C Brockmann

Heidelberg University, Heidelburg, Baden-Württemberg, Germany

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Publications (17)20.8 Total impact

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    ABSTRACT: Purpose: Intra-arterial (IA) administration of nimodipine has been shown to be an effective treatment for subarachnoid hemorrhage-related cerebral vasospasm. The concentrations achieved in cerebral arteries during this procedure, though, are unknown. Therefore, there are no clinical studies investigating dose-dependent effects of nimodipine. We aimed at providing a pharmacokinetic model for IA nimodipine therapy for this purpose. Methods: A two-compartment pharmacokinetic model for intravenous nimodipine therapy was modified and used to assess cerebral arterial nimodipine concentration during IA nimodipine infusion into the internal carotid artery (ICA). Results: According to our simulations, continuous IA nimodipine infusion at 2 mg/h and 1 mg/h resulted in steady-state cerebral arterial concentrations of about 200 ng/ml and 100 ng/ml assuming an ICA blood flow of 200 ml/min and a clearance of 70 l/h. About 85 % of the maximal concentration is achieved within the first minute of IA infusion independent on the infusion dose. Within the range of physiological and pharmacokinetic data available in the literature, ICA blood flow has more impact on cerebral arterial concentration than nimodipine clearance. Conclusion: The presented pharmacokinetic model is suitable for estimations of cerebral arterial nimodipine concentration during IA infusion. It may, for instance, assist in dose-dependent analyses of angiographic results.
    09/2015; DOI:10.1007/s00062-015-0464-1
  • C Brockmann · T Sommer · R Pirzer · H U Kerl · I S Nolte · A Förster · M A Brockmann ·

    10/2012; 23(3). DOI:10.1007/s00062-012-0176-8
  • A Förster · I Nölte · H Wenz · M Al-Zghloul · H U Kerl · C Brockmann · M A Brockmann · C Groden ·
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    ABSTRACT: Introduction: Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are rare neurological disorders characterized by demyelination in and/or outside the pons. Whether diffusion-weighted imaging (DWI) might facilitate an earlier diagnosis has not yet been studied systematically. Methods: We describe demographics, clinical presentation, and early magnetic resonance imaging (MRI) findings with special emphasis on the relevance for diagnosis of CPM and/or EPM in eight patients. Results: Of the analysed eight patients (aged 37-70 years; two men, six women), CPM was diagnosed in three, EPM in one, and a combination of CPM and EPM in four patients. Aetiology was rapid correction of sodium in two patients; a combination of hyponatremia, alcoholism and alcohol withdrawal in five patients and unclear in one patient. Seven patients suffered from chronic alcoholism and four from malnutrition. Demyelinating lesions were found in the pons, thalamus, caudate nucleus, putamen and midbrain. While the lesions could be clearly delineated on T2- and T1-weighted images, DWI demonstrated a strong signal in only six patients. Furthermore, DWI demonstrated lesions only to some extent in two patients and was completely negative in two patients on initial MRI. In none of the patients did the demonstration of hyperintense lesions on DWI precede detection on conventional MRI sequences. Apparent diffusion coefficient (ADC) values were heterogenous with a decrease in two cases and an increase in the remainder. Conclusions: We conclude that early DWI changes are a common finding in CPM/EPM but do not regularly precede tissue changes detectable on conventional MRI sequences. Heterogenous ADC values possibly represent different stages of disease.
    Neuroradiology 08/2012; 55(1). DOI:10.1007/s00234-012-1083-z · 2.49 Impact Factor
  • C Brockmann · L Gerigk · P Vajkoczy · C Groden · E Neumaier-Probst ·
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    ABSTRACT: The patency of a bypass plays an important role in the postoperative recovery of patients especially when dealing with complicated intracranial aneurysms. In this study two-dimensional phase contrast magnetic resonance angiography (PC-MRA) was used to measure cerebral blood flow in 23 patients before extracranial-intracranial high-flow bypass surgery using the excimer laser-assisted non-occlusive anastomosis (ELANA) technique and in 15 patients following surgery. The results showed that PC-MRA is a suitable technique for assessing bypass patency and that with the ELANA technique the bypass has the capability of compensating the blood flow of an occluded internal carotid artery (ACI) in cases of complex aneurysms.
    12/2011; 22(1):39-45. DOI:10.1007/s00062-011-0116-z
  • C Brockmann · F Seker · C Weiss · C Groden · J Scharf ·
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    ABSTRACT: Assuming thromboembolic events to be the origin of silent strokes during cerebral digital subtraction angiography (DSA), antiplatelet therapy with acetylsalicylic acid (ASA) should significantly reduce the risk for DSA-related silent stroke. The aim of this retrospective analysis was to assess whether ASA does prevent DSA-related silent stroke in terms of high signal intensity lesions in diffusion-weighted magnetic resonance imaging (DW-MRI). All patients underwent a baseline DW-MRI 24 h before DSA and a follow-up DW-MRI 3-24 h after DSA. Patients were considered to have an acute (silent) infarction caused by DSA if there was at least one hyperintense lesion of at least 1 mm in diameter and no neurological deficits. Out of 52 patients in the ASA group 11 (21.2%) had high signal lesions on DW-MRI and 20 out of 123 (16.3%) in the non-ASA group. No significant relationship between the ASA and non-ASA group and the post-angiographic appearance of high signal intensity lesions in DW-MRI could be found (Wilcoxon 2-sample test: p-value 0.9). The use of oral antiplatelet therapy by ASA (100 mg/day) in cerebrovascular patients did not prevent DSA-related high signal intensity lesions in DW-MRI in this study. Despite a potential bias of this retrospective analysis the findings challenge the current theory of thromboembolisms being the predominant origin of silent stroke. The findings therefore support alternative hypotheseses of the etiology of silent strokes, such as air embolism and mobilized embolic material by the catheter at the vessel wall.
    05/2011; 22(1):15-20. DOI:10.1007/s00062-011-0076-3
  • T J Schulze · C Weiss · J Luhm · C Brockmann · S Görg · H Hennig ·
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    ABSTRACT: The aim of this study was to evaluate the optimal preanalytical conditions prior to nucleic acid amplification technology (NAT) for human immunodeficiency virus-1 (HIV-1) or Hepatitis C virus (HCV) RNA in pools of 96 plasma specimens with regard to storage temperature, time and plasma separation in a blood donation environment. Changes in viral nucleic acid concentration of HIV-1 and HCV were observed for 5 days according to the Paul-Ehrlich-Institute's (PEI) guidelines that demand 95%-detection limit of at least 10 000 IU mL(-1) for HIV-1 RNA and 5000 IU mL(-1) for HCV RNA within a single donor blood specimen. Ninety-five per cent detection limits of HIV-1 RNA over 3 days after storage at either 5 or 21 °C were evaluated by using standardised HIV-1 RNA-positive plasma. HCV RNA in whole blood samples proved to be more stable than HIV-1 RNA. Whole blood storage at 21 °C was shown to decrease the detectability of HIV-1 RNA even after only 18 h. Plasma samples once used for NAT at time 18 h did not alter viral stability up to 48 h after donation. Ninety-five per cent detection limits of HIV-1 RNA were securely below 10 000 IU mL(-1) for 24 h after whole blood storage at 5 °C. These results may lead to a discussion around the most suitable preanalytical conditions in blood donation environments. Contrary to the current PEI guidelines that allow storage of whole blood specimens up to 18 h at 21 °C, these results suggest that immediate storage in a 5 °C container after blood donation is more suitable and would permit storage of whole blood up to 24 h prior to the separation of plasma from cells.
    Transfusion Medicine 04/2011; 21(2):99-106. DOI:10.1111/j.1365-3148.2010.01051.x · 1.65 Impact Factor
  • S Jochum · C Brockmann · K Lederle · SO Schönberg · SJ Diehl · J Scharf ·

    RöFo - Fortschritte auf dem Gebiet der R 04/2011; 183(S 01). DOI:10.1055/s-0031-1279477 · 1.40 Impact Factor
  • C Brockmann · J Scharf · I S Nölte · M Seiz · C Groden · M A Brockmann ·
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    ABSTRACT: The aim was to assess the feasibility of dual-energy computed tomography (DE-CT) for detection of peri-interventional re-bleeding in patients with aneurysmal subarachnoid hemorrhage (re-SAH). For in vitro-analyses DE-CT of partially clotted blood intermixed with fresh blood containing contrast agent was performed. In a clinical setting, 4 patients routinely underwent DE-CT after suspected peri-interventional re-SAH. DE-CT source data images, iodine maps and virtual non-contrast images (VNC) were analyzed and regions-of-interest (ROI) measurements of density values were performed. In vitro experiments demonstrated the feasibility of DE-CT to discriminate between blood with and without contrast agent. In all patients peri-interventional re-SAH was confirmed by detection of extravasated iodine within the subarachnoid spaces in post-interventional DE-CT. Dual-energy CT allowed the discrimination of old blood clots of the initial SAH and blood originating from peri-interventional re-SAH. After subtraction of the iodine-related high density signal, VNC images optimized the estimation of the true amount of subarachnoid blood. Dual-energy CT allows the discrimination and subtraction of blood and iodine mixed within the subarachnoid spaces in patients with peri-interventional re-SAH. It helps to avoid overestimation of SAH after peri-interventional re-bleeding and therefore is a potentially valuable tool in the assessment of peri-interventional re-SAH.
    11/2010; 20(4):231-5. DOI:10.1007/s00062-010-0036-3
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    ABSTRACT: PURPOSE: Injuries of the craniocervical vessels in multi-traumatized patients are rare but devastating and can lead to stroke and death; nevertheless the diagnostic assessment of these injuries is often not part of the CT trauma examination protocol. MATERIALS AND METHODS: A total of 44 out of 315 multi-traumatized patients were defined to be at high risk for vessel injuries. Two readers analyzed the CT angiography (CTA) with respect to 1.) type and extent of fractures and 2.) trauma-associated pathologies of the vessels from the aortic arch to the cerebrum. The CTs were presented as original scans with the possibility to view the multiplanar reconstructions. RESULTS: The two readers could detect 12 out of 14 and 14 out of 14 cervical fractures, respectively. Both readers could demonstrate 28 out of 28 fractures of the skull, skull base and extended facial fractures. The diagnostic evaluation of vessel diseases showed correct classification of the type of pathology in 8 out of 12 and 7 out of 12 cases for the two readers, respectively. CONCLUSIONS: CTA of the craniocervical vessels is an important tool for rapid detection of vessel injuries and diseases in trauma patients. Different types of fractures may indicate the need for focused attention to vessel injuries, but even if there are no fractures present dissection of internal carotid and vertebral arteries can occur.
    Der Unfallchirurg 04/2010; 114(6). DOI:10.1007/s00113-010-1780-1 · 0.65 Impact Factor
  • S Jochum · C Brockmann · KW Neff · AK Kilian · SO Schoenberg · S Diehl ·

    RöFo - Fortschritte auf dem Gebiet der R 04/2009; 181. DOI:10.1055/s-0029-1221386 · 1.40 Impact Factor
  • C Brockmann · S Jochum · K Huck · P Ziegler · M Sadick · C Fink · SO Schoenberg · S Diehl ·

    RöFo - Fortschritte auf dem Gebiet der R 04/2009; 181(S 01). DOI:10.1055/s-0029-1221442 · 1.40 Impact Factor
  • C. Brockmann · T. Wilhelm · C. Barth · K. Hörmann · S.O. Schoenberg · C. Fink ·
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    ABSTRACT: Eine schmerzlose Parotisschwellung mit unspezifischen Symptomen und uncharakteristischem Blutbild rührt nicht unbedingt von einer Mumpserkrankung her. Vielmehr sollte mittels gezielter Bildgebung, konventioneller Thoraxröntgenaufnahme in 2 Ebenen und – zur weiteren differenzialdiagnostischen Abklärung – CT des Thorax, nach weiteren Ursachen gefahndet werden. A painless swelling of the parotid gland with non-specific symptoms and uncharacteristic blood values is not necessarily caused by mumps. On the contrary, this should be examined with targeted imaging, conventional X-rays of the thorax on two levels and for further differential diagnostic clarification, computed tomography of the thorax in order to search for further causes.
    Der Radiologe 01/2009; 49(4):340-343. DOI:10.1007/s00117-008-1746-2 · 0.43 Impact Factor
  • C Brockmann · T Wilhelm · C Barth · K Hörmann · S O Schoenberg · C Fink ·
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    ABSTRACT: A painless swelling of the parotid gland with non-specific symptoms and uncharacteristic blood values is not necessarily caused by mumps. On the contrary, this should be examined with targeted imaging, conventional X-rays of the thorax on two levels and for further differential diagnostic clarification, computed tomography of the thorax in order to search for further causes.
    Der Radiologe 10/2008; 49(4):340-3. · 0.43 Impact Factor
  • Source
    D. Finke · R. Hoerster · C. Brockmann · K. Kropf · H. Hennig · R. Zawatzky · S. Goerg ·
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    ABSTRACT: The absence of early complement components (C1, C4 and C2 but not C3) is a predisposing factor for systemic lupus erythematosus (SLE). Recently, we demonstrated that, in C4-deficient (C4 def.) mice, IgM-containing immune complexes (IgM-IC) are filtered by the splenic barrier of marginal zone macrophages (MZM), resulting in an increased immune response against antigens within these IgM-IC, but this could not be observed in wildtype or C3 def. mice. We hypothesized that splenic CD11b+ MZM play an important role in the induction of autoimmunity, and we therefore analysed their cytokine profile after isolation with the help of magnetic antibody cell sorting. mRNA was isolated, and real-time PCR was performed with specific primers for murine IFN-γ (IFN-γ), interleukin-12 (IL-12) and IFN-α (IFN-α). We observe a moderate increase of IL-12 and IFN-γ mRNA in CD11b+ cells of C4 def. mice compared to wildtype cells. Surprisingly, the concentration of IFN-α mRNA is six times higher in C4 def. mice. Preliminary results suggest that mRNA in CD11b+ cells of C3 def. mice is even lower than that in wt. Six hours following i.v. application of 20 µg of a murine monoclonal IgM anti-dsDNA antibody, production of IL-12, IFN-γ and IFN-α mRNA is increased in CD11b+ cells of both C4 def. and wt mice. Several references described increased levels of INF-α in patients with SLE. Dendritic cells are discussed as a major source of IFN-α. Our observation that C4-deficient, SLE-susceptible mice demonstrate an increased spontaneous IFN-α production by splenic CD11b+ marginal zone macrophages could be an early sign and a trigger for the development of SLE. This is supported by the fact that the absence of C3 is not a predisposing factor for SLE and our observation that C3 def. animals display low levels of IFN-α mRNA.
    Scandinavian Journal of Immunology 04/2008; 59(6):625-626. DOI:10.1111/j.0300-9475.2004.01423am.x · 1.74 Impact Factor
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    ABSTRACT: Systemic lupus erythematosus (SLE), an autoimmune disease characterized by chronic nephritis, arthritis and dermatitis, and the presence of antinuclear autoantibodies, is associated with complement factor deficiencies in the classical activation pathway. In addition, IFN-alpha seems to be a key cytokine in SLE as an activated IFN-alpha system is regularly observed in patients with SLE. Here, we demonstrate that in lupus-susceptible, complement C4-deficient mice the lack of complement results in elevated intravascular levels of apoptotic DNA. The apoptotic DNA is targeted to the splenic marginal zone where it accumulates and induces IFN-alpha. As such, we present here a unifying hypothesis for the induction of SLE that incorporates the role of complement deficiency and elevated levels of IFN-alpha.
    European Journal of Immunology 06/2007; 37(6):1702-9. DOI:10.1002/eji.200636719 · 4.03 Impact Factor
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    ABSTRACT: Usually, a predonation hemoglobin (Hb) measurement must precede blood donation. Hb values of a donor's previous donation might be used for selecting a subgroup in which predonation Hb measurements are unnecessary. Only donors with historical Hb values below 129 or 139 g per L for female and male donors, respectively, underwent venous Hb measurement before phlebotomy with an automated hematology analyzer. All other donor phlebotomies were collected without initial Hb testing. Hb values from diversion samples from 81,913 consecutive donors between May 2003 and November 2005 were subsequently analyzed as representing their present values. Donors were grouped according to interdonation intervals of less than 6, 6 to 11, 12 to 23, and 24 months or more. The arithmetic mean deviation between historical and present Hb values was between -0.3 and +1.8 g per L for each group (mean deviation, 5.2-6.7 g/L). Not testing selected donors spared 77.7 percent from a prephlebotomy Hb measurement and showed a specificity of 29 percent. Sensitivities for detection of donors below Hb limits (between 56% and 67% for the different subgroups) and donors with Hb values below 110 g per L (82%-88%) were at least comparable to capillary Hb screening. A total of 4.8 percent of donors were phlebotomized with values below 125 and 135 g per L, whereas only 0.016 percent of donors were bled despite Hb levels below 110 g per L. Selecting donors for a current Hb measurement based upon their last whole-blood predonation Hb value is a useful method, even after prolonged interdonation intervals.
    Transfusion 01/2007; 46(12):2176-83. DOI:10.1111/j.1537-2995.2006.01049.x · 3.23 Impact Factor
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    ABSTRACT: The peptide hormone prolactin (PRL) is produced by specialized cells in the anterior pituitary gland and in a number of sites outside the pituitary. Its biological actions consist of various roles in reproduction, lactation, and of a number of homeostatic biological activities that also include immune functions. Elevated serum PRL concentrations often correlate with abnormalities in immune responses. To determine the influence of PRL on human immune cells, human whole blood cultures were stimulated with lipopolysaccharide (LPS), supplemented with various concentrations of human recombinant PRL. We found that PRL, at concentrations achievable during pregnancy, anesthesia and medication, significantly amplified interleukin (IL)-12 and tumor necrosis factor-alpha (TNF-alpha) synthesis in LPS-stimulated cultures, in a dose-dependent manner. Conversely, synthesis of the anti-inflammatory cytokine IL-10 only increased significantly at very high concentrations of supplemented PRL. PRL alone was not able to induce any measurable secretion of TNF-alpha, IL-10, or IL-12 in non-stimulated, whole blood cultures. However, we demonstrated that PRL, by itself or in combination with LPS, causes an increase in the binding activity of the transcription factors nuclear factor-kappaB (NFkappaB) and interferon regulatory factor-1 (IRF-1), which are known to promote TNF-alpha and IL-12 secretion. These data suggest that PRL promotes pro-inflammatory immune responses via NFkappaB and IRF-1, which may affect pathophysiological processes in physiological hyperprolactinemic states.
    European cytokine network 04/2004; 15(2):99-104. · 1.96 Impact Factor

Publication Stats

88 Citations
20.80 Total Impact Points


  • 2008-2012
    • Heidelberg University
      • • Neuroradiology
      • • Institute of Clinical Radiology
      Heidelburg, Baden-Württemberg, Germany
  • 2007-2011
    • University Medical Center Schleswig-Holstein
      Kiel, Schleswig-Holstein, Germany
  • 2007-2008
    • Universität zu Lübeck
      Lübeck Hansestadt, Schleswig-Holstein, Germany

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