Publications by authors named "Felix Arlt"

Background: Acute subdural hematoma is a critical condition, leading to significant morbidity and mortality. Despite advancements in surgical techniques, a portion of patients only show limited clinical improvement post-evacuation. Surgical intervention decisions are critically important, as they can either improve or worsen a patient's condition.

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Sphenoid wing meningiomas (SWM) frequently compress structures of the optic pathway, resulting in significant visual dysfunction characterized by vision loss and visual field deficits, which profoundly impact patients' quality of life (QoL), daily activities, and independence. The objective of this study was to assess the impact of SWM surgery on patient-reported outcome measures (PROMs) regarding postoperative visual function. The Visual Function Score Questionnaire (VFQ-25) is a validated tool designed to assess the impact of visual impairment on quality of life.

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Background And Importance: Arteriovenous malformations (AVMs) are complex vascular anomalies that pose significant risks, including intracranial hemorrhage and neurological deficits. Surgical resection is the preferred treatment, requiring precise intraoperative imaging to ensure complete removal while preserving critical structures. This case report presents the first combined use of hyperspectral imaging (HSI) and indocyanine green video angiography (ICG VA) to visualize perfusion during brain AVM surgery, highlighting the potential benefits of these advanced imaging techniques.

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Article Synopsis
  • Obstructive hydrocephalus (HCP) related to vestibular schwannoma (VS), particularly in larger tumors, often requires patients to undergo ventriculo-peritoneal (VP) surgery even after the tumor is removed; this study investigates why some patients still need VP surgery post-surgery.
  • Using advanced MRI techniques, the research assessed brain volumes and found that a specific brain ventricle to total brain volume (VTB) ratio can help predict whether patients will need a VP shunt after surgery, with a sensitivity of 67% and specificity of 81% based on optimal threshold values.
  • Key factors associated with dependency on VP shunts include having a higher preoperative
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Facial nerve paralysis is a severe dysfunction after vestibular schwannoma (VS) surgery. This monocentric study analyzed 61 patients who underwent sporadic VS surgery in a standardized manner. The primary endpoint was the facial nerve outcome (FNO) at 3 months after VS surgery.

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Seizure is a common symptom of meningioma that has a major impact on patients' quality of life. The purpose of this study was to identify predictive factors for the occurrence of preoperative and postoperative seizures. The data of patients with resection of histologically confirmed meningioma at University Hospital Leipzig from 2009 to 2018 were retrospectively examined.

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Objective: Cranial meningioma surgeries often involve significant blood loss and transfusions. Tranexamic acid (TXA) has been used to reduce blood loss in various surgeries. This meta-analysis of randomized placebo-controlled trials (RCTs) evaluates the impact of TXA in cranial meningioma surgery.

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Background: Although postoperative quality of life (QoL) has been studied in relation to a variety of aspects following meningioma resection, the impact of meningiomas on sexual life has not been investigated. The aim of this study is to determine the impact of cranial meningioma surgery on patients' postoperative sexual life.

Methods: A standardized questionnaire, anonymous and based on the Arizona Sexual Experiences Scale (ASEX), was sent to 87 patients who had been selected for participation in the study based on the following criteria: a postoperative Karnofsky performance of ≥ 80 and below 60 years of age at diagnosis.

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Article Synopsis
  • The study investigates the impact of dexamethasone on postoperative outcomes in patients undergoing meningioma surgery, despite limited prospective evidence supporting its routine use.
  • A total of 148 patients were retrospectively analyzed to assess safety, complications, and changes in their performance status (KPS) at 3 and 12 months post-surgery, along with monitoring for peritumoral T2/FLAIR hyperintensity.
  • Results indicated that dexamethasone did not increase the incidence of surgical complications but was linked to significant improvements in KPS over time and reduced peritumoral hyperintensity, suggesting a potential benefit in patient recovery.
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Objective: Spinal meningiomas (SM) account for 25%-46% of all primary spinal tumors and show an excellent long-term disease control in case of complete resection. Therefore, the postoperative functional outcome is of high importance. To date, reports on dorsally located SM are scarce.

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  • Homozygous CDKN2A/B deletions are linked to a higher risk of meningioma recurrence, but research on heterozygous deletions is limited.
  • A meta-analysis reconstructed individual patient data from four studies involving 2,521 participants to analyze progression-free survival (PFS) rates based on CDKN2A/B deletion status.
  • The findings indicated that both types of deletions significantly shorten time to progression, with median PFS times being drastically lower for those with deletions compared to wild-type status (180 months for wild-type vs. 11 months for homozygous deletions).
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Background:  In general, sufficient anchoring of screws in the bone material ensures the intended primary stability.

Methods:  Shape memory materials offer the option of using temperature-associated deformation energy in a targeted manner to compensate the special situation of osteoporotic bones or the potential lack of anchoring. An expansion screw was developed for these purposes.

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  • Damage to white matter tracts, particularly the frontal aslant tract (FAT), can lead to significant neurological issues post-brain tumor surgery, affecting functions like speech and movement.
  • In a study with 15 right-handed patients who had left hemispheric tumors, researchers conducted FAT tractography before and after surgery to evaluate neurological performance and aphasia scores.
  • The findings revealed that the preoperative integrity of the left FAT predicted pre-surgery aphasia scores, while postoperative evaluations of the same tract were significant indicators of expected aphasia outcomes three months later.
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Background: Unplanned early readmission (UER) within 30 days after hospital release is a negative prognostic marker for patients diagnosed with glioblastoma (GBM). This work analyzes the impact of UER on the effects of standard therapy modalities for GBM patients, including the extent of resection (EOR) and adjuvant therapy regimen.

Methods: Records were searched for patients with newly diagnosed GBM between 2014 and 2020 who were treated at our facility.

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Medial sphenoid wing meningiomas (MSWM) are surgically challenging skull base tumors. Irregular tumor shapes are thought to be linked to histopathology. The present study aims to investigate the impact of tumor shape on postoperative functioning, progression-free survival, and neuropathology.

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Objective: Patient positioning is a matter of ongoing debate in the surgical treatment of vestibular schwannoma (VS). Main endpoints of this discussion are preservation of facial nerve functioning, extent of resection, and complications. In this meta-analysis, we aim to investigate the impact of patient positioning on VS surgery the retrosigmoid approach.

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Background: It is suspected that microbiome-derived trimethylamine N-oxide (TMAO) may enhance platelet responsiveness and accordingly be thrombophilic. The purpose of this prospective observational study is to evaluate TMAO in patients with subarachnoid hemorrhage (SAH) and compare it with a control group. A secondary aim was to investigate TMAO in the cerebrospinal fluid (CSF) from SAH patients.

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Background: Tractography has become a standard tool for planning neurosurgical operations and has been proven to be useful for risk stratification. In various conditions, tractography-derived white matter integrity has been shown to be associated with neurological outcome. Postoperative performance has been shown to be a prognostic marker in glioma.

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Background: The use of intraoperative neurophysiological monitoring, including direct nerve stimulation (especially the facial nerve), acoustic evoked potentials (AEP) and somatosensory evoked potentials (SSEP), is a helpful tool in the microsurgery of vestibular schwannoma to prevent nerve injury. Patient characteristics and intraoperative and postoperative variables might also influence the postoperative facial nerve function. The study was performed to investigate these variables and the intraoperative neurophysiological monitoring values.

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The resection of tumors within the primary motor cortex is a constant challenge. Although tractography may help in preoperative planning, it has limited application. While it can give valuable information on subcortical fibers, it is less accurate in the cortical layer of the brain.

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Background: Brain metastasis (BM) of colorectal cancer is a disease with a poor prognosis of only a few months survival. However, it is difficult to estimate the individual prognosis of each patient due to the lack of definitive prognosis parameters. The number of metastases and the Karnofsky performance score are known predictors for survival.

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Background: IDH-wild-type glioblastoma (GBM) is the most frequent brain-derived malignancy. Despite intense research efforts, it is still associated with a very poor prognosis. Several parameters were identified as prognostic, including general physical performance.

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The healthcare system has been placed under an enormous burden by the SARS-CoV-2 (COVID-19) pandemic. In addition to the challenge of providing sufficient care for COVID-19 patients, there is also a need to ensure adequate care for non-COVID-19 patients. We investigated neurosurgical care in a university hospital during the pandemic.

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Objective:  Treatment for newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma (GBM) includes maximum safe resection, followed by adjuvant radio(chemo)therapy (RCx) with temozolomide. There is evidence that it is safe for GBM patients to prolong time to irradiation over 4 weeks after surgery. This study aimed at evaluating whether this applies to GBM patients with different levels of residual tumor volume (RV).

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Low-profile flow diverter stents (FDS) quite recently amended peripheral segments as targets for hemodynamic aneurysm treatment; however, reports on outcomes, especially later than 3 months, are scarce. This study therefore reports our experience with the novel silk vista baby (SVB) FDS and respective outcomes after 8 and 11 months with special respect to specific adverse events. Forty-four patients (mean age, 53 years) harboring 47 aneurysms treated with the SVB between June 2018 and December 2019 were included in our study.

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