Publications by authors named "Anders V Holst"

This review summarises the current knowledge of posterior reversible encephalopathy syndrome which is an acute and severe neurological condition characterised by headache, encephalopathy, epileptic seizures, and visual disturbances. Typical radiological findings are cerebral vasogenic oedema, predominantly localised in the posterior cerebral circulation. The exact pathophysiological mechanisms remain unknown but involve dysfunction of the blood-brain barrier.

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This review investigates that there has been an increase in incidental brain MRI findings due to better technology and more scans. These unexpected, asymptomatic anomalies range from harmless to serious, requiring careful clinical and ethical handling. The prevalence of incidental findings with brain MRI is 4.

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Objective: Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP and intracranial pressure pulse wave amplitude (PWA) values in healthy individuals poses ethical challenges, and thus the current documentation remains scarce. This study explores ICP and PWA values for healthy adults without intracranial pathology expected to influence ICP.

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Article Synopsis
  • Idiopathic normal pressure hydrocephalus (iNPH) is a treatable condition lacking reliable prognostic tests, prompting a study on the predictive power of various clinical and imaging parameters following a lumbar infusion test.
  • A retrospective analysis of 127 iNPH patients revealed an 82% positive response rate after ventriculo-peritoneal shunt operations, with responders showing more severe gait issues at baseline.
  • The study concluded that while lumbar infusion test results may boost the chances of a successful shunt outcome, pulse amplitude measures particularly warrant further research due to their promising performance.
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Objective: The aim of the study was to investigate (1) the 30-day, 3-month, and 12-month cumulative mortalities for patients who underwent aneurysm occlusion, and (2) the causes of death, and (3) the potential risk factors for death.

Methods: All patients who underwent surgical clipping or endovascular treatment of a ruptured aneurysm at Copenhagen University Hospital, during the period of January 1, 2017-December 31, 2019, were included and followed up for 12 months. Data regarding vital status, causes of death, comorbidities, treatment, and clinical presentations on admission was collected.

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Arachnoid cysts are frequent incidental findings on brain scans. Traditionally, they are regarded as harmless, congenital structures which do not require surgical treatment. In the rare cases where surgery is indicated it can be due to haemorrhage, hydrocephalus or cranial nerve affection caused by the cyst.

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Endoscopic treatment of hydrocephalus provides an opportunity to reach deeply located intraventricular obstacles and, as such, it is currently the primary treatment for obstructive hydrocephalus in Denmark. This review provides an overview of conditions treatable with endoscopic neurosurgery including the surgical principles, success rate and challenges with this neurosurgical procedure.

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This review summarises the current knowledge of normal pressure hydrocephalus (NPH), which is considered to be a reversible cause of dementia. Early identification is important to select patients for surgical treatment with ventricular shunting. The symptoms of NPH are gait disturbance, cognitive dysfunction and urinary incontinence.

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Background: Infusion tests, which measure resistance to outflow (R), are used in selecting patients suspected for idiopathic normal pressure hydrocephalus (iNPH) for shunt surgery. Infusion tests can be performed through an external ventricular drain (EVD). A 24-hour time gap from EVD insertion to an infusion test is a routine practice at our department due to concerns that the surgical procedure might influence the test results in the immediate postoperative period.

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Background: Implant infection and obstruction are major complications for ventriculoperitoneal shunts in patients with post-haemorrhagic hydrocephalus. In an effort to (1) reduce the incidence of these complications, (2) reduce the rate of shunt failure and (3) shorten the duration of neurosurgical hospitalisation, we have implemented valveless ventriculoperitoneal shunts at our department for adult patients with post-haemorrhagic hydrocephalus and haemorrhagic cerebrospinal fluid at the time of shunt insertion.

Methods: All adult patients (>18 years old) treated for post-haemorrhagic hydrocephalus with ventriculoperitoneal shunting at our institution from 1 January 2008 to 31 December 2014 were included in this retrospective population-based consecutive cohort study.

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Background: Ventriculostomy is one of the most common neurosurgical procedures and an important tool in the treatment and monitoring of elevated intracranial pressure. Low accuracy has frequently been reported in the literature with risk of drain misplacement over 20% and with a need for reinsertion in up to 40%. As an alternative to the tunnelated EVD technique we often use a bolt-connected EVD.

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The best surgical treatment of cerebral arachnoid cysts is yet to be established. Treatment options are shunting, endoscopic fenestration or microsurgical fenestration through craniotomy.Data from 69 patients with cerebral arachnoid cysts treated in our institution between 1997 and 2007 were reviewed.

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Background: The collagenolytic matrix metalloproteinase-8 (MMP-8) is essential for normal tissue repair but is often overexpressed in wounds with disrupted healing. Our aim was to study the impact of a local excess of this neutrophil-derived proteinase on wound healing using recombinant adenovirus-driven transduction of full-length Mmp8 (AdMMP-8).

Methods: The effect of MMP-8 overexpression was evaluated in dermal fibroblasts and in two wound healing models in male Wistar rats: subcutaneously positioned ePTFE catheters and linear incisional skin wounds.

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Tetracykline is a first-line treatment of the common skin disorder acne vulgaris. A rare side effect of tetracycline treatment is intracranial hypertension also called pseudotumor cerebri (PTC). We report a severe case of PTC with cranial nerve palsy and visual loss in a 16 year old girl following acne vulgaris treatment with tetracycline.

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