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Urbonas M, Raskauskiene N, Deltuva V, Bunevicius A. Quantitative Evans index estimation using ultrasonographic measurement of the optic nerve sheath diameter in supine and upright position. Acta Neurochir (Wien) 2022; 164:1755-1764. [PMID: 35595855 DOI: 10.1007/s00701-022-05234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/29/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to quantitatively assess Evans index (EI) using ultrasonographic optic nerve sheath diameter (ONSD) measurements in supine and upright position in normal pressure hydrocephalus (NPH) patients. METHODS Ultrasonographically ONSD was measured in a supine and upright position before and 4-5 days after the ventriculoperitoneal shunt surgery. The changes of the ONSD between supine and upright positions were calculated as ∆ONSD = sONSD-uONSD and as the variation ONSD_V = 100% × [(sONSD - uONSD)/sONSD]. Multiple linear regression analyses were conducted to assess associations between EI and the variation of ONSD. We derived the mathematical function to predict EI. Bland-Altman analysis was applied to evaluate the accuracy and precision of the EI prediction. RESULTS Thirteen adult patients (mean age 61.8 ± 11.1 (SD) years; 6 (46%) female) undergone VP shunt implantation for NPH. The mean EI was 0.432 (95% CI, 0.393-0.471) preoperatively and 0.419 (95% CI, 0.373-0.466) postoperatively (p = 0.066). There is a decrease of the ONSD during positional changes from supine to upright position and pre- and postoperative EI correlated with preoperative variation ONSD_V1 (r = - 0.610 and - 0.648, p < 0.05). The mathematical function for preoperative EI estimation was EIpreop = 0.504 - 0.022 × ONSD_V1 + 0.101 × gender (M = 0; W = 1), (Durbin-Watson value = 1.94), and for postoperative was EIpostop = 0.487 - 0.022 × ONSD_V1 + 0.117 × gender; (Durbin-Watson value 2.23). CONCLUSIONS Ultrasonographic ONSD measurements in supine and upright position provide a potential method to quantify EI that can be conducted at the bedside.
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Affiliation(s)
- Mindaugas Urbonas
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania.
- Neuroscience Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Nijole Raskauskiene
- Neuroscience Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vytenis Deltuva
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
- Neuroscience Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Adomas Bunevicius
- Neuroscience Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania
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Blay JY, Casali P, Bouvier C, Dehais C, Galloway I, Gietema J, Halámková J, Hindi N, Idbaih A, Kinloch E, Klümpen HJ, Kolarova T, Kopeckova K, Lovey J, Magalhaes M, Oselin K, Piperno-Neumann S, Ravnsbaek A, Rogasik M, Safwat A, Scheipl S, Seckl M, Taylor J, Temnyk M, Trama A, Urbonas M, Wartenberg M, Weinman A. European Reference Network for rare adult solid cancers, statement and integration to health care systems of member states: a position paper of the ERN EURACAN. ESMO Open 2021; 6:100174. [PMID: 34139485 PMCID: PMC8219752 DOI: 10.1016/j.esmoop.2021.100174] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- J-Y Blay
- Department of Medical Oncology, Centre Leon Berard & Centre de Recherche en Cancérologie de Lyon (CRCL) & Université Claude Bernard Lyon 1, Lyon, France.
| | - P Casali
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | - C Bouvier
- Neuroendocrine Cancer Unit, Royal Free Hospital, London, UK
| | - C Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - I Galloway
- Melanoma Patient Network Europe, OcuMel, Birmingham, UK
| | - J Gietema
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | - J Halámková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - N Hindi
- Institute of Biomedicine of Sevilla (IBIS, HUVR, CSIC, Universidad de Sevilla), Virgen, Virgen del Rocío University Hospital, Seville, Spain
| | - A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | | | - H-J Klümpen
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - T Kolarova
- International Neuroendocrine Cancer Alliance, Boston, USA
| | - K Kopeckova
- Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - J Lovey
- National Institute of Oncology, Budapest, Hungary
| | - M Magalhaes
- Oncology Department, Centro Hospitalar e Universitário Universitário do Porto, Porto, Portugal
| | - K Oselin
- Department of Chemotherapy, Clinic of Haematology and Oncology, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | | | - A Ravnsbaek
- Oncology Department, and Danish Centre for Particle Therapy, University Hospital, Aarhus, Denmark
| | - M Rogasik
- Research and Innovation Department, Centre Léon Bérard, Lyon, France
| | - A Safwat
- Oncology Department, and Danish Centre for Particle Therapy, University Hospital, Aarhus, Denmark
| | - S Scheipl
- Medical University of Graz, Graz, Austria
| | - M Seckl
- Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, London, UK
| | - J Taylor
- Thyroid Cancer Alliance, Rotterdam, The Netherlands
| | - M Temnyk
- Maria Skłodowska Curie Institute, Warsaw, Poland
| | - A Trama
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | - M Urbonas
- Lithuanian University of Health Sciences, Department of Neurosurgery, Kaunas, Lithuania
| | | | - A Weinman
- EURORDIS-Rare Diseases Europe (European Patient Organisation for Rare Diseases)
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Tamasauskas A, Bunevicius A, Matukevicius A, Radziunas A, Urbonas M, Deltuva V. Extended pterional approach for initial surgical management of craniopharyngiomas: a case series. Turk Neurosurg 2015; 24:174-83. [PMID: 24831357 DOI: 10.5137/1019-5149.jtn.6995-12.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
AIM Treatment of craniopharyngiomas remains challenging. The aim of this study was to evaluate results of initial surgical management of craniopharyngiomas via the extended pterional approach. MATERIAL AND METHODS Nineteen patients (10 female; median age of 23 years; ranging from 10 months to 67 years) undergone initial surgery for craniopharyngiomas through the extended pterional approach. Data were retrospectively collected by reviewing medical records, operative reports and imaging results. RESULTS The median size of craniopharyngiomas was 3.2 cm (range 1.3 - 4.8). Visual deterioration (n=12) and headache (n=10) were the most common symptoms on admission. After surgery, one patient died due to medical complications, 12 patients developed diabetes insipidus and eight patients developed anterior pituitary dysfunction. Median follow-up period was 9 years (range 2 - 13). Patients with progression of craniopharyngioma (n=5) when compared to patients without progression of craniopharyngioma (n=14) were significantly younger at the time of surgery, had less visual deterioration before surgery and had higher rates of not changed vision after surgery. Children had larger craniopharyngiomas when compared to adults. CONCLUSION Initial surgery for craniopharyngioma via the extended pterional approach is a safe and effective treatment option with low postoperative mortality, and acceptable postoperative morbidity and recurrence rate.
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Affiliation(s)
- Arimantas Tamasauskas
- Lithuanian University of Health Sciences, Department of Neurosurgery, Kaunas, Lithuania
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