Joseph Maroon MD, FACS | |
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Born | Wheeling, West Virginia, U.S. | May 26, 1940
Alma mater | Indiana University Bloomington (B.S.), Indiana University School of Medicine (M.D.) |
Occupation | Neurosurgeon |
Known for | Team neurosurgeon for the Pittsburgh Steelers Medical Director of WWE |
Website | www.josephmaroon.com |
Joseph Maroon (born May 26, 1940) is an American neurosurgeon, author, and triathlon athlete. He is the professor and vice chairman of the Department of Neurological Surgery at the University of Pittsburgh Medical Center and is the medical director of WWE. [1] [2] He is particularly known for his work studying concussions and concussion prevention as well as his hypothesis (after the discovery of the CTE by Dr. Bennet Omalu) on the development of chronic traumatic encephalopathy (CTE).
Maroon earned his B.S. degree in anatomy and physiology from Indiana University Bloomington in 1961 and his M.D. from the Indiana University School of Medicine (IUSM) in 1965. He received post-graduate education at IUSM (1966), Georgetown University Hospital (1967), John Radcliffe Hospital (1969), IUSM (1971), and the University of Vermont College of Medicine (1972). [3]
Maroon has conducted extensive research into neurotrauma, brain tumors, and diseases of the spine, which led to many innovative techniques for diagnosing and treating these disorders. Maroon was the first to publish on the use of ultrasound to detect venous air emboli (1968). Maroon et al. were the first to publish on the use of ultrasound to detect air in patients during neurosurgical procedures (1969) and to assess ophthalmic artery reversal of flow, indicating a thrombosis of the carotid artery (1969). [4] Maroon et al. published the simplified instrumentation for performing microvascular surgery in 1973, and in 1975, they pioneered the microsurgical approach to intra-orbital tumors. [5] In 1977, they pioneered the use of CT scanning as a guidance system for performing intracranial biopsy. In the same year, Maroon published the first paper on “burning hands” syndrome related to sports-related spinal cord injuries in JAMA. [6]
In 1982, Maroon et al. pioneered the radical orbital decompression procedure for severe dysthyroid exophthalmos. [7] In 1985, they were the first to compare microsurgical disc removal with chemonucleolysis [8] and in 1986, they were the first to use a carbon dioxide laser in the management of lymphangiomas of the orbit. [9] That year, Maroon et al. were among the first to describe their surgery outcomes with microlumbar discectomy. [10] In 1987, Maroon and Onik introduced percutaneous automated discectomy as a new minimally invasive way to remove lumbar discs and subsequently published extensively on this technique. [11] [12] [13] In 1990, Maroon et al. published the first microsurgical approach to far lateral disc herniations in the lumbar spine [14] [15] and in 2007, they published the case of Golfer's Stroke from Vertebral Artery Dissection. [16]
Further groundbreaking publications include the use of fish oil as an anti-inflammatory and alternative to nonsteroidal drugs for discogenic pain (2006); [17] a unifying, immunoexcitotoxicity hypothesis for chronic traumatic encephalopathy (2011); [18] and the possible use of a restricted calorie ketogenic diet for the treatment of glioblastoma multiforme (2013). [19]
Maroon is the team neurosurgeon for the Pittsburgh Steelers [20] and the medical director of WWE. [21] He is past president of the Congress of Neurological Surgeons. [22]
Together with neuropsychologist Mark Lovell, Maroon developed ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), [23] a test to assess the presence and severity of concussion symptoms. This has become the standard tool to assess sports-related concussions. [24]
Maroon is interested in the prevention and treatment of concussions, specifically in football. [25] In 2006, he joined the National Football League’s Mild Traumatic Brain Injury Committee, which, in 2007, was renamed the Head, Neck, and Spine Committee. He has been consulted as an expert by American media on this subject. [26] [27] [28]
Based on his research into the predictors and scope of chronic traumatic encephalopathy (CTE), [29] he claims there is reason to be skeptical of the reported widespread incidence of CTE. His position has mostly been met with negative comments across the media and sports press due to the NFL having as many as 4500 former players reporting symptoms of CTE. [30] [31] [32] [33] [34] [35] [36] [37]
Maroon was asked to testify to the New York City Council on a proposed rule on sideline medical coverage for organized youth football in the city. [38] Together with Russell Blaylock, he developed an inflammation hypothesis for the biochemical mechanisms involved in the development of CTE following head trauma. [39] In the 2015 movie Concussion, which "examines how American football players suffer from major head injuries and life-long debilitating problems as a result of repeated concussions, and efforts by the National Football League to deny it," [40] Maroon was played by actor Arliss Howard. [41] In the movie, Maroon is portrayed as an NFL-biased doctor who tries to deny any relationship between football concussions and the brain pathology that Dr. Bennet Omalu found and attributed to CTE. Since the release of the movie, several people have come forward in defense of Maroon, stating that his portrayal in the movie is sensationalized and incorrect. [42] [43] [44]
After his personal experience with burnout at the peak of his medical career, Maroon developed a strong interest in burnout prevention and living a more balanced life. He conducted extensive research into burnout, burnout prevention, and what constitutes a healthy, balanced, and successful life outside of a professional career. Maroon has given keynote presentations on this subject matter at national and international conferences. [45] In 2017, he published the book Square One: A Simple Guide to a Balanced Life. [4]
Maroon has published over 300 peer-reviewed scientific articles, some of which may be found in the United States National Library of Medicine's publication database; his H-index, a measure of scientific research impact, is 58. [3] Currently, Maroon is working with Dr. Pravat K. Mandal and has proposed oxidative stress as the underlying pathogenesis of Alzheimer's disease and Parkinson's disease. [6] [7] [8] [9] [10] [11] [12]
Square One: A Simple Guide to a Balanced Life [46] Maroon J, Kennedy C. (2017) ISBN 978-0-9983509-0-5
The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a longer and Healthier Life [47] [48] Maroon JC. (2008) ISBN 9781416565161 (made into a PBS Special)
Fish Oil: The Natural Anti-Inflammatory [49] Maroon JC, Bost J. (2006) ISBN 9781591201823
Practice Diagnosis and Management of Orbital Disease [50] Kennerdell JS, Cockerham KP, Maroon JC, Rothfus WE. (2001) ISBN 9780750672603
What You Can Do About Cancer. Maroon JC. (1969) Doubleday& Co., New York, 185 pp. (English, Italian, German and French translations).
Maroon has competed in 8 Ironman Triathlons (Hawaii – 1993, 2003, 2008, 2010, 2013; [51] [52] Canada – 1995; New Zealand – 1997; Germany – 2000) [53] and is to this day an active triathlon athlete. Dr. Maroon was inducted into the Lou Holtz Upper Ohio Valley Hall of Fame [54] in 1999, the Western Chapter of the Pennsylvania Sports Hall of Fame in 2009 and in 2010 also to the National Fitness Hall of Fame in Chicago. [55] For 2016, in the global ranking of Ironman athletes, Maroon ranks in 4th place in his age group. In 2022, Maroon placed second in the National Senior Games for his age group [13] and placed first in the Chicago Triathlon for his age group. [14]
Maroon received the Distinguished Alumni Service Award from Indiana University in 2011. He was also named the Humanitarian of the Year by the Jerome Bettis Bus Stops Here Foundation in 2018. Furthermore, the Indiana University Medical School presented him with the Distinguished Alumni Award in 2022.
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.
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.
A discectomy is the surgical removal of abnormal disc material that presses on a nerve root or the spinal cord. The procedure involves removing a portion of an intervertebral disc, which causes pain, weakness or numbness by stressing the spinal cord or radiating nerves. The traditional open discectomy, or Love's technique, was published by Ross and Love in 1971. Advances have produced visualization improvements to traditional discectomy procedures, or endoscopic discectomy. In conjunction with the traditional discectomy or microdiscectomy, a laminotomy is often involved to permit access to the intervertebral disc. Laminotomy means a significant amount of typically normal bone is removed from the vertebra, allowing the surgeon to better see and access the area of disc herniation.
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.
Ralph Bingham Cloward was an American neurosurgeon, best known for his innovations in spinal neurosurgery. Cloward is known for the development of the Posterior Lumbar Interbody Fusion and Anterior Cervical Discectomy and Fusion. Cloward moved from Chicago to Hawaii in 1938, becoming the state's lone neurosurgeon. He is well known for his work treating victims of brain injuries after the Pearl Harbor attack in 1941.
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.
Andre Maurice Waters was an American professional football player who was a safety for the Philadelphia Eagles and Arizona Cardinals of the National Football League (NFL) from 1984 to 1995. Waters was regarded as one of the NFL's most aggressive players, serving as an integral part of one of the league's top defenses. On November 20, 2006, Waters died by suicide and was subsequently diagnosed with chronic traumatic encephalopathy (CTE). He is one of at least 345 NFL players to be diagnosed after death with CTE, which is caused by repeated hits to the head.
Frederick Arnold McNeill was an American professional football player who was a linebacker for the Minnesota Vikings of the National Football League (NFL) for 12 seasons from 1974 to 1985. He played college football for the UCLA Bruins. In 1973, he was named to the All-Coast/Conference First-team. McNeil was selected by the Vikings in the first round of the 1974 NFL draft with the 17th overall selection. He was the first person to have been diagnosed with CTE while alive and have it confirmed following his death.
Ron Johnson was an American professional football player who was a cornerback for seven seasons with the Pittsburgh Steelers of the National Football League (NFL).
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.
Samuel E. Gandy, is a neurologist, cell biologist, Alzheimer's disease (AD) researcher and expert in the metabolism of the sticky substance called amyloid that clogs the brain in patients with Alzheimer's. His team discovered the first drugs that could lower the formation of amyloid.
Dr. Bennet Ifeakandu Omalu is a Nigerian-American physician, forensic pathologist, and neuropathologist who was the first to discover and publish findings on chronic traumatic encephalopathy (CTE) in American football players while working at the Allegheny County coroner's office in Pittsburgh. He later became the chief medical examiner for San Joaquin County, California, and is a professor at the University of California, Davis, department of medical pathology and laboratory medicine. He is currently the president and medical director of Bennet Omalu Pathology.
Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.
Minimally invasive spine surgery, also known as MISS, has no specific meaning or definition. It implies a lack of severe surgical invasion. The older style of open-spine surgery for a relatively small disc problem used to require a 5-6 inch incision and a month in the hospital. MISS techniques utilize more modern technology, advanced imaging techniques and special medical equipment to reduce tissue trauma, bleeding, radiation exposure, infection risk, and decreased hospital stays by minimizing the size of the incision. Modern endoscopic procedures can be done through a 2 to 5 mm skin opening. By contrast, procedures done with a microscope require skin openings of approximately one inch, or more.
Parviz Kambin was an American-Iranian medical doctor and orthopaedic surgeon. He was a Professor of Orthopaedic Surgery and has established an Endowed Chair of Spinal Surgery Research at Drexel University College of Medicine. He published more than 55 articles in peer-reviewed journals, edited two textbooks and contributed chapters in spinal surgery textbooks. He lectured worldwide in the field of minimally invasive spinal surgery. His research and development in this specialty began in 1970.
Concussion is a 2015 American biographical sports drama film written and directed by Peter Landesman, based on the exposé "Game Brain" by Jeanne Marie Laskas, published in 2009 by GQ magazine. Set during the 2000s, the film stars Will Smith as Bennet Omalu, a forensic pathologist who fights against the National Football League trying to suppress his research on chronic traumatic encephalopathy (CTE) brain degeneration suffered by professional football players.
Stewart Dunsker M.D., a neurosurgeon, is Professor and Director of Spinal Neurosurgery at the University of Cincinnati College of Medicine, and Director of the Department of Neurosurgery at the Christ Hospital, Cincinnati, Ohio.
The Boston University CTE Center is an independently run medical research lab located at the Boston University School of Medicine. The Center focuses on research related to the long-term effects of brain trauma and degenerative brain diseases, specializing in the diagnosis and analysis of chronic traumatic encephalopathy (CTE). According to researchers at Boston University, CTE is a brain disease involving progressive neurological deterioration common in athletes, military personnel, and others who have a history of brain trauma. The disease is primarily caused by repeated blows to the head, some of which result in concussions or sub-concussive symptoms.
Most documented cases of chronic traumatic encephalopathy have occurred in many athletes involved in contact sports such as boxing, American football, professional wrestling, ice hockey, mixed martial arts, rugby and soccer. Other risk factors include being in the military, prior domestic violence, and repeated banging of the head. The exact amount of trauma required for the condition to occur is unknown. Below is a list of notable cases of CTE in sports.
Daniel H. Daneshvar is an American neuroscientist, brain injury physician, and physiatrist. He is known for his academic work in traumatic brain injury and the long-term consequences of repetitive head impacts, including chronic traumatic encephalopathy (CTE). He also founded Team Up Against Concussions, the first scientifically validated concussion education program for children. He is the Director of the Institute for Brain Research and Innovation at TeachAids, which created CrashCourse, a virtual-reality or video based concussion education program.