A walk in the park- or over the bridge?
Here in Sofia, all roads lead to the impressive congress venue, and we encountered crisp morning weather with the perfect outdoor temperature. After a busy yet well-organised registration on this first full day of the congress, Monday kicked off with no less than eight parallel sessions. Neurosurgical life is full of tough decisions—which one to attend? While some quantum mechanics suggest that particles can exist in two places at once, this notion seems difficult to realise for us humans. This challenging choice may not significantly influence your career, but it will certainly affect what you learn.
In the morning, we could choose between a revival of lesioning in the DBS era or recent advances in molecular neuro-oncology—both sessions were not to be missed! The discussions on neurosurgical treatment of pain and shunt technology were top-notch. In this era of navigation and various technological aids, should we focus on learning neuroanatomy for skull base surgery or interpreting angiograms of complex vascular disorders? All the sessions were excellent.
The Interactive Trauma section featured a program on multimodal monitoring in non-traumatic brain injury conditions commonly encountered in neurocritical care. Through a show of hands, Dr. Svedung Wettervik demonstrated how differently the audience responded to the monitoring of relatively common lesions, such as epidural hematomas. Dr. Toth discussed tools for monitoring ischemic strokes, where there was limited enthusiasm for invasive monitoring. Dr. Depreitere provided important discussion points and take-home messages regarding multimodal monitoring of high-grade SAH and its consequences, particularly emphasising the role of early mobilisation.
Do we really need to monitor or surgically treat severe meningitis? Dr. Rostami elegantly summarised the current evidence, clearly arguing for the role of neurosurgeons in reducing the extent of brain injury, as ICP is often elevated in these cases. The session concluded with brief presentations, revealing some fascinating new results. Dr. Vreeburg demonstrated, in a large observational study, the significant between-center variations in the treatment of TBI concerning age, particularly evident in pediatric and elderly patients. Dr. Reen showed that a minor change in the monitoring of severe TBI—specifically adjusting the transducer level for ICP and arterial blood pressure—drastically altered the treatment of severe TBI patients. Notably, the use of vasoactive drugs changed markedly, with higher ICP and lower mean arterial blood pressure after adjusting the transducer level. However, the overall outcome was not significantly affected.
Dr. Petkov highlighted the value of Transcranial Ultrasound Imaging (not monitoring) after decompressive craniectomy in 17 patients. He demonstrated that ultrasound could be used to assess the ventricular system and midline shift, but perhaps less effectively for detecting infarctions or intracerebral hemorrhages. Still, it may help reduce the incidence of CT scans in these patients. Finally, Dr. Karepov discussed the problems, risks, and lack of regulations—along with helmet use—in e-bike usage, presenting a case series on facial and brain injuries.
In preclinical research, cognition is often evaluated by exposing rodents to mazes. This EANS congress could be a gold mine for cognitive researchers—imagine every smart, well-educated neurosurgeon equipped with a GPS transmitter so that everyone could be tracked moving across the venue. Presumably, patterns of confused attendees might emerge, suggesting that we humans may not be as advanced as we think. Nonetheless, most were able to locate the coffee break area, and many took the opportunity to visit our exhibitors. With great products come great advancements in neurosurgery, and we should all spend quality time with our colleagues and friends in the industry.
What everyone should also do is swing by the e-posters, which were well attended. Many excellent presentations of important scientific discoveries were on display here
Dr. Roelfsema of the Netherlands Institute of Neuroscience, the first keynote speaker, presented his work on developing a visual brain prosthesis to restore a rudimentary form of vision for the blind. The idea is that AI, in combination with implanted arrays in the visual cortex, can restore aspects of vision such as light detection. The projects are moving from “camera to phosphene” and are also transitioning from primate experiments to human trials.
The first subject, Bernadette, volunteered for two brain surgeries—one to implant electrodes and one to remove them. This blind individual was able to see a dot using implants placed in a very small area of the visual cortex. Developments in very flexible electrodes and wireless technology will likely make this technology highly useful. Additionally, in humans, DBS electrodes have been implanted in the lateral geniculate nucleus, a technology that holds much promise.
Never has the phrase “the future is here” felt more accurate.
In the 2nd keynote presentation of the day- Dr Jocelyne Bloch provided us with astonishing information regarding the possibilities and innovations in implantable technologies for the treatment of paralysis following spinal cord injury.
In the second keynote presentation of the day, Dr. Jocelyne Bloch provided us with astonishing information regarding the possibilities and innovations in implantable technologies for the treatment of paralysis following spinal cord injury.
The second plenary session followed, with the spotlight now on the Spine section. Technology was the focus of the plenary talks. First, Dr. Ivanov firmly stated that navigation remains superior to robotics in spinal instrumentation.
After a well-deserved coffee break among our sponsors, the final parallel sessions commenced. Once again, high-quality sessions took place simultaneously, including those on spinal infections, aneurysms, sellar region surgery, rare peripheral nerve conditions, neurosurgical research, and the joint EANO/EANS session on brain metastases. As society is rapidly changing, so is neurosurgery, which is one oft he main reasons why the diversity task force’s work is important. Since education is a key aim of the EANS, educational policies from a diversity perspective are crucial and were addressed in the Diversity session.
The congress day ended with the inaugural ceremony for those who completed EANS exams 1 and 2, formalising their efforts and introducing this new ceremony. Too often, there is not enough appreciation for hard work, gaining knowledge, and passing tough exams. This has now changed, and this was an excellent initiative that hopefully will be transformed into an EANS tradition.
Overall, we had an excellent first day in Sofia. There was truly much innovation today that will require significant education and leadership by neurosurgeons to implement. Fortunately, innovation, education, and leadership are the moto of the Congress. This day was also an impressive demonstration of the strengths and advancements of European neurosurgery—exhausting but very rewarding.
Thankfully, there is more to come in the next few days!
Advancing Ethical Standards in Neurosurgery: Highlights from the EANS Ethico-Legal Committee
The principal focus of the Ethico-Legal Committee is to discuss medico-legal aspects pertaining to neurosurgical practice and ethical matters related to the care of our patients, including the ethics of scientific research. Under the leadership of the newly elected Chair, Mario Ganau (Oxford), the Committee has become even more international, featuring a diverse group of energetic members working in prestigious neurosurgical units across Europe as well as in other continents. This ensures strong representation of the entire EANS community and its interests.
The Ethico-Legal Committee meets regularly, every three months, to coordinate its activities, some of which are in close collaboration with other EANS Committees, Sections, and Task Forces. Examples from the past year include contributions to webinars run by the Young Neurosurgeons Committee and the Emerging Technologies and Innovation in Neurosurgery (ETIN) Task Force, as well as the preparation, alongside the Examination Committee and the Young Neurosurgeons Committee, of scientific manuscripts published in Brain & Spine.
To ensure that our initiatives remain relevant to the EANS family, the Committee strives to incorporate an ethico-legal perspective in every EANS activity, such as training courses, seminars, and the annual congress. Our Parallel Session is scheduled for the morning of Tuesday, 15th, in Hall 3.1 at Sofia 2024.
Beside that, we also try to be as close as possible to the national societies who request our presence in their flagship events: for instance, in 2024 we have contributed to the First Congress of the Georgian Society of Neurological Surgery (GSNS) in Tbilisi, and to the meeting of the Ukrainian American NeuroFriendship (UANF) in Lviv.
With these successful experiences as a foundation, we aim to maintain strong connections by visiting our members regularly in the future. Therefore, please start booking your calendars for the Joint Meeting of the Serbian NeuroSurgical Society (SNSS) and the EANS Ethico-Legal Committee, which will be held in Novi Sad on October 24-25, 2025 to explore “Ethico-Legal aspects of Neurosurgery in the 21st century: challenges and opportunities”.
You are all invited!
EANS Research Fund and Future Initiatives
This year, there was a huge interest in the EANS Research Fund, as we received 76 well-written applications. The competition was fierce, and we congratulate the 6 Research Fund winners who will be acknowledged at the EANS2024 Congress in Sofia.
We are also grateful to our sponsors that enabled us to provide young neurosurgical researchers with this opportunity to move their projects forward. It’s a fact that the EANS Research Fund aims to nurture young researchers.
For the upcoming application year, the Research Fund Chair, Niklas Marklund, and the President-elect, Francesco Sala, are working to improve the application process and evaluation strategies further, and to create opportunities for those from less experienced research centers. The Research Fund is actively working to promote research excellence in neurosurgery, and actively encouraging applications from across Europe. The seed grants will be available to the EANS Individual Members in all country members to encourage European cooperation and collaboration. Both laboratory and clinical research projects are eligible for funding.
The application process for the 2025 EANS Research Fund will open on the 1st of December. Only applications submitted by the EANS Individual Members of good standing will be considered in the selection process. Stay tuned!
EANS IM Welcome Reception: An event honoring our Individual Members
In a warm and welcoming atmosphere, EANS members gathered in the EANS Individual Membership Lounge for a reception dedicated to their involvement and devotion to the organisation. Marisa Gandia, the EANS Individual Membership Chair, was there to welcome and invite them all to enjoy refreshments and engage in interactive conversations.
The Members mingled and forged new connections, creating an atmosphere of friendship and warmth. The reception not only honored past accomplishments but also ignited inspiration for future collaboration and innovation among EANS members.
The Inaugural Fellow of the European Board of Neurological Surgery (FEBNS) Award Ceremony: A celebration of Neurosurgical Excellence
For the first time, EANS celebrated the FEBNS (Fellow of the European Board of Neurological Surgery) Diploma with an inspiring ceremony, marking a significant milestone in its history. This event highlighted the contributions of neurosurgeons dedicated to advancing the specialty and improving patient care across Europe. The ceremony recognised the achievements of those who successfully passed both Part I and Part II of the exams required to earn the prestigious FEBNS Diploma.
During the FEBNS Ceremony at EANS2024, the Fellows were honored for their hard work and dedication. EANS President Torstein Meling, along with Marcel Ivanov, EANS Examination Committee Chair, and Wilco Peul, President of the UEMS Section of Neurosurgery, delivered inspiring talks, congratulating the succesful candidates and their fellow professionals.
In the years to come, this ceremony will become a valued tradition, providing a way to celebrate excellence in neurosurgery. As the field continues to evolve, the commitment to education and innovation remains essential. Join us in honoring the future leaders of neurosurgery and their dedication to advancing healthcare.
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