A5065953606- Neurosurgical Procedures and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Intracranial Aneurysms: Treatment and Complications
- Cerebrospinal fluid and hydrocephalus
- Spinal Dysraphism and Malformations
- Hemoglobin structure and function
- Neuroinflammation and Neurodegeneration Mechanisms
- Memory and Neural Mechanisms
- Anesthesia and Pain Management
- Cardiac, Anesthesia and Surgical Outcomes
- Vascular Malformations Diagnosis and Treatment
- Meningioma and schwannoma management
- Medical Malpractice and Liability Issues
- Spine and Intervertebral Disc Pathology
- Neuroscience and Neuropharmacology Research
- Spinal Hematomas and Complications
- Acute Ischemic Stroke Management
- Head and Neck Surgical Oncology
- Heme Oxygenase-1 and Carbon Monoxide
- Cerebrovascular and Carotid Artery Diseases
- Pain Management and Opioid Use
- Mobile Health and mHealth Applications
- Cerebral Venous Sinus Thrombosis
- Surgical Simulation and Training
University Hospital Southampton NHS Foundation Trust
2016-2025
Southampton General Hospital
2024-2025
Essex Cardiothoracic Centre
2016-2024
University of Southampton
2019-2020
Warwick Hospital
2013-2014
Chronic subdural hematoma is a common neurologic disorder that especially prevalent among older people. The effect of dexamethasone on outcomes in patients with chronic has not been well studied.
Traumatic acute subdural hematomas frequently warrant surgical evacuation by means of a craniotomy (bone flap replaced) or decompressive craniectomy not replaced). Craniectomy may prevent intracranial hypertension, but whether it is associated with better outcomes unclear. Download PDF the Research Summary. We conducted trial in which patients undergoing surgery for traumatic hematoma were randomly assigned to undergo craniectomy. An inclusion criterion was bone an anteroposterior diameter...
Abstract After subarachnoid haemorrhage, prolonged exposure to toxic extracellular haemoglobin occurs in the brain. Here, we investigate role of neurotoxicity vivo and its prevention. In humans after cerebrospinal fluid was associated with neurofilament light chain, a marker neuronal damage. Most not complexed haptoglobin, an endogenous scavenger present at very low concentration Exogenously added haptoglobin bound most uncomplexed haemoglobin, first 2 weeks human indicating wide therapeutic...
Functional outcome after subarachnoid haemorrhage has traditionally been assessed using scales developed for other neurological conditions. The modified Rankin score and Glasgow Outcome Scale are most commonly used. Employment of these in is hampered by well recognized limitations. We set out to develop validate a new condition-specific tool (SAHOT). Items addressing diverse aspects the impact were collected during focus groups involving patients, next-of-kin multidisciplinary professionals...
OBJECTIVE Chronic subdural hematoma (CSDH) is among the most common neurosurgical conditions. Patient selection for surgical intervention often complex and multifactorial. The objective of this study was to examine predictors clinical outcomes, complications, hospital length stay (LOS) in patients with burr hole drainage CSDH. METHODS A retrospective electronic database search performed between January 2009 2020 at a single tertiary referral unit. Adult treated evacuation CSDH extractable...
Abstract The molecular processes underlying the aging-related decline in cognitive performance and memory observed humans are poorly understood. Studies rodents have shown a decrease N-methyl-D-aspartate receptors (NMDARs) that contain GluN2B subunit aging synapses, this is correlated with impaired functions. However, age-dependent contribution of GluN2B-containing to synaptic transmission human cortical synapses has not been previously studied. We investigated GluN2A NMDARs adult neurons...
Background Chronic subdural haematoma is a collection of ‘old blood’ and its breakdown products in the space predominantly affects older people. Surgical evacuation remains mainstay management symptomatic cases. Objective The Dex-CSDH (DEXamethasone SubDural Haematoma) randomised trial investigated clinical effectiveness cost-effectiveness dexamethasone patients with chronic haematoma. Design This was parallel, superiority, multicentre, pragmatic, controlled trial. Assigned treatment...
Introduction Subarachnoid haemorrhage (SAH) from a ruptured cerebral aneurysm carries high morbidity and mortality. Despite huge advances in techniques to secure the aneurysm, there has been little progress treatment of deleterious effects haemorrhage. Sulforaphane is an Nrf2 inducer with anti-oxidant anti-inflammatory properties. It shown improve clinical outcome experimental models SAH, but unstable. SFX-01 (Evgen Pharma) novel composition comprised synthetic sulforaphane stabilised within...
Abstract To improve outcome prediction following subarachnoid haemorrhage (SAH), we sought a biomarker integrating early brain injury and multiple secondary pathological processes in prospective study of 42 non-traumatic SAH patients 19 control individuals. Neurofilament light (NF-L) was elevated CSF serum SAH. NF-L on Days 1–3 post-SAH strongly predicted modified Rankin score at 6 months, independent World Federation Neurosurgical Societies (WFNS) score. from Day 4 onwards also had profound...
Abstract SFX-01 is a novel drug for clinical delivery of sulforaphane (SFN). SFN potent nuclear factor erythroid 2-related 2 activator that reduces inflammation and oxidation, improving outcomes after subarachnoid haemorrhage (SAH) in animal models. This was multi-centre, double-blind, placebo-controlled, parallel-group randomised trial to evaluate the safety, pharmacokinetics efficacy 28 days 300 mg BD patients aged 18–80 with spontaneous SAH high blood load on CT. Primary were (1) (2)...
A common neurosurgical condition, chronic subdural haematoma (cSDH) typically affects older people with other underlying health conditions. The care of this potentially vulnerable cohort is often, however, fragmented and suboptimal. In complex conditions, multidisciplinary guidelines have transformed patient experience outcomes, but no such framework exists for cSDH. This paper outlines a protocol to develop the first comprehensive guideline from diagnosis long-term recovery
Abstract The Dex-CSDH trial is a randomised, double-blind, placebo-controlled of dexamethasone for patients with symptomatic chronic subdural haematoma. commenced an internal pilot, whose primary objective was to assess the feasibility multi-centre recruitment. Primary outcome data collection and safety were also assessed, whilst maintaining blinding. We aimed recruit 100 from United Kingdom Neurosurgical Units within 12 months. Trial participants randomised 2-week course or placebo in...
Objective After aneurysmal subarachnoid haemorrhage (aSAH), extracellular haemoglobin (Hb) in the space is bound by haptoglobin, neutralising Hb toxicity and helping its clearance. Two exons HP gene (encoding haptoglobin) exhibit copy number variation (CNV), giving rise to HP1 HP2 alleles, which influence haptoglobin expression level possibly function. We hypothesised that CNV associates with long-term outcome beyond first year after aSAH. Methods The was typed using quantitative PCR 1299...
This study aimed to describe the relationship between blood and CSF volumes in different compartments on baseline CT after aSAH, assess if they independently predict long-term outcome, explore their interaction with age. scans from patients participating a prospective multicenter randomized controlled trial of aSAH were segmented for volumes. The primary outcomes mRS, Subarachnoid Hemorrhage Outcome Tool (SAHOT) at day 28 180. Univariate regressions conducted identify significant predictors...
A chronic subdural haematoma (cSDH) is an encapsulated collection of fluid and blood degradation products in the space. It increasingly common, affecting older people those living with frailty. Currently, no guidance exists to define optimal care from onset symptoms through recovery. This paper presents first consensus-built recommendations for best practice cSDH, co-designed support each stage patient pathway. Guideline development was led by a multidisciplinary Steering Committee...
The work presented in this paper is focused on the use of spectroscopy to identify type tissue human brain samples employing support vector machine classifiers. Two different spectrometers were used acquire infrared spectroscopic signatures wavenumber range between 1200⁻3500 cm-1. An extensive analysis was performed find optimal configuration for a classifier and determine most relevant regions spectra particular application. results demonstrate that developed algorithm robust enough...