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1. Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study

Author

Claudia Fanizzi, Giovanni Carone, Alessandra Rocca, Roberta Ayadi, Veronika Petrenko, Cecilia Casali, Martina Rani, Marta Giachino, Lydia Viviana Falsitta, Enrico Gambatesa, Tommaso Francesco Galbiati, Eleonora Francesca Orena, Irene Tramacere, Nicole Irene Riker, Alessandro Mocca, Karl Schaller, Torstein Ragnar Meling, Francesco DiMeco, Alessandro Perin, Abdelaziz Najib, Adrian Ndroqi, Ana Tomas-Biosca, Anatoli Dimitrov, Antanas Budenas, Augustinas Fedaravicius, Aicha Ouchene, Dauleac Corentin, Djenaba Bah, Friedrich Erhart, Fahrudin Alić, Foughali Mehdi, Hajar Bechri, Jagoš Golubović, Julien Delaunois, Angela Rampini, Karolis Simaitis, Milan Lepic, Mirel Grada, Miroslav Fimic, Mohamed Amgad Elsayed Matter, Benachour Mohamed Safouane, Nebojsa Lasica, Olga Parras, Ran Xu, Demaerel Rik, Sandra Rutkowska, Margherita Castaldo, Tatyana Sarnecki, Angela Elia, Tobias Rossmann, Volodymyr Smolanka, Fatima Fakhro, Yinqian Wang, Yakun Yang, Hu Yeshuai, Bianca Baldassarre, Giuseppe Di Perna, Lei Qi, Ye Zhongxing, Alice Lucifero, Yuhao Zhao, Vittoria Cojazzi, Gianluca Mezzini, Bektaşoğlu Pınar Kuru, Marina Minichiello, Wenping Xiong, Yan Cui, Zhigang Tan, Yue Lu, Li Xu, Deng Gang, Xiaoyang Tao, Norbert Svoboda, Shiqiang Wang, Zhijie Zhoul, Chang Tao, Antonio D'Ammando, Fabio Grassia, Dong Wang, Jidong Sun, Yanwei Chen, Zongdang Wei, Andrew Stevens, Niko Njiric, Marco Cancedda, Ahmet Faruk Özdemir, Burak Tahmazoglu, Edoardo Porto, Namer Thana, Aqsa Adil, and Francesco Crisà

Subjects
Simulation, Neurosurgery, Training, Soft skills, Psychometric testing, Virtual reality, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. Research question: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. Material and methods: Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. Results: The SG demonstrated superior performance (p

Published
2024
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2. An integrative survival analysis and a systematic review of the cerebellopontine angle glioblastomas

Author

Nebojsa Lasica, Kenan Arnautovic, Tomita Tadanori, Petar Vulekovic, and Dusko Kozic

Subjects
Medicine, Science
Abstract

Abstract Glioblastomas presenting topographically at the cerebellopontine angle (CPA) are exceedingly rare. Given the specific anatomical considerations and their rarity, overall survival (OS) and management are not discussed in detail. The authors performed an integrative survival analysis of CPA glioblastomas. A literature search of PubMed, Scopus, and Web of Science databases was performed per PRISMA guidelines. Patient data including demographics, clinical features, neuroimaging, management, follow-up, and OS were extracted. The mean age was 39 ± 26.2 years. The mean OS was 8.9 months. Kaplan–Meier log-rank test and univariate Cox proportional-hazards model identified hydrocephalus (log-rank, p = 0.034; HR 0.34; 95% CI 0.12–0.94; p = 0.038), chemotherapy (log-rank, p

Published
2023
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3. Metabolomics as a potential tool for monitoring patients with aneurysmal subarachnoid hemorrhage

Author

Nebojsa Lasica, Vidak Raicevic, Nikola M. Stojanovic, Djula Djilvesi, Igor Horvat, Bojan Jelaca, Filip Pajicic, and Petar Vulekovic

Subjects
metabolomics, metabonomics, stroke, subarachnoid hemorrhage, intracranial aneurysm, neurocritical care, Neurology. Diseases of the nervous system, RC346-429
Abstract

Metabolomics has evolved into a particularly useful tool to study interactions between metabolites and serves as an aid in unraveling the complexity of entire metabolomes. Nonetheless, it is increasingly viewed as a methodology with practical applications in the clinical setting, where identifying and quantifying biomarkers of interest could prove useful for diagnostics. Starting from a concise overview of the most prominent analytical techniques employed in metabolomics, herein we present a review of its application in studies of brain metabolism and cerebrovascular diseases, paying most attention to its uses in researching aneurysmal subarachnoid hemorrhage. Both animal models and human studies are considered, and metabolites identified as potential biomarkers are highlighted.

Published
2023
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4. Case Report: Atypical Solitary Brain Metastasis: The Role of MR Spectroscopy In Differential Diagnosis

Author

Dusko Kozic, Nebojsa Lasica, Danica Grujicic, Savo Raicevic, Natasa Prvulovic Bunovic, Igor Nosek, and Jasmina Boban

Subjects
brain metastasis, nonenhancing, magnetic resonance spectroscopy, case report, neuroendocrine tumor, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

BackgroundMetastatic brain tumors are typically located at the cerebral hemispheres or the cerebellum and most frequently originate from primary breast or lung tumors. Metastatic lesions are usually associated with blood–brain barrier disruption, solid or ring-like contrast enhancement, and perilesional vasogenic edema on brain imaging. Even in cases where metastases are predominantly cystic, enhancement of the minor solid component can be detected. In contrast, non-enhancing secondary brain tumors were only reported in a patient after antiangiogenic treatment with bevacizumab.Case reportWe report a case of a 54-year-old male who presented with left-sided weakness and multiple seizures. Brain magnetic resonance imaging revealed a T2-weighted heterogeneous solid tumor in the right frontoparietal parasagittal region, with no apparent enhancement on T1-weighted post-contrast images and no evident perilesional edema. Further MRS analysis revealed markedly increased choline and lipid peaks. The patient underwent craniotomy for tumor removal. Histopathology revealed findings consistent with metastatic non-microcellular neuroendocrine lung cancer. positron emission tomography/computed tomography (PET/CT) revealed a stellate lesion within the right upper lung lobe, compatible with primary lung cancer.ConclusionNon-enhancing brain metastatic tumors are rarely reported in the literature, usually following antiangiogenic treatment. Here, we report the first ever case of a non-enhancing metastatic brain tumor with no prior history of antiangiogenic treatment, with particular emphasis on the importance of MRS analysis in atypical brain lesions.

Published
2022
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5. Venous thromboembolic and hemorrhagic events after meningioma surgery: A single-center retrospective cohort study of risk factors.

Author

Nebojsa Lasica, Djula Djilvesi, Vladimir Papic, Mladen Karan, Bojan Jelaca, Jagos Golubovic, Filip Pajicic, Milica Medic-Stojanoska, Petar Vulekovic, and Lukas Rasulic

Subjects
Medicine, Science
Abstract

Microsurgical resection of meningiomas in a majority of cases leads to a favorable outcome. Therefore, severe postoperative adverse events are less acceptable. The main purpose of this study was to investigate the incidence of symptomatic venous thromboembolism (VTE) and hemorrhagic complications in patients after operative treatment of intracranial meningiomas and to identify the risk factors in this patient subgroup. Of 106 patients undergoing elective craniotomy for meningioma overall incidence of symptomatic VTE was noted in 5.7% (six patients). For the risk-factor analysis older age (57.20 ± 11.60 vs. 71.00 ± 0.90 years, p < 0.001), higher body mass index (27.60 ± 4.80 vs. 33.16 ± 0.60 kg/m2, p < 0.001), WHO grade II (3.00% vs. 33.33%, p = 0.02), lower intraoperative blood loss (466.00 ± 383.70 vs. 216.70 ± 68.30 mL, p < 0.001), bedridden status and neurologic deficit (0.00% vs. 33.33%, p = 0.003 and 38.00% vs. 100.00%, p = 0.004) were associated with greater VTE risk. No risk factors for hemorrhagic complications were identified on univariate analysis. In conclusion, the incidence of VTE in meningioma patients is not negligible. Identified risk factors should be taken into account in the decision-making process for chemoprophylaxis when the risk of bleeding decreases.

Published
2022
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6. Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

Author

David Clark, Alexis Joannides, Amos Olufemi Adeleye, Abdul Hafid Bajamal, Tom Bashford, Hagos Biluts, Karol Budohoski, Ari Ercole, Rocío Fernández-Méndez, Anthony Figaji, Deepak Kumar Gupta, Roger Härtl, Corrado Iaccarino, Tariq Khan, Tsegazeab Laeke, Andrés Rubiano, Hamisi K Shabani, Kachinga Sichizya, Manoj Tewari, Abenezer Tirsit, Myat Thu, Manjul Tripathi, Rikin Trivedi, Bhagavatula Indira Devi, Franco Servadei, David Menon, Angelos Kolias, Peter Hutchinson, Ghayur Abbas, Omar Ibrahim Abdallah, Ahmed Abdel-Lateef, Khalif Abdifatah, Awfa Abdullateef, Ruvini Abeygunaratne, Mostafa Aboellil, Abass Adam, Robert Adams, Amos Adeleye, Augustine Adeolu, Novan Krisno Adji, Nur Afianti, Sudarsan Agarwal, Ifeanyi Kene Aghadi, Paúl Martín Méndez Aguilar, Syeda Rida Ahmad, Daniyal Ahmed, Nafees Ahmed, Haider Aizaz, Yunus Kuntawi Aji, Alex Alamri, Augusto Jacinto Mussindo Alberto, Luis Alcocer Alcocer, Lesly Gonzales Alfaro, Amro Al-Habib, Ahmad Alhourani, Syed Muhammad Rafay Ali, Fahad Alkherayf, Ahmed AlMenabbawy, Aliyah Alshareef, Muhammad Adil s/o Aminullah, Madeha Amjad, Robson Luis Oliveira de Amorim, Sathiaprabhu Anbazhagan, Almir Andrade, Waleed Antar, Theophilus T.K. Anyomih, Salah Aoun, Tedy Apriawan, Daniele Armocida, Paul Arnold, Miguel Arraez, Temesgen Assefa, Andres Asser, S.P. Athiththan, Deepal Attanayake, Maung Maung Aung, Allan Avi, Victor Enrique Antolinez Ayala, Mohammed Azab, Gaousul Azam, Mohd Azharuddin, Olukemi Badejo, Mohamed Badran, Azam Ali Baig, Rehman Ali Baig, Ankur Bajaj, Paul Baker, Renu Bala, Artur Balasa, Ross Balchin, James Balogun, Vin Shen Ban, Bharath Kumar Reddy Bandi, Soham Bandyopadhyay, Matthew Bank, Ernest Barthelemy, Mohammed Talha Bashir, Luciano Silveira Basso, Surajit Basu, Auricelio Batista, Marlies Bauer, Devi Bavishi, Abi Beane, Shmuel Bejell, Anteneh Belachew, Antonio Belli, Amani Belouaer, Najia El Abbadi Bendahane, Okanga Benjamin, Youssef Benslimane, Chaymae Benyaiche, Claudio Bernucci, Luigi Valentino Berra, Arnold Bhebe, Alexios Bimpis, Diana Blanaru, Jean Claude Bonfim, Luis A B Borba, Alp Ozgun Borcek, Erika Borotto, Ahmad Elmabri Mohammad Bouhuwaish, Facundo Bourilhon, Gioia Brachini, Joshua Breedon, Maximilian Broger, Giacoma Maria Floriana Brunetto, Placido Bruzzaniti, Natalia Budohoska, Hira Burhan, Maximiliano Luis Calatroni, Catherine Camargo, Pier Francesco Cappai, Salvatore Massimiliano Cardali, Ana M Castaño-Leon, David Cederberg, Mikel Celaya, Marco Cenzato, Lakshmi Madhavi Challa, Dhanny Charest, Bipin Chaurasia, Rabah Chenna, Iype Cherian, Juliana Henry Ching'o, Tejas Chotai, Ajay Choudhary, Nabeel Choudhary, Florence Choumin, Tomislav Cigic, Juan Ciro, Carlo Conti, Antônio Carlos de Souza Corrêa, Giulia Cossu, Maíra Piani Couto, Aurora Cruz, Divya D'Silva, Giuseppe Antonio D'Aliberti, Lamin Dampha, Roy Thomas Daniel, Andrew Dapaah, Aneela Darbar, Gabriel Dascalu, Happy Amos Dauda, Owain Davies, Andrea Delgado-Babiano, Markus Dengl, Marko Despotovic, Indira Devi, Celeste Dias, Mohamed Dirar, Melina Dissanayake, Hananiah Djimbaye, Simon Dockrell, Ali Dolachee, Julija Dolgopolova, Muge Dolgun, Abdalrouf Dow, Davide Drusiani, Artjom Dugan, Dinh Tuan Duong, Trung Kien Duong, Tomasz Dziedzic, Ali Ebrahim, Nizar El Fatemi, Antonios El El Helou, Rachid El El Maaqili, Brahim El El Mostarchid, Abdessamad El El Ouahabi, Mohammad Elbaroody, Ahmed El-Fiki, Ahmed El-Garci, Nasser M.F. El-Ghandour, Muhammed Elhadi, Vanessa Elleder, Safa Elrais, Mohamed El-shazly, Mohamed Elshenawy, Hesham Elshitany, Omar El-Sobky, Marwa Emhamed, Basil Enicker, Onur Erdogan, Sebastian Ertl, Ignatius Esene, Omar Ocampo Espinosa, Tarig Fadalla, Mohammed Fadelalla, Rodrigo Moreira Faleiro, Nida Fatima, Charbel Fawaz, Assefa Fentaw, Carla Eiriz Fernandez, Ana Ferreira, Francesco Ferri, Tony Figaji, Emerson L B Filho, Loic Fin, Benjamin Fisher, Fitra Fitra, Alexis Palpan Flores, Ioan Stefan Florian, Vincenzo Fontana, Lauren Ford, Daniel Fountain, Jose Maria Roda Frade, Antonio Fratto, Christian Freyschlag, Aranzazu Sánchez Gabin, Clare Gallagher, Mario Ganau, Maria Luisa Gandia-Gonzalez, Andoni Garcia, Borja Hernandez Garcia, Sanjeewa Garusinghe, Biniam Gebreegziabher, Adrian Gelb, Jerome St George, Antonino Francesco Germanò, Ilaria Ghetti, Prajwal Ghimire, Alessandro Giammarusti, Jose Luis Gil, Panagiota Gkolia, Yoseph Godebo, Prakash Rao Gollapudi, Jagos Golubovic, Jeremias Fernando Gomes, Javier Gonzales, William Gormley, Alexander Gots, Giulia Letizia Gribaudi, Dylan Griswold, Paolo Gritti, Ruan Grobler, Rudy Gunawan, Birhanu Hailemichael, Elmehdi Hakkou, Mark Haley, Alhafidz Hamdan, Ali Hammed, Waeel Hamouda, Nurul Ashikin Hamzah, Nyein Latt Han, Sahin Hanalioglu, Rashan Haniffa, Martin Hanko, John Hanrahan, Timothy Hardcastle, Fahd Derkaoui Hassani, Volkmar Heidecke, Eirik Helseth, Miguel Ángel Hernández-Hernández, Zachary Hickman, Le Minh Chau Hoang, Alexa Hollinger, Lenka Horakova, Kismet Hossain-Ibrahim, Boru Hou, Samer Hoz, Janine Hsu, Martin Hunn, Madiha Hussain, Giorgia Iacopino, Mylena Miki Lopes Ideta, Irene Iglesias, Ali Ilunga, Nafiz Imtiaz, Rafiza Islam, Serge Ivashchenko, Karim Izirouel, Mohamed Sobhi Jabal, Soubhi Jabal, John Nute Jabang, Aimun Jamjoom, Irfan Jan, Landing BM Jarju, Saad Javed, Bojan Jelaca, Sukhdeep Singh Jhawar, Ting Ting Jiang, Fernando Jimenez, Jorge Jiris, Ron Jithoo, Walt Johnson, Mathew Joseph, Rameshman Joshi, Eija Junttila, Mubashir Jusabani, Stephen Akau Kache, Satyavara Prasad Kadali, Gabriela F Kalkmann, Usman Kamboh, Hitham Kandel, Ahmet Kamil Karakus, Mengistu Kassa, Ari Katila, Yoko Kato, Martin Keba, Kristy Kehoe, Huseyin Hayri Kertmen, Soha Khafaji, Monty Khajanchi, Mohammed Khan, Muhammad Mukhtar Khan, Sohail Daud Khan, Ahtesham Khizar, Amir Khriesh, Sara Kierońska, Paul Kisanga, Boniface Kivevele, Kacper Koczyk, Anna-Lucia Koerling, Danielle Koffenberger, Kennet Kõiv, Leho Kõiv, Branislav Kolarovszki, Marton König, Dilek Könü-Leblebicioglu, Santhoshi Devi Koppala, Tommi Korhonen, Boguslaw Kostkiewicz, Kacper Kostyra, Srinivas Kotakadira, Arjun Reddy Kotha, Madhu Narayana Rao Kottakki, Nenad Krajcinovic, Michal Krakowiak, Andreas Kramer, Selvamuthukumaran Krishnamoorthy, Ashok Kumar, Pankaj Kumar, Pradhumna Kumar, Nilaksha Kumarasinghe, Gowtham Kuncha, Raja K. Kutty, Ghazwan Lafta, Simon Lammy, Pierfrancesco Lapolla, Jacopo Lardani, Nebojsa Lasica, Giancarlo Lastrucci, Yoann Launey, Laura Lavalle, Tim Lawrence, Albert Lazaro, Vitalii Lebed, Ville Leinonen, Lawrence Lemeri, Leon Levi, Jia Yi Lim, Xiao Yi Lim, Jorge Linares-Torres, Laura Lippa, Lurdes Lisboa, Jinfang Liu, Ziyuan Liu, William B Lo, Jan Lodin, Federico Loi, Daniella Londono, Pedro Antonio Gomez Lopez, Cristina Barceló López, Madeleine De Lotbiniere-Bassett, Rihards Lulens, Facundo Hector Luna, Teemu Luoto, Vijaya Sekhar M.V., Ndyebo Mabovula, Matthew MacAllister, Alcina Americo Macie, Rodolfo Maduri, Moufid Mahfoud, Ashraf Mahmood, Fathia Mahmoud, Dominic Mahoney, Wissam Makhlouf, George Malcolm, Adefolarin Malomo, Toluyemi Malomo, Manoranjitha Kumari Mani, Tomás Gazzinelli Marçal, Jacopo Marchello, Nicolò Marchesini, Franz Marhold, Niklas Marklund, Rubén Martín-Láez, Vickneswaran Mathaneswaran, David José Mato-Mañas, Helen Maye, Aaron Lawson McLean, Catherine McMahon, Saniya Mediratta, Mehreen Mehboob, Alisson Meneses, Nesrine Mentri, Hagos Mersha, Ana Milena Mesa, Cristy Meyer, Christopher Millward, Salomao Amone Mimbir, Andrea Mingoli, Parashruram Mishra, Tejesh Mishra, Basant Misra, Siddharth Mittal, Imran Mohammed, Ioana Moldovan, Masechaba Molefe, Alexis Moles, Preston Moodley, Mario Augusto Narváez Morales, Lucy Morgan, German Del Castillo Morillo, Wahab Moustafa, Nikolaos Moustakis, Salma Mrichi, Satya Shiva Munjal, Abdul-Jalilu Mohammed Muntaka, Denver Naicker, Paulo E H Nakashima, Pratap Kumar Nandigama, Samantha Nash, Ionut Negoi, Valetina Negoita, Samundra Neupane, Manh Hung Nguyen, Fajar Herbowo Niantiarno, Abbi Noble, Mohd Arman Muhamad Nor, Blazej Nowak, Andrei Oancea, Frazer O'Brien, Oghenekevwe Okere, Sandra Olaya, Leandro Oliveira, Louise Makarem Oliveira, Fatma Omar, Okezi Ononeme, René Opšenák, Simone Orlandini, Alrobah Osama, Dorcas Osei-Poku, Haytham Osman, Alvaro Otero, Malte Ottenhausen, Shuli Otzri, Oumaima Outani, Emmanuel Abem Owusu, Kevin Owusu-Agyemang, Ahmad Ozair, Baris Ozoner, Elli Paal, Mauro Sérgio Paiva, Wellingson Paiva, Sharad Pandey, Gastone Pansini, Luigi Pansini, Tobias Pantel, Nikolaos Pantelas, Konstantinos Papadopoulos, Vladimir Papic, Kee Park, Nick Park, Eric Homero Albuquerque Paschoal, Mylla Christie de Oliveira Paschoalino, Rajesh Pathi, Anilkumar Peethambaran, Thiago Andrade Pereira, Irene Panero Perez, Claudio José Piqueras Pérez, Tamilanandh Periyasamy, Stefano Peron, Michael Phillips, Sofía Sotos Picazo, Ertugrul Pinar, Daniel Pinggera, Rory Piper, Pathmanesan Pirakash, Branko Popadic, Jussi P. Posti, Rajmohan Bhanu Prabhakar, Sivanesalingam Pradeepan, Manjunath Prasad, Paola Calvachi Prieto, Ron Prince, Andrea Prontera, Eva Provaznikova, Danilo Quadros, Nezly Jadid Romero Quintero, Mahmood Qureshi, Happiness Rabiel, Gabriel Rada, Sivagnanam Ragavan, Jueria Rahman, Omar Ramadhan, Padma Ramaswamy, Sakina Rashid, Jagath Rathugamage, Tõnu Rätsep, Minna Rauhala, Asif Raza, Naga Raju Reddycherla, Linus Reen, Mohamed Refaat, Luca Regli, Haijun Ren, Antonio Ria, Thales Francisco Ribeiro, Alessandro Ricci, Romana Richterová, Florian Ringel, Faith Robertson, Catarina Mayrink Siqueira Cabral Rocha, Juvenal de Souza Rogério, Adan Anibal Romano, Sally Rothemeyer, Gail Rousseau Gail Rousseau, Ranette Roza, Kevin David Farelo Rueda, Raiza Ruiz, Malin Rundgren, Radoslaw Rzeplinski, Raj S.Chandran, Ramesh Andi Sadayandi, William Sage, André Norbert Josef Sagerer, Mustafa Sakar, Mohcine Salami, Danjuma Sale, Youssuf Saleh, Cristina Sánchez-Viguera, Saning'o Sandila, Ahmet Metin Sanli, Laura Santi, Antonio Santoro, Aieska Kellen Dantas Dos Santos, Samir Cezimbra dos Santos, Borja Sanz, Shabal Sapkota, Gopalakrishnan Sasidharan, Ibrahim Sasillo, Rajeev Satoskar, Ali Caner Sayar, Vignesh Sayee, Florian Scheichel, Felipe Lourenzon Schiavo, Alexander Schupper, Andreas Schwarz, Teresa Scott, Esther Seeberger, Claudionor Nogueira Costa Segundo, Anwar Sadat Seidu, Antonio Selfa, Nazan Has Selmi, Claudiya Selvarajah, Necmiye Şengel, Martin Seule, Luiz Severo, Purva Shah, Muhammad Shahzad, Thobekile Shangase, Mayur Sharma, Ehab Shiban, Emnet Shimber, Temitayo Shokunbi, Kaynat Siddiqui, Emily Sieg, Martin Siegemund, Shahidur Rahman Sikder, Ana Cristina Veiga Silva, Ana Silva, Pedro Alberto Silva, Deepinder Singh, Carly Skadden, Josef Skola, Eirini Skouteli, Pawel Słoniewski, Brandon Smith, Guirish Solanki, Davi Fontoura Solla, Davi Solla, Ozcan Sonmez, Müge Sönmez, Wai Cheong Soon, Roberto Stefini, Martin Nikolaus Stienen, Bogdan Stoica, Matthew Stovell, Maria Natalia Suarez, Alaa Sulaiman, Mazin Suliman, Adi Sulistyanto, Şeniz Sulubulut, Sandra Sungailaite, Madlen Surbeck, Tomasz Szmuda, Graziano Taddei, Abraham Tadele, Ahmed Saleh Ahmed Taher, Riikka Takala, Krishna Murthy Talari, Bih Huei Tan, Leonardo Tariciotti, Murad Tarmohamed, Oumayma Taroua, Emiliano Tatti, Olli Tenovuo, Sami Tetri, Poojan Thakkar, Nqobile Thango, Satish Kumar Thatikonda, Tuomo Thesleff, Claudius Thomé, Owen Thornton, Shelly Timmons, Eva Ercilio Timoteo, Campbell Tingate, Souhil Tliba, Christos Tolias, Emma Toman, Ivan Torres, Luis Torres, Youness Touissi, Musa Touray, Maria Pia Tropeano, Georgios Tsermoulas, Christos Tsitsipanis, Mehmet Erhan Turkoglu, Özhan Merzuk Uçkun, Jamie Ullman, Gheorghe Ungureanu, Sarah Urasa, Obaid Ur-Rehman, Muhammed Uysal, Antonios Vakis, Egils Valeinis, Vaishali Valluru, Debby Vannoy, Pablo Vargas, Phillipos Varotsis, Rahul Varshney, Atul Vats, Damjan Veljanoski, Sara Venturini, Abhijit Verma, Clara Villa, Genaro Villa, Sofia Villar, Erin Villard, Antonio Viruez, Stefanos Voglis, Petar Vulekovic, Saman Wadanamby, Katherine Wagner, Rebecca Walshe, Jan Walter, Marriam Waseem, Tony Whitworth, Ruwani Wijeyekoon, Adam Williams, Mark Wilson, Sein Win, Achmad Wahib Wahju Winarso, Abraão Wagner Pessoa Ximenes, Anurag Yadav, Dipak Yadav, Kamal Makram Yakoub, Ali Yalcinkaya, Guizhong Yan, Eesha Yaqoob, Carlos Yepes, Ayfer Nazmiye Yılmaz, Betelehem Yishak, Farhat Basheer Yousuf, Muhammad Zamzuri Zahari, Hussein Zakaria, Diego Zambonin, Luca Zavatto, Bassel Zebian, Anna Maria Zeitlberger, Furong Zhang, Fengwei Zheng, and Michal Ziga

Subjects
casemix, management, mortality, emergency neurosurgery, traumatic brain injury, prospective observational cohort study, Neurology (clinical)
Abstract

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. Methods: We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)—a composite of life expectancy, education, and income measures—into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. Findings: Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24–51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34–69) and the youngest in the low HDI tier (median 28 years, IQR 20–38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6–32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55–5·2) and high HDI tier (2·26, 1·23–4·15), but not the low HDI tier (1·66, 0·61–4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17–2·49). Interpretation: Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. Funding: National Institute for Health Research Global Health Research Group.

Published
2022
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8. Venous thromboembolic and hemorrhagic events after meningioma surgery: A single-center retrospective cohort study of risk factors

Author

Nebojsa Lasica, Djula Djilvesi, Vladimir Papic, Mladen Karan, Bojan Jelaca, Jagos Golubovic, Filip Pajicic, Milica Medic-Stojanoska, Petar Vulekovic, and Lukas Rasulic

Subjects
Multidisciplinary, Postoperative Complications, Incidence, Meningeal Neoplasms, Humans, Venous Thromboembolism, Meningioma, Retrospective Studies
Abstract

Microsurgical resection of meningiomas in a majority of cases leads to a favorable outcome. Therefore, severe postoperative adverse events are less acceptable. The main purpose of this study was to investigate the incidence of symptomatic venous thromboembolism (VTE) and hemorrhagic complications in patients after operative treatment of intracranial meningiomas and to identify the risk factors in this patient subgroup. Of 106 patients undergoing elective craniotomy for meningioma overall incidence of symptomatic VTE was noted in 5.7% (six patients). For the risk-factor analysis older age (57.20 ± 11.60 vs. 71.00 ± 0.90 years, p < 0.001), higher body mass index (27.60 ± 4.80 vs. 33.16 ± 0.60 kg/m2, p < 0.001), WHO grade II (3.00% vs. 33.33%, p = 0.02), lower intraoperative blood loss (466.00 ± 383.70 vs. 216.70 ± 68.30 mL, p < 0.001), bedridden status and neurologic deficit (0.00% vs. 33.33%, p = 0.003 and 38.00% vs. 100.00%, p = 0.004) were associated with greater VTE risk. No risk factors for hemorrhagic complications were identified on univariate analysis. In conclusion, the incidence of VTE in meningioma patients is not negligible. Identified risk factors should be taken into account in the decision-making process for chemoprophylaxis when the risk of bleeding decreases.

Published
2021

9. Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review

Author

M. Fimić, Bojan Jelaca, Nebojsa Lasica, Jagos Golubovic, Filip Pajicic, Dusko Kozic, Vladimir Papic, Nada Vuckovic, Djula Djilvesi, and Petar Vulekovic

Subjects
Adult, Cerebral Cortex, Male, medicine.medical_specialty, Brain development, business.industry, Brain Neoplasms, Incidence (epidemiology), Radiography, medicine.disease, World health, Meningioma, Cyst formation, Meningeal Neoplasms, Medicine, Humans, Surgery, Histopathology, Neurology (clinical), Radiology, Differential diagnosis, business
Abstract

Background Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology. Methods A literature search of the Web of Science and PubMed databases and crossed references was performed in March 2021, per PRISMA guidelines, with no restrictions regarding publication date. Data regarding demographic features, clinical, radiographic, and histopathologic characteristics were extracted. Results A total of 52 patients (including the reported case) were included in this review. The mean age was 21.1 years (range, 0.3–66 years) with a male/female ratio of 1.9:1. The most common localizations of intraparenchymal meningiomas were in the frontal (30.8%) and temporal (21.2%) lobes. Cyst formation was more readily observed and was noted in 51.4% of patients. Histopathology showed a higher incidence of World Health Organization grade II (14/52, 26.9%) and World Health Organization grade III (7/52, 13.5%) of primary intraparenchymal meningiomas. Conclusions We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.

Published
2021

10. Nokardijalni apsces mozga koji je oponašao metastazu karcinoma pluća kod imunokompetentnog bolesnika s plućnom nokardijazom: prikaz slučaja

Author

Petar Vulekovic, Nada Vuckovic, Ante Rotim, Mladen Karan, Nebojsa Lasica, and Lukas Rasulić

Subjects
Pathology, medicine.medical_specialty, Lung, Case reports, biology, business.industry, Mortality rate, Nokardija, infekcije, Moždani apsces, Plućni tumori, Prikazi slučaja, Nocardiosis, Nocardia, General Medicine, medicine.disease, biology.organism_classification, 3. Good health, Metastasis, Brain abscess, medicine.anatomical_structure, Lung neoplasms, medicine, Nocardia, infections, Lung cancer, business, Nocardia Infections
Abstract

Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. Immunocompetent and immunocompromised patients both can be affected and Nocardia cyriacigeorgica was reported as a pathogen isolated in patients worldwide. In most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise aware-ness of the possibility for this rare but potentially fatal condition. We present a case where nocardial ab-scesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome., Nocardia je ubikvitaran mikroorganizam koji može biti uzročnik lokalnih i sistemskih infekcija kod čovjeka. No-cardia cyriacigeorgica je patogen koji je izoliran i prijavljen u svim dijelovima svijeta. I imunokompetentne i imu-nokompromitirane osobe mogu biti zahvaćene ovom infekcijom. U većini slučajeva prisutna je infekcija pluća bu-dući da je inhalacija primarni put unošenja uzročnika. Nokardijalni apscesi mozga se obično javljaju uslijed posto-janja žarišta infekcije u drugim dijelovima organizma. Imajući u vidu činjenicu da raste broj osoba starije životne dobi i broj imunokompromitiranih osoba u ukupnoj populaciji, uz visoku smrtnost bolesnika s nokardijalnom infek-cijom središnjega živčanog sustava, moramo biti svjesni mogućnosti za razvoj ovog rijetkog, ali potencijalno fatal-nog stanja. Prikazujemo slučaj bolesnika kod kojega su plućna nokardijalna infekcija i nokardijalni apsces mozga inicijalno shvaćeni kao karcinom pluća i metastatski tumor mozga. Bolesnik je liječen kombinacijom kirurškog liječenja i antimikrobne terapije s dobrim ishodom.

Published
2019

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