Roel Haeren

Roel Haeren
Maastricht Universitair Medisch Centrum

M.D. Ph.D.
Analysis of cerebral microvasculature in DCI

About

44
Publications
7,499
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175
Citations
Introduction
Neurosurgeon at Maastricht University Medical Center. Clinical interests: vascular neurosurgery, spine surgery, neurotrauma. Research interest: vascular neurosurgery, DCI, cerebral microcirculation (patho)physiology, autoregulation, TBI, economic evaluations.
Additional affiliations
January 2020 - December 2020
Helsinki University Central Hospital
Position
  • Fellow
December 2019 - present
Maastricht University Medical Center, Netherlands
Position
  • Neurosurgeon
September 2013 - December 2019
Maastricht Universitair Medisch Centrum
Position
  • Neurosurgeon in training
Education
September 2005 - August 2012
Maastricht University
Field of study
  • Medicine

Publications

Publications (44)
Article
Full-text available
The glycocalyx is a gel-like layer lining the luminal surface of the endothelium. The glycocalyx exerts an important barrier role because it prevents exposure of plasma components to the endothelial surface. Disruption of the glycocalyx by local inflammation or ischemia results in decreased glycocalyx thickness which is associated with a number of...
Article
Full-text available
Purpose Surgical resection of intracranial meningiomas in patients that are 80 years old and older, i.e. very old patients, is increasingly considered. Meningiomas with a largest diameter of at least 5 cm—‘giant meningiomas’—form a distinct entity, and their surgical resection is considered more difficult and prone to complications. Here, we evalua...
Article
Full-text available
Managing traumatic brain injury (TBI) patients with a cerebral perfusion pressure (CPP) near to the cerebral autoregulation (CA)-guided "optimal" CPP (CPPopt) value is associated with improved outcome and might be useful to individualize care, but has never been prospectively evaluated. This study evaluated the feasibility and safety of CA-guided C...
Article
Full-text available
The glycocalyx is an important constituent of blood vessels located between the bloodstream and the endothelium. It plays a pivotal role in intercellular interactions in neuroinflammation, reduction of vascular oxidative stress, and provides a barrier regulating vascular permeability. In the brain, the glycocalyx is closely related to functions of...
Article
Full-text available
The blood-brain barrier (BBB) is dysfunctional in temporal lobe epilepsy (TLE). In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of seizure induced angiogenesis, barriergenesis and m...
Article
The cerebral pressure reactivity index (PRx), through intracranial pressure (ICP) measurements, informs clinicians about the cerebral autoregulation (CA) status in adult sedated traumatic brain injury (TBI) patients. Using PRx in clinical practice is currently limited by variability over shorter monitoring periods. We applied an innovative method t...
Article
Full-text available
Objective: Anterior communicating artery aneurysms (ACoAAs) are challenging to treat both surgically and endovascularly. In this study, we evaluate the treatment-related morbidity and clinical outcome of microsurgical clipping and endovascular treatment for a consecutive series of unruptured ACoAAs while the treatment paradigm was in transition fr...
Article
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Background and objectives The modified Rankin Scale (mRS) is one of the most frequently used outcome measures in trials in patients with an aneurysmal subarachnoid hemorrhage (aSAH). The assessment method of the mRS is often not clearly described in trials, while the method used might influence the mRS score. The aim of this study is to evaluate th...
Article
Introduction: Intensive care management for TBI patients aims to prevent secondary cerebral damage. Targeted temperature management is one option to prevent cerebral damage, as hypothermia may have protective effects. By conducting a systematic literature review, we evaluated (1) the presence of a temperature difference (gradient) between brain te...
Article
Introduction: There are two treatment modalities for aneurysmal subarachnoid hemorrhage: endovascular treatment and neurosurgical clipping. Results of economic evaluations are needed to gain insight into the relationship between clinical effectiveness and costs of these treatment modalities. This important information can inform both clinical deci...
Article
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Objective: Spinal meningiomas are neurosurgical rarities that manifest with progressive para- or tetraparesis. The effect of timing of surgery on the recovery after the loss of walking ability is poorly known. We studied the effect of timing of surgery on restoring walking ability in surgically-treated spinal meningioma patients. Methods: Using...
Article
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BACKGROUND: In recent years, three-dimensional (3D) digital exoscope systems have been developed and reported to form an adequate alternative to the conventional operating microscope. OBJECTIVE: To illustrate essential and practical features in a surgical video comparing a robotic arm 3D digital exoscope and a conventional operating microscope to c...
Article
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Background Can elderly patients with thoracic meningioma and severe paraparesis benefit from delayed surgery? Case Description Two out of three octogenarians with severe preoperative paraparesis (all wheelchair-bound) were able to walk again following delayed (60–120 days from onset of deficit) surgical resection of thoracic spinal meningiomas. C...
Article
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Background: Intracranial intraparenchymal schwannomas (IS) are rare tumors that have mainly been described in case reports. Here, we report on a case of a brainstem IS and included a comprehensive literature review. Case Description: A 74-year-old man presented with progressive gait disturbances. CT- and MRI-imaging revealed a contrast-enhancing ma...
Article
Full-text available
Background Carotid artery dissections (CADs) are a relatively rare disorder, whereas intracranial aneurysms (IAs) form a common cerebrovascular pathology. Since both vascular entities share similar risk factors and associations with connective tissue and vascular disorders, a common pathogenesis has been suggested. Here, we present a case of the co...
Article
A 39-year-old man with a history of von Hippel-Lindau (VHL) syndrome presented with acute onset of headache at our emergency department. He previously underwent multiple neurosurgical resections of cerebellar and spinal hemangioblastomas. During his most recent surgery, which was roughly 1 year ago, a symptomatic right-sided large and cystic cerebe...
Article
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Objective: Metabolic demand increases with neuronal activity and adequate energy supply is ensured by neurovascular coupling (NVC). Impairments of NVC have been reported in the context of several diseases and may correlate with disease severity and outcome. Voltage-gated Ca ²⁺ -channels (VGCCs) are involved in the regulation of vasomotor tone. In t...
Article
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Despite extensive research, the exact pathomechanisms associated with epileptic seizure formation and propagation have not been elucidated completely. Two-photon imaging (2PI) is a fluorescence-based microscopy technique that, over the years, has been used to evaluate pathomechanisms associated with epileptic seizures and epilepsy. Here, we review...
Article
Cerebrovascular, particularly open aneurysm, surgery opportunities are decreasing. Improving training by establishing cerebrovascular fellowships may compensate for this decrease to maintain quality standards. We believe European vascular neurosurgical education would greatly benefit in the long-term from these potential developments.
Article
Full-text available
Background: The pathophysiology of temporal lobe epilepsy (TLE) has not been elucidated yet. A reduced functioning and integrity of the blood-brain barrier has been described in epileptogenesis and epilepsy. Moreover, microcirculatory alterations have been related to TLE and hippocampal sclerosis. An important barrier function is exerted by the gly...
Article
Background The use of a digital 3D exoscope system in neurosurgery is increasing as an alternative to the operative microscope. The objective of this study was to compare the use of a digital 3D exoscope system to that of a standard operating microscope as a neurosurgical visualization tool in a highly challenging, experimental setting. Methods En...
Article
Introduction Identifying costs and values in healthcare interventions as well as the ability to measure and consider costs relative to value for patients are pivotal in clinical decision-making and medical education. This study explores residents' preferences in educating value-based healthcare (VBHC) during postgraduate medical education. Explori...
Article
Full-text available
Increased oxidative stress has been associated with several neurodegenerative diseases such as Alzheimer’s disease, but also with neurological diseases sharing pathophysiological pathways like epilepsy. Lipofuscin is a non‐degradable end‐product of oxidative stress; its cerebral presence reflects the cumulative amount of oxidative stress the brain...
Article
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Tijdens een wakkere hersenoperatie worden hersengebieden in kaart gebracht die betrokken zijn bij taalfuncties. In een onderzoek waarvan hier verslag wordt gedaan, werden van patiënten die in aanmerking kwamen voor epilepsiechirurgie de expressieve en receptieve taalfunctie en de aanvalsfrequentie pre- en postoperatief onderzocht. De resultaten ton...
Article
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Gezichtsvelduitval na epilepsiechirurgie: een nieuwe scoringsmethode Anterieure temporaalkwabresectie als behandeling voor medicatie-resistente epilepsie kan gezichtsvelduitval veroorzaken. Deze uitval bestaat uit een homonieme contralaterale bovenste kwadrantanopsie, ook wel een 'pie in the sky' genoemd. De incidentie varieert van 15% tot 90% in d...
Article
Full-text available
Anterieure temporaalkwabresectie als behandeling voor medicatie-resistente epilepsie kan gezichtsvelduitval veroorzaken. Deze uitval bestaat uit een homonieme contralaterale bovenste kwadrantanopsie, ook wel een ‘pie in the sky’ genoemd. De incidentie varieert van 15% tot 90%. In deze bijdrage wordt een kwantitatieve perimetrie-methode beschreven o...
Article
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Background: Anterior temporal lobectomy (ATL) as a treatment for drug-resistant temporal lobe epilepsy (TLE) frequently causes visual field deficits (VFDs). Reported VFD encompasses homonymous contralateral upper quadrantanopia. Its reported incidence ranges from 15 to 90%. To date, a quantitative method to evaluate postoperative VFD in static per...
Article
Full-text available
FULL TEXT: https://authors.elsevier.com/a/1W-6PbXTOpTs3 Introduction The cerebral microcirculation and its glycocalyx, a matrix coating the luminal endothelium, are key regulators of capillary permeability and cerebral blood flow. Microvascular abnormalities are described in several neurological disorders. However, assessment of the cerebral micr...
Article
Background We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbi...
Article
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Background: The regulation of cerebral arterial vasomotor tone involves several mechanisms. The role of sympathetic nerves and the adrenergic neurotransmitter, noradrenaline (NA), has been subject of debate for decades. Moreover, the specific role of endothelin-1 (ET-1) in cerebral arterial vasoconstriction has not been elucidated to date. In this...
Article
Introduction: Adequate functioning of the blood-brain barrier (BBB) is important for brain homeostasis and neuronal function. Disruption of the BBB has been described in several neurological disorders, including increased seizure susceptibility. The glycocalyx is coating the luminal side of the endothelium and exerts important barrier functions. Be...
Article
Full-text available
Glioblastoma is the most common and most fatal primary malignant brain tumour. In this case we report on a 49-year-old man presenting with a postoperative wound healing problem, 2 weeks after a burr hole biopsy of a pathology-proven glioblastoma. Antibiotics were started for a suspected wound infection. Since treatment was unsuccessful, a subsequen...
Article
Full-text available
Introduction: Adequate functioning of the blood-brain barrier (BBB) is important for brain homoeostasis and normal neuronal function. Disruption of the BBB has been described in several neurological diseases. Recent reports suggest that an increased permeability of the BBB also contributes to increased seizure susceptibility in patients with epile...
Article
Bij medicatieresistente temporaalkwabepilepsie (temporal lobe epilepsy, TLE) is een anterieure temporaalkwabresectie (anterior temporal lobectomy (ATL) met amygdalohippocampectomie een succesvolle behandeling met ongeveer 70% kans op aanvalsvrijheid (Tellez-Zenteno et al., 2005). Wij presenteren een patiënte met een medicatieresistente TLE die ope...
Article
Full-text available
Het onderzoek naar de bloed-hersenbarrière (BHB) is de laatste jaren in een stroomversnelling geraakt. Het goed functioneren van de BHB lijkt namelijk erg belangrijk te zijn in het voorkomen van neurologische aandoeningen. Hierdoor is ons inzicht in veel neurologische aandoeningen, waaronder epilepsie, aan het veranderen. Ze worden minder als puur...
Article
We present a patient with drug-resistant right-sided temporal lobe epilepsy, caused by a ganglioglioma of the parahippocampal gyrus. Preoperatively, the patient was also known to have dyslexia. A right-sided anterior temporal lobectomy, including complete lesionectomy, was performed. Several months after the otherwise uncomplicated procedure, the p...
Article
We present a patient with drug-resistant right-sided temporal lobe epilepsy, caused by a ganglioglioma of the parahippocampal gyrus. Preoperatively, the patient was also known to have dyslexia. A right-sided anterior temporal lobectomy, including complete lesionectomy, was performed. Several months after the otherwise uncomplicated procedure, the p...
Article
Introduction: Blood-brain barrier dysfunction allows for alterations in brain homeostasis and neuronal functions. It has been shown that these alterations are involved in generating seizures. Recent studies have pointed out that leakage of nutrients and proteins are common in epileptic brain tissue. Aim of our study is to characterize blood-brain b...
Article
Introduction: Blood-brain barrier dysfunction allows for alterations in brain homeostasis and neuronal functions. It has been shown that these alterations are involved in generating seizures. The vessel wall consists of three layers. The inner layer, called intima, is the most important barrier layer containing the endothelium, basement membrane an...
Article
Full-text available
Intraosseous cavernous hemangiomas of the skull are rare lesions for which the origin is unclear. The authors present a case in which there was a radiologically documented history of trauma preceding the development of a hemangioma in the frontal bone. In a review of the literature the authors found 83 cases of skull hemangiomas, and 43% of the les...
Article
Full-text available
Background: Patients with transient ischaemic attack (TIA) or minor stroke generally receive, besides secondary prevention, no regular follow up care after discharge directly home from the Emergency Room or TIA outpatient clinic; because it is believed that they will experience no consequences. Objectives: To explore whether the TIA and minor st...
Conference Paper
Introduction Patient suffering from a minor stroke or TIA do not receive the needed outpatient care, because it is believed that they experience no difficulties. We have initiated research into long term problems and possible health care models. The aim of this study is to explore whether TIA or minor stroke patients experience difficulties after d...

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Project (1)
Project
The aim of this study to visualize the sublingual, cortical and hippocampal endothelial glycocalyx in patients with temporal lobe epilepsy and control patients, who will undergo a craniotomy for other indications.