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  • 1. Ashkan, K
    et al.
    Blomstedt, P
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurosurgery.
    Zrinzo, L
    Tisch, S
    Yousry, T
    Limousin-Dowsey, P
    Hariz, M I
    Variability of the subthalamic nucleus: the case for direct MRI guided targeting2007In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 21, no 2, p. 197-200Article in journal (Other academic)
  • 2.
    Blomstedt, Patric
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Hariz, Marwan I
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Koskinen, Lars-Owe D
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Thalamic deep brain stimulation in the treatment of essential tremor: a long-term follow-up2007In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 21, no 5, p. 504-509Article in journal (Refereed)
    Abstract [en]

    Deep brain stimulation (DBS) of the nucleus ventralis intermedius thalami (Vim) in the treatment of essential tremor (ET) is well documented concerning the acute effects. Reports of the long-term effects are, however, few and the aim of the present study was to analyse the long-term efficacy of this treatment. Nineteen patients operated with unilateral Vim-DBS were evaluated with the Essential Tremor Rating Scale (ETRS) before surgery, and after a mean time of 1 and 7 years after surgery. The ETRS score for tremor of the contralateral hand was reduced from 6.8 at baseline to 1.2 and 2.7, respectively, on stimulation at follow-up. For hand function (item 11 – 14) the score was reduced from 12.7 to 4.1 and 8.2, respectively. Vim-DBS is an efficient treatment for ET, also after many years of treatment. There is, however, a decreasing effect over time, most noticeable concerning tremor of action.

    Read More: http://informahealthcare.com/doi/abs/10.1080/02688690701552278

  • 3.
    Lindvall, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Runnerstam, Magnus
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Koskinen, Lars-Owe D
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage2009In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 23, no 2, p. 188-192Article in journal (Refereed)
    Abstract [en]

    Cerebral vasospasm is the major cause of delayed ischemia in patients with subarachnoid haemorrhage (SAH). The Fisher grading scale has been used to predict patients in risk of developing vasospasm. Improved radiological techniques and treatment may have changed the relevance of the Fisher scale. We have now evaluated the Fisher scale, Hunt and Hess and age in relation to outcome in patients with SAH. Eighty- three patients were admitted with SAH during two years, and 84 aneurysms were treated in 78 patients. The Glasgow outcome score (GOS) within 3 months were as follows; GOS 1 (19%), GOS 2 (2%), GOS 3 (11%), GOS 4 (9%), GOS 5 (59%). There was a significant correlation between both the Fisher grading scale, Hunt and Hess scale and outcome. Age was not correlated to the Fisher grading scale or the Hunt and Hess scale. Age was also not correlated to outcome in our patients. Despite the correlation to outcome both Hunt and Hess and the Fisher grading scale had a limited predictive value of outcome due to a low specificity and/or sensitivity.

  • 4. Shah, Rahul S.
    et al.
    Hariz, Marwan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Aziz, Tipu Z.
    Pereira, Erlick A. C.
    Biographical sketch: Jason Brice2014In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 28, no 5, p. 595-597Article in journal (Refereed)
    Abstract [en]

    This article is a biographical sketch of retired British neurosurgeon Jason Brice, who is a pioneer of deep brain stimulation and helped establish the Wessex Neurological Centre.

  • 5.
    Sjöberg, Rickard L.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Five psychological mechanisms that might bias learning from neurosurgical complications: case discussions and a narrative review2022In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 36, no 3, p. 323-328Article, review/survey (Refereed)
    Abstract [en]

    Purpose: The ability of neurosurgeons to analyze and reflect on their complications in a constructive way is important both for professional development and for patient safety. The purpose of the present paper is to highlight some psychological factors that might impair or bias the ability of the neurosurgeon to do this successfully.

    Methods: Five fictitious cases, loosely inspired by real events and situations, are used as a basis for a discussion of some of the most important potential sources of psychological bias in the context of understanding neurosurgical complications.

    Results: The issues of a) self-serving bias and the actor-observer effect; b) heuristics and biases in interpreting probabilistic events; c) emotional avoidance and denial; d) limitations of attention (dual systems theory) and e) errors of memory, are discussed.

    Conclusion: There are a number of psychological factors, that are well known to science that may be ubiquitous sources of influence on the ability of neurosurgeons to grow by reflection on their own complications. Exactly how these factors can and should be efficiently adressed by the individual neurosurgeon and/or the organisation and team in which the neurosurgeon works may vary according to type of bias, context and circumstances. However, being aware of these issues and addressing them on an individual and organizational level remains important to the quality of our craft.

    Download full text (pdf)
    fulltext
  • 6.
    Sundström, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Laurell, Katarina
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Lundin, Fredrik
    Kahlon, Babar
    Cesarini, Kristina G
    Leijon, Göran
    Wikkelsö, Carsten
    Incidence and outcome of surgery for adult hydrocephalus patients in Sweden2017In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 31, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    OBJECT: To present population-based and age related incidence of surgery and clinical outcome for adult patients operated for hydrocephalus, registered in the Swedish Hydrocephalus Quality Registry (SHQR).

    METHODS: All patients registered in SHQR during 2004-2011 were included. Data on age, gender, type of hydrocephalus and type of surgery were extracted as well as three months outcome for patients with idiopathic normal pressure hydrocephalus (iNPH).

    RESULTS: The material consisted of 2360 patients, 1229 men and 1131 women, age 63.8 ± 14.4 years (mean ± standard deviation (SD)). The mean total incidence of surgery was 5.1 ± 0.9 surgeries/100,000/year; 4.7 ± 0.9 shunt surgeries and 0.4 ± 0.1 endoscopic third ventriculostomies. For iNPH, secondary communicating hydrocephalus and obstructive hydrocephalus, the incidence of surgery was 2.2 ± 0.8, 1.9 ± 0.3 and 0.8 ± 0.1/100,000/year, respectively. During 2004-2011, the incidence of surgery increased in total (p = .044), especially in age groups 70-79 years and ≥80 years (p = .012 and p = .031). After surgery, 253 of 652 iNPH patients (38.8%) improved at least one step on the modified Rankin scale (mRS). Number needed to treat was 3.0 for improving one patient from unfavourable (mRS 3-5) to favourable (mRS 0-2). The mean score of a modified iNPH scale increased from 54 ± 23 preoperatively to 63 ± 25 postoperatively (p < .0001, n = 704), and 58% improved. No significant regional differences in incidence, surgical techniques or outcome were found.

    CONCLUSIONS: Incidence of hydrocephalus surgery increased significantly during 2004-2011, specifically in elderly patients. Surgical treatment of iNPH markedly improved functional independence, but the improvement rate was low compared to recent single- and multicentre studies. Thus, the potential for surgical improvement is likely lower than generally reported when treating patients as part of everyday clinical care.

  • 7. Zrinzo, Ludvic
    et al.
    Hariz, Marwan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Conclusions should be supported by the data presented2013In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 27, no 4, p. 545-546Article in journal (Refereed)
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