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1. Ruptured PICA aneurysms: presentation and treatment outcomes compared to other posterior circulation aneurysms. A Swiss SOS study

Author

Starnoni, Daniele, Maduri, Rodolfo, Al Taha, Khalid, Bervini, David, Zumofen, Daniel Walter, Stienen, Martin Nikolaus, Schatlo, Bawarjan, Fung, Christian, Robert, Thomas, Seule, Martin A., Burkhardt, Jan-Karl, Maldaner, Nicolai, Rothlisberger, Michel, Blackham, Kristine A., Marbacher, Serge, D’Alonzo, Donato, Remonda, Luca, Machi, Paolo, Gralla, Jan, Bijlenga, Philippe, Saliou, Guillaume, Ballabeni, Pierluigi, Levivier, Marc, Messerer, Mahmoud, Swiss SOS Group, and Daniel, Roy Thomas

Published
2019
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2. Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry

Author

Maduri, Rodolfo, Starnoni, Daniele, Rocca, Alda, Bervini, David, Zumofen, Daniel Walter, Stienen, Martin Nikolaus, Schatlo, Bawarjan, Fung, Christian, Robert, Thomas, Seule, Martin A., Burkhardt, Jan-Karl, Maldaner, Nicolai, Rothlisberger, Michel, Blackham, Kristine A., Marbacher, Serge, D’Alonzo, Donato, Remonda, Luca, Machi, Paolo, Gralla, Jan, Bijlenga, Philippe, Saliou, Guillaume, Ballabeni, Pierluigi, Levivier, Marc, Messerer, Mahmoud, Daniel, Roy Thomas, and Swiss SOS Group

Published
2019
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4. Incidence and Outcome of Aneurysmal Subarachnoid Hemorrhage: The Swiss Study on Subarachnoid Hemorrhage (Swiss SOS)

Author

Schatlo, Bawarjan, Fung, Christian, Stienen, Martin N., Fathi, Ali R., Fandino, Javier, Smoll, Nicolas R., Zumofen, Daniel, Daniel, Roy Thomas, Burkhardt, Jan-Karl, Bervini, David, Marbacher, Serge, Reinert, Michael, D´Alonzo, Donato, Ahlborn, Peter, Mendes Pereira, Vitor, Roethlisberger, Michel, Seule, Martin, Kerkeni, Hassen, Remonda, Luca, Weyerbrock, Astrid, Woernle, Kerstin, Venier, Alice, Perren, Fabienne, Sailer, Martin, Robert, Thomas, Rohde, Veit, Schöni, Daniel, Goldberg, Johannes, Nevzati, Edin, Diepers, Michael, Gralla, Jan, Z’Graggen, Werner, Starnoni, Daniele, Woernle, Christoph, Maldaner, Nicolai, Kulcsar, Zsolt, Mostaguir, Khaled, Maduri, Rodolfo, Eisenring, Christian, Bernays, René, Ferrari, Andrea, Dan-Ura, Hiroki, Finkenstädt, Sina, Gasche, Yvan, Sarrafzadeh, Asita, Jakob, Stephan M., Corniola, Marco, Baumann, Fabian, Regli, Luca, Levivier, Marc, Hildebrandt, Gerhard, Landolt, Hans, Mariani, Luigi, Guzman, Raphael, Beck, Jürgen, Raabe, Andreas, Keller, Emanuela, Bijlenga, Philippe, and Schaller, Karl

Published
2021
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5. Herniation World Federation of Neurosurgical Societies Scale Improves Prediction of Outcome in Patients With Poor-Grade Aneurysmal Subarachnoid Hemorrhage

Author

Raabe, Andreas, Beck, Jürgen, Goldberg, Johannes, Z'Graggen, Werner J, Branca, Mattia, Marbacher, Serge, D'Alonzo, Donato, Fandino, Javier, Stienen, Martin N, Neidert, Marian C, Burkhardt, Jan-Karl, Regli, Luca, Hlavica, Martin, Seule, Martin, Roethlisberger, Michel, Guzman, Raphael, Zumofen, Daniel Walter, Maduri, Rodolfo, Daniel, Roy Thomas, El Rahal, Amir, Corniola, Marco V, Bijlenga, Philippe, Schaller, Karl, Rölz, Roland, Scheiwe, Christian, Shah, Mukesch, Heiland, Dieter Henrik, Schnell, Oliver, Fung, Christian, University of Zurich, and Fung, Christian

Subjects
Advanced and Specialized Nursing, 2902 Advanced and Specialized Nursing, 610 Medicine & health, Subarachnoid Hemorrhage, 2705 Cardiology and Cardiovascular Medicine, Cohort Studies, 10180 Clinic for Neurosurgery, 2728 Neurology (clinical), Treatment Outcome, Predictive Value of Tests, Humans, Prospective Studies, Neurology (clinical), Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract

Background: Favorable outcomes are seen in up to 50% of patients with World Federation of Neurosurgical Societies (WFNS) grade V aneurysmal subarachnoid hemorrhage. Therefore, the usefulness of the current WFNS grading system for identifying the worst scenarios for clinical studies and for making treatment decisions is limited. We previously modified the WFNS scale by requiring positive signs of brain stem dysfunction to assign grade V. This study aimed to validate the new herniation WFNS grading system in an independent prospective cohort. Methods: We conducted an international prospective multicentre study in poor-grade aneurysmal subarachnoid hemorrhage patients comparing the WFNS classification with a modified version—the herniation WFNS scale (hWFNS). Here, only patients who showed positive signs of brain stem dysfunction (posturing, anisocoric, or bilateral dilated pupils) were assigned hWFNS grade V. Outcome was assessed by modified Rankin Scale score 6 months after hemorrhage. The primary end point was the difference in specificity of the WFNS and hWFNS grading with respect to poor outcomes (modified Rankin Scale score 4–6). Results: Of the 250 patients included, 237 reached the primary end point. Comparing the WFNS and hWFNS scale after neurological resuscitation, the specificity to predict poor outcome increased from 0.19 (WFNS) to 0.93 (hWFNS) (McNemar, P P P P P Conclusions: The identification of objective positive signs of brain stem dysfunction significantly improves the specificity and positive predictive value with respect to poor outcome in grade V patients. Therefore, a simple modification—presence of brain stem signs is required for grade V—should be added to the WFNS classification. Registration: URL: https://clinicaltrials.gov ; Unique identifier: NCT02304328.

Published
2022
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6. Decision-making and neurosurgeons’ agreement in the management of aneurysmal subarachnoid haemorrhage based on computed tomography angiography

Author

Maldaner, Nicolai, Burkhardt, Jan-Karl, Stienen, Martin Nikolaus, Goldberg, Johannes, Bervini, David, Bijlenga, Philippe, Croci, Davide, Zumofen, Daniel, D’Alonzo, Donato, Marbacher, Serge, Maduri, Rodolfo, Daniel, Roy Thomas, Serra, Carlo, Esposito, Giuseppe, Neidert, Marian C., Bozinov, Oliver, and Regli, Luca

Published
2017
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7. Computed tomography angiography spot sign predicts intraprocedural aneurysm rupture in subarachnoid hemorrhage

Author

Burkhardt, Jan-Karl, Neidert, Marian Christoph, Stienen, Martin Nikolaus, Schöni, Daniel, Fung, Christian, Roethlisberger, Michel, Corniola, Marco Vincenzo, Bervini, David, Maduri, Rodolfo, Valsecchi, Daniele, Tok, Sina, Schatlo, Bawarjan, Bijlenga, Philippe, Schaller, Karl, Bozinov, Oliver, Regli, Luca, Fathi, Ali-Reza, Fandino, Javier, Marbacher, Serge, D’Alonzo, Donato, Kerkeni, Hassen, Soleman, Jahuda, Coluccia, Daniel, Muroi, Carl, Danura, Hiroki, Schmid, Nicole, Zumofen, Daniel, Röthlisberger, Michel, Mariani, Luigi, Guzman, Rahael, Monsch, Andreas U., Bläsi, Stephan, Fung, Christian, Bervini, David, Beck, Jürgen, Raabe, Andreas, Goldberg, Johannes, Schöni, Daniel, Gralla, Jan, Zweifel-Zehnder, Antoinette, Gutbrod, Klemens, Müri, Rene, Maduri, Rodolfo, Daniel, Roy Thomas, Starnoni, Daniele, Messerer, Mahmoud, Levivier, Marc, Beaud, Valérie, Valsecchi, Daniele, Arrighi, Marta, Venier, Alice, Reinert, Michael, Kuhlen, Dominique E., Robert, Thomas, Rossi, Stefania, Sacco, Leonardo, Bijlenga, Philippe, Corniola, Marco, Schaller, Karl, Chicherio, Christian, Seule, Martin A., Ferrari, Andrea, Weyerbrock, Astrid, Hlavica, Martin, Fournier, Jean-Yves, Früh, Severin, Schatlo, Bawarjan, Burkhardt, Jan-Karl, Stienen, Martin N., Keller, Emanuela, Regli, Luca, Bozinov, Oliver, Maldaner, Nicolai, Tok, Sina, Neidert, Marian C., Brugger, Peter, Mondadori, Christian, and on behalf of the Swiss SOS study group

Published
2017
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8. Home-Time as a Surrogate Marker for Functional Outcome After Aneurysmal Subarachnoid Hemorrhage

Author

Stienen, Martin Nikolaus, Smoll, Nicolas Roydon, Fung, Christian, Goldberg, Johannes, Bervini, David, Maduri, Rodolfo, Chiappini, Alessio, Robert, Thomas, May, Adrien, Bijlenga, Philippe, Zumofen, Daniel, Roethlisberger, Michel, Seule, Martin Alexander, Marbacher, Serge, Fandino, Javier, Schatlo, Bawarjan, Schaller, Karl, Keller, Emanuela, Bozinov, Oliver, and Regli, Luca

Published
2018
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9. Correction to: Ruptured PICA aneurysms: presentation and treatment outcomes compared to other posterior circulation aneurysms. A Swiss SOS study

Author

Starnoni, Daniele, Maduri, Rodolfo, Al Taha, Khalid, Bervini, David, Zumofen, Daniel Walter, Stienen, Martin Nikolaus, Schatlo, Bawarjan, Fung, Christian, Robert, Thomas, Seule, Martin A., Burkhardt, Jan-Karl, Maldaner, Nicolai, Roethlisberger, Michel, Blackham, Kristine A., Marbacher, Serge, D’Alonzo, Donato, Remonda, Luca, Machi, Paolo, Gralla, Jan, Bijlenga, Philippe, Saliou, Guillaume, Ballabeni, Pierluigi, Levivier, Marc, Swiss SOS Group, Messerer, Mahmoud, and Daniel, Roy Thomas

Published
2019
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10. Predictors of In-Hospital Death After Aneurysmal Subarachnoid Hemorrhage: Analysis of a Nationwide Database (Swiss SOS [Swiss Study on Aneurysmal Subarachnoid Hemorrhage])

Author

Stienen, Martin Nikolaus, Germans, Menno, Burkhardt, Jan-Karl, Neidert, Marian C., Fung, Christian, Bervini, David, Zumofen, Daniel, Roethlisberger, Michel, Marbacher, Serge, Maduri, Rodolfo, Robert, Thomas, Seule, Martin A., Bijlenga, Philippe, Schaller, Karl, Fandino, Javier, Smoll, Nicolas R., Maldaner, Nicolai, Finkenstädt, Sina, Esposito, Giuseppe, Schatlo, Bawarjan, Keller, Emanuela, Bozinov, Oliver, Regli, Luca, Serra, Carlo, Krayenbühl, Niklaus, Schöni, Daniel, Raabe, Andreas, Beck, Jürgen, Goldberg, Johannes, Mariani, Luigi, Guzman, Raphael, D’Alonzo, Donato, Coluccia, Daniel, Daniel, Roy Thomas, Starnoni, Daniele, Messerer, Mahmoud, Levivier, Marc, Valsecchi, Daniele, Arrighi, Marta, Venier, Alice, Reinert, Michael, Kuhlen, Dominique Emmanuelle, Ferrari, Andrea, Weyerbrock, Astrid, Hildebrandt, Gerhard, Hlavica, Martin, Fournier, Jean-Yves, and Corniola, Marco

Published
2018
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11. Correction to: Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry

Author

Maduri, Rodolfo, Starnoni, Daniele, Rocca, Alda, Bervini, David, Zumofen, Daniel Walter, Stienen, Martin Nikolaus, Schatlo, Bawarjan, Fung, Christian, Robert, Thomas, Seule, Martin A., Burkhardt, Jan-Karl, Maldaner, Nicolai, Rothlisberger, Michel, Blackham, Kristine A., Marbacher, Serge, D’Alonzo, Donato, Remonda, Luca, Machi, Paolo, Gralla, Jan, Bijlenga, Philippe, Saliou, Guillaume, Ballabeni, Pierluigi, Levivier, Marc, Messerer, Mahmoud, Daniel, Roy Thomas, and Swiss SOS Group

Published
2019
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12. Introducing a nationwide registry: the Swiss study on aneurysmal subarachnoid haemorrhage (Swiss SOS)

Author

Schatlo, Bawarjan, Fung, Christian, Fathi, Ali-Reza, Sailer, Martin, Winkler, Kerstin, Daniel, Roy Thomas, Bijlenga, Philippe, Ahlborn, Peter, Seule, Martin, Zumofen, Daniel, Reinert, Michael, Woernle, Christoph, Stienen, Martin, Levivier, Marc, Hildebrandt, Gerhard, Mariani, Luigi, Bernays, René, Fandino, Javier, Raabe, Andreas, Keller, Emanuela, and Schaller, Karl

Published
2012
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13. Orthostatic mesodiencephalic dysfunction after decompressive craniectomy

Author

Bijlenga, Philippe, Zumofen, Daniel, Yilmaz, Hasan, Creisson, Eric, and Tribolet, Nicolas de

Subjects
Skull -- Care and treatment, Magnetic resonance imaging -- Usage, Brain -- Surgery, Brain -- Complications and side effects, Brain -- Management, Company business management, Health, Psychology and mental health
Published
2007

14. Factors associated with clinical and radiological status on admission in patients with aneurysmal subarachnoid hemorrhage

Author

Zumofen, Daniel Walter, Roethlisberger, Michel, Achermann, Rita, Bawarjan, Schatlo, Stienen, Martin N., Fung, Christian, D'Alonzo, Donato, Maldaner, Nicolai, Ferrari, Andrea, Corniola, Marco Vincenzo, Schoeni, Daniel, Goldberg, Johannes, Valsecchi, Daniele, Robertson, Thomas, Maduri, Rodolfo, Seule, Martin, Burkhardt, Jan-Karl, Marbacher, Serge, Bijlenga, Philippe Alexandre Pierre, Blackham, Kristine A., Bucher, Heiner C., Mariani, Luigi, Guzman, Raphael, Swiss SOS Study Group, University of Zurich, and Zumofen, Daniel W

Subjects
Male, Clinical presentation, medicine.medical_treatment, clinical presentation, Aneurysm, Ruptured, Cohort Studies, 0302 clinical medicine, radiological presentation, Intubation, Registries, 030212 general & internal medicine, 610 Medicine & health, Child, Aged, 80 and over, Age Factors, General Medicine, Middle Aged, 2746 Surgery, 2728 Neurology (clinical), Child, Preschool, Cohort, Female, Neurosurgery, Switzerland, Cohort study, Adult, medicine.medical_specialty, Subarachnoid hemorrhage, Adolescent, Referral, Endpoint Determination, subarachnoid hemorrhage, Tertiary referral hospital, Young Adult, 03 medical and health sciences, 10180 Clinic for Neurosurgery, Age, Aneurysm, Predictive Value of Tests, Internal medicine, medicine, Humans, Glasgow Coma Scale, Aged, business.industry, Infant, Newborn, Radiological presentation, Infant, medicine.disease, ddc:616.8, age, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Grading scales yield objective measure of the severity of aneurysmal subarachnoid hemorrhage and serve as to guide treatment decisions and for prognostication. The purpose of this cohort study was to determine what factors govern a patient's disease-specific admission scores in a representative Central European cohort. The Swiss Study of Subarachnoid Hemorrhage includes anonymized data from all tertiary referral centers serving subarachnoid hemorrhage patients in Switzerland. The 2009-2014 dataset was used to evaluate the impact of patient and aneurysm characteristics on the patients' status at admission using descriptive and multivariate regression analysis. The primary/co-primary endpoints were the GCS and the WFNS grade. The secondary endpoints were the Fisher grade, the presence of a thick cisternal or ventricular clot, the presence of a new focal neurological deficit or cranial nerve palsy, and the patient's intubation status. In our cohort of 1787 consecutive patients, increasing patient age by 10 years and low pre-ictal functional status (mRS 3-5) were inversely correlated with "high" GCS score (GCS ≥ 13) (OR 0.91, 95% CI 0.84-0.97 and OR 0.67, 95% CI 0.31-1.46), "low" WFNS grade (grade VI-V) (OR 1.21, 95% CI 1.04-1.20 and OR 1.47, 95% CI 0.66-3.27), and high Fisher grade (grade III-IV) (OR 1.08, 95% CI 1.00-1.17 and OR 1.54, 95% CI 0.55-4.32). Other independent predictors for the patients' clinical and radiological condition at admission were the ruptured aneurysms' location and its size. In sum, chronological age and pre-ictal functional status, as well as the ruptured aneurysm's location and size, determine the patients' clinical and radiological condition at admission to the tertiary referral hospital.

Published
2018
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15. Early permanent cerebrospinal fluid diversion in aneurysmal subarachnoid hemorrhage: does a lower rate of nosocomial meningitis outweigh the risk of delayed cerebral vasospasm related morbidity?

Author

Croci, Davide Marco, Dalolio, Martina, Aghlmandi, Soheila, Taub, Ethan, Rychen, Jonathan, Chiappini, Alessio, Zumofen, Daniel, Guzman, Raphael, Mariani, Luigi, and Roethlisberger, Michel

Abstract

Objective: Early permanent cerebrospinal fluid (CSF) diversion for hydrocephalus during the first 2 weeks after aneurysmal subarachnoid hemorrhage (aSAH) shortens the duration of external ventricular drainage (EVD) and reduces EVD-associated infections (EVDAI). The objective of this study was to detect any association with symptomatic delayed cerebral vasospasm (DCVS), or delayed cerebral ischemia (DCI) by the time of hospital discharge. Methods: We used a single-center dataset of aSAH patients who had received a permanent CSF diversion. We compared an ‘early group’ in which the procedure was performed up to 14 days after the ictus, to a ‘late group’ in which it was performed from the 15th day onward. Results: Among 274 consecutive aSAH patients, 39 (14%) had a permanent CSF diversion procedure with a silver-coated EVD. While the blood clot burden was similarly distributed, patients with early permanent CSF diversion (20 out of 39; 51%) had higher levels of consciousness on admission. Early permanent CSF diversion was associated with less colonized catheter, a shorter duration of extracorporeal CSF diversion (OR 0.73, 95%CI 0.58–0.92 per EVD day), and a lower rate of EVDAI (OR 0.08, 95%CI 0.01–0.80). The occurrence of CSF diversion device obstruction, the rate of symptomatic DCVS or detected DCI on computed tomography and the likelihood of a poor outcome at discharge did not differ between the two groups. Discussion: Early permanent CSF diversion lowers the occurrence of catheter colonization and infectious complication without affecting DCVS-related morbidity in good-grade aSAH patients. These findings need confirmation in larger prospective multicenter cohorts. Abbreviations: aSAH: aneurysmal subarachnoid hemorrhage; BNI: Barrow Neurological Institute Scale; CSF: Cerebrospinal fluid; DCVS: Delayed Cerebral Vasospasm; DCI: Delayed Cortical Ischemia; EKNZ: Ethik-Kommission Nordwest Schweiz; EVD: External ventricular drain; EVDAI: External ventricular drain-associated infections; GCS: Glasgow Coma Scale; IRB: Institutional Review Board; IVH: Inraventricular hemorrhage; mRS: Modified Rankin Scale; SOS: Swiss Study of Subarachnoid Hemorrhage Registry; WFNS: World Federation Neurological-Surgeon Scale

Published
2020
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16. Cerebral venous thrombosis requiring invasive treatment for elevated intracranial pressure in women with combined hormonal contraceptive intake: risk factors, anatomical distribution, and clinical presentation

Author

Roethlisberger, Michel, primary, Gut, Lara, additional, Zumofen, Daniel Walter, additional, Fisch, Urs, additional, Boss, Oliver, additional, Maldaner, Nicolai, additional, Croci, Davide Marco, additional, Taub, Ethan, additional, Corti, Natascia, additional, Burkhardt, Jan-Karl, additional, Guzman, Raphael, additional, Bozinov, Oliver, additional, and Mariani, Luigi, additional

Published
2018
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17. Factors associated with clinical and radiological status on admission in patients with aneurysmal subarachnoid hemorrhage

Author

Zumofen, Daniel W, Roethlisberger, Michel, Achermann, Rita, Bawarjan, Schatlo, Stienen, Martin N, Fung, Christian, D'Alonzo, Donato, Maldaner, Nicolai, Ferrari, Andrea, Corniola, Marco V, Schoeni, Daniel, Goldberg, Johannes, Valsecchi, Daniele, Robert, Thomas, Maduri, Rodolfo, Seule, Martin, Burkhardt, Jan-Karl, Marbacher, Serge, Bijlenga, Philippe, Blackham, Kristine A, Bucher, Heiner C, Mariani, Luigi, Guzman, Raphael, Zumofen, Daniel W, Roethlisberger, Michel, Achermann, Rita, Bawarjan, Schatlo, Stienen, Martin N, Fung, Christian, D'Alonzo, Donato, Maldaner, Nicolai, Ferrari, Andrea, Corniola, Marco V, Schoeni, Daniel, Goldberg, Johannes, Valsecchi, Daniele, Robert, Thomas, Maduri, Rodolfo, Seule, Martin, Burkhardt, Jan-Karl, Marbacher, Serge, Bijlenga, Philippe, Blackham, Kristine A, Bucher, Heiner C, Mariani, Luigi, and Guzman, Raphael

Abstract

Grading scales yield objective measure of the severity of aneurysmal subarachnoid hemorrhage and serve as to guide treatment decisions and for prognostication. The purpose of this cohort study was to determine what factors govern a patient's disease-specific admission scores in a representative Central European cohort. The Swiss Study of Subarachnoid Hemorrhage includes anonymized data from all tertiary referral centers serving subarachnoid hemorrhage patients in Switzerland. The 2009-2014 dataset was used to evaluate the impact of patient and aneurysm characteristics on the patients' status at admission using descriptive and multivariate regression analysis. The primary/co-primary endpoints were the GCS and the WFNS grade. The secondary endpoints were the Fisher grade, the presence of a thick cisternal or ventricular clot, the presence of a new focal neurological deficit or cranial nerve palsy, and the patient's intubation status. In our cohort of 1787 consecutive patients, increasing patient age by 10 years and low pre-ictal functional status (mRS 3-5) were inversely correlated with "high" GCS score (GCS ≥ 13) (OR 0.91, 95% CI 0.84-0.97 and OR 0.67, 95% CI 0.31-1.46), "low" WFNS grade (grade VI-V) (OR 1.21, 95% CI 1.04-1.20 and OR 1.47, 95% CI 0.66-3.27), and high Fisher grade (grade III-IV) (OR 1.08, 95% CI 1.00-1.17 and OR 1.54, 95% CI 0.55-4.32). Other independent predictors for the patients' clinical and radiological condition at admission were the ruptured aneurysms' location and its size. In sum, chronological age and pre-ictal functional status, as well as the ruptured aneurysm's location and size, determine the patients' clinical and radiological condition at admission to the tertiary referral hospital.

Published
2018

18. Introducing a nationwide registry: the Swiss study on aneurysmal subarachnoid haemorrhage (Swiss SOS)

Author

Schatlo, Bawarjan, Fung, Christian, Fathi, Ali-Reza, Sailer, Martin, Winkler, Kerstin, Daniel, Roy, Bijlenga, Philippe, Ahlborn, Peter, Seule, Martin, Zumofen, Daniel, Reinert, Michael, Woernle, Christoph, Stienen, Martin, Levivier, Marc, Hildebrandt, Gerhard, Mariani, Luigi, Bernays, René, Fandino, Javier, Raabe, Andreas, Keller, Emanuela, Schaller, Karl, Schatlo, Bawarjan, Fung, Christian, Fathi, Ali-Reza, Sailer, Martin, Winkler, Kerstin, Daniel, Roy, Bijlenga, Philippe, Ahlborn, Peter, Seule, Martin, Zumofen, Daniel, Reinert, Michael, Woernle, Christoph, Stienen, Martin, Levivier, Marc, Hildebrandt, Gerhard, Mariani, Luigi, Bernays, René, Fandino, Javier, Raabe, Andreas, Keller, Emanuela, and Schaller, Karl

Abstract

Background: Aneurysmal subarachnoid haemorrhage (aSAH) is a haemorrhagic form of stroke and occurs in a younger population compared with ischaemic stroke or intracerebral haemorrhage. It accounts for a large proportion of productive life-years lost to stroke. Its surgical and medical treatment represents a multidisciplinary effort. Due to the complexity of the disease, the management remains difficult to standardise and quality of care is accordingly difficult to assess. Objective: To create a registry to assess management parameters of patients treated for aSAH in Switzerland. Methods: A cohort study was initiated with the aim to record characteristics of patients admitted with aSAH, starting January 1st 2009. Ethical committee approval was obtained or is pending from the institutional review boards of all centres. In the study period, seven Swiss hospitals (five university [U], two non-university medical centres) harbouring a neurosurgery department, an intensive care unit and an interventional neuroradiology team so far agreed to participate in the registry (Aarau, Basel [U], Bern [U], Geneva [U], Lausanne [U], St. Gallen, Zürich [U]). Demographic and clinical parameters are entered into a common database. Discussion: This database will soon provide (1) a nationwide assessment of the current standard of care and (2) the outcomes for patients suffering from aSAH in Switzerland. Based on data from this registry, we can conduct cohort comparisons or design diagnostic or therapeutic studies on a national level. Moreover, a standardised registration system will allow healthcare providers to assess the quality of care

Published
2018

21. Optimizing Tigertriever adjustable stentriever technique: Operators’ experience

Author

Jankowitz, Brian, Abergel, Eitan, Agid, Ronit, Al-Schameri, Abdul Rahman, Bartosz Kądziołka, Krzysztof, Brook, Allan, Diepers, Michael, Farkas, Jeffrey, Fifi, Johanna, Fischer, Sebastian, Gandhi, Chirag, Gooch, Reid, Grandhi, Ramesh, Pero, Guglielmo, Raphaeli, Guy, Roychowdhury, Sudipta, Majidi, Shahram, Stracke, Christian Paul, Sourour, Nader, Tanweer, Omar, Tateshima, Satoshi, Taussky, Phil, Wiesmann, Martin, Yoo, Albert, Zumofen, Daniel W, and Singer, Justin

Abstract

The Tigertriever is a novel, radially adjustable stentriever that addresses limitations in traditional mechanical thrombectomy devices by providing enhanced user control over clot integration. This provides the ability to adapt to patient-specific factors such as varying vessel sizes and clot compositions and may be particularly crucial for ensuring efficacy and safety in distal locations. This consensus paper synthesizes the clinical techniques from a consortium of experienced international operators. It outlines the current data on the Tigertriever, discusses the new operator-controlled capabilities, and provides a recommended approach for both proximal and distal mechanical thrombectomy, emphasizing the “FLEX” approach (Fast Controlled Expansion with Relaxation) for optimal integration and reduced clot disruption.

Published
2024
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22. Decision-making and neurosurgeons' agreement in the management of aneurysmal subarachnoid haemorrhage based on computed tomography angiography.

Author

Maldaner, Nicolai, Burkhardt, Jan-Karl, Stienen, Martin Nikolaus, Goldberg, Johannes, Bervini, David, Bijlenga, Philippe, Croci, Davide, Zumofen, Daniel, D’Alonzo, Donato, Marbacher, Serge, Maduri, Rodolfo, Daniel, Roy Thomas, Serra, Carlo, Esposito, Giuseppe, Neidert, Marian C., Bozinov, Oliver, and Regli, Luca

Subjects
SUBARACHNOID hemorrhage, CEREBRAL hemorrhage, ANEURYSMS, VASCULAR diseases, NEUROSURGEONS
Abstract

Background: To determine the neurosurgeon's agreement in aneurysmal subarachnoid haemorrhage (aSAH) management with special emphasis on the rater's level of experience. A secondary aim was to analyse potential aneurysm variables associated with the therapeutic recommendation. Method: Basic clinical information and admission computed tomography angiography (CTA) images of 30 consecutive aSAH patients were provided. Twelve neurosurgeons independently evaluated aneurysm characteristics and gave recommendations regarding the emergency management and aneurysm occlusion therapy. Inter-rater variability and predictors of treatment recommendation were evaluated. Results: There was an overall moderate agreement in treatment decision [κ = 0.43; 95% confidence interval ((CI), 0.387-0.474] with moderate agreement for surgical (κ = 0.43; 95% CI, 0.386-0.479) and endovascular treatment recommendation (κ = 0.45; 95% CI, 0.398-0.49). Agreement on detailed treatment recommendations including clip, coil, bypass, stent, flow diverter and ventriculostomy was low to moderate. Inter-rater agreement did not significantly differ between residents and consultants. Middle cerebral artery (MCA) aneurysm location was a positive predictor of surgical treatment [odds ratio (OR), 49.57; 95% CI, 10.416-235.865; p < 0.001], while patients aged >65 years (OR, 0.12; 95% CI, 0.03-0.0434; p = 0.001), fusiform aneurysm type (OR, 0.18; 95% CI, 0.044-0.747; p = 0.018) and intracerebral haematoma (ICA) aneurysm location (OR, 0.24; 95% CI, 0.088-0.643; p = 0.005) were associated with a recommendation for endovascular treatment. Conclusions: Agreement on aSAH management varies considerably across neurosurgeons, while therapeutic decision-making is challenging on an individual patient level. However, patients aged >65 years, fusiform aneurysm shape and ICA location were associated with endovascular treatment recommendation, while MCA aneurysm location remains a surgical domain in the opinion of neurosurgeons without formal endovascular training. [ABSTRACT FROM AUTHOR]

Published
2018
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24. Introducing a nationwide registry: the Swiss study on aneurysmal subarachnoid haemorrhage (Swiss SOS)

Author

Schatlo, Bawarjan, Fung, Christian, Fathi, Ali-Reza, Sailer, Martin, Winkler, Kerstin, Daniel, Roy, Bijlenga, Philippe, Ahlborn, Peter, Seule, Martin, Zumofen, Daniel, Reinert, Michael, Woernle, Christoph, Stienen, Martin, Levivier, Marc, Hildebrandt, Gerhard, Mariani, Luigi, Bernays, René, Fandino, Javier, Raabe, Andreas, Keller, Emanuela, Schaller, Karl, Schatlo, Bawarjan, Fung, Christian, Fathi, Ali-Reza, Sailer, Martin, Winkler, Kerstin, Daniel, Roy, Bijlenga, Philippe, Ahlborn, Peter, Seule, Martin, Zumofen, Daniel, Reinert, Michael, Woernle, Christoph, Stienen, Martin, Levivier, Marc, Hildebrandt, Gerhard, Mariani, Luigi, Bernays, René, Fandino, Javier, Raabe, Andreas, Keller, Emanuela, and Schaller, Karl

Abstract

Background: Aneurysmal subarachnoid haemorrhage (aSAH) is a haemorrhagic form of stroke and occurs in a younger population compared with ischaemic stroke or intracerebral haemorrhage. It accounts for a large proportion of productive life-years lost to stroke. Its surgical and medical treatment represents a multidisciplinary effort. Due to the complexity of the disease, the management remains difficult to standardise and quality of care is accordingly difficult to assess. Objective: To create a registry to assess management parameters of patients treated for aSAH in Switzerland. Methods: A cohort study was initiated with the aim to record characteristics of patients admitted with aSAH, starting January 1st 2009. Ethical committee approval was obtained or is pending from the institutional review boards of all centres. In the study period, seven Swiss hospitals (five university [U], two non-university medical centres) harbouring a neurosurgery department, an intensive care unit and an interventional neuroradiology team so far agreed to participate in the registry (Aarau, Basel [U], Bern [U], Geneva [U], Lausanne [U], St. Gallen, Zürich [U]). Demographic and clinical parameters are entered into a common database. Discussion: This database will soon provide (1) a nationwide assessment of the current standard of care and (2) the outcomes for patients suffering from aSAH in Switzerland. Based on data from this registry, we can conduct cohort comparisons or design diagnostic or therapeutic studies on a national level. Moreover, a standardised registration system will allow healthcare providers to assess the quality of care

25. Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease.

Author

D'Antico C, Hofer A, Fassl J, Tobler D, Zumofen D, Steiner LA, and Goettel N

Abstract

We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease., Competing Interests: Competing interests: No competing interests were disclosed.

Published
2016
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