Karsten H Wrede

University Hospital Essen | UK Essen · Neurosurgery and Spine Surgery

Purpose Conventional saturation pulses cannot be used for 7 Tesla ultra-high-resolution time-of-flight magnetic resonance angiography (TOF MRA) due to specific absorption rate (SAR) limitations. We overcome these limitations by utilizing low flip angle, variable rate selective excitation (VERSE) algorithm saturation pulses. Material and Methods Tw...

To prospectively evaluate 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) in comparison to 1.5 Tesla TOF MRA and 7 Tesla non-contrast enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of unruptured intracranial aneurysms (UIA). Sixteen neurosurgical patients (male n = 5, female n = 11) with s...

Purpose: The increasing number of clinically oriented MRI studies at 7 T motivates the safety assessment of implants, since many 7 T research sites conservatively exclude all subjects with metallic implants, regardless of type or location. The purpose of this study was to investigate potential RF-induced heating during a 7 T MRI scan using a self-...

Glioblastoma may develop rapidly without evidence for precursor lesions (primary glioblastomas), or progress from diffuse or anaplastic astrocytomas (secondary glioblastomas). Despite having distinct genetic profiles, these glioblastoma subtypes have similar histological features. We hypothesized that the highly malignant phenotype of glioblastoma...

The magnetization-prepared rapid-acquisition gradient-echo (MPRAGE) sequence regularly shows caudal image contrast inversion at 7 T and therefore reduced clinical applicability. The investigators report the technical source of this problem and present a practical solution. A total of 71 subjects were scanned using a 7-T whole-body magnetic resonanc...

Objective Childhood hydrocephalus patients treated by ventriculo-peritoneal (v.-p.) shunting are sometimes referred years after this therapy for evaluation of suspicious pituitary enlargement. Since pituitary size has been shown to depend on cerebrospinal fluid (CSF) pressure, we assume this phenomenon to be caused by shunt overdrainage. Therefore,...

Anemia is a common, treatable condition in patients with aneurysmal subarachnoid hemorrhage (SAH) and has been associated with poor outcome. As there are still no guidelines for anemia management after aneurysm rupture, we aimed to identify outcome-relevant severity of anemia in SAH. We systematically searched PubMed, Embase, Scopus, Web of Science...

Background: Symptomatic epilepsy is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) associated with poor outcome. We sought to analyze the risk factors leading to post-SAH epilepsy. Methods: All consecutive aSAH cases treated between 01/2003 and 06/2016 were retrospectively included. Post-aSAH period was followed up to 03/2020...

Objective: The aim of this study was to investigate the functional outcome in spinal cavernous malformation (SCM) patients with single or multiple intramedullary hemorrhagic events. Methods: SCM patients who were conservatively treated between 2003 and 2021 and had complete clinical baseline characteristics, an MRI data set, at least one SCM-rel...

Background: According to the ISUIA, small (<7 mm) unruptured intracranial aneurysms (IA) of the anterior circulation (aC) carry a neglectable 5-years rupture risk. In contrast, some studies report frequencies of more than 20% of all ruptured IA being small IA of the aC. This contradiction was addressed in this study by analyzing the rates and risk...

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is characterized by high morbidity and mortality proceeding from the initial severity and following complications during aSAH. Various scores were developed to predict these risks. We analyzed the clinical value of different radiographic scores for prognostication of aSAH outcome. Methods: Ini...

Objective: Previous reports indicate a negative impact of anemia on the outcome of an aneurysmal subarachnoid hemorrhage (SAH). We aimed to identify the outcome-relevant severity of post-SAH anemia. Methods: SAH cases treated at our institution between 01/2005 and 06/2016 were included (n = 640). The onset, duration, and severity (nadir hemoglob...

Background and Purpose To assess the impact of posterior fossa pilocytic astrocytoma (PA) removal in pediatric patients, with special focus on postoperative neurological outcome after repeated surgery for tumor remnants. Methods Our institutional database was screened for patients with PA treated between 2000 and 2019. Patients ≤18 years of age wi...

Background Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported. Aim To evaluate the value of regular medication on the risk of development and rupture of IA. Methods Data on medication use and related...

Purpose This study retrospectively examined the extent to which computed tomography angiography (CTA) and digital subtraction angiography (DSA) can help identify the cause of lobar intracerebral bleeding. Materials and methods In the period from 2002 to 2020, data from patients who were >18 years at a university and an academic teaching hospital w...

Background: The purpose of this study was to investigate the 5-year risk of a third bleeding event in cavernous malformations (CM) of the central nervous system (CNS). Methods: Patients with cerebral or spinal CM treated between 2003 and 2021 were screened using our institutional database. Patients with complete magnetic resonance imaging (MRI)...

Background: Rosette-forming glioneuronal tumor (RGNT) is an extremely rare entity described for the first time in the WHO classification of tumors of the central nervous system in 2007. Predominantly, single case reports of RGNT in the pineal region have been published, and specific therapy concepts are pending. Methods: The study group comprise...

Background Cerebral infarction is a major contributor to poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Timing of treatment has been discussed as a possible contributor. We aimed to analyze the impact of treatment timing on the risk of cerebral infarction and poor outcome following aSAH. Methods Consecutive aSAH cases tre...

Purpose Breast cancer (BC) is the most frequently diagnosed tumor entity in women. Occurring at different time intervals (TI) after BC diagnosis, brain metastases (BM) are associated with poor prognosis. We aimed to identify the risk factors related to and the clinical impact of timing on overall survival (OS) after BM surgery. Methods We included...

OBJECTIVE The pathophysiology of development, growth, and rupture of arteriovenous malformations (AVMs) is only partially understood. However, inflammation is known to play an essential role in many vascular diseases. This feasibility study was conducted to investigate the expression of enzymes (cyclooxygenase 2 [COX-2] and NLRP3 [NOD-, LRR-, and p...

Abstract Blood pressure management is crucial in the treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH). Possible association between the blood pressure increase and the risk of delayed cerebral ischemia (DCI) and different systemic complications after aSAH is still a matter of debate. This study aims to elucidate the influence of...

Temozolomide (TMZ) is the first line of standard therapy in glioblastoma (GBM). However, relapse occurs due to TMZ resistance. We attempted to establish an acquired TMZ resistance model that recapitulates the TMZ resistance phenotype and the relevant gene signature. Two GBM cell lines received two cycles of TMZ (150 µM) treatment for 72 h each. Reg...

Background To estimate the quality of life, anxiety, depression, and illness perception in patients with medically treated cerebral cavernous malformation (CCM) and associated epilepsy. Methods Nonsurgically treated patients with CCM‐related epilepsy (CRE) were included. Demographic, radiographic, and clinical features were assessed. All participa...

Background: Brain metastases requiring surgical treatment determine the prognosis of patients with breast cancer. We aimed to develop the scores for the prediction of short (<6 months) and long (≥3 years) survival after BCBM surgery. Methods: Female patients with BCBM surgery between 2008 and 2019 were included. The new scores were constructed u...

Purpose We aimed to investigate treatment effect of endovascular thrombectomy (EVT) on the change of National Institutes of Health Stroke Scale (NIHSS) scores in acute ischemic stroke (AIS) patients with anterior large vessel occlusion (LVO). Predictors of early neurological improvement (ENI) were assessed in those with successful reperfusion. Met...

Purpose The aim of this study was to determine local diagnostic reference levels (DRLs) during endovascular diagnostics and therapy of carotid-cavernous fistulas (CCF). Methods In a retrospective study design, DRLs, achievable dose (AD) and mean values were assessed for all patients with CCF undergoing diagnostic angiography (I) or embolization (I...

Background and Objectives: Spinal schwannomas are benign tumours that can present with various symptoms such as pain, radiculopathy and neurological deficit. Gross total resection (GTR) is of key importance for local recurrence. The aim of this study is to describe the clinical characteristics, resection rate, clinical outcome, as well as tumour re...

OBJECTIVE The objective of this study was to analyze the impact of medication intake on hemorrhage risk in patients with familial cerebral cavernous malformation (FCCM). METHODS The authors’ institutional database was screened for patients with FCCM who had been admitted to their department between 2003 and 2020. Patients with a complete magnetic...

Objective The objective of this study is to investigate the relationship between the thrombus signal intensity and aneurysm wall thickness in partially thrombosed intracranial aneurysms in vivo with magnetization-prepared rapid acquisition gradient echo (MPRAGE) taken using 7T magnetic resonance imaging (MRI) and correlate the findings to wall inst...

Objective: The prevalence of multiple intracranial aneurysms (MIAs) has increased over the last decades. Because MIAs have been identified as an independent risk factor for formation, growth, and rupture of intracranial aneurysms (IAs), a more profound understanding of the underlying pathophysiology of MIAs is needed. Therefore, the authors' exten...

Objective Occurrence of brain metastases BM is associated with poor prognosis in patients with breast cancer (BC). Magnetic resonance imaging (MRI) is the standard of care in the diagnosis of BM and determines further treatment strategy. The aim of the present study was to evaluate the association between the radiographic markers of BCBM on MRI wit...

Full-text access: https://rodemerk.com/publications/original-research/ptgwt/ Background: Preoperative traction with the Gardner-Wells tongs (PTGWT) is a valuable option for cervical spine injuries with malalignment. The aim of this study was to analyze the factors related to the treatment success of PTGWT. Methods: All consecutive cases with P...

Background and Purpose: Analyze and compare the natural course of confirmed familial cerebral cavernous malformation (FCCM), assumed FCCM and non-familial multiple cerebral cavernous malformation (CCM) disease over a 5-year period. Methods: Our institutional database was screened for patients with CCM admitted between 2003 and 2020. Patients with...

Spinal epidural lipomatosis (SEL) is a rare condition caused by hypertrophic growth of epidural fat. The prevalence of SEL in the Western world is approximately 1 in 40 patients and is likely to increase due to current medical and socio-economic developments. Rarely, SEL can lead to rapid severe neurological deterioration. The pathophysiology, opti...

OBJECTIVE Cavernous spinal cord malformations (SCMs) are believed to have a high rate of bleeding. The risk of intramedullary hemorrhage (IMH) or recurrent IMH and the neurological impact of bleeding events are important for clinical decision-making and could impact current treatment strategies. METHODS The authors screened their institutional dat...

Objective: The aim of this study was to investigate the diagnostic accuracy of a radiomics analysis based on a fully automated segmentation and a simplified and robust MR imaging protocol to provide a comprehensive analysis of the genetic profile and grading of cerebral gliomas for everyday clinical use. Methods: MRI examinations of 217 therapy-...

Neurosurgical procedures often involve local skull bone removal to combat specific pathologies. Defect covering is mandatory in most cases and usually requires the application of bespoke and synthetically engineered implants. Since manufacturing management faces several barriers in the design, fabrication, and application process, there is an unmet...

Background This study aimed to assess occurrence and significance of postoperative neuropathic pain in patients with surgically-treated brainstem cavernous malformations (BSCM). Methods Seventy-four BSCM patients surgically treated between 2003 and 2019 were reviewed for the occurrence of postoperative NP and related treatment. We evaluated releva...

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the natural course of cerebral cavernous malformations (CCM) in the pediatric population, with special emphasis on the risk of first and recurrent bleeding over a 5-year period. METHODS: Our institutional database was screened for patients with CCM treated between 2003 and 2020. P...

Purpose: Disturbances of electrolytes and renal function have been linked to the prognosis of critically ill patients and recently also of cancer patients. This study aimed to assess electrolyte and renal disorders in glioblastoma patients and evaluate their prognostic effect. Methods: Medical records of patients with newly diagnosed glioblastoma b...

The partial pressure of carbon dioxide (PaCO2) in the arterial blood is a strong vasomodulator affecting cerebral blood flow and the risk of cerebral edema and ischemia after acute brain injury. In turn, both complications are related to poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). We aimed to analyze the effect of PaCO2...

Traumatic acute subdural hematoma (aSDH) is associated with a high mortality rate due to postoperative cerebral infarction. Recently, brain natriuretic peptide (BNP) was considered a reliable biomarker in the acute phase of traumatic brain injuries. We therefore aimed in this study to analyze BNP levels on admission, identify the predictors of thei...

Objective: To evaluate the predictive value of intraoperative neuromonitoring (IONM) in brainstem cavernous malformation (BSCM) surgery. Methods: Surgically treated BSCM patients were included. All patients received IONM consisting of motor- and somatosensory-evoked potentials (MEP, SSEP). Neurological examination was conducted preoperatively an...

Introduction: Brain natriuretic peptide (BNP) is a reliable biomarker in the acute phase of traumatic brain injury. However, the relationship between BNP and traumatic acute subdural hematoma (aSDH) has not yet been addressed. This study aimed to analyze BNP levels on admission in surgically treated patients and assess their relationship with earl...

Introduction The severity of early brain edema after aneurysm rupture was reported to be strongly associated with the risk of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Objective/Aim Using the recently developed SEBES, we analyzed the predictors of early brain edema and its impact on the complications related to intracranial pres...

Objective Microsurgical resection of spinal ependymomas is associated with a considerable risk of postoperative neurological deterioration. We aimed to develop a risk score for outcome prediction after surgery for spinal ependymoma. Materials and Methods All patients who underwent microsurgical resection of spinal ependymoma between 1980 and 2015...

Despite multimodal treatment, the prognosis of patients with glioblastoma (GBM) remains poor. Previous studies showed conflicting results on the effect of antiepileptic drugs (AED) on GBM survival. We investigated the associations of different AED with overall survival (OS) and progression-free survival (PFS) in a large institutional GBM cohort (n...

Objective The severity of early brain edema after aneurysm rupture was reported to be strongly associated with the risk of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Using the recently developed SEBES (Subarachnoid Hemorrhage Early Brain Edema Score), we analyzed the predictors of early brain edema and its impact on the complicati...

Objective: Brain natriuretic peptide serum levels (BNP) on admission are frequently elevated in patients with symptomatic chronic subdural hematoma (cSDH). However, the reasons for these elevated levels remain unclear. In patients with traumatic brain injuries, elevated BNP was associated with increased intracranial pressure (ICP), but cSDH exhibit...

Introduction: Preoperative traction with the Gardner-Wells Tongs (PTGWT) is a valuable option for the cervical spine injuries with malalignment. The aim of this study was to analyze the factors related to the treatment success of PTGWT. Methods: All consecutive cases with PTGWT due to cervical spine injury with malalignment treated in our hospita...

Objective: Brain natriuretic peptide (BNP) is known as a reliable biomarker in the acute phase of traumatic brain injury, related to its severity, presence of increased intracranial pressure and unfavorable outcome. The purpose of this study was to analyze the plasma BNP level in patients with traumatic acute subdural hematoma (aSDH) and assess its...

Objective: A recent study showed a frequent elevation of brain natriuretic peptide (BNP) serum levels in patients with symptomatic chronic subdural hematoma (cSDH). In this study, the prediction of the long-term functional outcome was assessed, and a new predictive score developed. Methods: We prospectively included patients with symptomatic cSDH...

Objective: The increase of plasma brain natriuretic peptide (BNP) concentrations on admission was demonstrated in patients with traumatic brain injury (TBI), but has been not yet addressed in traumatic acute subdural hematoma (aSDH). The aim of this study was to assess the relationship between plasma BNP levels and radiological findings in patients...

Objective: The frequency of aneurysmal subarachnoid hemorrhage (aSAH) presents complex fluctuations that have been attributed to weather and climate changes in the past. In the present long-term big data and deep learning analysis, we have addressed this long-held myth. Methods: Bleeding dates and basic demographic data for all consecutive patients...

Background: Brain natriuretic peptide serum levels (BNP) on admission are frequently elevated in patients with symptomatic chronic subdural hematoma (cSDH) and predict unfavorable long-term functional outcomes. However, the reasons for these elevated levels remain unclear. Therefore, we aimed to identify the predictors of BNP elevation. Methods:...

Introduction Brachial plexus lipomas are extremely rare benign tumors that may cause slow progression of neurological deficits leading to thoracic outlet syndrome. Up to now, surgery remains challenging. The aim of this study is to present our surgical treatment regime and long-term neurological outcome in three cases of giant brachial plexus lipom...

Background and Study Aims/Object Despite the relevance of molecular criteria for brain tumor diagnosis and prognosis, meningioma grading is still solely based on histologic features. Atypical meningiomas (AMs; WHO grade II) display a great histologic heterogeneity and individual courses of disease can differ significantly. This study aimed to ident...

Background In previous studies with traumatic brain injury and ischemic stroke patients, the size of decompressive craniectomy (DC) was reported to be essential for patients’ outcome. We aimed at identifying the impact of DC size on treatment results in individuals with aneurysmal subarachnoid hemorrhage (SAH). Methods The extent of DC in 232 SAH...

Background To determine the prevalence of cardiovascular comorbidities and allergic diseases in patients with cavernous malformations of the central nervous system (CCM) compared to normal population. Methods Clinical and MRI data of 1,352 patients with CCM from an observational cross‐sectional single‐institutional study were analyzed and compared...

Background and Purpose This study aims to assess the influence of modifiable cardiovascular risk factors on hemorrhage risk of sporadic cerebral cavernous malformations (CCMs). Methods From 1219 consecutive CCM patients (2003–2018), adult subjects with sporadic CCM and complete magnetic resonance imaging were included. We evaluated presence of int...