2006 - UZ Leuven

Object: Based on data from primate experiments it is known thatrotational acceleration in the sagittal plane and in a forward directionis most likely to produce acute subdural hematomas due to bridgingvein rupture. For protection against these lesions, knowledge ofrotational acceleration tolerance levels in humans is required. In thepresent study the authors analyze human tolerance levels for bridgingvein rupture by performing head impact tests in cadavers.Methods: Ten unembalmed cadavers were subjected to 18 occipitalimpacts producing head rotation in the sagittal plane with varyingrotational acceleration magnitudes and pulse durations. Rotationalacceleration was calculated from the linear acceleration historiesrecorded by three uniaxial accelerometers mounted on the side of thehead. Bridging vein ruptures were detected by injecting contrast dyeinto the superior sagittal sinus under fluoroscopy and by autopsyprocedures. Bridging vein ruptures were produced in six head impacttests: one test with a pulse duration of 5.2 msec and a peak rotationalacceleration of 13,411 rad/second2; three tests with a pulse durationbetween 7 and 8 msec and a peak rotational acceleration of 12,558,10,607, and 8567 rad/second2; and two tests with a pulse durationlonger than 10 msec and a peak rotational acceleration as low as5267 rad/second2.Conclusions: This is the only cadaveric study of bridging vein rupturefocused on short pulse durations, which are usually associated withfalls. The data suggest a tolerance level of approximately 10,000rad/second2 for pulse durations shorter than 10 msec, which seems todecrease for longer pulse durations.DE VLEESCHOUWER S., RAPP M., SORG R.V., STEIGER H.J.,STUMMER W., VAN GOOL S., SABEL M.: Dendritic cell vaccination inpatients with malignant gliomas: actual status and future directions.Neurosurgery, 2006; 59(5): 988-1000.Objective: Despite recent advances in neurosurgical resectiontechniques, radiation therapy, and chemotherapy, malignant gliomascontinue to have a dismal prognosis because relapses areunavoidable.Methods: Dendritic cell vaccination has recently emerged as apromising type of active immunotherapy that aims to induce ratherthan transfer specific antitumor immune responses in patients. Activeimmunotherapy is the only type of immunotherapy able to induceimmunological memory.Results: Although an increasing number of small clinical trials showsafety, feasibility, and immunological and clinical responses, thistechnology requires further clarification of some critical basic andclinical issues before its presumed place in the treatment of malignant40