The EU-Japanese Neurovascular Biennial Congress, Vienna 2024
Every two years experts in cerebrovascular surgery from Japan and Europe convene to share their unique perspectives and experiences. I was honoured to be invited to contribute again and this remains one of my favourite meetings to attend.
The meeting is held alternately in Europe of Japan every two years and this year ours hosts were in the beautiful city of Vienna in Austria.
The Venue...
The venue was particularly special this year. Delegates had exclusive access to the Josephimium which was opened in 1785 s a Military Academy of Medicine and Surgery by the Austro-Hungarian Emperor Joseph II with the intention of improving the medical care of his troops. It later was converted into a museum and has recently been restored shortly to reopen and display the unique collections described below.
Academic Activity
This meeting always allows something that is iceaingly absent at neurosurgical conferences- time to discuss the presentation. There were vigorous discussions around topics ranging from novel endovasclar devices, new data to inform decision making on unruptured aneurysms, radiosurgery for AVMadmuch more. Threre were fascinating descriptions of services providing surgical stroke thrombectomy in Japan to complement their endovascular services.
I presented our experience with in-situ microsurgical disconnection of highly eloquent AVMs ahead of doing so at the EANS congress. It was also a great pleasure to participate in complex case review of spinal cord arteriovenous malformations with colleagues prepared to share disappointments as well as good outcomes for this rare pathology. such exchanges are vital to pool our understanding of what works for these very challenging lesions.
All discussions were held in the auditorium where lectures were once delivered to the medical student s of the "Vienna School". Outside the sponsors displayed the latest visualisation tools, surgical instruments and there were exhibits of microsurgical simulation equipment developed at the University in Vienna.
The Museum Collection
Away from the academic presentations we had our run of the museum collection and it was possible to wander through rooms full of remarkable items related to the history of medicine and surgery in Europe. Most famous amongst them is the huge collection of medical wax sculptures assembled by Joseph II. The combination of anatomical accuracy and artistry is staggering anyone visiting Vienna should consider a visit. The Emperor has seen such models in Italy and commissioned almost 1200 for his new medical school. These were manufactured in taly and the delicate components transported by mules through the Brenner pass tot he Danube finishing their long journey by boat.
There were reminders too of times when medicine has been co-opted for evil. Reminding me of a horrible exhibit at the Imperial War Museum where what appeared to me to be a very typical textbook of surgery open on a page describing the repair of an inguinal hernia but in fact based on abhorrent experiments carried out on fellow human beings.
The image to the right would be unremarkable in any neuropathology laboratory today until one learns its sickening provenance.
On a final wonder through the empty museum before the meeting closed I came across a model of a skull alongside some fragments of a human cranium that re believed to belong to Ludwig van Beethoven. Apparently they were retained by another unscrupulous member of my profession as a souvenir when his body underwent autopsy ahead of reburial at Vienna's Zentralfriedhof.
Still more fascinating though because of its connection to his music was the device pictured below. He began to lose hearing in 1798 after a heated argument with a singer by his own account. He never completely lost his hearing and is known to have suffered with tinnitus. To see a device as intensely personal as his ear trumpet made him feel very close.
