Mads Aarhus

• Lidström, Hanna; Hutchens, Anna; Froese, Logan; Nelson, David W.; Bartek, Jiri & Fletcher-Sandersjöö, Alexander [Vis alle 16 forfattere av denne artikkelen] (2026). Management and outcome of patients with traumatic brain injury treated in three major Nordic intensive care units: a comparative cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 34(1). doi: 10.1186/s13049-026-01657-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Traumatic brain injury (TBI) is a major cause of death and disability, with large variations in management strategies and outcomes across countries. Nordic countries are similar in demographics, but differences in treatment strategies likely exist and outcome differences have been reported. We aimed to assess temporal differences in treatments and outcomes in three large Nordic centers, with a hypothesis that outcomes, after adjustment for injury severity, are generally similar and have improved over time. Materials and methods We performed an international, multicenter, retrospective, observational registry study including consecutive intensive care unit (ICU) managed TBI patients from three of the largest university hospitals in the Nordics (Helsinki (HUS), Finland [2005–2020]; Stockholm (KUH), Sweden [2005–2022]; Oslo (OUH), Norway [2015–2022]). Our primary outcome was 6–12-month unfavorable Glasgow Outcome Scale (GOS, 1–3) and secondary outcome was 30-day mortality. We compared outcomes after adjusting for TBI outcome predictors: age, pupil responsiveness and admission Glasgow Coma Scale (GCS) over time. Other known outcome predictors like computerized tomography (CT) scores (Marshall CT classification and Rotterdam CT score) were collected if available, and intracranial pressure monitoring (ICP) for GCS 3–8 patients was specifically analyzed. Results In total, 5,970 patients were included (HUS = 2,769, KUH = 1,390, OUH = 1,811). Six-months crude unfavorable outcome was 43% and predicted unfavorable outcome was 44%. Crude 30-day mortality was 17% and predicted 30-day mortality was 18%. Of the included patients, 72% had a moderate-to-severe TBI (GCS 3–12) and 54% underwent some form of neurosurgical intervention. Model application diminished differences between centers, across both outcome measures. Minimal variation in outcomes between hospitals was observed, with a hospital-level variance after applying the model of 0.02 (SD 0.15) for unfavorable outcome and 0.06 (SD 0.24) for 30-day mortality. Overall, no significant temporal trend in predicted unfavorable outcome was observed (OR per year 0.95, 95% CI 0.88–1.03, p = 0.20). Variations in ICP monitoring, but also caseload, were observed. Conclusion Differences in patient case-mix and caseload between hospitals were associated with variation in treatment strategies and crude outcomes. However, after adjusting for TBI outcome predictors, no meaningful between-hospital variation in outcomes was observed, and no temporal trends in outcome found over the study period.

• Aarhus, Mads; Netteland, Dag Ferner; Tverdal, Cathrine Buaas; Stenset, Vidar; Rønning, Pål Andre & Helseth, Eirik (2026). CT-positive traumatic brain injury in patients ≥ 80 years: mortality and 6-months functional outcome. Acta Neurochirurgica. ISSN 0001-6268. 168. doi: 10.1007/s00701-026-06964-7. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Traumatic brain injury (TBI) in patients ≥ 80 years poses major clinical challenges, with limited evidence to guide neurosurgical decision-making. We evaluated mortality, functional outcomes, and prognostic factors in patients undergoing neurosurgical versus conservative management. Methods This cohort study included patients ≥ 80 years with imaging-verified TBI treated at a tertiary trauma centre. Demographics, injury characteristics, treatment, mortality, and 6-month outcomes were collected. Favourable outcome was defined as Glasgow Outcome Scale 4 and 5. Multivariable logistic regression identified predictors of mortality and unfavourable outcome, and Cox regression assessed 30, 180, and 365 days mortality. Results A total of 608 patients (median age 85.8 years; 52% female) were included; 84 (14%) underwent neurosurgical intervention. Thirty-day and one-year mortality were 24% and 42%, respectively. Neurosurgical intervention was associated with reduced 30-day mortality (HR 0.46, 95% CI 0.28–0.76; p = 0.002) but not one-year mortality (HR 0.84, 95% CI 0.63–1.12; p = 0.23). Favourable 6-month outcome occurred in 29% of patients having intervention versus 34% of conservatively managed patients (p = 0.439). Increasing age, higher ASA class, dependent preinjury living, and injury severity were independently associated with unfavourable outcome. Acute craniotomy was associated with higher mortality and unfavourable outcome, whereas later trephination for subsequent chronic subdural haematoma was associated with lower mortality (5%) and better outcomes. Guideline adherence for ICP monitoring was 54%. Conclusion In patients ≥ 80 years with TBI, neurosurgical intervention was associated with reduced early mortality but was not associated with improved 365-days survival or functional outcome at 6 months. Outcomes were largely determined by preinjury status and injury severity. These findings suggest selective surgical decision-making, with consideration of baseline function, comorbidity, and patient-centred goals of care.

• Aarhus, Mads; Netteland, Dag Ferner; Tverdal, Cathrine Buaas; Stenset, Vidar; Rønning, Pål Andre & Helseth, Eirik (2026). Civilian penetrating traumatic brain injury in South-East Norway. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 34(1). doi: 10.1186/s13049-026-01623-3. Fulltekst i vitenarkiv Vis sammendrag

  Background Civilian penetrating traumatic brain injury (cpTBI) is a rare entity associated with severe and often devastating consequences. Guidelines recommend CT angiography (CTA), prophylactic antibiotics (AB) and antiseizure medication (ASM), early surgical revision with dural closure whenever feasible, and intracranial pressure (ICP)-guided therapy. The study aimed to investigate guideline compliance, as well as outcome after cpTBI for patients admitted to Oslo University Hospital (OUH). Methods We identified and included cpTBI patients admitted to OUH between 2015 and 2023 through the Oslo TBI Registry – Neurosurgery. Guideline adherence was assessed and variables associated with 30-day mortality and Glasgow Outcome Scale (GOS) were examined using standard uni- and multivariable techniques. Results The incidence of cpTBI was 1.9/1.000.000 with a 30-day mortality rate of 42.3%. Among the survivors, 70% achieved a favourable outcome (GOS 4 and 5) at 6 months. CTA was obtained at an acceptable rate (81%) in concordance with guidelines, but the guideline compliance for AB (12%) and ASM (29%) was substantially lower-than-expected. Surgery started within 12 h after injury in 58%, and ICP was monitored in 53.5% of patients with GCS < 9. Conclusions Despite high mortality in cpTBI, most survivors achieved favourable outcome. We found a lower-than-expected guideline compliance for prophylactic AB and ASM, ICP monitoring, and surgical revision within 12 h. Thus, we identified several key factors that can improve cpTBI treatment at our institution. For patients considered potential survivors, management should be aggressive and aligned with established TBI treatment principles, including early vascular imaging with CTA, prompt wound debridement with dural closure, and prophylactic administration of AB and ASM.

• Mireles, Eduardo Erasmo Mendoza; Blakstad, Hanne Kristin; Server, Andres Alonso; Leske, Henning; Skaga, Erlend & Aarhus, Mads [Vis alle 11 forfattere av denne artikkelen] (2026). Extent of resection and perioperative neurological status as prognostic markers in glioblastoma: a population-based study. Journal of Neuro-Oncology. ISSN 0167-594X. 177(1). doi: 10.1007/s11060-026-05481-y. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Maximal safe resection is the suggested standard for surgical treatment for patients with IDH-wildtype glioblastoma. Surgical safety is prioritized over radical extent of resection (EOR) because new neurological deficits are considered detrimental for survival. The aim of this study was to explore the combined impact of extent of resection and neurological status on survival in glioblastoma patients, using standardized tools for neurological function (neurological assessment in neuro-oncology (NANO scale) and extent of resection (RANO resect classification). Methods Population-based study of all adult patients who underwent resection for newly diagnosed glioblastoma from 2019 to 2022 in a geographically defined region. EOR was evaluated according to the RANO resect classification. Neurological function was assessed using the NANO scale preoperatively, immediately after surgery, and before start of radiotherapy. Kaplan Meier survival analysis, chi-square and log-rank tests were used to compare groups. Results The median overall survival (mOS) for 503 patients was 12.9 months. RANO resect class 1 was associated with significantly longer mOS compared to patients with RANO classes 2, 3, and 4 (21.0 vs. 14.8, 8.3, and 4.5 months, respectively; p < 0.01). Preoperatively neurologically intact patients (NANO-score 0) had a longer mOS, than patients with neurological deficits. Neither the postoperative NANO-score nor the change in the score impacted survival. Conclusions Being neurologically intact before surgery and supramaximal resection were independent, strong predictors of longer survival. Mild to moderate new postoperative neurological deficits did not impact mOS, suggesting that supramaximal resection may confer a survival benefit even when such deficits are induced.

• MIRZAMOHAMMADI, JALAL; Austad, Tor Arnøy; Stenset, Vidar; Biernat, Donata; Aarhus, Mads & Helseth, Eirik [Vis alle 7 forfattere av denne artikkelen] (2026). Accuracy and safety of navigated pedicle screw insertion in cervical spine fractures. Frontiers in Surgery. 13. doi: 10.3389/fsurg.2026.1773142. Fulltekst i vitenarkiv
• Strøm, Mona; MIRZAMOHAMMADI, JALAL; Glott, Thomas; Brommeland, Tor; Linnerud, Hege & Rønning, Pål Andre [Vis alle 12 forfattere av denne artikkelen] (2025). Epidemiology of Traumatic Cervical Spinal Cord Injury in Southeast Norway. Neurotrauma Reports. 6(1), s. 539–550. doi: 10.1089/neur.2025.0013. Fulltekst i vitenarkiv
• Tverdal, Cathrine Buaas; Reiner, Andrew Henry; Helseth, Eirik; Hellstrøm, Torgeir; Manskow, Unn Sollid & Aarhus, Mads [Vis alle 9 forfattere av denne artikkelen] (2025). Comparison of traumatic brain injury resulting from stair-related falls to falls from standing height—a neurotrauma center cohort. Frontiers in Neurology. 16. doi: 10.3389/fneur.2025.1599229. Fulltekst i vitenarkiv Vis sammendrag

  Background: Falls are the leading cause of traumatic brain injury (TBI) in high-income countries, and globally, the incidence of fall-reBackground: Falls are the leading cause of traumatic brain injury (TBI) in high-income countries, and globally, the incidence of fall-related injuries is projected to rise. In this study, we compare TBI resulting from stair-related falls (SRFs) to falls from standing height (FSH), analyzing their epidemiology and outcomes. Methods: In a single-center, registry-based cohort study using the Oslo TBI Registry-Neurosurgery (OTBIR-N), we identified adults (≥18 years) admitted to Oslo University Hospital with TBI from either SRFs or FSH between 2015 and 2022. Epidemiology and outcome measures were compared between the two groups, and a multivariate logistic regression model was used to evaluate the adjusted effect of the fall mechanisms on dichotomized functional outcome (Glasgow outcome score (GOS) 1–3 vs. GOS 4–5). Results: A total of 1,432 patients with a median age of 71 years were included. SRFs represented 25%, while FSH represented 52% of all fall-related TBIs. SRF patients were generally younger and healthier, with a higher frequency of moderate to severe TBI than FSH patients (53% vs. 31%; p < 0.001). SRFs also occurred more often during evenings and nights, on weekends, and were more often related to alcohol influence (58% vs. 22%; p < 0.001). Both fall types resulted in unfavorable functional outcomes (GOS 1–3) for a substantial proportion of patients (37% in SRFs and 42% in FSH; p = 0.066). When adjusting for covariates in the multivariable logistic regression model, there was a tendency of SRFs being associated with unfavorable outcomes compared to FSH, but the effect was not statistically significant (OR 1.43, 95%CI 0.97–2.12; p = 0.073). Conclusion: SRFs represented a considerable proportion of fall-related TBIs and were associated with poor outcomes in a substantial proportion of patients. Targeted public awareness campaigns addressing the risks associated with staircases, especially when combined with alcohol influence, seem warranted to prevent such injuries.

• Netteland, Dag Ferner; Rønning, Pål Andre; Brommeland, Tor; Stenset, Vidar; Tverdal, Cathrine Buaas & Aarhus, Mads [Vis alle 7 forfattere av denne artikkelen] (2025). Age and Time as Predictors of Outcome in Patients Undergoing Decompressive Craniectomy for Traumatic Brain Injury. World Neurosurgery. ISSN 1878-8750. 203. doi: 10.1016/j.wneu.2025.124471. Fulltekst i vitenarkiv
• 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. Fulltekst i vitenarkiv
• Rizvi, Syed Ali Mujtaba; Linnerud, Hege; Rønning, Pål Andre; Brommeland, Tor; Aarhus, Mads & MIRZAMOHAMMADI, JALAL [Vis alle 10 forfattere av denne artikkelen] (2025). Traumatic odontoid fracture – Proposal of a treatment algorithm. Clinical neurology and neurosurgery (Dutch-Flemish ed. Print). ISSN 0303-8467. 254. doi: 10.1016/j.clineuro.2025.108951. Fulltekst i vitenarkiv
• Aarhus, Mads; Rønning, Pål Andre; Vik-Mo, Einar Osland; Marthinsen, Pål Bache; Ramm-Pettersen, Jon-Terje & Eide, Per Kristian [Vis alle 7 forfattere av denne artikkelen] (2025). Kolloidcyster i tredje hjerneventrikkel. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(2). doi: 10.4045/tidsskr.24.0500. Fulltekst i vitenarkiv
• Netteland, Dag Ferner; Aarhus, Mads; Sandset, Else Charlotte; Sorteberg, Angelika; Padayachy, Llewellyn & Helseth, Eirik [Vis alle 7 forfattere av denne artikkelen] (2025). Real-Time Automated Measurements of Optic Nerve Sheath Diameter for Noninvasive Assessment of Intracranial Pressure in Aneurysmal Subarachnoid Hemorrhage. Neurocritical Care. ISSN 1541-6933. 42, s. 1043–1053. doi: 10.1007/s12028-024-02194-w. Fulltekst i vitenarkiv Vis sammendrag

  Background Optic nerve sheath diameter (ONSD) is a promising noninvasive parameter for intracranial pressure (ICP) assessment. However, in the setting of aneurysmal subarachnoid hemorrhage (aSAH), several previous studies have reported no association between ultrasonically measured ONSD and ICP. In this study, we evaluate ONSD in patients with aSAH using a novel method of automated real-time ultrasonographic measurements and explore whether factors such as having undergone surgery affects its association to ICP. Methods We prospectively included adult patients with aSAH undergoing invasive ICP monitoring. ONSD was obtained using a prototype ultrasound machine with software for real-time automated measurements at the bedside. Correlation between ONSD and ICP was explored, and the ability of ONSD to discriminate dichotomized ICP was evaluated. Abovementioned analyses were performed for the whole cohort and repeated for subgroups by whether the basal cisterns had been surgically entered before ultrasound examination. Results Twenty-six ultrasound examinations were performed in 20 patients. There was a positive correlation between ONSD and ICP (R = 0.43; p = 0.03). In the subgroup where the basal cisterns had not been surgically entered before ultrasound examination, there was a stronger correlation (R = 0.55; p = 0.01), whereas no correlation was seen in the subgroup where the basal cisterns had been surgically entered (R = − 0.16; p = 0.70). ONSD displayed an ability to discriminate ICP dichotomized at ≥ 15 mm Hg (area under the curve [AUC] = 0.84, 95% confidence interval [CI] 0.65–0.96). Subgroup analysis revealed a perfect discriminatory ability (AUC = 1, 95% CI 0.81–1) where the basal cisterns had not been surgically entered and no discriminatory ability (AUC = 0.47, 95% CI 0.16–0.84) where the basal cisterns had been surgically entered before ultrasound examination. Conclusions Automatically measured ONSD correlated well with ICP and displayed a perfect discriminatory ability in patients with aSAH in whom the basal cisterns had not been entered surgically before ultrasound examination, and may be a clinically valuable noninvasive marker of ICP in these patients. Caution should be exercised in using ONSD in patients in whom the basal cisterns have been entered surgically before ONSD measurements, as no association was observed in this subgroup.

• Rydning, pål Nicolay; Linnerud, Hege; MIRZAMOHAMMADI, JALAL; Brommeland, Tor; Rønning, Pål Andre & Mejlænder-Evjensvold, Magnus [Vis alle 9 forfattere av denne artikkelen] (2024). Decreasing incidence of cervical spine fractures in patients with ankylosing spondylitis: a population-based study in Southeast Norway. The spine journal. ISSN 1529-9430. 24(8), s. 1502–1509. doi: 10.1016/j.spinee.2024.03.004. Fulltekst i vitenarkiv Vis sammendrag

  Background Context Individuals diagnosed with ankylosing spondylitis (AS) face an increased risk of spine fractures, specifically cervical spine fractures (CS-Fxs). In the past two decades, biological disease-modifying antirheumatic drugs (bDMARDs) have provided considerable relief from pain and an enhanced sense of wellbeing for a large segment of AS patients. Despite these improvements, it remains unclear whether extended use of bDMARDs can indeed reduce the risk of spine fractures. Purpose In this study, we aimed to investigate the evolving patterns and epidemiology of traumatic CS-Fxs in both AS and non-AS populations. We hypothesized that the risk of CS-Fxs among AS patients would show a decreasing trend over time, while the risk among non-AS patients would remain constant. Study Design/Setting Retrospective cohort study based on a prospective database. Patient Sample A total of 3,598 consecutive patients with CS-Fxs were treated at Oslo University Hospital over an 8-year period. Outcome Measures CS-Fxs in AS patients were contrasted with non-AS-related CS-Fxs in terms of temporal trends, age, sex, injury mechanism, associated cervical spinal cord injury (cSCI), need for surgical fixation, and 30-day mortality. Methods Data regarding all CS-Fxs diagnosed between 2015 and 2022 were extracted from the Southeast Norway population-based quality control database for traumatic CS-Fxs. Categorical data were summarized using frequencies, and continuous data were summarized using medians. The Wilcoxon rank-sum test was used to compare continuous variables, and the chi-squared test and Fischer exact test were used to compare categorical variables. To investigate the trend in the incidence of fractures, two different Poisson models were fitted with the number of non-AS and AS fractures as dependent variables and the year as the explanatory variable. Results Over an 8-year period, we registered 3,622 CS-Fxs in 3598 patients, with AS patients accounting for 125 of these fractures. Relative to their non-AS counterparts, AS patients presented a 9-fold and 8-fold higher risk of initial and subsequent CS-Fxs, respectively. We observed a declining trend in AS-related CS-Fxs with an annual linear decrease of 8.4% (p=.026), whereas non-AS-related CS-Fxs showed an annual linear increase of 3.7% (p<.001). AS patients sustaining CS-Fxs were typically older (median age 70 vs 63 years), predominantly male (89% vs 67%), and more frequently experienced injuries due to falls (82% vs 57%). They also exhibited a higher prevalence of subaxial CS-Fxs (91% vs 62%), fewer C0-C2 CS-Fxs (14% vs 44%), a higher rate of associated cSCI (21% vs 11%), and a greater tendency for surgical fixation (66% vs 21%). We observed a 30-day mortality rate of 11% in AS patients and 5.4% in non-AS patients (p=.005). Conclusions The results of this study confirm the elevated risk of CS-Fxs among AS patients, although this risk appears to show a decreasing trend. The most plausible explanation for this risk reduction is the widespread application of bDMARDs

• Brommeland, Tor; Strøm, Mona; MIRZAMOHAMMADI, JALAL; Glott, Thomas; Linnerud, Hege & Rønning, Pål Andre [Vis alle 12 forfattere av denne artikkelen] (2024). Traumatic cervical spinal cord injury in southeastern Norway: acute treatment, specialized rehabilitation referral and mortality. Frontiers in Neurology. 15. doi: 10.3389/fneur.2024.1452194. Fulltekst i vitenarkiv Vis sammendrag

  Background: Traumatic cervical spinal cord injury (cSCI) is a serious condition that requires a multidisciplinary treatment approach involving care at a neurotrauma center (NTC) and specialized rehabilitation. Contemporary population-based studies of cSCI are important for ensuring the quality and planning of health care approaches for these patients. Methods: This is a population-based cohort study of patients with traumatic cSCI who were admitted to the NTC in Southeast Norway between 2015 and 2022. The main outcome variables were length of stay (LOS), rate of surgical fixation/stabilization, rate of transfer to specialized rehabilitation, and 90-day mortality. Uni-and multivariate binary logistic regression analyses were used to investigate the effect of different covariates on LOS, transfer to specialized rehabilitation and 90-day mortality. Results: The median age of the 370 patients admitted to the NTC was 64 years, 75% were males, 40% had severe comorbidities, 45% had multiple injuries, and 67% underwent primary triage at a local hospital (LH). Surgical cervical stabilization/decompression was performed in 78% of the patients. The median LOS at the NTC was 9 days, and increasing LOS was significantly associated with young age, American Spinal Injury Association Impairment Scale (AIS) grade B, surgery and prolonged ventilatory support. Inpatient specialized rehabilitation was provided to 54% of patients. Receiving specialized rehabilitation was associated with younger age, preinjury independent living, more severe cSCI, no need for acute phase tracheostomy, and surgical stabilization/decompression. Only 6% of the octogenarians received specialized rehabilitation. The 90-day mortality rate was 13%, which was associated with older age, preinjury dependent living, more severe cSCI, upper cervical injuries, and days on ventilator and inversely correlated with LOS. Conclusion: Advanced age, especially among octogenarians, was significantly linked to a lack of specialized rehabilitation. Qualified physicians should assess all patients with cSCI for their need of rehabilitation and their potential to benefit from it. If the number of patients who are likely to respond to rehabilitation outnumbers the capacity of the rehabilitation center, we have two choices. Either guidelines for prioritization of patients for rehabilitation should be developed, or the capacity of the rehabilitation centers should be increased.

• Netteland, Dag Ferner; Aarhus, Mads; Sandset, Else Charlotte; Padayachy, Llewellyn; Helseth, Eirik & Brekken, Reidar (2024). Noninvasive Assessment of Intracranial Pressure: Deformability Index as an Adjunct to Optic Nerve Sheath Diameter to Increase Diagnostic Ability. Neurocritical Care. ISSN 1541-6933. 41, s. 479–488. doi: 10.1007/s12028-024-01955-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Today, invasive intracranial pressure (ICP) measurement remains the standard, but its invasiveness limits availability. Here, we evaluate a novel ultrasound-based optic nerve sheath parameter called the deformability index (DI) and its ability to assess ICP noninvasively. Furthermore, we ask whether combining DI with optic nerve sheath diameter (ONSD), a more established parameter, results in increased diagnostic ability, as compared to using ONSD alone. Methods We prospectively included adult patients with traumatic brain injury with invasive ICP monitoring, which served as the reference measurement. Ultrasound images and videos of the optic nerve sheath were acquired. ONSD was measured at the bedside, whereas DI was calculated by semiautomated postprocessing of ultrasound videos. Correlations of ONSD and DI to ICP were explored, and a linear regression model combining ONSD and DI was compared to a linear regression model using ONSD alone. Ability of the noninvasive parameters to distinguish dichotomized ICP was evaluated using receiver operating characteristic curves, and a logistic regression model combining ONSD and DI was compared to a logistic regression model using ONSD alone. Results Forty-four ultrasound examinations were performed in 26 patients. Both DI (R =  − 0.28; 95% confidence interval [CI] R <  − 0.03; p = 0.03) and ONSD (R = 0.45; 95% CI R > 0.23; p < 0.01) correlated with ICP. When including both parameters in a combined model, the estimated correlation coefficient increased (R = 0.51; 95% CI R > 0.30; p < 0.01), compared to using ONSD alone, but the model improvement did not reach statistical significance (p = 0.09). Both DI (area under the curve [AUC] 0.69, 95% CI 0.53–0.83) and ONSD (AUC 0.72, 95% CI 0.56–0.86) displayed ability to distinguish ICP dichotomized at ICP ≥ 15 mm Hg. When using both parameters in a combined model, AUC increased (0.80, 95% CI 0.63–0.90), and the model improvement was statistically significant (p = 0.02). Conclusions Combining ONSD with DI holds the potential of increasing the ability of optic nerve sheath parameters in the noninvasive assessment of ICP, compared to using ONSD alone, and further study of DI is warranted.

• Aarhus, Mads; MIRZAMOHAMMADI, JALAL; Rønning, Pål Andre; Strøm, Mona; Glott, Thomas & Rizvi, Syed Ali Mujtaba [Vis alle 15 forfattere av denne artikkelen] (2024). Time from injury to acute surgery for patients with traumatic cervical spinal cord injury in South-East Norway. Frontiers in Neurology. 15. doi: 10.3389/fneur.2024.1420530. Fulltekst i vitenarkiv Vis sammendrag

  Background: The recommended treatment for cervical spinal cord injury (cSCI) is surgical decompression and stabilization within 24 h after injury. The aims of the study were to estimate our institutional compliance with this recommendation and identify potential factors associated with surgical delay. Methods: Population-based retrospective database study of patients operated for cSCI in 2015–2022 within the South-East Norway Health Region (3.1 million inhabitants). Data extracted were demographics, injury description, management timeline, place of primary triage [local hospital (LH) or neurotrauma center (NTC)]. Main outcome variables were: (1) time from injury to surgery at NTC, (2) time from injury to admission NTC, and (3) time from admission NTC to surgery. Results: We found 243 cSCI patients having acute neck surgery. Their median age was 63 years (IQR 47–74 years), 77% were male, 48% were ≥65 years old. Primary triage at an LH occurred in 150/243 (62%). The median time from injury to acute surgery was 27.8 h (IQR 15.4–61.9 h), and 47% had surgery within 24 h. The median time from injury to NTC admission was 5.6 h (IQR 1.9–19.4 h), and 67% of the patients were admitted to the NTC within 12 h. Significant factors associated with increased time from injury to NTC admission were transfer via LH, severe preinjury comorbidities, less severe cSCI, time of injury other than night, absence of multiple injuries. The median time from NTC admission to surgery was 16.7 h (IQR 9.5–31.0 h), and 70% had surgery within 24 h. Significant factors associated with increased time from NTC admission to surgery were increasing age and non-translational injury morphology. Conclusion: Less than half of the patients with cSCI were operated on within the recommended 24 h time frame after injury. To increase the fraction of early surgery, we suggest the following: (1) patients with clinical suspicion of cSCI should be transported directly to the NTC from the scene of the accident, (2) MRI should be performed only at the NTC, (3) at the NTC, surgery should commence on the same calendar day as arrival or as the first operation the following day.

• Netteland, Dag Ferner; Sandset, Else Charlotte; Mejlænder-Evjensvold, Magnus; Aarhus, Mads; Jeppesen, Elisabeth & Sousa, Diana [Vis alle 8 forfattere av denne artikkelen] (2023). Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up. Frontiers in Neurology. 13(2022). doi: 10.3389/fneur.2022.1079579. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Cerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on mortality and the diagnostic and therapeutic management and follow-up of CVST in the setting of TBI. Methods: Key clinical questions were posed and used to define the scope of the review within the following topics of complications; effect on mortality; diagnostics; therapeutics; recanalization and follow-up of CVST in TBI. We searched relevant databases using a structured search strategy. We screened identified records according to eligibility criteria and for information regarding the posed key clinical questions within the defined topics of the review. Results: From 679 identified records, 21 studies met the eligibility criteria and were included, all of which were observational in nature. Data was deemed insufficiently homogenous to perform meta-analysis and was narratively synthesized. Reported rates of venous infarctions ranged between 7 and 38%. One large registry study reported increased in-hospital mortality in CVSP and TBI compared to a control group with TBI alone in adjusted analyses. Another two studies found midline CVST to be associated with increased risk of mortality in adjusted analyses. Direct data to inform the optimum diagnostic and therapeutic management of the condition was limited, but some data on the safety, and effect of anticoagulation treatment of CVST in TBI was identified. Systematic data on recanalization rates to guide follow-up was also limited, and reported complete recanalization rates ranged between 41 and 86%. In the context of the identified data, we discuss the diagnostic and therapeutic management and follow-up of the condition. Conclusion: Currently, the available evidence is insufficient for evidence-based treatment of CVST in the setting of TBI. However, there are clear indications in the presently available literature that CVST in TBI is associated with complications and increased mortality, and this indicates that management options for the condition must be considered. Further studies are needed to confirm the effects of CVST on TBI patients and to provide evidence to support management decisions.

• Netteland, Dag Ferner; Aarhus, Mads; Smistad, Erik; Sandset, Else Charlotte; Padayachy, Llewellyn & Helseth, Eirik [Vis alle 7 forfattere av denne artikkelen] (2023). Noninvasive intracranial pressure assessment by optic nerve sheath diameter: Automated measurements as an alternative to clinician-performed measurements. Frontiers in Neurology. 14. doi: 10.3389/fneur.2023.1064492. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Optic nerve sheath diameter (ONSD) has shown promise as a noninvasive parameter for estimating intracranial pressure (ICP). In this study, we evaluated a novel automated method of measuring the ONSD in transorbital ultrasound imaging. Methods From adult traumatic brain injury (TBI) patients with invasive ICP monitoring, bedside manual ONSD measurements and ultrasound videos of the optic nerve sheath complex were simultaneously acquired. Automatic ONSD measurements were obtained by the processing of the ultrasound videos by a novel software based on a machine learning approach for segmentation of the optic nerve sheath. Agreement between manual and automated measurements, as well as their correlation to invasive ICP, was evaluated. Furthermore, the ability to distinguish dichotomized ICP for manual and automatic measurements of ONSD was compared, both for ICP dichotomized at ≥20 mmHg and at the 50th percentile (≥14 mmHg). Finally, we performed an exploratory subgroup analysis based on the software's judgment of optic nerve axis alignment to elucidate the reasons for variation in the agreement between automatic and manual measurements. Results A total of 43 ultrasound examinations were performed on 25 adult patients with TBI, resulting in 86 image sequences covering the right and left eyes. The median pairwise difference between automatically and manually measured ONSD was 0.06 mm (IQR −0.44 to 0.38 mm; p = 0.80). The manually measured ONSD showed a positive correlation with ICP, while automatically measured ONSD showed a trend toward, but not a statistically significant correlation with ICP. When examining the ability to distinguish dichotomized ICP, manual and automatic measurements performed with similar accuracy both for an ICP cutoff at 20 mmHg (manual: AUC 0.74, 95% CI 0.58–0.88; automatic: AUC 0.83, 95% CI 0.66–0.93) and for an ICP cutoff at 14 mmHg (manual: AUC 0.70, 95% CI 0.52–0.85; automatic: AUC 0.68, 95% CI 0.48–0.83). In the exploratory subgroup analysis, we found that the agreement between measurements was higher in the subgroup where the automatic software evaluated the optic nerve axis alignment as good as compared to intermediate/poor. Conclusion The novel automated method of measuring the ONSD on the ultrasound videos using segmentation of the optic nerve sheath showed a reasonable agreement with manual measurements and performed equally well in distinguishing high and low ICP.

• Utheim, Nils Christian; Helseth, Eirik; Strøm, Mona; Rydning, pål Nicolay; Mejlænder-Evjensvold, Magnus & Glott, Thomas [Vis alle 10 forfattere av denne artikkelen] (2022). Epidemiology of traumatic cervical spinal fractures in a general Norwegian population. Injury Epidemiology. 9(10). doi: 10.1186/s40621-022-00374-w. Fulltekst i vitenarkiv Vis sammendrag

  Background: In Western countries, the typical cervical spine fracture (CS‑Fx) patient has historically been a young male injured in a road traffic accident. Recent reports and daily clinical practice clearly indicate a change in the typical patient from a young male to an elderly male or female with comorbidities. This study aimed to establish contempo‑ rary population‑based epidemiological data of traumatic CS‑Fx for use in health‑care planning and injury prevention. Methods: This is a population‑based retrospective database study (with prospectively collected data) from the Southeast Norway health region with 3.0 million inhabitants. We included all consecutive cases diagnosed with a CS‑Fx between 2015 and 2019. Information regarding demographics, preinjury comorbidities, trauma mechanisms, injury description, treatment, and level of hospital admittance is presented. Results: We registered 2153 consecutive cases with CS‑Fx during a 5‑year period, with an overall crude incidence of CS‑Fx of 14.9/100,000 person‑years. Age‑adjusted incidences using the standard population for Europe and the World was 15.6/100,000 person‑years and 10.4/100,000 person‑years, respectively. The median patient age was 62 years, 68% were males, 37% had a preinjury severe systemic disease, 16% were under the influence of ethanol, 53% had multiple trauma, and 12% had concomitant cervical spinal cord injury (incomplete in 85% and complete in 15%). The most common trauma mechanisms were falls (57%), followed by bicycle injuries (12%), and four‑wheel motorized vehicle accidents (10%). The most common upper CS‑Fx was C2 odontoid Fx, while the most common subaxial Fx was facet joint Fx involving cervical level C6/C7. Treatment was external immobilization with a stiff neck collar alone in 65%, open surgical fixation in 26% (giving a 3.7/100,000 person‑years surgery rate), and no stabilization in 9%. The overall 90‑day mortality was 153/2153 (7.1%). Conclusions: This study provides an overview of the extent of the issue and patient complexity necessary for plan‑ ning the health‑care management and injury prevention of CS‑Fx. The typical CS‑Fx patient was an elderly male or female with significant comorbidities injured in a low‑energy trauma. The overall crude incidences of CS‑Fx and surgi‑ cal fixation of CS‑Fx in Southeast Norway were 14.9/100,000 person‑years and 3.7/100,000 person‑years, respectively. Keywords: Spinal fracture, Spinal cord injury, Cervical, Traumatic, Epidemiology, Population‑based

• Eng, Svend Filip; Næss, Ingar; Linnerud, Hege; Rønning, Pål Andre; Brommeland, Tor & Mejlænder-Evjensvold, Magnus [Vis alle 12 forfattere av denne artikkelen] (2022). Bicycle-related cervical spine injuries. North American Spine Society Journal (NASSJ). 10. doi: 10.1016/j.xnsj.2022.100119. Fulltekst i vitenarkiv
• Sørensen, Petter Toivo; Nyborg, Geir; Lorentsen, Torleif; Olasveengen, Theresa M.; Langerud, Anne Kathrine & Aarhus, Mads [Vis alle 9 forfattere av denne artikkelen] (2022). Vasospasm Surveillance by a Simplified Transcranial Doppler Protocol in Traumatic Brain Injury. World Neurosurgery. ISSN 1878-8750. 164, s. e318–e325. doi: 10.1016/j.wneu.2022.04.108. Fulltekst i vitenarkiv Vis sammendrag

  Objective To detect post-traumatic vasospasm in patients with traumatic brain injury (TBI), we implemented a simplified transcranial Doppler (TCD) surveillance protocol in a neurointensive care setting. In this study, we evaluate the yield of this protocol. Methods Adult patients with TBI admitted to the neurointensive care unit were examined with TCD by 2 intensive care nurses trained in TCD examinations. Flow velocities of the middle cerebral arteries were recorded. TCD suspected vasospasm was defined as the mean flow velocity >120 cm/s, and when detected, the protocol recommended a supplementary computed tomography angiography. The rate of detection of TCD suspected vasospasm and the subsequent rate of radiological diagnosis of vasospasm were recorded. In multivariate logistic regression analysis, we evaluated age, initial Glasgow Coma Scale, craniotomy, and decompressive craniectomy as potential predictors of developing increased TCD velocity. Results A total of 84 patients with TBI with a median initial Glasgow Coma Scale score of 6 were examined by TCD. TCD suspected vasospasm was found in the middle cerebral arteries of 18% of examined patients. Two-thirds of patients with TCD suspected vasospasm were investigated with a subsequent computed tomography angiography, and 80% of these patients received a radiological diagnosis of vasospasm. In logistic regression analysis, decompressive craniectomy was significantly associated with increased risk of developing TCD suspected vasospasm (odds ratio: 11.57, 95% confidence interval: 2.59–51.73, P = 0.001). Conclusions The implementation of a simplified TCD surveillance protocol in a neurointensive care setting yielded an 18% detection rate of TCD suspected vasospasm. In our cohort of patients with TBI, decompressive craniectomy was associated with increased risk of developing TCD suspected vasospasm.

• Tverdal, Cathrine Buaas; Brunborg, Cathrine; Helseth, Eirik; Andelic, Nada; Koch, Marte Ellersgaard & Røe, Cecilie [Vis alle 8 forfattere av denne artikkelen] (2022). Referrals to early specialized rehabilitation after traumatic brain iinjury during the Covid-19 pandemic. Journal of Rehabilitation Medicine. ISSN 1650-1977. 54:jrm00334, s. 1–9. doi: 10.2340/jrm.v54.2203. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To quantify potential changes in direct referral to early specialized rehabilitation during the COVID-19 pandemic and the injury pattern of patients hospitalized with traumatic brain injury (TBI) at a level 1 trauma centre.Methods: In this registry-based study, data were retrieved from the Oslo TBI Registry-Neurosurgery and included adult patients with injury-related intracranial findings admitted to Oslo University Hospital (OUH). The study focused on a period of time when OUH was in any level of preparedness because of the COVID-19 pandemic; March 2020 to August 2021. For comparison, the study used patients hospitalized for TBI in 2018 and 2019.Results: A total of 1,310 hospitalized patients with TBI were divided into 2 groups; pre-pandemic and pandemic. Direct referral to early rehabilitation was maintained. Patient volume remained stable, and there were no differences between the groups regarding patient characteristics and acute management, although there was a significantly higher proportion of TBIs secondary to electric scooter accidents in the pandemic group. Results from univariable and multivariable logistic regression showed a multifaceted reality, but younger age, none or mild preinjury comorbidity and severe disability due to TBI at discharge from acute care remained stable strong predictors of direct referral to rehabilitation.Conclusion: For patients with moderate-severe TBI, the direct pathway to early specialized rehabilitation was maintained during 2020–21. However, the pandemic continued and the long-term impact for rehabilitation services is not yet known. LAY ABSTRACTAfter traumatic brain injury, early rehabilitation is important in order to achieve optimal functional outcome. The COVID-19 pandemic has put the health services under pressure, and hospitals in Norway were reorganized to be able to treat a large number of patients with COVID-19. Therefore, this study investigated to what extent the transfer to early rehabilitation has been affected and whether there have been changes in volume and characteristics of patients admitted to hospital with traumatic brain injury. In conclusion, the direct pathway to early rehabilitation was maintained during the pandemic years 2020 and 2021. Moreover, there was no change in the number of hospital admissions or patient characteristics, and acute management was maintained. However, the true long-term consequences for rehabilitation are not yet known.

• Tverdal, Cathrine Buaas; Aarhus, Mads; Rønning, Pål Andre; Skaansar, Ola Fougner; Skogen, Karoline & Andelic, Nada [Vis alle 7 forfattere av denne artikkelen] (2022). Incidence of emergency neurosurgical TBI procedures: a population-based study. BMC Emergency Medicine. 22(1), s. 1–11. doi: 10.1186/s12873-021-00561-w. Fulltekst i vitenarkiv Vis sammendrag

  Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and planning of specialized health care services. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures. Methods Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). Incidence was calculated in person-pears (crude) and age-adjusted for standard population. We conducted multivariate multivariable logistic regression models to assess variables associated with emergency neurosurgical procedures. Results A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100,000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100,000 and 3.3/100,000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low Glasgow coma score) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability. Conclusions The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers.

• Netteland, Dag Ferner; Mejlænder-Evjensvold, Magnus; Skaga, Nils Oddvar; Sandset, Else Charlotte; Aarhus, Mads & Helseth, Eirik (2021). Cerebral venous thrombosis in traumatic brain injury: A cause of secondary insults and added mortality. Journal of Neurosurgery. ISSN 0022-3085. 134(6), s. 1912–1920. doi: 10.3171/2020.4.JNS20511. Fulltekst i vitenarkiv Vis sammendrag

  OBJECTIVE Cerebral venous thrombosis (CVT) is increasingly recognized in traumatic brain injury (TBI), but its complications and effect on outcome remain undetermined. In this study, the authors characterize the complications and outcome effect of CVT in TBI patients. METHODS In a retrospective, case-control study of patients included in the Oslo University Hospital trauma registry and radiology registry from 2008 to 2014, the authors identified TBI patients with CVT (cases) and without CVT (controls). The groups were matched regarding Abbreviated Injury Scale 1990, update 1998 (AIS’98) head region severity score 3–6. Cases were identified by AIS’98 or ICD-10 code for CVT and CT or MR venography findings confirmed to be positive for CVT, whereas controls had no AIS’98 or ICD-10 code for CVT and CT venography or MR venography findings confirmed to be negative for CVT. All images were reviewed by a neuroradiologist. Rates of complications due to CVT were recorded, and mortality was assessed both unadjusted and in a multivariable logistic regression analysis adjusting for initial Glasgow Coma Scale score, Rotterdam CT score, and Injury Severity Score. Complications and mortality were also assessed in prespecified subgroup analysis according to CVT location and degree of occlusion from CVT. Lastly, mortality was assessed in an exploratory subgroup analysis according to the presence of complications from CVT. RESULTS The CVT group (73 patients) and control group (120 patients) were well matched regarding baseline characteristics. In the CVT group, 18% developed venous infarction, 11% developed intracerebral hemorrhage, and 19% developed edema, all representing complications secondary to CVT. Unadjusted 30-day mortality was 16% in the CVT group and 4% in the no-CVT group (p = 0.004); however, the difference was no longer significant in the adjusted analysis (OR 2.24, 95% CI 0.63–8.03; p = 0.215). Subgroup analysis by CVT location showed an association between CVT location and rate of complications and an unadjusted 30-day mortality of 50% for midline or bilateral CVT and 8% for unilateral CVT compared with 4% for no CVT (p < 0.001). The adjusted analysis showed a significantly higher mortality in the midline/ bilateral CVT group than in the no-CVT group (OR 8.41, 95% CI 1.56–45.25; p = 0.032). CONCLUSIONS There is a significant rate of complications from CVT in TBI patients, leading to secondary brain insults. The rate of complications is dependent on the anatomical location of the CVT, and midline and bilateral CVT is associated with an increased 30-day mortality in TBI patients. https://thejns.org/doi/abs/10.3171/2020.4.JNS20511 KEYWORDS cerebral venous thrombosis; traumatic brain injury; complications; mortality; outcome

• Switlyk, Marta Daniela; Niehusmann, Pitt; Sprauten, Mette; Magelssen, Henriette; Aarhus, Mads & Rasmussen, Finn [Vis alle 8 forfattere av denne artikkelen] (2021). Neurosarcoidosis resembling multiple meningiomas: A misleading presentation of the disease and diagnostic challenge. Acta Radiologica Open. 10(7), s. 1–8. doi: 10.1177/20584601211036550. Fulltekst i vitenarkiv Vis sammendrag

  Sarcoidosis is characterized by the presence of noncaseating granulomatous inflammation in the affected organs. Neurosarcoidosis denotes the involvement of the nervous system and can be either isolated or coexisting with extraneural systemic inflammation. The diagnosis of isolated neurosarcoidosis may be challenging due to unspecific symptoms and similar appearances with other disease processes. This report presents an uncommon case of intracranial sarcoidosis mimicking multiple meningiomas. Familiarity with the spectrum of magnetic resonance imaging findings in neurosarcoidosis is crucial to prevent interpretive errors which may in turn lead to an inappropriate diagnosis and treatment.

• Tverdal, Cathrine Buaas; Andelic, Nada; Helseth, Eirik; Brunborg, Cathrine; RØNNING, PÅL ANDRE & Hellstrøm, Torgeir [Vis alle 8 forfattere av denne artikkelen] (2021). In the aftermath of acute hospitalization for traumatic brain injury: Factors associated with the direct pathway into specialized rehabilitation. Journal of Clinical Medicine. 10(16), s. 1–14. doi: 10.3390/jcm10163577. Fulltekst i vitenarkiv Vis sammendrag

  Previous research has demonstrated that early initiation of rehabilitation and direct care pathways improve outcomes for patients with severe traumatic brain injury (TBI). Despite this knowledge, there is a concern that a number of patients are still not included in the direct care pathway. The study aim was to provide an updated overview of discharge to rehabilitation following acute care and identify factors associated with the direct pathway. We analyzed data from the Oslo TBI Registry—Neurosurgery over a five-year period (2015–2019) and included 1724 adults with intracranial injuries. We described the patient population and applied multivariable logistic regression to investigate factors associated with the probability of entering the direct pathway. In total, 289 patients followed the direct pathway. For patients with moderate–severe TBI, the proportion increased from 22% to 35% during the study period. Significant predictors were younger age, low preinjury comorbidities, moderate–severe TBI and disability due to TBI at the time of discharge. In patients aged 18–29 years, 53% followed the direct pathway, in contrast to 10% of patients aged 65–79 years (moderate–severe TBI). This study highlights the need for further emphasis on entering the direct pathway to rehabilitation, particularly for patients aged &gt;64 years.

• Rizvi, Syed Ali Mujtaba; Helseth, Eirik; Aarhus, Mads; Harr, Marianne Efskind; MIRZAMOHAMMADI, JALAL & RØNNING, PÅL ANDRE [Vis alle 8 forfattere av denne artikkelen] (2021). Favorable prognosis with nonsurgical management of type III acute odontoid fractures: a consecutive series of 212 patients. The spine journal. ISSN 1529-9430. 21(7), s. 1149–1158. doi: 10.1016/j.spinee.2021.02.003. Fulltekst i vitenarkiv Vis sammendrag

  BACKGROUND CONTEXT The recommended primary treatment for type III odontoid fractures (OFx) is external immobilization, except for patients having major displacement of the odontoid fragment. The bony fusion rate of type III OFx has been reported to be >85%. High compliance to treatment recommendations is favorable only if the treatment leads to a good outcome. PURPOSE The primary aim of this study was to determine the long-term outcome after conservative and surgical treatment of type III OFx and to reaffirm that primary external immobilization is the best treatment for most type III fractures. STUDY DESIGN/SETTING Retrospective study based on a prospective database. PATIENT SAMPLE Two hundred twelve consecutive patients with type III OFx treated at Oslo University Hospital over an 8-year period (2009–2017). OUTCOME MEASURES Long-term rates of bony fusion, crossover from primary conservative treatment to surgical fixation, new onset spinal cord injury (SCI), severe persistent neck pain (visual analogue scale - VAS), and persistent disability measured with Neck Disability index (NDI). METHODS The present study was based on data extracted from our quality control database for acute cervical spine fractures from a general population. During the years 2018 to 2019 long-term follow-up of alive patients was performed (median follow-up time was 38.0 months; range 3.0–108.0 months). The follow-up included neurological examination, radiological examination and scoring of bony fusion status, crossover from primary conservative treatment to surgical fixation, new onset SCI, neck pain, and Neck Disability Index (NDI score). RESULTS In this consecutive series of 212 patients with type III acute OFx, median patient age was 72 years, 56% had severe preinjury comorbidities (ASA score ≥3) and 22% lived dependently. Severe comorbidities and dependent living were significantly associated with increasing age (p<.001). The trauma mechanism was fall injury in 82%. The median age of patients injured by falls was significantly higher than in patients with a nonfall injury (p<.001). At the time of diagnosis, 4% had an OFx related SCI. Primary treatment was external immobilization alone in 95.3% and open surgical fixation in 4.7%. Patients treated with primary external immobilization alone presented with significantly less translation of the odontoid fragment (p<.001) and less angulation of the odontoid fragment (p=.025) than patients treated with primary surgery. Subsequent crossover to surgical fixation was performed in 5.4%. At long-term follow-up, 95.7% of patients had bony fusion of the OFx, 80.5% had minimal/no neck pain, and none developed new onset SCI. There was no significant difference in long-term follow-up VAS (p=.444) or NDI (p=.562) between the primary external immobilization group and the primary surgical group. CONCLUSION This study reaffirms that nonsurgical treatment remains the preferable option in the majority of patients with type III OFx.

• RØNNING, PÅL ANDRE; Helseth, Eirik; Skaansar, Ola Fougner; Tverdal, Cathrine Buaas; Andelic, Nada & Bhatnagar, Rahul [Vis alle 11 forfattere av denne artikkelen] (2021). Impact of Preinjury Antithrombotic Therapy on 30-Day Mortality in Older Patients Hospitalized With Traumatic Brain Injury (TBI). Frontiers in Neurology. doi: 10.3389/fneur.2021.650695. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Elderly patients are frequently in need of antithrombotic therapy for reducing thrombotic events. The association between antithrombotic drugs and survival after traumatic brain injury (TBI) is, nevertheless, unclear. Methods: This retrospective study included patients ≥65 years admitted to a Norwegian Level 1 trauma center with TBI identified on cerebral computed tomography (cerebral-CT) during 2014–2019. Preinjury use of antiplatelets and anticoagulants was compared to the prescription rate in the general Norwegian population. The primary outcome was 30-day mortality. Uni- and multivariate logistic regression analyses estimated the association between the use of antithrombotic drugs and mortality. Results: The study includes 832 consecutive TBI patients ≥65 years. The median age was 76 years, 58% were males, 51% had moderate or severe TBI, and 39% had multiple traumas. Preinjury use of antithrombotics was registered in 471/832 (55.6%) patients; antiplatelet therapy alone in 268, anticoagulant therapy alone in 172, and combined antiplatelet and anticoagulant therapy in 31. Antiplatelet use did not differ between the study cohort and the general Norwegian population ≥65 years (31 vs. 31%, p = 0.87). Anticoagulant therapy was used more commonly in the study cohort than in the general Norwegian population (24 vs. 19%, p = 0.04). Combined use of antiplatelet and anticoagulant therapy was significantly associated with 30-day mortality, while preinjury antiplatelet or anticoagulation treatment alone was not. No difference in 30-day mortality between patients using VKA, DOACs, or LMWH was encountered. Conclusions: In this cohort, neither antiplatelet nor anticoagulant therapy alone was associated with increased 30-day mortality. Anticoagulant use was more prevalent among TBI patients than the general population, suggesting that anticoagulation might contribute to the initiation of intracranial bleeding after blunt head trauma. Combined antiplatelet and anticoagulant therapy posed increased risk of 30-day mortality.

• Rizvi, Syed Ali Mujtaba; Helseth, Eirik; Rønning, Pål André; MIRZAMOHAMMADI, JALAL; Harr, Marianne Efskind & Brommeland, Tor [Vis alle 13 forfattere av denne artikkelen] (2020). Odontoid fractures: impact of age and comorbidities on surgical decision making. BMC Surgery. 20(236), s. 1–10. doi: 10.1186/s12893-020-00893-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Surgical fixation is recommended for type II and III odontoid fractures (OFx) with major translation of the odontoid fragment, regardless of the patient’s age, and for all type II OFx in patients aged ≥50 years. The level of compliance with this recommendation is unknown, and our hypothesis is that open surgical fixation is less frequently performed than recommended. We suspect that this discrepancy might be due to the older age and comorbidities among patients with OFx. Methods We present a prospective observational cohort study of all patients in the southeastern Norwegian population (3.0 million) diagnosed with a traumatic OFx in the period from 2015 to 2018. Results Three hundred thirty-six patients with an OFx were diagnosed, resulting in an overall incidence of 2.8/100000 persons/year. The median age of the patients was 80 years, and 45% were females. According to the Anderson and D’Alonzo classification, the OFx were type II in 199 patients (59%) and type III in 137 patients (41%). The primary fracture treatment was rigid collar alone in 79% of patients and open surgical fixation in 21%. In the multivariate analysis, the following parameters were significantly associated with surgery as the primary treatment: independent living, less serious comorbidities prior to the injury, type II OFx and major sagittal translation of the odontoid fragment. Conversion from external immobilization alone to subsequent open surgical fixation was performed in 10% of patients. Significant differences the in conversion rate were not observed between patients with type II and III fractures. The level of compliance with the treatment recommendations for OFx was low. The main deviation was the underuse of primary surgical fixation for type II OFx. The most common reasons listed for choosing primary external immobilization instead of primary surgical fixation were an older age and comorbidities. Conclusion Major comorbidities and an older age appear to be significant factors contributing to physicians’ decision to refrain from the surgical fixation of OFx. Hence, comorbidities and age should be considered for inclusion in the decision tree for the choice of treatment for OFx in future guidelines.

• Tverdal, Cathrine Buaas; Aarhus, Mads; Andelic, Nada; Skaansar, Ola Fougner; Skogen, Karoline & Helseth, Eirik (2020). Characteristics of traumatic brain injury patients with abnormal neuroimaging in Southeast Norway. Injury Epidemiology. 7:45, s. 1–13. doi: 10.1186/s40621-020-00269-8. Fulltekst i vitenarkiv Vis sammendrag

  Background The vast majority of hospital admitted patients with traumatic brain injury (TBI) will have intracranial injury identified by neuroimaging, requiring qualified staff and hospital beds. Moreover, increased pressure in health care services is expected because of an aging population. Thus, a regular evaluation of characteristics of hospital admitted patients with TBI is needed. Oslo TBI Registry – Neurosurgery prospectively register all patients with TBI identified by neuroimaging admitted to a trauma center for southeast part of Norway. The purpose of this study is to describe this patient population with respect to case load, time of admission, age, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival. Methods Data for 5 years was extracted from Oslo TBI Registry – Neurosurgery. Case load, time of admission, age, sex, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival was compiled and compared. Results From January 1st, 2015 to December 31st, 2019, 2153 consecutive patients with TBI identified by neuroimaging were registered. The admission rate of TBI of all severities has been stable year-round since 2015. Mean age was 52 years (standard deviation 25, range 0–99), and 68% were males. Comorbidities were common; 28% with pre-injury ASA score of ≥3 and 25% used antithrombotic medication. The dominating cause of injury in all ages was falls (55%) but increased with age. Upon admission, the head injury was classified as mild TBI in 46%, moderate in 28%, and severe (Glasgow coma score ≤ 8) in 26%. Case load was stable without seasonal variation. Majority of patients (68%) were admitted during evening, night or weekend. 68% was admitted to intensive care unit. Length of hospital stay was 4 days (median, interquartile range 3–9). 30-day survival for mild, moderate and severe TBI was 98, 94 and 69%, respectively. Conclusions The typical TBI patients admitted to hospital with abnormal neuroimaging were aged 50–79 years, often with significant comorbidity, and admitted outside ordinary working hours. This suggests the necessity for all-hour presence of competent health care professionals.

• Skansaar, Ola Fougner; Tverdal, Cathrine Buaas; Rønning, Pål André; Skogen, Karoline; Brommeland, Tor & Røise, Olav [Vis alle 9 forfattere av denne artikkelen] (2020). Traumatic brain injury—the effects of patient age on treatment intensity and mortality. BMC Neurology. 20:376, s. 1–10. doi: 10.1186/s12883-020-01943-6. Fulltekst i vitenarkiv Vis sammendrag

  Background Ageing is associated with worse treatment outcome after traumatic brain injury (TBI). This association may lead to a self-fulfilling prophecy that affects treatment efficacy. The aim of the current study was to evaluate the role of treatment bias in patient outcomes by studying the intensity of diagnostic procedures, treatment, and overall 30-day mortality in different age groups of patients with TBI. Methods Included in this study was consecutively admitted patients with TBI, aged ≥ 15 years, with a cerebral CT showing intracranial signs of trauma, during the time-period between 2015–2018. Data were extracted from our prospective quality control registry for admitted TBI patients. As a measure of management intensity in different age groups, we made a composite score, where placement of intracranial pressure monitor, ventilator treatment, and evacuation of intracranial mass lesion each gave one point. Uni- and multivariate survival analyses were performed using logistic multinomial regression. Results A total of 1,571 patients with TBI fulfilled the inclusion criteria. The median age was 58 years (range 15–98), 70% were men, and 39% were ≥ 65 years. Head injury severity was mild in 706 patients (45%), moderate in 437 (28%), and severe in 428 (27%). Increasing age was associated with less management intensity, as measured using the composite score, irrespective of head injury severity. Multivariate analyses showed that the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, severe comorbidities, severe TBI, Rotterdam CT-score ≥ 3, and low management intensity. Conclusion The present study indicates that the management intensity of hospitalised patients with TBI decreased with advanced age and that low management intensity was associated with an increased risk of 30-day mortality. This suggests that the high mortality among elderly TBI patients may have an element of treatment bias and could in the future be limited with a more aggressive management regime.

• Brommeland, Tor; Helseth, Eirik; Aarhus, Mads; Moen, Kent Gøran; Dyrskog, Stig & Bergholt, Bo [Vis alle 8 forfattere av denne artikkelen] (2018). Best practice guidelines for blunt cerebrovascular injury (BCVI). Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 26, s. 1–10. doi: 10.1186/s13049-018-0559-1. Fulltekst i vitenarkiv Vis sammendrag

  Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1–2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created. The current guideline is the end result of this committees work. It is based on a systematic literature search and critical review of all available publications in addition to a standardized consensus process. We recommend using the expanded Denver screening criteria and CT angiography (CTA) for the detection of BCVI. Early antithrombotic treatment should be commenced as soon as considered safe and continued for at least 3 months. A CTA at 7 days to confirm or discard the diagnosis as well as a final imaging control at 3 months should be performed.

• Håvik, Aril Løge; Bruland, Ove; Aarhus, Mads; Kalland, Karl-Henning; Stokowy, Tomasz & Lund-Johansen, Morten [Vis alle 7 forfattere av denne artikkelen] (2018). Screening for viral nucleic acids in vestibular schwannoma. Journal of Neurovirology. ISSN 1355-0284. 24(6), s. 730–737. doi: 10.1007/s13365-018-0669-6. Fulltekst i vitenarkiv
• Håvik, Aril Løge; Bruland, Ove; Myrseth, Erling; Miletic, Hrvoje; Aarhus, Mads & Knappskog, Per [Vis alle 7 forfattere av denne artikkelen] (2017). Genetic landscape of sporadic vestibular schwannoma. Journal of Neurosurgery. ISSN 0022-3085. 128(3), s. 911–922. doi: 10.3171/2016.10.JNS161384. Fulltekst i vitenarkiv
• Brostigen, C. S.; Meling, Torstein Ragnar; Marthinsen, Pål Bache; Scheie, David; Aarhus, Mads & Helseth, Eirik (2016). Surgical management of colloid cyst of the third ventricle. Acta Neurologica Scandinavica. ISSN 0001-6314. 135(4), s. 484–487. doi: 10.1111/ane.12632. Fulltekst i vitenarkiv
• Klink, Barbara; Miletic, Hrvoje; Stieber, Daniel; Huszthy, Peter Csaba; Campos, Valenzuela Jaime Alberto & Balss, Jörg [Vis alle 19 forfattere av denne artikkelen] (2013). A novel, diffusely infiltrative xenograft model of human anaplastic oligodendroglioma with mutations in FUBP1, CIC, and IDH1. PLOS ONE. 8, s. e59773–e59773. doi: 10.1371/journal.pone.0059773. Fulltekst i vitenarkiv
• Berle, Magnus Foldal; Kroksveen, Ann Cathrine; Garberg, Hilde Kristin; Aarhus, Mads; Haaland, Øystein & Wester, Knut [Vis alle 9 forfattere av denne artikkelen] (2013). Quantitative proteomics comparison of arachnoid cyst fluid and cerebrospinal fluid collected perioperatively from arachnoid cyst patients. Fluids and Barriers of the CNS. 10(17). doi: 10.1186/2045-8118-10-17. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is little knowledge concerning the content and the mechanisms of filling of arachnoid cysts. The aim of this study was to compare the protein content of arachnoid cysts and cerebrospinal fluid by quantitative proteomics to increase the understanding of arachnoid cysts. Methods: Arachnoid cyst fluid and cerebrospinal fluid from five patients were analyzed by quantitative proteomics in two separate experiments. In a label-free experiment arachnoid cyst fluid and cerebrospinal fluid samples from individual patients were trypsin digested and analyzed by Orbitrap mass spectrometry in a label-free manner followed by data analysis using the Progenesis software. In the second proteomics experiment, a patient sample pooling strategy was followed by MARS-14 immunodepletion of high abundant proteins, trypsin digestion, iTRAQ labelling, and peptide separation by mix-phase chromatography followed by Orbitrap mass spectrometry analysis. The results from these analyzes were compared to previously published mRNA microarray data obtained from arachnoid membranes. Results: We quantified 348 proteins by the label-free individual patient approach and 1425 proteins in the iTRAQ experiment using a pool from five patients of arachnoid cyst fluid and cerebrospinal fluid. This is by far the largest number of arachnoid cyst fluid proteins ever identified, and the first large-scale quantitative comparison between the protein content of arachnoid cyst fluid and cerebrospinal fluid from the same patients at the same time. Consistently in both experiment, we found 22 proteins with significantly increased abundance in arachnoid cysts compared to cerebrospinal fluid and 24 proteins with significantly decreased abundance. We did not observe any molecular weight gradient over the arachnoid cyst membrane. Of the 46 proteins we identified as differentially abundant in our study, 45 were also detected from the mRNA expression level study. None of them were previously reported as differentially expressed. We did not quantify any of the proteins corresponding to gene products from the ten genes previously reported as differentially abundant between arachnoid cysts and control arachnoid membranes. Conclusions: From our experiments, the protein content of arachnoid cyst fluid and cerebrospinal fluid appears to be similar. There were, however, proteins that were significantly differentially abundant between arachnoid cyst fluid and cerebrospinal fluid. This could reflect the possibility that these proteins are affected by the filling mechanism of arachnoid cysts or are shed from the membranes into arachnoid cyst fluid. Our results do not support the proposed filling mechanisms of oncotic pressure or valves.

• Sundstrøm, Terje; Helland, Christian Andre; Aarhus, Mads & Wester, Knut (2012). What is the pressure in chronic subdural hematomas? A prospective, population-based study. Journal of Neurotrauma. ISSN 0897-7151. 29(1), s. 137–142. doi: 10.1089/neu.2011.1776. Fulltekst i vitenarkiv
• Aarhus, Mads; Lund-Johansen, Morten & Knappskog, Per (2011). Gene expression profiling of meningiomas: current status after a decade of microarray-based transcriptomic studies. Acta Neurochirurgica. ISSN 0001-6268. 153(3), s. 447–456. doi: 10.1007/s00701-010-0906-0. Fulltekst i vitenarkiv Vis sammendrag

  Purpose This article provides a review of the transcriptomic expression profiling studies that have been performed on meningiomas so far. We discuss some future prospects and challenges ahead in the field of gene expression profiling. Methods We performed a systematic search in the PubMed and EMBASE databases in May 2010 using the following search terms alone or in combination: “meningioma”, “microarray analysis”, “oligonucleotide array sequence analysis”, or “gene expression profiling”. Only original research articles in English that had used RNA hybridized to high-resolution microarray chips to generate gene expression profiles were included. Results We identified 13 articles matching the inclusion criteria. All studies had been performed during the last decade. Conclusions The main results of the studies can be grouped in three categories: (1) several groups have identified meningioma-specific genes and genes associated with the three WHO grades, and the main histological subtypes of grade I meningiomas; (2) one publication has shown that the general transcription profile of samples of all WHO grades differs in vivo and in vitro; (3) one report provides evidence that microarray technology can be used in an automated fashion to classify tumors. Due to lack of consensus on how microarray data are presented, possible general trends found across the studies are difficult to extract. This could obstruct the discovery of important genes and pathways universally involved in meningioma biology.

• Aarhus, Mads; Helland, Christian Andre; Lund-Johansen, Morten; Wester, Knut & Knappskog, Per Morten (2010). Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts. Cerebrospinal Fluid Research. 7. doi: 10.1186/1743-8454-7-6. Fulltekst i vitenarkiv Vis sammendrag

  Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a high-resolution mRNA microarray analysis. In addition we have screened DNA from AC samples for chromosomal duplications or deletions using DNA microarray-based copy number variation analysis. Results The transcriptome consisting of 33096 gene probes showed a near-complete similarity in expression between AC and AM samples. Only nine genes differed in expression between the two tissues: ASGR1, DPEP2, SOX9, SHROOM3, A2BP1, ATP10D, TRIML1, NMU were down regulated, whereas BEND5 was up regulated in the AC samples. Three of the AC samples had unreported human DNA copy number variations, all DNA gains. Conclusions Extending results of previous anatomical studies, the present study has identified a small subset of differentially expressed genes and DNA alterations in arachnoid cysts compared to normal arachnoid membrane.

• Aarhus, Mads; Sætran, Hege Aase; Mørk, Sverre; Lund-Johansen, Morten & Knappskog, Per Morten (2010). Global Gene Expression Profiling and Tissue Microarray Reveal Novel Candidate Genes and Down-Regulation of the Tumor Suppressor Gene CAV1 in Sporadic Vestibular Schwannomas. Neurosurgery. ISSN 0148-396X. 67(4), s. 998–1019. doi: 10.1227/NEU.0b013e3181ec7b71. Fulltekst i vitenarkiv
• Helland, Christian Andre; Aarhus, Mads; Knappskog, Per Morten; Olsson, Lisa K; Lund-Johansen, Morten & Amiry-Moghaddam, Mahmood Reza [Vis alle 7 forfattere av denne artikkelen] (2010). Increased NKCC1 expression in arachnoid cysts supports secretory basis for cyst formation. Experimental Neurology. ISSN 0014-4886. 224(2), s. 424–428. doi: 10.1016/j.expneurol.2010.05.002. Fulltekst i vitenarkiv
• Aarhus, Mads; Helland, Christian Andre & Wester, Knut (2009). Differences in anatomical distribution, gender, and sidedness between ruptured and unruptured intracranial aneurysms in a defined patient population. Acta Neurochirurgica. ISSN 0001-6268. 151(12), s. 1569–1574. doi: 10.1007/s00701-009-0316-3. Fulltekst i vitenarkiv
• Wibom, Carl; Mörén, Lina; Aarhus, Mads; Knappskog, Per; Lund-Johansen, Morten & Antti, Henrik [Vis alle 7 forfattere av denne artikkelen] (2009). Proteomic profiles differ between bone invasive and noninvasive benign meningiomas of fibrous and meningothelial subtype. Journal of Neuro-Oncology. ISSN 0167-594X. 94(3), s. 321–331. doi: 10.1007/s11060-009-9865-9. Fulltekst i vitenarkiv
• Aarhus, Mads; Bruland, Ove; Bredholt, Geir; Lybæk, Helle; Husebye, Eystein Sverre & Krossnes, Bård Kronen [Vis alle 10 forfattere av denne artikkelen] (2008). Microarray analysis reveals down-regulation of the tumour suppressor gene WWOX and up-regulation of the oncogene TYMS in intracranial sporadic meningiomas. Journal of Neuro-Oncology. ISSN 0167-594X. 88(3), s. 251–259. doi: 10.1007/s11060-008-9569-6. Fulltekst i vitenarkiv

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• Netteland, Dag Ferner; Aarhus, Mads; Sandset, Else Charlotte; Sorteberg, Angelika; Padayachy, Llewellyn & Helseth, Eirik [Vis alle 7 forfattere av denne artikkelen] (2025). In Reply: Comment on “Real-Time Automated Measurements of Optic Nerve Sheath Diameter for Noninvasive Assessment of Intracranial Pressure in Aneurysmal Subarachnoid Hemorrhage”. Neurocritical Care. ISSN 1541-6933. doi: 10.1007/s12028-025-02279-0. Fulltekst i vitenarkiv
• Rasmussen, Mari Storli; Andelic, Nada; Selj, Joanna Nordhagen; Danielsen, Vilde Marie; Løvstad, Marianne & Howe, Emilie Isager [Vis alle 30 forfattere av denne artikkelen] (2024). Self-management support program delivered in the sub-acute phase after traumatic injury-study protocol for a pragmatic randomized controlled trial. Trials. 25(1), s. 639–639. doi: 10.1186/s13063-024-08492-0. Fulltekst i vitenarkiv Vis sammendrag

  Background Traumatic injuries, defined as physical injuries with sudden onset, are a major cause of distress and disability, with far-reaching societal consequences. A significant proportion of trauma survivors report persistent symptoms and difficulties after the injury, and studies show unmet health care needs. Self-management programs delivered in the sub-acute phase after traumatic injuries are scarcely evaluated. The aim of the present study is to evaluate the effectiveness of a self-management program (SEMPO), delivered 3–4 months after moderate-to-severe traumatic injury. Methods This study protocol describes a pragmatic randomized controlled trial (RCT) with two classical RCT arms (intervention and control) and an explorative self-selection arm. 220 patients will be recruited from Oslo University Hospital, the largest Trauma Referral Centre in Norway. Patients aged 18–72 years residing in the south-east region of Norway, admitted to the Trauma Centre directly or within 72 h after having sustained a moderate to severe traumatic injury, defined as a New Injury Severity Score > 9, having at least 2 days hospital stay, and reporting injury-related symptoms and impairment at discharge from the acute hospital will be included. Patients will be randomly assigned to either a classical RCT randomization arm (intervention or control arm) or to a self-selection arm. In the randomization arm, participants are further randomized into intervention or control group. Participants allocated to the self-selection arm will choose to partake either in the intervention or control arm. The primary outcome is the level of self-efficacy in trauma coping assessed 6 months after completion of the intervention, with a similar time point for the control group. Secondary outcomes include symptom burden, physical functioning and disability, return to work and health care utilization, health-related quality of life, and communication competency. In addition, patients will be asked to nominate one domain-related measurement as their preferred outcome measure. Discussion This RCT will determine the effect of a self-management program tailored to patients with moderate to severe physical trauma, and the self-selection arm incorporates the potential influence of patient treatment preferences on intervention results. If the intervention proves effective, cost-effectiveness and cost-utility analyses will be performed and thereby provide important information for clinicians and policy makers. Trial registration The study is registered in Clinical Trials with the identifier: NCT06305819. Registered on March 05, 2004.

• Netteland, Dag Ferner; Aarhus, Mads; Sandset, Else Charlotte; Padayachy, Llewellyn; Helseth, Eirik & Brekken, Reidar (2024). In Reply: Noninvasive Assessment of Intracranial Pressure: Deformability Index as an Adjunct to Optic Nerve Sheath Diameter to Increase Diagnostic Ability. Neurocritical Care. ISSN 1541-6933. 41, s. 307–309. doi: 10.1007/s12028-024-02027-w. Fulltekst i vitenarkiv
• Netteland, Dag Ferner; Aarhus, Mads; Sandset, Else Charlotte; Padayachy, Llewellyn; Helseth, Eirik & Brekken, Reidar (2024). In Reply: Possible Factors Missed While Assessing Optic Nerve Sheath Diameter and Deformability Index in Patients with Severe Traumatic Brain Injury. Neurocritical Care. ISSN 1541-6933. 41, s. 305–306. doi: 10.1007/s12028-024-02015-0. Fulltekst i vitenarkiv
• Aarhus, Mads (2010). Transcriptome analysis of meningiomas, vestibular schwannomas, and arachnoid cysts. Universitetet i Bergen. Fulltekst i vitenarkiv

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