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  1. Article ; Online: In Reply: Blood Biomarkers and Structural Imaging Correlations Post-Traumatic Brain Injury: A Systematic Review.

    Whitehouse, Daniel P / Newcombe, Virginia F J

    Neurosurgery

    2022  Volume 91, Issue 1, Page(s) e26

    MeSH term(s) Biomarkers ; Chronic Traumatic Encephalopathy ; Humans
    Chemical Substances Biomarkers
    Language English
    Publishing date 2022-05-02
    Publishing country United States
    Document type Systematic Review ; Research Support, Non-U.S. Gov't ; Letter ; Comment
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/neu.0000000000002011
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  2. Article ; Online: The features of the typical traumatic brain injury patient in the ICU are changing: what will this mean for the intensivist?

    Newcombe, Virginia F J / Chow, Andrew

    Current opinion in critical care

    2021  Volume 27, Issue 2, Page(s) 80–86

    Abstract: Purpose of review: To describe the key features and epidemiology of traumatic brain injury (TBI) and how they may be changing, with an emphasis on how this may affect care in the intensive care unit.: Recent findings: TBI has been traditionally ... ...

    Abstract Purpose of review: To describe the key features and epidemiology of traumatic brain injury (TBI) and how they may be changing, with an emphasis on how this may affect care in the intensive care unit.
    Recent findings: TBI has been traditionally perceived as occurring mainly in a younger, predominantly male population injured in high velocity motor vehicle crashes or assaults. However, there are an increasing number of patients over 65 years who have sustained a TBI secondary to low velocity falls. Considering the effects of frailty, comorbidities and extracranial injuries is important when making management decisions. Mild TBI comprises a third of those admitted and as a significant proportion may have poor outcomes secondary to their TBI they should be assessed to ensure appropriate follow-up. Multimodal monitoring may offer a way in the future to offer more personalised management to this very complex and heterogeneous patient group.
    Summary: This review highlights the urgent need to develop more age-inclusive TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing TBI population. Being elderly does not necessarily portend a poor outcome, and more research is needed to better triage, guide management and prognosticate on these patients.
    MeSH term(s) Accidental Falls ; Aged ; Brain Injuries, Traumatic/epidemiology ; Brain Injuries, Traumatic/therapy ; Hospitalization ; Humans ; Intensive Care Units ; Male
    Language English
    Publishing date 2021-02-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000814
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  3. Article ; Online: Neurological complications of COVID-19.

    Newcombe, Virginia F J / Dangayach, Neha S / Sonneville, Romain

    Intensive care medicine

    2021  Volume 47, Issue 9, Page(s) 1021–1023

    MeSH term(s) COVID-19 ; Headache ; Humans ; Nervous System Diseases/etiology ; SARS-CoV-2
    Language English
    Publishing date 2021-06-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-021-06439-6
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  4. Article ; Online: Could spinal cord oscillation contribute to spinal cord injury in degenerative cervical myelopathy?

    Schaefer, Samuel D / Davies, Benjamin M / Newcombe, Virginia F J / Sutcliffe, Michael P F

    Brain & spine

    2023  Volume 3, Page(s) 101743

    Abstract: Introduction: Degenerative Cervical Myelopathy [DCM] is a slow-motion spinal cord injury. Compression and dynamic compression have been considered disease hallmarks. However, this is likely an oversimplification, as compression is more commonly ... ...

    Abstract Introduction: Degenerative Cervical Myelopathy [DCM] is a slow-motion spinal cord injury. Compression and dynamic compression have been considered disease hallmarks. However, this is likely an oversimplification, as compression is more commonly incidental and has only modest correlation to disease severity. MRI studies have recently suggested spinal cord oscillation could play a role.
    Research question: To determine if spinal cord oscillation could contribute to spinal cord injury in degenerative cervical myelopathy.
    Material and methods: A computational model of an oscillating spinal cord was developed from imaging of a healthy volunteer. Using finite element analysis, the observed implications of stress and strain, were measured in the context of a simulated disc herniation. The significance was bench marked by comparison to a more recognised dynamic injury mechanism; a flexion extension model of dynamic compression.
    Results: Spinal cord oscillation altered both compressive and shear strain on the spinal cord. Following initial compression, compressive strain moves from within the spinal cord to the spinal cord surface, whilst shear strain is magnified by 0.1-0.2, depending on the amplitude of oscillation. These orders of magnitude are equivalent to a dynamic compression model.
    Discussion and conclusion: Spinal cord oscillation could significantly contribute to spinal cord damage across DCM. Its repeated occurrence with every heartbeat, draws parallels to the concept of fatigue damage, which could reconcile differing theories on the origins of DCM. This remains hypothetical at this stage, and further investigations are required.
    Language English
    Publishing date 2023-04-13
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2772-5294
    ISSN (online) 2772-5294
    DOI 10.1016/j.bas.2023.101743
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  5. Article ; Online: Is the type and/or co-existence of degenerative spinal pathology associated with the occurrence of degenerative cervical myelopathy? A single centre retrospective analysis of individuals with MRI defined cervical cord compression.

    Davies, Benjamin M / Banerjee, Arka / Mowforth, Oliver D / Kotter, Mark R N / Newcombe, Virginia F J

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

    2023  Volume 117, Page(s) 84–90

    Abstract: Background: Degenerative cervical myelopathy (DCM) arises from spinal degenerative changes injuring the cervical spinal cord. Most cord compression is incidental, referred to as asymptomatic spinal cord compression (ASCC). How and why ASCC differs from ... ...

    Abstract Background: Degenerative cervical myelopathy (DCM) arises from spinal degenerative changes injuring the cervical spinal cord. Most cord compression is incidental, referred to as asymptomatic spinal cord compression (ASCC). How and why ASCC differs from DCM is poorly understood. In this paper, we study a local cohort to identify specific types and groups of degenerative pathology more likely associated with DCM than ASCC.
    Methods: This study was a retrospective cohort analysis (IRB Approval ID: PRN10455). The frequency of degenerative findings between those with ASCC and DCM patients were compared using network analysis, hierarchical clustering, and comparison to existing literature to identify potential subgroups in a local cohort (N = 155) with MRI-defined cervical spinal cord compression. Quantitative measures of spinal cord compression (MSCC and MCC) were used to confirm their relevance.
    Results: ELF (8.7 %, 95 % CI 3.8-13.6 % vs 35.7 %, 95 % CI 27.4-44.0 %) Congenital Stenosis (3.9 %, 95 % CI 0.6-7.3 % vs 25.0 %, 95 % CI 17.5-32.5 %), and OPLL (0.0 %, 95 % CI 0.0-0.0 % vs 3.6 %, 95 % CI 0.3-6.8 %) were more likely in patients with DCM. Comparative network analysis indicated loss of lordosis was associated with ASCC, whilst ELF with DCM. Hierarchical Cluster Analysis indicated four sub-groups: multi-level disc disease with ELF, single-level disc disease without loss of lordosis and OPLL with DCM, and single-level disc disease with loss of lordosis with ASCC. Quantitative measures of cord compression were higher in groups associated with DCM, but similar in patients with single-level disc disease and loss of lordosis.
    Conclusions: This study identified four subgroups based on degenerative pathology requiring further investigation.
    MeSH term(s) Animals ; Humans ; Spinal Cord Compression/etiology ; Spinal Cord Compression/complications ; Retrospective Studies ; Cervical Cord/diagnostic imaging ; Cervical Cord/pathology ; Lordosis/pathology ; Spinal Cord Diseases/complications ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/pathology ; Magnetic Resonance Imaging ; Musculoskeletal Diseases/pathology
    Language English
    Publishing date 2023-09-30
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 1193674-5
    ISSN 1532-2653 ; 0967-5868
    ISSN (online) 1532-2653
    ISSN 0967-5868
    DOI 10.1016/j.jocn.2023.09.015
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  6. Article ; Online: Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome.

    Adatia, Krishma / Newcombe, Virginia F J / Menon, David K

    Neurocritical care

    2020  Volume 34, Issue 1, Page(s) 312–324

    Abstract: Secondary injuries remain an important cause of the morbidity and mortality associated with traumatic brain injury (TBI). Progression of cerebral contusions occurs in up to 75% of patients with TBI, and this contributes to subsequent clinical ... ...

    Abstract Secondary injuries remain an important cause of the morbidity and mortality associated with traumatic brain injury (TBI). Progression of cerebral contusions occurs in up to 75% of patients with TBI, and this contributes to subsequent clinical deterioration and requirement for surgical intervention. Despite this, the role of early clinical and radiological factors in predicting contusion progression remains relatively poorly defined due to studies investigating progression of all types of hemorrhagic injuries as a combined cohort. In this review, we summarize data from recent studies on factors which predict contusion progression, and the effect of contusion progression on clinical outcomes.
    MeSH term(s) Brain Contusion ; Brain Injuries, Traumatic/diagnostic imaging ; Brain Injuries, Traumatic/therapy ; Contusions ; Disease Progression ; Humans ; Radiography
    Keywords covid19
    Language English
    Publishing date 2020-11-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-020-00994-4
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  7. Article: Automatic localisation and per-region quantification of traumatic brain injury on head CT using atlas mapping.

    Piçarra, Carolina / Winzeck, Stefan / Monteiro, Miguel / Mathieu, Francois / Newcombe, Virginia F J / Menon, Prof David K / Ben Glocker, Prof

    European journal of radiology open

    2023  Volume 10, Page(s) 100491

    Abstract: Rationale and objectives: To develop a method for automatic localisation of brain lesions on head CT, suitable for both population-level analysis and lesion management in a clinical setting.: Materials and methods: Lesions were located by mapping a ... ...

    Abstract Rationale and objectives: To develop a method for automatic localisation of brain lesions on head CT, suitable for both population-level analysis and lesion management in a clinical setting.
    Materials and methods: Lesions were located by mapping a bespoke CT brain atlas to the patient's head CT in which lesions had been previously segmented. The atlas mapping was achieved through robust intensity-based registration enabling the calculation of per-region lesion volumes. Quality control (QC) metrics were derived for automatic detection of failure cases. The CT brain template was built using 182 non-lesioned CT scans and an iterative template construction strategy. Individual brain regions in the CT template were defined via non-linear registration of an existing MRI-based brain atlas.Evaluation was performed on a multi-centre traumatic brain injury dataset (TBI) (n = 839 scans), including visual inspection by a trained expert. Two population-level analyses are presented as proof-of-concept: a spatial assessment of lesion prevalence, and an exploration of the distribution of lesion volume per brain region, stratified by clinical outcome.
    Results: 95.7% of the lesion localisation results were rated by a trained expert as suitable for approximate anatomical correspondence between lesions and brain regions, and 72.5% for more quantitatively accurate estimates of regional lesion load. The classification performance of the automatic QC showed an AUC of 0.84 when compared to binarised visual inspection scores. The localisation method has been integrated into the publicly available Brain Lesion Analysis and Segmentation Tool for CT (BLAST-CT).
    Conclusion: Automatic lesion localisation with reliable QC metrics is feasible and can be used for patient-level quantitative analysis of TBI, as well as for large-scale population analysis due to its computational efficiency (<2 min/scan on GPU).
    Language English
    Publishing date 2023-05-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2810314-2
    ISSN 2352-0477
    ISSN 2352-0477
    DOI 10.1016/j.ejro.2023.100491
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  8. Article ; Online: Correction: Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Neuroimaging.

    Edlow, Brian L / Boerwinkle, Varina L / Annen, Jitka / Boly, Melanie / Gosseries, Olivia / Laureys, Steven / Mukherjee, Pratik / Puybasset, Louis / Stevens, Robert D / Threlkeld, Zachary D / Newcombe, Virginia F J / Fernandez-Espejo, Davinia

    Neurocritical care

    2023  Volume 39, Issue 3, Page(s) 753

    Language English
    Publishing date 2023-10-05
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-023-01842-x
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  9. Article ; Online: The neurological sequelae of pandemics and epidemics.

    Valerio, Fernanda / Whitehouse, Daniel P / Menon, David K / Newcombe, Virginia F J

    Journal of neurology

    2020  Volume 268, Issue 8, Page(s) 2629–2655

    Abstract: Neurological manifestations in pandemics frequently cause short and long-term consequences which are frequently overlooked. Despite advances in the treatment of infectious diseases, nervous system involvement remains a challenge, with limited treatments ... ...

    Abstract Neurological manifestations in pandemics frequently cause short and long-term consequences which are frequently overlooked. Despite advances in the treatment of infectious diseases, nervous system involvement remains a challenge, with limited treatments often available. The under-recognition of neurological manifestations may lead to an increase in the burden of acute disease as well as secondary complications with long-term consequences. Nervous system infection or dysfunction during pandemics is common and its enduring consequences, especially among vulnerable populations, are frequently forgotten. An improved understanding the possible mechanisms of neurological damage during epidemics, and increased recognition of the possible manifestations is fundamental to bring insights when dealing with future outbreaks. To reverse this gap in knowledge, we reviewed all the pandemics, large and important epidemics of human history in which neurological manifestations are evident, and described the possible physiological processes that leads to the adverse sequelae caused or triggered by those pathogens.
    MeSH term(s) COVID-19 ; Humans ; Nervous System Diseases/epidemiology ; Nervous System Diseases/etiology ; Pandemics ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-26
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-020-10261-3
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  10. Article ; Online: Automatic localisation and per-region quantification of traumatic brain injury on head CT using atlas mapping

    Carolina Piçarra / Stefan Winzeck / Miguel Monteiro / Francois Mathieu / Virginia F.J. Newcombe / Prof David K. Menon / Prof Ben Glocker

    European Journal of Radiology Open, Vol 10, Iss , Pp 100491- (2023)

    2023  

    Abstract: Rationale and objectives: To develop a method for automatic localisation of brain lesions on head CT, suitable for both population-level analysis and lesion management in a clinical setting. Materials and methods: Lesions were located by mapping a ... ...

    Abstract Rationale and objectives: To develop a method for automatic localisation of brain lesions on head CT, suitable for both population-level analysis and lesion management in a clinical setting. Materials and methods: Lesions were located by mapping a bespoke CT brain atlas to the patient’s head CT in which lesions had been previously segmented. The atlas mapping was achieved through robust intensity-based registration enabling the calculation of per-region lesion volumes. Quality control (QC) metrics were derived for automatic detection of failure cases. The CT brain template was built using 182 non-lesioned CT scans and an iterative template construction strategy. Individual brain regions in the CT template were defined via non-linear registration of an existing MRI-based brain atlas.Evaluation was performed on a multi-centre traumatic brain injury dataset (TBI) (n = 839 scans), including visual inspection by a trained expert. Two population-level analyses are presented as proof-of-concept: a spatial assessment of lesion prevalence, and an exploration of the distribution of lesion volume per brain region, stratified by clinical outcome. Results: 95.7% of the lesion localisation results were rated by a trained expert as suitable for approximate anatomical correspondence between lesions and brain regions, and 72.5% for more quantitatively accurate estimates of regional lesion load. The classification performance of the automatic QC showed an AUC of 0.84 when compared to binarised visual inspection scores. The localisation method has been integrated into the publicly available Brain Lesion Analysis and Segmentation Tool for CT (BLAST-CT). Conclusion: Automatic lesion localisation with reliable QC metrics is feasible and can be used for patient-level quantitative analysis of TBI, as well as for large-scale population analysis due to its computational efficiency (<2 min/scan on GPU).
    Keywords Traumatic brain injury ; CT ; Image registration ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 616
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
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