A5041697994- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Retinal Development and Disorders
- Neurosurgical Procedures and Complications
- Neuroscience and Neuropharmacology Research
- Photoreceptor and optogenetics research
- Glaucoma and retinal disorders
- Cerebrovascular and Carotid Artery Diseases
- Spine and Intervertebral Disc Pathology
- Cerebrospinal fluid and hydrocephalus
- Intraoperative Neuromonitoring and Anesthetic Effects
- Spinal Fractures and Fixation Techniques
- Vascular Malformations Diagnosis and Treatment
- Retinal Imaging and Analysis
- Cervical and Thoracic Myelopathy
- Acute Ischemic Stroke Management
- Ion channel regulation and function
- Neonatal Health and Biochemistry
- Connexins and lens biology
- Neurological disorders and treatments
- Trace Elements in Health
- Moyamoya disease diagnosis and treatment
- Neuropeptides and Animal Physiology
- Intracerebral and Subarachnoid Hemorrhage Research
- Nicotinic Acetylcholine Receptors Study
RWTH Aachen University
2016-2024
University of Cologne
2010-2024
Universitätsklinikum Aachen
2021-2023
Städtisches Klinikum Solingen
2010-2018
OBJECTIVE The current definition of delayed cerebral ischemia (DCI) is based on clinical characteristics precluding its use in patients with poor-grade subarachnoid hemorrhage (SAH). Additional concepts to evaluate the unconscious patient are required. Invasive neuromonitoring (INM) may allow timely detection metabolic and oxygenation crises before irreversible damage has occurred. METHODS authors present a cohort analysis all consecutive SAH referred single tertiary care center between 2010...
Chronic subdural hematomas (cSDHs) constitute one of the most prevalent intracranial disease entities requiring surgical treatment. Although mostly taking a benign course, recurrence after treatment is common and associated with additional morbidity costs. Aim this study was to develop hematoma-specific characteristics risk recurrence. All consecutive patients treated for cSDH in single university hospital between 2015 2019 were retrospectively considered inclusion. Size, volume, midline...
Background: Targeting a cerebral perfusion pressure optimal for autoregulation (CPPopt) has been gaining more attention to prevent secondary damage after acute neurological injury. Brain tissue oxygenation (PbtO 2 ) can identify insufficient blood flow and brain Defining the relationship between CPPopt PbtO aneurysmal subarachnoid hemorrhage may result in (1) mechanistic insights into whether how CPPopt-based strategies might be beneficial (2) establishing support use of as an adjunctive...
Background: The implementation of rescue efforts for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage remains largely empirical a lack supporting evidence, while the associated risk profile is also unclear. Objective: present study evaluates safety and efficacy endovascular treatment (ERT: continuous intraarterial nimodipine, IAN; transcutaneous balloon angioplasty, TBA). Methods: In this prospective observational study, we assessed periprocedural complications side effects...
The recommendation of induced hypertension for delayed cerebral ischemia treatment after aneurysmal subarachnoid hemorrhage has been challenged recently and ideal pressure targets are missing. A new concept advocates an individual perfusion where autoregulation functions best to ensure optimal global perfusion. We characterized at time tested the conformity with this target value.Retrospective analysis prospectively collected data.University hospital neurocritical care unit.Thirty-nine...
Abstract Background Cerebral autoregulation (CA) can be impaired in patients with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) . The Pressure Reactivity Index (PRx, correlation of blood pressure and intracranial pressure) Oxygen (ORx, perfusion brain tissue oxygenation, PbtO 2 ) are both believed to estimate CA. We hypothesized that CA could poorer hypoperfused territories during DCI ORx PRx may not equally effective detecting such local variances. Methods...
Abstract BACKGROUND: Critical hypoperfusion and metabolic derangement are frequently encountered with refractory vasospasm. Endovascular rescue therapies (ERT) have proven beneficial in selected cases. However, angioplasty (AP) intraarterial lysis (IAL) measures of last resort prospective, quantitative results regarding the efficacy (cerebral oxygenation, metabolism) largely lacking. OBJECTIVE: To evaluate ERTs for medically vasospasm using multimodal, continuous event neuromonitoring....
Abstract Background Delayed cerebral ischemia (DCI) is one of the main determinants clinical outcome after aneurysmal subarachnoid hemorrhage (SAH). The classical description risk for DCI over time currently based on outdated concept angiographic vasospasm. goal this study was to assess temporal profile DCI, defined by extended and radiological criteria, as well impact point onset has outcome. Methods All patients with SAH referred a single tertiary care center between 2010 2018 were...
Abstract Background Good-grade aneurysmal subarachnoid hemorrhage (Hunt and Hess 1–2) is generally associated with a favorable prognosis. Nonetheless, patients may still experience secondary deterioration due to delayed cerebral ischemia (DCI), contributing poor outcome. In those patients, neurological assessment challenging invasive neuromonitoring (INM) help guide DCI treatment. Methods An observational analysis of 135 good-grade SAH referred single tertiary care center between 2010 2018...
Abstract Purpose Decompressive hemicraniectomy (DHC) is a potentially lifesaving procedure in refractory intracranial hypertension, which can prevent death from brainstem herniation but may cause survival disabled state. The spectrum of indications expanding, and we present long-term results series patients suffering aneurysmal subarachnoid hemorrhage (SAH). Methods We performed retrospective analysis previously registered data including all treated for SAH between 2010 2018 single...
Rescue treatment for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage can include induced hypertension (iHTN) and, in refractory cases, endovascular approaches, of which selective, continuous intraarterial nimodipine (IAN) is one variant. The combination iHTN and IAN dramatically increase vasopressor demand. In case unsustainable doses, often prioritized over IAN. However, evidence this regard largely lacking. We investigated the effects a classical (iHTN+IAN) modified (IANonly)...
For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences the impact clinical routines outcome in a prospectively collected data set.We observed 150 consecutive patients undergoing craniotomy recorded technical variables...
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) initiates a deleterious cascade activating multiple inflammatory processes, which can contribute to delayed cerebral ischemia (DCI). Procalcitonin (PCT) is an established marker for sepsis treatment monitoring, and its time course in the context of DCI after aSAH remains unclear. The aim this trial was assess predictive confirmative value PCT levels DCI. METHODS All patients admitted authors’ institution with between 2014 2018 were...
Abstract. Purpose: NiCl 2 (15 μM) stimulates the electroretinogram (ERG) b‐wave amplitude of vertebrate retina up to 1.5‐fold through its blocking E/R‐type voltage‐gated Ca 2+ channels. Assuming that such an increase is mediated by release inhibitory neurotransmitter γ‐aminobutyric acid (GABA) via ionotropic GABA receptors, we tested effect both itself and GABA‐receptor antagonists as (−)bicuculline (1.51‐fold increase) (1,2,5,6‐tetrahydropyridin‐4‐yl)methylphosphinic (TPMPA; 1.46‐fold on...
Background Anterior cervical diskectomy and fusion (ACDF) or posterior foraminotomy (PF) are standard treatment options for radiculopathy due to disk prolapse. Which method produces superior results has not yet been established. One reason the dilemma, among others, is a lack of detailed outcome analysis in previous studies. We quantified compare both methods our retrospective single-center series. Method conducted 107 patients with who were operated on via ACDF PF. Demographic data,...