Torstein Ragnar Meling

• Bains, Simer Jit; Niehusmann, Pitt; Meling, Torstein Ragnar; Saxhaug, Cathrine; Züchner, Mark & Brandal, Petter (2019). Disseminated central nervous system hemangioblastoma in a patient with no clinical or genetic evidence of von Hippel-Lindau disease-a case report and literature review. Acta Neurochirurgica.  ISSN 0001-6268.  161(2), s 343- 349 . doi: 10.1007/s00701-019-03800-z
• Corniola, Marco V.; Lemee, Jean-Michel; Da Broi, Michele; Joswig, Holger; Schaller, Karl; Helseth, Eirik & Meling, Torstein Ragnar (2019). Posterior fossa meningiomas: perioperative predictors of extent of resection, overall survival and progression-free survival. Acta Neurochirurgica.  ISSN 0001-6268.  161(5), s 1003- 1011 . doi: 10.1007/s00701-019-03862-z
• König, Marton; Osnes, Terje; Bratland, Åse; Jebsen, Peter Wilhelm & Meling, Torstein Ragnar (2019). Treatment of Sinonasal Adenocarcinoma: A Population-Based Prospective Cohort Study. Journal of Neurological Surgery. Part B: Skull Base: an interdisciplinary approach.  ISSN 2193-6331. . doi: https://doi.org/ 10.1055/s-0039-1694050
• König, Marton; Osnes, Terje; Bratland, Åse & Meling, Torstein Ragnar (2019). Squamous Cell Carcinoma of the Paranasal Sinuses: A Single Center Experience. Journal of Neurological Surgery. Part B: Skull Base: an interdisciplinary approach.  ISSN 2193-6331. . doi: https://doi.org/ 10.1055/s-0039-1694967
• Lemee, Jean-Michel; Corniola, Marco V.; Da Broi, Michele; Joswig, Holger; Scheie, David; Schaller, Karl; Helseth, Eirik & Meling, Torstein Ragnar (2019). Extent of Resection in Meningioma: Predictive Factors and Clinical Implications. Scientific Reports.  ISSN 2045-2322.  9(1), s 1- 6 . doi: 10.1038/s41598-019-42451-z Vis sammendrag

  Meningiomas present as intracranial extra-axial lesions with dural attachment, which are primarily managed surgically. The extent of resection (EOR) may vary depending on patient- and tumor-related factors. The aim of this study is to identify preoperative predictive factors of EOR and to propose an estimation of the predicted gross total resection (GTR) based of patient- and tumor-characteristics. 1469 patients from a retrospectively (1990 to 2002) and prospectively managed (2003 to 2010) databank of Oslo University Hospital, Norway, totalling 11,414 patient-years of follow-up were included. Patients had a mean age at surgery of 64 ± 20.1 years with a female-to-male ratio was 2.4:1 and a mean KPS of 81.2 ± 12.1. Skull-base meningiomas represented 47% of all cases. WHO grades were I in 92.3%, II in 5.2%, and III in 2.2%. Bone infiltration was described in 18.7% of cases. 39.3% of patients had Simpson I resection, 34.3% had Simpson II, 5.4% had Simpson III, 20.6% had Simpson IV, and 0.5% had Simpson V. The risk factors for incomplete resection were: symptomatic presentation (OR 0.56 [0.43–0.72]), skull-base location (OR 0.79 [0.70–0.88]), and bone invasion (OR 0.85 [0.73–0.99]). Using a recursive partitioning analysis, we propose a classification-tree for the prediction of GTR rate based on preoperatively determinable patient- and tumor characteristics. The identification of preoperative predictors of poor GTR rate may aid clinicians managing meningioma patients. In selected cases were the predicted GTR rate is low, staged treatment with surgical debulking followed by adjuvant therapy may be favored in order to minimize postoperative morbidity and mortality.

• Lemee, Jean-Michel; Corniola, Marco V.; Da Broi, Michele; Schaller, Karl & Meling, Torstein Ragnar (2019). Early Postoperative Complications in Meningioma: Predictive Factors and Impact on Outcome. World Neurosurgery.  ISSN 1878-8750. . doi: 10.1016/j.wneu.2019.05.010 Vis sammendrag

  Background Craniotomies carry inherent risks of postoperative complications that may have a negative impact on patients' status. Recognizing and preventing surgical complications is of paramount importance, especially in meningioma surgery, where most of these tumors are benign and current management protocols are effective in terms of disease control and maintenance of higher quality of life. The objective of this study was to describe the early complications after surgery and their predictive factors in patients undergoing resection of intracranial meningiomas. Methods A partly retrospective, partly prospective review was conducted in a Norwegian population-based cohort of 1469 consecutive cases of meningioma surgery treated at the university hospitals of Oslo, totaling 11,414 patient-years of follow-up. Results 2.6% of patients had a postoperative hematoma, 2.7% a postoperative infection, 3.9% a postoperative worsening of neurologic status; 5.4% of patients died during a 30-day period after surgery. Predictive factors of increased risk of postoperative complications were patient's age for the hematoma, a non–skull base meningioma for infection, and postoperative hematoma for the risk of neurologic worsening or 30-day mortality. Conclusions Early postoperative complications in meningioma surgery have a negative impact on patient survival and postoperative neurologic status, in a disease where survival is usually not limited by the meningioma itself. In this study, we identified risk factors for early postoperative complications, the identification of at-risk populations may help to prevent the occurrence of these risk factors.

• Lemée, Jean-Michel; Joswig, Holger; Broi, Michele Da; Corniola, Marco Vincenzo; Scheie, David; Schaller, Karl; Helseth, Eirik & Meling, Torstein Ragnar (2019). WHO grade I meningiomas: classification-tree for prognostic factors of survival. Neurosurgical review.  ISSN 0344-5607.  s 1- 10 . doi: 10.1007/s10143-019-01117-0 Vis sammendrag

  World Health Organization (WHO) grade I meningiomas are intracranial extracerebral tumors, in which microsurgery as a stand-alone therapy provides high rates of disease control and low recurrence rates. Our aim was to identify prognostic factors of overall survival and time-to-retreat (OS; TTR) in a cohort of patients with surgically managed WHO grade I meningioma. Patients with WHO grade I meningiomas from a retrospectively (1990 to 2002) and prospectively managed (2003 to 2010) databank of Oslo University Hospital, Norway, were included. The mean follow-up was 9.2 ± 5.7 years, with a total of 11,414 patient-years. One thousand three hundred fifty-five patients were included. The mean age was 58 ± 13.2, mean Karnofsky Performance Status (KPS) 92.6 ± 26.1 and female-to-male ratio 2.5:1. The 1-year, 5-year, 10-year, 15-year, and 20-year probabilities were 0.98, 0.91, 0.87, 0.84, and 0.8 for TTR. Patient age (OR 0.92 [0.91, 0.94]), male sex (OR 0.59 [0.45, 0.76]), preoperative KPS ≥ 70 (OR 2.22 [1.59, 3.13]), skull base location (OR 0.77 [0.60, 1]), and the occurrence of a postoperative hematoma (OR 0.44 [0.26, 0.76]) were identified as independent prognostic factors of OS. Patient age (OR 1.02 [1.01, 1.03]) and skull base location (OR 0.30 [0.21, 0.45]) were independent predictors of decreased PFS. Using a recursive partitioning analysis, we suggest a classification tree for the prediction of 5-year PFS based on patient and tumor characteristics. The findings from this cohort of meningioma WHO I patients helps to identify patients at risk of recurrence and tailor the therapeutic management. Keywords Meningioma Overall survival Prognostic factors Time-to-retreat WHO grade I

• Meling, Torstein Ragnar; Broi, Michele Da; Scheie, David; Helseth, Eirik & Smoll, Nicolas Roydon (2019). Meningioma surgery-are we making progress?. World Neurosurgery.  ISSN 1878-8750.  125(5), s e205- e213 . doi: 10.1016/j.wneu.2019.01.042
• Meling, Torstein Ragnar; Da Broi, Michele; Scheie, David & Helseth, Eirik (2019). Meningiomas - skull-base vs non-skull base. Neurosurgical review.  ISSN 0344-5607.  42(1), s 163- 173 . doi: 10.1007/s10143-018-0976-7
• Meling, Torstein Ragnar & Patet, Gildas (2019). Clip-wrapping of ruptured blood blister-like aneurysms of the internal carotid artery. Neurosurgical review.  ISSN 0344-5607.  s 1- 7 . doi: 10.1007/s10143-019-01172-7
• Meling, Torstein Ragnar & Patet, Gildas (2019). What is the best therapeutic approach to a pediatric patient with a deep-seated brain AVM?. Neurosurgical review.  ISSN 0344-5607.  42(2), s 409- 416 . doi: 10.1007/s10143-019-01101-8
• Sadaghiani, Sepideh; Dombert, Pascasie L.; Løvstad, Marianne; Funderud, Ingrid; Meling, Torstein Ragnar; Endestad, Tor; Knight, Robert T.; Solbakk, Anne-Kristin & D'Esposito, Mark (2019). Lesions to the fronto-parietal network impact alpha-band phase synchrony and cognitive control. Cerebral Cortex.  ISSN 1047-3211.  29(10), s 4143- 4153 . doi: 10.1093/cercor/bhy296
• Broi, Michele Da; Jahr, Guro; Beiske, Klaus; Holte, Harald & Meling, Torstein Ragnar (2018). Efficacy of the Nordic and the MSKCC chemotherapy protocols on the overall and progression-free survival in intracranial PCNSL. Blood Cells, Molecules & Diseases.  ISSN 1079-9796.  73, s 25- 32 . doi: 10.1016/j.bcmd.2018.08.005 Fulltekst i vitenarkiv.
• Hosainey, Sayied Abdol Mohieb; Lassen, Benjamin; Hald, John K; Helseth, Eirik & Meling, Torstein Ragnar (2018). The effect of tumor removal via craniotomies on preoperative hydrocephalus in adult patients with intracranial tumors. Neurosurgical review.  ISSN 0344-5607.  s 1- 11 . doi: 10.1007/s10143-018-1021-6
• Jahr, Guro; Broi, Michele Da; Holte, Harald; Beiske, Klaus & Meling, Torstein Ragnar (2018). Evaluation of Memorial Sloan-Kettering Cancer Center and International Extranodal Lymphoma Study Group prognostic scoring systems to predict Overall Survival in intracranial Primary CNS lymphoma. Brain and Behavior.  ISSN 2162-3279.  8(3) . doi: 10.1002/brb3.928 Fulltekst i vitenarkiv.
• Jahr, Guro; Broi, Michele Da; Holte, Harald; Beiske, Klaus & Meling, Torstein Ragnar (2018). The role of surgery in intracranial PCNSL. Neurosurgical review.  ISSN 0344-5607.  41(4), s 1037- 1044 . doi: 10.1007/s10143-018-0946-0
• Johnson, Elizabeth L.; Adams, Jenna N.; Solbakk, Anne-Kristin; Endestad, Tor; Larsson, Pål Gunnar; Ivanovic, Jugoslav; Meling, Torstein Ragnar; Lin, Jack J. & Knight, Robert T. (2018). Dynamic frontotemporal systems process space and time in working memory. PLoS Biology.  ISSN 1544-9173.  16(3) . doi: 10.1371/journal.pbio.2004274
• Kam, Julia W.Y.; Solbakk, Anne-Kristin; Endestad, Tor; Meling, Torstein Ragnar & Knight, Robert Thomas (2018). Lateral prefrontal cortex lesion impairs regulation of internally and externally directed attention. NeuroImage.  ISSN 1053-8119.  175(15), s 91- 99 . doi: 10.1016/j.neuroimage.2018.03.063
• Kam, Julia W.Y.; Solbakk, Anne-Kristin; Funderud, Ingrid; Endestad, Tor; Meling, Torstein Ragnar & Knight, Robert T. (2018). Orbitofrontal damage reduces auditory sensory response in humans.. Cortex.  ISSN 0010-9452.  101, s 309- 312 . doi: 10.1016/j.cortex.2017.12.023 Vis sammendrag

  The orbitofrontal cortex (OFC) is centrally involved in high-level cognitive functions. For instance, it has long been associated with decision-making (Wallis, 2012), with traditional views focusing on its role in response inhibition (Dias, Robbins, & Roberts, 1996), and more recent studies emphasizing valuation or outcome prediction (Rudebeck & Murray, 2014; Schoenbaum, Roesch, Stalnaker, & Takahashi, 2009). The OFC is also implicated in emotional processing, evidenced by OFC patients having difficulties attending to emotional stimuli (Hartikainen & Knight, 2003), and recognizing emotional expressions (Hornak et al., 2003). These studies suggest that the OFC subserves high-level functions; however, its role in lower-level functions of sensory processing remains largely unknown. The OFC’s involvement in sensory response draws support from animal and human research. Functional data has shown the OFC receives information from the auditory sensory modality in monkeys (Zald & Kim, 1996). Structural studies have demonstrated connections between the OFC and the superior temporal gyrus in monkeys (Barbas, Ghashghaei, Dombrowski, & Rempel-Clower, 1999; Petrides & Pandya, 2007) and Heschl’s gyrus in humans (Cammoun et al., 2015), areas critical for auditory sensory processing. The sensory response to auditory input is commonly indexed by the N1 event-related potential (ERP) component, which is primarily generated in the supratemporal plane in humans, with additional contributions from lateral temporal regions and the parietal cortex (Knight, Hillyard, Woods, & Neville, 1980; Nååtånen & Picton, 1987). Top-down attentional control

• König, Marton; Osnes, Terje; Jebsen, Peter Wilhelm & Meling, Torstein Ragnar (2018). Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review. Acta Neurochirurgica.  ISSN 0001-6268.  160(12), s 2339- 2348 . doi: 10.1007/s00701-018-3716-4 Fulltekst i vitenarkiv.
• Latysheva, Anna; Emblem, Kyrre Eeg; Server, Andrés; Brandal, Petter; Meling, Torstein Ragnar; Pahnke, Jens & Hald, John K (2018). Survival associations using perfusion and diffusion magnetic resonance imaging in patients with histologic and genetic defined diffuse glioma World Health Organization grades II and III. Journal of computer assisted tomography.  ISSN 0363-8715.  42(5), s 807- 815 . doi: 10.1097/RCT.0000000000000742 Fulltekst i vitenarkiv.
• Meling, Torstein Ragnar (2018). Craniopharyngiomas, In  Surgery of the Skull Base.  Springer Publishing Company.  ISBN 978-3-319-64017-4.  Tumors of the Skull Base.  s 91 - 242

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• Meling, Torstein Ragnar (2019). Anterior clinoidectomy - what, why & how?.
• Meling, Torstein Ragnar (2019). Anterior cranial fossa repairs.
• Meling, Torstein Ragnar (2019). Assessment of clinical outcomes of patients with multidisciplinary management of cochleo-vestibular schwannoma.
• Meling, Torstein Ragnar (2019). Brain cancer.
• Meling, Torstein Ragnar (2019). Bypass: aneurysms.
• Meling, Torstein Ragnar (2019). Bypass: aneurysms. Case presentations.
• Meling, Torstein Ragnar (2019). Craniopharyngiomas.
• Meling, Torstein Ragnar (2019). Cranioplasty.
• Meling, Torstein Ragnar (2019). Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteiorvenous Malformation.
• Meling, Torstein Ragnar (2019). Early postoperative complications in meningioma: Predictive factors and impact on outcome.
• Meling, Torstein Ragnar (2019). Early postoperative complications in meningioma: predictive factors and impact on outcome.
• Meling, Torstein Ragnar (2019). Exploring unruptured intracranial aneurysm instability-markers in lumen morphology, dome wall aspect, and histology to improve disease-modelling.
• Meling, Torstein Ragnar (2019). Extent of resection in meningioma: predictive factors and clinical implications.
• Meling, Torstein Ragnar (2019). Frontobasal craniotomies.
• Meling, Torstein Ragnar (2019). Frontolateral Approach to the Orbit, In Andreas Raabe (ed.),  The Craniotomy Atlas.  Thieme Medical Publishers.  ISBN 9783132057913.  9.1 Frontolateral Approach to the Orbit.
• Meling, Torstein Ragnar (2019). Fronto-temporo-parietal craniotomy.
• Meling, Torstein Ragnar (2019). Giant aneurysm of the anterior circulation - How I do it.
• Meling, Torstein Ragnar (2019). Hybrid cerebrovascular surgery in the 21st century - Quo Vadis?.
• Meling, Torstein Ragnar (2019). ICA blister aneurysms.
• Meling, Torstein Ragnar (2019). ICA blister aneurysms.
• Meling, Torstein Ragnar (2019). Indications for bypass: ischemia.
• Meling, Torstein Ragnar (2019). Intracranial Aneurysms are more frequently located in the Sylvian bifurcation in Polycystic Kidney Disease patients as compared to Sporadic patients.
• Meling, Torstein Ragnar (2019). Lateral Orbitotomy, In Andreas Raabe (ed.),  The Craniotomy Atlas.  Thieme Medical Publishers.  ISBN 9783132057913.  9.2 Lateral Orbitotomy.
• Meling, Torstein Ragnar (2019). Lateral Sphenoid wing Meningiomas with bone invasion- still skull base surgery?.
• Meling, Torstein Ragnar (2019). Lumbar disc herniation - indications and surgical technique.
• Meling, Torstein Ragnar (2019). Lumbar micro-decompression.
• Meling, Torstein Ragnar (2019). Masterclass: Meningioma surgery.
• Meling, Torstein Ragnar (2019). Masterclass: Transbasal resections.
• Meling, Torstein Ragnar (2019). Meningiomas of the skull base: treatment, outcome, follow-up.
• Meling, Torstein Ragnar (2019). Microsurgical Training between Scylla and Charybdis.
• Meling, Torstein Ragnar (2019). Microsurgical techniques: aorto-aortic termino-terminal anastomosis on rats.
• Meling, Torstein Ragnar (2019). Microvascular surgery.
• Meling, Torstein Ragnar (2019). Multidisciplinary approach to patients with cervical myelopathy: Is it possible to identify the best responders to surgery?.
• Meling, Torstein Ragnar (2019). Neurosurgical Training - idir dhá thine Bhealtaine.
• Meling, Torstein Ragnar (2019). Orbital tumours.
• Meling, Torstein Ragnar (2019). Posterior fossa arteriovenous malformations - experience with 14 patients.
• Meling, Torstein Ragnar (2019). Posterior fossa lesion resection and post-operative hydrocephalus: A multicenter retrospective study for risk factor identification and state-of-art treatment methods.
• Meling, Torstein Ragnar (2019). Principles of aneurysm surgery.
• Meling, Torstein Ragnar (2019). Pterional craniotomy.
• Meling, Torstein Ragnar (2019). Pterional craniotomy - «one layer approach».
• Meling, Torstein Ragnar (2019). Rare aneurysms. What we need to know.
• Meling, Torstein Ragnar (2019). Skull base approaches in vascular neurosurgery.
• Meling, Torstein Ragnar (2019). Skull base versus skull top meningiomas.
• Meling, Torstein Ragnar (2019). Supratentorial decompressive craniectomy.
• Meling, Torstein Ragnar (2019). Surgical Simulation Training And Patient Outcomes: A Systematic Review.
• Meling, Torstein Ragnar (2019). Surgical management of CSF fistulae.
• Meling, Torstein Ragnar (2019). Surgical vs endovascular treatment for unruptured intracranial aneurysms: When to choose what?.
• Meling, Torstein Ragnar (2019). Survival and risk analysis of shunting after surgery for brain tumours in the adult population.
• Meling, Torstein Ragnar (2019). Technical and non-technical skills training by combined simulation and cadaver lab dissection: The ABC Basic Brain Course (Mi-Ge).
• Meling, Torstein Ragnar (2019). The Fronto-Temporal Orbito-Zygomatic Craniotomy.
• Meling, Torstein Ragnar (2019). The Supraorbital Craniotomy.
• Meling, Torstein Ragnar (2019). The bifrontal approach.
• Meling, Torstein Ragnar (2019). The bifrontal approach.
• Meling, Torstein Ragnar (2019). The interfacial technique for pterional craniotomy.
• Meling, Torstein Ragnar (2019). The one-layer technique for pterional craniotomy.
• Meling, Torstein Ragnar (2019). The one-layer technique for pterional craniotomy.
• Meling, Torstein Ragnar (2019). Transcavernous approach to basilar tip aneurysms.
• Meling, Torstein Ragnar (2019). Trans-sinusal / bifrontal approach and surgical anatomy of frontal area.
• Meling, Torstein Ragnar (2019). What is the best therapeutic approach to a pediatric patient with a deep-seated brain AVM?.
• Meling, Torstein Ragnar & König, Marton (2019). Bifrontal craniotomy, In Andreas Raabe (ed.),  The Craniotomy Atlas.  Thieme Medical Publishers.  ISBN 9783132057913.  5.1.1.  s 112 - 118 Vis sammendrag

  Given that the great majority of brain surgeries are preceded by a craniotomy, mastering the procedure is essential for junior residents. Choosing the appropriate craniotomy and executing it safely is the difference between a straightforward case with good access to the target and a procedure where access to the target is needlessly traumatic and may even be impossible. Professor Raabe's The Craniotomy Atlas provides precise instructions for performing all common neurosurgical cranial exposures, including: convexity approaches, midline approaches, skull base approaches, transsphenoidal approaches and more. Instructions for each craniotomy include positioning, head fixation, aesthetic considerations, and protecting the dura mater.

• Blenkmann, Alejandro Omar; Lubell, James; Llorens, Anais; Funderud, Ingrid; Collavini, Santiago; Larsson, PG; Ivanovic, Jugoslav; Meling, Torstein Ragnar; Bekinschtein, Tristan; Kochen, Silvia; Endestad, Tor; Knight, Robert T & Solbakk, Anne-Kristin (2018). Human insula response to auditory deviants: Evidence from intracranial EEG recordings.
• Da Broi, Michele; Jahr, Guro; Holte, Harald; Beiske, Klaus & Meling, Torstein Ragnar (2018). The role of surgery in intracranial Primary CNS Lymphoma..
• Kam, Julia W.Y.; Solbakk, Anne-Kristin; Funderud, Ingrid; Endestad, Tor; Meling, Torstein Ragnar & Knight, Robert Thomas (2018). Orbitofrontal damage reduces auditory sensory response in humans. Cortex.  ISSN 0010-9452.  101, s 309- 312 . doi: 10.1016/j.cortex.2017.12.023
• König, Marton; Osnes, Terje; Jebsen, Peter Wilhelm; Bratland, Åse & Meling, Torstein Ragnar (2018). Squamous cell carcinoma of the paranasal sinuses: a single center experience.
• König, Marton; Osnes, Terje; Jebsen, Peter Wilhelm; Evensen, Jan Folkvard & Meling, Torstein Ragnar (2018). Olfactory neuroblastoma: a single-center experience.
• König, Marton; Osnes, Terje; Jebsen, Peter Wilhelm & Meling, Torstein Ragnar (2018). Craniofacial resection of malignant tumors of the anterior skull base.
• Meling, Torstein Ragnar (2018). Aneurysm Surgery - Principles & Practice.
• Meling, Torstein Ragnar (2018). Blister aneurysms of the ICA.
• Meling, Torstein Ragnar (2018). Bypass: aneurysms..
• Meling, Torstein Ragnar (2018). Case discussion of meningiomas.
• Meling, Torstein Ragnar (2018). Cerebral revascularization.
• Meling, Torstein Ragnar (2018). Cerebral revascularization.
• Meling, Torstein Ragnar (2018). Cranial fossa repairs (open and endoscopic).
• Meling, Torstein Ragnar (2018). Craniofacial Resections of Anterior Skull Base Lesions.
• Meling, Torstein Ragnar (2018). Craniofacial resections of malignant anterior skull base lesions.
• Meling, Torstein Ragnar (2018). Craniopharyngiomas.
• Meling, Torstein Ragnar (2018). Do you continue to treat unruptured bAVM?.
• Meling, Torstein Ragnar (2018). Education: How to balance hyperspecialization in the general curriculum of a neurosurgeon: Qualifications and skills of a general neurosurgeon in subspecialities.

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