Laurence A G Marshman

Laurence A G Marshman
James Cook University · Discipline of Medicine

MB ChB FRCS MD FRCSN FRACS

About

105
Publications
13,534
Reads
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1,189
Citations
Citations since 2017
21 Research Items
516 Citations
2017201820192020202120222023020406080100
2017201820192020202120222023020406080100
2017201820192020202120222023020406080100
2017201820192020202120222023020406080100
Additional affiliations
July 2008 - present
Townsville Hospital
Position
  • Consultant

Publications

Publications (105)
Article
Introduction ‘Post Traumatic Amnesia’ (‘PTA’) duration is used to predict outcome after traumatic brain injury (TBI): however, no meta-analysis exists. Methods Systematic review following PRISMA reporting guidelines. Databases Scopus-1966, PubMed/MEDLINE, CINAHL, PSYCHINFO and EMBASE were searched for relevant texts. Random-effects meta-analysis d...
Conference Paper
Full-text available
Purpose: To provide an objective summary post traumatic amnesia's (PTA) utility in predicting outcome after traumatic brain injury (TBI). Methods: Electronic databases, Scopus, PubMed, and EMBASE were searched. Studies on adult TBI, which had subsequent PTA and Glasgow Outcome Scale (GOS) or Glasgow Outcome Scale Extended (GOSE) measurement were se...
Article
Background and Objective Post-traumatic amnesia (PTA) is an early significant stage of recovery from traumatic brain injury (TBI). Current prospective PTA scales do not assess the full range of PTA symptomatology. This study conducted a novel integrated assessment of cognition and behaviour during PTA. Method Twenty-four moderate-to-severe TBI par...
Article
The duration of post-traumatic amnesia (PTA) following traumatic brain injury (TBI) is a key diagnostic and outcome indicator. However, concerningly, different PTA paradigms record different PTA durations: some over-estimate, others under-estimate, PTA. Thus, a compromise is implied. The potential effect of in-hospital confounders including opioids...
Article
Most chronic subdural haematomas (CSDH) are successfully treated neurosurgically. However, operative recurrences occur with a frequency 3-30%, consume resources and potentially prolong length-of stay (LOS). The only adjuvant factor proven to significantly decrease CSDH recurrence rate (RR) is post-operative subdural drainage. Corticosteroids have b...
Article
Background: To explain why some chronic subdural hematomas (CSDHs) grow and/or resorb, a physically decreasing outer membrane (OM) surface area (SA) to CSDH volume (V) ratio has been reexplored, and a critical CSDH size inferred (OM SA ≈ V). Gardner showed that since CSDH protein exceeded cerebrospinal fluid (CSF) protein, CSF→CSDH osmosis occurre...
Article
Chronic subdural haematoma (CSDH) is invariably classified as ‘neurotrauma’. However, whilst a history of trauma/fall is frequent, it is usually distant, mild or even absent. SerumS-100>1.38μg/L is associated with a 100% specificity for mortality/poor outcome acutely after moderate-severe neurotrauma. SerumS-100>0.10μg/L is used to screen mild ne...
Article
In Reply We have read with great interest the letter by Rato et al regarding our study¹ that investigated the effect of pregabalin and gabapentin on pain intensity in adults. We thank the authors for their insight into the methodological aspects of the crossover design used.
Article
Background Although chronic subdural hematoma (CSDH) is generally benign, long-term survival (LTS) after CSDH is poor in a significant subgroup. This dichotomy has been compared to fractured neck of femur. However, although early postoperative mortality (within 30 days of CSDH) is well recorded with CSDH and similar to fractured neck of femur (4%–8...
Article
Importance Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective...
Article
Real-time ultrasound imaging (US) to measure abdominal muscle dimensions has aided low back pain rehabilitation and research. Notwithstanding, ultrasound imaging measurement of transversus abdominis muscle activation in chronic low back pain populations has been characterized by variable and generally suboptimal intra-observer reliability. Methodol...
Article
Background: Juxtafacet cysts (JFCs) are uncommon spinal lesions that can cause neural compression and are typically managed surgically. Rarely, JFCs can spontaneously resolve. Case description: We present the case of a spontaneously resolving right L4/5 JFC in an otherwise fit and well 60-year-old female. She presented with progressive chronic l...
Article
Background: Post-traumatic amnesia (PTA) after traumatic brain injury (TBI) comprises anterograde amnesia (AA), disorientation and retrograde amnesia (RA). However, RA is often neither assessed nor emphasized. A recent study demonstrated that, whilst AA and disorientation were both present in non-TBI in-patients uniformly taking opioids, RA was ab...
Article
Full-text available
Background: There is currently an absence of high-grade evidence regarding the treatment of chronic sciatica (CS). Whilst gabapentin (GBP) and pregabalin (PGB) are both currently used to treat CS, equipoise exists regarding their individual use. In particular, no head-to-head study of GBP and PGB in CS exists. Despite equipoise, most countries' fo...
Article
The Glasgow Coma Scale (GCS) only assesses orientation after traumatic brain injury (TBI). 'Post-traumatic amnesia' (PTA) comprises orientation, anterograde amnesia (AA) and retrograde amnesia (RA). However, RA is often disregarded in formalized PTA assessment. Drugs can potentially confound PTA assessment: e.g. midazolam can cause AA. However, pot...
Article
Mathematical formulae are commonly used to estimate intra-cranial haematoma volume. Such formulae tacitly assume an ellipsoid geometrical morphology. Recently, the 'XYZ/2' formula has been validated and recommended for chronic subdural haematoma (CSDH) volumetric estimation. We aimed to assess the precision and accuracy of mathematical formulae spe...
Article
Background: It is unknown why some chronic subdural haematomas (CSDH) grow and require surgery, whilst others spontaneously resolve. Although a relatively small CSDH volume (V) reduction may induce resolution, V% reduction is often unreliable in predicting resolution. Whilst CSDH evolve distinctive inner and outer neo- membranes (IM and OM), the O...
Article
Background: Physiotherapists use musculo-skeletal classification systems for patient assessment. Since its early development, the McKenzie lumbar spine assessment (MK) has been incorporated into examination algorithms and combined with a series of patho-anatomical diagnostic tests. No previous studies have used a MK and a combined examination (MK-...
Article
Conclusions: Despite a lower cut-off, no validated TnI elevation was observed in any group by 24h after surgery. One non-STEMI had not been associated with TnI-elevation by 24h. Immediately peri-operative cardiac stress therefore appeared comparatively rare in patients undergoing routine elective spine surgery. Further, prone positioning did not r...
Article
Outcome after chronic subdural haematoma (CSDH) is invariably assumed favourable: however, little data regarding long term survival (LTS) exists. One study reported excess mortality restricted to year 1, but with expected actuarial rates thereafter. We aimed to determine LTS after CSDH in a retrospective analysis relative to actuarial data from age...
Article
Prior studies, using systemic hypertension and elastase infusion, have induced cerebral aneurysm (CA) formation in mice. However, the CAs induced were rapidly formed, relatively large, and often ruptured. These features are not completely representative of human CAs. We set out to develop a mouse model representative of the early pathological featu...
Article
Setting. There is currently a gross lack of evidence base guiding the medical management of chronic sciatica (CS). Only scant previous studies have assessed gabapentin (GBP) in CS. Extrapolating NICE-UK guidelines, prescribing authorities often insist on trialling anti-depressants (e.g., amytriptyline, AMP) as a first line for neuropathic pain stat...
Poster
Full-text available
Chronic subdural haematoma (CSDH) is a common neurosurgical condition with estimated annual incidence rates varying from 1 to 13.1 per 100,000. Despite its relatively common presentation, outcomes beyond the main neurosurgical variables of mortality and recurrence are limited. The aim of this study was to conduct a retrospective long-term follow-up...
Poster
Full-text available
Background/Aims: Chronic subdural haematoma is one of the most common neurosurgical conditions with an estimated annual incidence rates varying from 1 to 13.1 per 100,000. Despite its relatively common presentation, information on health outcomes beyond the main neurosurgical variables of mortality and recurrence are limited. The aim of this study...
Article
Despite the option to not answer, there is widespread anecdotal belief that the Oswestry Disability Index (ODI) section 8 (ODI-8/sex-life) is answered inaccurately (i.e. in relation to psychosocial factors, not pain), or that it repels ODI participation. ODI versions have therefore been created which omit ODI-8: however, no evidence-base justifies...
Article
Objective: The 'subdural space' is an artefact of inner dural border layer disruption: it is not anatomical but always pathological. A male bias has long been accepted for chronic subdural haematomas (CSDH), and increased male frequencies of trauma and/or alcohol abuse are often cited as likely explanations: however, no study has validated this. W...
Article
Full-text available
Background and importance Pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is rare: only 7 cases have been reported to date. Clinical presentation A 68-year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicaemia. CT and MRI revealed a Pan-regional CTLS SEA associ...
Article
We have reviewed the scant literature on status epilepticus in patients with brain tumours. Patients with brain tumour-associated epilepsy (TAE) appear less likely to develop status epilepticus (TASE) than patients with epilepsy in the general population (EGP) are to develop status epilepticus (SEGP). TASE is associated with lesions in similar loca...
Article
Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture...
Article
Background: Low back pain (LBP) classification systems are used by physical therapists to classify patients. Classification systems require observation, and are at risk of rater bias and erroneous classification decisions, if the reliability among raters is poor. Rater reliability of individual systems in subgroups of LBP is important, to justify t...
Article
Visual inspection for "xanthochromia" (VIX) is used to diagnose subarachnoid haemorrhage (SAH), validate CT-SAH diagnosis, and was used to determine 'Walton's rule'. No study has assessed VIX reliability. To determine intra- and inter-observer VIX agreement. Mock CSF samples contained increasing concentrations of human oxyhaemoglobin, bilirubin, an...
Article
Of patients hospitalised for traumatic brain injury (TBI), most pass through a state of altered consciousness known as "post-traumatic amnesia" (PTA). Despite the lack of a consistent definition, PTA is widely used as a construct in neurosurgical practice to guide decision-making and prognosis. Accurate PTA assessment is important, because over-eva...
Article
Modic changes (MCs) and high-intensity zones (HIZs) potentially serve as variably sensitive markers for discogenic chronic low-back pain (CLBP). No study has hitherto assessed the phenomenon of MC-HIZ coexistence at a single level, and the goal in this study was to assess the nature and frequency of this phenomenon. One hundred twenty consecutive p...
Article
Study design: Original report. Objective: To investigate the putative negative correlation between the duration of symptoms (DOS) and outcome after surgery for chronic low back pain (CLBP). Summary of background data: Posterior lumbar interbody fusion (PLIF) is a well established treatment for CLBP. Anecdotally, a prolonged DOS is associated w...
Article
Technical report. To minimize the gross artefact associated with a conventional metallic lumbar total disc arthroplasty (TDA) device on a conventional high field-strength (1.5 Tesla [T]) magnetic resonance imaging (MRI) scanner. Gross artefact is often apparent with ferromagnetic metallic TDA devices on conventional high field-strength MRI scanners...
Article
Acute haematogenous infection of a closed fractures is rare. A 68-year-old diabetic male sustained a burst fracture of a lumbar vertebra (L2) after a fall onto his back. After 5 days of conservative management, he developed a chest infection and amoxicillin was commenced empirically. However, after 6 days his previously moderate focal L2 back pain...
Article
Original study. Prospective comparison of clinical outcomes after a standard posterior lumbar interbody fusion (ST-PLIF) and after a limited exposure PLIF incorporating total facetectomy (LI-PLIF). Most groups have reported significantly improved clinical outcomes after ST-PLIF. To our knowledge, however, a comparison of outcomes between ST-PLIF an...
Article
Dear Editor: We thank Raabe and Müller [3] for the opportunity to elaborate on the issue of fetal dose and the associated risk. The risk–benefit assessments for radiology of pregnant patients are complicated as risks to both mother and the developing embryo or fetus must be considered. These should include an assessment of the risk to the mother if...
Article
The A-Mav (Medtronic, Sofamor Danek, Memphis, TN) is a well-established lumbar total disc arthroplasty device. The O-Mav (Medtronic) is a more recent innovation designed to minimize the potential vascular complications associated with A-Mav insertion at L4/5. No study has hitherto studied the relative accuracy or safety of the two techniques. To co...
Article
Primary pyomyositis (PM) is a rare bacterial infection of skeletal muscle usually restricted to tropical zones. Typically caused by Staphylococcus aureus, primary staphylococcal PM associated with an epidural abscess has not been reported before. We present the first case of staphylococcal PM associated with an epidural abscess. Case report. A 56-y...
Article
It is a general principle with arthroplasty insertion that precise implant centering is critical for long term function and outcome. Whilst some authors have proclaimed that lumbar total disc arthroplasty (TDA) may be different, and that off -centre placement may be functionally well tolerated, these claims are premature: significantly worse clinic...
Article
Discal cysts are rare lesions that can result in refractory sciatica. Because they are so rare, their exact origin and details of the clinical manifestations are still unknown. The authors report on five men treated for discal cysts. The mean age of the patients at the time of the surgery was 32 years (range 25-38 years). All patients suffered from...
Article
Spontaneous bilateral carotid and vertebral artery dissections (CADs and VADs) are rare. A 29-year-old female presented with a collapse, 4 weeks after a sudden onset of severe neck and shoulder pain. CT scan revealed diffuse subarachnoid hemorrhage (SAH) and early hydrocephalus. Angiography revealed bilateral CADs and VADs, along with multiple fusi...
Article
Original study. To compare the accuracy of radiograph (XR) estimates of lumbar total disc arthroplasty placement with high-resolution computed tomography (CT). Most lumbar disc arthroplasties are inserted and subsequently analyzed using anteroposterior and lateral XR: XR estimates are often correlated with clinical outcomes. No study has hitherto a...
Article
Widespread fibrotic obliteration of the spinal subarachnoid space after cerebral aneurysmal subarachnoid hemorrhage (SAH) is rare. A 57-year-old woman presented with the gradual development of a spastic paraparesis. Two years earlier, she experienced a cerebral aneurysmal SAH that was successfully managed with endovascular coiling. However, the SAH...
Article
Technical report. To compare the accuracy of lumbar total disc arthroplasty placement using an image-guidance system (IGS) with conventional fluoroscopy. Most disc arthroplasties are inserted and analyzed using fluoroscopy. One previous cadaveric study demonstrated beneficial, but insignificant, effects of IGS on total disc arthroplasty placement c...
Article
The authors describe a case of a discal cyst that resolved almost completely without direct intervention. Discal cysts are rare, with the authors of only a few case reports describing this entity. These reports all identify at least some intervention performed for alleviation of the symptoms, including open surgery, minimally invasive surgery, or p...
Article
Most spinal arteriovenous malformations (AVMs) are dural arteriovenous fistulas in which a singularly intradural venous drainage emanates from an extradural nidus. A pure extradural spinal arteriovenous malformation (E-AVM), in the absence of a vertebral body (cavernous) hemangioma, is extremely rare, and full clinical, radiological, and operative...
Article
Full-text available
Modic Type 2 (MT2) neuroimaging changes are considered stable or invariant over time and relatively quiescent, whereas Modic Type 1 (MT1) changes are considered unstable and more symptomatic. The authors report two cases in which MT2 changes were symptomatic and evidently unstable, and in which chronic low-back pain severity remained unaltered desp...
Article
Infundibula are frequently regarded as incidental anatomical variants that are of no pathogenetic significance. A 51-year-old man presented with a sudden onset of severe occipital headache. Computed tomographic scan revealed a predominantly perimesencephalic pattern of SAH with a slight bias toward the left side. Angiography demonstrated a left PCo...
Article
Anterior spinal cord herniation is a well-documented condition in which the thoracic cord becomes tethered within a defect in the anterior dura mater. Typical procedures have involved a posterior approach with direct manipulation of the thoracic cord to expose and blindly release its point of tethering. The authors report three cases in which a nov...
Article
Full-text available
Extradural cysts intimately associated with relatively normal lumbar discs have rarely been reported. Histologically nonspecific, most have been designated posterior longitudinal ligament (PLL) or annulus fibrosus (AF) "ganglion cysts." Recently, "disc cysts" have been distinguished as a separate entity, mostly on the grounds of cyst-disc communica...
Article
Obstructive hydrocephalus complicating foramen magnum decompression (FMD) for a Chiari malformation (CM) Type I is rare. Two female patients (17 and 55 years old) presented with strain-related headaches. In both cases magnetic resonance (MR) imaging studies confirmed a CM Type I, which was accompanied by syringomyelia in one case. Both patients und...
Article
No case of primary epithelioid leiomyosarcoma involving the spine has been reported previously. A 61-year-old Nigerian woman presented with progressive spastic quadriparesis and acute urinary retention. Her only medical history included a total abdominal hysterectomy for fibroids 10 years earlier in Nigeria. Results of the general examination were...
Article
. Subarachnoid hemorrhage from an intracranial aneurysm during pregnancy is a rare complication with high maternal and fetal morbidity-mortality. We report three cases of ruptured intracranial aneurysms during pregnancy, treated by the minimal invasive endovascular approach.
Article
Full-text available
A unique case is presented of a decrease in density on CT scans of a colloid cyst of the third ventricle with time. This occurred in the absence of any operative intervention in a 35-year-old woman.
Article
Fibrous dysplasia (FD) is an uncommon benign fibro-osseous abnormality of bone, of unknown aetiology and equal sex incidence, which is most commonly restricted to one bone (monostotic FD: MFD, 70%). Less commonly multiple bones are affected (polyostotic FD: PFD, 27%). Vertebral involvement is uncommon (4%), but more common with PFD (7 - 24%) than M...
Article
Although uncommon, aneurysmal subarachnoid haemorrhage (SAH) in pregnancy can be devastating for both mother and baby. It is the leading cause of other indirect maternal death in England and Wales accounting for 60 deaths in the decade 1988-1999. No single obstetric or neurosurgical unit has sufficiently large database or experience in managing thi...
Article
Ring-enhancement on CT (RECT) is generally considered a sine qua non in diagnosing a cerebral abscess. We describe a 16-year-old female who presented with headaches, vomiting and drowsiness, which over 2 weeks rapidly progressed to coma. CT demonstrated a moderately large left frontal extradural abscess, associated with contiguous left frontal oste...
Article
Full-text available
Maxillary expansion using either a quadhelix appliance (Qx) or a nickel titanium palatal expander (Nt) was prospectively compared in 28 consecutive new patients (19 female, nine male) presenting with posterior buccal segment crossbites. Study models taken at each activation were measured to determine the mean maxillary expansion efficacy (Emax) and...
Article
The authors present two cases of thoracic idiopathic spinal cord herniation (TISCH) occurring at the vertebral body (VB) level in whom adequate surgical reduction failed to reverse symptoms. In the second case, in which TISCH occurred into a VB cavity, presentation was atypical (subacute spinal cord syndrome) and there was persistent postoperative...
Article
It is currently unknown whether endovascular filament (EF) models of acute subarachnoid hemorrhage (SAH) introduce any 'side bias' upon cerebrovascular reactivity by virtue of unilateral carotid manipulation, unilateral EF insertion, or potentially ipsilateral site of intracranial rupture. In this study, three experimental groups of adult male wist...
Article
Iatrogenic internal carotid artery-cavernous sinus fistula complicating percutaneous foramen ovale (FO) instrumentation (e.g., retrogasserian rhizotomy for trigeminal neuralgia) has been reported in only four patients to date. To our knowledge, no case of fistula has previously been reported either to complicate FO telemetry or to involve the infer...
Article
OBJECTIVE AND IMPORTANCE : Iatrogenic internal carotid artery-cavernous sinus fistula complicating percutaneous foramen ovale (FO) instrumentation (e.g., retrogasserian rhizotomy for trigeminal neuralgia) has been reported in only four patients to date. To our knowledge, no case of fistula has previously been reported either to complicate FO teleme...
Article
Although other focal signs may prove "false localizing," it is a neurosurgical axiom that unilateral fixed dilation of the pupil occurs ipsilateral to a supratentorial mass. A 25-year-old man collapsed with a dense right hemiplegia and a Glasgow Coma Scale score of 6 (eye opening, 1; motor, 4; verbal, 1) after rupture of a left middle cerebral arte...
Article
Intracranial chondrosarcoma (Ch-S) is a slow-growing, locally recurrent, malignant cartilaginous tumour of the skull base. Intracranial mesenchymal chondrosarcoma (MsCh-S) is a rarer, more malignant variant associated with the supratentorial meninges. Only seven cases of Ch-S, and six of MsCh-S, that were primarily intraparenchymal in origin have b...
Article
OBJECTIVE AND IMPORTANCE : Although other focal signs may prove “false localizing,” it is a neurosurgical axiom that unilateral fixed dilation of the pupil occurs ipsilateral to a supratentorial mass. CLINICAL PRESENTATION : A 25-year-old man collapsed with a dense right hemiplegia and a Glasgow Coma Scale score of 6 (eye opening, 1; motor, 4; verb...
Article
Non-anthrax Bacillus species are rare, but serious causes of bacterial meningitis in those either immunocompromised or treated with CSF diversion. Although resistant to first-line antibiotics, they usually respond to chloramphenicol. We report a case of fulminant Bacillus cereus meningitis that complicated lumbar spinal drainage which proved resist...
Article
OBJECTIVE AND IMPORTANCE: Idiopathic spinal cord herniation (ISCH) is a rare condition, reported in only 25 patients thus far, in which the thoracic cord is prolapsed through an anterior dural defect. It typically presents in middle age as either Brown-Séquard syndrome or spastic paraparesis. CLINICAL PRESENTATION: A 55-year-old woman initially pre...
Article
Infundibula (IFs) are funnel-shaped symmetrical enlargements that occur at the origins of cerebral arteries and are apparent on 7 to 25% of otherwise normal angiograms. They are frequently considered as normal anatomic variants of no pathogenic significance. We report the case of a ruptured posterior communicating artery aneurysm that had developed...

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Projects (3)
Project
To develop a Positive Health framework that explains recovery beyond the boundaries of current medical-models of health.