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Dr Keong Chwee Har Nicole from National Neuroscience Institute

Dr Keong Nicole Chwee Har

MBBS with Merit (Newcastle, United Kingdom), MRCS (England), FRCS Neuro.Surg (England) MPhil (Cantab), MD (Cantab)

Consultant

National Neuroscience Institute

Specialty: Neurosurgery

Sub-specialties: Cerebrovascular Surgery, Neurotrauma, Hydrocephalus

Conditions Treated by this Doctor:
Cerebrovascular Surgery, Hydrocephalus, Neurotrauma.

Clinical Appointments

  • Consultant Department of Neurosurgery National Neuroscience InstituteNational Neuroscience Institute

Profile

Dr Keong is a Malaysian-born, Cambridge-trained academic neurosurgeon with an interest in reversible brain injury. In addition to obtaining a Certificate for the Completion of Training (CCT) in the UK, she was awarded MPhil and MD degrees from the University of Cambridge. For her MD, she received the Raymond Horton-Smith prize (founded 1900) for best thesis. Prior to relocating to Singapore, Dr Keong successfully applied for a Transitional Award Grant from the National Medical Research Council of Singapore to fund a longitudinal MR imaging study, SERENDIPITI, in which cross-correlations between normal pressure hydrocephalus (NPH) and secondary hydrocephalus (post-trauma and intracranial haemorrhage) are being sought. She has research interests in clinical interventions to modify disease outcomes. She was the Principal Investigator of the SILVER trial, a double-blind randomised controlled study, which produced Class I evidence for the reduction of infection using silver-impregnated external ventricular drains.

Her focus is on acute-on-chronic reversible brain injury and developing neuroimaging biomarkers using Diffusion Tensor Imaging (DTI) methodology to characterise white matter injury patterns remediable with surgical intervention. She is involved in scoring strategies for risk stratification, early diagnosis and prognostication of mild-to-moderate Traumatic Brain Injury (TBI), as well as translating cognitive neuroscience into learning micro-interventions.

Education

Doctor of Medicine (MD), Clinical Neuroscience, St Catharine’s College, University of Cambridge, England, United Kingdom, 2015
CCT in Neurosurgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, United Kingdom, 2012
FRCS Neuro.Surg, Royal College of Surgeons of England, United Kingdom, 2011
Master of Philosophy in Medical Sciences (MPhil), Clinical Neuroscience, St Catharine’s College, University of Cambridge, England, United Kingdom, 2009
MRCS, Royal College of Surgeons of England, United Kingdom, 2003
MBBS with Merit, University of Newcastle upon Tyne, England, United Kingdom, 1999

Professional Appointments and Committee Memberships

  • Consultant, Department of Neurosurgery, National Neuroscience Institute
  • Member of the International Society of Hydrocephalus and Cerebrospinal Fluid Disorders (ISHCSF)
  • Assistant Professor, Duke-NUS Graduate Medical School, Singapore
  • Member of the Congress of Neurological Surgeons (CNS)
  • Member of the Society of British Neurological Surgeons (SBNS)

Awards

  • Academic Clinical Programme – Pitch for Fund: NEURON-TBI study (NEurodegeneration & Understanding of Risk Overlay in Neuroimaging – a TBI study, 8 Jun 2017 - 30 Sep 2019
  • Khoo Pilot Award: Fluid Biomarkers in the Characterisation of Normal Pressure Hydrocephalus, 17 April 2017 – 16 April 2018, pending ethics approval
  • NMRC Clinician Scientist Nurturing Scheme: NEurodegeneration and Understanding of Risk Overlay in Neuroimaging – an NPH study, 1 Mar 2016 – 31 Jul 2017
  • NNI Centre Grant: PRECIPICE - Patterns of REversible Cord Injury Pre- & Post-Intervention in the CErvical spine, 1 Jun 2016 – 30 Jun 2017
  • NMRC Transition Award: SERENDIPITI - Surgical Exploration of REversible Normal pressure hydrocephalus vs Decline due to Injury Post-Intracranial pressure, Trauma or Intracranial haemorrhage, 21 Nov 2014 – ongoing
  • Awarded Raymond Horton-Smith Prize (founded 1900) for best MD thesis presented to the University of Cambridge for the academic year, 2013-14
  • Best Oral Presentation Prize, Society of British Neurological Surgeons meeting 2010 for the SILVER trial, 2010
  • Joint Royal College of Surgeons of England/ Dunhill medical Trust Research Fellowship, 2007-2008
  • Tunku Abdul Rahman Centenary Fund Research Project Grant Holder, 2007-2008

Publications and Research Trials

  • Diffusion tensor imaging profiles reveal specific neural tract distortion in normal pressure hydrocephalus. Keong NC, Pena A, Price SJ, Czosnyka M, Czosnyka Z, DeVito EE, Housden CR, Sahakian BJ, Pickard JD. PLoS ONE. 2017. (In press)
  • Cerebral autoregulation, CSF outflow resistance and outcome following CSF diversion in normal pressure hydrocephalus. Lalou AD, Czosnyka M, Donnelly J, Pickard JD, Garnett M, Nabbanja E, Keong NC, Czosnyka Z. Journal of Neurosurgery. 2017. (In press)
  • Imaging normal pressure hydrocephalus – theories, techniques and challenges. Keong NC, Price SJ, Gillard JH, Pickard JD. Neurosurgical Focus Sep 2016 edition. Adult hydrocephalus: advances in diagnosis and care. Mark Hamilton, Peter Gruen, Mark Luciano issue.
  • Diffusion tensor profiles of reversible vs. irreversible injury changes in normal pressure hydrocephalus. Keong NC, Pena A, Price, SJ, Czosnyka M, Czosnyka Z, DeVito, EE, Housden CR, Gillard JH, Sahakian BJ, Pickard JD. Lancet Neurology Conference 2016. (Poster)
  • The SILVER (Silver Impregnated Line Versus EVD Randomized trial): a double-blind, prospective, randomized, controlled trial of an intervention to reduce the rate of external ventricular drain infection. Keong NC, Bulters DO, Richards HK, Farrington M, Sparrow OC, Pickard JD, Hutchinson PJ, Kirkpatrick PJ. Neurosurgery. 2012 Aug;71(2):394-403; discussion 403-4.
  • Clinical evaluation of adult hydrocephalus. Keong NC, Czosnyka M, Czosnyka Z, Pickard JD. In Youmans Neurological Surgery, 6th edition 2011. Editor R Winn.
  • Anatomical considerations in neuroanaesthesia. Keong NC, Macfarlane R. In Core Topics in Neuroanaesthesia and Neurointensive Care, 2nd edition 2011. Editors B. Matta, D. Menon and M. Smith.
  • Clinical assessment of cerebrospinal fluid dynamics in hydrocephalus. Guide to interpretation based on observational study. Weerakkody RA, Czosnyka M, Schuhmann MU, Schmidt E, Keong NC, Santarius T, Pickard JD, Czosnyka Z. Acta Neurol Scand. 2011 Aug;124(2):85-98. doi: 10.1111/j.1600-0404.2010.01467.x. Epub 2011 Jan 6.
  • Impact of duration of symptoms on CSF dynamics in idiopathic normal pressure hydrocephalus. Czosnyka Z, Owler B, Keong NC, Santarius T, Baledent O, Pickard JD, Czosnyka M. Acta Neurol Scand. 2011 Jun;123(6):414-8. doi: 10.1111/j.1600-0404.2010.01420.x. Epub 2010 Sep 16.
  • Slow vasogenic fluctuations of intracranial pressure and cerebral near infrared spectroscopy – an observational study. Weerakkody RA, Czosnyka M, Zweifel C, Castellani G, Smielewski P, Keong N, Haubrich C, Pickard J, Czosnyka Z. Acta Neurochir (Wien). 2010 Oct;152(10):1763-9. Epub 2010 Aug 11.
  • The SILVER trial: proceedings of the 155th meeting of the Society of British Neurological Surgeons. British Journal of Neurosurgery. 2010;24(2):108-147.
  • Cerebrospinal compensation of pulsating cerebral blood volume in hydrocephalus. Kim DJ, Carrera E, Czosnyka M, Keong NC, Smielewski P, Balédent O, Sutcliffe MP, Pickard JD, Czosnyka Z. Neurol Res. 2010 Jul;32(6):587-92. Epub 2010 Jan 21.
  • Modelling normal pressure hydrocephalus using magnetic resonance imaging. Keong NC. Thesis for MPhil in Medical Sciences (Clinical Neuroscience). 2009.
  • Index of cerebrospinal compensatory reserve in hydrocephalus. Kim DJ, Czosnyka Z, Keong NC, Radolovich DK, Smielewski P, Sutcliffe MP, Pickard JD, Czosnyka M. Neurosurgery. 2009 Mar;64(3):494-501; discussion 501-2.
  • Normal pressure hydrocephalus (review). Juss JK, Keong NC, Forsyth DR, Pickard JD. CME Geriatric Medicine. 2008;10(2):45-82.
  • How does CSF dynamics change after shunting? Petrella G, Czosnyka M, Keong NC, Pickard JD, Czosnyka Z. Acta Neurol Scand. 2008 Sep;118(3):182-8. Epub 2008 May 29.
  • Clinical testing of CSF circulation. Czosnyka Z, Czosnyka M, Lavinio A, Keong NC, Pickard JD. Eur J Anaesthesiol Suppl. 2008;42:142-5.
  • Ventriculostomy for control of raised ICP in acute traumatic brain injury. Timofeev I, Dahyot-Fizelier C, Keong NC, Nortje J, Al-Rawi PG, Czosnyka M, Menon DK, Kirkpatrick PJ, Gupta AK, Hutchinson PJ. Acta Neurochir Suppl. 2008;102:99-104.
  • Pulse pressure waveform in hydrocephalus: what it is and what it isn’t. Czosnyka M, Czosnyka Z, Keong NC, Lavinio A, et al. Neurosurgical Focus. 2007;22(4):E2.
  • Neurosurgical history: comparing the management of penetrating head injury in 1969 with 2005. Keong NC, Gleave JR, Hutchinson PJ. Br J Neurosurg. 2006 Aug;20(4):227-32.
  • Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation. Keong NC, Ricketts D, Alakeson N, Rust P. Annals of the Royal College of Surgeons. 2004; 86: 174-176. Journal of Bone and Joint Surgery (accepted presentation abstract).
  • In vitro biopsy of colorectal carcinoma. Lavelle MA, Keong NC, Berresford PA. Colorectal Disease. 2004;6(5):320-322.
  • The hidden burden: referral workload in neurosurgery. Keong NC, Critchley G. British Journal of Neurosurgery. 2003;17(4). Proceedings: 384 (presentation abstract).
  • Asymptomatic cervical spondylosis in multiple sclerosis. Keong NC, Beveridge CJ, Coulthard A, Bates D. British Journal of Radiology. 1999:72 (Supplement) 75 (Poster).
  • Cognitive impairment and survival in very elderly people. Forster P, Heckford E, Hucker C, Keong NC. BMJ. 1998;316:1973 (Letter).

Research Trials

  • SERENDIPITI - Surgical Exploration of REversible Normal pressure hydrocephalus vs Decline due to Injury Post-Intracranial pressure, Trauma or Intracranial haemorrhage
  • NEURON-NPH – NEurodegeneration and Understanding of Risk Overlay in Neuroimaging- an NPH study
  • NEURON-NPH – NEurodegeneration and Understanding of Risk Overlay in Neuroimaging- a TBI study
  • FB-NPH – Fluid biomarkers in the Characterisation of Normal Pressure Hydrocephalus
  • RescueASDH – Randomised Evaluation of Surgery with Craniectomy for patients Undergoing Evacuation of Acute SubDural Haematoma (Singapore site for international study)
  • PRECIPICE - Patterns of REversible Cord Injury Pre- & Post-Intervention in the CErvical spine