- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- Cerebrovascular and Carotid Artery Diseases
- Meningioma and schwannoma management
- Acute Ischemic Stroke Management
- Neurosurgical Procedures and Complications
- Cerebrospinal fluid and hydrocephalus
- Vascular Malformations Diagnosis and Treatment
- Neurofibromatosis and Schwannoma Cases
- Head and Neck Surgical Oncology
- Pituitary Gland Disorders and Treatments
- Optical Imaging and Spectroscopy Techniques
- Moyamoya disease diagnosis and treatment
- Glioma Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Spinal Fractures and Fixation Techniques
- Trigeminal Neuralgia and Treatments
- S100 Proteins and Annexins
- Cardiovascular Health and Disease Prevention
- Cerebral Venous Sinus Thrombosis
- Traumatic Brain Injury Research
- Stroke Rehabilitation and Recovery
- Trauma and Emergency Care Studies
- Venous Thromboembolism Diagnosis and Management
- Spine and Intervertebral Disc Pathology
University of Utah
2021-2025
University of Cambridge
2015-2024
Addenbrooke's Hospital
2014-2024
University of Utah Health Care
2024
Cambridge University Hospitals NHS Foundation Trust
2015-2023
University of California, San Francisco
2021-2022
National Institute for Health Research
2020-2022
Neurological Surgery
2021
Stony Brook University
2021
Shinshu University
2021
Objectives: We have sought to develop an automated methodology for the continuous updating of optimal cerebral perfusion pressure (CPPopt) patients after severe traumatic head injury, using monitoring cerebrovascular reactivity. then validated CPPopt algorithm by determining association between outcome and deviation actual CPP from CPPopt. Design: Retrospective analysis prospectively collected data. Setting: Neurosciences critical care unit a university hospital. Patients: A total 327...
Delayed cerebral ischemia (DCI) is a recognized contributor to unfavorable outcome after subarachnoid hemorrhage (SAH). Recent data challenge the concept of vasospasm as sole cause and suggest multifactorial process with dysfunctional autoregulation component. We tested hypothesis that early autoregulatory failure, detected using near-infrared spectroscopy-based index, TOxa transcranial Doppler-based Sxa, can predict DCI.In this prospective observational study we enrolled consecutive...
BACKGROUND: Cerebrovascular pressure reactivity is the principal mechanism of cerebral autoregulation. Assessment autoregulation can be performed by using mean flow index (Mx) based on transcranial Doppler ultrasonography. monitored (PRx), which intracranial monitoring. From a practical point view, PRx continuously, whereas Mx only in short periods when probes applied. OBJECTIVE: To assess to what degree impairment (PRx) associated with (Mx). METHODS: A database 345 patients traumatic brain...
Abstract BACKGROUND Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period also seen changes management strategies the implementation of protocolled specialist neurocritical care, expansion neuromonitoring techniques, adjustments treatment targets. OBJECTIVE To describe intracranial monitoring variables...
In patients after subarachnoid hemorrhage (SAH) failure of cerebral autoregulation is associated with delayed ischemia (DCI). Various methods assessing are available, but their predictive values remain unknown. We characterize the relationship between different indices autoregulation. Patients SAH within 5 days were included in a prospective study. The three was analyzed: two calculated using spontaneous blood pressure fluctuations, Sxa (based on transcranial Doppler) and TOxa near-infrared...
The impulse response (IR)-based autoregulation index (ARI) allows for continuous monitoring of cerebral using spontaneous fluctuations arterial blood pressure (ABP) and flow velocity (FV). We compared three methods assessment in 288 traumatic brain injury (TBI) patients managed the Neurocritical Care Unit: (1) IR-based ARI; (2) transfer function (TF) phase, gain, coherence; (3) mean (Mx). Autoregulation was calculated TF estimation (Welch method) classified according to original Tiecks’...
Critical closing pressure (CCP) is the arterial blood (ABP) at which brain vessels collapse and cerebral flow (CBF) ceases. Using concept of impedance to CBF, CCP can be expressed with brain-monitoring parameters: perfusion (CPP), ABP, velocity (FV), heart rate. The novel multiparameter method (CCPm) was compared traditional transcranial Doppler (TCD) calculations (CCP1). Digital recordings intracranial (ICP), TCD-based FV from previously published studies 29 New Zealand White rabbits were...
In Brief BACKGROUND: A total hemoglobin reactivity index (THx) derived from near-infrared spectroscopy (NIRS) has recently been introduced to assess cerebrovascular noninvasively. Analogously the pressure (PRx), THx is calculated as correlation coefficient with arterial blood (ABP). However, reliability of in injured brain uncertain. Although slow oscillations have described NIRS signals, their significance for assessment autoregulation remains unclear. current study, we investigated role...
Clinical behaviour of atypical meningiomas is not uniform. While, as a group, they exhibit high recurrence rate, some pursue more benign course, whereas others progress early. We aim to investigate the imaging and pathological factors that predict risk early tumour progression determine whether related outcome. Adult patients with WHO grade II meningioma treated in three regional referral centres between 2007 2014 were included. MRI pathology characteristics assessed. Gross total resection...