ASNR: the silver anniversary. Neuroradiology: the next 25 years.

The President of the American Society of Neuroradiology (ASNR), Derek Harwood-Nash, asked me as founder of the Society to write an essay on the occasion of its 25th anniversary. I am extremely happy and highly honored to respond to this request but wonder if I can do justice to such an important occasion . The founding of the ASNR in 1962 was an important step in the development of neuroradiology in the United States and in a broader sense in the development of subspecialization within radiology in this country. Before 1962, Ernest Wood, the director of radiology at the Neurological Institute of New York, was the only full-time neuroradiologist in the United States, and after his departure in 1952 (to become Chairman of the Department of Radiology at the University of North Carolina in Chapel Hill) I was appointed director of the Department and again became virtually the only practicing fulltime neuroradiologist in the country. This continued for several years and, slowly, partly because of the stimulus engendered by the IV Symposium Neuroradiologicum, which took place in London in 1955, more radiologists in this country became interested in the subspecialty and some of them sought training outside the United States. In the late 1950s, Torgny Greitz, from Sweden, was invited to come to the Mallinckrodt Institute of Radiology at Washington University in St. Louis to spend a couple of years practicing and teaching neuroradiology. At that time, neuroradiology in Europe, particularly in Sweden, was far more developed than in the United States, and training opportunities were available there as well as in England. One reason why neuroradiology was not developed at that time in the United States was that the concept of subspecialization within radiology was really nonexistent and generally opposed by most chairmen of radiology departments [1] . It was obvious that neuroradiology could not grow as a subspecialty until the chairmen of radiology departments around the country accepted the need for such development. The same applied to other subspecialties within radiology . One important factor that slowed the development of neuroradiology was the need to perform invasive procedures such as angiography, pneumoencephalography, and myelography. Because radiologists were not accustomed to performing invasive procedures, these were carried out by the neurosurgeons and sometimes by the neurology residents in training who wanted to acquire the skills to perform such procedures. The idea that radiologists were capable of developing these skills had yet to be established and put into practice. A significant development in the early 1960s was the introduction of training programs in clinical neurology financed by the National Institutes of Health through the then National Institute of Neurological Diseases and Blindness (NINDB). At that t ime there was no opportunity for an individual who had completed full training in diagnostic radiology to obtain postresidency fellowship training because no financing was available from hospitals. Following the model established in cl inical neurology, the NINDB provided an opportunity to establish training programs in neuroradiology by offering special training fellowships to individuals who had completed full training in diagnostic radiology. I was fortunate to have been able to establish the first training program in the United States at the Neurological Institute, Columbia Presbyterian Medical Center, in New York; the second was established almost simultane-