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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282XOn-line version ISSN 1678-4227

Arq. Neuro-Psiquiatr. vol.77 no.3 São Paulo Mar. 2019

https://doi.org/10.1590/0004-282x20180158 

Historical Note

The Brazilian Society of Cerebrovascular Diseases – history

Sociedade Brasileira de Doenças Cerebrovasculares – histórico

Rubens José Gagliardi1 
http://orcid.org/0000-0002-3497-0174

Cesar Noronha Raffin2 

Jorge El Kadum Noujaim3 

Aroldo Luiz Silva Bacellar4 

Gabriel Rodriguez de Freitas5 

Jamary Oliveira-Filho6 

Sheila Cristina O. Martins7  8 

Gisele Sampaio Silva9  10 

Octávio Marques Pontes-Neto11 

1Santa Casa de São Paulo, Faculdade de Ciências Médicas, Departamento de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil

2Hospital Meridional Cariacica, Grande Vitória ES, Brasil

3Hospital dos Serviços do Estado, Departamento de Neurologia, Rio de Janeiro RJ, Brasil

4Hospital São Rafael, Serviço de Neurologia, Salvador BA, Brasil

5Universidade Federal Fluminense, Instituto D'Or de Pesquisa e Ensino (IDOR), Departamento de Neurologia, Rio de Janeiro RJ, Brasil

6Universidade Federal da Bahia, Programa de Pós-Graduação em Ciências da Saúde, Salvador BA, Brasil

7Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre e Hospital Moinhos de Vento, Porto Alegre RS, Brasil

8Universidade Federal do Rio Grande do Sul, Hospital Moinhos de Vento, Porto Alegre RS, Brasil

9Universidade Federal de São Paulo, Disciplina de Neurologia, São Paulo SP, Brasil

10Hospital Israelita Albert Einstein, Programa Integrado de Neurologia, São Paulo SP, Brasil

11Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil


ABSTRACT

The present article provides the historical background of the Sociedade Brasileira de Doenças Cerebrovasculares (Brazilian Society for Cerebrovascular Diseases), including details on its function, structure, challenges and main achievements.

Keywords: Stroke; history; societies, scientific; neurology

RESUMO

O presente texto apresenta um relato histórico da Sociedade Brasileira de Doenças Cerebrovasculares, incluindo detalhes da sua fundação, estruturação, dificuldades e principais realizações.

Palavras-chave: Acidente vascular cerebral; história; sociedades científicas; neurologia

The Sociedade Brasileira de Doenças Cerebrovasculares (SBDCV) encompasses the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology (ABN), and is, therefore, the body that represents specialists in cerebrovascular diseases in Brazil.

The SBDCV was spawned from the Working Group in Cerebrovascular Pathology of the ABN, the name formerly used by the ABN to group scholars of different subspecialties. These working groups are now referred to as Scientific Departments, whose mission it is to foster scientific development and help organize Brazilian Neurology meetings.

BEGINNINGS

The Cerebrovascular Diseases Working Group was set up in 1982, under the leadership of Prof. Dr. Roberto Melaragno Filho, an eminent neurologist deeply involved with cerebrovascular diseases. Professor Melaragno was tasked with the initial structuring of the group of neurologists interested in cerebrovascular diseases. This working group had the following coordinators, with two-year tenures:

1982-1984 Roberto Melaragno Filho

1984-1986 Sylvio Saraiva

1986-1988 Sylvio Saraiva

1988-1990 Roberto Melaragno Filho

1990-1992 José Ivan Cipoli Ribeiro

1992-1994 Rubens José Gagliardi

The working group was active but the need for greater involvement of specialists became clear. Few neurologists were interested in cerebrovascular diseases and the level of communication and tasks was lower than we wished. We recognized the need to solidify studies of cerebrovascular diseases; we needed to be more connected and to encourage neurologists to join our working group.

Creation of the SBDCV

Early in 1994, the board of the working group established new directions, widening the scope of the working group, and proposed setting up the SBDCV to address the above-mentioned challenges. Initially, all members of the ABN were sent a letter (Figure 1) about the creation of the SBDCV, informing them that this would be part of the Cerebrovascular Diseases Working Group, contribute to the ABN and comply with all regulatory rules. The beginning of 1994 marked the actual founding date of the SBDCV, while the society was formally instituted on the September 16, 1996, following its registration at the notary public office (Figure 2) and approval of the decision on its constitution at the Annual General Meeting of the working group held in Curitiba during the XVIII Brazilian Congress of Neurology. At this time, a call to all ABN members was made. At the AGM, the articles of incorporation, and the setting out of the main objectives of the SBDCV, were approved (Figure 3).

Figure 1 Letter to the members of Brazilian Academy of Neurology. 

Figure 2 Registry of constitution. 

Figure 3 Proposal. 

Another important discussion at the meeting was the analysis of the best name for the disease, since some advocated “encephalic vascular accident” as opposed to “cerebrovascular accident”; the meeting elected the best terminology to be: “cerebrovascular accident”, as this was more widely recognized and used.

Challenges and support

Although the articles of incorporation state that the SBDCV would be the working group of the ABN, abide by its regulations and would evolve within the ABN, there were reservations on the part of the ABN involving concerns over separate growth of the SBDCV and its consequent distancing from the ABN. This was not the intention of the new society, yet this concern almost led to the demise of this fledgling association. At the time, there was pivotal support from Professor Antonio Spina-França Neto, a former president of the ABN and one of the most respected neurologists, who backed the continuation of this idea. Professor Sérgio Novis then also supported the idea of setting up the SBDCV, which took shape little by little.

Directors of the SBDCV

The management boards of the SBDCV, from its founding to the present day, have had the following presidents:

1996-2000 Rubens José Gagliardi

2000-2004 Cesar Noronha Raffin

2004-2006 Jorge El Kadum Noujaim

2006-2008 Aroldo Luiz S. Bacellar

2008-2010 Gabriel Rodriguez de Freitas

2010-2012 Jamary Oliveira-Filho

2012-2104 Sheila Cristina O. Martins

2014-2016 Gisele Sampaio Silva

2016-2018 Octávio Marques Pontes-Neto

Main actions of the SBDCV

The SBDCV has carried out a range of activities, with key actions including: national consensus, congresses, teaching books, collaborative national and international studies, and the heading of campaigns on awareness, prevention and rehabilitation of stroke in Brazil.

The first communication disseminated by the SBDCV was the publication in the form of a four-monthly information release called the “Newsletter”, starting in January 2004, and containing abstracts of studies and research, local and international news, congresses, opinions of colleagues, etc. This initial milestone was fundamental for the ABN and SBDCV and prompted other publications, including those in other neurology subspecialties.

A number of book titles were released, under the SBDCV, on topics such as: cardiovascular diseases, management approaches; approaches in the acute phase of stroke, and Stroke Brazil.

Congresses of the SBDCV

The Annual General Meeting of the ABN in Curitiba (1996) approved the holding of the biannual Brazilian Congress on Cerebrovascular Diseases. It was decided to hold the first congress in São Paulo, November 13-15, 1997, in which 426 delegates took part, including eight overseas invitees. This represented a strong foundation and provided encouragement for further events, which have been held regularly ever since. To date, the following congresses have been held:

1st Congress, 1997: São Paulo (SP)

Chair: Rubens José Gagliardi

2nd Congress, 1999: Caldas Novas (GO)

Chair: Sebastião Eurico Melo-Souza

3rd Congress, 2001: Rio de Janeiro (RJ)

Chair: Jorge El-Kadum Noujaim

4th Congress, 2003: Porto Alegre (RS)

Chair: Sérgio Roberto Haussen

5th Congress, 2005: Salvador (BA)

Chair: Aroldo Luiz S. Bacellar

6th Congress: 2007 Joinville (SC)

Chair: Alexandre Luiz Longo

7th Congress, 2009: Vitoria (ES)

Chair: Cesar Noronha Raffin

8th Congress, 2011: Gramado (RS)

Chair: Maurício Friedrich

9th Congress, 2013: Fortaleza (CE)

Chair João José Freitas de Carvalho

10th Congress, 2015: Belo Horizonte (MG)

Chair: Romeu Vale Sant'Anna

11th Congress, 2017 Salvador (BA)

Chair: Bruno Bacellar Pedreira

These congresses have contributed greatly to the increase in study of cerebrovascular diseases in Brazil, promoting education on stroke, information exchange, the dissemination of studies and awards, recognition and elucidation of the current situation in Brazil, contribution of guidelines, among other positive outcomes. In this segment of activities, another major event promoted by the SBDCV was the securing of the World Stroke Congress for Brazil in 2012. This represented a concerted effort by a group of colleagues. The congress was held in Brasilia on October 10-13, 2012. It was chaired by Dr. Ayrton Massaro (Brazil) and Dr. Bo Norving (Sweden), and the local organizing committee comprised the following specialists: Elza Dias Tosta, Sheila Cristina O. Martins, Cesar Noronha Raffin, Linamara Rizzo Batistela and Rubens José Gagliardi. This event, besides technical advancement, allowed the dissemination of information about our society at an international level.

Consensus and guidelines of the SBDCV

Another highly-important activity performed by the SBDCV is the devising of “Consensus” and “Guidelines”. So far, a total of eight consensus and guidelines have been produced and published in the journal Arquivos de Neuro-Psiquiatria18:

  • Treatment of the acute phase of ischemic stroke – 20011

  • Thrombolysis in stroke – 20022

  • Neuroprotection in stroke – 20053

  • Treating carotid disease in the acute phase of stroke – 20054

  • Management of the acute phase of hemorrhagic stroke – 20095

  • Treatment of the acute phase of ischemic stroke. Part I – 20126

  • Treatment of the acute phase of ischemic stroke. Part II – 20127

  • Endovascular treatment (mechanical thrombectomy) – 20178

Stroke prevention programs

One of the purposes of the SBDCV is to raise the awareness in the lay public of the importance of recognizing a stroke, risks of having a stroke, how to prevent it and how to proceed in the event of a stroke. This has been achieved via talks for the public and publications, but mainly through participation in the “World Stroke Day” campaign9. This is an international activity coordinated by the World Stroke Organization, in which the SBDCV is engaged and coordinates nationally. This has been held annually, uninterrupted, since 2005, in different cities in Brazil. The campaign in Brazil has proven to be a huge success. In 2011, the SBDCV-ABN won first place in the World Stroke Day Awards and ranked second in 2009, 2012 and 2015. The letter sent by Dr. Stephen Davis, President of the World Stroke Organization to Dr. Sheila Martins, who headed the national campaign in 2011, can be seen in Figure 4.

Figure 4 Letter of World Stroke Organization. 

Contributions to the Brazilian Ministry of Health and to the Federal Board of Medicine

Given its main objectives of prevention and proper treatment of stroke in Brazil, since its founding, the SBDCV has worked with the Brazilian government to collaborate in the implementation of regulations and actions on this front. We were involved in the drafting of numerous important regulations, including those on guidelines for diagnosing brain death10, line of care in stroke11, rulings 664 and 665 on thrombosis, and on the establishment of stroke units12,13. Another conquest was the inclusion of neurologists in the group of interventionists.

In parallel, the SBDCV has played an active role in lobbying for improved public healthcare for stroke patients in Brazil14.

Other activities

There are several groups that have been working on providing new data on the epidemiology of stroke in Brazil. Dr. Norberto Cabral is one of the leading members of this group, with important contributions. His papers have contributed to a better understanding of the social disparities of our stroke patients, and the alerting of the International Stroke Society.

The relationship with the Ministry of Health began in 2008, with Dr. Sheila Cristina O. Martins as the lead person. She has made major contributions to improving stroke awareness among politicians and the Brazilian population, as well as fostering the inclusion of tPA as treatment of acute ischemic stroke by the National Healthcare System of Brazil.

Transcranial Doppler ultrasonography has a leading person in the country. Dr. Viviane Zétola has made several contributions, including the certification of neurologists to perform the technique.

The inclusion of intensive care as an area closely connected to cerebrovascular diseases in the Society has been an important achievement. Drs. Jamary Oliveira-Filho and Gisele Sampaio Silva are two major leaders who have helped in this approach.

FINAL COMMENTS

This article outlines some of the SBDCV's activities and its path to success, which have contributed to further studying of cerebrovascular diseases in Brazil, and consolidated our position in relation to international organizations. The journey of the SBDCV will be long-lasting and ongoing, given the collaboration of renowned colleagues and the new values they bring to the Society. The SBDCV shall continue to grow, while maintaining its important role in national and international Neurology.

References

1 Sociedade Brasileira de Doenças Cerebrovasculares. Brazilian guideline for the management of acute stroke. Arq Neuropsiquiatr. 2001;59(4):972-80. Portuguese. http://dx.doi.org/10.1590/S0004-282X2001000600026Links ]

2 Sociedade Brasileira de Doenças Cerebrovasculares. [Brazilian consensus for the thrombolysis in acute ischemic stroke]. Arq Neuropsiquiatr. 2002;60(3A):675-80. Portuguese. https://doi.org/10.1590/S0004-282X2002000400032Links ]

3 Freitas GR, Noujaim JE, Hausen SR, Yamamoto FJ, Novak EM, Gagliardi RJ. Neuroproteção no acidente vascular cerebral. opinião nacional. Arq Neuropsiquiatr. 2005;63(3B):880-91. https://doi.org/10.1590/S0004-282X2005000500035Links ]

4 Gagliardi RJ, André C, Fukujima MM, Melo-Souza SE, Zétola VF. [Management of carotid disease in acute phase of stroke: national opinion]. Arq Neuropsiquiatr. 2005 Sep;63(3A):709-12. Portuguese. https://doi.org/10.1590/S0004-282X2005000400032Links ]

5 Pontes-Neto OM, Oliveira-Filho J, Valiente R, Friedrich M, Pedreira B, Rodrigues BC et al. [Brazilian guidelines for the manegement of intracerebral hemorrhage]. Arq Neuropsiquiatr. 2009 Sep;67(3B):940-50. Portuguese. https://doi.org/10.1590/S0004-282X2009000500034Links ]

6 Oliveira-Filho J, Martins SC, Pontes-Neto OM, Longo A, Evaristo EF, Carvalho JJ et al. Guidelines for acute ischemic stroke treatment: part I. Arq Neuropsiquiatr. 2012 Aug;70(8):621-9. https://doi.org/10.1590/S0004-282X2012000800012Links ]

7 Martins SC, Freitas GR, Pontes-Neto OM, Pieri A, Moro CH, Jesus PA et al. Guidelines for acute ischemic stroke treatment: part II: stroke treatment. Arq Neuropsiquiatr. 2012 Nov;70(11):885-93. https://doi.org/10.1590/S0004-282X2012001100012Links ]

8 Pontes-Neto OM, Cougo P, Martins SC, Abud DG, Nogueira RG, Miranda M et al. Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke. Arq Neuropsiquiatr. 2017 Jan;75(1):50-6. https://doi.org/10.1590/0004-282x20160174Links ]

9 Gomes AB, Henrique Junior M, Schoeps VA, Santos MM, Pellegrinelli A, Matos BP, et al. Popular stroke knowledge in Brazil: A multicenter survey during “World Stroke Day”. eNeurologicalSci. 2016 Dec;6:63-7. [ Links ]

10 Conselho Federal de Medicina - CFM. Resolução N° 1.480/1997, de 08/08/1997. Diário Oficial União. 21 ago 1997. [ Links ]

11 Ministério da Saúde (BR). A linha de cuidado em acidente vascular cerebral nas rede de atençâo às urgencia e emergencia. 2012 [CITED 2017 Sep 15]. Available from: http://conitec.gov.br/images/Protocolos/pcdt-cuidados-AVC.pdfLinks ]

12 Ministério da Saúde (BR). Portaria N°.664, de 12 de abril de 2012. Aprova o Protocolo clínico e diretrizes terapêuticas - trombólise no acidente vascular cerebral isquêmico agudo. 2012 [cited 2017 Aug 9]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/PRT0664_12_04_2012.htmlLinks ]

13 Ministério da Saúde (BR). Portaria N° 665, de 12 de abril de 2012. Dispõe sobre os critérios de habilitação dos estabelecimentos hospitalares como Centro de Atendimento de Urgência aos Pacientes com Acidente Vascular Cerebral (AVC), no âmbito do Sistema Único de Saúde (SUS), institui o respectivo incentivo financeiro e aprova a Linha de Cuidados em AVC. 2012 [cited 2017 Dec 02]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/PRT0665_12_04_2012.htmlLinks ]

14 Martins SC, Pontes-Neto OM, Alves CV, Freitas GR, Oiliveira Filho J, Tosta ED, et al. Past, presente and future of stroke in middle-income countries: the Brazilian experience. Int J Stroke. 2013;8(supply A100):106-11. https://doi.org/10.1111/ijs.12062.Links ]

Received: June 28, 2018; Revised: August 20, 2018; Accepted: September 26, 2018

Correspondence: Rubens José Gagliardi; Irmandade da Santa Casa de Misericórdia de São Paulo, Pavilhão Conde de Lara; Rua: Dr. Cezário Motta Jr, 112 / 3° andar; 01221-020 São Paulo SP, Brasil; E-mail: rubensjg@apm.org.br

Conflict of interest: There is no conflict of interest to declare.

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