A5081004828- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- Optical Imaging and Spectroscopy Techniques
- Zebrafish Biomedical Research Applications
- Cerebrospinal fluid and hydrocephalus
- Neurosurgical Procedures and Complications
- Traumatic Brain Injury Research
- Vestibular and auditory disorders
- Cardiac Arrest and Resuscitation
- Acute Ischemic Stroke Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Heart Rate Variability and Autonomic Control
- Hearing, Cochlea, Tinnitus, Genetics
- Fish Ecology and Management Studies
- Pharmacological Effects and Toxicity Studies
- Intensive Care Unit Cognitive Disorders
- Ophthalmology and Eye Disorders
- Functional Brain Connectivity Studies
- Epilepsy research and treatment
- Takotsubo Cardiomyopathy and Associated Phenomena
- S100 Proteins and Annexins
- Injury Epidemiology and Prevention
- Retinal Development and Disorders
- Neuroscience and Neuropharmacology Research
- Mind wandering and attention
University of Cambridge
2023-2025
University Hospital of Zurich
2016-2025
University of Zurich
2016-2025
Addenbrooke's Hospital
2024-2025
Universidad de Cantabria
2024
Marqués de Valdecilla University Hospital
2024
Instituto de Investigación Marqués de Valdecilla
2024
Center for Pediatric Endocrinology Zurich
2020
The primary aim was to explore the association of global cerebral physiological variables including intracranial pressure (ICP), cerebrovascular reactivity (PRx), perfusion (CPP), and deviation from PRx-based optimal CPP value (∆CPPopt; actual CPP-CPPopt) in relation brain tissue oxygenation (pbtO2) traumatic injury (TBI).A total 425 TBI patients with ICP- pbtO2 monitoring for at least 12 h, who had been treated neurocritical care unit, Addenbrooke's Hospital, Cambridge, UK, between 2002...
The first aim was to investigate the combined effect of insult intensity and duration pressure reactivity index (PRx) deviation from autoregulatory cerebral perfusion target (∆CPPopt = actual CPP - optimal [CPPopt]) on outcome in traumatic brain injury. second determine if PRx influenced association between intracranial (ICP), CPP, ∆CPPopt with outcome.
Abstract Background The primary aim was to explore the concept of isolated and combined threshold-insults for brain tissue oxygenation (pbtO 2 ) in relation outcome traumatic injury (TBI). Methods A total 239 TBI patients with data on clinical (GOS) intracranial pressure (ICP) pbtO monitoring at least 12 h, who had been treated neurocritical care unit, Addenbrooke’s Hospital, Cambridge, UK, between 2002 2022 were included. Outcome dichotomised into favourable/unfavourable (GOS 4–5/1–3)...
Zebrafish is an established animal model for the reproduction and study of neurobiological pathogenesis human neurological conditions. The 'startle reflex' in zebrafish larvae evolutionarily preserved defence response, manifesting as a quick body-bend reaction to sudden sensory stimuli. Changes startle reflex habituation characterise several neuropsychiatric disorders hence represent informative index neurophysiological health. This aimed at establishing simple reliable experimental protocol...
Sex-related differences in patients with spontaneous, non-traumatic intracerebral hemorrhage (ICH) are poorly investigated so far. This study elucidates whether sex-related ICH care a neurocritical setting exist, particularly regarding provided care, while also taking patient characteristics, and outcomes into account.This retrospective single center includes all consecutive spontaneous admitted to the unit 10-year period. Patients' demographics, comorbidities, symptoms at presentation,...
Abstract Background New onset refractory status epilepticus (NORSE) is a neurologic emergency without an immediately identifiable cause. The complicated and long ICU stay of the patients can lead to perceiving prolongation therapies as futile. However, recovery possible even in severe cases. This retrospective study investigates treatments, short- long-term outcome ethical decisions case series with NORSE. Methods Overall, 283 adults were admitted (SE) Neurocritical Care Unit University...
Abstract Background The oxygen reactivity index (ORx) reflects the correlation between focal brain tissue (pbtO 2 ) and cerebral perfusion pressure (CPP). Previous, small cohort studies were conflicting on whether ORx conveys autoregulatory information if it is related to outcome in traumatic injury (TBI). Thus, we aimed investigate these issues a larger TBI cohort. Methods 425 patients with intracranial (ICP)- pbtO -monitoring for at least 12 h, who had been treated Addenbrooke’s Hospital,...
Abstract Background Although older traumatic brain injury (TBI) patients often exhibit cerebral autoregulatory impairment with high pressure reactivity index (PRx), the role of autoregulatory-guided management in these remains elusive. In this study, we aimed to explore if age affected prognostic variables, PRx and PRx-derived optimal perfusion (CPPopt), a large TBI cohort. Methods observational 550 who had been treated neurocritical care unit, Addenbrooke’s Hospital, Cambridge, UK, between...
A bstract Cerebrovascular autoregulation (CAR) maintains stable cerebral perfusion by adjusting arteriole diameters in response to slow pressure fluctuations. Various CAR correlation coefficients—PRx (based on intracranial pressure—ICP), Mx transcranial doppler—TCD), and COx/THx near‐infrared spectroscopy—NIRS)—are used interchangeably despite fundamental differences. 566 hours of ICP, NIRS, TCD data from 38 traumatic brain injury (TBI) patients were assessed. The intercorrelation between...
We aimed to evaluate the association between seizures as divided by timing and type (seizures or status epilepticus) outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH).All consecutive aSAH admitted neurocritical care unit of University Hospital Zurich 2016 2020 were included. Seizure frequency extracted from electronic patient files.Out 245 patients, 76 experienced acute symptomatic seizures, 39 experiencing at onset, 18 19 nonconvulsive epilepticus (NCSE). Multivariate...
Targeting single monitoring modalities such as intracranial pressure (ICP) or cerebral perfusion alone has shown to be insufficient in improving outcome after traumatic brain injury (TBI). Multimodality (MMM) allows for a more complete description of function and individualized management. Transcranial Doppler (TCD) represents the gold standard continuous blood flow velocity assessment, but requires high levels skill time. In TBI, practical aspects conducting extended TCD sessions have yet evaluated.
Sex-related differences in patients with aneurysmal subarachnoid hemorrhage (aSAH) exist. More females than males are affected. Aneurysm location is associated to sex. The relationship between sex and outcome, however, unclear. Possible management might influence the occurrence of primary secondary brain injury thus outcome. study compares demographics, intensity treatment, complications, outcome among aSAH.All consecutive aSAH admitted neurocritical care unit, University Hospital Zurich...
Detection of delayed cerebral ischemia (DCI) is challenging in comatose patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH). Brain tissue oxygen pressure (PbtO2) monitoring may allow early detection its occurrence. Recently, a probe for combined measurement intracranial (ICP) and intraparenchymal near-infrared spectroscopy (NIRS) has become available. In this pilot study, the parameters PbtO2, Hboxy, Hbdeoxy, Hbtotal rSO2 were measured parallel evaluated their potential to...
Signal complexity (i.e. entropy) describes the level of order within a system. Low physiological signal predicts unfavorable outcome in variety diseases and is assumed to reflect increased rigidity cardio/cerebrovascular system leading (or reflecting) autoregulation failure. Aneurysmal subarachnoid hemorrhage (aSAH) followed by cascade complex systemic cerebral sequelae. In aSAH, value entropy has not been established yet.
Entropy quantifies the level of disorder within a system. Low entropy reflects increased rigidity homeostatic feedback systems possibly reflecting failure protective physiological mechanisms like cerebral autoregulation. In traumatic brain injury (TBI), low heart rate and intracranial pressure (ICP) predict unfavorable outcome. Based on hypothesis that is dynamically changing process, we explored origin value time trends.
Most cases with new onset refractory status epilepticus (NORSE) remain cryptogenic despite extensive diagnostic workup. The aim of this study was to analyze the etiology and clinical features NORSE investigate known or potentially novel autoantibodies in (cNORSE). We retrospectively assessed medical records adults at a Swiss tertiary referral center between 2010 2021. Demographic, diagnostic, therapeutic, outcome parameters were characterized. performed post hoc screening for including...
In patients with myocardial infarction, atypical symptoms at onset have been demonstrated in women. We aimed to investigate the presence of sex-related differences symptom presentation aneurysmal subarachnoid hemorrhage (aSAH) enable earlier diagnosis and treatment.
Abstract The startle reflex in larval zebrafish describes a C-bend of the body occurring response to sudden, unexpected, stimuli different sensory modalities. Alterations habituation (SRH) have been reported various human and animal models neurological psychiatric conditions are hence considered an important behavioural marker neurophysiological function. amplitude, offset decay constant auditory SRH recently characterised, revealing that measures affected by variation vibratory frequency,...
The limitation of life sustaining treatments (LLST) causes ethical dilemmas even in patients faced with poor prognosis, which applies to many admitted a Neurocritical Care Unit (NCCU). effects social and cultural aspects on LLST an NCCU population remain poorly studied. All between 01.2018 08.2021 were included. Medical records reviewed for: demographics, diagnosis, severity disease, outcome. Advance directives (AD) discussions evaluating timing, degree, reason for LLST. Social/cultural...
Abstract Background In the general intensive care unit (ICU) women receive invasive mechanical ventilation (IMV) less frequently than men. We investigated whether sex differences in use of IMV also exist neurocritical (NCCU), where patients are intubated not only due to respiratory failure but neurological impairment. Methods This retrospective single-centre study included adults admitted NCCU University Hospital Zurich between January 2018 and August 2021 with or neurosurgical main...
Abstract Background The prevalence of dizziness increases with age. We aimed to determine the point and, in particular, benign paroxysmal positional vertigo (BPPV) among retirement home residents. Furthermore, we evaluate efficacy a 2-axis turntable based BPPV treatment. Methods contacted all large homes or around city Zurich (Switzerland). 10 (with total 536 residents) agreed participate this study. 83 rejected inquiries by residents led potential study population 453 After structured...
A mild traumatic brain injury is a neurological dysfunction caused by biomechanical forces transmitted to the in physical impacts. The current understanding of neuropathological cascade resulting manifested clinical signs and symptoms limited due absence sensitive imaging methods. Zebrafish are established models for reproduction study neurobiological pathologies. However, all available mostly recreate moderate-to-severe focal injuries adult zebrafish. present work has induced trauma larval...