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Faculty Spotlight: Brian Mac Grory, MD Thursday, August 13, 2020 Brian Mac Grory, MD, was a second-year resident when a new method of treating stroke revolutionized vascular neurology almost overnight. To see all the results from your Mac in the Finder, scroll to the bottom of the results list, then double-click “Show all in Finder.” Get definitions, calculations, and conversions Spotlight can show you dictionary definitions, calculations, measurement conversions, and more.
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Brian Mac Grory, MD, was a second-year resident when a new method of treating stroke revolutionized vascular neurology almost overnight. Now, as a new member of our faculty, he’s treating patients with strokes and co-creating a multidisciplinary clinic specializing in treating patients who’ve suffered strokes that affect their eyes. In this week’s spotlight interview, Mac Grory talks about what he enjoys in each of these areas, how Duke is poised to help patients with eye strokes, and how he sees treatment for strokes improving in the future.
What are your current responsibilities within the Neurology Department? How do they compare to your previous responsibilities at Brown and Rhode Island Hospital?
I am a vascular and general neurologist. My subspecialty training is in vascular neurology which includes the treatment of stroke and other disorders affecting the blood vessels in the brain and neck. I also treat people with seizures, headaches, autoimmune conditions affecting the brain and spine, disorders of movement, and disorders of muscle. I see patients in the inpatient service at Duke University Medical Center (DUMC), in the outpatient clinic and also via telemedicine (as part of a group of specialists who are on call 24/7 to provide virtual stroke consultations to a network of hospitals in North Carolina and Virginia). Additionally, I am setting up a multidisciplinary clinic at DUMC in which a vascular neurologist and ophthalmologist collaboratively see patients who have suffered a stroke affecting their eye (see below) and work together to preserve a person’s eye health while preventing further strokes in the future.
One of your clinical and research interests is “central retinal artery occlusion.” What is this and how does it relate to your work here at Duke?
Strokes affect the brain but they can also affect the eye. An eye stroke has the medical label “central retinal artery occlusion.” Eye strokes are difficult to recognize and treat because they cause sudden and entirely painless visual loss. However, if a person is brought to an emergency department immediately it is possible to reduce the impact of this problem or even fix it. Duke is uniquely poised to become a center of excellence for the treatment of eye strokes as we have a large multidisciplinary team capable of delivering advanced therapies. DUMC has a comprehensive stroke center, a large team of interventional radiologists, one of the premier ophthalmology programs in the country, and even a hyperbaric medicine program (high pressure oxygen that can be used to treat eye strokes). Perhaps most importantly, our telestroke network and ambulance/helicopter capabilities mean we can rapidly transfer patients from other parts of North Carolina and surrounding states to receive these treatments.
How and when did you first become interested in vascular neurology? What do you enjoy most about vascular neurology in particular?
My residency training was at an extremely high-volume stroke referral center, the first comprehensive stroke center in New England, and this fostered my interest in the field. Additionally, when I was a second-year neurology resident, a revolutionary new treatment (thrombectomy) was proven to be effective which transformed the field of stroke medicine almost overnight. Vascular neurology is something I find particularly interesting because it provides a window into some of the amazing properties of the brain while at the same time allowing doctors and nurses to treat a problem of enormous public health relevance (stroke causes 6 million deaths globally per year). I enjoy the fact that when treating a person with a stroke, one has to treat not just the brain but also the heart, lungs and other vital organs, as these are commonly affected as a complication of a stroke. This is not to mention the vast emotional and psychological issues that arise. Vascular neurology entails a large amount of general adult medicine and I enjoy the holistic approach to patient care that it requires.
What do you see as the most exciting or important change coming to how we treat or understand stroke in the coming decade?
Stroke is not a disease itself but rather a result of another medical condition in which the brain is secondarily affected. Every person with a stroke is different and requires treatment particular to them. In the coming decade, I see further research coming out that will allow us to use new measurements or tests (biomarkers) to personalize treatment for each patient even further. We will also likely be able to use existing biomarkers in new ways to give treatments to more people than we can at present. I also see eye stroke/CRAO being increasingly recognized as an analog of brain stroke and patients with this condition being treated with the same level of urgency (and hopefully the same level of success).
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What other passions or hobbies do you have outside of the Department?
My wife and I love to travel together. We also enjoy hiking, scuba diving and exploring North Carolina. I go to Ireland at least twice a year (2020 has been an exception, for obvious reasons).
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Mac Grory and his wife enjoy a pre-COVID vacation in Cancun, Mexico.