Ischemic Stroke - Hennepin County Medical Center

Profiles in Critical Care
Q and A withQ and A with
Adnan Qureshi, MD
“In terms of
training,
we now have
one of the
largest training
programs
in the
United States
in the
subspecialties
of stroke.”
In his clinical practice, Adnan
Qureshi, MD, has witnessed one of
the most dramatic evolutions in modern
medical care—the transformation
of stroke treatment. As an international
leader in stroke research and policy,
he has helped fuel that transformation.
Qureshi is a neurointerventionalist on
the in-house stroke teams at
Hennepin County Medical Center and
the University of Minnesota Medical
Center, Fairview. He also is an internationally
renowned speaker and
author, Executive Director of the
University-funded Minnesota Stroke
Initiative, associate head of the department
of neurology at the University of
Minnesota, and Executive Director of
the U’s Zeenat Qureshi Stroke
Research Center. We interviewed
Qureshi about his career path and
the state of stroke care in Minnesota.
What is a neurointerventionalist?
How did you train for the specialty?
A neurointerventionalist is a person
who has training in both medical
management of stroke and treating
stroke with endovascular procedures
like use of stents, specialized coils,
and other mechanical treatments. I
trained in neurology at Emory University
in Atlanta and did a fellowship at Johns
Hopkins, then another fellowship in
endovascular surgery at Millard Fillmore
Hospital in Buffalo, NY. So that’s the
training background for neurointerventionalists–beyond
neurology, I did
specialty training in stroke, neurocritical
care, and interventional procedures.
What led you into that subspecialty?
Many years ago, when I made the
decision, it was clear this was the
specialty that was going to evolve the
most. When I first started in this specialty,
there was only diagnosis—but
not much for treatment. You could
sense that treatment was coming. It
would have been sad to miss out on
something that was going to evolve
so rapidly and positively, and there
was an excitement of being part of
something so dynamic. What has
been fascinating and professionally
satisfying is the amount of treatment
we can do today, including reversing
stroke. Reversing stroke was
unheard of not that long ago, but
today there are treatments that can
restore blood and function to the brain.
Why has stroke care evolved
so rapidly?
When there’s no treatment, people
are likely to move faster. Also, the
evolution of cardiology and trauma
care has helped stroke care. Cardiology,
including the use of stents, angioplasty,
etc., has evolved in a similar way
to stroke care but over a longer period
of time. That’s allowed us to evaluate
new treatments and put them
into practice more quickly. Trauma
developed a system to take people
from the field and bring them to specialized
hospitals as quickly as possible.
Those lessons are being applied
to stroke care.
Approaches in Critical Care | December 2008 | 11