Publications by authors named "Kretschmer Thomas"

Background: Skull base tumors represent a small subset of intracranial neoplasm. Due to their proximity to critical neurovascular structures, their resection often leads to morbidity. As a result, surgical interventions can exacerbate symptoms or cause new deficits, thereby impacting the patients' perceived quality of life (QoL).

View Article and Find Full Text PDF

Objective: Common peroneal (fibular) neuropathy is the most common mononeuropathy of the lower extremity. Despite this, there are surprisingly few studies on the topic, and a knowledge gap remains in the literature. As one attempts to address this knowledge gap, a core outcome set (COS) is needed to guide the planning phases of future studies to allow synthesis and comparability of these studies.

View Article and Find Full Text PDF

Background And Objectives: Endovascular treatment of cerebral aneurysms has tremendously advanced over the past decades. Nevertheless, aneurysm residual and recurrence remain challenges after embolization. The objective of this study was to elucidate the portion of embolized aneurysms requiring open surgery and evaluate whether newer endovascular treatments have changed the need for open surgery after failed embolization.

View Article and Find Full Text PDF

Objective: When considering traumatic brachial plexus and upper extremity nerve injuries, iatrogenic nerve injuries, and nontraumatic nerve injuries, brachial plexus and upper extremity nerve injuries are commonly encountered in clinical practice. Despite this, data synthesis and comparison of available studies are difficult. This is at least in part due to the lack of standardization in reporting and a lack of a core outcome set (COS).

View Article and Find Full Text PDF
Article Synopsis
  • Ulnar neuropathy at the elbow (UNE) affects a notable portion of the population, but there is no clear agreement on treatment methods due to inconsistent outcome reporting in studies.
  • This study aimed to create a Core Outcome Set for UNE (COS-UNE) using the modified Delphi method, involving stages like literature review and consensus surveys.
  • The final COS-UNE includes 22 key outcomes spanning various domains, establishes guidelines for reporting, and stresses the importance of consistent data collection in future research on UNE.
View Article and Find Full Text PDF

The treatment of peripheral nerve pathologies requires a rapid and precise diagnosis. However, the correct identification of nerve pathologies is often difficult and valuable time is lost in the process. In this position paper of the German-Speaking Group for Microsurgery of Peripheral Nerves and Vessels (DAM), we describe the current evidence for various perioperative diagnostics for the detection of traumatic peripheral nerve lesions or compression syndromes.

View Article and Find Full Text PDF

Background: In the first part of this report, the European Association of Neurosurgical Societies' section of peripheral nerve surgery presented a systematic literature review and consensus statements on anatomy, classification, and diagnosis of thoracic outlet syndrome (TOS) along with a subclassification system of neurogenic TOS (nTOS). Because of the lack of level 1 evidence, especially regarding the management of nTOS, we now add a consensus statement on nTOS treatment among experienced neurosurgeons.

Objective: To document consensus and controversy on nTOS management, with emphasis on timing and types of surgical and nonsurgical nTOS treatment, and to support patient counseling and clinical decision-making within the neurosurgical community.

View Article and Find Full Text PDF

Aim: Peripheral nerve tumors (PNT) are rare lesions. To date, no systematic multicenter studies on epidemiology, clinical symptoms, treatment strategies and outcomes, genetic and histopathologic features, as well as imaging characteristics of PNT were published. The main goal of our PNT Registry is the systematic multicenter investigation to improve our understanding of PNT and to assist future interventional studies in establishing hypotheses, determining potential endpoints, and assessing treatment efficacy.

View Article and Find Full Text PDF

Reflecting the first wave COVID-19 pandemic in Central Europe (i.e. March 16th-April 15th, 2020) the neurosurgical community witnessed a general diminution in the incidence of emergency neurosurgical cases, which was impelled by a reduced number of traumatic brain injuries (TBI), spine conditions, and chronic subdural hematomas (CSDH).

View Article and Find Full Text PDF

Background: Thoracic outlet syndrome (TOS) refers to a group of disorders in which there is compression of and/or damage to the neurovascular structures at the thoracic outlet, i.e., at the transition from chest to neck.

View Article and Find Full Text PDF
Article Synopsis
  • Despite many studies on thoracic outlet syndrome (TOS), there is still controversy due to insufficient high-quality evidence, leading to inconsistent reporting standards.
  • The objective was to review existing literature and reach a consensus among neurosurgeons on TOS anatomy, diagnosis, and classification.
  • A systematic search resulted in 6 randomized trials, 4 guideline articles, and several other studies, culminating in 18 consensus statements with a high agreement level among experts, emphasizing the need for better standards and further research.
View Article and Find Full Text PDF

High-resolution neurosonography (HRNS) has become a major imaging modality in assessment of peripheral nerve trauma in the recent years. However, the vascular changes of traumatic lesions have not been quantitatively assessed in HRNS. Here, we describe the vascular-ratio, a novel HRNS-based quantitative parameter for the assessment of intraneural vascular alterations in patients with nerve lesions.

View Article and Find Full Text PDF

The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care.

View Article and Find Full Text PDF

Endothelial cells (ECs) have gained an increased scientific focus since they were reported to provide guidance for Schwann cells and subsequently following axons after nerve injuries. However, previous protocols for the isolation of nerve-derived ECs from human nerves are ineffective regarding time and yield. Therefore, we established a novel and efficient protocol for the isolation of ECs from human peripheral nerves by means of immunomagnetic CD31-antibody conjugated Dynabeads and assessed the purity of the isolated cells.

View Article and Find Full Text PDF

Forensic-psychiatric patients reoffending or absconding during the leave granted to them (hereafter referred to as "granted leave") have gained increased attention by researchers and the general public. The patients' right to freedom on the one hand and the need for protection of the general public from serious harm on the other hand represent broadly discussed ethical issues. Thus, demands on quality regarding decisions on patients' granted leaves might be high.

View Article and Find Full Text PDF

Background: Surgical treatment of retroperitoneal nerve and nerve-associated tumors is challenging, especially in cases with large extent. A single surgical access may have limitations and jeopardize patients.

Objective: To present a series of patients to illustrate our individually tailored treatment concept and decision pathway.

View Article and Find Full Text PDF

Background: Clinical and electrophysiological assessments prevail in evaluation of traumatic nerve lesions and their regeneration following nerve surgery in humans. Recently, high-resolution neurosonography (HRNS) and magnetic resonance neurography have gained significant importance in peripheral nerve imaging. The use of the grey-scale-based "fascicular ratio" (FR) was established using both modalities allowing for quantitative assessment.

View Article and Find Full Text PDF
Article Synopsis
  • This study investigates predictors of cerebrospinal fluid (CSF) shunt dependency after non-traumatic subarachnoid hemorrhage (SAH), identifying factors such as the amount of subarachnoid blood and the occurrence of vasospasm as significant.
  • A retrospective analysis of 107 patient cases from 2012-2014 revealed that 48% of patients requiring shunt treatment displayed higher rates of vasospasm and greater subarachnoid blood volume.
  • Findings suggest that monitoring for these predictors could aid physicians in deciding on treatment approaches for patients with SAH.
View Article and Find Full Text PDF

Background: Neuromas are pathologic nerve distensions caused by a nerve's response to trauma, resulting in a dysfunctional to non-functional nerve. Depending on the severance of the affected nerve, the resulting neuroma can be differentiated into continuous and stump neuroma. While neuroma formation has been investigated in animal models with enormous regenerative capacity, the search for differences in human response to nerve trauma on a molecular level ultimately seeks to identify reasons for functionally successful versus unsuccessful regeneration after peripheral nerve trauma in man.

View Article and Find Full Text PDF
Article Synopsis
  • This study investigates the effects of prophylactic nimodipine and hydroxyethyl starch (HES) on hearing preservation during vestibular schwannoma (VS) surgery, combining data from a pilot study and a Phase III trial involving a total of 142 patients.
  • Results showed that patients receiving the treatment had a significantly lower risk of hearing loss one year post-surgery compared to the control group, with adjusted analyses indicating an even stronger protective effect.
  • While the treatment did not significantly improve facial nerve function and caused some hypotension, it was generally well tolerated, suggesting that nimodipine could be a safe preventive measure to help preserve hearing in neurosurgical patients.
View Article and Find Full Text PDF

Background: Evidence of a high interobserver variability of the subjective House-Brackmann facial nerve grading system (HBGS) would justify cost- and time-consuming technological enhancements of objective classifications for facial nerve paresis.

Method: A total of 112 patients were recruited for a randomized multi-center trial to investigate the efficacy of prophylactic nimodipine treatment in vestibular schwannoma (VS) surgery. For the present investigation both treatment groups were pooled for the assessment of facial nerve function preoperatively, in the early postoperative course and 1 year after the surgery.

View Article and Find Full Text PDF

OBJECTIVE The purpose of this research was to examine the stability of long-term hearing preservation and the regeneration capacity of the cochlear nerve following vestibular schwannoma (VS) surgery in a prospective study. METHODS A total of 112 patients were recruited for a randomized multicenter trial between January 2010 and April 2012 to investigate the efficacy of prophylactic nimodipine treatment versus no prophylactic nimodipine treatment in VS surgery. For the present investigation, both groups were pooled to compare hearing abilities in the early postoperative course and 1 year after the surgery.

View Article and Find Full Text PDF

Objectives: Our main objective was to evaluate whether serum hypocalcaemia (defined as <2.1 mmol/L [8.5 mg/dL]) and ionized serum calcium (defined as <1.

View Article and Find Full Text PDF

Objective: A pilot study of prophylactic nimodipine and hydroxyethyl starch treatment showed a beneficial effect on facial and cochlear nerve preservation following vestibular schwannoma (VS) surgery. A prospective Phase III trial was undertaken to confirm these results.

Methods: An open-label, 2-arm, randomized parallel group and multicenter Phase III trial with blinded expert review was performed and included 112 patients who underwent VS surgery between January 2010 and February 2013 at 7 departments of neurosurgery to investigate the efficacy and safety of the prophylaxis.

View Article and Find Full Text PDF