A5083467074- Neurosurgical Procedures and Complications
- Head and Neck Surgical Oncology
- Spinal Hematomas and Complications
- Cerebrospinal fluid and hydrocephalus
- Intracerebral and Subarachnoid Hemorrhage Research
- Glioma Diagnosis and Treatment
- Cerebral Venous Sinus Thrombosis
- Traumatic Brain Injury and Neurovascular Disturbances
- Meningioma and schwannoma management
- Vascular Malformations Diagnosis and Treatment
- Epilepsy research and treatment
- Soft tissue tumor case studies
- Spine and Intervertebral Disc Pathology
- Intracranial Aneurysms: Treatment and Complications
- Spinal Fractures and Fixation Techniques
- Pituitary Gland Disorders and Treatments
- Pharmacological Effects and Toxicity Studies
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Sarcoidosis and Beryllium Toxicity Research
- Spinal Dysraphism and Malformations
- Adrenal and Paraganglionic Tumors
- Ear Surgery and Otitis Media
- Fetal and Pediatric Neurological Disorders
- Inhalation and Respiratory Drug Delivery
- Soft tissue tumors and treatment
University Medical Center Freiburg
2014-2025
University of Freiburg
2015-2025
Kaiser Permanente Santa Clara Medical Center
2024
University of Bern
2024
Hospital for Special Surgery
2024
University Hospital of Bern
2024
Cornell University
2024
University of Colorado Anschutz Medical Campus
2024
Cedars-Sinai Medical Center
2024
University of California, San Francisco
2024
Type 2 spinal cerebrospinal fluid leaks in patients with spontaneous intracranial hypotension occur after lateral dural tears through which the arachnoid herniates, is visible on MRI scans (ie, “bud-on-branch” sign).
Rationale: Previous studies suggest an important immunoregulatory role of vasoactive intestinal peptide (VIP) in experimental models chronic noninfectious inflammation. Sarcoidosis is characterized by noncaseating epitheloid cell granulomas, where excessive tumor necrosis factor-α production pulmonary macrophages plays a critical granuloma formation and disease progression, which may lead to fatal organ dysfunction.Objectives: To test whether inhaled VIP has role. Sarcoid alveolitis was used...
Spontaneous intracranial hypotension (SIH) caused by a spinal CSF leak is multisymptom syndrome, which can dramatically affect physical and mental health. However, systematic data on health-related quality of life (HRQoL) health are scarce. We hypothesized that surgical treatment leads to significant sustained improvements in HRQoL patients with SIH.
Abstract Background & purpose Around 5% of dementia patients have a treatable cause. To estimate the prevalence two rare diseases, in which cause is at spinal level. Methods A radiology information system was searched using terms CT myelography and operation classification (OPS) code 3-241. The clinical charts these were reviewed to identify with significant cognitive decline. Results Among 205 spontaneous intracranial hypotension (SIH) proven CSF leaks we identified five so-called...
Spontaneous intracranial hypotension (SIH) is a disease presenting mostly with orthostatic head and neck pain due to spontaneous cerebrospinal fluid (CSF) leak or CSF-venous fistula in the spinal region. It demonstrates typical MRI findings sagging of brain causing tension meninges sometimes cranial nerves. shares some clinical similarities post puncture headache but differs its pathophysiological cause, diagnosis, treatment. Many patients remain misdiagnosed wait too long for correct...
Spinal CSF leaks cause spontaneous intracranial hypotension (SIH). Surgical closure of spinal is the treatment choice for persisting leaks. approaches vary, and there are no studies in which minimally invasive techniques were used. In this study, authors aimed to detail safety feasibility microsurgical sealing using nonexpandable tubular retractors.
Cerebrospinal fluid (CSF)-venous fistulas (CVFs) are increasingly identified as a cause of spontaneous intracranial hypotension (SIH). Lateral decubitus digital subtraction myelography (LD-DSM) and CT (LD-CTM) mainly used for detection, but the most sensitive method is yet unknown.
Background Cerebrospinal fluid (CSF) loss in spontaneous intracranial hypotension (SIH) is accompanied by volume shifts between the compartments. This study investigated tricompartimental and longitudinal after closure of a CSF leak. Methods Patients with SIH suitable pre-therapeutic post-therapeutic imaging for volumetric analysis were identified from our tertiary care center 2020 2023. The Bern score was calculated. Pre-interventional post-interventional volumetry encompassed CSF,...
Type 2 CSF leaks are spinal lateral dural tears, causing spontaneous intracranial hypotension (SIH). They may be visualized with digital subtraction myelography (DSM), cone-beam CT (CBCT) myelography, energy-integrating detector or photon-counting myelography. A recently introduced ultrahigh-resolution (UHR-CBCT) has shown beneficial visualization of CSF-venous fistula, another cause SIH. However, the use this technique not yet been reported in imaging type leaks. In technical report, we...
Propionibacterium acnes was found in lungs and lymph nodes of patients with sarcoidosis may induce hypersensitivity type granuloma formation. Data regarding the immune response to P. European sarcoid are scarce. We assessed total IgG IgA amount specific antibodies Staphylococcus aureus, serving as a control, BAL fluid 64 21 healthy volunteers. In subcohort controls, TNF-α GM-CSF production cells stimulated heat-killed were measured. patients, levels significantly elevated compared titres...
Spinal cerebrospinal fluid (CSF) leaks may cause a myriad of symptoms, most common being orthostatic headache. In addition, ventral spinal CSF are possible etiology superficial siderosis (SS), rare condition characterized by hemosiderin deposits in the central nervous system (CNS). The classical presentation SS involves ataxia, bilateral hearing loss, and myelopathy. Unfortunately, treatment options scarce. This study was undertaken to evaluate whether microsurgical closure can prevent...
BACKGROUND AND OBJECTIVES: To systematically describe pertinent, intraoperative anatomic findings encountered when approaching spinal cerebrospinal fluid (CSF) leaks and CSF-venous fistulas in spontaneous intracranial hypotension (SIH). METHODS: In a retrospective study, we included surgically treated patients suffering from SIH at our institution April 2018 to March 2022. Anatomic, data were extracted operative notes supplemented with surgical videos images. Prominent features compared...
Spontaneous intracranial hypotension due to a spinal cerebrospinal fluid leak causes orthostatic headaches and impacts quality of life. Successful closure rates are often reported, whereas data on long-term outcome still scarce.Between April 2020 December 2022 surgically treated patients completed the Headache Impact Test-6 prior surgery at 14 days, three months, six 12 months postoperatively. In addition score, we extracted related symptoms.Eighty were included. Median score preoperatively...
Microsurgical sealing of spinal cerebrospinal fluid (CSF) leaks is a viable treatment option in spontaneous intracranial hypotension (SIH). Several factors may influence the outcome, with symptom duration probably most modifiable variable.
BACKGROUND: Cerebrospinal fluid-venous fistulas (CVFs) are a rare cause of spontaneous intracranial hypotension. Intraoperatively, CVFs not readily identifiable and difficult to differentiate from normal veins. OBJECTIVE: To assess the utility intrathecal fluorescein injection intraoperatively visualize identify CVF. METHODS: We report case series patients treated surgically for After surgical exposure, we injected (5-10 mg) through lumbar catheter, which placed immediately before surgery....
<h3>SUMMARY:</h3> Lateral dural tears as a cause spontaneous intracranial hypotension occur in ∼20% of patients. Common imaging modalities for their detection are lateral decubitus digital subtraction myelography or dynamic CT myelography. Reports on the use conebeam scarce. We show 3 patients whom targeted during was helpful confirming site leak.
Autoimmune and inflammatory mechanisms in psychotic disorders have attracted increasing scientific attention recent years. In this regard, we performed routine cerebrospinal fluid (CSF) basic diagnostics CSF/serum analyses for antibodies directed against neuronal intracellular surface antigens patients. context, the patient presented paper was diagnosed.We present case of a 20-year-old female with first episode drug-induced syndrome but without neurological deficits. Further investigations...
The identification of pathological atrophy in MRI scans requires specialized training, which is scarce outside dedicated centers. We sought to investigate the clinical usefulness computer-generated representations local grey matter (GM) loss or increased volume cerebral fluids (CSF) as normalized deviations (z-scores) from healthy aging either aid human visual readings directly detect atrophy. Two experienced neuroradiologists rated 30 patients with Alzheimer's disease (AD), frontotemporal...
The diagnostic work-up in patients with spontaneous intracranial hypotension (SIH) and spinal longitudinal extradural CSF collection (SLEC) on magnetic resonance imaging (MRI) comprises dynamic digital subtraction myelography (dDSM) prone position for leak detection. Dynamic computed tomography (CT) (dCT-M) follows if the is not unequivocally located. A drawback of dCT‑M a high radiation dose. This study evaluates needs dCT-M examinations measures to reduce doses.Frequency, sites, length...
Abstract Background Patients with spontaneous intracranial hypotension (SIH) report difficulties in concentration and memory. To objectify these deficits, we implemented standard cognitive tests into our routine SIH workup. Method Retrospective, single‐center of among patients consecutively admitted from May to July 2023. Cognitive testing involved the Montreal Assessment (MoCA©, alternate versions, 0–30 points, 30 points for best performance, ≤26 indicating mild impairment at age >64...