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1. Endovascular Versus Medical Therapy in Posterior Cerebral Artery Stroke: Role of Baseline NIHSS Score and Occlusion Site

Author

Strambo, Davide, Michel, Patrik, Nguyen, Thanh N., Abdalkader, Mohamad, Qureshi, Muhammad M., Strbian, Daniel, Herweh, Christian, Möhlenbruch, Markus A., Räty, Silja, Olivé-Gadea, Marta, Ribo, Marc, Psychogios, Marios, Fischer, Urs, Nguyen, Anh, Kuramatsu, Joji B., Haupenthal, David, Köhrmann, Martin, Deuschl, Cornelius, Kühne Escolà, Jordi, Demeestere, Jelle, Lemmens, Robin, Vandewalle, Lieselotte, Yaghi, Shadi, Shu, Liqi, Puetz, Volker, Kaiser, Daniel P.O., Kaesmacher, Johannes, Mujanovic, Adnan, Marterstock, Dominique Cornelius, Engelhorn, Tobias, Requena, Manuel, Dasenbrock, Hormuzdiyar H., Klein, Piers, Haussen, Diogo C., Mohammaden, Mahmoud H., Abdelhamid, Hend, Souza Viana, Lorena, Cunha, Bruno, Fragata, Isabel, Romoli, Michele, Diana, Francesco, Hu, Wei, Zhang, Chao, Virtanen, Pekka, Lauha, Riikka, Jesser, Jessica, Clark, Judith, Matsoukas, Stavros, Fifi, Johanna T., Sheth, Sunil A., Salazar-Marioni, Sergio, Marto, João Pedro, Ramos, João Nuno, Miszczuk, Milena, Riegler, Christoph, Poli, Sven, Poli, Khouloud, Jadhav, Ashutosh P., Desai, Shashvat M., Maus, Volker, Kaeder, Maximilian, Siddiqui, Adnan H., Monteiro, Andre, Masoud, Hesham E., Suryadareva, Neil, Mokin, Maxim, Thanki, Shail, Alpay, Kemal, Ylikotila, Pauli, Siegler, James E., Linfante, Italo, Dabus, Guilherme, Asdaghi, Negar, Saini, Vasu, Nolte, Christian H., Siebert, Eberhard, Serrallach, Bettina L., Weyland, Charlotte S., Hanning, Uta, Meyer, Lukas, Berberich, Anne, Ringleb, Peter A., Nogueira, Raul G., and Nagel, Simon

Published
2024
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2. Endovascular Versus Medical Management of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study

Author

Nguyen, Thanh N., Qureshi, Muhammad M., Strambo, Davide, Strbian, Daniel, Räty, Silja, Herweh, Christian, Abdalkader, Mohamad, Olive-Gadea, Marta, Ribo, Marc, Psychogios, Marios, Fischer, Urs, Nguyen, Anh, Kuramatsu, Joji B., Haupenthal, David, Köhrmann, Martin, Deuschl, Cornelius, Kühne Escola, Jordi, Yaghi, Shadi, Shu, Liqi, Puetz, Volker, Kaiser, Daniel P.O., Kaesmacher, Johannes, Mujanovic, Adnan, Marterstock, Dominique Cornelius, Engelhorn, Tobias, Klein, Piers, Haussen, Diogo C., Mohammaden, Mahmoud H., Abdelhamid, Hend, Souza Viana, Lorena, Cunha, Bruno, Fragata, Isabel, Romoli, Michele, Diana, Francesco, Virtanen, Pekka, Lappalainen, Kimmo, Clark, Judith, Matsoukas, Stavros, Fifi, Johanna T., Sheth, Sunil A., Salazar-Marioni, Sergio, Marto, João Pedro, Ramos, João Nuno, Miszczuk, Milena, Riegler, Christoph, Jadhav, Ashutosh P., Desai, Shashvat M., Maus, Volker, Kaeder, Maximilian, Siddiqui, Adnan H., Monteiro, Andre, Masoud, Hesham E., Suryadevara, Neil, Mokin, Maxim, Thanki, Shail, Siegler, James E., Khalife, Jane, Linfante, Italo, Dabus, Guilherme, Asdaghi, Negar, Saini, Vasu, Nolte, Christian H., Siebert, Eberhard, Meinel, Thomas R., Finitsis, Stefanos, Möhlenbruch, Markus A., Ringleb, Peter A., Berberich, Anne, Nogueira, Raul G., Hanning, Uta, Meyer, Lukas, Michel, Patrik, and Nagel, Simon

Published
2023
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3. Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis

Author

Kuramatsu, Joji B., Gerner, Stefan T., Ziai, Wendy, Bardutzky, Jürgen, Sembill, Jochen A., Sprügel, Maximilian I., Mrochen, Anne, Kölbl, Kathrin, Ram, Malathi, Avadhani, Radhika, Falcone, Guido J., Selim, Magdy H., Lioutas, Vasileios-Arsenios, Endres, Matthias, Zweynert, Sarah, Vajkoczy, Peter, Ringleb, Peter A., Purrucker, Jan C., Volkmann, Jens, Neugebauer, Hermann, Erbguth, Frank, Schellinger, Peter D., Knappe, Ulrich J., Fink, Gereon R., Dohmen, Christian, Minnerup, Jens, Reichmann, Heinz, Schneider, Hauke, Röther, Joachim, Reimann, Gernot, Schwarz, Michael, Bäzner, Hansjörg, Claßen, Joseph, Michalski, Dominik, Witte, Otto W., Günther, Albrecht, Hamann, Gerhard F., Lücking, Hannes, Dörfler, Arnd, Ishfaq, Muhammad Fawad, Chang, Jason J., Testai, Fernando D., Woo, Daniel, Alexandrov, Andrei V., Staykov, Dimitre, Goyal, Nitin, Tsivgoulis, Georgios, Sheth, Kevin N., Awad, Issam A., Schwab, Stefan, Hanley, Daniel F., and Huttner, Hagen B.

Published
2022
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4. Akutmanagement intrazerebraler Blutungen

Author

Sekita, A. and Kuramatsu, Joji B.

Abstract

Die intrazerebrale Blutung (ICB) ist eine der schwerwiegendsten Formen des akuten Schlaganfalls. Im Gegensatz zum ischämischen Schlaganfall gibt es nur wenige effektive, nachweislich den klinischen Zustand nach ICB verbessernde Interventionen. Wichtigstes Ziel der Akuttherapie ist die Verhinderung eines Hämatomwachstums durch umgehende aggressive und kontrollierte systolische Blutdrucksenkung sowie sofortige Hämostase, meist sind zudem intensivmedizinische Maßnahmen indiziert. Chirurgische Strategien beinhalten oft eine externe Ventrikeldrainage bei okklusivem Hydrozephalus. Die Hämatomevakuation, dekompressive Verfahren oder minimalinvasive Ansätze stellen individuelle Therapieentscheidungen dar. Die intraventrikuläre Fibrinolyse und die überlappende Lumbaldrainage scheinen mit einem besseren funktionellen Zustand nach ICB assoziiert zu sein. Dennoch ist die ICB-Mortalität nach wie vor hoch, sodass eine präzise Prognoseabschätzung wichtig ist, um voreilige Therapieeinschränkungen zu vermeiden.

Published
2022
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6. Hematoma Expansion and Clinical Outcomes in Patients With Factor-Xa Inhibitor–Related Atraumatic Intracerebral Hemorrhage Treated Within the ANNEXA-4 Trial Versus Real-World Usual Care

Author

Huttner, Hagen B., Gerner, Stefan T., Kuramatsu, Joji B., Connolly, Stuart J., Beyer-Westendorf, Jan, Demchuk, Andrew M., Middeldorp, Saskia, Zotova, Elena, Altevers, Julia, Andersohn, Frank, Christoph, Mary J., Yue, Patrick, Stross, Leonhard, and Schwab, Stefan

Abstract

Supplemental Digital Content is available in the text.

Published
2022
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7. Amantadine treatment is associated with improved consciousness in patients with non-traumatic brain injury

Author

Ru¨hl, Lena, Kuramatsu, Joji B, Sembill, Jochen A, Kallmu¨nzer, Bernd, Madzar, Dominik, Gerner, Stefan T, Giede-Jeppe, Antje, Balk, Stefanie, Mueller, Tamara, Ja¨ger, Jakob, Schwab, Stefan, Huttner, Hagen B, and Spru¨gel, Maximilian I

Abstract

ObjectiveThis study determined the effect of amantadine treatment on consciousness in patients with non-traumatic brain injury.MethodsWe pooled individual patient data of five single-centre observational studies to determine the effect of amantadine treatment among patients with ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, community-acquired bacterial meningitis and status epilepticus, admitted between January 2012 and December 2015 and ventilated ≥7 days. Patient selection and multivariable regression modelling were used to adjust for differences in intergroup comparison and for parameters associated with consciousness. Improvement of consciousness 5 days after treatment initiation was defined as primary outcome. Secondary outcomes included Glasgow Coma Scale (GCS) at day 5 and GCS at day 10, rate of ICU delirium, epileptic seizures and all-cause mortality at 90 days.ResultsOverall, 84 of 294 (28.6%) eligible patients received amantadine. Amantadine treatment was associated with improvement of consciousness at day 5 (amantadine: 86.9% vs control: 54.0%; absolute difference: 32.9 (20.0–44.2); adjusted OR (aOR): 5.71 (2.50–13.05), p<0.001). Secondary outcomes showed differences in GCS 5 days (9 (8–11) vs 6 (3–9), p<0.001) and GCS 10 days (10(8–11) vs 9(6–11),p=0.003) after treatment initiation. There were no significant differences regarding all-cause mortality (aOR: 0.89 (0.44–1.82), p=0.758) and ICU delirium (aOR: 1.39 (0.58–3.31), p=0.462). Rate of epileptic seizures after initiation of amantadine treatment was numerically higher in the amantadine group (amantadine: 10.7% vs control: 3.0%; absolute difference: 7.7 (0.3–16.4); aOR: 3.68 (0.86–15.71), p=0.079).ConclusionsAmantadine treatment is associated with improved consciousness among patients with different types of non-traumatic brain injury in this observational cohort analysis. Epileptic seizures should be considered as potential side effects and randomised controlled trials are needed to confirm these findings.

Published
2022
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8. Neues beim Schlaganfall: Prävention

Author

Diener, Hans-Christoph, Endres, Matthias, Fiehler, Jens, Gerloff, Christian, Häusler, Karl Georg, Kuramatsu, Joji B., Pfeilschifter, Waltraud, Poli, Sven, Purrucker, Jan Christoph, Bonin-Schnabel, Renate, Sembill, Jochen A., Veltkamp, Roland, and Weimar, Christian

Published
2021
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9. Neues beim Schlaganfall – Teil 2: Prävention

Author

Diener, Hans-Christoph, Endres, Matthias, Fiehler, Jens, Gerloff, Christian, Häusler, Hans Georg, Kuramatsu, Joji B, Pfeilschifter, Waltraud, Poli, Sven, Purrucker, Jan, Schnabel, Renate, Sembill, Jochen, Veltkamp, Roland, and Weimar, Christian

Published
2021
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10. Impact of Statins on Hematoma, Edema, Seizures, Vascular Events, and Functional Recovery After Intracerebral Hemorrhage

Author

Sprügel, Maximilian I., Kuramatsu, Joji B., Volbers, Bastian, Saam, Justina I., Sembill, Jochen A., Gerner, Stefan T., Balk, Stefanie, Hamer, Hajo M., Lücking, Hannes, Hölter, Philip, Nolte, Christian H., Scheitz, Jan F., Rocco, Andrea, Endres, Matthias, and Huttner, Hagen B.

Abstract

Supplemental Digital Content is available in the text.

Published
2021
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12. Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11–13 November 2018

Author

Ahmed, Niaz, Audebert, Heinrich, Turc, Guillaume, Cordonnier, Charlotte, Christensen, Hanne, Sacco, Simona, Sandset, Else Charlotte, Ntaios, George, Charidimou, Andreas, Toni, Danilo, Pristipino, Christian, Köhrmann, Martin, Kuramatsu, Joji B, Thomalla, Götz, Mikulik, Robert, Ford, Gary A, Martí-Fàbregas, Joan, Fischer, Urs, Thoren, Magnus, Lundström, Erik, Rinkel, Gabriel JE, Worp, H Bart van der, Matusevicius, Marius, Tsivgoulis, Georgios, Milionis, Haralampos, Rubiera, Marta, Hart, Robert, Moreira, Tiago, Lantz, Maria, Sjöstrand, Christina, Andersen, Grethe, Schellinger, Peter, Kostulas, Konstantinos, Sunnerhagen, Katharina Stibrant, Keselman, Boris, Korompoki, Eleni, Purrucker, Jan, Khatri, Pooja, Whiteley, William, Berge, Eivind, Mazya, Michael, Dippel, Diederik WJ, Mustanoja, Satu, Rasmussen, Mads, Söderqvist, Åsa Kuntze, Escudero-Martínez, Irene, and Steiner, Thorsten

Abstract

The purpose of the European Stroke Organisation–Karolinska Stroke Update Conference is to provide updates on recent stroke therapy research and to give an opportunity for the participants to discuss how these results may be implemented into clinical routine. The meeting started 22 years ago as Karolinska Stroke Update, but since 2014 it is a joint conference with European Stroke Organisation. Importantly, it provides a platform for discussion on the European Stroke Organisation guidelines process and on recommendations to the European Stroke Organisation guidelines committee on specific topics. By this, it adds a direct influence from stroke professionals otherwise not involved in committees and work groups on the guideline procedure. The discussions at the conference may also inspire new guidelines when motivated. The topics raised at the meeting are selected by the scientific programme committee mainly based on recent important scientific publications. This year’s European Stroke Organisation–Karolinska Stroke Update Meeting was held in Stockholm on 11–13 November 2018. There were 11 scientific sessions discussed in the meeting including two short sessions. Each session except the short sessions produced a consensus statement (Full version with background, issues, conclusions and references are published as web-material and atwww.eso-karolinska.organdhttp://eso-stroke.org) and recommendations which were prepared by a writing committee consisting of session chair(s), scientific secretary and speakers. These statements were presented to the 250 participants of the meeting. In the open meeting, general participants commented on the consensus statement and recommendations and the final document were adjusted based on the discussion from the general participants Recommendations (grade of evidence) were graded according to the 1998 Karolinska Stroke Update meeting with regard to the strength of evidence. Grade A Evidence: Strong support from randomised controlled trials and statistical reviews (at least one randomised controlled trial plus one statistical review). Grade B Evidence: Support from randomised controlled trials and statistical reviews (one randomised controlled trial or one statistical review). Grade C Evidence: No reasonable support from randomised controlled trials, recommendations based on small randomised and/or non-randomised controlled trials evidence.

Published
2019
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13. Characteristics in Non–Vitamin K Antagonist Oral Anticoagulant–Related Intracerebral Hemorrhage

Author

Gerner, Stefan T., Kuramatsu, Joji B., Sembill, Jochen A., Sprügel, Maximilian I., Hagen, Manuel, Knappe, Ruben U., Endres, Matthias, Haeusler, Karl Georg, Sobesky, Jan, Schurig, Johannes, Zweynert, Sarah, Bauer, Miriam, Vajkoczy, Peter, Ringleb, Peter A., Purrucker, Jan C., Rizos, Timolaos, Volkmann, Jens, Müllges, Wolfgang, Kraft, Peter, Schubert, Anna-Lena, Erbguth, Frank, Nueckel, Martin, Schellinger, Peter D., Glahn, Jörg, Knappe, Ulrich J., Fink, Gereon R., Dohmen, Christian, Stetefeld, Henning, Fisse, Anna Lena, Minnerup, Jens, Hagemann, Georg, Rakers, Florian, Reichmann, Heinz, Schneider, Hauke, Rahmig, Jan, Ludolph, Albert Christian, Stösser, Sebastian, Neugebauer, Hermann, Röther, Joachim, Michels, Peter, Schwarz, Michael, Reimann, Gernot, Bäzner, Hansjörg, Schwert, Henning, Claßen, Joseph, Michalski, Dominik, Grau, Armin, Palm, Frederick, Urbanek, Christian, Wöhrle, Johannes C., Alshammari, Fahid, Horn, Markus, Bahner, Dirk, Witte, Otto W., Günther, Albrecht, Hamann, Gerhard F., Engelhorn, Tobias, Lücking, Hannes, Dörfler, Arnd, Schwab, Stefan, and Huttner, Hagen B.

Abstract

Supplemental Digital Content is available in the text.

Published
2019
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14. Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage

Author

Spru¨gel, Maximilian I, Sembill, Jochen A, Kuramatsu, Joji B, Gerner, Stefan T, Hagen, Manuel, Roeder, Sebastian S, Endres, Matthias, Haeusler, Karl Georg, Sobesky, Jan, Schurig, Johannes, Zweynert, Sarah, Bauer, Miriam, Vajkoczy, Peter, Ringleb, Peter Arthur, Purrucker, Jan Christoph, Rizos, Timolaos, Volkmann, Jens, Muellges, Wolfgang, Kraft, Peter, Schubert, Anna-Lena, Erbguth, Frank, Nueckel, Martin, Schellinger, Peter D, Glahn, Jo¨rg, Knappe, Ulrich J, Fink, Gereon Rudolf, Dohmen, Christian, Stetefeld, Henning, Fisse, Anna Lena, Minnerup, Jens, Hagemann, Georg, Rakers, Florian, Reichmann, Heinz, Schneider, Hauke, Wo¨pking, Sigrid, Ludolph, Albert C, Sto¨sser, Sebastian, Neugebauer, Hermann, Ro¨ther, Joachim, Michels, Peter, Schwarz, Michael, Reimann, Gernot, Ba¨zner, Hansjo¨rg, Schwert, Henning, Classen, Joseph, Michalski, Dominik, Grau, Armin, Palm, Frederick, Urbanek, Christian, Wo¨hrle, Johannes C, Alshammari, Fahid, Horn, Markus, Bahner, Dirk, Witte, Otto W, Guenther, Albrecht, Hamann, Gerhard F, Lu¨cking, Hannes, Do¨rfler, Arnd, Schwab, Stefan, and Huttner, Hagen B

Abstract

ObjectiveTo determine the occurrence of intracranial haemorrhagic complications (IHC) on heparin prophylaxis (low-dose subcutaneous heparin, LDSH) in primary spontaneous intracerebral haemorrhage (ICH) (not oral anticoagulation-associated ICH, non-OAC-ICH), vitamin K antagonist (VKA)-associated ICH and non-vitamin K antagonist oral anticoagulant (NOAC)-associated ICH.MethodsRetrospective cohort study (RETRACE) of 22 participating centres and prospective single-centre study with 1702 patients with VKA-associated or NOAC-associated ICH and 1022 patients with non-OAC-ICH with heparin prophylaxis between 2006 and 2015. Outcomes were defined as rates of IHC during hospital stay among patients with non-OAC-ICH, VKA-ICH and NOAC-ICH, mortality and functional outcome at 3 months between patients with ICH with and without IHC.ResultsIHC occurred in 1.7% (42/2416) of patients with ICH. There were no differences in crude incidence rates among patients with VKA-ICH, NOAC-ICH and non-OAC-ICH (log-rank p=0.645; VKA-ICH: 27/1406 (1.9%), NOAC-ICH 1/130 (0.8%), non-OAC-ICH 14/880 (1.6%); p=0.577). Detailed analysis according to treatment exposure (days with and without LDSH) revealed no differences in incidence rates of IHC per 1000 patient-days (LDSH: 1.43 (1.04–1.93) vs non-LDSH: 1.32 (0.33–3.58), conditional maximum likelihood incidence rate ratio: 1.09 (0.38–4.43); p=0.953). Secondary outcomes showed differences in functional outcome (modified Rankin Scale=4–6: IHC: 29/37 (78.4%) vs non-IHC: 1213/2048 (59.2%); p=0.019) and mortality (IHC: 14/37 (37.8%) vs non-IHC: 485/2048 (23.7%); p=0.045) in disfavour of patients with IHC. Small ICH volume (OR: volume <4.4 mL: 0.18 (0.04–0.78); p=0.022) and low National Institutes of Health Stroke Scale (NIHSS) score on admission (OR: NIHSS <4: 0.29 (0.11–0.78); p=0.014) were significantly associated with fewer IHC.ConclusionsHeparin administration for venous thromboembolism (VTE) prophylaxis in patients with ICH appears to be safe regarding IHC among non-OAC-ICH, VKA-ICH and NOAC-ICH in this observational cohort analysis. Randomised controlled trials are needed to verify the safety and efficacy of heparin compared with other methods for VTE prevention.

Published
2019
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15. Cardioembolic Stroke Risk and Recovery After Anticoagulation-Related Intracerebral Hemorrhage

Author

Murphy, Meredith P., Kuramatsu, Joji B., Leasure, Audrey, Falcone, Guido J., Kamel, Hooman, Sansing, Lauren H., Kourkoulis, Christina, Schwab, Kristin, Elm, Jordan J., Gurol, M. Edip, Tran, Huy, Greenberg, Steven M., Viswanathan, Anand, Anderson, Christopher D., Schwab, Stefan, Rosand, Jonathan, Shi, Fu-Dong, Kittner, Steven J., Testai, Fernando D., Woo, Daniel, Langefeld, Carl D., James, Michael L., Koch, Sebastian, Huttner, Hagen B., Biffi, Alessandro, and Sheth, Kevin N.

Abstract

Supplemental Digital Content is available in the text.

Published
2018
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23. Hyponatremia Is an Independent Predictor of In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

Author

Kuramatsu, Joji B., Bobinger, Tobias, Volbers, Bastian, Staykov, Dimitre, Lücking, Hannes, Kloska, Stephan P., Köhrmann, Martin, and Huttner, Hagen B.

Abstract

Hyponatremia is the most frequent electrolyte disturbance in critical care. Across various disciplines, hyponatremia is associated with increased mortality and longer hospital stay, yet in intracerebral hemorrhage (ICH) no data are available. This the first study that investigated the prevalence and clinical associations of hyponatremia in patients with ICH.

Published
2014
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