Julian Cahill

Julian Cahill

MD FRCS

About

35
Publications
6,998
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1,834
Citations
Additional affiliations
August 2013 - present
Birmingham Children's Hospital NHS Foundation Trust
Position
  • SPR
January 2011 - present
Birmingham Childrens Hospital
January 2006 - December 2009
Loma Linda University

Publications

Publications (35)
Article
Full-text available
Introduction Primary chordomas and chondrosarcomas of the skull base are difficult tumours to treat successfully. Despite advances in surgical techniques, a gross total resection is often impossible to achieve. In addition, some patients may be deemed unsuitable or not wish to undergo extensive surgery for these conditions. This study examines the...
Article
Full-text available
Objective: To evaluate the role of single-session Gamma Knife stereotactic radiosurgery (GK-SRS) in the treatment of vestibular schwannomas (VSs) with volumes of greater 10 cm3. Methods: A retrospective analysis was performed of 103 patients treated with single-session GK-SRS between 1993 and 2011 with a mean follow-up of 6.2 years ± 4.4 SD. Tre...
Article
Spontaneous pneumocephalus is exceptionally rare, with few published cases in the literature. We describe a patient presenting with dysphasia, right facial weakness, headache and confusion who was subsequently found to have pneumocephalus due to an encephalocoele herniating into a tegmen tympani defect.
Chapter
Full-text available
Since subarachnoid hemorrhage is a devastating condition with high mortality and poor outcome, an appropriate animal model for research is needed. Although the monofilament perforation model in rats is a challenging procedure to learn, the induction of subarachnoid hemorrhage in this way is by far the most suited model for investigating the pathoph...
Article
Full-text available
INTRODUCTION Shared Decision Making (SDM) has been shown to be an effective tool in allowing patients to determine the treatment options best suited to their individual needs and is becoming the new standard of care in modern healthcare. It is invaluable in situations where reasonable options exist for a patient’s management, such as Neuro-Oncology...
Article
INTRODUCTION Maximal safe resection of high-grade glioma is the recommended standard of care and the outcomes following surgery and chemoradiotherapy are well described in the current era. However, for some patients only a biopsy is feasible or is their preference. It is essential to understand the outcomes in this cohort in order to support shared...
Article
Full-text available
Subarachnoid hemorrhage (SAH) due to intracranial aneurysm rupture is a complex clinical disease with high mortality and morbidity. Recent studies suggest that early brain injury (EBI) rather than vasospasm might be responsible for morbidity and mortality within 24-72 hours after SAH. The rise in intracranial pressure following SAH causes a signifi...
Article
Full-text available
A lumbar disc prolapse is commonly seen in the adult population and as a result, the signs and symptoms are well recognised and easily treated. A disc prolapse, in the adolescent and particularly the paediatric age group, is very rare indeed. The signs and symptoms are atypical in this age group, and there is often difficulty in recognising the pat...
Article
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Oculomotor nerve palsy due to a venous varix arising from flow anomalies caused by a dural arteriovenous fistula (AVF) is a rare phenomenon. We report a case of surgical third nerve palsy with a rare underlying AVF as the cause and discuss in detail the patho-anatomy and its significance. A tentorial dural AVF mimicking the arterial circle was foun...
Article
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Background ̶Subarachnoid hemorrhage (SAH) remains a disease without any definitive treatment options. Research, to date, has concentrated on the pathophysiology of vasospasm. Recent evidence supports the concept of Early Brain Injury (EBI), a phenomena which may help to explain the complex pathophysiology seen in patients after a SAH. Summary ̶EBI...
Article
Neurosurgical registrars are frequently called upon by A&E staff and physicians to interpret emergency head CT (computed tomography) scans out of hours. This appears to reflect the reduced threshold for scanning patients and the nonavailability of a radiologist to report these scans. This study was undertaken to assess the safety of such practices....
Article
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The molecular mechanisms of the anti-apoptotic and anti-inflammatory properties of granulocyte-colony stimulating factor (G-CSF) following focal cerebral ischemia in rats were examined in this study. Sprague-Dawley rats were randomly divided into three groups: sham, middle cerebral artery occlusion (MCAO) non-treatment and MCAO with G-CSF treatment...
Article
Full-text available
Lumboperitoneal shunting is the standard treatment for pseudotumour cerebri or idiopathic intracranial hypertension. Complications are common, particularly the problem of overdrainage leading to low pressure symptoms. The authors designed a simple experiment using catheters of different lengths that drained at different pressure heads and with diff...
Article
Background and purpose: Despite recent advances in the treatment of patients after subarachnoid hemorrhage, morbidity and mortality rates have failed to improve significantly. Although this was often blamed on vasospasm, is it time to consider alternative etiologies? Summary of Review- Early brain injury (EBI) is a recently described term that des...
Chapter
The monofilament puncture model for the induction of a subarach-noid hemorrhage in the rat is a difficult procedure to master. It is, however, important to do so, not only for subarachnoid hemorrhage research but also for stroke models, as the procedure is very similar. The monofilament model is by far the best model for investigating subarachnoid...
Chapter
Invasive measurement of cerebral blood flow (CBF) and blood pressure (BP) are important adjuncts to many different types of animal surgery. CBF can be measured by a number of different methods, including invasive methods such as placing probes into the subarachnoid space (Am. J. Physiol. Heart Circ. Physiol. 281:H308–H315, 2001), which can lead to...
Article
The use of animal models for neurological investigation often requires a specific skill set that allows the investigator to adequately prepare the animal for experimental surgery, correctly collect their brain samples from the specimen, and prepare them for subsequent analysis. This chapter will provide detailed explanations for methods of rodent i...
Article
Recent studies have demonstrated that apoptosis in cerebral arteries could play an essential role in cerebral vasospasm after subarachnoid hemorrhage (SAH) and that SP600125, an inhibitor of c-Jun N-terminal kinase (JNK) could suppress apoptosis. The present study examined whether SP600125 could reduce cerebral vasospasm through the suppression of...
Chapter
Despite modern advances in surgery, subarachnoid haemorrhage (SAH) continues to carry high morbidity and mortality rates. The reasons for this are currently unclear. It is certain however that vasospasm is not the only modality responsible for this. As a result the concept of Early Brain Injury (EBI) has been introduced in an effort to focus attent...
Chapter
Vasospasm remains a leading cause of morbidity and mortality in relation to subarachnoid haemorrhage (SAH). This study examined the role of apoptosis in vasospasm at 24 and 72 h. The main proteins of the caspase dependent, independent and mitochondrial pathways were examined in this study. Adult rats were divided into three groups: sham (n=21), non...
Chapter
BackgroundRecent studies have demonstrated that apoptosis in cerebral arteries could play an essential role in cerebral vasospasm after subarachnoid hemorrhage (SAH) and that SP600125, an inhibitor of c-Jun N-terminal kinase (JNK) could suppress apoptosis. The present study examined whether SP600125 could reduce cerebral vasospasm through the suppr...
Article
Full-text available
Hyperbaric oxygen (HBO) therapy is defined by the Undersea and Hyperbaric Medical Society (UHMS) as a treatment in which a patient intermittingly breathes 100% oxygen under a pressure that is greater than the pressure at sea level [a pressure greater than 1 atmosphere absolute (ATA)]. HBO has been shown to be a potent means to increase the oxygen c...
Article
Secondary brain injury after subarachnoid hemorrhage (SAH) is poorly understood. As a result, there are few treatment options. Consequently, SAH is associated with a high rate of morbidity and mortality. In an effort to combat these problems, the role of apoptosis was examined in the whole brain after SAH. In particular, the role of p53 and the thr...
Article
Full-text available
Excessive nitric oxide (NO) produced by inducible nitric oxide synthase (iNOS) may play a pivotal role in blood-brain barrier (BBB) breakdown following subarachnoid hemorrhage (SAH). We investigated if the inhibition of iNOS could reduce BBB breakdown and cerebral edema, thereby leading to improved outcome 24 h after SAH. Forty male rats were assig...
Article
We investigated the molecular mechanisms of the anti-apoptotic properties of granulocyte-colony stimulating factor (G-CSF) on neurons and whether G-CSF affects glial cell survival following focal cerebral ischemia in rats. Sprague-Dawley rats were subjected to a transient 90 min middle cerebral artery occlusion (MCAO) by the intraluminal occlusion...
Article
Full-text available
Apoptosis is the term given to programmed cell death, which has been widely connected to a number of intracranial pathologies including stroke, Alzheimer's disease, and more recently subarachnoid hemorrhage (SAH). Subarachnoid hemorrhage is a disease, without any form of effective treatment, that affects mainly the young and middle aged and as a re...
Article
Full-text available
Recently, mounting evidence has emerged to suggest that hyperbaric oxygenation (HBOT)-induced neuroprotection after experimental global ischemia and subarachnoid hemorrhage entails a decrease in the expression of hypoxia-inducible factor-1alpha (HIF-1alpha). Therefore, the purpose of this study was to test the hypothesis that oxygen-induced neuropr...
Article
Matrix metalloproteinases (MMPs) and cysteine proteases (calpain and cathepsin B) play an important role in cell death and are upregulated after focal cerebral ischemia. Because there is a significant interaction between MMP-9 with calpain and cathepsin B, we investigated the role of E64d (a calpain and cathepsin B inhibitor) on MMP-9 activation in...
Article
Despite intensive research efforts, the etiology of vasospasm (sustained constriction of the cerebral vessels) remains unknown. In this study, we investigated the role of p53-induced apoptosis in the vasculature at 24 and 72 hours. To completely examine the apoptotic cascades, key proteins of the caspase-dependent, -independent and mitochondrial pa...
Article
Response: We appreciate the comments of Drs Schabitz and Schneider regarding our review article on the neuroprotective effect of granulocyte-colony stimulating factor (G-CSF).1 A great deal of attention has been focused on the nonhematopoietic functions of hematopoietic factors in other tissues, including the central nervous system (CNS). Hematopo...
Article
Granulocyte-colony stimulating factor (G-CSF) is a growth factor that orchestrates the proliferation, differentiation, and survival of hematopoietic progenitor cells. It has been used for many years in clinical practice to accelerate the recovery of patients from neutropenia after cytotoxic therapy. However, there is a growing body of evidence from...

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