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Steinsiepe VK, Ruf MT, Rossi M, Fricker-Feer C, Kolenc D, Buser BS, Concu M, Neumayr A, Schneider UC. Human Taenia martis Neurocysticercosis, Switzerland. Emerg Infect Dis 2023; 29:2569-2572. [PMID: 37987597 PMCID: PMC10683805 DOI: 10.3201/eid2912.230697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
Neurocysticercosis is almost exclusively caused by Taenia solium tapeworms. We describe a case of neurocysticercosis in Switzerland caused by infection with Taenia martis, the marten tapeworm, and review all 5 published cases of human infection with the marten tapeworm. In epidemiologically nonplausible cases of neurocysticercosis, zoonotic spillover infections should be suspected.
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Roethlisberger M, Aghlmandi S, Rychen J, Chiappini A, Zumofen DW, Bawarjan S, Stienen MN, Fung C, D'Alonzo D, Maldaner N, Steinsiepe VK, Corniola MV, Goldberg J, Cianfoni A, Robert T, Maduri R, Saliou G, Starnoni D, Weber J, Seule MA, Gralla J, Bervini D, Kulcsar Z, Burkhardt JK, Bozinov O, Remonda L, Marbacher S, Lövblad KO, Psychogios M, Bucher HC, Mariani L, Bijlenga P, Blackham KA, Guzman R. Impact of Very Small Aneurysm Size and Anterior Communicating Segment Location on Outcome after Aneurysmal Subarachnoid Hemorrhage. Neurosurgery 2023; 92:370-381. [PMID: 36469672 DOI: 10.1227/neu.0000000000002212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 08/31/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Very small anterior communicating artery aneurysms (vsACoA) of <5 mm in size are detected in a considerable number of patients with aneurysmal subarachnoid hemorrhage (aSAH). Single-center studies report that vsACoA harbor particular risks when treated. OBJECTIVE To assess the clinical and radiological outcome(s) of patients with aSAH diagnosed with vsACoA after aneurysm treatment and at discharge. METHODS Information on n = 1868 patients was collected in the Swiss Subarachnoid Hemorrhage Outcome Study registry between 2009 and 2014. The presence of a new focal neurological deficit at discharge, functional status (modified Rankin scale), mortality rates, and procedural complications (in-hospital rebleeding and presence of a new stroke on computed tomography) was assessed for vsACoA and compared with the results observed for aneurysms in other locations and with diameters of 5 to 25 mm. RESULTS This study analyzed n = 1258 patients with aSAH, n = 439 of which had a documented ruptured ACoA. ACoA location was found in 38% (n = 144/384) of all very small ruptured aneurysms. A higher in-hospital bleeding rate was found in vsACoA compared with non-ACoA locations (2.8 vs 2.1%), especially when endovascularly treated (2.1% vs 0.5%). In multivariate analysis, aneurysm size of 5 to 25 mm, and not ACoA location, was an independent risk factor for a new focal neurological deficit and a higher modified Rankin scale at discharge. Neither very small aneurysm size nor ACoA location was associated with higher mortality rates at discharge or the occurrence of a peri-interventional stroke. CONCLUSION Very small ruptured ACoA have a higher in-hospital rebleeding rate but are not associated with worse morbidity or mortality.
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Affiliation(s)
- Michel Roethlisberger
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jonathan Rychen
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alessio Chiappini
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Daniel W Zumofen
- Department of Neurological Surgery, Maimonides Medical Center, New York, USA
| | - Schatlo Bawarjan
- Department of Neurosurgery, University Hospital of Göttingen, Göttingen, Germany
| | - Martin N Stienen
- Department of Neurosurgery and Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.,Departments of Neurosurgery and Neuroradiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Christian Fung
- Department of Neurosurgery, University Hospital of Freiburg, Freiburg Germany.,Departments of Neurosurgery and Neuroradiology, University Hospital of Bern, Bern Switzerland
| | - Donato D'Alonzo
- Departments of Neurosurgery and Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Nicolai Maldaner
- Department of Neurosurgery and Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Valentin K Steinsiepe
- Departments of Neurosurgery and Neuroradiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Marco V Corniola
- Departments of Neurosurgery and Neuroradiology, University Hospital of Geneva, Geneva Switzerland
| | - Johannes Goldberg
- Departments of Neurosurgery and Neuroradiology, University Hospital of Bern, Bern Switzerland
| | - Alessandro Cianfoni
- Departments of Neurosurgery and Neuroradiology, Neurocenter of Southern Switzerland, Ospedale regionale, Lugano, Switzerland
| | - Thomas Robert
- Departments of Neurosurgery and Neuroradiology, Neurocenter of Southern Switzerland, Ospedale regionale, Lugano, Switzerland
| | - Rodolfo Maduri
- Clinique de Genolier, Swiss Medical Network, Genolier, Switzerland
| | - Guillaume Saliou
- Departments of Neurosurgery and Neuroradiology, University Hospital of Lausanne, Switzerland
| | - Daniele Starnoni
- Departments of Neurosurgery and Neuroradiology, University Hospital of Lausanne, Switzerland
| | - Johannes Weber
- Departments of Neurosurgery and Neuroradiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Martin A Seule
- Departments of Neurosurgery and Neuroradiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Jan Gralla
- Departments of Neurosurgery and Neuroradiology, University Hospital of Bern, Bern Switzerland
| | - David Bervini
- Departments of Neurosurgery and Neuroradiology, University Hospital of Bern, Bern Switzerland
| | - Zsolt Kulcsar
- Department of Neurosurgery and Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Oliver Bozinov
- Department of Neurosurgery and Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.,Departments of Neurosurgery and Neuroradiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Luca Remonda
- Departments of Neurosurgery and Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Serge Marbacher
- Departments of Neurosurgery and Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Karl-Olof Lövblad
- Departments of Neurosurgery and Neuroradiology, University Hospital of Geneva, Geneva Switzerland
| | - Marios Psychogios
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Heiner C Bucher
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Luigi Mariani
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philippe Bijlenga
- Departments of Neurosurgery and Neuroradiology, University Hospital of Geneva, Geneva Switzerland
| | - Kristine A Blackham
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Raphael Guzman
- Departments of Neurosurgery and Interventional Neuroradiology, University Hospital Basel, University of Basel, Basel, Switzerland
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van Laarhoven CJHCM, Arnold M, Danilova M, Dreval M, Ferrari E, Simonetti BG, Gralla J, Heldner M, Kalashnikova L, Mancuso M, Metso TM, Steinsiepe VK, Strbian D, Tatlisumak T, de Kleijn DPV, de Borst GJ. Delayed Development of Aneurysmal Dilatations in Patients with Extracranial Carotid Artery Dissections. Eur J Vasc Endovasc Surg 2022; 64:595-601. [PMID: 35977695 DOI: 10.1016/j.ejvs.2022.08.010] [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: 06/21/2021] [Revised: 06/22/2022] [Accepted: 08/06/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Dissection of the carotid artery (CaAD) may result in aneurysm formation. The present study was undertaken to evaluate the time of onset of post-dissection extracranial carotid artery aneurysms (ECAA) following CaAD, and to analyse independent risk factors for the development of these aneurysms. METHODS From four European stroke centres, 360 patients with extracranial CaAD were included. The time between the estimated dissection onset and aneurysm formation was analysed, and the clinical risk factors increasing the probability of aneurysm were assessed. RESULTS The median duration of follow up was 5.2 months (range 0 - 24 months). A total of 75 post-dissection ECAAs were identified in 70 patients (19.4%, 95% confidence interval [CI] 15.7 - 23.8). In 52 of 70 (74%) patients, the ECAA was diagnosed at the initial clinical work up of CaAD diagnosis, with the median estimated time of dissection onset to ECAA diagnosis being six days (interquartile range [IQR] 0 - 25). In the remaining 18 (26%) patients who had normal carotid arteries at the initial imaging, the aneurysm diagnosis was made a median of 6.2 months (189 days) from the original imaging (IQR 128 - 198). A Cox proportional hazards model showed that both multiple artery dissections (hazard ratio [HR] 2.58, 95% CI 1.54 - 4.33) and arterial tortuosity (HR 1.79, 95% CI 1.08 - 2.95) were associated with presence of ipsilateral ECAA. CONCLUSION This post hoc cohort analysis showed substantially delayed development of ipsilateral ECAA in patients with CaAD, months after baseline. Multiple dissections and arterial tortuosity are associated with the presence of ECAA and can be used in future prediction models of ECAA development in patients with CaAD.
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Affiliation(s)
| | - Marcel Arnold
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Maria Danilova
- Research Centre of Neurology, University Hospital Moscow, University of Moscow, Moscow, Russia
| | - Marina Dreval
- Research Centre of Neurology, University Hospital Moscow, University of Moscow, Moscow, Russia
| | - Elena Ferrari
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Barbara G Simonetti
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland; Department of Neuropaediatrics, Institute of Paediatrics of Southern Switzerland EOC, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Jan Gralla
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Mirjam Heldner
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Ludmila Kalashnikova
- Research Centre of Neurology, University Hospital Moscow, University of Moscow, Moscow, Russia
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Tiina M Metso
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Valentin K Steinsiepe
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Daniel Strbian
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Turgut Tatlisumak
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dominique P V de Kleijn
- Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Gert J de Borst
- Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
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Steinsiepe VK, Frick H, Jochum W, Fournier JY. Differential Diagnosis of Central Neurocytoma: Two Cases. J Neurol Surg A Cent Eur Neurosurg 2020; 82:599-603. [PMID: 33352608 DOI: 10.1055/s-0040-1718693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Central neurocytoma are rare primary brain tumors of the young and middle-aged adult, typically located in the lateral ventricles. Diagnosis has historically been difficult due to histomorphologic similarities to oligodendroglioma and ependymal tumors and remains a challenge even today. We present two cases of intraventricular central neurocytoma in which careful consideration of the clinical and radiological findings led to reevaluation of the preliminary histological interpretation, highlighting the importance of a meticulous differential diagnosis.
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Affiliation(s)
- V K Steinsiepe
- Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - H Frick
- Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - W Jochum
- Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - J Y Fournier
- Department of Neurosurgery, Hôpital de Sion, Sion, Switzerland
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Maldaner N, Steinsiepe VK, Goldberg J, Fung C, Bervini D, May A, Bijlenga P, Schaller K, Roethlisberger M, Zumofen DW, D'Alonzo D, Marbacher S, Fandino J, Maduri R, Daniel RT, Burkhardt JK, Chiappini A, Robert T, Schatlo B, Seule MA, Weyerbrock A, Regli L, Stienen MN. Patterns of care for ruptured aneurysms of the middle cerebral artery: analysis of a Swiss national database (Swiss SOS). J Neurosurg 2019; 133:1811-1820. [PMID: 31731273 DOI: 10.3171/2019.9.jns192055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/11/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to determine patterns of care and outcomes in ruptured intracranial aneurysms (IAs) of the middle cerebral artery (MCA) in a contemporary national cohort. METHODS The authors conducted a retrospective analysis of prospective data from a nationwide multicenter registry of all aneurysmal subarachnoid hemorrhage (aSAH) cases admitted to a tertiary care neurosurgical department in Switzerland in the years 2009-2015 (Swiss Study on Aneurysmal Subarachnoid Hemorrhage [Swiss SOS]). Patterns of care and outcomes at discharge and the 1-year follow-up in MCA aneurysm (MCAA) patients were analyzed and compared with those in a control group of patients with IAs in locations other than the MCA (non-MCAA patients). Independent predictors of a favorable outcome (modified Rankin Scale score ≤ 3) were identified, and their effect size was determined. RESULTS Among 1866 consecutive aSAH patients, 413 (22.1%) harbored an MCAA. These MCAA patients presented with higher World Federation of Neurosurgical Societies grades (p = 0.007), showed a higher rate of concomitant intracerebral hemorrhage (ICH; 41.9% vs 16.7%, p < 0.001), and experienced delayed cerebral ischemia (DCI) more frequently (38.9% vs 29.4%, p = 0.001) than non-MCAA patients. After adjustment for confounders, patients with MCAA were as likely as non-MCAA patients to experience DCI (aOR 1.04, 95% CI 0.74-1.45, p = 0.830). Surgical treatment was the dominant treatment modality in MCAA patients and at a significantly higher rate than in non-MCAA patients (81.7% vs 36.7%, p < 0.001). An MCAA location was a strong independent predictor of surgical treatment (aOR 8.49, 95% CI 5.89-12.25, p < 0.001), despite statistical adjustment for variables traditionally associated with surgical treatment, such as (space-occupying) ICH (aOR 1.73, 95% CI 1.23-2.45, p = 0.002). Even though MCAA patients were less likely to die during the acute hospitalization (aOR 0.52, 0.30-0.91, p = 0.022), their rate of a favorable outcome was lower at discharge than that in non-MCAA patients (55.7% vs 63.7%, p = 0.003). At the 1-year follow-up, 68.5% and 69.6% of MCAA and non-MCAA patients, respectively, had a favorable outcome (p = 0.676). CONCLUSIONS Microsurgical occlusion remains the predominant treatment choice for about 80% of ruptured MCAAs in a European industrialized country. Although patients with MCAAs presented with worse admission grades and greater rates of concomitant ICH, in-hospital mortality was lower and long-term disability was comparable to those in patients with non-MCAA.
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Affiliation(s)
| | | | | | - Christian Fung
- 2Department of Neurosurgery, University Hospital Bern
- 13Department of Neurosurgery, University Hospital Freiburg, University of Freiburg, Germany
| | - David Bervini
- 2Department of Neurosurgery, University Hospital Bern
| | - Adrien May
- 3Department of Neurosurgery, University Clinic Geneva
| | | | - Karl Schaller
- 3Department of Neurosurgery, University Clinic Geneva
| | | | | | - Donato D'Alonzo
- 5Section for Diagnostic and Interventional Neuroradiology, Department of Radiology, Basel University Hospital, Basel
- 6Department of Neurosurgery, Kantonsspital Aarau
| | - Serge Marbacher
- 5Section for Diagnostic and Interventional Neuroradiology, Department of Radiology, Basel University Hospital, Basel
- 6Department of Neurosurgery, Kantonsspital Aarau
| | - Javier Fandino
- 5Section for Diagnostic and Interventional Neuroradiology, Department of Radiology, Basel University Hospital, Basel
- 6Department of Neurosurgery, Kantonsspital Aarau
| | - Rodolfo Maduri
- 7Department of Clinical Neurosciences, Service of Neurosurgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Roy Thomas Daniel
- 7Department of Clinical Neurosciences, Service of Neurosurgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | | | - Alessio Chiappini
- 8Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Thomas Robert
- 9Department of Neurosurgery, Ospedale Regionale di Lugano, Switzerland
| | - Bawarjan Schatlo
- 10Department of Neurosurgery, University Hospital Göttingen, Germany
| | | | | | - Luca Regli
- 11Department of Neurosurgery, University Hospital Zurich
- 12Clinical Neuroscience Center, University of Zurich, Switzerland; and
| | - Martin Nikolaus Stienen
- 11Department of Neurosurgery, University Hospital Zurich
- 12Clinical Neuroscience Center, University of Zurich, Switzerland; and
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