Stroke Seminar Honors Career of NINDS' Walker
By Paul Girolami
A gathering of the nation's top neurosurgeons and neurologists joined current and former NIH staff, along with Dr. Michael D. Walker and his friends and family, at the NINDS-sponsored seminar, "Stroke in the Next Millennium," held recently in Lipsett Amphitheater, Bldg. 10. Presented by Dr. J. Donald Easton, professor and cochair, department of clinical neurosciences, Brown University School of Medicine, and neurologist-in-chief, Rhode Island Hospital, the lecture was part of the tribute to Walker on his retirement. Walker served as director of the NINDS Division of Stroke, Trauma, and Neurodegenerative Disorders and had a more than 30-year career with NIH.
Presenting a 3-decade overview of research on stroke management, Easton noted that, despite the dramatic increase in life expectancy for Americans in this century (from age 49 in 1900 to age 77 in 1997), the prevalence of stroke is rising. Some 4.4 million people die each year from stroke, with a cost to the U.S. economy alone reaching $45 billion. Although NIH has been involved in several successful clinical trials regarding the treatment and prevention of stroke, Easton stressed a clear need for NIH to continue to lead and support clinical science, particularly in the areas of neuroprotective agents and the extension of stroke treatment beyond current time limits.
 | NINDS director Dr. Gerald Fischbach (l) presents an inscribed glass bowl to Dr. Michael Walker on his retirement from NINDS. Gifts from family and friends included a barometer, land telescope, and donation to the Children's Inn at NIH. |
"Clearly, understanding the role and mechanisms of these processes will lead to new therapeutic strategies," he said. "Very many challenges in stroke research remain. The need for training bright and dedicated young scientists has never been greater, and their opportunities will be greater than they have been for the last decade or two. I am very optimistic about the future of stroke research and the fruit it will bear. I hope Mike Walker's successors at the NINDS are as successful as he has been in their stewardship of the institute's resources."
NINDS director Dr. Gerald Fischbach called Walker "a Renaissance man of the neurosciences" for work that has "significantly improved our understanding of oncology, neuro-oncology, traumatic head injury, brain tumors, spinal cord injury, clinical trials, stroke, neurodegenerative diseases, and the mechanisms and complexities of pain. Mike's leadership at this institute has truly made a difference in public health." (The lecture was videocast throughout NIH and made accessible via the Internet. See http://www.ninds.nih.gov/stroke2000/ for more information about the tribute and speakers.)
Following the lecture, more than 100 friends, family members and others gathered at the Hyatt Regency Bethesda for a dinner tribute to Walker. Speakers included master of ceremonies Dr. Sid Gilman, department of neurology, University of Michigan; Fischbach; and former NINDS director Dr. Murray Goldstein.
Walker began his NIH career in 1965, in the National Cancer Institute's Laboratory of Chemical Pharmacology. At NCI's Baltimore Cancer Research Center, where he served as director from 1972 to 1977, he concentrated heavily on brain tumor research and helped introduce the concept of treating brain tumor patients with chemotherapy.
In his 20 years as director of the NINDS Division of Stroke and Trauma (which became the Division of Stroke, Trauma, and Neurodegenerative Disorders in 1996), Walker oversaw some of the institute's most dramatic scientific announcements, particularly in the area of clinical trials. He served as its public spokesperson in times of great excitement and challenging public controversies. He also personally recruited and mentored some of the institute's most prominent and successful program directors. He guided the division in four major endeavors of national and international importance:
- Completion of the pilot study proving the efficacy of tissue plasminogen activator (t-PA) when given within 3 hours of the occurrence of ischemic stroke, resulting in the redesign of the strategy for treating victims of stroke in the immediate hours following an episode.
- Completion of the clinical trial on the use of warfarin or aspirin in the prevention of stroke in patients who have atrial fibrillation, which increases the risk for stroke. Warfarin or aspirin was shown to sharply reduce the incidence of stroke in these patients, resulting in the prevention of some 20,000 to 30,000 strokes in the United States alone each year (a savings of about $200 million a year in medical costs). Nearly 1 million Americans suffer from atrial fibrillation.
- Completion of the first major controlled, multicenter clinical trial of the drug methylprednisolone, which was found to be effective in treating spinal cord injury when given within 8 hours after injury (some 10,000 spinal cord injuries occur each year). In 1990, this research milestone was proclaimed by U.S. News and World Report as one of the 10 top medical advances of the year.
- Management of the North American Symptomatic Carotid
Endarterectomy Trial, a 50-site international trial that produced
positive findings on the use of surgery to remove fatty deposits
from the carotid arteries. Hundreds of thousands of persons at
risk of stroke will benefit from this surgery.
"I think the contributions that Mike has made in the past 25 years, particularly those related to neurosurgery, will turn out to be some of the most important contributions in that quarter century," said Dr. Donlin Long, professor and chairman, department of neurosurgery, Johns Hopkins Hospital.
Widely admired by his peers, Walker counts among his many awards and honors the Farber Award, American Academy of Neurology (brain tumor research); the Sheline Award (research on brain tumors); and the Wakeman Award (awarded biennially for professional achievement in spinal cord injury research). He is founder and former editor-in-chief of the Journal of Neuro-Oncology; was deputy editor of the Annals of Neurology; and has reviewed many of the foremost medical journals on cancer, cancer research, neurosurgery, trauma and stroke.
Walker will continue to be seen around the Neuroscience Bldg., assisting on a variety of projects. Said Dr. James Toole, professor of neurology at Wake Forest, in saluting his good friend, "I think Mike Walker's just getting started. I expect we'll now see fireworks. It's not enough to remember Mike for what he's done; he's going to be remembered for what he's going to do."
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