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Objective: External ventricular drainage (EVD) is frequently used in pediatric brain surgery. During the externalization of cerebrospinal fluid (CSF), catheter-associated meningitis (CAM) remains a major issue. This study aimed to evaluate the incidence of CAM in a pediatric population and to elucidate[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: High-grade gliomas (HGG) are the most common malignant primary brain tumor in adults. During the course of disease, several challenges occur, like measuring tumor burden, monitoring of treatment response, estimating the patient’s prognosis and distinguishing between true progression[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Delayed cerebral ischemia (DCI) is strongly associated with poor outcome after subarachnoid hemorrhage (SAH). Cerebral vasospasm is major contributor to DCI and requires special attention. We aimed at analyzing the impact of vasospasm management on DCI and functional outcome of SAH. [for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: The aim of the study was to analyze the association of the morphological variations of the Sylvian fissure (SF) and vascular parameters on occurrence of different bleeding patterns in patients with ruptured middle cerebral artery (MCA) aneurysms. Methods: The data of consecutive 202 [for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Acute subdural hematoma (aSDH) is a life-threatening condition urging immediate surgery. Demographic changes bring along a raising number of elderly patients presenting in good neurological condition with aSDH. This retrospective analysis focuses on non-operative management or delayed surgery[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Malignant melanoma (MM) rank among the most common cancers spreading into to central nervous system (CNS). Brain metastasis (BM) is known to essentially influence treatment options and patients’ prognosis. Beside neurosurgical resection and radiotherapy, BRAF mutations are emerging[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: In newly diagnosed glioblastoma (ndGBM) patients therapy with Tumor Treating Fields (TTFields) in combination with adjuvant temozolomide (TMZ) demonstrated significantly increased survival in the EF-14 phase III trial, wherein TTFields treatment was initiated 4-7 weeks after completion of[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Several parameters are known to predict the survival of glioblastoma (GBM) comprising extend of resection and MGMT promotor methylation. Staining for glial fibrillary acidic protein (GFAP) is being frequently assessed during histological work-ups, however its clinical utility for GBM remains[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease. Arterial wall developmental disorders in TSC such as aneurysms have been well described for extracranial vasculature. The characteristics of intracranial aneurysms (IA) in TSC have not been addressed in the literature[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Delayed cerebral ischemia (DCI) is a severe complication of subarachnoid hemorrhage (SAH). Clinical and radiographic features of SAH may be helpful in the identification of individuals prone to DCI. The aim of this systematic review was to analyze the present evidence on the predictive value[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: To assess gadolinium contrast wall enhancement patterns of thrombosed intracranial aneurysms using in-vivo 7 Tesla MRI in correlation with histopathological findings. Methods: The study group comprised 13 patients (14 aneurysms) who were recruited between January 2011 and October 2018.[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Cervical spondylotic myelopathy (CSM), a slowly ongoing disease, is the most common reason for spinal cord injuries. Up to now, timing of surgical treatment still varies. In this study we analyzed the postoperative outcome of patients suffering from CSM with and without signs of myelopathy[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: The gold standard for the treatment of classic trigeminal neuralgia (TN) is carbamazepine. However, the efficacy of carbamazepine is compromised by its adverse effects. Aim of this study is to assess the clinical outcome following the surgical treatment of TN and to find potential factors[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Objective: Risk for recurrent symptomatic hemorrhage in CCM is an important factor in decision making/consultation of patients. In this report, we analyze the risk and time pattern of re-hemorrhage events after a first initial bleeding. Methods: We performed a cross-sectional study based on[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Knowledge of the exact tumor location and structures at risk in its vicinity are crucial for neurosurgical interventions. Neuronavigation systems support navigation within the patient's brain, based on preoperative MRI (preMRI). However, increasing tissue deformation during the course of tumor resection reduces navigation accuracy based on preMRI. Intraoperative ultrasound (iUS) is therefore used as real-time intraoperative imaging. Registration of preMRI and iUS remains a challenge due to different or varying contrasts in iUS and preMRI. Here, we present an automatic and efficient segmentation of B-mode US images to support the registration process. The falx cerebri and the tentorium cerebelli were identified as examples for central cerebral structures and their segmentations can serve as guiding frame for multi-modal image registration. Segmentations of the falx and tentorium were performed with an average Dice coefficient of 0.74 and an average Hausdorff distance of 12.2 mm. The subsequent registration incorporates these segmentations and increases accuracy, robustness and speed of the overall registration process compared to purely intensity-based registration. For validation an expert manually located corresponding landmarks. Our approach reduces the initial mean Target Registration Error from 16.9 mm to 3.8 mm using our intensity-based registration and to 2.2 mm with our combined segmentation and registration approach. The intensity-based registration reduced the maximum initial TRE from 19.4 mm to 5.6 mm, with the approach incorporating segmentations this is reduced to 3.0 mm. Mean volumetric intensity-based registration of preMRI and iUS took 40.5 s, including segmentations 12.0 s. Keywords: IGNS, Image-guided neurosurgery, Intra-operative ultrasound, MRI, Registration, Segmentation