Philippe Schucht

Philippe Schucht
Inselspital, Universitätsspital Bern · Department of Neurosurgery

MD, Professor of Neurosurgery

About

140
Publications
18,435
Reads
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2,835
Citations
Additional affiliations
September 2012 - February 2013
University of California, San Francisco
Position
  • Fellow
January 2011 - July 2011
Centre Hospitalier Universitaire de Montpellier
Position
  • Fellow
July 2004 - present
Inselspital, Universitätsspital Bern
Position
  • Oberarzt
Education
January 2006 - December 2006
Schulthess Klinik, Zürich
Field of study
  • Neurology
July 1999 - July 2000
University of Zurich
Field of study
  • Neuroplasticity

Publications

Publications (140)
Article
Background: Adult-type diffuse gliomas, CNS WHO grade 4 are the most aggressive primary brain tumors and represent a particular challenge of therapeutic intervention. Methods: In a single-center retrospective study of matched pairs of initial and post-therapeutic glioma cases with a recurrence period greater than one year, we performed whole exo...
Preprint
BACKGROUND With the current exponential increase in technical innovations worldwide, potential solutions for any new problem might already exist, despite having been developed to solve a different problem. We reached out to the crowd to raise awareness of our challenge of developing intraoperative, real-time identification of fiber tracts and tumor...
Article
Background The management of asymptomatic intracranial meningiomas is controversial. Through the assessment of growth predictors, we aimed to create the basis for practicable clinical pathways for the management of these tumors. Material and Methods We volumetrically analyzed meningiomas radiologically diagnosed at our institution between 2003 and...
Article
Background Glioblastomas with methylation of the promotor region of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene exhibit increased sensitivity to alkylating chemotherapy. Quantitative assessment of the MGMT promotor methylation status might provide additional prognostic information. The aim of our study was to determine a quantitative t...
Article
Full-text available
Background Glioblastoma is the most common malignant primary brain tumour in adults and driven by various genomic alterations. Next generation sequencing (NGS) provides timely information about the genetic landscape of tumours and might detect targetable mutations. To date, differences exist in the application and NGS assays used as it remains uncl...
Article
OBJECTIVE Decompressive hemicraniectomy (DCE) is the standard of care for space-occupying malignant infarction of the medial cerebral artery in suitable patients. After DCE, the brain is susceptible to trauma and at risk for the syndrome of the trephined. This study aimed to assess the feasibility of using temporary space-expanding flaps, implanted...
Article
Full-text available
Background: Glioblastomas with methylation of the promoter region of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene exhibit increased sensitivity to alkylating chemotherapy. Quantitative assessment of the MGMT promoter methylation status might provide additional prognostic information. The aim of our study was to determine a quantitative...
Article
Full-text available
Background Caring for patients with a malignant brain tumor is complex and requires a high degree of coordination. The disease reduces life expectancy and affects quality of life. Therefore, patients often depend on the support of their relatives. To achieve better care for such patients and their relatives, a Department of Neurosurgery at a Swiss...
Article
OBJECTIVE The management of asymptomatic intracranial meningiomas is controversial. Through the assessment of growth predictors, the authors aimed to create the basis for practicable clinical pathways for the management of these tumors. METHODS The authors volumetrically analyzed meningiomas radiologically diagnosed at their institution between 20...
Article
Full-text available
One of the major challenges during glioblastoma surgery is balancing between maximizing extent of resection and preventing neurological deficits. Several surgical techniques and adjuncts have been developed to help identify eloquent areas both preoperatively (fMRI, nTMS, MEG, DTI) and intraoperatively (imaging (ultrasound, iMRI), electrostimulation...
Article
Purpose: At ultra-high field (UHF), B1 + -inhomogeneities and high specific absorption rate (SAR) of adiabatic slice-selective RF-pulses make spatial resolved spectral-editing extremely challenging with the conventional MEGA-approach. The purpose of the study was to develop a whole-brain resolved spectral-editing MRSI at UHF (UHF, B0 ≥ 7T) within...
Preprint
Background . Glioblastoma (GBM) is the most aggressive primary brain tumor and represents a particular challenge of therapeutic intervention. Methods . In a single-center retrospective study of matched pairs of initial and post-therapeutic GBM cases with a recurrence period greater than one year, we performed whole exome sequencing combined with mR...
Article
Full-text available
Oligodendrogliomas are defined at the molecular level by the presence of an IDH mutation and codeletion of chromosomal arms 1p and 19q. In the past, case reports and small studies described gliomas with sarcomatous features arising from oligodendrogliomas, so called oligosarcomas. Here, we report a series of 24 IDH-mutant oligosarcomas from 23 pati...
Article
Full-text available
Purpose Due to the lack of consensus on the management of glioblastoma patients, there exists variability amongst surgeons and centers regarding treatment decisions. Though, objective data about the extent of this heterogeneity is still lacking. We aim to evaluate and analyze the similarities and differences in neurosurgical practice patterns. Met...
Article
Full-text available
Background Mapping techniques are frequently used to preserve neurological function during glioma surgery. There is however no consensus regarding the use of many variables of these techniques. Currently, there is almost no objective data available about potential heterogeneity between surgeons and centers. The goal of this survey is therefore to g...
Article
BACKGROUND In patients with locally recurrent brain metastases (LRBMs), the role of (repeat) craniotomy is controversial. This study aimed to analyze long-term oncological outcomes in this heterogeneous population. METHODS Craniotomies for LRBM were identified from a tertiary neuro-oncological institution. First, we assessed overall survival (OS)...
Article
Full-text available
Low-grade gliomas (LGGs) are brain tumors characterized by their slow growth and infiltrative nature. Treatment options for these tumors are surgery, radiation therapy and chemotherapy. The optimal use of radiation therapy and chemotherapy is still under study. In this paper, we construct a mathematical model of LGG response to combinations of chem...
Article
Full-text available
We suggest using the wide-field imaging Mueller polarimetry to contrast optically anisotropic fiber tracts of healthy brain white matter for the detection of brain tumor borders during neurosurgery. Our prior studies demonstrate that this polarimetric imaging modality detects correctly the in-plane orientation of brain white matter fiber tracts of...
Conference Paper
Full-text available
We use a wide field imaging Mueller polarimeter to visualize the fiber tracts of healthy brain in the retardance maps for the detection of tumor borders. The results of ex-vivo polarimetric studies of thick sections of brain tissue are presented
Preprint
BACKGROUND Telehealth services can contribute to fulfilling the long-standing promise of patient-centered care, by delivering high-quality care at a location convenient to patients or by increasing patient access to healthcare-related information. In German-speaking countries, telehealth consultations were not particularly widespread before the out...
Article
OBJECTIVE Postoperative internal carotid artery (ICA) intimal flap (IF) is a potential complication after carotid endarterectomy (CEA) for carotid artery stenosis. There are no clear recommendations in the current literature on the management of this condition due to sparse evidence. Some authors advocate carotid stent placement or reoperation, whi...
Article
Full-text available
Introduction: The main surgical dilemma during glioma resections is the surgeon's inability to accurately identify eloquent areas when the patient is under general anaesthesia without mapping techniques. Intraoperative stimulation mapping (ISM) techniques can be used to maximise extent of resection in eloquent areas yet simultaneously minimise the...
Article
Full-text available
Background: In patients with locally recurrent brain metastases (LRBMs), the role of (repeat) craniotomy is controversial. This study aimed to analyze long-term oncological outcomes in this heterogeneous population. Methods: Craniotomies for LRBM were identified from a tertiary neuro-oncological institution. First, we assessed overall survival (...
Article
The nerve fiber bundles constitutive of the white matter in the brain are organized in such a way that they exhibit a certain degree of structural anisotropy and birefringence. The birefringence exhibited by such aligned fibrous tissue is known to be extremely sensitive to small pathological alterations. Indeed, highly aligned anisotropic fibers ex...
Article
Full-text available
Background During carotid endarterectomy (CEA), significant amplitude decrement of somatosensory evoked potentials (SEPs) is associated with post-operative neurological deficits. Objective To investigate the association between an incomplete circle of Willis and/or contralateral ICA occlusion and subsequent changes in intra-operatively monitored S...
Article
Full-text available
Objective: The management of brain tumour patients who would like to resume driving is complex, and needs multidisciplinary input and a consensus among treating physicians. The Swiss Neuro-Oncology Society (SwissNOS) and the Swiss Society for Legal Medicine (SGRM) aim to provide guidance on how to assess “fitness-to-drive” of glioblastoma patients...
Preprint
Full-text available
Most physical and other natural systems are complex entities composed of a large number of interacting individual elements. It is a surprising fact that they often obey the so-called scaling laws relating an observable quantity with a measure of the size of the system. Here we describe the discovery of universal superlinear metabolic scaling laws i...
Preprint
Full-text available
More children and adults under the age of 40 die of brain tumor than from any other cancer. Brain surgery constitutes the first and decisive step for the treatment of such tumors. It is extremely crucial to achieve complete tumor resection during surgery, however, this is a highly challenging task, as it is very difficult to visually differentiate...
Chapter
Disease progression for Glioblastoma multiforme patients is currently assessed with manual bi-dimensional measurements of the active contrast-enhancing tumor on Magnetic Resonance Images (MRI). This method is known to be susceptible to error; in the lack of a data-driven approach, progression thresholds had been set rather arbitrarily considering m...
Article
Full-text available
Background: This study aims to identify robust radiomic features for Magnetic Resonance Imaging (MRI), assess feature selection and machine learning methods for overall survival classification of Glioblastoma multiforme patients, and to robustify models trained on single-center data when applied to multi-center data. Methods: Tumor regions were...
Article
Full-text available
Most physical and other natural systems are complex entities that are composed of a large number of interacting individual elements. It is a surprising fact that they often obey the so-called scaling laws that relate an observable quantity to a measure of the size of the system. Here, we describe the discovery of universal superlinear metabolic sca...
Article
Full-text available
Background: The rise of the internet and social media has boosted online crowdfunding as a novel strategy to raise funds for kick-starting projects, but it is rarely used in science. Objective: We report on an online crowdfunding campaign launched in the context of the neuroscience project HORAO. The aim of HORAO was to develop a noninvasive real-...
Article
Full-text available
Identification of white matter fiber tracts of the brain is crucial for delineating the tumor border during neurosurgery. A custom-built Mueller polarimeter was used in reflection configuration for the wide-field imaging of thick sections of fixed human brain and fresh calf brain. The maps of the azimuth of the fast optical axis of linear birefring...
Article
Full-text available
Gliomas are intrinsic brain tumours, which are classified by the World Health Organization (WHO) into different grades of malignancy, with glioblastoma being the most frequent and most malignant subtype (WHO grade IV). Mutations in the isocitrate dehydrogenase (IDH) 1 or 2 genes are frequent in lower (WHO II/III) grade tumours but typically absent...
Preprint
Identification of white matter fiber tracts of the brain is crucial for delineating the tumor border during neurosurgery. A custom-built Mueller polarimeter was used in reflection configuration for the wide-field imaging of thick section of fixed human brain and fresh calf brain. The experimental images of azimuth of the fast optical axis of linear...
Article
Interpreting the polarimetric data from fiber-like macromolecules constitutive of tissue can be difficult due to strong scattering. In this study, we probed the superficial layers of fibrous tissue models (membranes consisting of nanofibers) displaying varying degrees of alignment. To better understand the manifestation of membranes' degree of alig...
Preprint
BACKGROUND The rise of the internet and of social media has boosted online crowdfunding as a novel strategy to raise funds for kick-starting projects, but as yet it is rarely used in science. OBJECTIVE We report on an online crowdfunding campaign launched in the context of the neuroscience project HORAO. HORAO’s aim is to develop a non-invasive re...
Article
OBJECTIVE With global aging, elective craniotomies are increasingly being performed in elderly patients. There is a paucity of prospective studies evaluating the impact of these procedures on the geriatric population. The goal of this study was to assess the safety of elective craniotomies for elderly patients in modern neurosurgery. METHODS For t...
Article
Among the most challenging diagnostic issues in surgical neuropathology is the distinction between scant infiltration by diffuse gliomas and reactive gliosis. The best documented ancillary marker to establish a definitive diagnosis of glioma in this setting is the identification of hotspot mutations in the isocitrate dehydrogenase 1 and 2 (IDH1/IDH...
Article
Objective We recently developed a new subcortical mapping technique based on the concept of stimulating the tissue at the site of and synchronously with resection. Our hypothesis was that instead of performing resection and mapping sequentially, a synchronized resection and mapping could potentially improve deficit rates. Methods We report our 5-ye...
Article
Objective Clamping of the internal carotid artery (ICA) during carotid endarterectomy (CEA) is a critical step. In our neurosurgical department, CEAs are performed with transcranial Doppler (TCD) and somatosensory evoked potential (SEP) monitoring with a 50% flow velocity/amplitude decrement warning criteria for shunting. The aim of our study was t...
Article
Zusammenfassung Die moderne neurochirurgische Onkologie verfolgt das Konzept der maximalen Tumorentfernung mit gleichzeitiger Funktionserhaltung. Dies ist bei Gliomen eine Herausforderung, da Tumorgrenzen nicht immer sichtbar sind und anatomische Landmarken verschoben sein können. Im folgenden Artikel werden intraoperative neurophysiologische Metho...
Article
OBJECTIVE The use of subdural drains after surgical evacuation of chronic subdural hematoma (CSH) decreases the risk of recurrence and has become the standard of care. Halfway through the controlled, randomized TOSCAN (Randomized Trial of Follow-up CT after Evacuation of Chronic Subdural Hematoma) trial, the authors’ institutional guidelines change...
Article
Full-text available
Here we put forward a mathematical model describing the response of low-grade (WHO grade II) oligodendrogliomas (LGO) to temozolomide (TMZ). The model describes the longitudinal volumetric dynamics of tumor response to TMZ of a cohort of 11 LGO patients treated with TMZ. After finding patient-specific parameters, different therapeutic strategies we...
Article
Background: With only 4 active certified neurosurgeons for a population of 50 million, neurosurgical care was seriously underdeveloped in Myanmar in 2012. Together with the local neurosurgical community, Swiss Neurosurgeons International started a program of assisted education with the aim of increasing the neurosurgical capacity to 60 active neur...
Article
Objective: To know whether motor deficits after tumor surgery are transient is reassuring for the patient and crucial for planning rehabilitation and adjuvant treatment. We analyze the value of postoperative MRI navigated transcranial magnetic stimulation (nTMS) compared to intraoperative MEP monitoring in predicting recovery of motor function. M...
Article
Full-text available
In a single-center, randomized trial involving 361 patients, the use of routine computed tomography after the removal of a chronic hematoma had no advantage over CT performed only in patients with clinical deterioration.
Article
Full-text available
Background Administering stereotactic radiotherapy to the surgical cavity and thus omitting postoperative whole brain radiotherapy (WBRT) is a favored strategy in limited metastatic brain disease. Little is known about the impact of regular magnetic resonance imaging follow-up (MRI FU) in such patient cohorts. The aim of this study is to examine th...
Preprint
Full-text available
The use of mathematical models for personalization of cancer therapies and raising hypothesis of potential clinical impact is an emerging topic in the interface between mathematics and oncology. Here we put forward a mathematical model describing the response of low-grade (WHO grade II) oligodendrogliomas (LGO) to temozolomide (TMZ). The model desc...
Article
OBJECTIVE Decompressive craniectomy (DC) is an established treatment for refractory intracranial hypertension. It is usually followed by autologous cranioplasty (AC), the reinsertion of a patient's explanted bone flap. A frequent long-term complication of AC is bone flap resorption (BFR), which results in disfigurement as well as loss of the protec...
Article
Background: In contrast to isocitrate dehydrogenase (IDH) mutation analysis, which is homogenous within a given tumor, diagnostic errors in histological analysis following the 2016 World Health Organization (WHO) classification could be due to small samples because of histological heterogeneity. Objective: To assess whether the sample size sent...
Article
INTRODUCTION Removing the last part of a tumor near eloquent areas potentially puts neurological functions at risk. Knowing whether postoperative deficits are transient is important not only for the patient but also for the neurosurgeon and oncologist. The objective was to analyze the value of postoperative navigated transcranial magnetic stimulati...
Article
INTRODUCTION Chronic subdural hematoma has a high recurrence rate after surgery and postoperative scans often show substantial residuals, eventually leading to a higher rate of reoperation. However, the benefit of postsurgical imaging for patient outcome remains unknown. METHODS We randomly assigned 368 patients with newly diagnosed chronic subdur...
Article
Full-text available
Imaging-based diagnosis of intra-axial contrast-enhancing brain tumors is frequently challenging. We show that the diagnosis of medulloblastoma (MDB) versus pilocytic astrocytoma (PA) and ependymoma (EPM) profit from computational analyses, based on quantitative image properties (i.e. textural features from apparent diffusion coefficient (ADC)-maps...
Article
OBJECTIVE Cerebral cavernous malformations (CCMs) are frequently diagnosed vascular abnormalities. The hemorrhagic risk associated with the use of long-term antithrombotic medication (ATM) in patients with CCMs is a matter of controversy. The aim of this study was to determine the hemorrhagic risk associated with ATM use in patients diagnosed with...