emotional Lability as a Normal Reaction to Abnormal Circumstances (Dr. John Reiman)
Transcript
Provider Talk: Challenges in the Radiographic Diagnosis of Intracranial Hypotension (Dr. Jessica Houk)
Slides | Transcript
Special Speaker: Navigating Spinal CSF Leak Care When You Are Not at a Major Referral Center (Dr. Jill Rau)
Slides | Transcript
TREATMENT: PERCUTANEOUS AND SURGICAL
Provider Talk: Epidural Blood Patch Basics (Dr. Ian Carroll)
Slides | Transcript
Patient Voices: Epidural Blood Patches
Members of the spinal CSF leak community
Transcript
Provider Talk: The History of Surgical Treatment for Spinal CSF Leaks (Dr. Wouter Schievink)
Slides | Transcript
Patient Talk: The Surgical Experience (Dr. Claudia Perez Sandhu)
Transcript
The Scope of Surgery for CSF Leaks (Dr. Peter Lennarson)
Slides | Transcript
POST-TREATMENT: RECOVERY, REBOUND SYMPTOMS, AND POTENTIAL RELAPSE
What is the Evidence for Post-Patch Care (Dr. Lalani Carlton Jones)
Transcript
Patient Voices: Post-Patch Care and RIH
Members of the spinal CSF leak community
Transcript
Rebound Intracranial Hypertension: Clinical Presentation and Treatment (Dr. Prem Subramanian)
Transcript
Patient Talk: Recovery is a Verb (Jen MacKenzie)
Slides | Transcript
Provider Talk: The Approach to the Complex Patient (Dr. Ilene Ruhoy)
Slides | Transcript
Patient Talk: On Living with a Persistent Leak (Jodi Ettenberg)
Transcript
Patient Voices: Thoughts on Recovery
Transcript
Research Updates in Spinal CSF Leaks (Dr. Ian Carroll)
Slides | Transcript
Patient Voices: What Doctors Should Know
Transcript
LOCATION
ONLINE
Details included upon registration
IN-PERSON
University of Colorado Anschutz Health Sciences Building, Room 2010
1890 N Revere Ct
Aurora, CO 80045
AGENDA
CLICK HERE FOR FULL PROGRAM AND SPEAKER BIOS
7:30 – 8:15am
Registration
8:15 – 8:30am
Welcome & Introductions
Andrea Buchanan
SIH: ARRIVING AT A DIAGNOSIS
8:30 – 8:40am
Patient Talk: Challenges in Diagnosis – The Patient Experience
Nick Stevens
8:40 – 8:50am
Provider Talk: Challenges in the Clinical Diagnosis of Intracranial Hypotension
Dr. Marius Birlea
8:50 – 9:05am
Provider Talk: Clinical Mimics of SIH
Dr. Deborah Friedman
9:05 – 9:20am
Patient Talk: Emotional lability as a normal reaction to abnormal circumstances (Leakland)
Dr. John Reiman
9:20 – 9:35am
Provider Talk: Challenges in the Radiographic Diagnosis of Intracranial Hypotension
Dr. Jessica Houk
9:35 – 9:55am
Section Q&A
Moderator: Dr. Samantha Petrucci
9:55 – 10:10am
Break
10:10 – 10:25am
Special Speaker: Navigating CSF Leak Care When You Are Not at a Major Referral Center
Dr. Jill Rau
10:25 – 10:45am
Special Speaker: A Clinical Care Model for CSF Leaks
Dr. Andrew Callen
TREATMENT: PERCUTANEOUS AND SURGICAL
10:45 – 11:00am
Provider Talk: Epidural Patching 101
Dr. Ian Carroll
11:00 – 11:10am
Patient Talk: Getting A Patch
Spinal CSF leak patient community members
11:10 – 11:25am
Provider Talk: History of Surgical Treatment of CSF Leaks
Dr. Wouter Schievink
11:25 – 11:35am
Patient Talk: The Surgical Experience / When a physician becomes a patient
Dr. Claudia Perez Sandhu
11:35 – 11:50am
Provider Talk: The Scope of Surgery for CSF Leaks: Concepts, Techniques, and Expectations
Dr. Peter Lennarson
11:50 – 12:10pm
Section Q&A
Moderator: Terri Baker, PA
12:10 – 1:20pm
Lunch
1:20 – 1:30pm
Patient Voices: “The View From Here”
Spinal CSF leak patient community members
POST-TREATMENT: RECOVERY, REBOUND SYMPTOMS, AND POTENTIAL RELAPSE
1:30 – 1:45pm
Provider Talk: What is the Evidence for Post-Patch Care?
Dr. Lalani Carlton-Jones
1:45 – 1:55pm
Patient Talk: Post-patch recovery and RIH
Spinal CSF leak patient community members
1:55 – 2:10pm
Provider Talk: Rebound Intracranial Hypertension: Clinical Presentation and Treatment
Dr. Prem Subramanian
2:10 – 2:25pm
Patient Talk: Recovery is a verb
Jen MacKenzie
2:25 – 2:40pm
Provider Talk: The Approach to the Complex Patient
Dr. Ilene Ruhoy
2:40 – 2:55pm
Patient talk: On living with a persistent leak
Jodi Ettenberg
2:55 – 3:00pm
Patient Voices: Thoughts on Recovery
Spinal CSF leak patient community members
3:00 – 3:20pm
Section Q&A
Moderator: Dr. Danielle Wilhour
3:20 – 3:45pm
Break
3:45 – 4:00pm
Research Updates in Spinal CSF Leaks
Dr. Ian Carroll
CONCLUSION
4:00 – 4:15pm
Patient Voices: What Doctors Should Know
Spinal CSF leak patient community members
4:15 – 4:50pm
Q&A
Moderator: Martha Bond
4:50 – 5:00pm
Closing remarks
Dr. Andrew Callen
SPEAKERS
Marius Birlea, MD, FAHS
Andrea Buchanan
Andrew Callen, MD (Course Director)
Lalani Carlton Jones, MBBS
Ian Carroll, MD, MS
Jodi Ettenberg
Deborah Friedman, MD, MPH
Jessica Houk, MD
Peter Lennarson, MD
Jen MacKenzie
Jill Rau, MD, PhD
John Reiman, PhD
Ilene Ruhoy, MD, PhD
Claudia Perez Sandhu, MD
Wouter Schievink, MD
Nick Stevens
Prem Subramanian, MD, PhD
ACCREDITATION AND DESIGNATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Colorado School of Medicine and the Spinal CSF Leak Foundation. The University of Colorado School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The University of Colorado School of Medicine designates this live activity for a maximum of 7 AMA PRA Category 1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
LEARNING OBJECTIVES
- Identify and differentiate between typical and atypical presentations of spinal CSF leaks, enhancing diagnostic accuracy and reducing instances of underdiagnosis and overdiagnosis.
- Analyze the applications and limitations of the Bern score in the radiographic diagnosis of intracranial hypotension, facilitating a rigorous yet nuanced approach to interpreting radiographic results.
- Develop a comprehensive understanding of the available percutaneous and surgical treatment options, including the historical context and recent advancements, to better guide patients in choosing the most appropriate treatment path.
- Implement patient-centric approaches in their practice, utilizing the insights and experiences shared by patients during the conference to foster a more collaborative and empathetic healthcare environment.
- Assess and enhance their communication strategies among all team members, including the neurologist, neuroradiologist, neurosurgeon, and nursing staff, to optimize spinal CSF leak management and improve patient satisfaction and outcomes.