Review
Biochemistry & Molecular Biology
Lu-Ting Kuo, Abel Po-Hao Huang
Summary: This review discusses the molecular and cellular mechanisms of hydrocephalus following aneurysmal subarachnoid hemorrhage and the treatment strategies involved. Various mechanisms including alterations in cerebral spinal fluid dynamics and obstruction of arachnoid granulations have been implicated. Further investigations are needed to identify the optimal treatment strategy for better outcomes.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Clinical Neurology
Aiden Meyer, Elyse Forman, Scott Moody, Christoph Stretz, Nicholas S. Potter, Thanujaa Subramaniam, Ilayda Top, Linda C. Wendell, Bradford B. Thompson, Michael E. Reznik, Karen L. Furie, Ali Mahta
Summary: This study aimed to identify early radiographic predictors for persistent hydrocephalus requiring ventriculoperitoneal shunt (VPS) placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). The results showed that the thickness of blood clots in the basal cisterns, including interpeduncular, ambient, crural, prepontine, interhemispheric cisterns, and bilateral Sylvian fissures, on admission noncontrast head computed tomography scans was significantly different between patients who required VPS and those who did not. These findings suggest that cisternal blood clot quantification can be used to predict persistent hydrocephalus with VPS requirement in aSAH patients.
Article
Biochemistry & Molecular Biology
Sara Diana Lolansen, Nina Rostgaard, Tenna Capion, Nicolas H. Norager, Markus Harboe Olsen, Marianne Juhler, Tiit Illimar Mathiesen, Nanna MacAulay
Summary: The molecular mechanisms underlying the development of posthemorrhagic hydrocephalus (PHH) remain unclear, but elevated cerebrospinal fluid (CSF) osmolality is not the cause of PHH. The pathological CSF accumulation observed in these patients is instead attributed to other pathological alterations associated with the abnormal presence of blood within the CSF compartments following subarachnoid hemorrhage (SAH).
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Clinical Neurology
Joshua A. Cuoco, Evin L. Guilliams, Brendan J. Klein, Michael J. Benko, Jordan A. Darden, Adeolu L. Olasunkanmi, Mark R. Witcher, Cara M. Rogers, Eric A. Marvin, Biraj M. Patel, John J. Entwistle
Summary: In a retrospective analysis of 143 consecutive patients with aneurysmal subarachnoid hemorrhage, it was found that a neutrophil count >= 9.80 x 10^3/ml on admission predicted acute symptomatic hydrocephalus in an adjusted multivariate logistic regression model. Additionally, shunt dependence was associated with higher neutrophil counts.
WORLD NEUROSURGERY
(2021)
Review
Clinical Neurology
Manhal M. Siddiqi, Wasiq I. Khawar, Brianna M. Donnelly, Jaims Lim, Cathleen C. Kuo, Andre Monteiro, Ammad A. Baig, Muhammad Waqas, Mohammed A. R. Soliman, Jason M. Davies, Kenneth Snyder, Elad I. Levy, Adnan H. Siddiqui, Kunal Vakharia
Summary: This study aimed to evaluate novel preoperative and postoperative risk factors for shunt-dependent hydrocephalus (SDHC) after aneurysmal subarachnoid hemorrhage (aSAH) via a systematic review and meta-analysis. Several new factors associated with increased odds of developing SDHC after aSAH were found to be significant. This provides an identifiable list of evidence-based risk factors for surgeons to recognize, treat, and manage high-risk aSAH patients at risk for developing SDHC.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Haley K. Talbot-Stetsko, Kristen D. Raue, Bryan L. Aaron, Arjun R. Adapa, David B. Altshuler, Sudharsan Srinivasan, Aditya S. Pandey, Cormac O. Maher, Todd C. Hollon, Siri Sahib S. Khalsa
Summary: The study found that the AVV volume change after EVD clamping was significantly higher in patients with hydrocephalus compared to those without, serving as a predictive factor for determining the need for cerebrospinal fluid diversion.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Julien N. Jost, Yasin Irmak, Basil Gruter, Angelo Tortora, Serge Marbacher, Christian Musahl, Gerrit A. Schubert, Lukas Andereggen, Stefan Wanderer
Summary: This study aimed to compare the impact of early and late ventriculoperitoneal shunt (VPS) placement on functional clinical outcome. Data from 82 patients with VPS placement after aneurysmal subarachnoid hemorrhage (aSAH) were retrospectively analyzed. The results showed better functional outcome in patients with early cerebrospinal fluid diversion.
NEUROSURGICAL REVIEW
(2023)
Article
Surgery
Joshua A. Cuoco, Evin L. Guilliams, Brendan J. Klein, Mark R. Witcher, Eric A. Marvin, Biraj M. Patel, John J. Entwistle
Summary: This study aimed to evaluate whether immunologic counts on admission were associated with shunt-dependent hydrocephalus. The results showed that acute hydrocephalus and monocyte count on admission were independent predictors for shunt dependence.
FRONTIERS IN SURGERY
(2022)
Review
Clinical Neurology
Yao-Chung Yang, Chun-Hao Yin, Kuan-Ting Chen, Pei-Chin Lin, Ching-Chih Lee, Wei-Chuan Liao, Jin-Shuen Chen
Summary: This study aimed to create a prediction model for shunt-dependent hydrocephalus in patients with aneurysmal sub-arachnoid hemorrhage, identifying predictive factors and summarizing the current data on predicting SDHC.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Dietmar Frey, Adam Hilbert, Anton Frueh, Vince Istvan Madai, Tabea Kossen, Julia Kiewitz, Jenny Sommerfeld, Peter Vajkoczy, Meike Unteroberdoerster, Esra Zihni, Sophie Charlotte Brune, Stefan Wolf, Nora Franziska Dengler
Summary: Machine learning models can accurately predict shunt-dependent hydrocephalus (SDHC) after aneurysmal subarachnoid hemorrhage (aSAH), reducing hospital stay and the risk of catheter-associated meningitis. Compared to traditional non-ML methods, ML models offer better predictions of SDHC.
NEUROSURGICAL REVIEW
(2023)
Article
Critical Care Medicine
Steve Bibu, Alessandro Iliceto, Florence Chukwuneke, Sean Munier, Madeline Stecy, Bryan Green, Kiwon Lee
Summary: This study aimed to evaluate the factors influencing the need for extended extraventricular drainage in patients with high grade aSAH. The results suggest that daily CSF output and CSF characteristics may serve as potential markers for assessing the need for long term CSF diversion. However, further research is needed to establish clear correlations and cutoff values for these parameters.
JOURNAL OF INTENSIVE CARE MEDICINE
(2022)
Article
Clinical Neurology
Yibin Zhang, Shufa Zheng, Haojie Wang, Guogong Chen, Chunwang Li, Yuanxiang Lin, Peisen Yao, Dezhi Kang
Summary: This study aimed to investigate the association between serum phosphate ion (sPi) levels on admission and the occurrence of acute hydrocephalus (aHCP) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The results showed that lower sPi levels were associated with an increased risk of developing aHCP after aSAH. Additionally, a model combining sPi levels, Hunt-Hess grade, and modified Fisher grade improved the prediction of aHCP.
FRONTIERS IN NEUROLOGY
(2022)
Review
Biochemistry & Molecular Biology
Matthias Simon, Alexander Grote
Summary: IL-6 is a proinflammatory cytokine that may serve as a potential biomarker in SAH patients, although discrepancies in research findings and lack of defined clinical endpoints hinder its routine clinical use. Further research is needed to better understand the role of IL-6 and neuroinflammation in the pathophysiology of SAH.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Clinical Neurology
Badih J. Daou, Siri Sahib S. Khalsa, Sharath Kumar Anand, Craig A. Williamson, Noah S. Cutler, Bryan L. Aaron, Sudharsan Srinivasan, Venkatakrishna Rajajee, Kyle Sheehan, Aditya S. Pandey
Summary: The study found that total hemorrhage volume is an independent predictor of seizures and shunt-dependent hydrocephalus in patients with aSAH. Volumetric analysis may complement existing scales used in clinical practice and aid in patient prognostication and management.
JOURNAL OF NEUROSURGERY
(2021)
Article
Biochemistry & Molecular Biology
Nina Rostgaard, Markus Harboe Olsen, Tenna Capion, Nanna MacAulay, Marianne Juhler
Summary: This study aimed to identify inflammatory biomarkers in cerebrospinal fluid (CSF) that can predict the development of post-hemorrhagic hydrocephalus (PHH) and shunt-dependency, as well as functional outcome in patients with subarachnoid hemorrhage (SAH). Proximity extension assay (PEA) was used to analyze CSF samples from 31 SAH patients, and 7 markers were identified as predictors of shunt dependency and 4 markers as predictors of functional outcome. These inflammatory biomarkers hold potential as predictive tools in the clinic.
Article
Clinical Neurology
Erdem Gueresir, Tim Lampmann, Sylvia Bele, Marcus Czabanka, Patrick Czorlich, Jens Gempt, Roland Goldbrunner, Helene Hurth, Elvis Hermann, Ramazan Jabbarli, Marius Krauthausen, Ralph Koenig, Dirk Lindner, Vesna Malinova, Jurgen Meixensberger, Dorothee Mielke, Robert Nemeth, Marvin Darkwah Oppong, Andrej Pala, Vincent Prinz, Ali Rashidi, Constantin Roder, Ibrahim Erol Sandalcioglu, Thomas Sauvigny, Karl-Michael Schebesch, Marco Timmer, Peter Vajkoczy, Lars Wessels, Florian Wild, Christoph Wilhelm, Maria Wostrack, Hartmut Vatter, Christoph Coch
Summary: The FINISHER trial aims to determine whether dexamethasone improves outcome in SAH patients. It is a multicenter, prospective, randomized, double-blinded, placebo-controlled clinical phase III trial with a sample size of 334 patients. The primary outcome is the modified Rankin Scale at 6 months.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Oncology
Vicki M. Butenschoen, Maximilian Schwendner, Vanessa Hubertus, Julia Onken, Nikolaus Koegl, Theresa Mohme, Stefanie Maurer, Tobias Boeckh-Behrens, Sven O. Eicker, Claudius Thome, Peter Vajkoczy, Marcus Czabanka, Bernhard Meyer, Maria Wostrack
Summary: This retrospective multicenter study analyzed 60 patients with spinal hemangioblastomas in Germany and Austria. The results showed that early surgical treatment significantly benefited patients, with transient postoperative neurological deterioration in some cases but complete recovery during follow-up.
JOURNAL OF NEURO-ONCOLOGY
(2023)
Article
Multidisciplinary Sciences
Isabel C. C. Hostettler, Nicole Lange, Nina Schwendinger, Samira Frangoulis, Theresa Hirle, Dominik Trost, Jens Gempt, Kornelia Kreiser, Maria Wostrack, Bernhard Meyer
Summary: Timely treatment is crucial in preventing further rupture and poor outcomes in patients with aneurysmal subarachnoid haemorrhage (aSAH). This retrospective analysis of aSAH patients admitted between 2006 and 2020 found that patients with higher Hunt and Hess grades were treated faster. Delay in treatment was associated with higher mortality and cerebral infarction rates in lower-grade aSAH patients. Therefore, patients with lower-grade aSAH should be treated with the same urgency as higher-grade aSAH.
SCIENTIFIC REPORTS
(2023)
Article
Oncology
Christian D. Diehl, Enrike Rosenkranz, Maximilian Schwendner, Martin Misslbeck, Nico Sollmann, Sebastian Ille, Bernhard Meyer, Stephanie E. Combs, Sandro M. Krieg
Summary: Management of brain metastases adjacent to motor structures is challenging. Navigated transcranial magnetic stimulation (nTMS) motor mapping combined with diffusion tensor imaging (DTI)-based fiber tracking (DTI-FTmot.TMS) is used for safe resection and to preserve motor function. This study investigated the applicability of DTI-FTmot.TMS in adjuvant radiotherapy planning, demonstrating a potential significant reduction in dose to motor structures.
Article
Oncology
Christian D. Diehl, Steffi U. Pigorsch, Jens Gempt, Sandro M. Krieg, Silvia Reitz, Maria Waltenberger, Melanie Barz, Hanno S. Meyer, Arthur Wagner, Jan Wilkens, Benedikt Wiestler, Claus Zimmer, Bernhard Meyer, Stephanie E. Combs
Summary: Advancements in systemic cancer management have led to improved survival for multiple types of solid cancer, resulting in an increasing number of patients with brain metastases (BM). Resection is recommended for patients with single brain metastases and controlled primary disease, as well as cases requiring histopathologic diagnosis for cancer management decisions. However, local recurrence rates after surgery are high, necessitating adjuvant local radiation therapy (RT) to improve outcomes. Low-energy X-ray intraoperative radiation therapy (IORT) has emerged as a potential treatment option, offering local ablative treatment with steep dose gradients. This retrospective study describes the effectiveness and safety of IORT in 18 patients with resected brain metastases, supporting previous research findings.
Article
Clinical Neurology
Isabel Charlotte Hostettler, Nicole Lange, Nina Schwendinger, Gareth Ambler, Theresa Hirle, Samira Frangoulis, Dominik Trost, Jens Gempt, Kornelia Kreiser, Bernhard Meyer, Christof Winter, Maria Wostrack
Summary: Aneurysmal subarachnoid haemorrhage (aSAH) often leads to hydrocephalus and the need for ventriculoperitoneal shunt (VPS). This study aimed to evaluate the influence of specific clinical and biochemical factors on VPS dependency, with a focus on hyperglycaemia on admission. The results showed that hyperglycaemia on admission was associated with an increased probability of VPS placement.
EUROPEAN STROKE JOURNAL
(2023)
Article
Oncology
Michael Griessmair, Claire Delbridge, Julian Ziegenfeuter, Denise Bernhardt, Jens Gempt, Friederike Schmidt-Graf, Olivia Kertels, Marie Thomas, Hanno S. Meyer, Claus Zimmer, Bernhard Meyer, Stephanie E. Combs, Igor Yakushev, Benedikt Wiestler, Marie-Christin Metz
Summary: By using advanced imaging and AI-based image processing, this study demonstrates significant differences in biological MR imaging metrics among molecularly defined glioma subgroups. The findings contribute to the understanding that fine tumor grading is possible through visualization of tumor biology with advanced MRI.
Article
Oncology
Wei Zhang, Sebastian Ille, Maximilian Schwendner, Benedikt Wiestler, Bernhard Meyer, Sandro M. Krieg
Summary: The use of intraoperative MRI in modern neurosurgery significantly reduces residual tumor volume and helps achieve comparable progression-free survival. This is true even for patients with unexpected residual tumor after initial resection.
Review
Oncology
Christian D. Diehl, Frank A. Giordano, Anca-L. Grosu, Sebastian Ille, Klaus-Henning Kahl, Julia Onken, Stefan Rieken, Gustavo R. Sarria, Ehab Shiban, Arthur Wagner, Juergen Beck, Stefanie Brehmer, Oliver Ganslandt, Motaz Hamed, Bernhard Meyer, Marc Muenter, Andreas Raabe, Veit Rohde, Karl Schaller, Daniela Schilling, Matthias Schneider, Elena Sperk, Claudius Thome, Peter Vajkoczy, Hartmut Vatter, Stephanie E. Combs
Summary: Brain metastases are a growing concern in cancer patients and various treatment options are available. Small asymptomatic lesions are usually treated with focal stereotactic radiotherapy, while large or symptomatic metastases require surgical resection. Postsurgical radiotherapy has been proven effective in preventing local recurrence, and different techniques such as stereotactic radiosurgery and intraoperative radiotherapy have been introduced. This consensus paper summarizes the current local treatment strategies for resectable brain metastases.
Article
Oncology
Lisa S. Hoenikl, Nicole Lange, Bernhard Meyer, Jens Gempt, Hanno S. Meyer
Summary: Postoperative communicating hydrocephalus can develop following glioma resection, and it's more common in higher tumor grade and in cases with postoperative re-bleeding, ventriculitis, and infratentorial tumor localization. Physicians treating brain tumor patients should be aware of the risk factors and timing of post-resection hydrocephalus.
Article
Oncology
Jonas Lin, Yannik Kaiser, Benedikt Wiestler, Denise Bernhardt, Stephanie E. Combs, Claire Delbridge, Bernhard Meyer, Jens Gempt, Amir Kaywan Aftahy
Summary: This study aims to investigate the impact of postoperative tumor burden on the survival of patients with recurrent brain metastases and found that residual tumor burden is a significant prognostic factor. Operated patients have longer survival regardless of systemic progression.
Article
Neurosciences
Corinna Boerner, Axel Schroeder, Bernhard Meyer, Sandro M. Krieg, Sebastian Ille
Summary: Using navigated repetitive transcranial magnetic stimulation and fiber tracking of diffusion tensor imaging, the neural representation of language can be identified in the cortex and subcortex. A study on 40 brain lesion patients speaking different languages found significant differences in the cortical locations of language between Balto-Slavic and Indo-European languages, as well as between bilingual individuals. However, no differences were found in the white matter language pathway volumes between different languages or bilingual patients. These findings suggest that while there may be differences in cortical locations, the underlying subcortical structure is likely similar across languages.
Article
Oncology
Julian Ziegenfeuter, Claire Delbridge, Denise Bernhardt, Jens Gempt, Friederike Schmidt-Graf, Michael Griessmair, Marie Thomas, Hanno S. Meyer, Claus Zimmer, Bernhard Meyer, Stephanie E. Combs, Igor Yakushev, Benedikt Wiestler, Marie-Christin Metz
Summary: Reliable differentiation between true tumor progression and treatment-related changes in glioma patients is challenging. This study investigated the diagnostic performance of simultaneous and sequential acquisition of PET and MRI in 38 glioblastoma patients. The results showed no significant difference in global and local image metrics, as well as the diagnostic performance, between the two acquisition methods. This suggests that sequential acquisition is clinically and scientifically acceptable, supporting further research on multi-parametric models for personalized decision-making in neuro-oncology.
Article
Medicine, General & Internal
Kateryna Goloshchapova, Maria Goldberg, Bernhard Meyer, Maria Wostrack, Vicki M. Butenschoen
Summary: This study investigated the postoperative clinical course of intramedullary spinal cord tumors (IMSCT) in the upper cervical spine. The results showed that over 60% of patients developed new neurological deficits in the immediate postoperative period, and over 40% of these deficits were permanent. However, these deficits did not significantly impact daily functioning in most cases, as most patients maintained functional independence.
MEDICINA-LITHUANIA
(2023)
Article
Medicine, General & Internal
Ann-Kathrin Joerger, Carolin Albrecht, Nicole Lange, Bernhard Meyer, Maria Wostrack
Summary: This study investigates early mortality and risk factors in patients with spondylodiscitis. The results suggest that despite immediate treatment, a subset of patients still experience mortality during their hospital stay. Advanced age, diabetes mellitus, and previous steroid medication were identified as significant risk factors.
JOURNAL OF CLINICAL MEDICINE
(2023)