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  • 1
    Online Resource
    Online Resource
    Neurocognitive changes after awake surgery in glioma patients: a retrospective cohort study
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Neuro-Oncology Vol. 146, No. 1 ( 2020-01), p. 97-109
    Details
    In: Journal of Neuro-Oncology, Springer Science and Business Media LLC, Vol. 146, No. 1 ( 2020-01), p. 97-109
    Abstract: Deficits in neurocognitive functioning (NCF) frequently occur in glioma patients. Both treatment and the tumor itself contribute to these deficits. In order to minimize the harmful effects of surgery, an increasing number of patients undergo awake craniotomy. To investigate whether we can indeed preserve cognitive functioning after state-of-the art awake surgery and to identify factors determining postoperative NCF, we performed a retrospective cohort study. Methods In diffuse glioma (WHO grade 2–4) patients undergoing awake craniotomy, we studied neurocognitive functioning both pre-operatively and 3–6 months postoperatively. Evaluation covered five neurocognitive domains. We performed analysis of data on group and individual level and evaluated the value of patient-, tumor- and treatment-related factors for predicting change in NCF, using linear and logistic regression analysis. Results We included 168 consecutive patients. Mean NCF-scores of psychomotor speed and visuospatial functioning significantly deteriorated after surgery. The percentage of serious neurocognitive impairments (− 2 standard deviations) increased significantly for psychomotor speed only. Tumor involvement in the left thalamus predicted a postoperative decline in NCF for the domains overall-NCF, executive functioning and psychomotor speed. An IDH-wildtype status predicted decline for overall-NCF and executive functioning. Conclusions In all cognitive domains, except for psychomotor speed, cognitive functioning can be preserved after awake surgery. The domain of psychomotor speed seems to be most vulnerable to the effects of surgery and early postoperative therapies. Cognitive performance after glioma surgery is associated with a combination of structural and biomolecular effects from the tumor, including IDH-status and left thalamic involvement.
    Type of Medium: Online Resource
    ISSN: 0167-594X , 1573-7373
    URL: Article
    DOI: 10.1007/s11060-019-03341-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2007293-4
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  • 2
    Online Resource
    Online Resource
    Cerebrospinal fluid leakage after cranial surgery in the pediatric population—a systematic review and meta-analysis
    Springer Science and Business Media LLC ; 2021
    In:  Child's Nervous System Vol. 37, No. 5 ( 2021-05), p. 1439-1447
    Details
    In: Child's Nervous System, Springer Science and Business Media LLC, Vol. 37, No. 5 ( 2021-05), p. 1439-1447
    Abstract: Cerebrospinal fluid (CSF) leakage is a common complication after neurosurgical intervention. It is associated with substantial morbidity and increased healthcare costs. The current systematic review and meta-analysis aim to quantify the incidence of cerebrospinal fluid leakage in the pediatric population and identify its risk factors. Methods The authors followed the PRISMA guidelines. The Embase, PubMed, and Cochrane database were searched for studies reporting CSF leakage after intradural cranial surgery in patients up to 18 years old. Meta-analysis of incidences was performed using a generalized linear mixed model. Results Twenty-six articles were included in this systematic review. Data were retrieved of 2929 patients who underwent a total of 3034 intradural cranial surgeries. Surprisingly, only four of the included articles reported their definition of CSF leakage. The overall CSF leakage rate was 4.4% (95% CI 2.6 to 7.3%). The odds of CSF leakage were significantly greater for craniectomy as opposed to craniotomy (OR 4.7, 95% CI 1.7 to 13.4) and infratentorial as opposed to supratentorial surgery (OR 5.9, 95% CI 1.7 to 20.6). The odds of CSF leakage were significantly lower for duraplasty use versus no duraplasty (OR 0.41 95% CI 0.2 to 0.9). Conclusion The overall CSF leakage rate after intradural cranial surgery in the pediatric population is 4.4%. Risk factors are craniectomy and infratentorial surgery. Duraplasty use is negatively associated with CSF leak. We suggest defining a CSF leak as “leakage of CSF through the skin,” as an unambiguous definition is fundamental for future research.
    Type of Medium: Online Resource
    ISSN: 0256-7040 , 1433-0350
    URL: Article
    DOI: 10.1007/s00381-021-05036-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1463024-2
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  • 3
    Online Resource
    Online Resource
    Cerebrospinal fluid leakage after intradural spinal surgery in children
    Springer Science and Business Media LLC ; 2023
    In:  Child's Nervous System Vol. 39, No. 4 ( 2023-04), p. 1013-1019
    Details
    In: Child's Nervous System, Springer Science and Business Media LLC, Vol. 39, No. 4 ( 2023-04), p. 1013-1019
    Abstract: This study aimed to establish the incidence of CSF leakage in children and associated complications after intradural spinal surgery in three tertiary neurosurgical referral centers and to describe the treatment strategies applied. Methods Patients of 18 years or younger who underwent intradural spinal surgery between 2015 and 2021 in three tertiary neurosurgical referral centers were included. Patients who died or were lost to follow-up within six weeks after surgery were excluded. The primary outcome measure was CSF leakage within six weeks after surgery, defined as leakage of CSF through the skin. Secondary outcome measures included the presence of pseudomeningocele (PMC), meningitis, and surgical site infection (SSI). Results We included a total of 75 procedures, representing 66 individual patients. The median age in this cohort was 5 (IQR = 0-13 years. CSF leakage occurred in 2.7% (2/75) of procedures. It occurred on days 3 and 21 after the index procedure, respectively. One patient was treated with a pressure bandage and an external lumbar drain on day 4 after diagnosis of the leak, and the other was treated with wound revision surgery on day 1 after the leak occurred. In total, 1 patient developed a PMC without a CSF leak which was treated with wound revision surgery. SSI occurred in 10.7%, which included both cases of CSF leak. Conclusions CSF leakage after intradural spinal surgery in the pediatric population is relatively rare (2.7%). Nevertheless, the clinical consequences with respect to secondary complications such as infection and the necessity for invasive treatment are serious.
    Type of Medium: Online Resource
    ISSN: 0256-7040 , 1433-0350
    URL: Article
    DOI: 10.1007/s00381-022-05797-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463024-2
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  • 4
    Online Resource
    Online Resource
    Tumor-related neurocognitive dysfunction in patients with diffuse glioma: a retrospective cohort study prior to antitumor treatment
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Practice Vol. 6, No. 6 ( 2019-12-07), p. 463-472
    Details
    In: Neuro-Oncology Practice, Oxford University Press (OUP), Vol. 6, No. 6 ( 2019-12-07), p. 463-472
    Abstract: Impairments in neurocognitive functioning (NCF) frequently occur in glioma patients. Both the tumor and its treatment contribute to these impairments. We aimed to quantify NCF in glioma patients before treatment and to investigate which factors influence NCF. Methods We performed a retrospective cohort study in diffuse glioma patients according to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria. All patients had undergone neuropsychological assessment as part of routine clinical care, before awake surgery. We studied “overall NCF” and NCF in 5 neurocognitive domains separately. For “overall NCF” and per domain, we performed analyses at 2 different levels of outcome measures: (1) group level: mean cognitive functioning of the study sample, and (2) individual level: the percentage of impaired patients. We performed multivariable logistic regression analyses to investigate which factors were associated with the occurrence of cognitive impairments. Results From our cohort of glioma patients (2010-2016), 168 patients met all the inclusion criteria. All cognitive domains were significantly affected at the group level. The percentages of neurocognitive impairments (–2SD) were highest for Executive Functioning, Psychomotor Speed, and Memory (26.5%, 23.2%, and 19.3%, respectively). Patients with high-grade glioma were affected more severely than patients with low-grade glioma. Tumor volume, isocitrate dehydrogenase status, WHO grade, and histology were associated with the occurrence of domain-specific impairments. Conclusions Cognitive impairment occurs in the majority of treatment-naive glioma patients. The domains Executive Functioning, Speed, and Memory are involved most frequently. These impairments in NCF are explained not only by tumor location and volume, but also by other (biological) mechanisms.
    Type of Medium: Online Resource
    ISSN: 2054-2577 , 2054-2585
    URL: Article
    DOI: 10.1093/nop/npz008
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2768945-1
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  • 5
    Online Resource
    Online Resource
    Incisional CSF leakage after intradural cranial surgery in children: incidence, risk factors, and complications
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2023
    In:  Journal of Neurosurgery: Pediatrics Vol. 31, No. 4 ( 2023-04-01), p. 313-320
    Details
    In: Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 31, No. 4 ( 2023-04-01), p. 313-320
    Abstract: The risk of cerebrospinal fluid (CSF) leakage after cranial surgery and its associated complications in children are unclear because of variable definitions and the lack of multicenter studies. In this study, the authors aimed to establish the incidence of CSF leakage after intradural cranial surgery in the pediatric population. In addition, they evaluated potential risk factors and complications related to CSF leakage in the pediatric population. METHODS The authors performed an international multicenter retrospective cohort study in three tertiary neurosurgical referral centers. Included were all patients aged 18 years or younger who had undergone cranial surgery to reach the subdural space during the period between 2015 and 2021. Patients who died or were lost to follow-up within 6 weeks after surgery were excluded. The primary outcome measure was the incidence of CSF leakage, defined as leakage through the skin, within 6 weeks after surgery. Univariable and multivariable logistic regression analyses were performed to identify risk factors for and complications related to CSF leakage. RESULTS In total, 759 procedures were identified, performed in 687 individual patients. The incidence of CSF leakage was 7.5% (95% CI 5.7%–9.6%). In the multivariate model, independent risk factors for CSF leakage were hydrocephalus (OR 4.5, 95% CI 2.2–8.9) and craniectomy (OR 7.6, 95% CI 3.0–19.5). Patients with CSF leakage had higher odds of pseudomeningocele (5.7, 95% CI 3.0–10.8), meningitis (21.1, 95% CI 9.5–46.8), and surgical site infection (7.4, 95% CI 2.6–20.8) than patients without leakage. CONCLUSIONS CSF leakage risk in children after cranial surgery, which is comparable to the risk reported in adults, is an event of major concern and has a serious clinical impact.
    Type of Medium: Online Resource
    ISSN: 1933-0707 , 1933-0715
    URL: Article
    DOI: 10.3171/2022.11.PEDS22421
    RVK:
    XA 55270.2
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2023
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  • 6
    Online Resource
    Online Resource
    Radiological differences between subtypes of WHO 2016 grade II–III gliomas: a systematic review and meta-analysis
    Oxford University Press (OUP) ; 2020
    In:  Neuro-Oncology Advances Vol. 2, No. 1 ( 2020-01-01)
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 2, No. 1 ( 2020-01-01)
    Abstract: Isocitrate dehydrogenase (IDH) mutation and 1p/19q-codeletion are oncogenetic alterations with a positive prognostic value for diffuse gliomas, especially grade II and III. Some studies have suggested differences in biological behavior as reflected by radiological characteristics. In this paper, the literature regarding radiological characteristics in grade II and III glioma subtypes was systematically evaluated and a meta-analysis was performed. Methods Studies that addressed the relationship between conventional radiological characteristics and IDH mutations and/or 1p/19q-codeletions in newly diagnosed, grade II and III gliomas of adult patients were included. The “3-group analysis” compared radiological characteristics between the WHO 2016 glioma subtypes (IDH-mutant astrocytoma, IDH-wildtype astrocytoma, and oligodendroglioma), and the “2-group analysis” compared radiological characteristics between 1p/19q-codeleted gliomas and 1p/19q-intact gliomas. Results Fourteen studies (3-group analysis: 670 cases, 2-group analysis: 1042 cases) were included. IDH-mutated astrocytomas showed more often sharp borders and less frequently contrast enhancement compared to IDH-wildtype astrocytomas. 1p/19q-codeleted gliomas had less frequently sharp borders, but showed a heterogeneous aspect, calcification, cysts, and edema more frequently. For the 1p/19q-codeleted gliomas, a sensitivity of 96% was found for heterogeneity and a specificity of 88.1% for calcification. Conclusions Significant differences in conventional radiological characteristics exist between the WHO 2016 glioma subtypes, which may reflect differences in biological behavior. However, the diagnostic value of the independent radiological characteristics is insufficient to reliably predict the molecular genetic subtype.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdaa044
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 3009682-0
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  • 7
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    Advanced intraoperative MRI in pediatric brain tumor surgery
    Frontiers Media SA ; 2023
    In:  Frontiers in Physiology Vol. 14 ( 2023-4-13)
    Details
    In: Frontiers in Physiology, Frontiers Media SA, Vol. 14 ( 2023-4-13)
    Abstract: Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides “real-time” imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging. Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care. Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent. Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.
    Type of Medium: Online Resource
    ISSN: 1664-042X
    URL: Article
    DOI: 10.3389/fphys.2023.1098959
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2564217-0
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  • 8
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    Online Resource
    Robotic alignment system Cirq (Brainlab) for navigated brain tumor biopsies in children
    Springer Science and Business Media LLC ; 2023
    In:  Child's Nervous System
    Details
    In: Child's Nervous System, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 0256-7040 , 1433-0350
    URL: Article
    DOI: 10.1007/s00381-023-06060-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463024-2
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  • 9
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    Online Resource
    Interrelationships between molecular subtype, anatomical location, and extent of resection in diffuse glioma: a systematic review and meta-analysis
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Advances Vol. 1, No. 1 ( 2019-05-01)
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 1, No. 1 ( 2019-05-01)
    Abstract: The introduction of the 2016 WHO Classification of Tumors of the Central Nervous System has resulted in tumor groupings with improved prognostic value for diffuse glioma patients. Molecular subtype, primarily based on IDH-mutational status and 1p/19q-status, is a strong predictor of survival. It is unclear to what extent this finding may be mediated by differences in anatomical location and surgical resectability among molecular subgroups. Our aim was to elucidate possible correlations between (1) molecular subtype and anatomical location and (2) molecular subtype and extent of resection. Methods We performed a systematic review of literature searching for studies on molecular subtype in relation to anatomical location and extent of resection. Only original data concerning adult participants suffering from cerebral diffuse glioma were included. Studies adopting similar outcomes measures were included in our meta-analysis. Results In the systematic analysis for research questions 1 and 2, totals of 20 and 9 studies were included, respectively. Study findings demonstrated that IDH-mutant tumors were significantly more frequently located in the frontal lobe and less often in the temporal lobe compared with IDH-wildtype gliomas. Within the IDH-mutant group, 1p/19q-codeleted tumors were associated with more frequent frontal and less frequent temporal localization compared with 1p/19q-intact tumors. In IDH-mutant gliomas, greater extent of resection was achieved than in IDH-wildtype tumors. Conclusions Genetic profile of diffuse cerebral glioma influences their anatomical location and seems to affect tumor resectability.
    Type of Medium: Online Resource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdz032
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 3009682-0
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  • 10
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    Epilepsy surgery provides new insights in retinotopic organization of optic radiations. A systematic review
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Current Opinion in Ophthalmology Vol. 20, No. 6 ( 2009-11), p. 490-494
    Details
    In: Current Opinion in Ophthalmology, Ovid Technologies (Wolters Kluwer Health), Vol. 20, No. 6 ( 2009-11), p. 490-494
    Type of Medium: Online Resource
    ISSN: 1040-8738
    URL: Article
    DOI: 10.1097/ICU.0b013e3283313c02
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
    detail.hit.zdb_id: 2026983-3
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