Clinic for Neurosurgery

Buch, Germany

Clinic for Neurosurgery

Buch, Germany

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Maier-Hauff K.,Bundeswehrkrankenhaus Berlin | Ulrich F.,Clinic for Neurosurgery | Nestler D.,Bundeswehrkrankenhaus Berlin | Niehoff H.,Clinic for Neurosurgery | And 6 more authors.
Journal of Neuro-Oncology | Year: 2011

Therapy options at the time of recurrence of glioblastoma multiforme are often limited. We investigated whether treatment with a new intratumoral thermotherapy procedure using magnetic nanoparticles improves survival outcome. In a single-arm study in two centers, 66 patients (59 with recurrent glioblastoma) received neuronavigationally controlled intratumoral instillation of an aqueous dispersion of iron-oxide (magnetite) nanoparticles and subsequent heating of the particles in an alternating magnetic field. Treatment was combined with fractionated stereotactic radiotherapy. A median dose of 30 Gy using a fractionation of 5 x 2 Gy/week was applied. The primary study endpoint was overall survival following diagnosis of first tumor recurrence (OS-2), while the secondary endpoint was overall survival after primary tumor diagnosis (OS-1). Survival times were calculated using the Kaplan-Meier method. Analyses were by intention to treat. The median overall survival from diagnosis of the first tumor recurrence among the 59 patients with recurrent glioblastoma was 13.4 months (95% CI: 10.6-16.2 months). Median OS-1 was 23.2 months while the median time interval between primary diagnosis and first tumor recurrence was 8.0 months. Only tumor volume at study entry was significantly correlated with ensuing survival (P < 0.01). No other variables predicting longer survival could be determined. The side effects of the new therapeutic approach were moderate, and no serious complications were observed. Thermotherapy using magnetic nanoparticles in conjunction with a reduced radiation dose is safe and effective and leads to longer OS-2 compared to conventional therapies in the treatment of recurrent glioblastoma. © 2010 The Author(s).


News Article | March 2, 2017
Site: marketersmedia.com

Speeding up of European Expansion US Commercialization expected to start early 2018​ Issuance of Convertible, subscribed by Lansdowne Partners Austria BERLIN, GERMANY, AND NEVADA / ACCESSWIRE / March 2, 2017 / MagForce AG (Frankfurt, Scale, XETRA: MF6, ISIN: DE000A0HGQF5), a leading medical device company in the field of nanomedicine focused on oncology, today published its first Shareholder Letter 2017: Since the publication of our last Shareholder Letter, we have continued our joint efforts on both of our defined paths to create additional shareholder value: Path 2: Treatment of intermediate risk prostate cancer in the USA We are pleased to give you an interim update on the respective developments. MagForce AG is continuing to expand the commercialization of its innovative NanoTherm(R) therapy. We successfully installed NanoActivator(R) devices in 2014 and 2015 in Germany to assist the neurosurgeons and radiologists as they became familiar with our NanoTherm(R) therapy and its applicability. In their quest to improve patient care, the neurosurgeons applying NanoTherm(R) therapy to the treatment of brain tumors continue to find additional medical benefits when NanoTherm(R) therapy is incorporated into their usual treatment regimen. Such a positive finding for example was described by Dr. med. Johannes Wölfer, Deputy Director of the Neurosurgical Department, Clinic and Policlinic for Neurosurgery, University Hospital Münster and part of the team of Prof. Dr. med. Walter Stummer, Director of the Department of Neurosurgery at the University Hospital Münster and President of the German Neurosurgical Society (DGNC), as described in our press release as of December 2, 2016. Since the last Shareholder Letter we presented at the following conferences and congresses: 13th AIO Autumn Convention - Oncology in Internal Medicine Working Group (AIO) - Update Medical Oncology - November 17-19, 2016, Berlin 21st Annual Scientific Meeting and Education Day of the Society for Neuro-Oncology (SNO) - November 17-20, 2016, Scottsdale, Arizona Presentation: "Inflammatory response after modified NanoTherm(R) and radiotherapy of recurrent glioblastoma" Presenter: Team of Prof. Dr. med. Walter Stummer, Director of the Clinic for Neurosurgery, University Hospital Münster Speaker: Dr. Dr. med. Oliver Grauer, Head of Neuro-Oncology Team, University Hospital Münster NOA Winter School 2016 - Neuro-oncological Working Group - December 1-2, 2016, Münster Presentation: "Local Hyperthermia as an adjuvant for malignant glioblastoma - NanoTherm and NanoPaste" Speaker: Dr. med. Johannes Wölfer, Deputy Director of the Neurosurgical Department, Clinic and Policlinic for Neurosurgery, University Hospital Münster European CanCer Organization (ECCO) - January 27-30, 2017, Amsterdam MagForce's participation in these conferences and congresses increases the awareness of our unique therapy within the main target groups, such as patient advocacy groups, patients, their relatives, caregivers, and the medical community. We increasingly receive positive feedback from patients regarding their experiences with our NanoTherm(R) therapy. These examples, one of which we are showing in a new video on our website http://www.magforce.de/en/home.html, are an important driver for the commercialization of our innovative therapy. During 2016, we have streamlined the implementation of the cross-border reimbursement process, however, due to the aggressiveness of glioblastoma, there is a limited time interval to achieve treatment. In order to give patients the benefit from our NanoTherm(R) treatment, we will continue to increase the medical awareness of the value of NanoTherm(R) therapy to encourage patients and neurosurgeons to consider NanoTherm(R) therapy earlier following the diagnosis of their tumor status. Further, we have developed a European roll-out plan, anticipating treatment centers in selected European countries to allow patient treatment in their home countries. From this approach we expect advantages in the areas of reimbursement and timely availability of NanoTherm(R) therapy. At the same time, we are in the process of obtaining domestic reimbursement for NanoTherm(R) therapy in Germany and we are preparing the same for those selected countries in the EU where MagForce has the CE Mark for the treatment of brain tumors. Our commercial and medical teams have identified the respective countries and clinics which qualify as NanoTherm(R) treatment centers. Based on the very gratifying medical results, management is confident that the European expansion starting in 2017, when combined with reimbursement approval in these countries, will significantly speed up revenue and profit generation in Europe. Treatment of intermediate risk prostate cancer in the USA: MagForce USA, Inc. in 2015, filed an Investigational Device Exemption (IDE) with the USA Food and Drug Administration (FDA) for NanoTherm(R) therapy to treat Intermediate Risk Prostate Cancer. Our objective with this early filing was to obtain FDA guidance as to their required pre-clinical studies to allow a pivotal clinical evaluation with our innovative and unknown NanoTherm(R) therapy. During 2016, MagForce USA repeated and updated its pre-clinical studies, which were previously conducted in Germany approximately ten years ago, at the recommendation of the FDA. MagForce USA repeated all of the previous biocompatibility studies designed to assess the toxicity and possible migration of MagForce's nanoparticles once instilled into the prostate. These studies again confirmed the lack of toxicity and lack of migration of the nanoparticles. The results of these pre-clinical studies and the proposed clinical trial protocol were submitted to the FDA in late fourth quarter, 2016. An in-person follow-up meeting with FDA representatives was held in early January, 2017 to discuss MagForce's submissions and identify required clarification. This meeting was again very productive and MagForce believes we can successfully address their questions. While we are now approximately three months behind our schedule, we are still confident and will make every effort to achieve our original targets in terms of market entry and commercialization of NanoTherm(R) therapy in the USA - which is projected for early 2018. The key to achieving our goals is to continue to establish our clinical treatment sites and obtain the necessary approvals to treat patients. After having announced Seattle Washington in 2015 for pre-clinical and clinical studies, we have now identified a second planned site to exclusively participate in the pivotal clinical studies. In addition to our lead site at The University of Washington in Seattle, Washington, our second site is now located at CHRISTUS Santa Rosa Hospital - Medical Center in San Antonio, Texas. Ian M. Thompson Jr., MD, our Co-Principle Investigator, has been newly appointed as President of CHRISTUS Santa Rosa Hospital - Medical Center among his many responsibilities. This clinical site will encompass both a clinical office and the NanoActivator(R) treatment center. CHRISTUS Santa Rosa Health is an international Catholic, faith-based, not-for-profit health system, and comprised of over 500 services and facilities, including more than 50 hospitals and long-term facilities and 275 clinics and outpatient centers. CHRISTUS Santa Rosa's services can be found in over 100 cities in the United States, Chile, Mexico and Colombia, and employs over 40,000 associates and has more than 10,000 physicians on medical staff. We are very excited to work with the team of CHRISTUS Santa Rosa Hospital - Medical Center with its exceptional experience and knowledge. This partnership also gives MagForce the potential to utilize CHRISTUS Santa Rosa's established network once the FDA approval is obtained and our partners at CHRISTUS Santa Rosa Hospital - Medical Center are satisfied with the treatment regimen. MagForce's management is pursuing non/low dilutive financing options to reach our European expansion goals. In addition, in order to bolster liquidity and facilitate new product development beyond 2017, we have issued a three-year convertible note. Product development includes laying the groundwork for expanding MagForce's therapy to additional tumors, like brain metastasis, and to also use our nano-particles as a drug delivery mechanism. The note is in the amount of EUR 5 million, will bear an interest rate at 5% p.a. and have a conversion price at 5,00 EUR/share. The note has been issued to an investment vehicle managed by Lansdowne Partners Austria. Dear Shareholders, we are very grateful for your continuous support of our efforts, and we are very confident that 2017 will turn out to be the best and most defining year in the history of MagForce. About MagForce AG and MagForce USA, Inc. MagForce AG, listed in the new Scale segment of the Frankfurt Stock Exchange (MF6, ISIN: DE000A0HGQF5), together with its subsidiary MagForce USA, Inc. is a leading medical device company in the field of nanomedicine focused on oncology. The Group's proprietary NanoTherm(R) therapy enables the targeted treatment of solid tumors through the intratumoral generation of heat via activation of superparamagnetic nanoparticles. Mithril Capital Management, a growth-stage technology fund founded by Ajay Royan and Peter Thiel, along with MagForce AG, are investors and strategic partners in MagForce USA, Inc. NanoTherm(R), NanoPlan(R), and NanoActivator(R) are components of the therapy and have received EU-wide regulatory approval as medical devices for the treatment of brain tumors. MagForce, NanoTherm, NanoPlan, and NanoActivator are trademarks of MagForce AG in selected countries. For more information, please visit: www.magforce.com. Get to know our Technology: video (You Tube) Stay informed and subscribe to our mailing list. This release may contain forward-looking statements and information which may be identified by formulations using terms such as "expects", "aims", "anticipates", "intends", "plans", "believes", "seeks", "estimates" or "will". Such forward-looking statements are based on our current expectations and certain assumptions, which may be subject to a variety of risks and uncertainties. The results actually achieved by MagForce AG may substantially differ from these forward-looking statements. MagForce AG assumes no obligation to update these forward-looking statements or to correct them in case of developments, which differ from those, anticipated. SOURCE: MagForce AG via the EQS Newswire distribution service including Press Releases and Regulatory Announcements Speeding up of European Expansion US Commercialization expected to start early 2018​ Issuance of Convertible, subscribed by Lansdowne Partners Austria BERLIN, GERMANY, AND NEVADA / ACCESSWIRE / March 2, 2017 / MagForce AG (Frankfurt, Scale, XETRA: MF6, ISIN: DE000A0HGQF5), a leading medical device company in the field of nanomedicine focused on oncology, today published its first Shareholder Letter 2017: Since the publication of our last Shareholder Letter, we have continued our joint efforts on both of our defined paths to create additional shareholder value: Path 2: Treatment of intermediate risk prostate cancer in the USA We are pleased to give you an interim update on the respective developments. MagForce AG is continuing to expand the commercialization of its innovative NanoTherm(R) therapy. We successfully installed NanoActivator(R) devices in 2014 and 2015 in Germany to assist the neurosurgeons and radiologists as they became familiar with our NanoTherm(R) therapy and its applicability. In their quest to improve patient care, the neurosurgeons applying NanoTherm(R) therapy to the treatment of brain tumors continue to find additional medical benefits when NanoTherm(R) therapy is incorporated into their usual treatment regimen. Such a positive finding for example was described by Dr. med. Johannes Wölfer, Deputy Director of the Neurosurgical Department, Clinic and Policlinic for Neurosurgery, University Hospital Münster and part of the team of Prof. Dr. med. Walter Stummer, Director of the Department of Neurosurgery at the University Hospital Münster and President of the German Neurosurgical Society (DGNC), as described in our press release as of December 2, 2016. Since the last Shareholder Letter we presented at the following conferences and congresses: 13th AIO Autumn Convention - Oncology in Internal Medicine Working Group (AIO) - Update Medical Oncology - November 17-19, 2016, Berlin 21st Annual Scientific Meeting and Education Day of the Society for Neuro-Oncology (SNO) - November 17-20, 2016, Scottsdale, Arizona Presentation: "Inflammatory response after modified NanoTherm(R) and radiotherapy of recurrent glioblastoma" Presenter: Team of Prof. Dr. med. Walter Stummer, Director of the Clinic for Neurosurgery, University Hospital Münster Speaker: Dr. Dr. med. Oliver Grauer, Head of Neuro-Oncology Team, University Hospital Münster NOA Winter School 2016 - Neuro-oncological Working Group - December 1-2, 2016, Münster Presentation: "Local Hyperthermia as an adjuvant for malignant glioblastoma - NanoTherm and NanoPaste" Speaker: Dr. med. Johannes Wölfer, Deputy Director of the Neurosurgical Department, Clinic and Policlinic for Neurosurgery, University Hospital Münster European CanCer Organization (ECCO) - January 27-30, 2017, Amsterdam MagForce's participation in these conferences and congresses increases the awareness of our unique therapy within the main target groups, such as patient advocacy groups, patients, their relatives, caregivers, and the medical community. We increasingly receive positive feedback from patients regarding their experiences with our NanoTherm(R) therapy. These examples, one of which we are showing in a new video on our website http://www.magforce.de/en/home.html, are an important driver for the commercialization of our innovative therapy. During 2016, we have streamlined the implementation of the cross-border reimbursement process, however, due to the aggressiveness of glioblastoma, there is a limited time interval to achieve treatment. In order to give patients the benefit from our NanoTherm(R) treatment, we will continue to increase the medical awareness of the value of NanoTherm(R) therapy to encourage patients and neurosurgeons to consider NanoTherm(R) therapy earlier following the diagnosis of their tumor status. Further, we have developed a European roll-out plan, anticipating treatment centers in selected European countries to allow patient treatment in their home countries. From this approach we expect advantages in the areas of reimbursement and timely availability of NanoTherm(R) therapy. At the same time, we are in the process of obtaining domestic reimbursement for NanoTherm(R) therapy in Germany and we are preparing the same for those selected countries in the EU where MagForce has the CE Mark for the treatment of brain tumors. Our commercial and medical teams have identified the respective countries and clinics which qualify as NanoTherm(R) treatment centers. Based on the very gratifying medical results, management is confident that the European expansion starting in 2017, when combined with reimbursement approval in these countries, will significantly speed up revenue and profit generation in Europe. Treatment of intermediate risk prostate cancer in the USA: MagForce USA, Inc. in 2015, filed an Investigational Device Exemption (IDE) with the USA Food and Drug Administration (FDA) for NanoTherm(R) therapy to treat Intermediate Risk Prostate Cancer. Our objective with this early filing was to obtain FDA guidance as to their required pre-clinical studies to allow a pivotal clinical evaluation with our innovative and unknown NanoTherm(R) therapy. During 2016, MagForce USA repeated and updated its pre-clinical studies, which were previously conducted in Germany approximately ten years ago, at the recommendation of the FDA. MagForce USA repeated all of the previous biocompatibility studies designed to assess the toxicity and possible migration of MagForce's nanoparticles once instilled into the prostate. These studies again confirmed the lack of toxicity and lack of migration of the nanoparticles. The results of these pre-clinical studies and the proposed clinical trial protocol were submitted to the FDA in late fourth quarter, 2016. An in-person follow-up meeting with FDA representatives was held in early January, 2017 to discuss MagForce's submissions and identify required clarification. This meeting was again very productive and MagForce believes we can successfully address their questions. While we are now approximately three months behind our schedule, we are still confident and will make every effort to achieve our original targets in terms of market entry and commercialization of NanoTherm(R) therapy in the USA - which is projected for early 2018. The key to achieving our goals is to continue to establish our clinical treatment sites and obtain the necessary approvals to treat patients. After having announced Seattle Washington in 2015 for pre-clinical and clinical studies, we have now identified a second planned site to exclusively participate in the pivotal clinical studies. In addition to our lead site at The University of Washington in Seattle, Washington, our second site is now located at CHRISTUS Santa Rosa Hospital - Medical Center in San Antonio, Texas. Ian M. Thompson Jr., MD, our Co-Principle Investigator, has been newly appointed as President of CHRISTUS Santa Rosa Hospital - Medical Center among his many responsibilities. This clinical site will encompass both a clinical office and the NanoActivator(R) treatment center. CHRISTUS Santa Rosa Health is an international Catholic, faith-based, not-for-profit health system, and comprised of over 500 services and facilities, including more than 50 hospitals and long-term facilities and 275 clinics and outpatient centers. CHRISTUS Santa Rosa's services can be found in over 100 cities in the United States, Chile, Mexico and Colombia, and employs over 40,000 associates and has more than 10,000 physicians on medical staff. We are very excited to work with the team of CHRISTUS Santa Rosa Hospital - Medical Center with its exceptional experience and knowledge. This partnership also gives MagForce the potential to utilize CHRISTUS Santa Rosa's established network once the FDA approval is obtained and our partners at CHRISTUS Santa Rosa Hospital - Medical Center are satisfied with the treatment regimen. MagForce's management is pursuing non/low dilutive financing options to reach our European expansion goals. In addition, in order to bolster liquidity and facilitate new product development beyond 2017, we have issued a three-year convertible note. Product development includes laying the groundwork for expanding MagForce's therapy to additional tumors, like brain metastasis, and to also use our nano-particles as a drug delivery mechanism. The note is in the amount of EUR 5 million, will bear an interest rate at 5% p.a. and have a conversion price at 5,00 EUR/share. The note has been issued to an investment vehicle managed by Lansdowne Partners Austria. Dear Shareholders, we are very grateful for your continuous support of our efforts, and we are very confident that 2017 will turn out to be the best and most defining year in the history of MagForce. About MagForce AG and MagForce USA, Inc. MagForce AG, listed in the new Scale segment of the Frankfurt Stock Exchange (MF6, ISIN: DE000A0HGQF5), together with its subsidiary MagForce USA, Inc. is a leading medical device company in the field of nanomedicine focused on oncology. The Group's proprietary NanoTherm(R) therapy enables the targeted treatment of solid tumors through the intratumoral generation of heat via activation of superparamagnetic nanoparticles. Mithril Capital Management, a growth-stage technology fund founded by Ajay Royan and Peter Thiel, along with MagForce AG, are investors and strategic partners in MagForce USA, Inc. NanoTherm(R), NanoPlan(R), and NanoActivator(R) are components of the therapy and have received EU-wide regulatory approval as medical devices for the treatment of brain tumors. MagForce, NanoTherm, NanoPlan, and NanoActivator are trademarks of MagForce AG in selected countries. For more information, please visit: www.magforce.com. Get to know our Technology: video (You Tube) Stay informed and subscribe to our mailing list. This release may contain forward-looking statements and information which may be identified by formulations using terms such as "expects", "aims", "anticipates", "intends", "plans", "believes", "seeks", "estimates" or "will". Such forward-looking statements are based on our current expectations and certain assumptions, which may be subject to a variety of risks and uncertainties. The results actually achieved by MagForce AG may substantially differ from these forward-looking statements. MagForce AG assumes no obligation to update these forward-looking statements or to correct them in case of developments, which differ from those, anticipated. SOURCE: MagForce AG via the EQS Newswire distribution service including Press Releases and Regulatory Announcements


Schick U.,University of Heidelberg | Jung C.,University of Heidelberg | Hassler W.E.,Clinic for Neurosurgery
Zentralblatt fur Neurochirurgie | Year: 2010

Objective: The management of optic nerve sheath meningiomas (ONSM) remains controversial, but includes surgery, radiotherapy and plain observation. We present a follow-up study and treatment modalities based on our classification system. Patients and Methods: A retrospective analysis was performed of 90 patients with optic nerve sheath meningiomas who were treated between 1991 and 2008 (n=65 surgery only, n=5 radiation only, n=18 surgery and postoperative radiation, n=2 observation). Follow-up data was available, ranging from 6 to 220 months with a median of 45.8 months. Results: Our classification system differentiates between intraorbital (type 1), intracanalicular or intrafissural (type 2), and intraorbital and intracranial (type 3) ONSMs. Thirty-seven tumors demonstrated extension through the optic canal (type 2a). 41 further tumors reached the chiasm (type 3a) or contralateral side (type 3b). Visual acuity was not significantly influenced by surgery but did become worse with a longer duration of preoperative symptoms and a longer follow-up period. Radiotherapy improved vision in 4 and preserved vision in 16 out of 23 cases. Conclusions: Loss of vision in optic nerve sheath meningiomas is a question of time. Radiotherapy should be offered for intraorbital ONSM. Surgery with decompression of the optic canal and intracranial tumor resection is still favored for tumors with intracanalicular and intracranial extension. © Georg Thieme Verlag Stuttgart - New York.


Neubert J.,Institute of Cell Biology and Neurobiology | Wagner S.,Charité - Medical University of Berlin | Kiwit J.,Clinic for Neurosurgery | Brauer A.U.,Institute of Cell Biology and Neurobiology | Glumm J.,Institute of Cell Biology and Neurobiology
International Journal of Nanomedicine | Year: 2015

The physicochemical properties of superparamagnetic iron oxide nanoparticles (SPIOs) enable their application in the diagnostics and therapy of central nervous system diseases. However, since crucial information regarding side effects of particle–cell interactions within the central nervous system is still lacking, we investigated the infuence of novel very small iron oxide particles or the clinically approved ferucarbotran or ferumoxytol on the vitality and morphology of brain cells. We exposed primary cell cultures of microglia and hippocampal neurons, as well as neuron–glia cocultures to varying concentrations of SPIOs for 6 and/or 24 hours, respectively. Here, we show that SPIO accumulation by microglia and subsequent morphological alterations strongly depend on the respective nanoparticle type. Microglial viability was severely compromised by high SPIO concentrations, except in the case of ferumoxytol. While ferumoxytol did not cause immediate microglial death, it induced severe morphological alterations and increased degeneration of primary neurons. Additionally, primary neurons clearly degenerated after very small iron oxide particle and ferucarbotran exposure. In neuron–glia cocultures, SPIOs rather stimulated the outgrowth of neuronal processes in a concentration- and particle-dependent manner. We conclude that the infuence of SPIOs on brain cells not only depends on the particle type but also on the physiological system they are applied to. © 2015, Neubert et al.


Hildebrandt G.,Clinic for Neurosurgery | Surbeck W.,Clinic for Neurosurgery | Stienen M.N.,Clinic for Neurosurgery
Acta Neurochirurgica | Year: 2012

Background: Emil Theodor Kocher (1841-1917) was elected as head of the university clinic for surgery in Berne, Switzerland at the age of 31 years. During the 45 years of his professorship he became one of the outstanding surgeons of Europe by using surgical techniques based predominately on physiological and biological ideas. The aim of this article was to highlight his neurosurgical achievements published in the German language. Methods: The illustrations of Kocher's works in the field of neurosurgery are exclusively based on his publications and works published by his co-workers. Results: Kocher received the Nobel Prize in Physiology or Medicine in 1909 because he devoted himself to intense research and development in the pathophysiology and surgical treatment of diseases of the thyroid gland. His particular neurosurgical interests were in cerebral and spinal trauma, operative treatment of epilepsy and the pathophysiology of elevated intracranial pressure. Conclusion: Studies of Kocher's contributions, published exclusively in the German language, lead to the conclusion that Kocher must be designated as the first Swiss neurosurgeon. © 2012 Springer-Verlag.


Ottenhausen M.,Clinic for Neurosurgery | Meier U.,Clinic for Neurosurgery | Tittel A.,Institute for Radiology | Lemcke J.,Clinic for Neurosurgery
Journal of Neurological Surgery, Part A: Central European Neurosurgery | Year: 2013

Background and Importance Even though dilated Virchow-Robin spaces (VRS) are a very rare entity, they can compel the clinician to start immediate intervention in the case of acute onset of symptoms. To allow a well-balanced management decision, we compiled a summary of all cases published in the literature and discuss the different methods and indications for neurosurgical intervention in relation to dilated VRS. Clinical Presentation We report a case of a 43-year-old female patient who came to admission after syncope with a history of unspecific neck pain, fatigue, diplopia, and dizziness. Dilated VRS type III causing a noncommunicating hydrocephalus were found to be responsible. Although the patient was initially awake, within 72 hours after admission, a deterioration of consciousness and repeated vomiting were observed. The patient underwent an urgent endoscopic third ventriculostomy (ETV) and was discharged in a good condition. Conclusion To the best of our knowledge, the case presented here is the first case of acute decompensation of a noncommunicating hydrocephalus caused by dilated VRS. Neurosurgical intervention is required in cases of noncommunicating hydrocephalus caused by giant tumefactive VRS. The treatment options are mono- or biventricular shunt surgery or ETV. Because ETV provides the possibility of cyst fenestration and membrane sampling, it appears to be the most advantageous treatment option. © 2013 Georg Thieme Verlag KG Stuttgart New York.


Surbeck W.,Clinic for Neurosurgery | Stienen M.N.,Clinic for Neurosurgery | Hildebrandt G.,Clinic for Neurosurgery
Epilepsia | Year: 2012

Emil Theodor Kocher (1841-1917) was a pioneering and versatile Swiss surgeon who played a decisive role in the surgical evolution on the threshold to the 20th century. Apart from conducting intense research and fostering the development of the surgical treatment of thyroid gland diseases (honored with a Nobel Prize in 1909), he remained a generalist and was active in orthopedic, genitourinary, and neurologic surgery. Even today, many surgical techniques and instruments are still named after him, thus providing evidence of his great impact. His neurosurgical ambitions included, in particular, cerebral and spinal trauma, the pathophysiology of elevated intracranial pressure, as well as etiological considerations and the operative treatment of epilepsy. This article aims to shed light on Kocher's work on epilepsy, published exclusively in German, and illustrates the development of his idea on valve surgery for recurrent general convulsions. © 2012 International League Against Epilepsy.


Kaminski M.,Charité - Medical University of Berlin | Bechmann I.,University of Leipzig | Pohland M.,Charité - Medical University of Berlin | Kiwit J.,Clinic for Neurosurgery | And 2 more authors.
Journal of Leukocyte Biology | Year: 2012

The lack of classical lymph vessels within brain tissue complicates immune surveillance of the CNS, and therefore, cellular emigration out of the CNS parenchyma requires alternate pathways. Whereas invasion of blood-derived mononuclear cells and their transformation into ramified, microglia-like cells in areas of ax-onal degeneration across an intact BBB have been demonstrated, it still remained unclear whether these cells reside permanently, undergo apoptosis, or leave the brain to present antigen in lymphoid organs. With the use of ECL of mice and injection of GFP-expressing monocytes, we followed the appearance of injected cells in spleen and LNs and the migratory pathways in whole-head histological sections. Monocytes migrated from the lesion site to deep CLNs, peaking in number at Day 7, but they were virtually absent in spleen and in superficial CLNs and inguinal LNs until Day 21 after lesion/injection. In whole-head sections, GFP monocytes were found attached to the olfactory nerves and located within the nasal mucosa at 48 hpi. Thus, mono-cytes are capable of migrating from lesioned brain areas to deep CLNs and use the cribriform plate as an exit route. © Society for Leukocyte Biology.


Konnopka A.,University of Hamburg | Heinrich S.,University of Hamburg | Zieger M.,University of Leipzig | Luppa M.,University of Leipzig | And 5 more authors.
Spine Journal | Year: 2011

Background context: Back pain presents a significant cause of health care costs and lost productivity. In most cases, conservative treatment will be sufficient, but in the most severe cases, disc surgery is indicated. Purpose: To analyze the effect of psychiatric comorbidity on health care costs and lost productivity in patients with back pain undergoing disc surgery. Study design: A cross-sectional study design was used. Patient sample: A sample of 305 disc surgery patients (lumbar, 239; cervical, 66). Outcome measures: Patients were interviewed using the German version of the Composite International Diagnostic Interview to assess psychiatric comorbidity and a questionnaire to assess resource utilization and lost productivity for a 3-month period prior disc surgery. Health care resources were monetarily valued by unit costs, whereas productivity was valuated by labor costs. Methods: Cost differences between patients with and without psychiatric comorbidity were analyzed using bootstrap regression techniques. Results: Back pain was associated with mean 3-month direct health care costs ranging from €5,534 (lumbar disc herniation without psychiatric comorbidity) to €8,507 (cervical disc herniation with psychiatric comorbidity), of which between 51% and 79% were caused by disc surgery. Mean indirect costs ranged from €7,589 to €8,492. Psychiatric comorbidity was significantly associated with increased direct costs in lumbar disc herniation (€7,042 vs. €5,534). Regression analysis showed increments of €851 (p=.043) in direct costs and €1,636 (p=.058) in total costs for psychiatric comorbidity, which predominantly resulted from nonpsychiatric health care utilization. Conclusions: Severe back pain is associated with high direct and indirect costs, which are influenced by the presence of psychiatric comorbidity. We found a lack of treatment for psychiatric comorbidity indicated by low mental health care utilization in affected individuals. More attention should be given to psychiatric comorbidity in the treatment of patients undergoing disc surgery. Clinicians should be aware of the high prevalence rates of psychiatric comorbidity in this patient group. They should consider the assessment of psychiatric distress and support of mental health professionals if applicable. © 2011 Elsevier Inc. All rights reserved.


PubMed | Clinic for Neurosurgery and Charité - Medical University of Berlin
Type: | Journal: International journal of nanomedicine | Year: 2015

The physicochemical properties of superparamagnetic iron oxide nanoparticles (SPIOs) enable their application in the diagnostics and therapy of central nervous system diseases. However, since crucial information regarding side effects of particle-cell interactions within the central nervous system is still lacking, we investigated the influence of novel very small iron oxide particles or the clinically approved ferucarbotran or ferumoxytol on the vitality and morphology of brain cells. We exposed primary cell cultures of microglia and hippocampal neurons, as well as neuron-glia cocultures to varying concentrations of SPIOs for 6 and/or 24 hours, respectively. Here, we show that SPIO accumulation by microglia and subsequent morphological alterations strongly depend on the respective nanoparticle type. Microglial viability was severely compromised by high SPIO concentrations, except in the case of ferumoxytol. While ferumoxytol did not cause immediate microglial death, it induced severe morphological alterations and increased degeneration of primary neurons. Additionally, primary neurons clearly degenerated after very small iron oxide particle and ferucarbotran exposure. In neuron-glia cocultures, SPIOs rather stimulated the outgrowth of neuronal processes in a concentration- and particle-dependent manner. We conclude that the influence of SPIOs on brain cells not only depends on the particle type but also on the physiological system they are applied to.

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