Vedran Deletis, MD PhD 1946–2023

Shortly after finishing the paper on the History of Intraoperative Neurophysiology for this year’s Child’s Nervous System Annual Issue, on September 12th, I received the shocking news that Dr. Vedran Deletis suddenly passed away in Stari Grad, Croatia, at the age of 77. His passing leaves the feeling of an unbearable loss not only for the worldwide neuromonitoring community but also for many neurosurgeons who had the privilege of meeting him.

Vedran Deletis was unanimously considered one of the fathers of modern Intraoperative Neurophysiology and his contribution to this field will probably remain unsurpassed for many years to come.

He was trained as a Neurologist and Neurophysiologist first in Sarajevo, and then as a Fellow at the Baylor College of Medicine in Houston, with Prof. Milan Dimitrijevic.

In 1987, Dr. Deletis was invited to New York City to join the Pediatric Neurosurgery team at the New York University (NYU), led by Fred Epstein. At that time, operating on intramedullary spinal cord tumors as well as brainstem tumors was still considered being in the front line of Neurosurgery. Dr. Deletis was hence recruited with the main goal of improving the safety of these and other challenging neurosurgical procedures, implementing intraoperative neurophysiology techniques. In 1996, he then followed Fred Epstein and Rick Abbott at the Institute for Neurology and Neurosurgery (INN) where he worked until the late 2000s before moving back to his homeland, in Split.

First at NYU and then at the INN, Deletis established a unique fellowship program in Intraoperative Neurophysiology where not only neurophysiologists but also neurosurgeons from all over the world were trained (Fig. 1). Some of them, like Nobuhito Morota and Karl Kothbauer, engaged in both an Intraoperative Neurophysiology and a Pediatric Neurosurgery Fellowship, others trained with Fred in Pediatric Neurosurgery while enjoying the golden age of neuromonitoring or—like me—trained in Intraoperative Neurophysiology with the opportunity to observe pediatric neurosurgical procedures on a daily basis.

Fig. 1

Vedran Deletis with some of his former fellows from NYU and INN during the Gala Dinner of the last New York Symposium in Intraoperative Neurophysiology in 2006. From left to right: Sedat Ulkatan (neurophysiologist), Isabel Fernandez-Conejero (neurophysiologist), Klaus Novak (neurosurgeon), Vedran Deletis, Francesco Sala (neurosurgeon), Jay Shils (neurophysiologist), Nobuhito Morota (neurosurgeon), and Andrea Szelenyi (neurophysiologist)

This unique liaison between Pediatric Neurosurgery and Intraoperative Neurophysiology (Fig. 2) turned out as a win-to-win opportunity also from a scientific standpoint, with a number of seminal papers in the field of neuromonitoring coming out from the “New York School.”

Fig. 2

Vedran Deletis chairing the session and Fred Epstein introducing the third New York Symposium in Intraoperative Neurophysiology in 2002

Dr. Deletis’ innate curiosity, deep knowledge of the nervous system, and methodological rigor resulted in the introduction of novel neuromonitoring techniques—or implementation of pre-existing ones—which had a remarkable impact in the neurosurgical practice. He found in Fred Epstein and Rick Abbott great supporters and loyal partners to develop the field of intraoperative neurophysiology in Neurosurgery and particularly in Pediatric Neurosurgery.

D-wave monitoring in intramedullary spinal cord tumor surgery, direct mapping of the cerebral peduncle, and the refinement of other brainstem mapping techniques, corticobulbar motor evoked potentials for motor cranial nerves, monitoring of the bulbocavernosus reflex during surgery in the conus–cauda region, and mapping of pudendal afferents during selective dorsal rhizotomy are just a few of the neuromonitoring techniques which came out from that partnership.

In 2004, after more than fifteen years working back to back in the operating room, Fred stated that “Intraoperative neurophysiological monitoring is likely one of the major achievement in modern neurosurgery,” paving the way for a growing recognition of this new discipline.

In 2005, Vedran Deletis was the Founder and first President of the International Society of Intraoperative Neurophysiology (Fig. 3), and upon returning to Europe, he continued to remain actively involved in the field with appointments in Zagreb, Split, visiting professorships at several European neurosurgical centers, and tireless commitment to travel worldwide to provide education in the field of neuromonitoring.

Fig. 3

Vedran Deletis and other past Presidents of the International Society of Intraoperative Neurophysiology, at the Seoul Meeting in 2017. From left to right: Francesco Sala, Karl Kothbauer, Francisco Soto Silva, David MacDonald, Vedran Deletis, Andrea Szelenyi, and Jay Shils

Just three days before his sudden passing, he conveyed a small workshop in Stari Grad, his secluded home town in the Croatian island of Hvar, to discuss with some of his former fellows and colleagues novel techniques to improve the safety of neurosurgical procedures. The last words I’ve got from him, while connecting via zoom during the workshop, were about details to implement a technique for monitoring the dentate-thalamo-cortical pathway and possibly predict and prevent cerebellar mutism. He was, once again, back to Pediatric Neurosurgery.

For those who had the privilege to know the man behind the scientist, Vedran was a very personable gentleman, with a unique attitude towards mentoring and caring for people, with humbleness, generosity, frankness, and intellectual honesty.

One of his favorite mottos was “Ars long, vita brevis,” reflecting the awareness of how intrinsically limited we are in understanding and developing not just the Art of Medicine but any “Art.” His life was not “brevis” but certainly prematurely lost considering how passionately active he still was in the field of neuromonitoring. Certainly, his legacy in the art of understanding and protecting the nervous system is here to stay, thanks also to the contribution of many neurosurgeons who will continue to use and implement his neuromonitoring techniques, for which we are very grateful. We lost a truly outstanding neuroscientist and, for those who had the privilege to know him personally, a special colleague, mentor, and friend.