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1. Metabolomics as a potential tool for monitoring patients with aneurysmal subarachnoid hemorrhage

Author

Nebojsa Lasica, Vidak Raicevic, Nikola M. Stojanovic, Djula Djilvesi, Igor Horvat, Bojan Jelaca, Filip Pajicic, and Petar Vulekovic

Subjects
metabolomics, metabonomics, stroke, subarachnoid hemorrhage, intracranial aneurysm, neurocritical care, Neurology. Diseases of the nervous system, RC346-429
Abstract

Metabolomics has evolved into a particularly useful tool to study interactions between metabolites and serves as an aid in unraveling the complexity of entire metabolomes. Nonetheless, it is increasingly viewed as a methodology with practical applications in the clinical setting, where identifying and quantifying biomarkers of interest could prove useful for diagnostics. Starting from a concise overview of the most prominent analytical techniques employed in metabolomics, herein we present a review of its application in studies of brain metabolism and cerebrovascular diseases, paying most attention to its uses in researching aneurysmal subarachnoid hemorrhage. Both animal models and human studies are considered, and metabolites identified as potential biomarkers are highlighted.

Published
2023
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2. Venous thromboembolic and hemorrhagic events after meningioma surgery: A single-center retrospective cohort study of risk factors.

Author

Nebojsa Lasica, Djula Djilvesi, Vladimir Papic, Mladen Karan, Bojan Jelaca, Jagos Golubovic, Filip Pajicic, Milica Medic-Stojanoska, Petar Vulekovic, and Lukas Rasulic

Subjects
Medicine, Science
Abstract

Microsurgical resection of meningiomas in a majority of cases leads to a favorable outcome. Therefore, severe postoperative adverse events are less acceptable. The main purpose of this study was to investigate the incidence of symptomatic venous thromboembolism (VTE) and hemorrhagic complications in patients after operative treatment of intracranial meningiomas and to identify the risk factors in this patient subgroup. Of 106 patients undergoing elective craniotomy for meningioma overall incidence of symptomatic VTE was noted in 5.7% (six patients). For the risk-factor analysis older age (57.20 ± 11.60 vs. 71.00 ± 0.90 years, p < 0.001), higher body mass index (27.60 ± 4.80 vs. 33.16 ± 0.60 kg/m2, p < 0.001), WHO grade II (3.00% vs. 33.33%, p = 0.02), lower intraoperative blood loss (466.00 ± 383.70 vs. 216.70 ± 68.30 mL, p < 0.001), bedridden status and neurologic deficit (0.00% vs. 33.33%, p = 0.003 and 38.00% vs. 100.00%, p = 0.004) were associated with greater VTE risk. No risk factors for hemorrhagic complications were identified on univariate analysis. In conclusion, the incidence of VTE in meningioma patients is not negligible. Identified risk factors should be taken into account in the decision-making process for chemoprophylaxis when the risk of bleeding decreases.

Published
2022
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3. Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

Author

David Clark, Alexis Joannides, Amos Olufemi Adeleye, Abdul Hafid Bajamal, Tom Bashford, Hagos Biluts, Karol Budohoski, Ari Ercole, Rocío Fernández-Méndez, Anthony Figaji, Deepak Kumar Gupta, Roger Härtl, Corrado Iaccarino, Tariq Khan, Tsegazeab Laeke, Andrés Rubiano, Hamisi K Shabani, Kachinga Sichizya, Manoj Tewari, Abenezer Tirsit, Myat Thu, Manjul Tripathi, Rikin Trivedi, Bhagavatula Indira Devi, Franco Servadei, David Menon, Angelos Kolias, Peter Hutchinson, Ghayur Abbas, Omar Ibrahim Abdallah, Ahmed Abdel-Lateef, Khalif Abdifatah, Awfa Abdullateef, Ruvini Abeygunaratne, Mostafa Aboellil, Abass Adam, Robert Adams, Amos Adeleye, Augustine Adeolu, Novan Krisno Adji, Nur Afianti, Sudarsan Agarwal, Ifeanyi Kene Aghadi, Paúl Martín Méndez Aguilar, Syeda Rida Ahmad, Daniyal Ahmed, Nafees Ahmed, Haider Aizaz, Yunus Kuntawi Aji, Alex Alamri, Augusto Jacinto Mussindo Alberto, Luis Alcocer Alcocer, Lesly Gonzales Alfaro, Amro Al-Habib, Ahmad Alhourani, Syed Muhammad Rafay Ali, Fahad Alkherayf, Ahmed AlMenabbawy, Aliyah Alshareef, Muhammad Adil s/o Aminullah, Madeha Amjad, Robson Luis Oliveira de Amorim, Sathiaprabhu Anbazhagan, Almir Andrade, Waleed Antar, Theophilus T.K. Anyomih, Salah Aoun, Tedy Apriawan, Daniele Armocida, Paul Arnold, Miguel Arraez, Temesgen Assefa, Andres Asser, S.P. Athiththan, Deepal Attanayake, Maung Maung Aung, Allan Avi, Victor Enrique Antolinez Ayala, Mohammed Azab, Gaousul Azam, Mohd Azharuddin, Olukemi Badejo, Mohamed Badran, Azam Ali Baig, Rehman Ali Baig, Ankur Bajaj, Paul Baker, Renu Bala, Artur Balasa, Ross Balchin, James Balogun, Vin Shen Ban, Bharath Kumar Reddy Bandi, Soham Bandyopadhyay, Matthew Bank, Ernest Barthelemy, Mohammed Talha Bashir, Luciano Silveira Basso, Surajit Basu, Auricelio Batista, Marlies Bauer, Devi Bavishi, Abi Beane, Shmuel Bejell, Anteneh Belachew, Antonio Belli, Amani Belouaer, Najia El Abbadi Bendahane, Okanga Benjamin, Youssef Benslimane, Chaymae Benyaiche, Claudio Bernucci, Luigi Valentino Berra, Arnold Bhebe, Alexios Bimpis, Diana Blanaru, Jean Claude Bonfim, Luis A B Borba, Alp Ozgun Borcek, Erika Borotto, Ahmad Elmabri Mohammad Bouhuwaish, Facundo Bourilhon, Gioia Brachini, Joshua Breedon, Maximilian Broger, Giacoma Maria Floriana Brunetto, Placido Bruzzaniti, Natalia Budohoska, Hira Burhan, Maximiliano Luis Calatroni, Catherine Camargo, Pier Francesco Cappai, Salvatore Massimiliano Cardali, Ana M Castaño-Leon, David Cederberg, Mikel Celaya, Marco Cenzato, Lakshmi Madhavi Challa, Dhanny Charest, Bipin Chaurasia, Rabah Chenna, Iype Cherian, Juliana Henry Ching'o, Tejas Chotai, Ajay Choudhary, Nabeel Choudhary, Florence Choumin, Tomislav Cigic, Juan Ciro, Carlo Conti, Antônio Carlos de Souza Corrêa, Giulia Cossu, Maíra Piani Couto, Aurora Cruz, Divya D'Silva, Giuseppe Antonio D'Aliberti, Lamin Dampha, Roy Thomas Daniel, Andrew Dapaah, Aneela Darbar, Gabriel Dascalu, Happy Amos Dauda, Owain Davies, Andrea Delgado-Babiano, Markus Dengl, Marko Despotovic, Indira Devi, Celeste Dias, Mohamed Dirar, Melina Dissanayake, Hananiah Djimbaye, Simon Dockrell, Ali Dolachee, Julija Dolgopolova, Muge Dolgun, Abdalrouf Dow, Davide Drusiani, Artjom Dugan, Dinh Tuan Duong, Trung Kien Duong, Tomasz Dziedzic, Ali Ebrahim, Nizar El Fatemi, Antonios El El Helou, Rachid El El Maaqili, Brahim El El Mostarchid, Abdessamad El El Ouahabi, Mohammad Elbaroody, Ahmed El-Fiki, Ahmed El-Garci, Nasser M.F. El-Ghandour, Muhammed Elhadi, Vanessa Elleder, Safa Elrais, Mohamed El-shazly, Mohamed Elshenawy, Hesham Elshitany, Omar El-Sobky, Marwa Emhamed, Basil Enicker, Onur Erdogan, Sebastian Ertl, Ignatius Esene, Omar Ocampo Espinosa, Tarig Fadalla, Mohammed Fadelalla, Rodrigo Moreira Faleiro, Nida Fatima, Charbel Fawaz, Assefa Fentaw, Carla Eiriz Fernandez, Ana Ferreira, Francesco Ferri, Tony Figaji, Emerson L B Filho, Loic Fin, Benjamin Fisher, Fitra Fitra, Alexis Palpan Flores, Ioan Stefan Florian, Vincenzo Fontana, Lauren Ford, Daniel Fountain, Jose Maria Roda Frade, Antonio Fratto, Christian Freyschlag, Aranzazu Sánchez Gabin, Clare Gallagher, Mario Ganau, Maria Luisa Gandia-Gonzalez, Andoni Garcia, Borja Hernandez Garcia, Sanjeewa Garusinghe, Biniam Gebreegziabher, Adrian Gelb, Jerome St George, Antonino Francesco Germanò, Ilaria Ghetti, Prajwal Ghimire, Alessandro Giammarusti, Jose Luis Gil, Panagiota Gkolia, Yoseph Godebo, Prakash Rao Gollapudi, Jagos Golubovic, Jeremias Fernando Gomes, Javier Gonzales, William Gormley, Alexander Gots, Giulia Letizia Gribaudi, Dylan Griswold, Paolo Gritti, Ruan Grobler, Rudy Gunawan, Birhanu Hailemichael, Elmehdi Hakkou, Mark Haley, Alhafidz Hamdan, Ali Hammed, Waeel Hamouda, Nurul Ashikin Hamzah, Nyein Latt Han, Sahin Hanalioglu, Rashan Haniffa, Martin Hanko, John Hanrahan, Timothy Hardcastle, Fahd Derkaoui Hassani, Volkmar Heidecke, Eirik Helseth, Miguel Ángel Hernández-Hernández, Zachary Hickman, Le Minh Chau Hoang, Alexa Hollinger, Lenka Horakova, Kismet Hossain-Ibrahim, Boru Hou, Samer Hoz, Janine Hsu, Martin Hunn, Madiha Hussain, Giorgia Iacopino, Mylena Miki Lopes Ideta, Irene Iglesias, Ali Ilunga, Nafiz Imtiaz, Rafiza Islam, Serge Ivashchenko, Karim Izirouel, Mohamed Sobhi Jabal, Soubhi Jabal, John Nute Jabang, Aimun Jamjoom, Irfan Jan, Landing BM Jarju, Saad Javed, Bojan Jelaca, Sukhdeep Singh Jhawar, Ting Ting Jiang, Fernando Jimenez, Jorge Jiris, Ron Jithoo, Walt Johnson, Mathew Joseph, Rameshman Joshi, Eija Junttila, Mubashir Jusabani, Stephen Akau Kache, Satyavara Prasad Kadali, Gabriela F Kalkmann, Usman Kamboh, Hitham Kandel, Ahmet Kamil Karakus, Mengistu Kassa, Ari Katila, Yoko Kato, Martin Keba, Kristy Kehoe, Huseyin Hayri Kertmen, Soha Khafaji, Monty Khajanchi, Mohammed Khan, Muhammad Mukhtar Khan, Sohail Daud Khan, Ahtesham Khizar, Amir Khriesh, Sara Kierońska, Paul Kisanga, Boniface Kivevele, Kacper Koczyk, Anna-Lucia Koerling, Danielle Koffenberger, Kennet Kõiv, Leho Kõiv, Branislav Kolarovszki, Marton König, Dilek Könü-Leblebicioglu, Santhoshi Devi Koppala, Tommi Korhonen, Boguslaw Kostkiewicz, Kacper Kostyra, Srinivas Kotakadira, Arjun Reddy Kotha, Madhu Narayana Rao Kottakki, Nenad Krajcinovic, Michal Krakowiak, Andreas Kramer, Selvamuthukumaran Krishnamoorthy, Ashok Kumar, Pankaj Kumar, Pradhumna Kumar, Nilaksha Kumarasinghe, Gowtham Kuncha, Raja K. Kutty, Ghazwan Lafta, Simon Lammy, Pierfrancesco Lapolla, Jacopo Lardani, Nebojsa Lasica, Giancarlo Lastrucci, Yoann Launey, Laura Lavalle, Tim Lawrence, Albert Lazaro, Vitalii Lebed, Ville Leinonen, Lawrence Lemeri, Leon Levi, Jia Yi Lim, Xiao Yi Lim, Jorge Linares-Torres, Laura Lippa, Lurdes Lisboa, Jinfang Liu, Ziyuan Liu, William B Lo, Jan Lodin, Federico Loi, Daniella Londono, Pedro Antonio Gomez Lopez, Cristina Barceló López, Madeleine De Lotbiniere-Bassett, Rihards Lulens, Facundo Hector Luna, Teemu Luoto, Vijaya Sekhar M.V., Ndyebo Mabovula, Matthew MacAllister, Alcina Americo Macie, Rodolfo Maduri, Moufid Mahfoud, Ashraf Mahmood, Fathia Mahmoud, Dominic Mahoney, Wissam Makhlouf, George Malcolm, Adefolarin Malomo, Toluyemi Malomo, Manoranjitha Kumari Mani, Tomás Gazzinelli Marçal, Jacopo Marchello, Nicolò Marchesini, Franz Marhold, Niklas Marklund, Rubén Martín-Láez, Vickneswaran Mathaneswaran, David José Mato-Mañas, Helen Maye, Aaron Lawson McLean, Catherine McMahon, Saniya Mediratta, Mehreen Mehboob, Alisson Meneses, Nesrine Mentri, Hagos Mersha, Ana Milena Mesa, Cristy Meyer, Christopher Millward, Salomao Amone Mimbir, Andrea Mingoli, Parashruram Mishra, Tejesh Mishra, Basant Misra, Siddharth Mittal, Imran Mohammed, Ioana Moldovan, Masechaba Molefe, Alexis Moles, Preston Moodley, Mario Augusto Narváez Morales, Lucy Morgan, German Del Castillo Morillo, Wahab Moustafa, Nikolaos Moustakis, Salma Mrichi, Satya Shiva Munjal, Abdul-Jalilu Mohammed Muntaka, Denver Naicker, Paulo E H Nakashima, Pratap Kumar Nandigama, Samantha Nash, Ionut Negoi, Valetina Negoita, Samundra Neupane, Manh Hung Nguyen, Fajar Herbowo Niantiarno, Abbi Noble, Mohd Arman Muhamad Nor, Blazej Nowak, Andrei Oancea, Frazer O'Brien, Oghenekevwe Okere, Sandra Olaya, Leandro Oliveira, Louise Makarem Oliveira, Fatma Omar, Okezi Ononeme, René Opšenák, Simone Orlandini, Alrobah Osama, Dorcas Osei-Poku, Haytham Osman, Alvaro Otero, Malte Ottenhausen, Shuli Otzri, Oumaima Outani, Emmanuel Abem Owusu, Kevin Owusu-Agyemang, Ahmad Ozair, Baris Ozoner, Elli Paal, Mauro Sérgio Paiva, Wellingson Paiva, Sharad Pandey, Gastone Pansini, Luigi Pansini, Tobias Pantel, Nikolaos Pantelas, Konstantinos Papadopoulos, Vladimir Papic, Kee Park, Nick Park, Eric Homero Albuquerque Paschoal, Mylla Christie de Oliveira Paschoalino, Rajesh Pathi, Anilkumar Peethambaran, Thiago Andrade Pereira, Irene Panero Perez, Claudio José Piqueras Pérez, Tamilanandh Periyasamy, Stefano Peron, Michael Phillips, Sofía Sotos Picazo, Ertugrul Pinar, Daniel Pinggera, Rory Piper, Pathmanesan Pirakash, Branko Popadic, Jussi P. Posti, Rajmohan Bhanu Prabhakar, Sivanesalingam Pradeepan, Manjunath Prasad, Paola Calvachi Prieto, Ron Prince, Andrea Prontera, Eva Provaznikova, Danilo Quadros, Nezly Jadid Romero Quintero, Mahmood Qureshi, Happiness Rabiel, Gabriel Rada, Sivagnanam Ragavan, Jueria Rahman, Omar Ramadhan, Padma Ramaswamy, Sakina Rashid, Jagath Rathugamage, Tõnu Rätsep, Minna Rauhala, Asif Raza, Naga Raju Reddycherla, Linus Reen, Mohamed Refaat, Luca Regli, Haijun Ren, Antonio Ria, Thales Francisco Ribeiro, Alessandro Ricci, Romana Richterová, Florian Ringel, Faith Robertson, Catarina Mayrink Siqueira Cabral Rocha, Juvenal de Souza Rogério, Adan Anibal Romano, Sally Rothemeyer, Gail Rousseau Gail Rousseau, Ranette Roza, Kevin David Farelo Rueda, Raiza Ruiz, Malin Rundgren, Radoslaw Rzeplinski, Raj S.Chandran, Ramesh Andi Sadayandi, William Sage, André Norbert Josef Sagerer, Mustafa Sakar, Mohcine Salami, Danjuma Sale, Youssuf Saleh, Cristina Sánchez-Viguera, Saning'o Sandila, Ahmet Metin Sanli, Laura Santi, Antonio Santoro, Aieska Kellen Dantas Dos Santos, Samir Cezimbra dos Santos, Borja Sanz, Shabal Sapkota, Gopalakrishnan Sasidharan, Ibrahim Sasillo, Rajeev Satoskar, Ali Caner Sayar, Vignesh Sayee, Florian Scheichel, Felipe Lourenzon Schiavo, Alexander Schupper, Andreas Schwarz, Teresa Scott, Esther Seeberger, Claudionor Nogueira Costa Segundo, Anwar Sadat Seidu, Antonio Selfa, Nazan Has Selmi, Claudiya Selvarajah, Necmiye Şengel, Martin Seule, Luiz Severo, Purva Shah, Muhammad Shahzad, Thobekile Shangase, Mayur Sharma, Ehab Shiban, Emnet Shimber, Temitayo Shokunbi, Kaynat Siddiqui, Emily Sieg, Martin Siegemund, Shahidur Rahman Sikder, Ana Cristina Veiga Silva, Ana Silva, Pedro Alberto Silva, Deepinder Singh, Carly Skadden, Josef Skola, Eirini Skouteli, Pawel Słoniewski, Brandon Smith, Guirish Solanki, Davi Fontoura Solla, Davi Solla, Ozcan Sonmez, Müge Sönmez, Wai Cheong Soon, Roberto Stefini, Martin Nikolaus Stienen, Bogdan Stoica, Matthew Stovell, Maria Natalia Suarez, Alaa Sulaiman, Mazin Suliman, Adi Sulistyanto, Şeniz Sulubulut, Sandra Sungailaite, Madlen Surbeck, Tomasz Szmuda, Graziano Taddei, Abraham Tadele, Ahmed Saleh Ahmed Taher, Riikka Takala, Krishna Murthy Talari, Bih Huei Tan, Leonardo Tariciotti, Murad Tarmohamed, Oumayma Taroua, Emiliano Tatti, Olli Tenovuo, Sami Tetri, Poojan Thakkar, Nqobile Thango, Satish Kumar Thatikonda, Tuomo Thesleff, Claudius Thomé, Owen Thornton, Shelly Timmons, Eva Ercilio Timoteo, Campbell Tingate, Souhil Tliba, Christos Tolias, Emma Toman, Ivan Torres, Luis Torres, Youness Touissi, Musa Touray, Maria Pia Tropeano, Georgios Tsermoulas, Christos Tsitsipanis, Mehmet Erhan Turkoglu, Özhan Merzuk Uçkun, Jamie Ullman, Gheorghe Ungureanu, Sarah Urasa, Obaid Ur-Rehman, Muhammed Uysal, Antonios Vakis, Egils Valeinis, Vaishali Valluru, Debby Vannoy, Pablo Vargas, Phillipos Varotsis, Rahul Varshney, Atul Vats, Damjan Veljanoski, Sara Venturini, Abhijit Verma, Clara Villa, Genaro Villa, Sofia Villar, Erin Villard, Antonio Viruez, Stefanos Voglis, Petar Vulekovic, Saman Wadanamby, Katherine Wagner, Rebecca Walshe, Jan Walter, Marriam Waseem, Tony Whitworth, Ruwani Wijeyekoon, Adam Williams, Mark Wilson, Sein Win, Achmad Wahib Wahju Winarso, Abraão Wagner Pessoa Ximenes, Anurag Yadav, Dipak Yadav, Kamal Makram Yakoub, Ali Yalcinkaya, Guizhong Yan, Eesha Yaqoob, Carlos Yepes, Ayfer Nazmiye Yılmaz, Betelehem Yishak, Farhat Basheer Yousuf, Muhammad Zamzuri Zahari, Hussein Zakaria, Diego Zambonin, Luca Zavatto, Bassel Zebian, Anna Maria Zeitlberger, Furong Zhang, Fengwei Zheng, and Michal Ziga

Subjects
casemix, management, mortality, emergency neurosurgery, traumatic brain injury, prospective observational cohort study, Neurology (clinical)
Abstract

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. Methods: We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)—a composite of life expectancy, education, and income measures—into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. Findings: Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24–51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34–69) and the youngest in the low HDI tier (median 28 years, IQR 20–38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6–32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55–5·2) and high HDI tier (2·26, 1·23–4·15), but not the low HDI tier (1·66, 0·61–4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17–2·49). Interpretation: Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. Funding: National Institute for Health Research Global Health Research Group.

Published
2022
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4. Minimally invasive treatment of transorbital penetrating injury of skull base and cavernous sinus: A case report

Author

Papic Vladimir, Filip Pajicic, Milan Lepić, Bojan Jelaca, Petar Vulekovic, and Djula Djilvesi

Subjects
medicine.medical_specialty, business.operation, business.industry, Neurovascular bundle, medicine.disease, Surgery, Head trauma, Skull, medicine.anatomical_structure, Cavernous sinus, medicine, Pharmacology (medical), Foreign body, business, Transorbital, Penetrating trauma, Orbit (anatomy)
Abstract

Introduction. A transorbital intracranial injury with a foreign body can be a very complex and controversial therapeutic problem. The orbit's content is susceptible to penetrating trauma, and neurovascular skull base structures are at high risk from injury. There are some traditional cranial surgical approaches, and more recently reported different endoscopic approaches for treating this kind of injury. Case report. We present a case of a 30-year-old male who had an accident at work when a piece of wood hit him in his head and entered through the medial aspect of his left orbit with skull base and cavernous sinus injury. Rapid and complete radiological and clinical assessments were performed, and the patient was treated in a minimally invasive manner. The foreign body was manually extracted with an endoscopic and endovascular team ready to treat adverse events. No postoperative complications were reported, and visual acuity increased at one month follow up. Conclusion. Penetrating wounds of the orbit represent a challenge that requires a multidisciplinary assessment and well-organized management. Combined endoscopic minimally invasive approaches should be considered during the treatment of this kind of injury.

Published
2022
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5. Comparison of radiological versus clinical cerebral vasospasm after aneurysmal subarachnoid hemorrhage: is vasospasm always present?

Author

Bojan Jelaca, Djula Djilvesi, Filip Pajicic, Jagos Golubovic, Igor Horvat, and Petar Vulekovic

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Subarachnoid hemorrhage, Cerebral arteries, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Cerebral vasospasm, Internal medicine, medicine, Humans, Vasospasm, Intracranial, Glasgow Coma Scale, cardiovascular diseases, Aged, medicine.diagnostic_test, business.industry, Intracranial Aneurysm, Vasospasm, General Medicine, Middle Aged, Subarachnoid Hemorrhage, medicine.disease, nervous system diseases, Radiography, 030104 developmental biology, Neurology, Radiological weapon, cardiovascular system, Cardiology, Female, Neurology (clinical), Angiographic vasospasm, business, Serbia, 030217 neurology & neurosurgery, Cerebral angiography
Abstract

Radiological and clinical cerebral vasospasm (CV) is defined either as a delayed narrowing of cerebral arteries after aneurysmal subarachnoid hemorrhage (aSAH) or/and occurrence of new neurological deficit/worsening of Modified Glasgow coma score for 2 or more points. The objective of this study is to determine the presence and correlation between clinical and radiological presence of vasospasm in patients with aSAH.This study was designed as a clinical, prospective single center study at the Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia. A total of 50 patients was included in the study after having radiologically confirmed aSAH. Intensity and region of CV was determined by CT and CTA performed both on admission and on day 9 of hospitalization, except for cases where clinical protocol required earlier imaging due to occurrence of clinical signs and symptoms of CV. In all patients, values of arterial blood pressure (PABP), headache (HA), body temperature (PBT), nonspecific behaviors (NSB), deterioration of consciousness (DC), new neurological deficit (NND), deterioration of two points or more per modified Glasgow Coma Scale (DmGCS ≥ 2) were monitored.CTA showed angiographic vasospasm detected in 100% patients with aSAH. Statistically significant positive correlation was found between the intensity of radiological CV and appearance of NND and DmGCS ≥ 2.This study confirms that CV always follows aSAH. Future research into pathophysiology of CV is needed in order to determine exact treatment strategies and targets so treatment towards zero mortality can be achieved.

Published
2020
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7. Venous thromboembolic and hemorrhagic events after meningioma surgery: A single-center retrospective cohort study of risk factors

Author

Nebojsa Lasica, Djula Djilvesi, Vladimir Papic, Mladen Karan, Bojan Jelaca, Jagos Golubovic, Filip Pajicic, Milica Medic-Stojanoska, Petar Vulekovic, and Lukas Rasulic

Subjects
Multidisciplinary, Postoperative Complications, Incidence, Meningeal Neoplasms, Humans, Venous Thromboembolism, Meningioma, Retrospective Studies
Abstract

Microsurgical resection of meningiomas in a majority of cases leads to a favorable outcome. Therefore, severe postoperative adverse events are less acceptable. The main purpose of this study was to investigate the incidence of symptomatic venous thromboembolism (VTE) and hemorrhagic complications in patients after operative treatment of intracranial meningiomas and to identify the risk factors in this patient subgroup. Of 106 patients undergoing elective craniotomy for meningioma overall incidence of symptomatic VTE was noted in 5.7% (six patients). For the risk-factor analysis older age (57.20 ± 11.60 vs. 71.00 ± 0.90 years, p < 0.001), higher body mass index (27.60 ± 4.80 vs. 33.16 ± 0.60 kg/m2, p < 0.001), WHO grade II (3.00% vs. 33.33%, p = 0.02), lower intraoperative blood loss (466.00 ± 383.70 vs. 216.70 ± 68.30 mL, p < 0.001), bedridden status and neurologic deficit (0.00% vs. 33.33%, p = 0.003 and 38.00% vs. 100.00%, p = 0.004) were associated with greater VTE risk. No risk factors for hemorrhagic complications were identified on univariate analysis. In conclusion, the incidence of VTE in meningioma patients is not negligible. Identified risk factors should be taken into account in the decision-making process for chemoprophylaxis when the risk of bleeding decreases.

Published
2021

8. Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review

Author

M. Fimić, Bojan Jelaca, Nebojsa Lasica, Jagos Golubovic, Filip Pajicic, Dusko Kozic, Vladimir Papic, Nada Vuckovic, Djula Djilvesi, and Petar Vulekovic

Subjects
Adult, Cerebral Cortex, Male, medicine.medical_specialty, Brain development, business.industry, Brain Neoplasms, Incidence (epidemiology), Radiography, medicine.disease, World health, Meningioma, Cyst formation, Meningeal Neoplasms, Medicine, Humans, Surgery, Histopathology, Neurology (clinical), Radiology, Differential diagnosis, business
Abstract

Background Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology. Methods A literature search of the Web of Science and PubMed databases and crossed references was performed in March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathologic characteristics were extracted. Results A total of 52 patients (including the reported case) were included in this review. The mean age was 21.1 years (range, 0.3–66 years) with a male/female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology showed a higher incidence of World Health Organization grade II (14/52, 26.9%) and World Health Organization grade III (7/52, 13.5%) of primary intraparenchymal meningiomas. Conclusions We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.

Published
2021

9. Rare case of dural arteriovenous fistula presenting by spontaneous acute subdural hematoma: A case report and review of literature

Author

Vladimir Papic, Bojan Jelaca, Tomislav Cigic, Jagos Golubovic, Petar Vulekovic, and Djula Djilvesi

Subjects
body regions, medicine.medical_specialty, business.industry, Rare case, Medicine, Arteriovenous fistula, Pharmacology (medical), business, medicine.disease, Acute subdural hematoma, Surgery
Abstract

Introduction. Dural arteriovenous fistulas represent pathological acquired bonds between the meningeal blood vessels (arteries) and drainage veins associated to them. These fistulas can vary in clinical presentations, from being asymptomatic to causing serious neurological deficits, depending mostly on the localization and size. Only one fourth of dural fistulas present themselves with intracranial bleeding. This hemorrhage is most frequently localized in subarachnoid space, occasionally intracerebrally, and seldom beneath the dura mater, ie subdurally. Case report. We presented a rare case of a patient with spontaneous acute subdural hematoma. After the initial treatment and consequent imaging methods, a diagnosis of a dural arteriovenous fistula was established. After the craniotomy for hematoma evacuation, the patient underwent an uneventful endovascular treatment. Despite the rarity of non-traumatic acute subdural hematoma caused by dural arteriovenous fistula, one should not overlook the possible pathogenesis and etiology in patients with spontaneous acute subdural hematoma. Even with the absence of the symptoms and signs of subdural bleeding, dural arteriovenous fistula, as a cause of it, should not be immediately ruled out. Conclusion. Despite the rarity of non-traumatic acute subdural hematoma being caused by dural arteriovenous fistulas, one should not immediately overlook the possible pathogenesis and etiology. Cautious approach is needed when treating such diseases even in the absence of typical symptoms.

Published
2020
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10. Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations

Author

J. Russell Huie, Stefania Mondello, Christopher J. Lindsell, Luca Antiga, Esther L. Yuh, Elisa R. Zanier, Serge Masson, Bedda L. Rosario, Adam R. Ferguson, Opeolu Adeoye, Neeraj Badjatia, Kim Boase, Yelena Bodien, M. Ross Bullock, Randall Chesnut, John D. Corrigan, Karen Crawford, Ramon Diaz-Arrastia, Sureyya Dikmen, Ann-Christine Duhaime, Richard Ellenbogen, V. Ramana Feeser, Brandon Foreman, Raquel Gardner, Etienne Gaudette, Joseph Giacino, Dana Goldman, Luis Gonzalez, Shankar Gopinath, Rao Gullapalli, J. Claude Hemphill, Gillian Hotz, Sonia Jain, Frederick Korley, Joel Kramer, Natalie Kreitzer, Harvey Levin, Joan Machamer, Christopher Madden, Geoffrey T. Manley, Alastair Martin, Thomas McAllister, Michael McCrea, Randall Merchant, Pratik Mukherjee, Lindsay Nelson, Laura B. Ngwenya, Florence Noel, David Okonkwo, Daniel Perl, Ava Puccio, Miri Rabinowitz, Claudia Robertson, Jonathan Rosand, Angelle Sander, David Schnyer, Seth Seabury, Murray Stein, Sabrina Taylor, Nancy Temkin, Arthur Toga, Alex Valadka, Mary Vassar, Paul Vespa, Kevin Wang, John K. Yue, Ross Zafonte, Cecilia Ackerlund, Hadie Adams, Vanni Agnoletti, Judith Allanson, Krisztina Amrein, Norberto Andaluz, Nada Andelic, Lasse Andreassen, Audny Anke, Azasevac Antun, Anna Antoni, Hilko Ardon, Kaspars Auslands, Philippe Azouvi, Maria Luisa Azzolini, Camelia Baciu, Rafael Badenes, Ronald Bartels, Pál Barzó, Ursula Bauerfeind, Romuald Beauvais, Ronny Beer, Francisco Javier Belda, Bo Michael Bellander, Antonio Belli, Rémy Bellier, Habib Benali, Thierry Benard, Maurizio Berardino, Luigi Beretta, Christopher Beynon, Federico Bilotta, Harald Binder, Erta Biqiri, Morten Blaabjerg, Hugo den Boogert, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Lozano Guillermo Carbayo, Marco Carbonara, Elsa Carise, K. Carpenter, Ana M. Castaño León, Francesco Causin, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Maryse Cnossen, Mark Coburn, Jonathan Coles, Lizzie Coles-Kemp, Johnny Collett, Jamie D. Cooper, Marta Correia, Amra Covic, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot Fizelier, François Damas, Pierre Damas, Helen Dawes, Véronique De Keyser, Francesco Della Corte, Bart Depreitere, Godard C.W. de Ruiter, Dula Dilvesi, Shenghao Ding, Diederik Dippel, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy Loup Dulière, Heiko Engemann, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Junfeng Feng, Kelly Foks, Francesca Fossi, Gilles Francony, Ulderico Freo, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Karin Geleijns, Pradeep George, Alexandre Ghuysen, Lelde Giga, Benoit Giraud, Ben Glocker, Jagos Golubovic, Pedro A. Gomez, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Asta Kristine Håberg, Bram Jacobs, Iain Haitsma, Jed A. Hartings, Raimund Helbok, Eirik Helseth, Daniel Hertle, Astrid Hoedemaekers, Stefan Hoefer, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Stefan Jankowski, Mike Jarrett, Bojan Jelaca, Ji yao Jiang, Kelly Jones, Konstantinos Kamnitsas, Mladen Karan, Ari Katila, Maija Kaukonen, Thomas Kerforne, Riku Kivisaari, Angelos G. Kolias, Bálint Kolumbán, Erwin Kompanje, Ksenija Kolundzija, Daniel Kondziella, Lars Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Christian Ledig, Rolf Lefering, Valerie Legrand, Jin Lei, Leon Levi, Roger Lightfoot, Hester Lingsma, Dirk Loeckx, Angels Lozano, Andrew I.R. Maas, Stephen MacDonald, Marc Maegele, Majdan Marek, Sebastian Major, Alex Manara, Geoffrey Manley, Didier Martin, Leon Francisco Martin, Costanza Martino, Hugues Maréchal, Armando Maruenda, Alessandro Masala, Julia Mattern, Charles McFadyen, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Cristina Morganti Kossmann, Davide Mulazzi, Holger Mühlan, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, Quentin Noirhomme, József Nyirádi, Mauro Oddo, Annemarie Oldenbeuving, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Adriana Patruno, Jean François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Floury Sébastien Pili, Matti Pirinen, Horia Ples, Maria Antonia Poca, Suzanne Polinder, Inigo Pomposo, Jussi Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Ruben Real, Veronika Rehorčíková, Jonathan Rhodes, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Gerwin Roks, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Marco Sacchi, Barbara Sahakian, Juan Sahuquillo, Oliver Sakowitz, Francesca Sala, Renan Sanchez Porras, Janos Sandor, Edgar Santos, Luminita Sasu, Davide Savo, Nadine Schäffer, Inger Schipper, Barbara Schlößer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Michael Schöll, Charlie Sewalt, Özcan Sir, Toril Skandsen, Lidwien Smakman, Dirk Smeets, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Nicole Steinbüchel, Ana Stevanovic, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Fabio Silvio Taccone, Riikka Takala, Viktória Tamás, Päivi Tanskanen, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Ralph Telgmann, Guido Teodorani, Alice Theadom, Matt Thomas, Dick Tibboel, Christos Tolias, Jean Flory Luaba Tshibanda, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Gregory Van der Steen, Mathieu van der Jagt, JV de Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Julia Van Waesberghe, Audrey Vanhaudenhuyse, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Giacinta Vizzino, Carmen Vleggeert Lankamp, Victor Volovici, Daphne Voormolen, Peter Vulekovic, Zoltán Vámos, Derick Wade, Kevin K.W. Wang, Lei Wang, Lars Wessels, Eveline Wiegers, Eno Wildschut, Guy Williams, Lindsay Wilson, Maren K.L. Winkler, Stefan Wolf, Peter Ylén, Alexander Younsi, Menashe Zaaroor, Frederik Zeiler, Yang Zhihui, Agate Ziverte, Fabrizio Zumbo, Huie, J Russell, Mondello, Stefania, Lindsell, Christopher J, Antiga, Luca, Yuh, Esther L, Zanier, Elisa R, Masson, Serge, Rosario, Bedda L, Ferguson, Adam R (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Participants and Investigators), Beretta, Luigi, Huie, J, Mondello, S, Lindsell, C, Antiga, L, Yuh, E, Zanier, E, Masson, S, Rosario, B, Ferguson, A, Citerio, G, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
Traumatic, 030506 rehabilitation, Data Interpretation, Data management, data sharing, TERMINAL HYDROLASE-L1, Big data, Poison control, 0302 clinical medicine, Brain Injuries, Traumatic, TBI, Medicine, Biomarker discovery, Common Data Elements, traumatic brain injury, Injuries and accidents, Statistical, Reference Standards, NET RECLASSIFICATION INDEX, Data Interpretation, Statistical, Biomarker (medicine), biomarker, 0305 other medical science, Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Investigators, CT, The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Investigators, medicine.medical_specialty, Physical Injury - Accidents and Adverse Effects, Clinical Sciences, Context (language use), Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Traumatic Brain Injury (TBI), Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Participants and Investigators, 03 medical and health sciences, MICROARRAY, Special Section: Statistical Methods in Tbi Research, Humans, biomarkers, Intensive care medicine, Traumatic Head and Spine Injury, Neurology & Neurosurgery, business.industry, Information Dissemination, OUTCOME PREDICTION, Neurosciences, COMMON DATA ELEMENTS, Precision medicine, Brain Disorders, DIFFUSE AXONAL INJURY, Data sharing, Good Health and Well Being, Brain Injuries, DISCOVERY, TRACK, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Contains fulltext : 238746.pdf (Publisher’s version ) (Closed access) Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks. In this review, we discuss data management concepts and statistical and data sharing strategies when dealing with biomarker data in the context of TBI research. We propose that application of biomarkers involves three distinct steps-discovery, evaluation, and evidence synthesis. First, complex/big data has to be reduced to useful data elements at the stage of biomarker discovery. Second, inferential statistical approaches must be applied to these biomarker data elements for assessment of biomarker clinical utility and validity. Last, synthesis of relevant research is required to support practice guidelines and enable health decisions informed by the highest quality, up-to-date evidence available. We focus our discussion around recent experiences from the International Traumatic Brain Injury Research (InTBIR) initiative, with a specific focus on four major clinical projects (Transforming Research and Clinical Knowledge in TBI, Collaborative European NeuroTrauma Effectiveness Research in TBI, Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe, and Approaches and Decisions in Acute Pediatric TBI Trial), which are currently enrolling subjects in North America and Europe. We discuss common data elements, data collection efforts, data-sharing opportunities, and challenges, as well as examine the statistical techniques required to realize successful adoption and use of biomarkers in the clinic as a foundation for precision medicine in TBI.

Published
2021

12. Cerebral arteriovenous malformation radiosurgery after intracranial hemorrhage: A case report and literature review

Author

Vladimir Papic, Mladen Karan, Jagos Golubovic, T. Cigic, Bojan Jelaca, and Petar Vulekovic

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine, Arteriovenous malformation, General Medicine, Radiology, business, medicine.disease, Radiosurgery
Abstract

Introduction. Treatment of cerebral arteriovenous malformations is very challenging and controversial in spite of current recommendations. Surgery is recommended in patients with hemorrhagic stroke, but in patients with good neurological status, when symptoms improve rapidly, the risk of surgical morbidity may be much higher than the risk of rebleeding. Case report. We report a case of a patient with an intracranial hemorrhage due to a ruptured arteriovenous malformation located in the right temporal region of the brain. Because of angiographic and anatomical features of the arteriovenous malformation (deep location and deep venous drainage, but also small arteriovenous malformation nidus size), radiosurgery was the preferred treatment modality. The patient was treated conservatively in the acute stage, and the arteriovenous malformation was subsequently completely eradicated with gamma knife radiosurgery. During the 3-year imaging follow-up, no sings of rebleeding were found. Also, angiography demonstrated that the arteriovenous malformation was completely excluded from the cerebral circulation. The patient was in a good condition and presented without neurological deficits or seizures during the follow-up period. Conclusion. All treatment modalities carry a risk of neurological compromise, but gamma knife radiosurgery may be a good option, even in cases with hemorrhagic presentation. It needs to be mentioned that complete obliteration takes approximately 1 to 3 years after the treatment, and in some cases it cannot be obtained.

Published
2017
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13. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

van Essen, Thomas A., den Boogert, Hugo F., Cnossen, Maryse C., de Ruiter, Godard C. W., Haitsma, Iain, Polinder, Suzanne, Steyerberg, Ewout W., Menon, David, Maas, Andrew I. R., Lingsma, Hester F., Peul, Wilco C., Cecilia, Ackerlund, Hadie, Adams, Vanni, Agnoletti, Judith, Allanson, Krisztina, Amrein, Norberto, Andaluz, Nada, Andelic, Lasse, Andreassen, Azasevac, Antun, Audny, Anke, Anna, Antoni, Hilko, Ardon, Gerard, Audibert, Kaspars, Auslands, Philippe, Azouvi, Luisa, Azzolini Maria, Camelia, Baciu, Rafael, Badenes, Ronald, Bartels, Pal, Barzo, Ursula, Bauerfeind, Romuald, Beauvais, Ronny, Beer, Francisco Javier, Belda, Bo-Michael, Bellander, Antonio, Belli, Remy, Bellier, Habib, Benali, Thierry, Benard, Maurizio, Berardino, Luigi, Beretta, Christopher, Beynon, Federico, Bilotta, Harald, Binder, Erta, Biqiri, Morten, Blaabjerg, Hugo, den Boogert, Pierre, Bouzat, Peter, Bragge, Alexandra, Brazinova, Vibeke, Brinck, Joanne, Brooker, Camilla, Brorsson, Andras, Buki, Monika, Bullinger, Emiliana, Calappi, Rosa, Calvi Maria, Peter, Cameron, Lozano Guillermo, Carbayo, Marco, Carbonara, Elsa, Carise, Carpenter, K., Ana M, Castano-Leon, Francesco, Causin, Giorgio, Chevallard, Arturo, Chieregato, Giuseppe, Citerio, Maryse, Cnossen, Mark, Coburn, Jonathan, Coles, Lizzie, Coles-Kemp, Johnny, Collett, Jamie, Cooper D., Marta, Correia, Amra, Covic, Nicola, Curry, Endre, Czeiter, Marek, Czosnyka, Claire, Dahyot-Fizelier, Francois, Damas, Pierre, Damas, Helen, Dawes, Veronique, De Keyser, Francesco, Della Corte, Bart, Depreitere, Godard, de Ruiter C. W., Dula, Dilvesi, Diederik, Dippel, Abhishek, Dixit, Emma, Donoghue, Jens, Dreier, Guy-Loup, Duliere, George, Eapen, Heiko, Engemann, Ari, Ercole, Patrick, Esser, Erzsebet, Ezer, Martin, Fabricius, Valery, Feigin L., Kelly, Foks, Francesca, Fossi, Gilles, Francony, Ulderico, Freo, Shirin, Frisvold, Alex, Furmanov, Pablo, Gagliardo, Damien, Galanaud, Dashiell, Gantner, Karin, Geleijns, Pradeep, George, Alexandre, Ghuysen, Lelde, Giga, Benoit, Giraud, Ben, Glocker, Jagos, Golubovic, Pedro, Gomez A., Francesca, Grossi, Russell, Gruen L., Deepak, Gupta, Juanita, Haagsma A., Iain, Haitsma, Jed, Hartings A., Raimund, Helbok, Eirik, Helseth, Daniel, Hertle, Astrid, Hoedemaekers, Stefan, Hoefer, Lindsay, Horton, Jilske, Huijben, Peter, Hutchinson J., Kristine, Haberg Asta, Bram, Jacobs, Stefan, Jankowski, Mike, Jarrett, Bojan, Jelaca, Kelly, Jones, Konstantinos, Kamnitsas, Mladen, Karan, Ari, Katila, Maija, Kaukonen, Thomas, Kerforne, Riku, Kivisaari, Angelos, Kolias G., Balint, Kolumban, Erwin, Kompanje, Ksenija, Kolundzija, Daniel, Kondziella, Lars-Owe, Koskinen, Noemi, Kovacs, Alfonso, Lagares, Linda, Lanyon, Steven, Laureys, Fiona, Lecky, Christian, Ledig, Rolf, Lefering, Valerie, Legrand, Jin, Lei, Leon, Levi, Roger, Lightfoot, Hester, Lingsma, Dirk, Loeckx, Angels, Lozano, Andrew, Maas I. R., Stephen, MacDonald, Marc, Maegele, Marek, Majdan, Sebastian, Major, Alex, Manara, Geoffrey, Manley, Didier, Martin, Francisco, Martin Leon, Costanza, Martino, Armando, Maruenda, Hugues, Marechal, Alessandro, Masala, Julia, Mattern, Charles, McFadyen, Catherine, McMahon, Bela, Melegh, David, Menon, Tomas, Menovsky, Cristina, Morganti-Kossmann, Davide, Mulazzi, Visakh, Muraleedharan, Lynnette, Murray, Holger, Muehlan, Nandesh, Nair, Ancuta, Negru, David, Nelson, Virginia, Newcombe, Daan, Nieboer, Quentin, Noirhomme, Jozsef, Nyiradi, Mauro, Oddo, Annemarie, Oldenbeuving, Matej, Oresic, Fabrizio, Ortolano, Aarno, Palotie, Paul, Parizel M., Adriana, Patruno, Jean-Francois, Payen, Natascha, Perera, Vincent, Perlbarg, Paolo, Persona, Anna, Piippo-Karjalainen, Sebastien, Pili Floury, Matti, Pirinen, Horia, Ples, Maria Antonia, Poca, Suzanne, Polinder, Inigo, Pomposo, Jussi, Posti, Louis, Puybasset, Andreea, Radoi, Arminas, Ragauskas, Rahul, Raj, Malinka, Rambadagalla, Ruben, Real, Veronika, Rehorcikova, Jonathan, Rhodes, Samuli, Ripatti, Saulius, Rocka, Cecilie, Roe, Olav, Roise, Gerwin, Roks, Jonathan, Rosand, Jeffrey, Rosenfeld, Christina, Rosenlund, Guy, Rosenthal, Rolf, Rossaint, Sandra, Rossi, Daniel, Rueckert, Martin, Rusnak, Marco, Sacchi, Barbara, Sahakian, Juan, Sahuquillo, Oliver, Sakowitz, Francesca, Sala, Renan, Sanchez-Porras, Janos, Sandor, Edgar, Santos, Luminita, Sasu, Davide, Savo, Nadine, Schaeffer, Inger, Schipper, Barbara, Schloesser, Silke, Schmidt, Herbert, Schoechl, Guus, Schoonman, Frederik, Schou Rico, Elisabeth, Schwendenwein, Michael, Schoell, Ozcan, Sir, Toril, Skandsen, Lidwien, Smakman, Dirk, Smeets, Peter, Smielewski, Abayomi, Sorinola, Emmanuel, Stamatakis, Simon, Stanworth, Nicole, Steinbuechel, Ana, Stevanovic, Robert, Stevens, William, Stewart, Ewout, Steyerberg W., Nino, Stocchetti, Nina, Sundstrom, Anneliese, Synnot, Fabio Silvio, Taccone, Riikka, Takala, Viktoria, Tamas, Paivi, Tanskanen, Steven, Taylor Mark, Braden, Te Ao, Olli, Tenovuo, Ralph, Telgmann, Guido, Teodorani, Alice, Theadom, Matt, Thomas, Dick, Tibboel, Christos, Tolias, Luaba, Tshibanda Jean-Flory, Tony, Trapani, Maria, Tudora Cristina, Peter, Vajkoczy, Shirley, Vallance, Egils, Valeinis, Gregory, Van der Steen, Mathieu, Van der Jagt, Joukje, Van der Naalt, Jeroen, van Dijck T. J. M., Thomas, Van Essen A., Wim, Van Hecke, Caroline, van Heugten, Dominique, Van Praag, Thijs, Vande Vyvere, Julia, Van Waesberghe, Audrey, Vanhaudenhuyse, Alessia, Vargiolu, Emmanuel, Vega, Kimberley, Velt, Jan, Verheyden, Paul, Vespa M., Anne, Vik, Rimantas, Vilcinis, Giacinta, Vizzino, Carmen, Vleggeert-Lankamp, Victor, Volovici, Daphne, Voormolen, Peter, Vulekovic, Zoltan, Vamos, Derick, Wade, Kevin, Wang K. W., Lei, Wang, Lars, Wessels, Eno, Wildschut, Guy, Williams, Lindsay, Wilson, Maren, Winkler K. L., Stefan, Wolf, Peter, Ylen, Alexander, Younsi, Menashe, Zaaroor, Yang, Zhihui, Agate, Ziverte, Fabrizio, Zumbo, van Essen, Thomas A., den Boogert, Hugo F., Cnossen, Maryse C., de Ruiter, Godard C. W., Haitsma, Iain, Polinder, Suzanne, Steyerberg, Ewout W., Menon, David, Maas, Andrew I. R., Lingsma, Hester F., Peul, Wilco C., Cecilia, Ackerlund, Hadie, Adams, Vanni, Agnoletti, Judith, Allanson, Krisztina, Amrein, Norberto, Andaluz, Nada, Andelic, Lasse, Andreassen, Azasevac, Antun, Audny, Anke, Anna, Antoni, Hilko, Ardon, Gerard, Audibert, Kaspars, Auslands, Philippe, Azouvi, Luisa, Azzolini Maria, Camelia, Baciu, Rafael, Badenes, Ronald, Bartels, Pal, Barzo, Ursula, Bauerfeind, Romuald, Beauvais, Ronny, Beer, Francisco Javier, Belda, Bo-Michael, Bellander, Antonio, Belli, Remy, Bellier, Habib, Benali, Thierry, Benard, Maurizio, Berardino, Luigi, Beretta, Christopher, Beynon, Federico, Bilotta, Harald, Binder, Erta, Biqiri, Morten, Blaabjerg, Hugo, den Boogert, Pierre, Bouzat, Peter, Bragge, Alexandra, Brazinova, Vibeke, Brinck, Joanne, Brooker, Camilla, Brorsson, Andras, Buki, Monika, Bullinger, Emiliana, Calappi, Rosa, Calvi Maria, Peter, Cameron, Lozano Guillermo, Carbayo, Marco, Carbonara, Elsa, Carise, Carpenter, K., Ana M, Castano-Leon, Francesco, Causin, Giorgio, Chevallard, Arturo, Chieregato, Giuseppe, Citerio, Maryse, Cnossen, Mark, Coburn, Jonathan, Coles, Lizzie, Coles-Kemp, Johnny, Collett, Jamie, Cooper D., Marta, Correia, Amra, Covic, Nicola, Curry, Endre, Czeiter, Marek, Czosnyka, Claire, Dahyot-Fizelier, Francois, Damas, Pierre, Damas, Helen, Dawes, Veronique, De Keyser, Francesco, Della Corte, Bart, Depreitere, Godard, de Ruiter C. W., Dula, Dilvesi, Diederik, Dippel, Abhishek, Dixit, Emma, Donoghue, Jens, Dreier, Guy-Loup, Duliere, George, Eapen, Heiko, Engemann, Ari, Ercole, Patrick, Esser, Erzsebet, Ezer, Martin, Fabricius, Valery, Feigin L., Kelly, Foks, Francesca, Fossi, Gilles, Francony, Ulderico, Freo, Shirin, Frisvold, Alex, Furmanov, Pablo, Gagliardo, Damien, Galanaud, Dashiell, Gantner, Karin, Geleijns, Pradeep, George, Alexandre, Ghuysen, Lelde, Giga, Benoit, Giraud, Ben, Glocker, Jagos, Golubovic, Pedro, Gomez A., Francesca, Grossi, Russell, Gruen L., Deepak, Gupta, Juanita, Haagsma A., Iain, Haitsma, Jed, Hartings A., Raimund, Helbok, Eirik, Helseth, Daniel, Hertle, Astrid, Hoedemaekers, Stefan, Hoefer, Lindsay, Horton, Jilske, Huijben, Peter, Hutchinson J., Kristine, Haberg Asta, Bram, Jacobs, Stefan, Jankowski, Mike, Jarrett, Bojan, Jelaca, Kelly, Jones, Konstantinos, Kamnitsas, Mladen, Karan, Ari, Katila, Maija, Kaukonen, Thomas, Kerforne, Riku, Kivisaari, Angelos, Kolias G., Balint, Kolumban, Erwin, Kompanje, Ksenija, Kolundzija, Daniel, Kondziella, Lars-Owe, Koskinen, Noemi, Kovacs, Alfonso, Lagares, Linda, Lanyon, Steven, Laureys, Fiona, Lecky, Christian, Ledig, Rolf, Lefering, Valerie, Legrand, Jin, Lei, Leon, Levi, Roger, Lightfoot, Hester, Lingsma, Dirk, Loeckx, Angels, Lozano, Andrew, Maas I. R., Stephen, MacDonald, Marc, Maegele, Marek, Majdan, Sebastian, Major, Alex, Manara, Geoffrey, Manley, Didier, Martin, Francisco, Martin Leon, Costanza, Martino, Armando, Maruenda, Hugues, Marechal, Alessandro, Masala, Julia, Mattern, Charles, McFadyen, Catherine, McMahon, Bela, Melegh, David, Menon, Tomas, Menovsky, Cristina, Morganti-Kossmann, Davide, Mulazzi, Visakh, Muraleedharan, Lynnette, Murray, Holger, Muehlan, Nandesh, Nair, Ancuta, Negru, David, Nelson, Virginia, Newcombe, Daan, Nieboer, Quentin, Noirhomme, Jozsef, Nyiradi, Mauro, Oddo, Annemarie, Oldenbeuving, Matej, Oresic, Fabrizio, Ortolano, Aarno, Palotie, Paul, Parizel M., Adriana, Patruno, Jean-Francois, Payen, Natascha, Perera, Vincent, Perlbarg, Paolo, Persona, Anna, Piippo-Karjalainen, Sebastien, Pili Floury, Matti, Pirinen, Horia, Ples, Maria Antonia, Poca, Suzanne, Polinder, Inigo, Pomposo, Jussi, Posti, Louis, Puybasset, Andreea, Radoi, Arminas, Ragauskas, Rahul, Raj, Malinka, Rambadagalla, Ruben, Real, Veronika, Rehorcikova, Jonathan, Rhodes, Samuli, Ripatti, Saulius, Rocka, Cecilie, Roe, Olav, Roise, Gerwin, Roks, Jonathan, Rosand, Jeffrey, Rosenfeld, Christina, Rosenlund, Guy, Rosenthal, Rolf, Rossaint, Sandra, Rossi, Daniel, Rueckert, Martin, Rusnak, Marco, Sacchi, Barbara, Sahakian, Juan, Sahuquillo, Oliver, Sakowitz, Francesca, Sala, Renan, Sanchez-Porras, Janos, Sandor, Edgar, Santos, Luminita, Sasu, Davide, Savo, Nadine, Schaeffer, Inger, Schipper, Barbara, Schloesser, Silke, Schmidt, Herbert, Schoechl, Guus, Schoonman, Frederik, Schou Rico, Elisabeth, Schwendenwein, Michael, Schoell, Ozcan, Sir, Toril, Skandsen, Lidwien, Smakman, Dirk, Smeets, Peter, Smielewski, Abayomi, Sorinola, Emmanuel, Stamatakis, Simon, Stanworth, Nicole, Steinbuechel, Ana, Stevanovic, Robert, Stevens, William, Stewart, Ewout, Steyerberg W., Nino, Stocchetti, Nina, Sundstrom, Anneliese, Synnot, Fabio Silvio, Taccone, Riikka, Takala, Viktoria, Tamas, Paivi, Tanskanen, Steven, Taylor Mark, Braden, Te Ao, Olli, Tenovuo, Ralph, Telgmann, Guido, Teodorani, Alice, Theadom, Matt, Thomas, Dick, Tibboel, Christos, Tolias, Luaba, Tshibanda Jean-Flory, Tony, Trapani, Maria, Tudora Cristina, Peter, Vajkoczy, Shirley, Vallance, Egils, Valeinis, Gregory, Van der Steen, Mathieu, Van der Jagt, Joukje, Van der Naalt, Jeroen, van Dijck T. J. M., Thomas, Van Essen A., Wim, Van Hecke, Caroline, van Heugten, Dominique, Van Praag, Thijs, Vande Vyvere, Julia, Van Waesberghe, Audrey, Vanhaudenhuyse, Alessia, Vargiolu, Emmanuel, Vega, Kimberley, Velt, Jan, Verheyden, Paul, Vespa M., Anne, Vik, Rimantas, Vilcinis, Giacinta, Vizzino, Carmen, Vleggeert-Lankamp, Victor, Volovici, Daphne, Voormolen, Peter, Vulekovic, Zoltan, Vamos, Derick, Wade, Kevin, Wang K. W., Lei, Wang, Lars, Wessels, Eno, Wildschut, Guy, Williams, Lindsay, Wilson, Maren, Winkler K. L., Stefan, Wolf, Peter, Ylen, Alexander, Younsi, Menashe, Zaaroor, Yang, Zhihui, Agate, Ziverte, and Fabrizio, Zumbo

Abstract

BackgroundNeurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe.MethodsA survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP).ResultsThe survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25mmHg, 18% 30mmHg, and 17% 20mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions.ConclusionDespite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.

Published
2019

14. SEMIOLOGY OF PATHOLOGICAL CONDITIONS IN PATIENTS INDICATED FOR STEREOTACTIC BIOPSY

Author

Bojan Jelaca, T. Cigic, Mladen Karan, Jagos Golubovic, Petar Vulekovic, and Djula Djilvesi

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Weakness, Stereotactic biopsy, Adolescent, Biopsy, Organic brain syndrome, Stereotaxic Techniques, Young Adult, medicine, Humans, Medical history, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Brain Neoplasms, Brain biopsy, General Medicine, Semiology, Middle Aged, medicine.disease, Surgery, Vomiting, Female, Epileptic seizure, medicine.symptom, business
Abstract

Introduction. Brain tumors produce symptoms and signs which are often non-specific, and therefore they may occur for more than a few months prior to diagnosis. The aim of this study was to determine the frequency of referent signs and symptoms among patients referred for stereotactic brain biopsy. Material and Methods. In this study, we retrospectively analyzed medical history of 65 patients (67.7% males and 32.3% females) between the ages of 16 and 81 years. The following symptoms and signs were included in the analysis: organic brain syndrome, lateralization of crossed pyramidal tract, cranial nerve dysfunction, speech disorders, cerebellar-vestibular syndrome, nausea, vomiting, headache, the occurrence of at least one epileptic seizure and respondents? physical weakness. Results. Physical weakness was the most frequent symptom to be recognized (76.9%), whereas pyramidal neurological lateralization was the most commonly recognized sign (58.5%). There was a significant correlation between the course of disease and physical weakness (rho = -0.34, p = 0.005), as well as the course of disease and lateralization of the pyramidal tract (rho = 0.65, p = 0.00). No significant correlation was found between other clinical signs and symptoms. Conclusion. An accurate diagnosis and early recognition of signs and symptoms may be useful in determining indications for stereotactic brain biopsy.

Published
2018

15. Acute Quadriplegia Caused by Idiopathic Spontaneous Epidural Haematoma in Young Adult-Case Report and Review of Literature

Author

T. Cigic, Petar Vulekovic, N. Krajčinović, Mladen Karan, Sonja Golubović, Jagos Golubovic, Bojan Jelaca, and Vladimir Papic

Subjects
medicine.medical_specialty, Weakness, Neck pain, business.industry, medicine.medical_treatment, Laminectomy, medicine.disease, Chest pain, Surgery, Hematoma, Epidural hematoma, Spinal cord compression, Paralysis, medicine, medicine.symptom, business
Abstract

Introduction: Authors tried to emphasize the importance of diagnosing and rapidly treating spontaneous spinal epidural hematoma (SSEH), a rare idiopathic condition which if not recognized early can have catastrophic consequences. The definition and pathophysiology of this condition remains controversial. Usual management consists of urgent MRI imaging followed by immediate surgical decompression. Clinical presentation: A 22 year young adult presented with the symptoms of sudden severe chest pain, followed by weakness and numbness over the all four extremities, progressing to intense paraparesis, anesthesia and consecutively quadriplegia and sphincter control loss. MR imaging demonstrated acute epidural hematoma of cervico-thoracic spinal segments (C7-Th2) with cord compression. Idiopathic SSEH was diagnosed and prompt decompressive laminectomy with hematoma evacuation was performed. During the operation cause of bleeding was not identified. Postoperatively CTA and DSA were performed which came back negative. After 2 weeks, there was no residual weakness/parasthaesias, sphincter control was fully obtained and full motor power was required. Discussion: SSEH in its true idiopathic form is a rare pathologic entity which can be disabling or fatal. According to the literature, most patients present with severe back and/or neck pain, often with a radicular component, followed by motor and/or sensory deficits which are symptoms to be aware of. Prompt diagnosis should be made with MRI, and evacuation of the hematoma should be immediate, ideally before the onset of neurologic signs or symptoms. As evidenced outcome depends on prompt operation timing and prognosis is impacted by age and preoperative deficit. Because of the high risk of poor outcome without treatment, SSEH should always be a diagnostic consideration in patients whose presentation is even slightly suggestive. Rapid, appropriate surgical treatment can often lead to complete recovery of function, whereas any delay in appropriate treatment can be disastrous. The role of conservative management needs to be proven and should be tailored on an individual basis. Conclusion: SSEH is a rare and potentially fatal disease. Prompt diagnosis and surgical treatment is required to obtain good outcome results. Physicians should be aware of the early symptoms so the best treatment can be achieved.

Published
2016
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16. Characteristics of Traumatic Brain Injury Patients in the Province of Vojvodina: Impact of CENTER-TBI Study

Author

Đula Đilvesi, Vladimir Papic, A. Azaševac, Bojan Jelaca, M. Loc, I. Meljnikov, Igor Horvat, T. Cigic, Jagos Golubovic, M. Fimić, N. Krajčinović, Mladen Karan, and Petar Vulekovic

Subjects
medicine.medical_specialty, business.industry, Traumatic brain injury, Emergency medicine, Medicine, Surgery, Center (algebra and category theory), Neurology (clinical), business, medicine.disease
Published
2015
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17. Modified Glasgow Coma Scale Score as an Early Indicator of Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage

Author

N. Krajčinović, T. Cigic, Jagos Golubovic, Vladimir Papic, Mladen Karan, A. Azaševac, Igor Horvat, Đula Đilvesi, Petar Vulekovic, and Bojan Jelaca

Subjects
medicine.medical_specialty, Subarachnoid hemorrhage, Cerebral vasospasm, business.industry, Anesthesia, medicine, Glasgow Coma Scale, Surgery, In patient, Neurology (clinical), business, medicine.disease
Published
2015
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