17 results on '"Josefsen R"'
Search Results
2. Traumatic Aneurysm of the Superior Cerebellar Artery
- Author
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Ø. Gjertsen, Pedersen Hk, P. H. Nakstad, and Josefsen R
- Subjects
medicine.medical_specialty ,Subarachnoid hemorrhage ,medicine.diagnostic_test ,business.industry ,Original Articles ,medicine.disease ,030218 nuclear medicine & medical imaging ,Surgery ,Head trauma ,03 medical and health sciences ,Traumatic Aneurysm ,Skull ,0302 clinical medicine ,medicine.anatomical_structure ,Aneurysm ,Clivus ,030220 oncology & carcinogenesis ,medicine.artery ,Angiography ,medicine ,cardiovascular diseases ,business ,Superior cerebellar artery - Abstract
Following a head trauma in a 40-year-old male, massive subarachnoid hemorrhage and fractures of the skull base/clivus was found at CT. CT angiography demonstrated an aneurysm on the proximal part of the right superior cerebellar artery. The aneurysm was successfully coiled without any complication and the patient improved clinically during the following three months. The decline in use of angiography in head trauma patients during the last two decades may lead to a lower detection of traumatic aneurysm than in previous times. The value of angiographic procedures in patients suffering head traumas with SAH and skull base fractures is therefore emphasized.
- Published
- 2007
3. Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema
- Author
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Server, A., primary, Kulle, B., additional, Mæhlen, J., additional, Josefsen, R., additional, Schellhorn, T., additional, Kumar, T., additional, Langberg, C.W., additional, and Nakstad, P.H., additional
- Published
- 2009
- Full Text
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4. Traumatic Aneurysm of the Superior Cerebellar Artery
- Author
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Gjertsen, Ø., primary, Nakstad, PHJ, additional, Pedersen, HKR, additional, and Josefsen, R., additional
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- 2007
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5. Proton magnetic resonance spectroscopy in the distinction of high-grade cerebral gliomas from single metastatic brain tumors.
- Author
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Server A, Josefsen R, Kulle B, Maehlen J, Schellhorn T, Gadmar ø, Kumar T, Haakonsen M, Langberg CW, and Nakstad PH
- Subjects
- *
PROTON magnetic resonance spectroscopy , *GLIOMAS , *METABOLITES , *BRAIN tumors , *LIPIDS , *EDEMA - Published
- 2010
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6. Collet-Sicard-syndrome with spinal epidural hematoma due to occipital condyle fracture – a case report
- Author
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Nakstad Per, Josefsen Roger, Utheim Nils, and Røise Olav
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2009
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7. [Toothless specialty committees].
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Randsborg PH, Kalager G, Owe JF, Thorsen EV, Josefsen R, Löffeler S, and Kleppe LK
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- 2023
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8. Hyperbaric oxygen therapy of air embolus in the cerebral venous sinuses after intracranial surgery: a case report.
- Author
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Lundborg M, Helseth E, Josefsen R, Braathen M, Skogen K, and Ramm-Pettersen J
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- Cerebral Veins pathology, Cranial Sinuses pathology, Embolism, Air therapy, Humans, Male, Middle Aged, Postoperative Complications therapy, Craniotomy adverse effects, Embolism, Air etiology, Hematoma surgery, Hyperbaric Oxygenation methods, Postoperative Complications etiology
- Abstract
A case with cerebral venous air embolism (CVAE) after neurosurgery and treated with hyperbaric oxygen therapy (HBOT) is presented. This is a rare and potentially fatal complication that neurosurgeons should be aware of. A 52-year-old male was diagnosed with an intracerebral hematoma. An emergency evacuation of the hematoma was performed with a craniotomy and the postoperative CT scan showed a complete evacuation of the hematoma, but it also revealed a CVAE. The patient was immediately referred to HBOT and received three sessions within 48 h. The CT scan after the first HBOT showed no CVAE, venous thrombosis, or new hematoma.
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- 2018
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9. Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma - a literature review and case report.
- Author
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Utheim NC, Josefsen R, Nakstad PH, Solgaard T, and Roise O
- Abstract
Background: Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reported one could suspect they have been under-diagnosed. During the past decade they have been seen more frequently, most probably due to increased use of CT- and MRI-scanning. The purpose of this review is to increase the awareness of complications following injuries in the craniocervical region., Methods: We based this article on a retrospective review of the medical record of a 24-year old woman admitted to our trauma center after being involved in a car accident and a review of the literature on occipital condyle fractures associated with lower cranial nerve palsy., Results: The multitraumatized patient had suffered a dislocated occipital condyle fracture. Months later she was diagnosed with palsy to cranial nerve IX-XII. Literature review shows that occipital condyle fractures are rare as isolated injuries and are in many cases accompanied by further injuries to the cervical spine and soft tissue structures, in many cases ending with severe disability. The exact mechanism leading to these injuries cannot always be explained., Conclusion: Recognition of soft tissue injuries in patients with blunt head trauma is important. CT findings involving the craniocervical junction in these patients advocates further investigations including a thorough neurological examination and liberal use of MRI.
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- 2015
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10. Surgical complications after transsphenoidal microscopic and endoscopic surgery for pituitary adenoma: a consecutive series of 506 procedures.
- Author
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Halvorsen H, Ramm-Pettersen J, Josefsen R, Rønning P, Reinlie S, Meling T, Berg-Johnsen J, Bollerslev J, and Helseth E
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Cohort Studies, Confidence Intervals, Endoscopy statistics & numerical data, Female, Humans, Incidence, Male, Middle Aged, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local surgery, Neurosurgical Procedures statistics & numerical data, Postoperative Complications classification, Reoperation statistics & numerical data, Survival Rate, Treatment Outcome, Young Adult, Adenoma surgery, Endoscopy adverse effects, Neurosurgical Procedures adverse effects, Pituitary Neoplasms surgery, Postoperative Complications epidemiology, Postoperative Complications etiology
- Abstract
Background: This single-institution, consecutive series of transsphenoidal procedures included all patients in a defined population of 2.6 million inhabitants who underwent surgery during a specific time period., Objective: We sought to determine the surgical complication rate and overall survival rate after transsphenoidal surgery for pituitary adenoma., Methods: All transsphenoidal procedures for histologically verified pituitary adenomas performed between September 2002 and February 2011 at our institution were included in this study. The data were obtained from a prospectively collected database and from reviewing medical records. No patients were lost to follow-up, and the median follow-up time was 28 months., Results: A total of 506 transsphenoidal procedures were performed on 446 patients. There were 268 microscopic and 238 endoscopic procedures involving 352 non-functioning and 154 hormone-secreting adenomas. A total of 73% of the procedures were primary surgeries, and 27% were repeat surgeries for tumor recurrence. The overall complication rate was 9.1%. The three most frequent complications were cerebrospinal fluid (CSF) leakage (4.7%), meningitis (2%), and visual deterioration (2%). Multivariate analyses showed that the overall risk for complications increased with older age, surgery for recurrent tumors, and surgery performed by a low-volume surgeon. There was no significant difference in the overall complication rate between the microsurgical and endoscopic techniques. The rate of surgical mortality was 0.6%, and the overall survival rates at 1 and 5 years were 95% and 90%, respectively. The only negative predictor of survival was older age., Conclusions: Transsphenoidal surgery for pituitary adenomas has a low complication rate and a low rate of mortality. We did not find a significant difference in the complication rate between endoscopic and microscopic techniques.
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- 2014
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11. Analysis of diffusion tensor imaging metrics for gliomas grading at 3 T.
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Server A, Graff BA, Josefsen R, Orheim TE, Schellhorn T, Nordhøy W, and Nakstad PH
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- Adult, Aged, Aged, 80 and over, Female, Humans, Image Enhancement methods, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Algorithms, Brain Neoplasms pathology, Diffusion Tensor Imaging methods, Glioma pathology, Image Interpretation, Computer-Assisted methods, Neoplasm Grading methods
- Abstract
Objectives: To assess the diagnostic accuracy of axial diffusivity (AD), radial diffusivity (RD), apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values derived from DTI for grading of glial tumors, and to estimate the correlation between DTI parameters and tumor grades., Methods: Seventy-eight patients with glial tumors underwent DTI. AD, RD, ADC and FA values of tumor, peritumoral edema and contralateral normal-appearing white matter (NAWM) and AD, RD, ADC and FA ratios: lowest average AD, RD, ADC and FA values in tumor or peritumoral edema to AD, RD, ADC and FA of NAWM were calculated. DTI parameters and tumor grades were analyzed statistically and with Pearson correlation. Receiver operating characteristic (ROC) curve analysis was also performed., Results: The differences in ADC, AD and RD tumor values, and ADC and RD tumor ratios were statistically significant between grades II and III, grades II and IV, and between grades II and III-IV. The AD tumor ratio differed significantly among all tumor grades. Tumor ADC, AD, RD and glial tumor grades were strongly correlated. In the ROC curve analysis, the area under the curve (AUC) of the parameter tumor ADC was the largest for distinguishing grade II from grades III to IV (98.5%), grade II from grade IV (98.9%) and grade II from grade III (97.0%)., Conclusion: ADC, RD and AD are useful DTI parameters for differentiation between low- and high-grade gliomas with a diagnostic accuracy of more than 90%. Our study revealed a good inverse correlation between ADC, RD, AD and WHO grades II-IV astrocytic tumors., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
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- 2014
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12. Measurements of diagnostic examination performance using quantitative apparent diffusion coefficient and proton MR spectroscopic imaging in the preoperative evaluation of tumor grade in cerebral gliomas.
- Author
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Server A, Kulle B, Gadmar ØB, Josefsen R, Kumar T, and Nakstad PH
- Subjects
- Area Under Curve, Aspartic Acid analogs & derivatives, Aspartic Acid metabolism, Brain Neoplasms metabolism, Brain Neoplasms pathology, Choline metabolism, Creatine metabolism, Female, Glioma metabolism, Glioma pathology, Humans, Image Interpretation, Computer-Assisted, Logistic Models, Male, Middle Aged, Neoplasm Grading, Predictive Value of Tests, Protons, ROC Curve, Sensitivity and Specificity, Brain Neoplasms diagnosis, Diffusion Magnetic Resonance Imaging methods, Glioma diagnosis, Magnetic Resonance Spectroscopy methods
- Abstract
Purpose: Tumor grading is very important both in treatment decision and evaluation of prognosis. While tissue samples are obtained as part of most therapeutic approaches, factors that may result in inaccurate grading due to sampling error (namely, heterogeneity in tissue sampling, as well as tumor-grade heterogeneity within the same tumor specimen), have led to a desire to use imaging better to ascertain tumor grade. The purpose in our study was to evaluate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and accuracy of diffusion-weighted MR imaging (DWI), proton MR spectroscopic imaging (MRSI) or both in grading primary cerebral gliomas., Materials and Methods: We performed conventional MR imaging (MR), DWI, and MRSI in 74 patients with newly diagnosed brain gliomas: 59 patients had histologically verified high-grade gliomas: 37 glioblastomas multiform (GBM) and 22 anaplastic astrocytomas (AA), and 15 patients had low-grade gliomas. Apparent diffusion coefficient (ADC) values of tumor and peritumoral edema, and ADC ratios (ADC in tumor or peritumoral edema to ADC of contralateral white matter, as well as ADC in tumor to ADC in peritumoral edema) were determined from three regions of interest. The average of the mean, maximum, and minimum for ADC variables was calculated for each patient. The metabolite ratios of Cho/Cr and Cho/NAA at intermediate TE were assessed from spectral maps in the solid portion of tumor, peritumoral edema and contralateral normal-appearing white matter. Tumor grade determined with the two methods was then compared with that from histopathologic grading. Logistic regression and receiver operating characteristic (ROC) curve analysis were performed to determine optimum thresholds for tumor grading. Measures of diagnostic examination performance, such as sensitivity, specificity, PPV, NPV, AUC, and accuracy for identifying high-grade gliomas were also calculated., Results: Statistical analysis demonstrated a threshold minimum ADC tumor value of 1.07 to provide sensitivity, specificity, PPV, and NPV of 79.7%, 60.0%, 88.7%, and 42.9% respectively, in determining high-grade gliomas. Threshold values of 1.35 and 1.78 for peritumoral Cho/Cr and Cho/NAA metabolite ratios resulted in sensitivity, specificity, PPV, and NPV of 83.3%, 85.1%, 41.7%, 97.6%, and 100%, 57.4%, 23.1% and 100% respectively for determining high-grade gliomas. Significant differences were noted in the ADC tumor values and ratios, peritumoral Cho/Cr and Cho/NAA metabolite ratios, and tumoral Cho/NAA ratio between low- and high-grade gliomas. The combination of mean ADC tumor value, maximum ADC tumor ratio, peritumoral Cho/Cr and Cho/NAA metabolite ratios resulted in sensitivity, specificity, PPV, and NPV of 91.5%, 100%, 100% and 60% respectively., Conclusion: Combining DWI and MRSI increases the accuracy of preoperative imaging in the determination of glioma grade. MRSI had superior diagnostic performance in predicting glioma grade compared with DWI alone. The predictive values are helpful in the clinical decision-making process to evaluate the histologic grade of tumors, and provide a means of guiding treatment., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2011
- Full Text
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13. Measurements of diagnostic examination performance and correlation analysis using microvascular leakage, cerebral blood volume, and blood flow derived from 3T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in glial tumor grading.
- Author
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Server A, Graff BA, Orheim TE, Schellhorn T, Josefsen R, Gadmar ØB, and Nakstad PH
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- Adult, Aged, Aged, 80 and over, Brain pathology, Brain Neoplasms pathology, Contrast Media, Diagnosis, Differential, Female, Glioma pathology, Humans, Male, Microvessels physiopathology, Middle Aged, Neoplasm Grading, Perfusion, Prospective Studies, Brain blood supply, Brain Neoplasms diagnosis, Cerebrovascular Circulation, Glioma diagnosis, Magnetic Resonance Imaging, Microvessels pathology
- Abstract
Introduction: To assess the diagnostic accuracy of microvascular leakage (MVL), cerebral blood volume (CBV) and blood flow (CBF) values derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MR imaging) for grading of cerebral glial tumors, and to estimate the correlation between vascular permeability/perfusion parameters and tumor grades., Methods: A prospective study of 79 patients with cerebral glial tumors underwent DSC-MR imaging. Normalized relative CBV (rCBV) and relative CBF (rCBF) from tumoral (rCBVt and rCBFt), peri-enhancing region (rCBVe and rCBFe), and the value in the tumor divided by the value in the peri-enhancing region (rCBVt/e and rCBFt/e), as well as MVL, expressed as the leakage coefficient K(2) were calculated. Hemodynamic variables and tumor grades were analyzed statistically and with Pearson correlations. Receiver operating characteristic (ROC) curve analyses were also performed for each of the variables., Results: The differences in rCBVt and the maximum MVL (MVL(max)) values were statistically significant among all tumor grades. Correlation analysis using Pearson was as follows: rCBVt and tumor grade, r = 0.774; rCBFt and tumor grade, r = 0.417; MVL(max) and tumor grade, r = 0.559; MVL(max) and rCBVt, r = 0.440; MVL(max) and rCBFt, r = 0.192; and rCBVt and rCBFt, r = 0.605. According to ROC analyses for distinguishing tumor grade, rCBVt showed the largest areas under ROC curve (AUC), except for grade III from IV., Conclusion: Both rCBVt and MVL(max) showed good discriminative power in distinguishing all tumor grades. rCBVt correlated strongly with tumor grade; the correlation between MVL(max) and tumor grade was moderate.
- Published
- 2011
- Full Text
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14. Diagnostic examination performance by using microvascular leakage, cerebral blood volume, and blood flow derived from 3-T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in the differentiation of glioblastoma multiforme and brain metastasis.
- Author
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Server A, Orheim TE, Graff BA, Josefsen R, Kumar T, and Nakstad PH
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- Adult, Aged, Aged, 80 and over, Brain pathology, Brain physiopathology, Brain Neoplasms blood supply, Brain Neoplasms physiopathology, Cerebrovascular Circulation, Contrast Media, Diagnosis, Differential, Female, Glioblastoma blood supply, Glioblastoma physiopathology, Humans, Image Enhancement methods, Magnetic Resonance Angiography, Male, Microvessels physiopathology, Middle Aged, Prospective Studies, Blood Volume, Brain blood supply, Brain Neoplasms diagnosis, Brain Neoplasms secondary, Glioblastoma diagnosis, Magnetic Resonance Imaging methods
- Abstract
Introduction: Conventional magnetic resonance (MR) imaging has limited capacity to differentiate between glioblastoma multiforme (GBM) and metastasis. The purposes of this study were: (1) to compare microvascular leakage (MVL), cerebral blood volume (CBV), and blood flow (CBF) in the distinction of metastasis from GBM using dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MRI), and (2) to estimate the diagnostic accuracy of perfusion and permeability MR imaging., Methods: A prospective study of 61 patients (40 GBMs and 21 metastases) was performed at 3 T using DSC-MRI. Normalized rCBV and rCBF from tumoral (rCBVt, rCBFt), peri-enhancing region (rCBVe, rCBFe), and by dividing the value in the tumor by the value in the peri-enhancing region (rCBVt/e, rCBFt/e), as well as MVL were calculated. Hemodynamic and histopathologic variables were analyzed statistically and Spearman/Pearson correlations. Receiver operating characteristic curve analysis was performed for each of the variables., Results: The rCBVe, rCBFe, and MVL were significantly greater in GBMs compared with those of metastases. The optimal cutoff value for differentiating GBM from metastasis was 0.80 which implies a sensitivity of 95%, a specificity of 92%, a positive predictive value of 86%, and a negative predictive value of 97% for rCBVe ratio. We found a modest correlation between rCBVt and rCBFt ratios., Conclusion: MVL measurements in GBMs are significantly higher than those in metastases. Statistically, both rCBVe, rCBVt/e and rCBFe, rCBFt/e were useful in differentiating between GBMs and metastases, supporting the hypothesis that perfusion MR imaging can detect infiltration of tumor cells in the peri-enhancing region.
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- 2011
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15. Characterization of Streptococcus constellatus strains recovered from a brain abscess and periodontal pockets in an immunocompromised patient.
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Marques da Silva R, Caugant DA, Josefsen R, Tronstad L, and Olsen I
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- Brain Abscess etiology, DNA, Bacterial analysis, Female, Humans, Middle Aged, Periodontal Pocket microbiology, Polymorphism, Restriction Fragment Length, Random Amplified Polymorphic DNA Technique, Ribotyping, Streptococcus constellatus isolation & purification, Brain Abscess microbiology, Focal Infection, Dental microbiology, Periodontal Pocket complications
- Abstract
Background: There have been a number of reports of brain abscesses suggesting an odontogenic etiology. However, no efforts have been made to compare brain abscess isolates with isolates from the oral cavity using highly discriminative methods. We report a brain abscess caused by Streptococcus constellatus in an immunocompromised patient where oral infection (periodontitis) was suspected to be implicated., Methods: The brain abscess and oral isolates were compared by means of one phenotypic and three genetic (restriction fragment length polymorphism [RFLP], ribotyping, and random amplified polymorphic DNA [RAPD]) fingerprinting techniques., Results: The phenotypic method and RFLP showed identical profiles between brain and periodontal isolates, while ribotyping and RAPD showed very close similarity, with only one band difference in one of the three ribotypes and in one of the three polymorphic RAPD., Conclusions: Gene transfer by genetic recombinational events in the periodontal pocket might have been responsible for the emergence of a strain variant of S. constellatus that had the potential to cause an abscess at a distant site (brain). The importance of odontogenic sources as potential foci of infection for brain abscesses is discussed.
- Published
- 2004
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16. [Cerebellar hemorrhage--a rare, but serious complication in decompression disease].
- Author
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Josefsen R and Wester K
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- Adult, Cerebral Hemorrhage, Traumatic diagnostic imaging, Follow-Up Studies, Humans, Hydrocephalus diagnostic imaging, Hydrocephalus etiology, Magnetic Resonance Imaging, Male, Prognosis, Tomography, X-Ray Computed, Cerebellum blood supply, Cerebellum diagnostic imaging, Cerebellum pathology, Cerebral Hemorrhage, Traumatic etiology, Decompression Sickness complications, Diving injuries
- Abstract
Since 1978, five conferences on diving-related illness have failed to conclude that diving could lead to brain damage. We present a case history of a diver with decompression disease who also experienced brain damage. He performed a normal dive down to a depth of ten metres, when suddenly he had to go up to the surface. The patient was brought to the nearest hospital with a decompression chamber and treated according to standard procedure, yet his condition did not improve as expected. A CT scan showed bilateral, cerebellar bleeding and a secondary hydrocephalus. A CT scan one year after the accident showed a normalisation. The changes in the cerebellum could be related to decompression disease. Neurosurgery may be necessary in some cases of decompression disease.
- Published
- 1999
17. [When a physician makes a mistake].
- Author
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Frich L, Andersen AV, Josefsen R, and Sagabråten SO
- Subjects
- Ethics, Medical, Humans, Insurance Claim Review, Interprofessional Relations, Norway, Patient Advocacy, Physician Impairment, Malpractice legislation & jurisprudence, Medical Errors
- Abstract
Inevitably, doctors make mistakes in the normal course of providing care. Making a mistake often causes distress for the doctor involved, but it can also be an important source of knowledge and self-reflection. This article discusses central aspects with respect to mistakes and medical malpractice. The doctor's relationship to ethics and legislation is discussed, and an overview of the administrative action taken by the Norwegian health authorities is presented. The organisations and offices a physician may come into contact with when involved in a patient's complaint are briefly presented. "Meldesentralen" was formed in 1993 by the Norwegian Directorate of Health for the purpose of collecting reports on accidents in medical practice. We argue that the accidents reported to "Meldesentralen" do not reflect the true situation on this issue. We introduce a model for a systematic approach towards a colleague who has made a mistake or who is suspected of having made one.
- Published
- 1997
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