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No joke as neurologist shines

Cate Swannell
Med J Aust
Published online: 29 October 2013

Dr Bruce Campbell is an award-winning neurologist with a pioneering drive to improve outcomes for stroke patients

There’s a cartoon about neurologists which features an armchair intellectual in raptures about a recent diagnosis he has made. When asked what can be done to help the patient, he replies: “Nothing. Still, fascinating, isn’t it?”1

It’s a picture that makes Dr Bruce Campbell, consultant neurologist at the Royal Melbourne Hospital (RMH), laugh, but he’s happy to report that things are different now.

“Neurology has changed a lot”, he tells the MJA. “The joke about neurologists used to be that we would make a brilliant diagnosis and then admire the natural history of the disease.

“These days neurology has become a very therapeutic specialty, not just in stroke but in multiple sclerosis, epilepsy, Parkinson’s, etc.”

Dr Campbell is described by the public relations staff at the RMH has “one of our stars”, and with good reason.

Now aged 36, he has been winning awards at regular intervals — four this year alone — since his schooldays at the prestigious Haileybury school in Melbourne.

The latest two — the Leonard Cox Award from the Australian and New Zealand Association of Neurologists (ANZAN) and the Chancellor’s Prize from the University of Melbourne — are for excellence in the research that led to the recent awarding of his PhD.

Dr Campbell is investigating whether an intra-arterial clot retrieval procedure improves patient outcomes when added to intravenous (IV) tissue plasminogen activator (tPA).

“When you block a blood vessel in the brain, some tissue around it dies rapidly but often there is a substantial region that is not functioning due to low blood flow, but could be saved if the blockage is opened quickly”, he says.

“We can use advanced MRI [magnetic resonance imaging] or CT [computed tomography] imaging to estimate what is dead and what is salvageable.

“MRI has been the more validated method but rapid access to CT is much more practical in acutely unwell stroke patients.

“We’ve been working on refining the MRI estimates of tissue status and a large part of my PhD involved translating the paradigm to CT.”

After completing his PhD, Dr Campbell went looking for a new challenge.

“To me, the natural extension was to implement the findings of our imaging research to select patients most likely to benefit from restoration of blood flow and combine this with technological advances in minimally invasive procedures to remove the blood clot causing the stroke”, he says.

“EXTEND-IA is a randomised controlled trial we have designed that does just this.”

Dr Campbell says three recent studies in the New England Journal of Medicine which were unable to demonstrate the benefit of similar clot-retrieval approaches have emphasised the critical need for an improved approach to patient selection for intra-arterial therapy.

The EXTEND-IA randomised controlled trial comparing intra-arterial clot retrieval after IV tPA with IV tPA alone, for which Dr Campbell is the co-principal investigator and medical coordinator, is now underway across Australia and New Zealand.

“It will take 2 to 3 years to complete. We have 27 patients at the moment and we need around 100”, he says.

Dr Campbell’s interest in neuroscience came early, although clinical work wasn’t his first choice.

“Initially I entered medicine thinking I would probably primarily be a research scientist”, he says. “However, along the way I discovered that clinical work was a great challenge and a lot of fun.

“The brain is the major unexplored frontier in biology and that’s a great place to work. There’s certainly plenty of room for improvement in our treatments.”

He completed a medical science degree before starting his MB BS at the University of Melbourne, and graduated in 2002, finishing second in his class and on the Dean’s List in every year of his degree except the first.

As well as his work as a consultant neurologist at RMH, Dr Campbell has a full-time research fellowship at the University of Melbourne and is a telestroke neurologist with the Victorian Stroke Telemedicine Project. He is also national coordinator of the ANZAN Brainschool.

High achievement isn’t confined to his professional life either.

Dr Campbell plays the violin with the Australian Pops Orchestra and Corpus Medicorum, the RMH’s orchestra.

“I’ve played since I was 6 years old”, he says. “It’s a great outlet and has given me opportunities to travel and experience different cultures.”

Dr Campbell’s daily work is a meld of clinical work and research, seeing acute stroke patients in the emergency department, running a couple of outpatient clinics a week, and ward service on the Stroke Unit, as well as continuing his imaging research as part of his postdoctoral fellowship.

“My plan is to remain in this field of acute stroke care imaging and therapy”, he says. “There’s a synergy to my clinical and research work which I really enjoy.”

1. Michelle Au. The 12 medical specialty stereotypes. http://bp2.blogger.com/_e85U4QbYG7s/Ru74v7u75xI/AAAAAAAAAbQ/AsnWxh3gh9M/s1600-h/12+medical+specialty+stereotypes+full.jpg

  • Cate Swannell


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