John Pickard (neurosurgeon)

Last updated

John Pickard
Born
John Douglas Pickard

(1946-03-21) 21 March 1946 (age 78)
AwardsFellow of the Academy of Medical Sciences (1998)
Robert H Pudenz Award for Excellence in CSF Physiology (2000)
Guthrie Memorial Medal, Royal Army Medical Corps (2010)
Scientific career
Institutions University of Cambridge
St Catharine's College

John Douglas Pickard CBE FRCS FMedSci (born 21 March 1946 [1] ) is a British professor emeritus of neurosurgery in the Department of Clinical Neurosciences of University of Cambridge. [2] [3] He is the honorary director of the National Institute for Health Research (NIHR) Healthcare Technology Cooperative (HTC) for brain injury. [4] His research focuses on advancing the care of patients with acute brain injury, hydrocephalus and prolonged disorders of consciousness through functional brain imaging, studies of pathophysiology and new treatments; as well as focusing on health, economic and ethical aspects. [2]

Contents

Pickard is an emeritus professorial Fellow of St Catharine's College, Cambridge, having retired as a professorial fellow and director of studies in medical sciences. [5] He served as president of the Society of British Neurological Surgeons from 2006 to 2008. [6]

Education

Pickard attended King George V Grammar School, Southport and then studied Natural Sciences at the University of Cambridge (Bachelor of Arts with First Class Honours in Physiology and Biophysics in 1967). [1] He then completed his Bachelor of Medicine and Surgery at King's College Hospital in London in 1970 and Master of Surgery (MChir with distinction for his thesis on ‘The Role of Prostaglandins in the Control of the Cerebral Circulation’) from the University of Cambridge in 1981. [7] [8] He is a Fellow of the Royal College of Surgeons of Edinburgh since 1974 and England (Ad eundem) since 1989. [7] Since 1998, Pickard has been a Fellow of the Academy of Medical Sciences. [9]

Career

Pickard trained in neurosurgery at the Institute of Neurological Sciences in Glasgow and at the University of Pennsylvania. He then became an honorary consultant neurosurgeon and senior lecturer, reader and professor of clinical neurology at the Wessex Neurological Centre and University of Southampton. [1] In 1991, he was appointed the first professor of neurosurgery at the University of Cambridge, based at Addenbrooke's Hospital. [10] His clinical practice included, at various times, subspecialty interests in neurovascular surgery, complex necks, hydrocephalus and tumours of the pituitary gland and IIIrd ventricle. [2]

With colleagues, Pickard established and was the first chairman and clinical director of the Wolfson Brain Imaging Centre (WBIC), a division of the University of Cambridge's Department of Clinical Neurosciences, [11] Pickard, in his capacity with the WBIC, worked with patients who were critically ill, the morbidly obese and patients with acute mental health and addiction problems. [12] From 2001 to 2013, Pickard was the National Health Service (NHS) divisional director for neurosciences at Addenbrooke's Hospital. [13] In 2009, Pickard became an NIHR senior investigator. [14] At the end of 2013, Pickard retired from full-time NHS practice and head of academic neurosurgery, but remained active in research as a voluntary director of research in the University of Cambridge. [15]

In 2013, Pickard became the first Cambridge HTC honorary director, which is one of eight national co-operatives that receive funding from the NIHR. The Cambridge HTC is the only HTC to focus on brain injury. [4] [16]

In addition to his presidency of Society of British Neurological Surgeons (SBNS), Pickard was previously chairman of the Joint Neurosciences Council and remains the honorary civilian consultant for neurosurgery to the British Army. [17] Pickard was a member of the UK Government's Animal Procedures Committee and chaired a report into the assessment of cumulative severity and lifetime experience in non-human primates used in neuroscience. This report, also called the Pickard Report, was published in 2013. [18] In addition, Pickard was also president of Academia Eurasiana Neurochirurgica from 2011 to 2012. [19]

Pickard is a patron and former president of Cambridgeshire Headway, [20] [21] a founder-trustee and chairman of the research committee of the Brain and Spine Foundation, [22] a trustee of the Brain Research Trust and was the first patron of Idiopathic Intracranial Hypertension (IIH) UK. [23]

Research

Pickard's research focuses on the care of critically ill patients after brain injury. [17] [24] [25] He led the British Aneurysm Nimodipine trial (BRANT), which demonstrated that nimodipine reduces the incidence of poor outcomes after subarachnoid haemorrhage by 40 per cent. [26] His work has included definition of how early insults to the brain in both childhood and later life may lead to late changes in cognitive outcome and new ways of detecting when the blood supply to critical areas of the brain becomes a risk. [27] Pickard established and chairs the Impaired Consciousness Research Group in Cambridge, [28] which demonstrated that functional neuroimaging could be used to detect awareness in patients who are incapable of generating any recognisable behavioural response and appeared to be in a vegetative state. [29] [30]

Pickard has also studied which parts of the brain are affected in normal pressure hydrocephalus [31] and novel treatments for pseudotumor cerebri and cerebral venous disorders. [3]

With others, Pickard established the Cambridge Shunt Evaluation Laboratory, which provides an international service for shunt testing in-vivo, and the UK Shunt Registry in 1994. [32] [33] The formation of the Registry was funded by the UK Department of Health Medical Devices Agency and contains data on over 70,000 cerebrospinal fluid (CSF) shunt-related procedures. [33] [34]

Pickard has published some 500 [35] publications in scientific and medical journals, including Nature New Biology, [36] the British Medical Journal , [26] Nature, [37] Science, [29] Brain, [31] The Lancet [38] and the New England Journal of Medicine . [39] He has co-authored 6 books, including a monograph on 'Pseudotumor cerebri syndrome'. [6] He was formerly editor-in-chief of the series Advances in Technical Standards in Neurosurgery, [40] editor-in-chief of the British Journal of Neurosurgery (2000-2006) and neurosurgical editor of the Journal of Neurology, Neurosurgery, and Psychiatry . [10] The ISI Web of Science credits him with an h-index of 67. [41]

Honours and awards

In 2000, Pickard received the Robert H. Pudenz Award for excellence in CSF physiology. [42] In 2008, he was awarded the Docteur Honoris Causa from the University of Liège, Belgium. [7] In 2010, Pickard was awarded the Guthrie Memorial Medal of the Royal Army Medical Corps [1] and named as one of Britain's top doctors by The Times . [43] [44] In 2014, he received the Lifetime Achievement Appreciation Award from the International Society for Hydrocephalus and CSF Disorders. [7]

Pickard was appointed Commander of the Order of the British Empire (CBE) in the 2020 New Year Honours for services to neurosciences, neurosurgery and research for patients with complex neurological disorders. [45]

Related Research Articles

<span class="mw-page-title-main">Neurosurgery</span> Medical specialty of disorders which affect any portion of the nervous system.

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nervous system, and cerebrovascular system. Neurosurgery as a medical specialty also includes non-surgical management of some neurological conditions.

<span class="mw-page-title-main">Syringomyelia</span> Disorder in which a cyst forms in the spinal cord

Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, paralysis, weakness, and stiffness in the back, shoulders, and extremities. Syringomyelia may also cause a loss of the ability to feel extremes of hot or cold, especially in the hands. It may also lead to a cape-like bilateral loss of pain and temperature sensation along the upper chest and arms. The combination of symptoms varies from one patient to another depending on the location of the syrinx within the spinal cord, as well as its extent.

<span class="mw-page-title-main">Hydrocephalus</span> Abnormal increase in cerebrospinal fluid in the ventricles of the brain

Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.

<span class="mw-page-title-main">Chiari malformation</span> Structural defect in the cerebellum of the brain

In neurology, the Chiari malformation is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum.

<span class="mw-page-title-main">Colpocephaly</span> Brain malformation in which the lateral ventricles are enlarged

Colpocephaly is a cephalic disorder involving the disproportionate enlargement of the occipital horns of the lateral ventricles and is usually diagnosed early after birth due to seizures. It is a nonspecific finding and is associated with multiple neurological syndromes, including agenesis of the corpus callosum, Chiari malformation, lissencephaly, and microcephaly. Although the exact cause of colpocephaly is not known yet, it is commonly believed to occur as a result of neuronal migration disorders during early brain development, intrauterine disturbances, perinatal injuries, and other central nervous system disorders. Individuals with colpocephaly have various degrees of motor disabilities, visual defects, spasticity, and moderate to severe intellectual disability. No specific treatment for colpocephaly exists, but patients may undergo certain treatments to improve their motor function or intellectual disability.

<span class="mw-page-title-main">Cerebral edema</span> Excess accumulation of fluid (edema) in the intracellular or extracellular spaces of the brain

Cerebral edema is excess accumulation of fluid (edema) in the intracellular or extracellular spaces of the brain. This typically causes impaired nerve function, increased pressure within the skull, and can eventually lead to direct compression of brain tissue and blood vessels. Symptoms vary based on the location and extent of edema and generally include headaches, nausea, vomiting, seizures, drowsiness, visual disturbances, dizziness, and in severe cases, death.

<span class="mw-page-title-main">Brenda Milner</span> British-Canadian neuroscientist and neuropsychologist (born 1918)

Brenda Milner is a British-Canadian neuropsychologist who has contributed extensively to the research literature on various topics in the field of clinical neuropsychology. Milner is a professor in the Department of Neurology and Neurosurgery at McGill University and a professor of Psychology at the Montreal Neurological Institute. As of 2020, she holds more than 25 honorary degrees and she continued to work in her nineties. Her current work covers many aspects of neuropsychology including her lifelong interest in the involvement of the temporal lobes in episodic memory. She is sometimes referred to as the founder of neuropsychology and has been essential in its development. She received the Balzan Prize for Cognitive Neuroscience in 2009, and the Kavli Prize in Neuroscience, together with John O'Keefe, and Marcus E. Raichle, in 2014. She turned 100 in July 2018 and at the time was still overseeing the work of researchers.

<span class="mw-page-title-main">Subarachnoid hemorrhage</span> Bleeding into the brains subarachnoid space

Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, weakness, numbness, and sometimes seizures. Neck stiffness or neck pain are also relatively common. In about a quarter of people a small bleed with resolving symptoms occurs within a month of a larger bleed.

Normal pressure hydrocephalus (NPH), also called malresorptive hydrocephalus, is a form of communicating hydrocephalus in which excess cerebrospinal fluid (CSF) builds up in the ventricles, leading to normal or slightly elevated cerebrospinal fluid pressure. The fluid build-up causes the ventricles to enlarge and the pressure inside the head to increase, compressing surrounding brain tissue and leading to neurological complications. Although the cause of idiopathicNPH remains unclear, it has been associated with various co-morbidities including hypertension, diabetes mellitus, Alzheimer's disease, and hyperlipidemia. Causes of secondary NPH include trauma, hemorrhage, or infection. The disease presents in a classic triad of symptoms, which are memory impairment, urinary frequency, and balance problems/gait deviations. The disease was first described by Salomón Hakim and Raymond Adams in 1965.

<span class="mw-page-title-main">Intracerebral hemorrhage</span> Type of intracranial bleeding that occurs within the brain tissue itself

Intracerebral hemorrhage (ICH), also known as hemorrhagic stroke, is a sudden bleeding into the tissues of the brain, into its ventricles, or into both. An ICH is a type of bleeding within the skull and one kind of stroke. Symptoms can vary dramatically depending on the severity, acuity, and location (anatomically) but can include headache, one-sided weakness, numbness, tingling, or paralysis, speech problems, vision or hearing problems, memory loss, attention problems, coordination problems, balance problems, dizziness or lightheadedness or vertigo, nausea/vomiting, seizures, decreased level of consciousness or total loss of consciousness, neck stiffness, and fever.

<span class="mw-page-title-main">Dandy–Walker malformation</span> Congenital malformation of the cerebellar vermis

Dandy–Walker malformation (DWM), also known as Dandy–Walker syndrome (DWS), is a rare congenital brain malformation in which the part joining the two hemispheres of the cerebellum does not fully form, and the fourth ventricle and space behind the cerebellum are enlarged with cerebrospinal fluid. Most of those affected develop hydrocephalus within the first year of life, which can present as increasing head size, vomiting, excessive sleepiness, irritability, downward deviation of the eyes and seizures. Other, less common symptoms are generally associated with comorbid genetic conditions and can include congenital heart defects, eye abnormalities, intellectual disability, congenital tumours, other brain defects such as agenesis of the corpus callosum, skeletal abnormalities, an occipital encephalocele or underdeveloped genitalia or kidneys. It is sometimes discovered in adolescents or adults due to mental health problems.

Akinetic mutism is a medical condition where patients tend neither to move (akinesia) nor speak (mutism). It is the most extreme disorder of diminished motivation. Akinetic mutism was first described in 1941 as a mental state where patients lack the ability to move or speak. However, their eyes may follow their observer or be diverted by sound. Patients lack most motor functions such as speech, facial expressions, and gestures, but demonstrate apparent alertness. They exhibit reduced activity and slowness, and can speak in whispered monosyllables. Patients often show visual fixation on their examiner, move their eyes in response to an auditory stimulus, or move after often repeated commands. Patients with akinetic mutism are not paralyzed, but lack the will to move. Many patients describe that as soon as they "will" or attempt a movement, a "counter-will" or "resistance" rises up to meet them.

<span class="mw-page-title-main">Colloid cyst</span> Medical condition

A colloid cyst is a non-malignant tumor in the brain. It consists of a gelatinous material contained within a membrane of epithelial tissue. It is almost always found just posterior to the foramen of Monro in the anterior aspect of the third ventricle, originating from the roof of the ventricle. Because of its location, it can cause obstructive hydrocephalus and increased intracranial pressure. Colloid cysts represent 0.5–1.0% of intracranial tumors.

<span class="mw-page-title-main">Cerebral shunt</span> Surgical implant to treat hydrocephalus

A cerebral shunt is a device permanently implanted inside the head and body to drain excess fluid away from the brain. They are commonly used to treat hydrocephalus, the swelling of the brain due to excess buildup of cerebrospinal fluid (CSF). If left unchecked, the excess CSF can lead to an increase in intracranial pressure (ICP), which can cause intracranial hematoma, cerebral edema, crushed brain tissue or herniation. The drainage provided by a shunt can alleviate or prevent these problems in patients with hydrocephalus or related diseases.

<span class="mw-page-title-main">Intraventricular hemorrhage</span> Bleeding into the brains ventricular system

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<span class="mw-page-title-main">Ayub Ommaya</span> American neurosurgeon (1930-2008)

Ayub Khan Ommaya, MD, ScD (hc), FRCS, FACS was a Pakistani American neurosurgeon and the inventor of the Ommaya reservoir. The reservoir is used to provide chemotherapy directly to the tumor site for brain tumors. Ommaya was also a leading expert in traumatic brain injuries.

Endoscopic third ventriculostomy (ETV) is a surgical procedure for treatment of hydrocephalus in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, bypassing the obstruction. Specifically, the opening is created in the translucent tuber cinereum on the third ventricular floor.

<span class="mw-page-title-main">External ventricular drain</span> Medical device

An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed. An EVD is a flexible plastic catheter placed by a neurosurgeon or neurointensivist and managed by intensive care unit (ICU) physicians and nurses. The purpose of external ventricular drainage is to divert fluid from the ventricles of the brain and allow for monitoring of intracranial pressure. An EVD must be placed in a center with full neurosurgical capabilities, because immediate neurosurgical intervention can be needed if a complication of EVD placement, such as bleeding, is encountered.

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Eldon Leroy Foltz was born in Fort Collins, Colorado, Eldon L. Foltz grew up in East Lansing, Michigan. His father was Professor of Electrical Engineering at Michigan State University, and Foltz himself would go on to have a distinguished career as an academic and neurosurgeon.

References

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  4. 1 2 "Brain Injury Healthcare Technology Co-operative". National Institute for Health Research. Archived from the original on 14 February 2015. Retrieved 10 January 2015.
  5. ↑ "Profile: Professor John Pickard". St Catharine's College Cambridge. Retrieved 10 January 2015.
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  8. ↑ Gelling, L; Shiel, A; Elliott, L; Owen, A; Wilson, B; Menon, D; Pickard, J (January 2004). "Commentary on Oh H. and Seo W. (2003) Sensory stimulation programme to improve recovery in comatose patients. Journal of Clinical Nursing 12, 394–404". Journal of Clinical Nursing. 13 (1): 125–7. doi: 10.1046/j.1365-2702.2003.00832.x . hdl:10379/9206. PMID   14687306. S2CID   38785588.
  9. ↑ "Fellow: Professor John Pickard FMedSci". The Academy of Medical Sciences. Retrieved 10 January 2015.[ permanent dead link ]
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  17. 1 2 "Archibald Clark-Kennedy Lecture by Professor John Pickard, 16th February, 2013". Cambridge Neuroscience. 5 February 2013. Retrieved 10 January 2015.
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  24. ↑ Steiner, LA; Czosnyka, M; Piechnik, SK; Smielewski, P; Chatfield, D; Menon, DK; Pickard, JD (2002). "Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury". Critical Care Medicine. 30 (4): 733–8. doi:10.1097/00003246-200204000-00002. PMID   11940737. S2CID   19175665.
  25. ↑ Quested, Tony (29 January 2014). "Cambridge study to give every Schumacher personalised treatment". Business Weekly. Retrieved 10 January 2015.
  26. 1 2 Pickard, JD; Murray, GD; Illingworth, R; Shaw, MD; Teasdale, GM; Foy, PM; Humphrey, PR; Lang, DA; Nelson, R; Richards, P (1989). "Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial". BMJ. 298 (6674): 636–42. doi:10.1136/bmj.298.6674.636. PMC   1835889 . PMID   2496789.
  27. ↑ Pickard, JD; Matheson, M; Patterson, J; Wyper, D (1980). "Prediction of late ischemic complications after cerebral aneurysm surgery by the intraoperative measurement of cerebral blood flow". Journal of Neurosurgery. 53 (3): 305–8. doi:10.3171/jns.1980.53.3.0305. PMID   7420145. S2CID   33506496.
  28. ↑ "The Impaired Consciousness Research Group". Wolfson Brain Imaging Centre. Retrieved 10 January 2015.[ permanent dead link ]
  29. 1 2 Owen, AM; Coleman, MR; Boly, M; Davis, MH; Laureys, S; Pickard, JD (2006). "Detecting awareness in the vegetative state". Science. 313 (5792): 1402. CiteSeerX   10.1.1.1022.2193 . doi:10.1126/science.1130197. PMID   16959998. S2CID   54524352.
  30. ↑ "BBC Panorama highlights innovative brain function research at Addenbrooke's". Cambridge University Hospitals. 14 November 2012. Retrieved 10 January 2015.
  31. 1 2 Momjian, S; Owler, BK; Czosnyka, Z; Czosnyka, M; Pena, A; Pickard, JD (2004). "Pattern of white matter regional cerebral blood flow and autoregulation in normal pressure hydrocephalus". Brain. 127 (Pt 5): 965–72. doi: 10.1093/brain/awh131 . PMID   15033897.
  32. ↑ Czosnyka, M; Czosnyka, Z; Whitehouse, H; Pickard, JD (1997). "Hydrodynamic properties of hydrocephalus shunts: United Kingdom Shunt Evaluation Laboratory". Journal of Neurology, Neurosurgery, and Psychiatry. 62 (1): 43–50. doi:10.1136/jnnp.62.1.43. PMC   486694 . PMID   9010399.
  33. 1 2 Pickard, JD; Richards, HK (2001). "Principles of quality management in medicine: the British concept". Acta Neurochirurgica. Supplement. 78: 45–52. doi:10.1007/978-3-7091-6237-8_7. ISBN   978-3-7091-7275-9. PMID   11840730.
  34. ↑ Richards, H; Seeley, H; Pickard, J (2010). "Are adjustable valves effective in all ages of patient? Data from the UK Shunt Registry". Cerebrospinal Fluid Research. 7 (Suppl 1): S40. doi: 10.1186/1743-8454-7-S1-S40 . PMC   3026519 .
  35. ↑ "John D Pickard – List of Publications". Microsoft Academic Search . Archived from the original on 12 December 2013. Retrieved 10 January 2015.
  36. ↑ Pickard, JD; Mackenzie, ET (1973). "Inhibition of prostaglandin synthesis and the response of baboon cerebral circulation to carbon dioxide". Nature New Biology. 245 (145): 187–8. doi:10.1038/newbio245187a0. PMID   4200498.
  37. ↑ Pickard, JD; Gillard, JH (2005). "Guidelines reduce the risk of brain-scan shock". Nature. 435 (7038): 17. Bibcode:2005Natur.435...17P. doi: 10.1038/435017a . PMID   15874992.
  38. ↑ Higgins, JN; Owler, BK; Cousins, C; Pickard, JD (2002). "Venous sinus stenting for refractory benign intracranial hypertension". The Lancet. 359 (9302): 228–30. doi:10.1016/s0140-6736(02)07440-8. PMID   11812561. S2CID   12998222.
  39. ↑ Monti, MM; Vanhaudenhuyse, A; Coleman, MR; Boly, M; Pickard, JD; Tshibanda, L; Owen, AM; Laureys, S (2010). "Willful modulation of brain activity in disorders of consciousness". N Engl J Med. 362 (7): 579–89. doi: 10.1056/nejmoa0905370 . PMID   20130250. S2CID   13358991.
  40. ↑ Pickard, JD; Akalan, N; Benes, V; Di Rocco, C; Dolenc, VV; Antunes, JL; Johannes, J; Sindou, M (2010). Advances and Technical Standards in Neurosurgery: Volume 36. Austria: Springer Science & Business Media. ISBN   978-3709101797.
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  42. ↑ "Hydrocephalus News Letter". 2010. Retrieved 11 January 2015.
  43. ↑ Grainger, Lisa (13 November 2010). "Britain's top doctors directory". The Times. Retrieved 11 January 2015.
  44. ↑ "The Times: Six CUH doctors are best in Britain". Cambridge University Hospitals. 16 November 2010. Archived from the original on 28 November 2010. Retrieved 11 January 2015.
  45. ↑ "No. 62866". The London Gazette (Supplement). 28 December 2019. p. N10.
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