ABOUT DR. ERNEST WANG

Dr Ernest Wang is a senior consultant neurosurgeon with experience in spine surgery, brain tumour surgery, stroke surgery, neurotrauma, functional neurosurgery and skull base surgery. He was the President of the Clinical Neuroscience Society in 2013-14, a professional society for neurologists, neurosurgeons and other clinically related neuroscience professionals in Singapore. In 2001, he was awarded a 2-year fellowship to train with the world renowned Professor John Pickard in Cambridge. In 2008, he completed his 2nd HMDP fellowship (in spinal surgery) in South India - sub-specialising in spinal navigation. As a Spine neurosurgeon, he has spearheaded the use of navigation in both routine spinal cases and complex spinal surgery. He has adapted these techniques in
Minimally Invasive Spine (MIS) Surgery or Minimally Access Spinal Technologies (MAST) and is instrumental in a successful alliance between spinal neurosurgeons and spinal orthopaedic surgeons at Tan Tock Seng Hospital, the first fully combined spinal unit in Singapore. Dr Wang was the former head of the division of neurosurgery at the Changi General Hospital, providing specialized care to acute trauma and stroke patients. Together with the management of such patients in Singapore General Hospital and Tan Tock Seng Hospital, he has managed the largest cohort of these patients in Singapore. Dr Wang’s other clinical work in neurosurgery includes cerebrovascular surgery and the management of complex cerebrospinal fluid problems including normal pressure hydrocephalus.

Dr Wang was head of the clinical trials section at the National Neuroscience Institute from 2006-2015. He oversaw and ran all industry and academic clinical trials in the department. This includes multi-center studies on head injury, stroke and spinal injury. He is Regional Study Advocate and Clinical Study Advisor to two internal multi-center clinical trials and was also a member of the Singhealth medical ethics board from 2008-2012. He has also actively involved in the Steering Committee of a major Asia Pacific Clinical trial on Severe Head Injury. His personal clinical interests focuses on multimodality monitoring techniques in characterizing brain physiology and neurochemistry in acute brain injury.

Dr Wang is an Adjunct Assistant Professor at the NUS-Duke Graduate Medical School where he teaches medical students. He maintains his clinical position at the National Neuroscience Institute, Singapore General Hospital, Tan Tock Seng Hospital, Changi General Hospital and the KK Women’s and Children Hospital where he teaches and trains residents in neurosurgery.


BIBLIOGRAPHY

Original Articles
1. ECM Wang, AYT Lim, TT Yeo. Traumatic Posterior Fossa Extradural Haematomas (PFEDH). Singapore Med J 1998; Vol 39(3):107-111

2. ECM Wang, PY Ng, I Ng, PL Ong. Endoscopic Assisted Clipping of Aneurysms. J Clinical Neuroscience 2003; Vol 10(2): 174-176.

3. ECM Wang, BT Ang, J Wong, J Lim, I Ng. Cerebral Autoregulation and Pressure Reactivity in Decompressive Craniectomy. Br J Neurosurg. 2006 Feb;20(1):24-30.

4. ECM Wang, CL Ho, KK Lee, I Ng, BT Ang. Changes in brain biochemistry and oxygenation in the zone surrounding primary intracerebral haemorrhage. Acta Neurochir Suppl. 2008;102:293-7.

5. ECM Wang, CL Ho, KK Lee, I Ng, BT Ang. Effects of temperature changes on cerebral biochemistry in spontaneous intracerebral haematoma. Acta Neurochir Suppl. 2008;102:335-8.

6. BT Ang, J Wong, KK Lee, ECM Wang, I Ng.. Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injury. J Neurol Neurosurg Psychiatry. 2007 Mar;78(3):298-302.

7. WH Ng, ECM Wang, I Ng. Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services. Surg Neurol. 2007 Apr;67(4):338-41.

8. CL Ho, ECM Wang, KK Lee, I Ng, BT Ang. Cerebral oxygenation, vascular reactivity and biochemistry following decompressive craniectomy for severe traumatic brain injury (TBI). J of Neurosurgery. 2008 May; 108(5):943-949.

9. JD Thorat, ECM Wang, KK Lee, WT Seow, I Ng.. Barbiturate therapy for patients with refractory intracranial hypertension following severe traumatic brain injury: Its effects on tissue oxygenation, brain temperature and autoregulation. J Clin Neurosci. 2008 Feb;15(2):143-8. Epub 2007 Nov 7.

10. JD Thorat, ECM Wang. Gastric acid burns because of a disconnected nasogastric tube. Canadian Medical Association J. 2008 Mar; 178(6):680.

11. WH Wan, BT Ang, ECM Wang. The Cushing Response: a case for a review of its role as a physiologic reflex. J Clin Neurosci 2008 Mar: 13(3): 223-8. Review.

12. WH Ng, ECM Wang, I Ng. Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services. Surg Neurol 2007; 67(4):338-341.

13. WH Ng, ECM Wang, I Ng. Teleradiology Multimedia Messaging Service in the Provision of Emergency Neurosurgical Service. In Teleradiology 2008, Springer Berlin Verlag.

14. WH Ng, ECM Wang, I Ng, M Bernstein. Teleradiology and Emergency Neurosurgery- Presence in a small Asian city state and need in a large Canadian Province. Journal of Brain Disease (2009): 1: 7-11.

15. R Singh, WH Ng, I Ng, ECM Wang, KE Lee, WL Lee. Telemedicine in Emergency Neurological Service Provision in Singapore- Using technology to overcome limitations. Telemed J E Health. 2009 Jul-Aug;15(6):560-5.

16. P Steinbok, R Milner , D Agrawal, E Farace, GK Leung, I Ng, T Tomita, ECM Wang, N Wang, GK Wong, LF Zhou. A Multicenter Multinational Registry for Assessing Ventriculoperitoneal Shunt Infections for Hydrocephalus. Neurosurgery. 2010 Nov; 67(5):1303-10.

17. N Venketasubramaniam, BPL Chan, HM Chang, HC Chua, RN Gan, F Hui, W Lee, I Ng, VK Sharma, R Singh, HL Teoh, E Wang, CLH Chen. Brain attack: Need for resuscitation. Singapore Med J 2011; Vol 52(8): 620.

18. E Wang. Delayede Neurosurgical Complications After Traumatic Brain Injury. Coping After Brain Injury: Empowering Families; Moving Ahead. Chapter 14: 70.

19. RN Gan, E Wang. Acute Intracerebral Hemorrhage – Medical and BP Management. The Stroke Clinician’s Handbook. Chapter 1: 127.

20. NKK King, JL Lai, LB Tan, KK Lee, BC Pang, I Ng, E Wang. A randomized, placebo-controlled pilot study of patients with spontaneous intraventricular haemorrhage treated with intraventricular thrombolysis. Journal of Clinical Neuroscience. 2012 Jul;19(7):961-4.

21. Pople I, Poon W, Assaker R, Mathieu D, Iantosca M, Wang E, Zhang LW, Leung G, Chumas P, Menei P, Beydon L, Hamilton M, Kamaly I, Lewis S, Ning W, Megerian JT, McGirt MJ, Murphy JA, Michael A, Meling T. Comparison of Infection Rate With the Use of Antibiotic-Impregnated vs Standard Extraventricular Drainage Devices: A Prospective, Randomized Controlled Trial. Neurosurgery. 2012 Jul;71(1):6-13.

Clinical Trials
1. Synapse Trial
I am the principle investigator in this exciting multi-center, double-blind, placebo-controlled Phase 3 study to investigate the efficacy and safety of progesterone in patients with severe traumatic brain injury.

2. RESCUE ICP Trial
This is a prospective randomized trial initiated by the University of Cambridge (for which I am a co-investigator) aimed at studying the efficacy of decompressive craniectomy compared to optimal medical therapy in the treatment of intractable raised intracranial pressure.

3. Candidemia Fungal trial
I am the principal investigator of this industry trial - A Phase III, Double-Blind, Randomized Study to Evaluate the Safety and Efficacy of Isavuconazole Versus Caspofungin Followed by Voriconazole in the Treatment of Candidemia and Other Invasive Candida Infections. Candida

4. CSM-1
I am a co-investigator of this multi-center trial studying different surgical techniques in cervical spondylotic myelopathy.

5. Efficacy of clot thrombolysis in Intraventricular Haemorrhage
I am the principle investigator in this trial, for which I have received an NRMC Grant of $136, 004 over 2 years.

6. Conscious-2 trial
I am the principal site investigator in this trial this multicenter randomized phase III trial. It compares the use of Clanzostaten with standard therapy in reducing delayed neurological deficits due to cerebral vasospasm in subarachnoid haemorrhage.

7. Conscious-3 trial
I am the principal site investigator in this trial this multicenter randomized phase III trial. Similar to the Conscious-2 trial, this is trial recruits patients undergoing embolisation for subarachnoid haemorrhage secondary to ruptured cerebral aneurysms.

8. CENTRIC Study
I am the principal site investigator in this multicenter, open-label, controlled phase III study, testing cilengitide in combination with standard treatment (temozolomide with concomitant radiation therapy, followed by temozolomide maintenance therapy) versus standard treatment alone.

9. Simvastatin in Aneurysmal Subarachnoid Hemorrhage (STASH) trial
I am the principle site investigator in this multicenter randomized controlled phase III trial. It is believed that statins can effectively ameliorate cerebral vasospasm, maintain autoregulation, and decrease vasospasm related complications (including delayed ischemic deficits and mortality) following subarachnoid hemorrhage.

10. CODMAN Shunt Registry trial
I am the principle site investigator of this industry trial comparing antibiotic coated ventricular catheters with conventional standard catheters used in ventriculoperitoneal shunting.

11. B-EVD trial
I am the principal site investigator of this industry trial comparing the use of an antibiotic coated external ventricular catheter (BACTICEAL) with conventional standard catheters used in external ventricular shunting.

12. Multi-modality monitoring in head injury and stroke
In acute brain injury, prevention of secondary brain injury is the mainstay of treatment. Multi-modal techniques to measure brain tissue oxygenation, cerebrovascular reactivity (PRx), brain temperature and brain neurochemistry (through cerebral microdialysis) can help detect secondary insults. By integrating these parameters monitored with the ICM+ (Intracranial Monitoring Plus Software), we study these global and local indices of brain monitoring in the setting of traumatic brain injury and stroke.


Past projects
1. Cerebral autoregulation and pressure reactivity in decompressive craniectomy

2. Vascular endothelial growth factor and peritumoural oedema in meningiomas

3. Stereotactic aspiration of intracerebral haematomas

4. Endoscopic assisted microsurgical clipping of cerebral aneurysms

5. Information Technology and Neurosurgery

6. Anticoagulation in Neurosurgery

7. CD/Teaching Article on Carotid Endarterectomy

8. Quintel Drug Trial in Intracerebral Haemorrhagic Strokes

9. CHANT Trial

10. SAINT I Trial

11. Factor VII in Intracerebral Haemorrhagic Strokes

12. Factor VII in Traumatic Brain Injury

13. MMS Radiology in Neurosurgery and Neurology