Publications
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Ramm-Pettersen, Nora Marie; Ramm-Pettersen, Jon; Helseth, Eirik; Skogen, Karoline & Aarhus, Mads
(2025).
The Transciliary Supraorbital Keyhole Approach for Different Intracranial Pathologies: Lessons Learned After the Implementation of a New Surgical Technique in a General Neurosurgical Department.
World Neurosurgery.
ISSN 1878-8750.
205.
doi:
10.1016/j.wneu.2025.124704.
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Biernat, Donata; Bugge, Robin Antony Birkeland; Ramm-Pettersen, Jon-Terje; SCHELLHORN, TILL; Rønning, Pål Andre & Helseth, Eirik
[Show all 8 contributors for this article]
(2025).
Predicting intraoperative meningioma consistency using features from standard MRI sequences: a preoperative evaluation.
Acta Neurochirurgica.
ISSN 0001-6268.
167(1).
doi:
10.1007/s00701-025-06582-9.
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Abstract Background Symptomatic meningiomas may require surgical resection to save or improve neurological function. The extent of tumor resection depends on multiple factors, including the tumor's consistency, its location, and the patient's overall condition. This prospective study aims to explore new criteria in combination with previously proposed tumor features on MRI to establish a rapid approach to tumor consistency characterization pre-operatively. Methods Forty-eight patients with meningiomas were prospectively included and underwent a dedicated MRI protocol prior to surgery. Qualitative and quantitative MRI characteristics of the tumor were correlated to a previously proposed surgical tumor consistency grading. Results Soft tumors were associated with homogeneous contrast enhancement, high T2 signal, absence of peritumoral edema (PTE), the presence of tumor cysts, and a uniformly dark appearance on fractional anisotropy (FA) maps. In contrast, firmer tumors were characterized by heterogeneous contrast enhancement, low T2 signal, the presence of PTE, absence of tumor cysts and a heterogeneous appearance on FA maps, requiring supranormal ultrasonic aspirator settings. Tumor signal quantification on T2 and Apparent Diffusion Coefficient maps (ADC) correlated moderately to tumor consistency. T1 sequences did not contribute in determining tumor consistency. Conclusion An array of simple qualitative meningioma characteristics on MRI can assist in swift discrimination of soft and hard tumors preoperatively. These have been displayed in a figure that can easily be implemented clinically for optimal surgical planning.
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Døving, Mats; Galteland, Pål; Næss, Ingar; Sehic, Amer; Dalby, Marius & Utheim, Tor Paaske
[Show all 10 contributors for this article]
(2025).
Craniofacial Soft Tissue Injuries: An Observational Study of Bicycling Injuries from a Level 1 Trauma Center.
The Journal of craniofacial surgery (Print).
ISSN 1049-2275.
36(8),
p. 2696–2700.
doi:
10.1097/SCS.0000000000011409.
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Craniofacial injuries in bicycling accidents are common, yet limited information exists on associated soft tissue injuries. This study aims to investigate the prevalence and anatomic patterns of such injuries, and their association with helmet use and craniofacial fractures. The study included 1543 patients with bicycle injuries from a level 1 trauma center. Retrospective chart review was conducted for patients with craniofacial soft tissue injuries. Craniofacial soft tissue injuries were identified in 646 cyclists (41.9%). Odds of injury increased with years of age [aOR 1.02 (1.01–1.02), P<0.001], and women were at a higher risk compared with men [aOR 1.35 (1.05–1.75), P=0.02]. Injuries were distributed across the scalp (19%), upper third (56%), midface (69%), and lower third (32%) of the face. Helmets were used by 38% of the patients with soft tissue injuries. Helmet use reduced the odds of craniofacial soft tissue injuries overall [aOR 0.49 (0.39–0.62), P<0.001], scalp injuries [aOR 0.17 (0.10–0.28), P<0.001], and upper facial injuries [aOR 0.41 (0.31–0.54), P<0.001]. Conversely, helmet use increased the odds of lower facial injuries [aOR 1.48 (1.07–2.05), P=0.018]. Strong associations were found between lower face soft tissue injuries and mandible fractures [aOR 29.27 (15.50–55.30), P<0.001] and between soft tissue injuries of the midface and nasal bone fractures [aOR 22.70 (12.52–41.16), P<0.001]. Thus, craniofacial soft tissue injuries in cyclists are influenced by age, sex, and helmet use. Helmet use is associated with decreased odds of soft tissue injury of the upper face but with increased odds of soft tissue injury of the lower facial third.
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Galteland, Pål; Døving, Mats; Næss, Ingar; Sehic, Amer; Utheim, Tor Paaske & Eken, Torsten
[Show all 9 contributors for this article]
(2024).
The association between head injury and facial fracture treatment: an observational study of hospitalized bicyclists from a level 1 trauma centre.
Acta Neurochirurgica.
ISSN 0001-6268.
166(1).
doi:
10.1007/s00701-024-06019-9.
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Purpose To compare the types of facial fractures and their treatment in bicyclists admitted to a level 1 trauma centre with major and minor-moderate head injury. Methods Retrospective analysis of data from bicycle-related injuries in the period 2005–2016 extracted from the Oslo University Hospital trauma registry. Results A total of 967 bicyclists with head injuries classified according to the Abbreviated Injury Scale (AIS) were included. The group suffering minor-moderate head injury (AIS Head 1–2) included 518 bicyclists, while 449 bicyclists had major head injury (AIS Head 3–6). The mean patient age was 40.2 years (range 3–91 years) and 701 patients (72%) were men. A total of 521 facial fractures were registered in 262 patients (on average 2 facial fractures per bicyclist). Bicyclists with major head injury exhibited increased odds for facial fractures compared to bicyclists with minor-moderate head injury (sex and age adjusted odds ratio (OR) 2.75, 95% confidence interval (CI) 2.03–3.72, p < 0.001. More specifically, there was increased odds for all midface fractures, but no difference for mandible fractures. There was also increased odds for orbital reconstruction in cyclist with major head injury compared to bicyclist with minor-moderate head injury (adjusted OR 3.34, 95% CI 1.30–8.60, p = 0.012). Conclusion Bicyclists with more severe head injuries had increased odds for midface fractures and surgical correction of orbital fractures. During trauma triage, the head and the face should be considered as one unit.
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Næss, Ingar; Døving, Mats; Galteland, Pål; Skaga, Nils Oddvar; Eken, Torsten & Helseth, Eirik
[Show all 7 contributors for this article]
(2024).
Bicycle helmets are associated with fewer and less severe head injuries and fewer neurosurgical procedures.
Acta Neurochirurgica.
ISSN 0001-6268.
166(1).
doi:
10.1007/s00701-024-06294-6.
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Purpose This study explores the protective capabilities of bicycle helmets on serious head injury among bicyclists hospitalized in a Norwegian level 1 trauma centre. Method Information on helmet use, demographic variables, Abbreviated Injury Scale (AIS) and surgical procedure codes was retrieved from the Oslo University Hospital Trauma Registry for patients with bicycle-related injuries from 2005 through 2016. Outcomes were serious head injury defined as maximum AIS severity score ≥ 3 in the AIS region Head, any cranial neurosurgical procedure, and 30-day mortality. Results A total of 1256 hospitalized bicyclists were included. The median age was 41 years (quartiles 26–53), 73% were male, 5.3% had severe pre-injury comorbidities, and 54% wore a helmet at the time of injury. Serious head injury occurred in 30%, 9% underwent a cranial neurosurgical procedure, and 30-day mortality was 2%. Compared to non-helmeted bicyclists, helmeted bicyclists were older (43 years, quartiles 27–54, vs. 38 years, quartiles 23–53, p = 0.05), less often crashed during night-time (21% vs. 38%, p < 0.001), less frequently had serious head injury (22% vs. 38%, OR 0.29, 95% CI 0.22–0.39), and less often underwent cranial neurosurgery (6% vs. 14%, OR 0.36, 95% CI 0.24–0.54). No statistically significant difference in 30-day mortality between the two groups was found (1.5% vs. 2.9%, OR 0.50, 95% CI 0.22–1.11). Conclusion Helmet use was associated with fewer and less severe head injuries and fewer neurosurgical procedures. This adds evidence to the protective capabilities of bicycle helmets.
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Lioi, Francesco; Ramm-Pettersen, Jon-Terje; Fratini, Andrea; Riva, Camilla; Colella, Niccolò & Missori, Paolo
(2024).
Ultrasonographic Assessment of Optic Nerve Sheath Diameter as a Screening Tool for Intracranial Hypertension in Traumatic Brain Injury.
World Neurosurgery.
ISSN 1878-8750.
doi:
10.1016/j.wneu.2024.08.111.
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Background Severe traumatic brain injury (TBI) is a condition burdened by high morbidity and mortality. Prevention of secondary insults is 1 of the main goals of management and intracranial pressure (ICP) monitoring is a cornerstone in management of TBI. The relationship between ICP and optic nerve sheath is known from the literature. Optic nerve sheath ultrasonography could represent a method added to our armamentarium for monitoring ICP. Methods We investigated how ultrasound-measured optic nerve sheath diameter (ONSD) varies as a function of ICP in a cohort of patients with severe blunt head injury in whom an intraparenchymal sensor was placed. We evaluated the accuracy of ONSD in distinguishing dichotomized ICP cut-offs and analyzed the learning curve and its potential as screening tool to select TBI patients most in need of invasive ICP monitoring in a setting with constraints on resources. Results ONSD and ICP have a linear relationship. Nevertheless, there are limits of evaluating the one-to-one correspondence between those 2 variables. We selected a cut-off of sonographic ONSD above which there is a concernable elevation of ICP (ICP >15 mmHg) worthy of invasive second-line monitoring. Thus, it is possible to use ONSD as a first-line noninvasive tool to intercept patients at risk of developing frank intracranial hypertension. Conclusions We propose the use of ONSD ultrasound as a screening investigation for post-traumatic intracranial hypertension in the context of an emergency department, especially in contexts where there is limited availability of ICP monitors.
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Frič, Radek; König, Marton; Due-Tønnessen, Bernt Johan; Ramm-Pettersen, Jon-Terje & Berg-Johnsen, Jon
(2023).
Long-term outcome of patients treated for craniopharyngioma: a single center experience.
British Journal of Neurosurgery.
ISSN 0268-8697.
doi:
10.1080/02688697.2023.2179600.
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Purpose Treatment of craniopharyngiomas (CP) is challenging due to their proximity to critical neural structures, risk of serious complications and impaired quality of life after treatment. Recurrences may occur many years after surgical resection. However, long-term outcome data are still scarce. The purpose of this retrospective study was therefore to assess the long-term results after treatment of patients with CP. Material and method Patients surgically treated for a histologically verified CP at Oslo University Hospital between 1992 and 2015 and with at least a 5-year follow-up were included. Patients’ medical records and radiological studies were reviewed. Results Sixty-one patients (mean age 35.8 ± 22.2 years) were included; 18 patients (30%) were children <18 years of age. The incidence for the study period and the referral population was 1.1 cases/million/year, with trimodal peak incidence at 6, 32 and 59 years of age. The commonest presenting symptoms were visual disturbances (62%), headache (43%) and endocrine dysfunction (34%). The transcranial approach was utilized in 79% of patients. Gross total resection (GTR) was achieved in 59%. The surgical complication rate was 20%. Three patients (5%) received radiotherapy or radiosurgery after primary resection. The mean follow-up was 139 ± 76 months, with no patients lost to follow-up. Postoperatively, 59% of patients had panhypopituitarism and 56% diabetes insipidus. Eighteen patients (30%) developed tumour recurrence after a mean follow-up of 26 ± 25 months. The 10-year overall survival (OS) rate was 75%, whereas the disease-specific survival (DSS) rate was 84%, and recurrence-free survival (RFS) 61%. Subtotal resection (STR) (p = .01) and systemic comorbidity (p = .002) were associated with worse DSS. Conclusion Surgical treatment of CP, even though combined with adjuvant radiotherapy in only selected cases, provides good long-time OS and DSS, and relatively good functional outcome in long-term survivors despite postoperative morbidity, particularly endocrine dysfunction. Systemic comorbidity and STR are individual negative prognostic factors.
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Herrman, Helle; Osnes, Kåre; Egge, Arild; Konglund, Ane; Ramm-Pettersen, Jon-Terje & Dietrichs, Espen
[Show all 7 contributors for this article]
(2022).
ANT-DBS in epilepsy shows no effect on selected neuropsychiatric tests.
Acta Neurologica Scandinavica.
ISSN 0001-6314.
146(3),
p. 258–264.
doi:
10.1111/ane.13658.
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Objectives Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) is an established option in treatment-resistant epilepsy and obtained FDA approval in 2018. Increased psychiatric comorbidity is well known in epilepsy. The main objective of this study was to investigate possible neuropsychiatric treatment-related changes in patients receiving ANT-DBS. Materials and Methods Bilateral ANT electrodes were implanted in 18 adult patients with refractory epilepsy in a randomized, double-blinded study. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the next six months (open phase), both groups received active stimulation. Neuropsychiatric assessment was conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). Results Comparing preoperative status (T1) and 12 months (T3), postoperative outcome in all patients did not show significant differences between the two groups for any of the applied tests. Groupwise comparisons across the two first time points (the blinded period, representing the randomized controlled trial) showed no significant differences between the two groups in any of the neuropsychiatric parameters studied. Comparing test results after 6 months of stimulation in both groups (sum of ON group T1 to T2 and OFF group T2 to T3) did not show significant changes for any of the psychiatric assessments. Conclusions Our results indicate that ANT-DBS has limited effect concerning psychiatric issues. Subjective side effects were, however, reported in individual patients.
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Døving, Mats; Næss, Ingar; Galteland, Pål; Ramm-Pettersen, Jon-Terje; Dalby, Marius & Utheim, Tor Paaske
[Show all 9 contributors for this article]
(2022).
Anatomical distribution of mandibular fractures from severe bicycling accidents: A 12-year experience from a Norwegian level 1 trauma center.
Dental Traumatology.
ISSN 1600-4469.
38(5),
p. 424–430.
doi:
10.1111/edt.12756.
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Background/Aim The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations. Material and Methods Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12-year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed. Results Sixty-two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49–4.16, p < .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non-helmeted groups. Conclusions Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.
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Munkvold, Bodil Karoline Ravn; Solheim, Ole; Bartek, Jiri; Corell, Alba; Dios, Eddie De & Gulati, Sasha
[Show all 27 contributors for this article]
(2021).
Variations in the management of diffuse low-grade gliomas - A Scandinavian multicenter study.
Neuro-Oncology Practice.
ISSN 2054-2577.
8(6),
p. 706–717.
doi:
10.1093/nop/npab054.
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Background
Early extensive surgery is a cornerstone in treatment of diffuse low-grade gliomas (DLGGs), and an additional survival benefit has been demonstrated from early radiochemotherapy in selected “high-risk” patients. Still, there are a number of controversies related to DLGG management. The objective of this multicenter population-based cohort study was to explore potential variations in diagnostic work-up and treatment between treating centers in 2 Scandinavian countries with similar public health care systems.
Methods
Patients screened for inclusion underwent primary surgery of a histopathologically verified diffuse WHO grade II glioma in the time period 2012 through 2017. Clinical and radiological data were collected from medical records and locally conducted research projects, whereupon differences between countries and inter-hospital variations were explored.
Results
A total of 642 patients were included (male:female ratio 1:4), and annual age-standardized incidence rates were 0.9 and 0.8 per 100 000 in Norway and Sweden, respectively. Considerable inter-hospital variations were observed in preoperative work-up, tumor diagnostics, surgical strategies, techniques for intraoperative guidance, as well as choice and timing of adjuvant therapy.
Conclusions
Despite geographical population-based case selection, similar health care organizations, and existing guidelines, there were considerable variations in DLGG management. While some can be attributed to differences in clinical implementation of current scientific knowledge, some of the observed inter-hospital variations reflect controversies related to diagnostics and treatment. Quantification of these disparities renders possible identification of treatment patterns associated with better or worse outcomes and may thus represent a step toward more uniform evidence-based care.
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Døving, Mats; Galteland, Pål; Eken, Torsten; Sehic, Amer; Utheim, Tor Paaske & Skaga, Nils Oddvar
[Show all 8 contributors for this article]
(2020).
Dentoalveolar injuries, bicycling accidents and helmet use in patients referred to a Norwegian Trauma Centre: A 12‐year prospective study.
Dental Traumatology.
ISSN 1600-4469.
p. 1–7.
doi:
10.1111/edt.12627.
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Background/Aim Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use. Material and Methods A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12‐year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures. Results Twenty‐five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02‐2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non‐helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02‐2.31). Conclusions Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.
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Nome, Terje; Herrman, Helle; Lehtimäki, Kai; Egge, Arild; Konglund, Ane & Ramm-Pettersen, Jon-Terje
[Show all 8 contributors for this article]
(2020).
Direct visual targeting versus preset coordinates for ANT-DBS in epilepsy.
Acta Neurologica Scandinavica.
ISSN 0001-6314.
142(1),
p. 23–29.
doi:
10.1111/ane.13233.
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Objectives Deep brain stimulation (DBS) of the anterior thalamic nucleus (ANT) may be used against refractory focal epilepsy, but only two randomized double‐blinded trials have been performed. The Oslo study was discontinued prematurely since reduction in seizure frequency was less than expected. The aim of the present study was to review the targeting used in the Oslo study and to identify the actual positions of the contacts used for stimulation. Material and methods BrainLab MRI data were available from 12 Oslo study patients. Based on MRI the coordinates of the center of the ANT were identified. The coordinates were considered as the visually identified preferred target and were compared with the target originally used for ANT electrode implantation and with the actual electrode positions estimated from post‐operative CT scans. Results We found considerable differences between the visually identified preferred target, the originally planned target, and the actual electrode position. The total distance between the active electrode position and the visually identified preferred target was on average 3.3 mm on the right and 2.9 mm on the left side. Conclusion Indirect targeting based on preset coordinates may contribute to explain the modest effect of ANT‐DBS on seizure frequency seen in the Oslo study. Observed differences between the center of the ANT and the actual electrode position may at least in part be explained by variations in position and size of the ANT. Direct identification of the target using better MRI imaging protocols is recommended for future ANT‐DBS surgery.
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Næss, Ingar; Galteland, Pål; Skaga, Nils Oddvar; Eken, Torsten; Helseth, Eirik & Ramm-Pettersen, Jon-Terje
(2020).
The number of patients hospitalized with bicycle injuries is increasing - A cry for better road safety.
Accident Analysis and Prevention.
ISSN 0001-4575.
148:105836,
p. 1–7.
doi:
10.1016/j.aap.2020.105836.
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Introduction Norwegian authorities encourage people to commute by bicycle to improve public health, decrease rush-hour traffic jams and reduce pollution. However, increasing the number of bicyclists, especially in the rush-hour traffic, may increase the number of serious bicycle injuries. Objective To explore trends in hospitalized bicycle injuries at a Norwegian level I trauma centre during the last decade. Methods Data was extracted from the prospectively registered institutional trauma registry. We identified patients admitted after bicycle injuries between 2005 and 2016. Results A total of 1543 patients were identified. Median age was 40 years (range 3–91) and 73 % were males. The majority of weekday injuries occurred in the morning and during the afternoon rush-hour, peaking at 8 am. and 4 pm. The annual number of admitted bicycle injuries increased from 79 to 184 during the study period. Also, an increase in the share of bicyclists using helmets was observed. The median Injury Severity Score (ISS) of 10 remained unchanged. 63 % had serious trauma (ISS ≥ 9), while 34 % suffered severe trauma (ISS ≥ 16). The absolute number of both serious and severe trauma increased annually. 36 % had head and neck injuries, while 16 % had chest injuries graded with Abbreviated Injury Scale ≥3. Loss of consciousness with Glasgow Coma Scale score <9 was seen in 7%. Median length of hospitalization was 3 days, and 39 % had surgery in one or more body regions. The 30-day mortality was 2.3 %. Conclusions The number of admitted bicycle injuries to our trauma centre is increasing. Rush-hour injuries dominate during weekdays. Bicycle injuries can be devastating and deserve more public attention to promote road safety.
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Herrman, Helle; Egge, Arild; Konglund, Ane; Ramm-Pettersen, Jon-Terje; Dietrichs, Espen & Taubøll, Erik
(2018).
Anterior thalamic deep brain stimulation in refractory epilepsy: A randomized, double-blinded study.
Acta Neurologica Scandinavica.
ISSN 0001-6314.
139(3),
p. 294–304.
doi:
10.1111/ane.13047.
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Objectives The safety and effect on seizure frequency of anterior thalamic nucleus deep brain stimulation were studied in this prospective, randomized, double‐blinded study. Patients were followed for 12 months. The first 6 months were blinded with regard to active stimulation or not. After 6 months, all patients received active stimulation. Material and methods Bilateral ANT electrodes were implanted into 18 patients suffering from focal, pharmacoresistant epilepsy. Antiepileptic treatment was kept unchanged from three months prior to operation. The Liverpool seizure severity scale (LSSS) was used to measure the burden of epilepsy. Results There was no significant difference between the 2 groups at the end of the blinded period at 6 months. However, when considering all patients and comparing 6 months of stimulation with baseline, there was a significant, 22% reduction in the frequency of all seizures (P = 0.009). Four patients had ≥50% reduction in total seizure frequency and 5 patients ≥50% reduction in focal seizures after 6 months of stimulation. No increased effect over time was shown. LSSS at 6 months compared to baseline showed no significant difference between the 2 groups, but a small, significant reduction in LSSS was found when all patients had received stimulation for 6 months. Conclusions Our study supports results from earlier studies concerning DBS as a safe treatment option, with effects even in patients with severe, refractory epilepsy. However, our results are not as encouraging as those reported from many other, mainly unblinded, and open studies.
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Lundborg, Mina; Helseth, Eirik; Josefsen, Roger; Braathen, Martin; Skogen, Karoline & Ramm-Pettersen, Jon-Terje
(2018).
Hyperbaric oxygen therapy of air embolus in the cerebral venous sinuses after intracranial surgery: a case report.
Acta Neurochirurgica.
ISSN 0001-6268.
160(7),
p. 1401–1405.
doi:
10.1007/s00701-018-3537-5.
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Ramm-Pettersen, Jon-Terje; Fric, Radek & Berg-Johnsen, Jon
(2017).
Long-term follow-up after endoscopic trans-sphenoidal surgery or initial observation in clivus chordomas.
Acta Neurochirurgica.
ISSN 0001-6268.
159(10),
p. 1849–1855.
doi:
10.1007/s00701-017-3236-7.
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Ramm-Pettersen, Jon-Terje; Halvorsen, Helene; Evang, Johan Arild; RØNNING, PÅL ANDRE; Hol, Per Kristian & Bollerslev, Jens
[Show all 8 contributors for this article]
(2015).
Low immediate postoperative serum-cortisol nadir predicts the short-term, but not long-term, remission after pituitary surgery for Cushing's disease.
BMC Endocrine Disorders.
15:62.
doi:
10.1186/s12902-015-0055-9.
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Background: Cushing’s disease is an ACTH-producing pituitary adenoma, and the primary treatment is microscopic
or endoscopic transsphenoidal selective adenectomy. The aims of the present study were to evaluate whether the
early postoperative S-cortisol level can serve as a prognostic marker for short- and long-term remission, and
retrospectively review our own short and long term results after surgery for Cushing’s disease.
Methods: This single centre, retrospective study consists of 19 consecutive patients with Cushing’s disease who
underwent transsphenoidal surgery. S-cortisol was measured every 6 h after the operation without any
glucocorticoid replacement. We have follow-up on all patients, with a mean follow-up of 68 months.
Results: At the three-month follow-up, 16 patients (84 %) were in remission; at 12 months, 18 (95 %) were in
remission and at the final follow-up (mean 68 months), 13 (68 %) were in remission. Five-years recurrence rate was
26 %. The mean postoperative S-cortisol nadir was significantly lower in the group of patients in remission than in
the non-remission group at 3 months, but there was no difference between those in long-term remission
compared to those in long-term non-remission. The optimal cut-off value for classifying 3-month remission was
74 nmol/l.
Conclusion: We achieved a 95 % 1-year remission rate with transsphenoidal surgery for Cushing’s disease in this
series of consecutive patients. However, the 5-year recurrence rate was 26 %, showing the need for regular clinical
and biochemical controls in this patient group. The mean postoperative serum-cortisol nadir was significantly lower
in patients in remission at 3 months compared to patients not in remission at 3 months, but a low postoperative
S-cortisol did not predict long-term remission.
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Evang, Johan Arild; Bollerslev, Jens; Casar-Borota, Olivera; Lekva, Tove; Ramm-Pettersen, Jon-Terje & Berg, Jens Petter
(2013).
Different levels of various glucocorticoid-regulated genes in corticotroph adenomas.
Endocrine.
ISSN 1355-008X.
44(1),
p. 220–227.
doi:
10.1007/s12020-012-9871-0.
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Casar-Borota, Olivera; Heck, Ansgar; Schulz, S; Nesland, Jahn M; Ramm-Pettersen, Jon-Terje & Lekva, Tove
[Show all 8 contributors for this article]
(2013).
Expression of SSTR2a, but not of SSTRs 1, 3, or 5 in Somatotroph Adenomas Assessed by Monoclonal Antibodies Was Reduced by Octreotide and Correlated With the Acute and Long-Term Effects of Octreotide.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
98(11),
p. E1730–E1739.
doi:
10.1210/jc.2013-2145.
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Skogseid, Inger Marie; Ramm-Pettersen, Jon-Terje; Volkmann, Jens; Kerty, Emilia; Dietrichs, Espen & Røste, Geir Ketil
(2012).
Good long-term efficacy of pallidal stimulation in cervical dystonia: a prospective, observer-blinded study.
European Journal of Neurology.
ISSN 1351-5101.
19(4),
p. 610–615.
doi:
10.1111/j.1468-1331.2011.03591.x.
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Ramm-Pettersen, Jon-Terje; Berg-Johnsen, Jon; Hol, Per Kristian; Roy, Sumit K; Bollerslev, Jens & Schreiner, Thomas
[Show all 7 contributors for this article]
(2011).
Intra-operative MRI facilitates tumour resection during trans-sphenoidal surgery for pituitary adenomas.
Acta Neurochirurgica.
ISSN 0001-6268.
153(7),
p. 1367–1373.
doi:
10.1007/s00701-011-1004-7.
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Background During trans-sphenoidal microsurgical resection of pituitary adenomas, the extent of resection may be difficult to assess, especially when extensive suprasellar and parasellar growth has occurred. In this prospective study, we investigated whether intra-operative magnetic resonance imaging (iMRI) can facilitate tumour resection. Methods Twenty patients with macroadenomas, (16 non-functioning, three growth-hormone secreting and one pharmaco-resistant prolactinoma) were selected for surgery in the iMRI. The mean tumour diameter was 27 mm (range 11–41). The mean parasellar grade, according to the Knosp classification, was 2.3. Pre-operative coronal and sagittal T1-weighted and T2-weighted images were obtained. The trans-sphenoidal tumour resection was performed at the edge of the tunnel of a Signa SP 0.5-Tesla MRI. The surgeon aimed at a radical tumour resection that was followed by a peri-operative MRI scan. When a residual tumour was visualised and deemed resectable, an extended resection was performed, followed by another MRI scan. This procedure was repeated until the imaging results were satisfactory. In all patients, we were able to obtain images to assess the extent of resection and to classify the resection as either total or subtotal. Results After primary resection, eight out of 20 cases were classified as total resections. A second resection was performed in 11 of 12 cases classified as subtotal resections, and in four of these, total resection was achieved. A third resection was performed in three of the remaining seven cases with subtotal resections, but we did not achieve total resection in any of these cases. Therefore, the use of iMRI increased the number of patients with total resection from 8/20 (40%) to 12/20 (60%). The only observed complication was a transient spinal fluid leakage. Conclusion Intra-operative MRI during trans-sphenoidal microsurgery is useful in selected patients for a safe and more complete resection. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
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Lier, Helene Engstrand; Brede, Vegard Rødseth; Ramm-Pettersen, Jon-Terje & Gjønnæss, Eyvind
(2022).
En mann i 30-årene med gjenta hjerneabscesser.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
142(18).
doi:
10.4045/tidsskr.21.0811.
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Background: Brain abscess is a life-threatening condition. Congenital cardiovascular malformations can create right-to-left shunting and be an underlying cause. Case presentation: A young man was admitted due to headache and deteriorating general condition. He had a history of a surgically treated brain abscess 19 years earlier. Investigations now showed a new brain abscess. The patient was operated and received a peripherally inserted central catheter in his left arm for antibiotic treatment. A chest X-ray showed abnormal positioning of the catheter lying in a persistent left superior vena cava. One day later he experienced headache and photophobia. MRI showed reoccurrence of the brain abscess and he was reoperated. Persistent left superior vena cava was considered to be the cause of the brain abscesses and he underwent endovascular embolisation and placement of a vascular plug in his left superior vena cava. Interpretation: The oxygen-rich pulmonary circulation and its immune system make it difficult for anaerobic bacteria to pass to the arterial side. In most cases persistent left superior vena cava drains into the right atrium and is asymptomatic. In 10 % of patients the persistent left superior vena cava drains directly to the left atrium and gives a right-to-left shunt. This may cause arterial bacteraemia and brain abscesses.
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Published
Mar. 20, 2025 2:57 PM
- Last modified
Mar. 20, 2025 2:57 PM
