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2. Management of severe traumatic brain injury (first 24 hours)

Author

Geeraerts, Thomas, Velly, Lionel, Abdennour, Lamine, Asehnoune, Karim, Audibert, Gérard, Bouzat, Pierre, Bruder, Nicolas, Carrillon, Romain, Cottenceau, Vincent, Cotton, François, Courtil-Teyssedre, Sonia, Dahyot-Fizelier, Claire, Dailler, Frédéric, David, Jean-Stéphane, Engrand, Nicolas, Fletcher, Dominique, Francony, Gilles, Gergelé, Laurent, Ichai, Carole, Javouhey, Étienne, Leblanc, Pierre-Etienne, Lieutaud, Thomas, Meyer, Philippe, Mirek, Sébastien, Orliaguet, Gilles, Proust, François, Quintard, Hervé, Ract, Catherine, Srairi, Mohamed, Tazarourte, Karim, Vigué, Bernard, and Payen, Jean-François

Published
2018
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4. Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group

Author

Dreier, Jens P, Fabricius, Martin, Ayata, Cenk, Sakowitz, Oliver W, William Shuttleworth, C, Dohmen, Christian, Graf, Rudolf, Vajkoczy, Peter, Helbok, Raimund, Suzuki, Michiyasu, Schiefecker, Alois J, Major, Sebastian, Winkler, Maren KL, Kang, Eun-Jeung, Milakara, Denny, Oliveira-Ferreira, Ana I, Reiffurth, Clemens, Revankar, Gajanan S, Sugimoto, Kazutaka, Dengler, Nora F, Hecht, Nils, Foreman, Brandon, Feyen, Bart, Kondziella, Daniel, Friberg, Christian K, Piilgaard, Henning, Rosenthal, Eric S, Westover, M Brandon, Maslarova, Anna, Santos, Edgar, Hertle, Daniel, Sánchez-Porras, Renán, Jewell, Sharon L, Balança, Baptiste, Platz, Johannes, Hinzman, Jason M, Lückl, Janos, Schoknecht, Karl, Schöll, Michael, Drenckhahn, Christoph, Feuerstein, Delphine, Eriksen, Nina, Horst, Viktor, Bretz, Julia S, Jahnke, Paul, Scheel, Michael, Bohner, Georg, Rostrup, Egill, Pakkenberg, Bente, Heinemann, Uwe, Claassen, Jan, Carlson, Andrew P, Kowoll, Christina M, Lublinsky, Svetlana, Chassidim, Yoash, Shelef, Ilan, Friedman, Alon, Brinker, Gerrit, Reiner, Michael, Kirov, Sergei A, Andrew, R David, Farkas, Eszter, Güresir, Erdem, Vatter, Hartmut, Chung, Lee S, Brennan, KC, Lieutaud, Thomas, Marinesco, Stephane, Maas, Andrew IR, Sahuquillo, Juan, Dahlem, Markus A, Richter, Frank, Herreras, Oscar, Boutelle, Martyn G, Okonkwo, David O, Bullock, M Ross, Witte, Otto W, Martus, Peter, van den Maagdenberg, Arn MJM, Ferrari, Michel D, Dijkhuizen, Rick M, Shutter, Lori A, Andaluz, Norberto, Schulte, André P, MacVicar, Brian, Watanabe, Tomas, Woitzik, Johannes, Lauritzen, Martin, Strong, Anthony J, and Hartings, Jed A

Published
2017
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6. Peri-interventional outcome study in the elderly in Europe : A 30-day prospective cohort study

Author

Kowark, Ana, Rossaint, Rolf, Rückbeil, Marcia V., Hilgers, Ralf-Dieter, Bilotta, Federico, Bollheimer, Leo C., Buhre, Wolfgang, Guenther, Ulf, Hoeft, Andreas, Lee, Peter, Matot, Idit, Rex, Steffen, Steinmetz, Jacob, Tournoy, Jos, Alanoglu, Zekeriyya, Berger, Marc M., Falières, Xavier, Goettel, Nicolai, Kartalov, Andrijan, Katsanoulas, Konstantinos, Kenig, Jakub, Khoronenko, Victoria, Lundstrøm, Lars H., Macharadze, Tamar, Milenovic, Miodrag, Molliex, Serge, Órfão, Rosário, Soro, Marina, Stefan, Mihai, Sungur, Zerrin, Szakmany, Tamas, Baños, Victoria, Rodriguez, Mireia, Martinez, Selene, Saller, Thomas, Schäfer, Simon T., Clermond, Edouard, Martin, Charlotte, Le Moal, Charlene, Staikowsky, Frederik, Delannoy, Bertand, Desebbe, Olivier, Missant, Carlo, Desmet, Matthias, Gillmann, Hans-Joerg, Stueber, Thomas, Dalsø, Sille M., Vester-Andersen, Morten, Ranft, Andreas, Schneider, Gerhard, Huygens, Christel, Meeusen, Roselien, Cruz, Patricia, Fernández, Carmen, Otto, Mareike, Giltaire, Agathe, Hofmann, Pascal, Gurlit, Simone, Fernández, Alejandro Romero, Castelli, Federica, Ntouba, Alexandre, Lanoiselée, Julien, Schulz, Regina, Opperer, Mathias, Van Waesberghe, Julia, Ziemann, Sebastian, Refaeli-Awin, Einat, Bengisun, Zuleyha Kazak, Buchman, Immanuel, Yahav-Shafir, Dana, Dimakopoulou, Antonia, Le Guen, Morgan, Rodríguez-Pérez, Aurelio, Beran, Maud, Bonnal, Aurelien, Garot, Matthias, Maupain, Olivier, Michel, Denis, Fernandes, Sofia, Sanabra, Maria, Mangoubi, Eitan, Boselli, Emmanuel, Switzer, Timothy, García-Sánchez, Jose I., Boisson, Matthieu, Stamoulis, Konstantinos, García, María Merino, Wulf, Hinnerk, Gouraud, David, Lebrun, Christophe, Lasocki, Sigismond, Steiner, Luzius A., Bergmann, Lars, Baenziger, Bertram, Karpetas, Georgios, Meco, Basak C., Hızal, Ayşe, Hernández, Rosa Méndez, Smit-Fun, Valerie, Charco, Pedro, Nickel, Frank, Grau Torradeflot, Laura, Coburn, Mark, Berger, Marc, Farcher, Helmut, Adriaensens, Ine, Saldien, Vera, Berghmans, Johan, Van Hove, Sofie, Eerdekens, Gert-Jan, Mesotten, Dieter, Timmers, Maxim, Vandermeulen, Elly, De Bruyne, Ann, De Hert, Stefan, De Ruyter, Hendrik, Van Belleghem, Vincent, Boscart, Isabelle, De Corte, Wouter, Carlier, Stefaan, Castelain, Charlotte, Demeyer, Caroline, Vandenbossche, Carl, Detienne, Hans, Devroe, Sarah, Dewinter, Geertrui, Hoogma, Danny, Van de Velde, Marc, Poels, Stéphanie, Soetens, Filiep, Fenger-Eriksen, Christian, Draegert, Christina, Santos, Sofia Gaspar, Soelling, Christine, Andersen, Gertrud, Haderslev, Pernille, Rasmussen, Vibe M., Sommer, Tine G., Kirkegaard, Johan, Olesen, Christian M., Paramanathan, Sansu, Jensen, Lisbet Tokkesdal, Knudsen, Halfdan H., Schmidt, Jens C., Stehen, Nick P., Dupont, Hervé, Herbinet, Clément, Lorne, Emmanuel, Mahjoub, Yazine, Fritsch, Marine, Garcia, Manuela, Petit Phan, Jonathan, Lieutaud, Thomas, Bonneric, Laura, Gaillet, Maxime, des Déserts, Marc Danguy, Montelescaut, Etienne, Lamblin, Antoine, Muller, Violaine, Lagrange, Celine, Robert, Alain, Lebas, Benoit, Lebuffe, Gilles, Beuvelot, Johanne, Dejour, David, Deligne, Emmanuel, Gignoux, Benoit, Guillaud, Olivier, Nloga, Joseph, Prunier-Bossion, Florence, Sibellas, Franck, Abraham, Paul, Bidon, Cyril, Rimmele, Thomas, Bruge-Ansel, Marie-Hélène, Friggeri, Arnaud, Lukaszewicz, Anne-Claire, Dziadzko, Mikhail, Leone, Marc, Meresse, Zoe, Pastene, Bruno, Odin, Isabelle, Bouic, Nicolas, Trinh Duc, Pierre, Pillant, Thomas, Riboulet, Fabien, Degoul, Samuel, Saumier, Nicolas, Wasilewski, Marion, Asehnoune, Karim, Roquilly, Antoine, Glasman, Pauline, Puybasset, Louis, Garnier, Fanny, Verdonk, Franck, Samama, Charles M., Towa, Line, Blet, Alice, Barrau, Stéphanie, Debaene, Bertrand, Frasca, Denis, Imzi, Nadia, Delvaux, Bernard, Huynh, Davy, Mercadal, Luc, Zanoun, Nabil, de Baene, Armelle, Boulay-Maninovsky, Catherine, Fernandes, Olivier, Gomis, Philippe, Malinovsky, Jean-Marc, Romain, François-Xavier, Calmelet, Astrid, Dupont, Ségolène, Millet, Sophie, Simonneau, Frédéric, Charret, Francoise, Couturier, Charlène, Lornage, Estelle, Mallard, Jeremy, Milati, Ryan, Passot, Sylvie, Vallier, Sylvain, Agavriloaia, Mihaela L., Badoux, Quentin, Lewandowski, Mehdi, Mermet, Yanis, Kiskira, Olga, Adjavon, Sherifa, Dumans, Virginie, Josserand, Julien, Ma, Sabrina, Castanera, Jeremy, Massiera, Benjamin, Petua, Philippe, Bounes-Vardon, Fanny, Bosc, Gaëlle, Bosch, Laëtitia, Ferre, Fabrice, Labaste, François, Menut, Rémi, Minville, Vincent, Srairi, Mohamed, Tarasi, Maria, Varin, Florent, Grüßer, Linda, Nowak, Hartmuth, Oprea, Günther, Rump, Katharina, Unterberg, Matthias, Vogelsang, Heike, Klutzny, Mitja, Neumann, Claudia, Soehle, Martin, Wittmann, Maria, Scharffenberg, Martin, Wittenstein, Jakob, Hinterberg, Jonas, Kienbaum, Peter, Lurati-Buse, Giovanna, Schäfer, Maximilian, Lindau, Simone, Meybohm, Patrick, Piekarski, Florian, Kaufhold, Theresa A., Koppert, Wolfgang, Leffler, Andreas, Reiffen, Hans-Peter, Rudolph, Diana, Starke, Henning, Bischoff, Petra, Haberecht, Heinz, Plehn, Heiko, Bauer, Michael, Kortgen, Andreas, Sponholz, Christoph, Krüger, Uwe, Müller-Esch, Sabine, Rempf, Christian, Schmidt, Christian, Schumacher, Dunja, Blazek, Juliane, Büttner, Christin, Leibeling, Andrea, Rüsch, Dirk, Burow, Karsten, El-Hilali, Eugen A., Greke, Christian, Großmann, Paul, Kluth, Mario, Dridi, Sofiane, Popovska, Ivana, Brenes, Andrés, Feddersen, Pia, Gerstmeyer, Dominik, Fthenakis, Philippe, Miketta, Dirk, von Dossow, Vera, Groene, Philipp, Höchter, Dominik, Hofmann-Kiefer, Klaus, Kammerer, Tobias, Kamrath, Malte, Schaefer, Simon T., Tomasi, Roland, Wiedemann, Tobias, Zeuzem-Lampert, Catharina, Zwissler, Bernhard, Braune, Stephan, Brune, Mona, Hemping-Bovenkerk, André, Möllmann, Michael, Santamaria, Mario, Schirwitz, Leonie M., Meersch, Melanie, Zarbock, Alexander, Decker, Stefanie, Drexler, Berthold, Hipp, Silvia, Müller, Markus, Roth, Judith, Seiß, Miriam, Adam, Christian, Schwartges, Ingo, Kranke, Peter, Chloropoulou, Pelagia, Andreeva, Antonia, Douma, Amalia, Gregoriadou, Iphigeneia, Koutsouli, Evelina, Mendrinou, Konstantina, Mavrommati, Eirini, Stathopoulos, Anastasios, Batistaki, Chrysanthi, Matsota, Paraskevi, Kalopita, Konstantina, Skandalou, Vasiliki, Balanika, Marina, Papathanakos, Georgios, Tzimas, Petros, Ketikidou, Evgenia, Vachlioti, Anastasia, Kiamiloglou, Bioulent, Nikouli, Evangelia, Arnaoutoglou, Eleni, Kolonia, Konstantina, Laou, Eleni, Vlachakis, Epaminondas, Lianou, Ioanna, Spyraki, Maria, Tatani, Irini, Panagiotou, Eleni, Samara, Evangelia, Kolesnikova, Anna, Sifaki, Freideriki, Zarzava, Eirini, Bampzelis, Athanasios, Georgopoulou, Eleni, Christidou, Eleni, Tsaousi, Georgia, Nastou, Maria, Ioannidis, Orestis, Dolzenko, Eugene, Geleve, Georgia, Logotheti, Eleni, Yfantidis, Fotios, Rajamanickam, Senbagam, Ramaswamy, Shanmuga, Das Punshi, Gurmukh, Srinivasan, Karthikeyan, Gilmartin, Michael, Morris, Osmond, Gozal, Yaacov, Merissat, Amar, Peled, Reut, Willner, Dafna, Chariski, Hila A., Eidelman, Leonid A., Livne, Michal Y., Berkenstadt, Haim, Orlcin, Dina, Aharonov, Rita, Cattan, Anat, Felman, Lior, Steinberg, Yohai, Zabeeda, Wisam, Kuzmanovska, Biljana, Naumovski, Filip, Toleska, Marija, Sivevski, Atanas, Andriessen, Anouk, Kortekaas, Minke, Van Gorp, Roos, de Korte-de Boer, Dianne, Theunissen, Maurice, Droger, Mirjam, van den Enden, Toine, Koopman, Seppe, Marsman, Marije, van Schaik, Eva, Azenha, Marta, Lanzaro, Camile, Borrego, Andreia, Branquinho, Pedro, Laires, Miguel, de Noronha, Denise, Ferraz, Inês, Pires, Ana, Silva, Joana, Corneci, Dan, Oprea, Oana, Zahiu, Stefan-Vladimir, Tomescu, Dana R., Grintescu, Ioana M., Filipescu, Daniela, Stefanescu, Elena, Vazenin, Andrey, Baskakov, Danil, Tipisev, Dmitry, Kozlova, Ksenia, Marinkovic, Olivera, Sekulic, Ana, Rajkovic, Marija, Djukanovic, Marija, Nikolic, Jovanka, Sreckovic, Svetlana, Stojanovic, Marina, Ladjevic, Nebojsa, Jovicic, Jelena, Unic-Stojanovic, Dragana, Stosic, Biljana, Bulasevic, Aleksandra, Espinosa-Moreno, Alma M., Martín-Vaquerizo, Beatriz, Morandeira-Rivas, Clara, Zamudio, Diana, Guadalupe, Nerea, Herranz, Gracia, Baute, Javier, Madrona, Vanesa, de Jose, Roser, Miralles, Jordi, Merten, Alfred, Muñoz, Rolando, Delgado, Anabel, Moral, Victoria, Blesa, Aleix Carmona, Espejo, Sara, Grau Torredeflot, Laura, Pujol, Pere Serra, Alvira Uribe, Maria J., Perez, Astrid Alvarez, Brunetto, Espedito, Aguirre, Jorge Gonzalez, Villar, Adriana Herivas, Rojas, Guido Munoz, Montero, Natalia, González, Víctor Baladrón, Becerra-Bolaños, Ángel, Santana-Ortega, Luis, Suárez-Romero, Vanessa, Torres-Machí, María L., Ferrero de Paz, Javier, Marcos-Vidal, Jose M., Garcia, Ana Martín, Diaz, Consuelo Rego, Santiago, Ana Crespo, Laso, Lourdes Ferreira, Solores, Felix Lobato, Burgos, Alba, Calvo, Alberto, Fernández, Ignacio, Garutti, Ignacio, Higuero, Fernando, Martinez, David, Piñeiro, Patricia, Carazo, Sonia Expósito, Rodríguez, Mar Orts, Rueda, Fernando Ramasco, Abad-Motos, Ane, Ripollés-Melchor, Javier, López, Carmen Pastor, Perez-Palao, Sara, Sancho-Iñigo, Laura, Segura, Nasara, Utrera, Esther, Albinarrate, Ania, Fondarella, Ana M., Gallego-Ligorit, Lucia, Torrijos, Luisa Lacosta, Bandschapp, Oliver, Blum, Andrea A., Seeberger, Esther, Thomann, Alessandra E., Frei, Seraina, Hoehn, Susan, Capaldo, Giuliana, Christ, Daniel, Doerig, Ramon, Hodel, Daniel, Weiss, Andreas, Witt, Lukas, Schumacher, Philippe, Siebing, Dirk A., Akbuz, Seyma Orcan, Kazbek, Baturay K., Koksoy, Ulku C., Terzi, Engin Z., Yilmaz, Hakan, Alkis, Neslihan, Turhan, Sanem Cakar, Hajiyeva, Konul, Guclu, Cigdem Yildirim, Ergil, Jülide, Ceran, Emine Unal, Ozcelik, Menekse, Bülent, Atik, Gökhan, Kilinc, Saracoglu, Kemal T., Kir, Bunyamin, Koltka, Kemalettin, Sivrikoz, Nükhet, Dincer, Pelin Corman, Canbolat, Nur, Kudsioglu, Turkan, Aydin, Gaye, Mucuoglu, Ceren Aygün, Inal, Duriye G., Kucukguclu, Semih, Egilmez, Ayse I., Kozanhan, Betul, Yildiz, Munise, Pinar, Hüseyin U., Erdivanlı, Başar, Karagöz, Emre, Kazdal, Hızır, Özdemir, Abdullah, Tas Tuna, Ayca, Gulgun, Gamze, and Oleg, Dolya

Abstract

European journal of anaesthesiology : EJA 39(3), 198-209 (2022). doi:10.1097/EJA.0000000000001639, Published by Lippincott Williams & Wilkins, Philadelphia, Pa.

Published
2022
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9. Road traffic accident-related thoracic trauma: Epidemiology, injury pattern, outcome, and impact on mortality—A multicenter observational study.

Author

Benhamed, Axel, Ndiaye, Amina, Emond, Marcel, Lieutaud, Thomas, Boucher, Valérie, Gossiome, Amaury, Laumon, Bernard, Gadegbeku, Blandine, and Tazarourte, Karim

Subjects
RIB fractures, BRAIN injuries, SCIENTIFIC observation, AGE groups, WOUNDS & injuries, CHEST tubes
Abstract

Background: Thoracic trauma is a major cause of death in trauma patients and road traffic accident (RTA)-related thoracic injuries have different characteristics than those with non-RTA related thoracic traumas, but this have been poorly described. The main objective was to investigate the epidemiology, injury pattern and outcome of patients suffering a significant RTA-related thoracic injury. Secondary objective was to investigate the influence of serious thoracic injuries on mortality, compared to other serious injuries. Methods: We performed a multicenter observational study including patients of the Rhône RTA registry between 1997 and 2016 sustaining a moderate to lethal (Abbreviated Injury Scale, AIS≥2) injury in any body region. A subgroup (AISThorax≥2 group) included those with one or more AIS≥2 thoracic injury. Descriptive statistics were performed for the main outcome and a multivariate logistic regression was computed for our secondary outcome. Results: A total of 176,346 patients were included in the registry and 6,382 (3.6%) sustained a thoracic injury. Among those, median age [IQR] was 41 [25–58] years, and 68.9% were male. The highest incidence of thoracic injuries in female patients was in the 70–79 years age group, while this was observed in the 20–29 years age group among males. Most patients were car occupants (52.3%). Chest wall injuries were the most frequent thoracic injuries (62.1%), 52.4% of which were multiple rib fractures. Trauma brain injuries (TBI) were the most frequent concomitant injuries (29.1%). The frequency of MAISThorax = 2 injuries increased with age while that of MAISThorax = 3 injuries decreased. A total of 16.2% patients died. Serious (AIS≥3) thoracic injuries (OR = 12.4, 95%CI [8.6;18.0]) were strongly associated with mortality but less than were TBI (OR = 27.9, 95%CI [21.3;36.7]). Conclusion: Moderate to lethal RTA-related thoracic injuries were rare. Multiple ribs fractures, pulmonary contusions, and sternal fractures were the most frequent anatomical injuries. The incidence, injury pattern and mechanisms greatly vary across age groups. [ABSTRACT FROM AUTHOR]

Published
2022
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10. How should dexmedetomidine and clonidine be prescribed in the critical care setting?

Author

Longrois, Dan, Petitjeans, Fabrice, Simonet, Olivier, de Kock, Marc, Belliveau, Marc, Pichot, Cyrille, Lieutaud, Thomas, Ghignone, Marco, and Quintín, Luc

Subjects
CORONARY care units, BRADYCARDIA, DEXMEDETOMIDINE
Abstract

Copyright of Revista Brasileira de Terapia Intensiva is the property of Associacao de Medicina Intensiva Brasileira and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2021
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12. The Decrease in Traumatic Brain Injury Epidemics Deriving from Road Traffic Collision Following Strengthened Legislative Measures in France.

Author

Lieutaud, Thomas, Gadegbeku, Blandine, Ndiaye, Amina, Chiron, Mireille, and Viallon, Vivian

Subjects
*BRAIN injuries, *TRAFFIC accidents, *EPIDEMICS, *TRAUMA severity indices, *TRAFFIC regulations
Abstract

Background: Since 2002, France has been strengthening legislation on road traffic. This study is intended to evaluate the changes in Traumatic Brain Injury (TBI) incidence and mortality resulting from Road Traffic Collision (RTC) in the two 6-year periods before and after 2002. Methods: We used a Registry of all RTC casualties in the Rhône Department of France. Each casualty was coded according to the Abbreviated Injury Scale (AIS). The study describes changes in demographic variables, TBI (AIS ≥ 2) incidence and mortality, other body lesions (AIS ≥ 3) associated with TBI, road user types, seatbelt and helmet wearing. Findings: RTC casualty occurrences decreased by 21% (from 64,312 to 50,746) during the period after 2002. TBI occurrence accounted for 8.6% and 6.7% of all RTC in both periods. This corresponds to a reduction of TBI casualty incidence (-42%), which was much more pronounced than RTC casualty incidence (-25%) (p < 0.0001). Severe and critical TBI (AIS-4 and -5) incidences were reduced by half as much (-21%), compared to TBI incidence. TBI mortality rate (among population) and lethality (among TBI related to RTC casualties) decreased 56% and 23%, respectively. This reduction particularly affected car occupants and victims who deceased. TBI incidence decreased 43% in all 10-year age classes until 60 on average, this decrease declining with age in the period after 2002. After adjustment for age, sex, road user types, and severity of lesions at the head and other body regions, logistic regression analysis displayed a protective effect of the period following 2002, on the risk of death after RTC-related TBI. Interpretation: The greater reductions in the incidence, severity and mortality of TBI when compared with the reduction of casualty incidence have mainly affected car users. These results should be attributable to the improvements in standards of care, primary safety of the car fleet and general road architecture safety. However, the increased reduction in the TBI epidemics in France, when compared to those observed in other developed countries for the same periods, suggests that the effects should be strongly attributable to changes in road user behaviour induced by law enforcement. The at-risk groups for TBI after RTC are now two-wheel users (motorized or not) and individuals over 60 years of age. [ABSTRACT FROM AUTHOR]

Published
2016
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17. Peri-interventional outcome study in the elderly in Europe A 30-day prospective cohort study

Author

Ana Sekulic, Selene Martinez Perez, Danny Feike Hoogma, GÖKHAN KILINÇ, Marc Danguy des Déserts, Evangelia Samara, AYSE HIZAL, Nicolai Goettel, Martin Scharffenberg, Sofia Fernandes, Jose Ignacio García-Sánchez, Tobias Kammerer, Marc Moritz Berger, Florian Piekarski, CEREN AYGÜN MUÇUOĞLU, PATRICIA PIÑEIRO OTERO, Angel Becerra, Aurelio Rodriguez-Perez, Ülkü Ceren Köksoy, Jakob Wittenstein, Lars Lundstrøm, Diana Zamudio Penko, Hans-Joerg Gillmann, Dianne De Korte-de Boer, Jose miguel Marcos-vidal, Sebastian Ziemann, Tournoy, Jos, Kowark, Ana, Rossaint, Rolf, Matot, Idit, Nickel, Frank, Grau Torradeflot, Laura, Coburn, Mark, Berger, Marc, Farcher, Helmut, Opperer, Mathias, Adriaensens, Ine, Saldien, Vera, Berghmans, Johan, Van Hove, Sofie, Rex, Steffen, Beran, Maud, Eerdekens, Gert-Jan, Mesotten, Dieter, Timmers, Maxim, Vandermeulen, Elly, De Bruyne, Ann, De Hert, Stefan, De Ruyter, Hendrik, Van Belleghem, Vincent, Boscart, Isabelle, Steinmetz, Jacob, De Corte, Wouter, Desmet, Matthias, Missant, Carlo, Carlier, Stefaan, Castelain, Charlotte, Demeyer, Caroline, Vandenbossche, Carl, Detienne, Hans, Devroe, Sarah, Dewinter, Geertrui, Hoogma, Danny, Huygens, Christel, Meeusen, Roselien, Van de Velde, Marc, Lebrun, Christophe, Poels, Stéphanie, Soetens, Filiep, Fenger-Eriksen, Christian, Alanoglu, Zekeriyya, Draegert, Christina, Santos, Sofia Gaspar, Soelling, Christine, Andersen, Gertrud, Dalsø, Sille M., Haderslev, Pernille, Rasmussen, Vibe M., Vester-Andersen, Morten, Sommer, Tine G., Berger, Marc M., Kirkegaard, Johan, Lundstrøm, Lars H., Olesen, Christian M., Paramanathan, Sansu, Jensen, Lisbet Tokkesdal, Knudsen, Halfdan H., Schmidt, Jens C., Stehen, Nick P., Dupont, Hervé, Herbinet, Clément, Falières, Xavier, Lorne, Emmanuel, Mahjoub, Yazine, Ntouba, Alexandre, Fritsch, Marine, Garcia, Manuela, Lasocki, Sigismond, Petit Phan, Jonathan, Lieutaud, Thomas, Bonneric, Laura, Boselli, Emmanuel, Goettel, Nicolai, Gaillet, Maxime, des Déserts, Marc Danguy, Montelescaut, Etienne, Lamblin, Antoine, Muller, Violaine, Lagrange, Celine, Le Moal, Charlene, Robert, Alain, Staikowsky, Frederik, Lebas, Benoit, Kartalov, Andrijan, Lebuffe, Gilles, Garot, Matthias, Beuvelot, Johanne, Dejour, David, Deligne, Emmanuel, Desebbe, Olivier, Delannoy, Bertand, Gignoux, Benoit, Guillaud, Olivier, Nloga, Joseph, Katsanoulas, Konstantinos, Prunier-Bossion, Florence, Sibellas, Franck, Abraham, Paul, Bidon, Cyril, Rimmele, Thomas, Bruge-Ansel, Marie-Hélène, Friggeri, Arnaud, Lukaszewicz, Anne-Claire, Dziadzko, Mikhail, Leone, Marc, Rückbeil, Marcia V., Kenig, Jakub, Meresse, Zoe, Pastene, Bruno, Odin, Isabelle, Bonnal, Aurelien, Bouic, Nicolas, Trinh Duc, Pierre, Pillant, Thomas, Riboulet, Fabien, Degoul, Samuel, Saumier, Nicolas, Khoronenko, Victoria, Wasilewski, Marion, Asehnoune, Karim, Roquilly, Antoine, Glasman, Pauline, Puybasset, Louis, Garnier, Fanny, Verdonk, Franck, Samama, Charles M., Towa, Line, Blet, Alice, Barrau, Stéphanie, Boisson, Matthieu, Debaene, Bertrand, Frasca, Denis, Imzi, Nadia, Delvaux, Bernard, Huynh, Davy, Maupain, Olivier, Mercadal, Luc, Zanoun, Nabil, Macharadze, Tamar, de Baene, Armelle, Boulay-Maninovsky, Catherine, Fernandes, Olivier, Giltaire, Agathe, Gomis, Philippe, Malinovsky, Jean-Marc, Romain, François-Xavier, Calmelet, Astrid, Dupont, Ségolène, Gouraud, David, Milenovic, Miodrag, Millet, Sophie, Simonneau, Frédéric, Charret, Francoise, Couturier, Charlène, Lanoiselée, Julien, Lornage, Estelle, Mallard, Jeremy, Milati, Ryan, Passot, Sylvie, Vallier, Sylvain, Molliex, Serge, Agavriloaia, Mihaela L., Badoux, Quentin, Lewandowski, Mehdi, Mermet, Yanis, Michel, Denis, Kiskira, Olga, Adjavon, Sherifa, Dumans, Virginie, Le Guen, Morgan, Josserand, Julien, Órfão, Rosário, Ma, Sabrina, Castanera, Jeremy, Massiera, Benjamin, Petua, Philippe, Bounes-Vardon, Fanny, Bosc, Gaëlle, Bosch, Laëtitia, Clermond, Edouard, Ferre, Fabrice, Labaste, François, Soro, Marina, Martin, Charlotte, Menut, Rémi, Minville, Vincent, Srairi, Mohamed, Tarasi, Maria, Varin, Florent, Grüßer, Linda, Stefan, Mihai, Van Waesberghe, Julia, Ziemann, Sebastian, Bergmann, Lars, Nowak, Hartmuth, Oprea, Günther, Rump, Katharina, Unterberg, Matthias, Vogelsang, Heike, Klutzny, Mitja, Neumann, Claudia, Sungur, Zerrin, Soehle, Martin, Wittmann, Maria, Scharffenberg, Martin, Wittenstein, Jakob, Hinterberg, Jonas, Kienbaum, Peter, Lurati-Buse, Giovanna, Schäfer, Maximilian, Lindau, Simone, Hilgers, Ralf-Dieter, Szakmany, Tamas, Meybohm, Patrick, Gillmann, Hans-Joerg, Piekarski, Florian, Kaufhold, Theresa A., Koppert, Wolfgang, Leffler, Andreas, Reiffen, Hans-Peter, Rudolph, Diana, Starke, Henning, Stueber, Thomas, Baños, Victoria, Bischoff, Petra, Haberecht, Heinz, Plehn, Heiko, Bauer, Michael, Kortgen, Andreas, Sponholz, Christoph, Krüger, Uwe, Müller-Esch, Sabine, Otto, Mareike, Rempf, Christian, Rodriguez, Mireia, Schmidt, Christian, Schumacher, Dunja, Blazek, Juliane, Büttner, Christin, Leibeling, Andrea, Rüsch, Dirk, Wulf, Hinnerk, Burow, Karsten, El-Hilali, Eugen A., Greke, Christian, Martinez, Selene, Großmann, Paul, Kluth, Mario, Schulz, Regina, Dridi, Sofiane, Popovska, Ivana, Brenes, Andrés, Ranft, Andreas, Feddersen, Pia, Gerstmeyer, Dominik, Fthenakis, Philippe, Saller, Thomas, Schneider, Gerhard, Miketta, Dirk, von Dossow, Vera, Groene, Philipp, Höchter, Dominik, Hofmann-Kiefer, Klaus, Kammerer, Tobias, Kamrath, Malte, Schaefer, Simon T., Schäfer, Simon T., Tomasi, Roland, Wiedemann, Tobias, Zeuzem-Lampert, Catharina, Zwissler, Bernhard, Braune, Stephan, Brune, Mona, Gurlit, Simone, Hemping-Bovenkerk, André, Möllmann, Michael, Santamaria, Mario, Schirwitz, Leonie M., Meersch, Melanie, Zarbock, Alexander, Guenther, Ulf, Decker, Stefanie, Drexler, Berthold, Hipp, Silvia, Hofmann, Pascal, Müller, Markus, Roth, Judith, Seiß, Miriam, Adam, Christian, Schwartges, Ingo, Kranke, Peter, Chloropoulou, Pelagia, Andreeva, Antonia, Dimakopoulou, Antonia, Douma, Amalia, Gregoriadou, Iphigeneia, Koutsouli, Evelina, Mendrinou, Konstantina, Mavrommati, Eirini, Stathopoulos, Anastasios, Batistaki, Chrysanthi, Matsota, Paraskevi, Kalopita, Konstantina, Skandalou, Vasiliki, Balanika, Marina, Papathanakos, Georgios, Tzimas, Petros, Ketikidou, Evgenia, Vachlioti, Anastasia, Kiamiloglou, Bioulent, Nikouli, Evangelia, Arnaoutoglou, Eleni, Kolonia, Konstantina, Laou, Eleni, Stamoulis, Konstantinos, Vlachakis, Epaminondas, Bilotta, Federico, Karpetas, Georgios, Lianou, Ioanna, Spyraki, Maria, Tatani, Irini, Panagiotou, Eleni, Samara, Evangelia, Kolesnikova, Anna, Sifaki, Freideriki, Zarzava, Eirini, Bampzelis, Athanasios, Georgopoulou, Eleni, Christidou, Eleni, Tsaousi, Georgia, Nastou, Maria, Ioannidis, Orestis, Dolzenko, Eugene, Geleve, Georgia, Logotheti, Eleni, Yfantidis, Fotios, Lee, Peter, Rajamanickam, Senbagam, Ramaswamy, Shanmuga, Switzer, Timothy, Das Punshi, Gurmukh, Srinivasan, Karthikeyan, Gilmartin, Michael, Morris, Osmond, Buchman, Immanuel, Gozal, Yaacov, Merissat, Amar, Peled, Reut, Willner, Dafna, Chariski, Hila A., Eidelman, Leonid A., Livne, Michal Y., Mangoubi, Eitan, Berkenstadt, Haim, Orlcin, Dina, Yahav-Shafir, Dana, Aharonov, Rita, Cattan, Anat, Felman, Lior, Refaeli-Awin, Einat, Steinberg, Yohai, Zabeeda, Wisam, Kuzmanovska, Biljana, Naumovski, Filip, Toleska, Marija, Sivevski, Atanas, Andriessen, Anouk, Kortekaas, Minke, Buhre, Wolfgang, Van Gorp, Roos, de Korte-de Boer, Dianne, Smit-Fun, Valerie, Theunissen, Maurice, Droger, Mirjam, van den Enden, Toine, Koopman, Seppe, Marsman, Marije, van Schaik, Eva, Azenha, Marta, Lanzaro, Camile, Borrego, Andreia, Branquinho, Pedro, Fernandes, Sofia, Laires, Miguel, de Noronha, Denise, Ferraz, Inês, Pires, Ana, Silva, Joana, Corneci, Dan, Oprea, Oana, Zahiu, Stefan-Vladimir, Tomescu, Dana R., Grintescu, Ioana M., Filipescu, Daniela, Stefanescu, Elena, Vazenin, Andrey, Baskakov, Danil, Tipisev, Dmitry, Kozlova, Ksenia, Marinkovic, Olivera, Sekulic, Ana, Rajkovic, Marija, Djukanovic, Marija, Nikolic, Jovanka, Sreckovic, Svetlana, Stojanovic, Marina, Ladjevic, Nebojsa, Jovicic, Jelena, Unic-Stojanovic, Dragana, Bollheimer, Leo C., Stosic, Biljana, Bulasevic, Aleksandra, Espinosa-Moreno, Alma M., García-Sánchez, Jose I., Martín-Vaquerizo, Beatriz, Morandeira-Rivas, Clara, Zamudio, Diana, Guadalupe, Nerea, Herranz, Gracia, Baute, Javier, Madrona, Vanesa, de Jose, Roser, Miralles, Jordi, Merten, Alfred, Muñoz, Rolando, Delgado, Anabel, Cruz, Patricia, Moral, Victoria, Blesa, Aleix Carmona, Espejo, Sara, Grau Torredeflot, Laura, Fernández, Alejandro Romero, Sanabra, Maria, Pujol, Pere Serra, Alvira Uribe, Maria J., Perez, Astrid Alvarez, Brunetto, Espedito, Fernández, Carmen, Castelli, Federica, Aguirre, Jorge Gonzalez, Villar, Adriana Herivas, Rojas, Guido Munoz, Montero, Natalia, González, Víctor Baladrón, Becerra-Bolaños, Ángel, Rodríguez-Pérez, Aurelio, Santana-Ortega, Luis, Suárez-Romero, Vanessa, Torres-Machí, María L., Ferrero de Paz, Javier, Marcos-Vidal, Jose M., Garcia, Ana Martín, García, María Merino, Diaz, Consuelo Rego, Santiago, Ana Crespo, Laso, Lourdes Ferreira, Solores, Felix Lobato, Burgos, Alba, Calvo, Alberto, Fernández, Ignacio, Garutti, Ignacio, Higuero, Fernando, Martinez, David, Piñeiro, Patricia, Carazo, Sonia Expósito, Hernández, Rosa Méndez, Rodríguez, Mar Orts, Rueda, Fernando Ramasco, Abad-Motos, Ane, Ripollés-Melchor, Javier, López, Carmen Pastor, Charco, Pedro, Perez-Palao, Sara, Sancho-Iñigo, Laura, Segura, Nasara, Utrera, Esther, Albinarrate, Ania, Fondarella, Ana M., Gallego-Ligorit, Lucia, Torrijos, Luisa Lacosta, Bandschapp, Oliver, Blum, Andrea A., Seeberger, Esther, Steiner, Luzius A., Thomann, Alessandra E., Frei, Seraina, Hoehn, Susan, Baenziger, Bertram, Capaldo, Giuliana, Christ, Daniel, Doerig, Ramon, Hodel, Daniel, Weiss, Andreas, Witt, Lukas, Schumacher, Philippe, Siebing, Dirk A., Akbuz, Seyma Orcan, Bengisun, Zuleyha Kazak, Kazbek, Baturay K., Koksoy, Ulku C., Terzi, Engin Z., Yilmaz, Hakan, Alkis, Neslihan, Turhan, Sanem Cakar, Meco, Basak C., Hajiyeva, Konul, Guclu, Cigdem Yildirim, Ergil, Jülide, Ceran, Emine Unal, Ozcelik, Menekse, Bülent, Atik, Gökhan, Kilinc, Saracoglu, Kemal T., Kir, Bunyamin, Koltka, Kemalettin, Sivrikoz, Nükhet, Dincer, Pelin Corman, Canbolat, Nur, Kudsioglu, Turkan, Aydin, Gaye, Mucuoglu, Ceren Aygün, Inal, Duriye G., Kucukguclu, Semih, Egilmez, Ayse I., Kozanhan, Betul, Yildiz, Munise, Pinar, Hüseyin U., Erdivanlı, Başar, Hızal, Ayşe, Karagöz, Emre, Kazdal, Hızır, Özdemir, Abdullah, Tas Tuna, Ayca, Gulgun, Gamze, Oleg, Dolya, Hoeft, Andreas, MUMC+: MA Anesthesiologie (3), RS: MHeNs - R3 - Neuroscience, and MUMC+: MA Anesthesiologie (9)

Subjects
Aged, 80 and over, Male, Patient, Frailty, Preoperative assessment, Surgical outcomes, Europe, Hospitalization, Older, Anesthesiology and Pain Medicine, Outcome Assessment, Health Care, Humans, Female, Surgery, Prospective Studies, Derivation, Mortality, Aged
Abstract

OBJECTIVES The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality. DESIGN A prospective cohort study. SETTING European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period. PATIENTS Nine thousand four hundred and ninety-seven consecutively recruited patients aged 80 years and older undergoing any kind of surgical or nonsurgical procedures under anaesthesia. MAIN OUTCOME MEASURES The primary outcome was all-cause mortality within 30 days after procedure described by Kaplan–Meier curves with 95% CI. Risk factors for 30-day mortality were analysed using a Cox regression model with 14 fixed effects and a random centre effect. RESULTS Data for 9497 patients (median age, 83.0 years; 52.8% women) from 177 academic and nonacademic hospitals in 20 countries were analysed. Patients presented with multimorbidity (77%), frailty (14%) and at least partial functional dependence (38%). The estimated 30-day mortality rate was 4.2% (95% CI 3.8 to 4.7). Among others, independent risk factors for 30-day mortality were multimorbidity, hazard ratio 1.87 (95% CI 1.26 to 2.78), frailty, hazard ratio 2.63 (95% CI 2.10 to 3.30), and limited mobility, hazard ratio 2.19 (95% CI 1.24 to 3.86). The majority of deaths (76%) occurred in hospital. Mortality risk for unplanned ICU admission was higher, hazard ratio 3.57 (95% CI 2.38 to 5.26) than for planned ICU admission, hazard ratio 1.92 (95% CI 1.47 to 2.50). Compared with other studies, the in-hospital complication rates of 17.4 and 3.9% after discharge were low. Admission to a unit with geriatric care within 30 days after the intervention was associated with a better survival within the first 10 days. CONCLUSIONS The estimated 30-day mortality rate of 4.2% was lower than expected in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03152734, https://clinicaltrials.gov. ispartof: European Journal Of Anaesthesiology vol:39 issue:3 pages:198-209 ispartof: location:England status: published

Published
2022
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18. Spinal cord injuries sustained in road crashes are not on the decrease in france: a study based on epidemiological trends.

Author

Lieutaud T, Ndiaye A, Laumon B, and Chiron M

Subjects
Adolescent, Adult, Aged, Automobiles, Bicycling injuries, Child, Child, Preschool, Female, France epidemiology, Humans, Infant, Male, Middle Aged, Motorcycles, Paraparesis epidemiology, Quadriplegia epidemiology, Registries, Spinal Cord Injuries mortality, Spinal Fractures epidemiology, Spinal Fractures mortality, Spine pathology, Survival, Young Adult, Accidents, Traffic statistics & numerical data, Spinal Cord Injuries epidemiology
Abstract

Traumatic spinal cord injuries (SCI) are rare but extremely costly. In order to improve the modelling of inclusion criteria for studies of SCI it is necessary to determine what epidemiological trends affect SCI. Using the Rhone Registry, which contains all the casualties resulting from road crashes in the Rhône département of France and codes their injuries using the Abbreviated Injury Scale (AIS), we describe the epidemiological trends that affect spinal cord injury (SCI), major spinal trauma (MST) and severe injuries (AIS4+) to other body regions between two periods 1996-2001 and 2003-2008. Although there has been a marked decrease (35%) in the incidence of casualties after a road traffic crash, and reductions of 22% in the incidence of MST and 33% in that of severe injuries (AIS4+) (p<0.001), for SCI the incidence rate and number of casualties have remained surprisingly stable. In the second period, there was no change in the incidence of SCI resulting from road traffic crashes, nor in the associated fatality, mortality and survival rates. The incidence for car users was significantly lower in the second period. This contrasts with the incidences for motorcyclists and for the group including pedestrians and cyclists which were respectively 47% and 77% higher in the second period. The median age of the casualties, the age-adjusted incidence of SCI and the number of associated injuries were also higher in the second period. We have observed a marked reduction in the incidence of road trauma including the most severe injuries, but not SCI. The higher proportion of motorcyclists, the increase in the age of casualties and the greater presence of multiple injuries are new factors in the epidemiology of SCI after a road crash.

Published
2012
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19. A 10-year population survey of spinal trauma and spinal cord injuries after road accidents in the Rhône area.

Author

Lieutaud T, Ndiaye A, Frost F, and Chiron M

Subjects
Accidents, Traffic mortality, Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Child, Female, France epidemiology, Head Protective Devices, Health Surveys, Humans, Incidence, Male, Middle Aged, Seat Belts, Sex Factors, Accidents, Traffic statistics & numerical data, Automobiles, Cervical Vertebrae injuries, Motorcycles, Spinal Cord Injuries epidemiology, Spinal Injuries epidemiology
Abstract

Fatalities or injuries following motorized and non-motorized vehicle accidents (MNMVA) are reported by police or health care systems. However, limited data exist for spinal injuries. Using an epidemiological database of road accidents occurring in a defined geographic area, we measured the incidence of major spinal trauma (MST, Abbreviated Injury Scale [AIS] score 2 or more), spinal cord injury (SCI, AIS score 4 or more), and associated lesions over a 10-year period (1997-2006). Among the 97,341 victims included, 21,623 (22.2%) suffered spinal trauma, but only 1523 (1.6%) and 144 (0.2%) sustained an MST or SCI, respectively, and among those 10% and 43% died, respectively, before reaching hospital facilities. Men were more likely to have SCI and die. Cervical injuries were more frequently observed for SCI (58%) than for MST (39%; p < 0.001). Motorcyclists were overrepresented in SCI (33%) compared to MST (21%; p < 0.001), and were at significant risk for fatality. Non-restrained car occupants were at risk of MST and SCI, whereas motorcyclists wearing helmets were not. The chest was the most frequently-injured body region. Nearly half of MNMVA victims suffering SCI die quickly after the crash. Young age, male gender, a motorcyclist, and non-restrained car occupant were risk factors for serious injury. These groups should be targeted in specific programs to decrease fatalities, spinal trauma, and SCI after MNMVA.

Published
2010
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20. Characterization of the pharmacokinetics of human recombinant erythropoietin in blood and brain when administered immediately after lateral fluid percussion brain injury and its pharmacodynamic effects on IL-1beta and MIP-2 in rats.

Author

Lieutaud T, Andrews PJ, Rhodes JK, and Williamson R

Subjects
Animals, Blood-Brain Barrier drug effects, Blood-Brain Barrier immunology, Blood-Brain Barrier metabolism, Brain immunology, Brain metabolism, Brain Injuries physiopathology, Chemokine CXCL2 immunology, Chemokine CXCL2 metabolism, Disease Models, Animal, Dose-Response Relationship, Drug, Down-Regulation drug effects, Down-Regulation physiology, Drug Administration Schedule, Encephalitis drug therapy, Encephalitis immunology, Encephalitis physiopathology, Erythropoietin blood, Functional Laterality drug effects, Functional Laterality physiology, Humans, Injections, Intraperitoneal, Injections, Intravenous, Interleukin-1beta immunology, Interleukin-1beta metabolism, Male, Rats, Rats, Sprague-Dawley, Recombinant Proteins, Time Factors, Brain drug effects, Brain Injuries drug therapy, Brain Injuries immunology, Chemokine CXCL2 drug effects, Erythropoietin pharmacokinetics, Interleukin-1beta drug effects
Abstract

This study sought to determine the bio-availability of recombinant human erythropoietin (EPO) in the brain and blood and its effects on the cerebral concentrations of the inflammatory mediators interleukin-1beta (IL-1beta) and macrophage-inflammation protein-2 (MIP-2) following lateral fluid percussion brain injury (FPI) in the rat. After induction of moderate FPI (1.6-1.8 atm), EPO was injected intraperitoneally (IP) or intravenously (IV) at doses of 1000-5000 U/kg in a randomized and blinded manner. Animals were then sacrificed at time points (4, 8, 12, 24 h) post-trauma, and the brain concentrations of EPO, IL-1beta, and MIP-2 were determined. EPO administration leads to a dose-dependent increase in the brain concentration of the drug; however, this could only be detected at doses of 3000 and 5000 U/kg. The cerebral concentration peaked in the first 4 h following trauma. EPO concentrations were significantly higher and decreased more slowly in the traumatized cortex compared to the contralateral side (p<0.0125). IV EPO (5000 U/kg) produced slightly higher concentrations of EPO than same doses injected IP; however, this was not significant. At a dose of 5000 U/kg, EPO significantly reduced the increase in IL-1beta at 8 and 12 h in both cortical sides. It also reduced the increase in MIP-2 but only after 8 h, on the contralateral side and after 12 h on the ipsilateral side. Our results suggest that EPO crosses the blood-brain barrier (BBB) by 4 h after trauma and is localized primarily in the traumatized cortex. Further, it has biological efficacy at 8 h on several inflammatory proteins, yet must be employed at high doses to cross the BBB.

Published
2008
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21. Long-term follow-up of meningiomas of the cavernous sinus after surgical treatment alone.

Author

Sindou M, Wydh E, Jouanneau E, Nebbal M, and Lieutaud T

Subjects
Adolescent, Adult, Aged, Brain Neoplasms pathology, Craniotomy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurosurgical Procedures methods, Neurosurgical Procedures mortality, Postoperative Complications, Treatment Outcome, Brain Neoplasms surgery, Cavernous Sinus, Meningioma surgery
Abstract

Object: The authors report on the long-term outcome in 100 consecutive patients with meningiomas arising from the cavernous sinus (CS) with compressive extension outside the CS. The treatment in all cases was surgery alone without adjuvant radiosurgery or radiotherapy. The aim of this study was to evaluate the percentage of patients in whom surgery alone was able to produce long-term tumor control., Methods: All 100 patients harbored meningiomas with supra- and/or laterocavernous extension, and 27 had petroclival extension. Surgery was performed via frontopterionotemporal craniotomy associated with orbital and/or zygomatic osteotomy in 97 patients. Proximal control of the internal carotid artery at the foramen lacerum was undertaken in 65 patients; the paraclinoid carotid segment was exposed extradurally at the space made by the anterior clinoidectomy in 81 patients. For the petroclival tumor extension, a second-stage surgery was performed via a presigmoid-retrolabyrinthine or retrosigmoid approach in 13 and 14 patients, respectively., Results: The mortality rate was 5% and two patients had severe hemiplegic or aphasic sequelae. The creation or aggravation of disorders in vision, ocular motility, or trigeminal function occurred in 19, 29, and 24% of patients respectively, with a significantly higher rate of complications when resection was performed inside the CS (p < 0.05). Gross-total removal of both the extra- and intracavernous portions was achieved in 12 patients (Group 1), removal of the extracavernous portions with only a partial resection of the intracavernous portion in 28 patients (Group 2), and removal only of the extracavernous portions was performed in 60 patients (Group 3). The follow-up period ranged from 3 to 20 years (mean 8.3 years). There was no tumor recurrence in Group 1. In the 83 surviving patients in Groups 2 and 3 combined, the tumor remnant did not regrow in 72 patients (86.7%); regrowth was noted in 11 (13.3%)., Conclusions: The results suggest that there is no significant oncological benefit in performing surgery within the CS. Because entering the CS entails a significantly higher risk of complications, radiosurgical treatment should be reserved for remnants with secondary growth and clinical manifestations.

Published
2007
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