PNA Spotlight: Dr. Daniel Prevedello

Prevedello  This month the PNA Spotlight focuses on Dr. Daniel Prevedello, who is a member of the PNA Board of Directors. Dr. Prevedello is an       Associate Professor and Director of the Minimally Invasive Cranial Surgery Program in the Department of Neurological Surgery at the Ohio   State University in Columbus.  He attended medical school at the Federal University of Parana, Brazil and did an internship there, and then   did two more internships, at Wayne State University in Michigan and at Ospedale Policlinico de Bari in Puglia, Italy.  He did his residency at   Hospital Nossa Senhora Das Gracas, in Curitiba, PR, Brazil. And he completed fellowships at the University of Virginia and the University of   Pittsburgh.  He was kind enough to answer some questions from the PNA. His responses follow. 

What inspired you to choose your career path?

There are many factors that inspired me to follow the pathway I took. Interestingly, I did not want to be a doctor when I was a teenager. It was the "challenge" of medical school admission that gave me extra motivation to enter the medical field. I was definitely inspired by my grandfather, a well-accomplished psychiatrist, who always gave me great advice in my life. Although my parents are not doctors, I also have two uncles and one aunt who I grew up observing and admiring. Their practices were in rheumatology, family general practice and pediatrics, respectively. I was really touched by the general practice of my uncle in the countryside of Brazil. I had the privilege of watching him performing surgery when I was 12 years old. It was an exciting experience, and honestly slightly traumatizing.

Once at medical school, I quickly fell in love with everything related to the brain. I loved neuroanatomy, neurophysiology, and all neurosciences. The fact that my young sister had fought seizures her whole life also activated a significant curiosity inside me. I was highly motivated to learn and understand the minutia of all neurobiological mechanisms.

 It was my grandfather who helped me to define that neurosurgery was my field. We had a long conversation, and he exposed straightforwardly: "If you like brain anatomy, you are a surgeon; if you like the interaction between the neurons, you are a neurologist; if you like what happens inside the neurons, you are a psychiatrist".  And he completed with "neurosurgeons solve problems; neurologists help patients with chronic diseases, and psychiatrists "marry" their patients as they never discharge patients from their practices". That conversation helped me to define neurosurgery as my future specialty, based on my personality.

What is the primary focus of your work/research?

In my research, I constantly work to find the best treatment for patients with skull base disease. In our laboratory, we simulate the surgical environment using cadaveric specimens and the same equipment encountered in the operating room. In this scenario, we design and compare different approaches in order to find a less disruptive way to reach deep portions of the head and skull base. These minimally invasive ways to perform surgery must be safe and effective, yet allow for similar maneuverability of surgical instruments. We also look for new treatments that will allow us to treat skull base tumors, including pituitary tumors, without the need for surgery.

What do you consider to be the future of your field?

 I had the privilege of seeing many patients benefit from the medical treatment of prolactinomas. Some of these patients had very large tumors, frequently causing vision loss, and I was ready to do surgery if necessary. Impressively, a couple of days after starting dopamine agonists (an oral tablet a couple of times/week), their tumors shrunk with vision improvement. Often their tumors disappeared over time (few years of treatment). I do think that at some point we will have this type of treatment for all kinds of pituitary tumors. For now, while we don't have this option for all, we will keep helping people with surgery and "mechanical" decompression of the important structures.

What should patients know about your field/what deserves more recognition/awareness?

Patients must have a family doctor that they trust. Only one doctor should be central to the care for any person and family. People need to report any symptoms to their doctors. Pituitary tumors can cause a constellation of symptoms, and it is very important to connect the dots in order to come up with a diagnosis. Pituitary tumors can be behind weight gain, carpal tunnel, acne, striae, tiredness, fractures, bruises, and many other symptoms that can appear benign or interpreted as aging. On the other hand, never be afraid of searching for second opinions when necessary. 

What would you like to convey about yourself to your patients?

I am here to help and we have a great team at the Ohio State University. We have a highly specialized multidisciplinary center focused on the treatment of pituitary tumors including neurosurgeons, ENTs, endocrinology, radiation oncology, neuroradiology, neuroophthalmology, neuroanesthesiology, and neuropathology.

Why did you get involved with the PNA and what is the extent of your involvement?

I have been involved with the PNA for more than 10 years. It all started when I met Robert Knutzen. His passion to help people with pituitary conditions was contagious. In few minutes, he was able to show me how important is to train and educate physicians about all pituitary conditions. He was able to share with me many examples of patients who were out there for many years suffering with multiple symptoms with no accurate diagnosis. I remember him telling me that some patients went as much as 40 years until a better-prepared doctor was able to connect all the information and help the patient. From that moment on, I have been committed to the PNA, helping to spread awareness! 

Daniel M. Prevedello, M.D. can be reached at (614) 293-7190.