“You must look within for value, but must look beyond for perspective.” – Denis Waitley
“…phenomena…that will not fit the box are often not seen at all…” – Thomas S. Kuhn, The Structure of Scientific Revolutions
What if the primary function of cerebrospinal fluid (CSF) in the brain isn’t to flow in and out of the brain, but rather to serve as a reservoir that not only protects the brain from injury but also provides a pathway for the brain to access important chemical compounds? By simply altering the way we think about CSF in the brain, we expand the universe of new scientific hypotheses that, through research, could help us to one day prevent or cure hydrocephalus.
I, along with approximately 100 clinical researchers from the United States, Canada and the Netherlands, had the great opportunity to ponder this and other thought-provoking questions at a stimulating conference held in late September by the Children’s Hospital in Birmingham, Alabama. Together, these researchers discussed the current state of clinical research on hydrocephalus and explored how that research might be expanded or redirected in the near-term future.
Entitled the Consensus Conference on Clinical Hydrocephalus in Children, this event included presentations by John Kestle, MD, University of British Columbia, Vancouver; Paul Leliefield, MD, PhD, University Medical Centre Utrecht, The Netherlands; Dave Limbrick, MD, PhD, and Cynthia Ortinau, MD, Washington University School of Medicine, St. Louis, MO.; Mark Souwdaine, MD, Weill Medical College of Cornell University; Leslie Sutton, MD, Children’s Hospital of Philadelphia; and Ben Warf, MD, Children’s Hospital of Boston.
Research-focused conferences like this one and HA’s own Research Conference on “Opportunities in Hydrocephalus Research: Pathways to Better Outcomes,” held in Seattle last July, provide unparalleled opportunities to enliven the hydrocephalus research ecosystem: they showcase research currently being done; they promote the need for additional research; they identify areas where research is most likely to provide measurable progress in treatments; and they provide a forum for researchers to collaborate, avoiding unnecessary duplication of effort.
At the Alabama conference, Dr. Benjamin Warf posed some challenging questions about what scientists think they know about the brain (and thus, the condition of hydrocephalus). He built the case for a need for research on the condition from a global perspective. Moreover, he demonstrated how a simple paradigm shift in thinking might cause a revolutionary change in the rate of progress for research around hydrocephalus, and he challenged the researchers present at the meeting to think beyond the current medical paradigm to explore what may be the next great breakthrough in hydrocephalus treatment. To support his challenge, Dr. Warf quoted Thomas Kuhn, who said back in 1962 in his book, The Structure of Scientific Revolutions, that:
“Discovery commences with the awareness of anomaly…
…it closes only when the paradigm theory has been adjusted so that
the anomalous has become the expected.”
The creative sparks among the researchers in the room were palpable, at least to this lone, non-clinician in the group. Only time will tell if the sparks were strong enough to light the proverbial fire for innovative research concepts.
While attending Children’s of Alabama’s conference, I also had the great pleasure of meeting Evelien van Houweninge Graftdijk and Frederika Vetkamp-van Houseninge Graftdijk, the granddaughters of Dr. Cornelius Joachimus van Houweninge Graftdijk, who, in the 1930’s, was a ground-breaking hydrocephalus researcher, pioneer of decompression for hindbrain herniation, and the first to report the surgical treatment of Chiari malformations. The van Houweninge Graftdijk Hydrocephalus Fund, a family foundation that works to honor the memory of Dr. van Houweninge Graftdijk, helped support the conference, proving that all good science, however innovative, follows on the pioneering work of those who came before.
Children’s of Alabama and the conference presenters have graciously agreed to allow the Hydrocephalus Association to share the slides for the presentations held in Birmingham as soon as they become available. Stay tuned for more information coming soon!