Daniel L. Barrow, MD

Pamela Rollins Professor and Chairman
Director, Emory MBNA Stroke Center
Neurosurgeon, Department of Neurosurgery, Emory University, Atlanta

Residency, Neurological Surgery, 1979-1985, Mayo Clinic School of Medicine
Fellowship, Cerebrovascular Diseases, 1985, Massachusetts General Hospital
Internship, Neurology, 1982, Emory University School of Medicine
Internship, Surgery, 1979, Southern Illinois University School of Medicine, 1979
Board Certifications: Neurological Surgery, American Board of Neurological Surgery, 1988

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Q 1. Do you think fellowship training in neuroanesthesia improves patient care?

Absolutely. “The nuances involved in the anesthetic management of the neurosurgical patient are at least as complex, if not more complicated, than those involving cardiac surgery. There is no apparent controversy regarding the need for training in cardiac anesthesia.  Seemingly minor manipulations of the neurosurgical patient can have profound impact on outcomes and neuroanesthesiologists play a critical role”.

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Q 2. What do you see as the value in a neuroanesthesia fellowship?

“There are many aspects of the management of the neurosurgical patient under anesthesia, whether it be general anesthesia for a ruptured aneurysm or an awake craniotomy for a glioma in a functionally important area of the brain, that are quite different from principles of anesthesiology for general surgical or other surgical subspecialties. The trainee in anesthesiology will not have the opportunity to experience these unique medical situations without a devoted period of study in the field of neuroanesthesia. The demarcation between the neurosurgical operating room and the neuro-critical care unit is a blurry one. Many neuroanesthesiologists diversify their careers and add substantial gratification by also working in the neuro-ICU”.

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Q 3. Does fellowship training factor into your hiring decisions?

“Like many large academic neurosurgical programs, we are intentionally recruiting for individuals with a clinical and academic interest in neuroanesthesia and neuro-critical care”.

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Q 4. What career benefits do you see for a resident pursuing a neuroanesthesia fellowship?

“An anesthesiologist with specialized expertise in neuroanesthesia is more than capable of providing anesthesia services for any of a number of surgical and obstetrical services but is additionally uniquely qualified to provide highly subspecialized care for patients undergoing neurosurgical procedures or for patients with neurological disorders undergoing non-neurosurgical procedures. This additional training will differentiate them from others with less experience”.

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Q 5. Would you recommend anesthesia residents consider a neuroanesthesia fellowship?

“Yes. I believe they have little to lose and much to gain. Even if they later decide not to subspecialize and restrict their practice to neuroanesthesia, they will be more capable of serving their patients through a better understanding of the human nervous system… after all, it is the nervous system anesthesiologists are manipulating to create a state of anesthesia”.

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Q 6. What would you say to a resident who is considering a neuroanesthesia fellowship, but is unsure if it’s worth it?

“Give it a try. Spend an elective rotation in the neurosurgical ICU and participating in the management of patients undergoing neurosurgical procedures and see why those who are involved in managing disorders of the human nervous system are so excited about working in the realm of one of the life’s great mysteries and wonders”.

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Q 7. Any other thoughts you would like to share?

“This is a particularly exciting time to be involved in the field of neuroscience.  Emerging technology promises to substantially impact our ability to use novel scientific methods to address a number of neurological disorders that heretofore have been poorly treated.  Much of that technology will involve surgical procedures, neuromodulation, gene therapy, stem cell therapy, and other techniques that will require neurosurgeons.  Neurosurgeons are incapable of providing these promising techniques in isolation and partnerships with neuroanesthesiologists is essential”.