A5082050889- Traumatic Brain Injury and Neurovascular Disturbances
- Cerebrospinal fluid and hydrocephalus
- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury Research
- Cardiac Arrest and Resuscitation
- Neurosurgical Procedures and Complications
- Cerebrovascular and Carotid Artery Diseases
- S100 Proteins and Annexins
- Intracerebral and Subarachnoid Hemorrhage Research
- Colorectal Cancer Surgical Treatments
- Craniofacial Disorders and Treatments
- Sepsis Diagnosis and Treatment
- Trauma and Emergency Care Studies
- Advanced MRI Techniques and Applications
- Thermal Regulation in Medicine
- Cleft Lip and Palate Research
- Hemodynamic Monitoring and Therapy
- Acute Ischemic Stroke Management
- Genetic factors in colorectal cancer
- Optical Imaging and Spectroscopy Techniques
- Moyamoya disease diagnosis and treatment
- Bacterial Infections and Vaccines
- Healthcare Technology and Patient Monitoring
- Vascular Malformations Diagnosis and Treatment
- Colorectal and Anal Carcinomas
Uppsala University
2016-2025
Uppsala University Hospital
2016-2025
Swedish Research Council
2010-2017
E Ink (South Korea)
2017
University of Cambridge
1993-2015
Addenbrooke's Hospital
1993-2012
Universitätsklinikum Tübingen
2012
Laerdal (Norway)
2011
Karolinska University Hospital
2010
Karolinska Institutet
2006-2010
Objective To evaluate today's refined neurosurgical intensive care of patients with traumatic brain injury after implementation an organized secondary insult program focused on the importance avoiding damage together a standardized treatment protocol system. Design Clinical observational patient study. Patients A total 154 16–79 yrs age acute head trauma and pathologic computed tomographic findings treated between 1996 1997. Setting Neurointensive unit. Interventions None. Measurements Main...
Microdialysis enables the chemistry of extracellular interstitial space to be monitored. Use this technique in patients with acute brain injury has increased our understanding pathophysiology several neurological disorders. In 2004, a consensus document on clinical application cerebral microdialysis was published. Since then, there have been significant advances use neurocritical care. The objective review is report International Forum held Cambridge, UK, April 2014 and produce revised...
<h3>OBJECTIVE</h3> Brain interstitial glycerol was studied as a potential marker for membrane phospholipid degradation in acute human brain injury. <h3>METHODS</h3> Glycerol measured microdialysis samples from the frontal lobe cortex four patients neurointensive care unit, during phase after severe aneurysmal subarachnoid haemorrhage. Microdialysis probes were inserted conjunction with ventriculostomy used routine intracranial pressure monitoring. Clinical events involving hypoxia/ischaemia...
✓ The authors have developed a method for routine monitoring of disturbances in brain energy metabolism and extracellular levels excitatory amino acids using intracerebral microdialysis 10 patients with subarachnoid hemorrhage. Microdialysis was conducted periods ranging from 6 to 11 days after ictus. Altogether, 16,054 chemical analyses 1647 dialysate samples were performed. Concentrations the energy-related substances lactate, pyruvate, glucose, hypoxanthine measured, lactate/pyruvate...
Object. The aim of this study was to compare the effects two different treatment protocols on physiological characteristics and outcome in patients with brain trauma. One protocol primarily oriented toward reducing intracranial pressure (ICP), other maintaining cerebral perfusion (CPP). Methods. A series 67 Uppsala were treated according a aimed at keeping ICP less than 20 mm Hg and, as secondary target, CPP approximately 60 Hg. Another 64 Edinburgh greater 70 secondarily, 25 for first 24...
Background and Purpose— It is often thought that elderly patients in particular would benefit from endovascular aneurysm treatment. The aim of this analysis was therefore to compare the efficacy safety coiling (EVT) with neurosurgical clipping (NST) subgroup SAH International Subarachnoid Aneurysm Trial (ISAT). Methods— In ISAT cohort 278 patients, 65 years or older, were enrolled. randomly allocated EVT (n=138) NST (n=140). primary outcome proportion a modified Rankin scale score 0 2...
Damage to axons contributes postinjury disabilities and is commonly observed following traumatic brain injury (TBI). Traumatic an important environmental risk factor for the development of Alzheimer disease (AD). In present feasibility study, aim was use intracerebral microdialysis catheters with a high molecular cutoff membrane (100 kD) harvest interstitial total tau (T-tau) amyloid beta 1-42 (Abeta42) proteins, which are biomarkers axonal AD, moderate-to-severe TBI.Eight patients (5 men 3...
Intracerebral microdialysis (MD) was applied in patients with subarachnoid hemorrhage. The regional CBF, the CMRO 2 , and oxygen extraction ratio (OER) were measured simultaneous positron emission tomography (PET). aim to directly correlate alterations dialysate levels of energy-related metabolites (lactate, lactate/pyruvate ratio, hypoxanthine) excitatory amino acids (EAAs) (glutamate aspartate) energy state MD probe region as determined by PET. Regional ischemia defined according Heiss et...
Clinical outcome after traumatic diffuse axonal injury (DAI) is difficult to predict. In this study, three magnetic resonance imaging (MRI) sequences were used quantify the anatomical distribution of lesions, grade DAI according Adams grading system, and evaluate value lesion localization in combination with clinical prognostic factors improve prediction. Thirty patients (mean 31.2 years ±14.3 standard deviation) severe (Glasgow Motor Score [GMS] <6) examined MRI within 1 week post-injury...
Intracranial pressure (ICP), cerebral perfusion (CPP), and the reactivity index (PRx) have been shown to correlate with outcome after traumatic brain injury (TBI), but their temporal evolution is less studied. Optimal CPP (CPPopt; i.e., lowest [optimal] PRx value) has proposed as a dynamic, individualized target. Our aim was map course of these parameters relation outcome, in particular extent impact insults based both on fixed thresholds divergence from CPPopt. Data 362 TBI patients...
Abstract Background High intracranial pressure (ICP) and low cerebral perfusion (CPP) may induce secondary brain injury following aneurysmal subarachnoid hemorrhage (aSAH). In the current study, we aimed to determine temporal incidence of insults above/below certain ICP/CPP thresholds, role autoregulation in CPP management (PRx CPPopt), relation clinical outcome. Methods this retrospective 242 patients were included with aSAH, who treated neurointensive care unit, Uppsala University...
The occurrence of a second primary malignant disease was analyzed in 38,166 patients with cancer the colon and 23,603 rectal reported to Swedish Cancer Registry between 1960 1981. overall relative risk (RR) developing significantly (P less than 0.05) increased both after (women, RR = 1.4; men, 1.3) rectum 1.3). Besides confirming an metachronous colorectal this study suggests that small intestine, breast, endometrium, possibly ovary prostate may have etiologic factors common large bowel,...
To study the occurrence of secondary insults during neurointensive care patients with subarachnoid hemorrhage using a computerized multimodality monitoring system and to impact on clinical deterioration functional outcome. Patients who were admitted unit between January 1999 December 2002 at least 120 hours data within first 240 included. Data continuously recorded for intracranial pressure (ICP), cerebral perfusion (CPP), mean arterial blood pressure, systolic oxygen saturation,...
Astrocytic glutamate (Glt) uptake keeps brain interstitial Glt levels low. Within the astrocytes is converted to glutamine (Gln), which released and reconverted in neurons. The Glt-Gln cycle energy demanding impaired metabolism has been suggested cause low Gln/Glt ratios. Using microdialysis (MD) measurements from visually noninjured cortex 33 neurointensive care patients with subarachnoid hemorrhage, we have determined how Gln, as a reflection of turnover, relate perturbed metabolism. A...
Gram-negative bacillary (GNB) ventriculitis and meningitis are rare but serious complications after neurosurgery. Prospective studies on antibiotic treatment for these infections lacking, retrospective reports sparse. At our hospital in Uppsala, Sweden, meropenem has been recommended as empirical therapy since 1996, with the addition of intraventricular gentamicin cases that do not respond satisfactorily to treatment. In this study, we retrospectively compare efficacy combination systemic...
The "neurological wake-up test" is needed to evaluate the level of consciousness in patients with severe traumatic brain injury. However, neurological test requires interruption continuous sedation and may induce a stress response its use neurocritical care controversial. We hypothesized that induces an additional biochemical injury.Twenty-four who received propofol mechanical ventilation after moderate injury (Glasgow Coma Scale score ≤ 8; patient age 18-71 yrs old) were analyzed. Exclusion...
Epidemiological evidence links severe or repeated traumatic brain injury (TBI) to the development of Alzheimer's disease (AD). Accumulation amyloid precursor protein (APP) occurs with high frequency after TBI, particularly in injured axons, and APP may be cleaved amyloid-β (Aβ) peptides playing key pathophysiological roles AD. We used cerebral microdialysis (MD) test hypothesis that interstitial Aβ levels are altered following TBI related type, energy metabolism, age patient, level...
The definition of cerebral perfusion pressure (CPP) secondary insults in severe traumatic brain injury remains unclear. purpose the present study is to visualize association intensity and duration episodes below or above CPP thresholds outcome. analysis was based on prospectively collected minute-by-minute intracranial (ICP) blood data outcome from 259 adult patients. relationship a certain threshold for with 6-month Glasgow Outcome Score visualized separately active deficient autoregulation...
Two randomised controlled trials (RCTs) of decompressive craniectomy (DC) in traumatic brain injury (TBI) have shown poor outcome, but there are considerations how these protocols relate to real practice. The aims this study were evaluate usage and outcome DC thiopental a single centre.
Abstract: Premature craniosynostosis is a rare condition, with wide range of incidence estimations in the literature. The aim this study was to establish current among Swedish population. Since surgical care for these children centralized 2 centers Sahlgrenska University Hospital and Uppsala Hospital, craniofacial hospital registries were examined surgically treated children, all having computed tomography verified diagnosis. Results show an 7.7 cases per 10,000 live births, including...