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5. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study

Author

Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., CENTER-Tbi Invest Participants, Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen, M. C., Polinder, S., Lingsma, H. F., Maas, A. I. R., Menon, D., Steyerberg, E. W., Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzo, P., Bauerfeind, U., Beer, R., Belda, F. J., Bellander, B. -M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L. S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Buckova, V., Calappi, E., Cameron, P., Carbayo, L. G., Carise, E., Carpenter, C., Castano-Leon, A. M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Coburn, M. C., Coles, J., Cooper, J. D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Della Corte, F., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Duliere, G. -L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V. L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzen, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P. A., Grossi, F., Gruen, R. L., Gupta, D., Haagsma, J. A., Hadzic, E., Haitsma, I., Hartings, J. A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P. J., Haberg, A. K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J., Jones, K., Kalala, J. -P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A. G., Kolumban, B., Kompanje, E., Kondziella, D., Koskinen, L. -O., Kovacs, N., Kalovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Macdonald, S., Macfayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Marechal, H., Mastelova, D., Mattern, J., Mcmahon, C., Melegh, B., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Muhlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyiradi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P. M., Patruno, A., Payen, J. -F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Pili, F. S., Pirinen, M., Ples, H., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorcikova, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D. L., Ruiz De Arcaute, F., Rusnak, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlosser, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R. F., Schwendenwein, E., Scholl, M., Sir, O., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E. L., Stanworth, S., Stegemann, K., Steinbuchel, N., Stevens, R., Stewart, W., Stocchetti, N., Sundstrom, N., Synnot, A., Szabo, J., Soderberg, J., Taccone, F. S., Tamas, V., Tanskanen, P., Tascu, A., Taylor, M. S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J. -F. L., Tudora, C. M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vande Vyvere, T., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P. M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vamos, Z., Wade, D., Wang, K. K. W., Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, M. K. L., Ylen, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., De Lange, S., De Ruiter, G. C. W., Den Boogert, H., Van Dijck, J., Van Essen, T. A., Van Heugten, C., Van Der Jagt, M., Van Der Naalt, J., Commission of the European Communities, Molecular Neuroscience and Ageing Research (MOLAR), Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, and Public Health

Subjects
Questionnaires, Comparative Effectiveness Research, Critical Care and Emergency Medicine, Medical Doctors, Neurologi, Health Care Providers, CENTER-TBI Investigators and Participants, lcsh:Medicine, Poison control, Occupational safety and health, Diagnostic Radiology, Geographical Locations, 0302 clinical medicine, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Brain Damage, Longitudinal Studies, Prospective Studies, Israel, lcsh:Science, Tomography, Trauma Medicine, Multidisciplinary, Radiology and Imaging, traumatic brain injury, Trauma center, Hospitals, 3. Good health, Europe, Hospitalization, Professions, Intensive Care Units, Neurology, Research Design, Intracranial pressure monitoring, Medical emergency, Engineering sciences. Technology, Research Article, medicine.medical_specialty, Imaging Techniques, Traumatic brain injury, General Science & Technology, Concordance, Comparative effectiveness research, Neuroimaging, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Physicians, Injury prevention, MD Multidisciplinary, medicine, Humans, Treatment Guidelines, Survey Research, Health Care Policy, business.industry, lcsh:R, Biology and Life Sciences, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, ta3124, Computed Axial Tomography, Health Care, Health Care Facilities, Family medicine, People and Places, lcsh:Q, Population Groupings, business, 030217 neurology & neurosurgery, Neuroscience
Abstract

© 2016 Cnossen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

Published
2020
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20. Abstracts

Author

Derlon J. M., Petit-taboué M. C., Dauphin F., Courtheoux P., Chapon F., Creissard P., Darcel F., Houtteville J. P., Kaschten, B., Sadzot, B., Stevenaert, A., Tjuvajev, Juri G., Macapinlac, Homer A., Daghighian, Farhad, Ginos, James Z., Finn, Ronald D., Jiaju Zhang, M. S., Beattie, Bradley, Graham, Martin, Larson, Steven M., Blasberg, Ronald G., Levivier, M., Goldman, S., Pirotte, B., Brucher, J. M., Balériaux, D., Luxen, A., Hildebrand, J., Brotchi, J., Go K. G., Kamman R. L., Mooyaart E. L., Heesters M. A. A. M., Sijens, P. E., Oudksrk, M., van Dijk, P., Levendag, P. C., Vecht, Ch. J., Metz, R. J., Kennedy, D. N., Rosen, B. R., Hochberg, F. H., Fishman, A. J., Filipek, P. A., Caviness, V. S., Gross, M. W., Weinzierl, F. X., Trappe, A. E., Goebel, W. E., Frank, A. M., Becker, Georg, Krone, Andreas, Schmidt, Karsten, Hofmann, Erich, Bogdahn, Ulrich, Bencsch, H., Fclber, S., Finkenstedt, G., Kremser, C., Sfockhammer, G., Aichner, F., Bogdahn U., Fröhlich T., Becker G., Krone A., Schlief R., Schürmann J., Jachimczak P., Hofmann E., Roggendorf W., Roosen K., Carapella, C. M., Carpinelli, G., Passalacqua, R., Raus, L., Giannini, M., Mastrostefano, R., Podo, F., Tofani, A., Maslrostefano, R., Mottoles, M., Ferraironi, A., Scelsa, M. G., Oppido, P., Riccio, A., Maini, C. L., Collombier, L., Taillandier, L., Dcbouverie, M., Laurens, M. H., Thouvenot, P., Weber, M., Bertrand, A., Cruickshank G. S., Patterson J., Hadley D., De Witte, Olivier, Hildebrand, Jerzy, Luxen, André, Goldman, Serge, Ernestus, R. -I., Bockhorst, K., Eis, M., Els, T., Hoehn-Berlage, M., Gliese, M., Fründ, R., Geissler, A., Woertgen, C., Holzschuh, M., Goldman, Serge, Levivier, M., Pirotte, B., Brucher, J. M., Luxen, A., Brotchi, J., Hildebrand, J., Hausmann, O., Merlo, A., Jerrnann, E., Uirich, J., Chiquet-Ehrismann, R., Müller, J., Mäcke, H., Gratzl, O., Herholz, K., Ghaemi, M., Würker, M., Pietrzyk, U., Heiss, W. -D., Kotitschke, K., Brandl, M., Tonn, J. C., Haase, A., Bogdahn, U., Kotitschke, K., Muigg, S., Felber, S., Aichner, F., Haase, A., Bogdahn, U., Krone A., Becker G., Woydt M., Roggendorf W., Hofmann E., Bogdahn U., Roosen K., Lanfermann, Heinrich, Heindel, Walter, Kugel, Harald, Erneslus, Ralf -Ingo, Röhn, Gabricle, Lackner, Klaus, Metz, R. J., Kennedy, D. N., Pardo, F. S., Kutke, S., Sorensen, A. G., Hochberg, F. H., Fishman, A. J., Filipek, P. A., Rosen, B. R., Caviness, V. S., Mechtler, L. L., Withiam-Lench, S., Shin, K., Klnkel, W. R., Patel, M., Truax, B., Kinkel, P., Shin, K., Mechtler, L., Ricci M., Pantano P., Maleci A., Pierallini S., Di Stefano D., Bozzao L., Cantore G. P., Röhn, Gabriele, Els, T., Schröder, R., Hoehn-Berlage, M., Ernestus, R. -I., Ruda, R., Mocellini, C., Soffietti, R., Campana, M., Ropolo, R., Riva, A., de Filippi, P. G., Schiffer, D., Salgado D., Rodrigues M., Salgado L., Fonseca A. T., Vieira M. R., Bravo Marques J. M., Satoh, H., Uozumi, T., Kiya, K., Kurisu, K., Arita, K., Sumida, M., Ikawa, F., Tzuk-Shina, Tz., Gomori, J. M., Rubinstein, R., Lossos, A., Siegal, T., Vaalburg, W., Paans, A. M. J., Willemsen, A. T. M., van Waarde, A., Pruim, J., Visser, G. M., Go, K. G., Valentini, S., Ting, Y. L. T., De Rose, R., Chidichimo, G., Corricro, G., van Lcycn-Pilgram, Karin, Erncslus, Ralf -Ingo, Klug, Norfried, van Leyen-Pilgram, K., Ernestus, R. -I., Schröder, R., Klug, N., Woydt M., Krone A., Tonn J. C., Becker G., Neumann U., Roggendorf W., Roosen K., Plate, Karl H., Breier, Georg, Millaucr, Birgit, Weich, Herbert A., Ullrich, Axel, Risau, Werner, Roosen N., Chopra R. K., Mikkelsen T., Rosenblum S. D., Yan P. 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D., Colombo, Bruno M., DiDonato, Stefano, Finocchiaro, Gaetano, Hebeda, K. M., Sterenborg, H. J. C. M., Saarnak, A. E., Wolbers, J. G., van Gemert, M. J. C., Kaaijk P., Troost D., Leenstra S., Das P. K., Bosch D. A., Kostron H., Hochleitner B. W., Obwegeser A., Ortler M., Seiwald M., Vooys, W., Krouwer, H. G. J., de Gast, G. C., Marx, J. J. M., Osman Farah J., Lunardi P., Puzzilli F., Menovsky, T., Beek, J. F., Wolbers, J. G., van Gemert, M. J. C., Naujocks, G., Wiestler, O. D., Schirrmacher, V., Schramm, J., Schmitz, A., Eis-Hübinger, A. M., Piepmeier, p. h., Pedersen, Patricia, Greer, Charles, Quigley, Matthew R., Shih, Tommy, Elrifal, Amr, Rothfus, William, Maroon, Joseph C., Rohertson, L., Rampling, R., Whoteley, T. L., Piumb, J. A., Kerr, D. J., Falina, P. A., Crossan, I. M., Roosen N., Rock J. P., Feng J., Zeng H., Ho K. L., Fenstermacher J. D., Rosenblum M. L., Ruchoux, M. M., Vincent, S., Jonca, F., Plouet, J., Lecomte, M., Samid, D., Thibault, A., Ram, Z., Oldfield, E. H., Myers, C. E., Reed, E., Schabet, M., Herrlinger, U., Buchholz, R., Shoshan, Y., Siegal, T., Siegal, T., Shezen, E., Siegal, Tz., Stockhammer, G., Rosenblum, M., Samid, D., Lieberman, F., Terzis, A. J. A., Bjerkvig, R., Laerum, O. D., Arnold, H., Thibault, A., Samid, D., Figg, W. D., Myers, C. E., Reed, E., Thomas, R., Flux, G., Chittenden, S., Doshi, P., Brazil, L., Thomas, D. G. T., Bignor, D., Zalutsky, M., Brada, M., Tjuvajev, Juri, Kaplitt, Michael, Desai, Revathi, Bradley, M. S., Bettie B. S., Gansbacher, Bernd, Blasberg, Ronald, Haugland, H. K., Saraste, J., Rooseni, K., Laerum, O. D., Vincent, A. J. P. E., Avezaat, C. J. J., Bout, A., Noteboom, J. L., Vecht, C. h., Valerio, D., Hoogerbrugge, P. M., Weber, F., Reszka, R., Zhu, J., Walther, W., List, J., Schulz, W., Wolbers, J. G., Sterenborg, I. I. J. C. M., Kamphorst, W., van Gemert, M. J. C., van Alplien, H. A. M., Salander P., Bergenheim T., Henriksson R., Grant, R., Brazil, L., Thomas, R., Guerrero, D., Laing, R., Ashley, S., Brada, M., Schmidt B., Bauer B., Grau G., Bohnstedt, T., Frydrych A., Franz K., Lorenz R., Brandes, A., Amanzo, P. D'., Zampieri, P., Rigon, A., Scelzi, E., Rotilio, A., Berti, F., Paccagnella, A., Fiorentino, M. V., Müller B., Krauseneck P., van Deventer, P. L., Dellemijn, P. L. I., van den Bent, M. J., Vecht, Ch. J., Kansen, P. J., Tredici, G., Petruccioli, N. G., Cavaletti, G., Cavalletti, E., Kiburg, B., Müller, L. J., Moorer-van Delft, C. M., Heimans, J. J., Boer, H. H., Pace A., Bove L., Pietrangeli A., Innocenti P., Aloe A., Nardi M., Jandolo B., Kellie S. J., De Graaf S. S. N., Bloemhof H., Roebuck D., Dalla Pozza L., Uges D. D. R., Johnston I., Besser M., Chaseling R. A., Koeppen, S., Gründemann, S., Lossos, A., Siegal, T., Nitschke M., Vieregge P., Reusche E., Rob P., Kömpf D., Postma, T. J., Vermorken, J. B., Heimans, J. J., Rampling R. P., Dunlop D. J., Steward M. S., Campbell S. M., Roy S., Hilkens, P. H. E., Verweij, J., van Putten, W. L. J., Vecht, Ch. J., van den Bent, M. J., Hilkens, P. H. E., Moll, J. W. B., van der Burg, M. E. L., Planting, A. S. T., van Putten, W. L. J., Vecht, Ch. J., van den Bent, M. J., Wondrusch E., Zifko U., Drlicek M., Liszka U., Grisold W., Zifko U., Fazeny B., Dittrich Ch., Wondrusch E., Grisold W., Verschuuren, Jan J., Meneses, Patricio I., Rosenfeld, Myrna R., Kaplitt, Michael G., Posner, Jerome B., Dalmau, Josep, Sillevis Smitt P. A. E., Manley G., Posner J. B., Cavaletti, G., Bogliun, G., Margorati, L., Bianchi, G., Drlicek, M., Liska, U., Casati, B., Kolig, C., Grisold, H., Graus, F., Reñe, R., Uchuya, M., Valldeoriola, F., Delattre, J. Y., Benedetti de Cosentiro C., Ortale D., Martinez R., Lambre J., Cagnolati S., Vinai C., Salmaggi A., Nemni R., Silvani A., Forno M. G., Luksch R., Confalonieri P., Boiardi A., Nitschke M., Scholz J., Vieregge P., Kömpf D., Hochberg F. H., Pfeiffer, G., Netzer, J., Hansen, Ch., Eggers, Ch., Hagel Ch., Kunze, K., Verschuuren, Jan J., Rosenblum, Marc K., Lieberman, Frank S., Posner, Jerome B., and Dalmau, Josep

Published
1994
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30. Subventricular zone contacting glioblastoma: tumor size, molecular biological factors and patient survival.

Author

Hallaert, G., Pinson, H., Van den Broecke, C., Vanhauwaert, D., Van Roost, D., Boterberg, T., and Kalala, J. P.

Subjects
GLIOMAS, MAGNETIC resonance imaging, METHYLATION, MOLECULAR biology, MULTIVARIATE analysis, GENETIC mutation, SURVIVAL, PROPORTIONAL hazards models, RETROSPECTIVE studies, DESCRIPTIVE statistics, KAPLAN-Meier estimator, TEMOZOLOMIDE, LOG-rank test, CHEMORADIOTHERAPY
Abstract

Several studies show that subventricular zone (SVZ) contact of glioblastoma at diagnosis is a negative prognosticator of survival. In this report, we study glioblastoma patient survival, molecular biological and MRI-based volumetric findings according to SVZ contact. We conducted a retrospective study of adult patients diagnosed with supratentorial glioblastoma and uniformly treated with temozolomide-based chemoradiotherapy after surgery. The patient cohort was dichotomized according to tumor contact with the SVZ at diagnosis as determined on preoperative MR imaging. Tumor volume was measured using semi-automated segmentation technique. MGMT-gene promoter methylation and IDH mutation status were determined on stored tumor tissue. Kaplan-Meier survival curves were constructed. Cox regression analysis was used to adjust for known confounding factors of glioblastoma patient survival. A total of 214 patients were included in the study of whom 68% belonged to the SVZpos group. Median tumor volume was significantly larger in the SVZpos group (33,8 mL vs 15,6 mL; p <.001). MGMT-unmethylated glioblastoma was more frequent in the SVZpos group (61.4% vs 44.9%; p =.028). The overall survival and progression-free survival were 12.2 months and 5.9 months for the SVZpos patient group but 16.9 months and 10.3 months for the SVZneg group (log-rank p =.016 and.007 respectively). In multivariate Cox survival analysis, SVZ contact proved a negative prognostic parameter, independent from age, KPS, extent of resection, MGMT-methylation and IDH mutation status. This study confirms SVZ contact at diagnosis as an independent negative prognostic factor for glioblastoma patient survival. SVZpos glioblastoma had larger tumor size and a larger proportion of unmethylated tumors than SVZneg glioblastoma. Further research is needed to establish whether the observed differences are solely explained by a different molecular profile of SVZpos glioblastoma or by interaction of glioblastoma with the unique SVZ microenvironment. [ABSTRACT FROM AUTHOR]

Published
2020
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32. Training charter in epilepsy surgery added competence

Author

Sakas, D. E. Krauss, J. K. Schramm, J. Scerrati, M. and Reulen, H. J. Cunha E Sa, M. van Loon, J. Nuttin, B. and Goncalves-Ferreira, A. Regis, J. Van Roost, D.

Abstract

The present Training Charter in Epilepsy Surgery Added Competence constitutes the third stage of a program initiated by the European Society for Stereotactic and Functional Neurosurgery (ESSFN) and substantiated in close collaboration with the Union Europ,ennedes M,decins Sp,cialists (UEMS) and the European Association of Neurosurgical Societies (EANS). This program aims to raise the standards of clinical practice by guiding education and quality control concepts. The particular sections of this Charter include: definitions and standards of added competence training, relations of the Epilepsy Unit with the Neurosurgical Department, duration of epilepsy surgery fellowship, institution and training program director requirements, operative totals for epilepsy surgery, educational program, individual requirements, and evaluation and qualification of the trainees. The specification of all these requirements is expected to improve harmonisation and quality of epilepsy surgery practice across Europe, and enhance the clinical activity and the scientific productivity of existing neurosurgical centres.

Published
2013

33. Three-dimensional methylacrylate and wax skull modelling preparing cranioplasty in the treatment of complex craniosynostosis and skull malformation

Author

Baert, E., Dewaele, F., Van Roost, D., and Caemaert, J.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Complex craniosynostosis (e.g. coronal plagiocephaly, trigonocephaly, multisuture synostosis or skull malformation of unknown etiology) requires complex and prolonged cranioplastic procedures with a high risk of comorbidity (blood loss, temperature decrease, cerebrospinal fluid leak, air [for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Published
2009

34. Intracavitary irradiation of cystic craniopharyngioma by stereotactic instillation of beta-emitting radioisotope (yttrium 90)

Author

Kalala Okito, JP, van Roost, D, Goethals, I, Achten, E, and Caemaert, J

Subjects
ddc: 610, genetic structures, 610 Medical sciences, Medicine
Abstract

Objective: Despite the existence of many treatment modalities, successful treatment of craniopharyngioma remains challenging. The radical surgical removal of cystic craniopharyngioma is often hazardous due to the vicinity of critical structures and to the inherent tendency of this pathology to recur.[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Published
2009
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35. Experimental and numerical modelling of the ventriculosinus shunt (El-Shafei shunt).

Author

Van Canneyt K, Kips J, Mareels G, Baert E, Van Roost D, Verdonck P, Van Canneyt, K, Kips, J, Mareels, G, Baert, E, Van Roost, D, and Verdonck, P

Abstract

This study assesses malresorptive hydrocephalus treatment by ventriculosinus shunting with the shunt in the antegrade or retrograde position. First, an experimental model of the cerebral ventricles, the arachnoid villi, the cortical veins, and the superior sagittal sinus was built. For this purpose, the compliance of a human cortical vein was measured and then modelled by means of Penrose tubes. The dimensions of the superior sagittal sinus were determined in vivo by measurements on magnetic resonance imaging scans of 21 patients. Second, a numerical model of the cortical veins and the superior sagittal sinus was built. The numerical results were validated with the results from the experimental model. The experimental and numerical pressure difference between the intracranial pressure and the static sinus pressure was small (0-20 Pa) and corresponded to the theoretically expected values. No overdrainage was found in either the antegrade or the retrograde position of the shunt. Blood reflow was only found while mimicking lumbar puncture or changes in position with the experimental model (lowering the intracranial pressure or increasing the sinus pressure rapidly). Optimal results can be obtained with the shunt positioned in the most downstream half of the superior sagittal sinus. The experimental and numerical results confirm the potential of ventriculosinus shunting as therapy for malresorptive hydrocephalus patients. The ventriculosinus shunt thus proves to be a promising technique. [ABSTRACT FROM AUTHOR]

Published
2008

37. Neurosurgical aspects of temporal deep brain stimulation for epilepsy.

Author

Steiger, H. -J., Sakas, Damianos E., Simpson, Brian A., Van Roost, D., Boon, P., Vonck, K., and Caemaert, J.

Abstract

Deep brain stimulation (DBS), which mimics the effect of ablative surgery in movement disorders, is considered by analogy as potentially useful in the epileptic temporal lobe as an alternative to resection. It could be applied to patients in whom resective surgery is less beneficial, e.g. cases without memory impairment or with bilateral hippocampal involvement. In patients who undergo invasive presurgical analysis, the necessary intrahippocampal leads can serve for the application of DBS, provided that they are suited for chronic use. The hippocampus, in which the focus of epilepsy is detected, is stimulated continuously using high-frequency square-wave pulses. The reduction of interictal spike activity during a period of acute stimulation is the criterion for deciding whether the leads will be connected to an internal pulse generator. We are conducting a pilot study, with 16 patients enrolled so far, ten of whom have been followed up for more than one year. Some theoretical considerations are dedicated to hippocampal DBS. [ABSTRACT FROM AUTHOR]

Published
2007
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38. Anatomical and physiological basis and mechanism of action of neurostimulation for epilepsy.

Author

Steiger, H. -J., Sakas, Damianos E., Simpson, Brian A., Vonck, Kristl, Boon, P., and Van Roost, D.

Abstract

Neurostimulation is an emerging treatment for neurological diseases. Different types of neurostimulation exist mainly depending of the part of the nervous system that is being affected and the way this stimulation is being administered. Vagus nerve stimulation (VNS) is a neurophysiological treatment for patients with medically or surgically refractory epilepsy. Over 30,000 patients have been treated with VNS. No clear predictive factors for responders have been identified. To date, the precise mechanism of action remains to be elucidated. Better insight in the mechanism of action may identify seizure types or syndromes that respond better to VNS and may guide the search for optimal stimulation parameters and finally improve clinical efficacy. Deep brain stimulation (DBS) has been used extensively as a treatment for movement disorders. Several new indications such as obsessive compulsive behaviour and cluster headache are being investigated with promising results. The vast progress in biotechnology along with the experience in other neurological diseases in the past ten years has led to a renewed interest in intracerebral stimulation for epilepsy. Epilepsy centers around the world have recently reinitiated trials with deep brain stimulation in different intracerebral structures such as the thalamus, the hippocampus and the subthalamic nucleus. [ABSTRACT FROM AUTHOR]

Published
2007
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39. Clinical experience with vagus nerve stimulation and deep brain stimulation in epilepsy.

Author

Steiger, H. -J., Sakas, Damianos E., Simpson, Brian A., Boon, Paul, De Herdt, V., Vonck, K., and Van Roost, D.

Abstract

Patients with refractory epilepsy present a particular challenge to new therapies. Vagus nerve stimulation (VNS) for the control of intractable seizures has become available since 1989. VNS is a relatively noninvasive treatment. It reduces seizure frequency by ≥50% in 1/3 of patients; an additional 1/3 of patients experience a worthwhile reduction of seizure frequency between 30 and 50%. In the remaining 1/3 of the patients there is little or no effect. Efficacy has a tendency to improve with longer duration of treatment up to 18 months postoperatively. Deep brain stimulation (DBS) or direct electrical stimulation of brain areas is an alternative neurostimulation modality. The cerebellum, various thalamic nuclei, the pallidum, and, more recently, medial temporal lobe structures have been chosen as targets. DBS for epilepsy is beyond the stage of proof-of-concept but still needs thorough evaluation in confirmatory pilot studies before it can be offered to larger patient populations. Analysis of larger patient groups and insight in the mode of action may help to identify patients with epileptic seizures or syndromes that respond better either to VNS or to DBS. Randomized and controlled studies in larger patient series are mandatory to identify the potential treatment population and optimal stimulation paradigms. Further improvements of clinical efficacy may result from these studies. [ABSTRACT FROM AUTHOR]

Published
2007
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45. Intracranial dural arteriovenous fistula successfully treated by combined open-endovascular procedure.

Author

Hallaert GG, De Keukeleire KM, Vanhauwaert DJ, Defreyne L, Van Roost D, Hallaert, Giorgio G, De Keukeleire, Katrien M, Vanhauwaert, Dimitri J, Defreyne, Luc, and Van Roost, Dirk

Abstract

Intracranial dural arteriovenous fistulas constitute a rare though potentially devastating disease. Because the arterial (high-pressure) blood flow drains directly into the low-pressure venous system, there is a high risk of bleeding and associated neurological deficit. The classifications by Borden and Cognard underline the correlation between bleeding risk and venous drainage pattern of the fistula. There are different treatment options for this vascular pathology, which always poses a challenge for the physicians involved to offer the optimal treatment for an individual patient. This case report illustrates how combining forces between the neurosurgical and endovascular team benefits outcome. Simultaneously, this contributes to the growing amount of evidence that a new endovascular technique with transarterial ONYX embolisation enables complete obliteration of the vascular malformation. [ABSTRACT FROM AUTHOR]

Published
2010
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46. Preoperative fMRI in tumour surgery.

Author

Tieleman A, Deblaere K, Van Roost D, Van Damme O, Achten E, Tieleman, Ann, Deblaere, Karel, Van Roost, Dirk, Van Damme, Olivier, and Achten, Eric

Abstract

Minimally invasive resection of brain tumours aims at removing as much pathological tissue as possible while preserving essential brain functions. Therefore, the precise spatial relationship between the lesion and adjacent functionally essential brain parenchyma needs to be known. Functional magnetic resonance imaging (fMRI) is increasingly being used for this purpose because of its non-invasiveness, its relatively high spatial resolution and the preoperative availability of the results. In this review, the goals of fMRI at various key points during the management of patients with a brain tumour are discussed. Further, several practical aspects associated with fMRI for motor and language functioning are summarised, and the validation of the fMRI results with standard invasive mapping techniques is addressed. Next, several important pitfalls and limitations that warrant careful interpretations of the fMRI results are highlighted. Finally, two important future perspectives of presurgical fMRI are emphasised. [ABSTRACT FROM AUTHOR]

Published
2009
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50. Influence of platelet clumps on platelet function analyser ( PFA)-200® testing.

Author

Mulliez, S. M. N., Hallaert, G., Van Roost, D., Vantilborgh, A., and Devreese, K. M. J.

Subjects
ASPIRIN, COLLECTION & preservation of biological specimens, BLOOD cell count, BLOOD platelet aggregation, CLINICAL pathology, DIAGNOSTIC errors, AUTOANALYZERS, PLATELET function tests
Abstract

A letter to the editor is presented regarding a study that investigated the function of platelet clumps on the platelet function analyser (PFA)-200®.

Published
2015
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