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Research Focus: Vascular/ Neurotrauma / Intensive Care

In addition to continual prospective analysis of treatment results of vascular pathologies (e.g., aneurysms, arteriovenous malformations, arteriovenous fistulas, intracerebral hematomas and strokes, etc.) and the constant improvements in technical standards, adjuncts and operative techniques, the use of advanced imaging along with various CFS / serum biomarkers are being investigated throughout all illness stages to beneficially influence patient treatment and final neurological outcome.

Our Department of Neurosurgery has been participating in several international registries and trials, and is in close collaboration with the Department of Neurology and Neuroradiology of Medical University Innsbruck.

Invasive multimodal neuromonitoring of brain oxygenation, metabolism, blood flow, and intracranial pressure alongside with advanced imaging and targeted metabolomics profiling of CSF and serum is being performed, continuously evaluating the use of these techniques on treatment optimization and patient outcome after subarachnoid hemorrhage and severe / moderate head trauma.

Researchers from the Department work in close collaboration with the Mayo Clinic in Rochester, Minnesota, the Washington University School of Medicine, St. Louis, the Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, the Weill Cornell Medicine in New York, the Zhang Research Lab in Loma Linda, California, the Charité in Berlin, the Charles University in Prague, and the Muhimbili Complex in Dar es Salaam.

Severe head injury, aneurysmal SAH as well as hemorrhagic strokes are common medical conditions at our Department. In addition to multimodal monitoring and numerous pathophysiological investigations, several mono-centric studies are being regularly commenced in close collaboration with the aforementioned Departments of Neuroradiology and Neurology of Medical University Innsbruck, ceaselessly pursuing the assessment of advanced MRI data and their correlation to various CFS-/serum biomarkers of primary and secondary brain injury.

Selected trials:

  • NICAPLANT: Phase IIb trial of Nicardipine prolonged release pellets in aneurysmatic subarachnoid hemorrhage.
  • TIBI I/II: multimodal invasive neuromonitoring in patients with severe and moderate head trauma in combination with early MRI and targeted metabolomics identifying CFS and serum biomarkers of neuronal injury.
  • MISA: prospective cohort trial of 31P-MR-spectroscopy and targeted metabolomics in patients undergoing treatment for incidental and ruptured aneurysms. It includes a thorough plasma and CSF analysis of various biomarkers to determine pertinent factors associated with delayed cerebral ischemia and neurological outcome.
  • Dual ICP: simultaneous application of multimodal invasive neuromonitoring in both intracranial supra-/ infratentorial  compartments in patients with posterior fossa lesions, obtaining additional comprehensive data from the entire brain.
  • Cerebral vasospasm and delayed cerebral ischemia after aneurysmal SAH: European / North American surveys and transnational cohort studies.
  • German Cranioplasty Register: active participation in this bilateral register for patients undergoing cranioplasty after decompressive surgery.
  • Cerebellar hematomas: several surveys and prospective multinational cohort studies.

Selected recent publications:

  • Time Course of Metabolomic Alterations in Cerebrospinal Fluid After Aneurysmal Subarachnoid Hemorrhage. Wing Mann Ho, Alice S. Görke, Bernhard Glodny, Herbert Oberacher, Raimund Helbok, Claudius Thomé and Ondra Petr. Front Neurol. 2020 Jun 23. https://doi.org/10.3389/fneur.2020.00589
  • Cerebral energy status and altered metabolism in early severe TBI: First results of a prospective 31P-MRS feasibility study. D. Pinggera, R. Steiger, M. Bauer, J. Kerschbaumer, M. Luger, R. Beer, A. Rietzler, AE. Grams, C. Thomé, O. Petr.Neurocritical Care. 2020 Jun 21.
  • Safety of Early MRI Examinations in Severe TBI: A Test Battery for Proper Patient Selection.. Pinggera D, Luger M, Bürgler I, Bauer M, Thomé C, Petr O.. Front Neurol. 2020 Apr 7;11:219. doi: 10.3389/fneur.2020.00219. eCollection 2020.
  • Transcallosal, transchoroidal clipping of a hypothalamic collateral vessel aneurysm in Moyamoya disease. Ho WM, Görke AS, Dazinger F, Pfausler B, Gizewski ER, Petr O, Thomé C. Acta Neurochir (Wien). 2020 Apr 19. doi: 10.1007/s00701-020-04335-4. [Epub ahead of print]
  • Treatment strategies of spinal arteriovenous fistulas and malformations: timing matters. Ho WM, Görke A, Petr O, Thomé C. J Neurosurg Sci. 2018 Apr;62(2):178-186. doi: 10.23736/S0390-5616.17.04260-6. Epub 2017 Nov 10. Review.
  • T2-Weighted-Fluid-Attenuated Inversion Recovery Hyperintensity on Magnetic Resonance Imaging Is Associated With Aggressive Symptoms in Patients With Dural Arteriovenous Fistulas.Patel B, Chatterjee A, Petr O, Collins H, Lanzino G, Derdeyn CP, Zipfel GJ. Stroke. 2019 Sep;50(9):2565-2567. doi: 10.1161/STROKEAHA.118.024285. Epub 2019 Aug 14.
  • Neck Remnants and the Risk of Aneurysm Rupture After Endovascular Treatment With Coiling or Stent-Assisted Coiling: Much Ado About Nothing? Munich SA, Cress MC, Rangel-Castilla L, Sonig A, Ogilvy CS, Lanzino G, Petr O, Mocco J, Morone PJ, Snyder KV, Hopkins LN, Siddiqui AH, Levy EI. Neurosurgery. 2019 Feb 1;84(2):421-427. doi: 10.1093/neuros/nyy056.
  • Management of patients with an unruptured intracranial aneurysm and a history of malignancy. Petr O, Burrows AM, Brinjikji W, Brown RD, Lanzino G. J Neurosurg Sci. 2017 May 31. doi: 10.23736/S0390-5616.17.04080-2. [Epub ahead of print]