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4. Association of Fluid Balance and Hemoglobin Decline With Neurological Outcome After Aneurysmal Subarachnoid Hemorrhage

Author

Truckenmueller, Peter, Wolf, Stefan, Wasilewski, David, Vajkoczy, Peter, Früh, Anton, Baro, Norbert, Bauer, Miriam, Barner, Christoph, Dengler, Nora F., von Dincklage, Falk, Finger, Tobias, Francis, Roland, Hotter, Benjamin, Hunsicker, Oliver, Jussen, Daniel, Jüttler, Eric, Pohrt, Anne, Salih, Farid, Schaumann, Andreas, Witsch, Jens, Nagel, Christoph, Lemcke, Johannes, Meier, Ullrich, Podlesik, Dino, Schackert, Gabriele, Juratli, Tareq A., Huttner, Hagen, Schwab, Stefan, Staykov, Dimitre, Hagedorn, Sabine, Müller, Daniela, Müller, Oliver, Sarge, Robert, Sure, Ulrich, Bardutzky, Jürgen, Niesen, Wolf-Dirk, Lange, Katharina, Malinova, Vesna, Mielke, Dorothee, Rohde, Veit, Päsler, Dennis, Reinhardt, Stephanie, Schroeder, Henry W.S., Czorlich, Patrick, Regelsberger, Jan, Sauvigny, Thomas, Westphal, Manfred, Ehlert, Angelika, Gremmer, Rudolf, Beyer, Christian, Beyer, Desiree, Huthmann, Alexandra, Kerz, Thomas, Landscheidt, Julia, Schürer, Ludwig, Schul, David B., Meyer, Bernhard, Ryang, Yu-Mi, Toeroek, Elisabeth, Wostrack, Maria, Arouk, Wasim, Al-Jehani, Hosam, Fritsch, Michael, Al-Jehani, Hosam, Alturk, Abdulrahman Y., Sinclair, David B., Beck, Jürgen, Fung, Christian, Soell, Nicole, Engel, Doortje C., Hildebrandt, Gerhard, Huscher, Karen, Lange, Heidrun, Hutchinson, Peter, and Tseng, Ming-Yuan

Published
2024
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7. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

Author

Acosta, Boris Raul, Aegidius, Karen, Albiker, Christian, Alegiani, Anna, Almendrote, Miriam, Alonso, Angelika, Althaus, Katharina, Amarenco, Pierre, Amiri, Hemasse, Anders, Bettina, Aniculaesei, Adriana, Appleton, Jason, Arenillas, Juan, Back, Christina, Bähr, Christian, Bardutzky, Jürgen, Baronnet-Chauvet, Flore, Bathe-Peters, Rouven, Bayer-Karpinska, Anna, Becerra, Juan L., Beck, Christoph, Belchí Guillamon, Olga, Benoit, Amandine, Berhoune, Nadia, Bindila, Daniela, Birchenall, Julia, Blanc-Lasserre, Karine, Blanco Gonzales, Miguel, Bobinger, Tobias, Bodechtel, Ulf, Bodiguel, Eric, Bojaryn, Urszula, Bonnet, Louise, Bouamra, Benjamin, Bourgeois, Paul, Boutitie, Florent, Breuer, Lorenz, Breynaert, Ludovic, Broughton, David, Brouns, Raf, Brugirard, Sébastian, Bruneel, Bart, Buggle, Florian, Cakmak, Serkan, Calleja, Ana, Calvet, David, Carrera, David, Chen, Hsin-Chieh, Cheng, Bastian, Cheripelli, Bharath, Cho, Tae-Hee, Choe, Chi-un, Choy, Lillian, Christensen, Hanne, Ciatipis, Mareva, Cloud, Geoffrey, Cogez, Julien, Cortijo, Elisa, Crozier, Sophie, Damgaard, Dorte, Dani, Krishna, De Coene, Beatrijs, De Hollander, Isabel, De Keyser, Jacques, De Klippel, Nina, De Maeseneire, Charlotte, De Smedt, Ann, del Mar Castellanos Rodrigo, Maria, Deltour, Sandrine, Demeestere, Jelle, Derex, Laurent, Desfontaines, Philippe, Dittrich, Ralf, Dixit, Anand, Dobbels, Laurens, Domigo, Valérie, Dorado, Laura, Druart, Charlotte, Dupont, Kristina Hougaard, Dusart, Anne, Dziewas, Rainer, Ebinger, Martin, Ebner, Matthias, Edjali-Goujon, Myriam, Eisele, Philipp, El Tawil, Salwa, Elhfnawy, Ahmed, Endres, Matthias, Etexberria, Ana, Evans, Nicholas, Fandler, Simon, Fazekas, Franz, Felix, Sandra, Fiebach, Jochen B., Fiehler, Jens, Filipov, Alexandra, Filipski, Katharina, Fleischmann, Robert, Foerch, Christian, Ford, Ian, Gaenslen, Alexandra, Galinovic, Ivana, Gancedo, Elena Meseguer, Ganeshan, Ramanan, García Esperón, Carlos, Garrido, Alicia, Gattringer, Thomas, Geraghty, Olivia, Geran, Rohat, Gerloff, Christian, Gerner, Stefan, Godon-Hardy, Sylvie, Göhler, Jos, Golsari, Amir, Gomis, Meritxell, Gorriz, David, Gramse, Verena, Grau, Laia, Griebe, Martin, Guerrero, Cristina, Guerzoglu, Damla, Guettier, Sophie, Guiraud, Vincent, Gumbinger, Christoph, Gunreben, Ignaz, Haertig, Florian, Hametner, Christian, Hanseeuw, Bernard, Hansen, Andreas, Hansen, Jakob, Harbo, Thomas, Harloff, Andreas, Harmel, Peter, Häusler, Karl Georg, Heinen, Florian, Held, Valentin, Hellwig, Simon, Hemelsoet, Dimitri, Hennerici, Michael, Herm, Juliane, Hermans, Sylvia, Hernández, María, Hervas Vicente, Jose, Hjort, Niels, Hobeanu, Cristina, Hobohm, Carsten, Höfner, Elmar, Hohenbichler, Katharina, Hommel, Marc, Hoppe, Julia, Hornberger, Eva, Hoyer, Carolin, Huang, Xuya, Ipsen, Nils, Isern, Irina, Ispierto, Lourdes, Iversen, Helle, Jeppesen, Lise, Jimenez, Marta, Jungehülsing, Jan, Jüttler, Eric, Kalladka, Dheeraj, Kallmünzer, Bernd, Kar, Arindam, Kellert, Lars, Kemmling, André, Kessler, Tobias, Khan, Usman, Klein, Matthias, Kleinschnitz, Christoph, Klockziem, Matti, Knops, Michael, Koehler, Luzie, Koehrmann, Martin, Kohlfürst, Heinz, Kollmar, Rainer, Kraft, Peter, Krause, Thomas, Kristensen, Bo, Kröber, Jan M., Kurka, Natalia, Ladoux, Alexandre, Laloux, Patrice, Lamy, Catherine, Landrault, Emmanuelle, Lauer, Arne, Lebely, Claire, Leempoel, Jonathan, Lees, Kennedy, Leger, Anne, Legrand, Laurence, Lemmens, Robin, Li, Lin, Löbbe, Anna-Mareike, London, Frederic, Lopez-cancio, Elena, Lorenz, Matthias, Louw, Stephen, Lovelock, Caroline, Lozano Sánchez, Manuel, Lucente, Giuseppe, Lückl, Janos, Luna, Alain, Macha, Kosmas, Machet, Alexandre, Mackenrodt, Daniel, Madzar, Dominik, Majoie, Charles, Männer, Anika, Maqueda, Vicky, Marstrand, Jacob, Martinez, Alicia, Marzina, Annika, Mechthouff, Laura, Meden, Per, Meersman, Guy, Meier, Julia, Mellerio, Charles, Menn, Oliver, Meyer, Nadja, Michalski, Dominik, Michels, Peter, Michelsen, Lene, Millán Torne, Monica, Minnerup, Jens, Modrau, Boris, Moeller, Sebastian, Møller, Anette, Morel, Nathalie, Moreton, Fiona, Morin, Ludovic, Moulin, Thierry, Moynihan, Barry, Mueller, Anne K., Muir, Keith W., Mulero, Patricia, Mundiyanapurath, Sibu, Mutzenbach, Johannes, Nagel, Simon, Naggara, Oliver, Nallasivan, Arumugam, Navalpotro, Irene, Nave, Alexander H., Nederkoorn, Paul, Neeb, Lars, Neugebauer, Hermann, Neumann-Haefelin, Tobias, Nighoghossian, Norbert, Oberndorfer, Stefan, Opherk, Christian, Oppel, Lorenz, Oppenheim, Catherine, Orthgieß, Johannes, Ostergaard, Leif, Paindeville, Perrine, Palomeras, Ernest, Panitz, Verena, Patel, Bhavni, Peeters, Andre, Peeters, Dirk, Pellisé, Anna, Pelz, Johann, Pereira, Anthony, Pérez de la Ossa, Natalia, Perry, Richard, Petraza, Salvador, Peysson, Stéphane, Pfeilschifter, Waltraud, Pichler, Alexander, Pierskalla, Alexandra, Pledl, Hans-Werner, Poli, Sven, Pomrehn, Katrin, Poulsen, Marika, Prats, Luis, Presas, Silvia, Prohaska, Elisabeth, Puetz, Volker, Puig, Josep, Puig Alcántara, Josep, Purrucker, Jan, Quenardelle, Veronique, Ramachandran, Sankaranarayanan, Raphaelle, Soulliard, Raposo, Nicolas, Reiff, Tilman, Remmers, Michel, Renou, Pauline, Ribitsch, Martin, Richter, Hardy, Ringleb, Peter, Ritter, Martin, Ritzenthaler, Thomas, Rodier, Gilles, Rodriguez-Regent, Christine, Rodríguez-Yáñez, Manuel, Roennefarth, Maria, Roffe, Christine, Rosenbaum, Sverre, Rosso, Charlotte, Röther, Joachim, Rozanski, Michal, Ruiz de Morales, Noelia, Russo, Francesca, Rutgers, Matthieu, Sagnier, Sharmilla, Samson, Yves, Sánchez, Josep, Sauer, Tamara, Schäfer, Jan H., Schieber, Simon, Schill, Josef, Schlak, Dennis, Schlemm, Ludwig, Schmidt, Sein, Schonewille, Wouter, Schröder, Julian, Schulz, Andreas, Schurig, Johannes, Schwarting, Sönke, Schwarz, Alexander, Schwarzbach, Christopher, Seidel, Matthias, Seiler, Alexander, Sembill, Jochen, Serena Leal, Joaquin, Shetty, Ashit, Sibon, Igor, Simonsen, Claus Z., Singer, Oliver, Sivagnanaratham, Aravinth, Smets, Ide, Smith, Craig, Soors, Peter, Sprigg, Nikola, Spruegel, Maximilian, Stark, David, Steinert, Susanne, Stösser, Sebastian, Stuermlinger, Markus, Swinnen, Bart, Tamazyan, Ruben, Tembl, Jose, Terceno Izaga, Mikel, Thijs, Vincent, Thomalla, Götz, Touze, Emmanuel, Truelsen, Thomas, Turc, Guillaume, Turine, Gaetane, Tütüncü, Serdar, Tyrell, Pippa, Ustrell, Xavier, Vadot, Wilfried, Vallet, Anne-Evelyne, Vallet, Pauline, van den Berg, Lucie, van den Berg, Sophie, van Eendenburg, Cecile, Van Hooff, Robbert-Jan, van Sloten, Isabelle, Vanacker, Peter, Vancaester, Evelien, Vanderdonckt, Patrick, Vandermeeren, Yves, Vanhee, Frederik, Veltkamp, Roland, Vestergaard, Karsten, Viguier, Alain, Vilas, Dolores, Villringer, Kersten, Voget, Dieke, von Schrader, Jörg, von Weitzel, Paul, Warburton, Elisabeth, Weber, Claudia, Weber, Jörg, Wegscheider, Karl, Wegscheider, Mirko, Weimar, Christian, Weinstich, Karin, Weise, Christopher, Weise, Gesa, Willems, Chris, Winder, Klemens, Wittayer, Matthias, Wolf, Marc, Wolf, Martin, Wolff, Valerie, Wollboldt, Christian, Wollenweber, Frank, Wouters, Anke, Yalo, Bertrand, Yger, Marion, Younan, Nadia, Yperzeele, Laetita, Zegarac, Vesna, Zeiner, Pia, Ziemann, Ulf, Zonneveld, Thomas, Zuber, Mathieu, Akutsu, Tsugio, Aoki, Junya, Arakawa, Shuji, Doijiri, Ryosuke, Egashira, Yusuke, Enomoto, Yukiko, Fukuda-Doi, Mayumi, Furui, Eisuke, Furuta, Konosuke, Gotoh, Seiji, Hamasaki, Toshimitsu, Hasegawa, Yasuhiro, Hirano, Teryuki, Homma, Kazunari, Ichijyo, Masahiko, Ide, Toshihiro, Igarashi, Shuichi, Iguchi, Yasuyuki, Ihara, Masafumi, Ikenouchi, Hajime, Inoue, Manabu, Inoue, Tsuyoshi, Itabashi, Ryo, Ito, Yasuhiro, Iwama, Toru, Kamiyama, Kenji, Kamiyoshi, Shoko, Kanai, Haruka, Kanematsu, Yasuhisa, Kanzawa, Takao, Kimura, Kazumi, Kitayama, Jiro, Kitazono, Takanari, Koga, Masatoshi, Kondo, Rei, Kudo, Kohsuke, Kusumi, Masayoshi, Kuwahara, Ken, Matsumoto, Shoji, Matsuoka, Hideki, Mihara, Ban, Minematsu, Kazuo, Miura, Ken, Miwa, Kaori, Morita, Naomi, Mouri, Wataru, Murata, Kayo, Nagakane, Yoshinari, Nakase, Taizen, Ohara, Hiromi, Ohara, Nobuyuki, Ohnishi, Hideyuki, Ohta, Hajime, Ohtaki, Masafumi, Ohtani, Ryo, Ohtsuki, Toshiho, Ohyama, Hideo, Okada, Takashi, Okada, Yasushi, Osaki, Masato, Sakai, Nobuyuki, Sanbongi, Yoshiki, Sasaki, Naoshi, Sasaki, Makoto, Sato, Shoichiro, Seki, Kenta, Shimizu, Wataru, Shiokawa, Yoshiaki, Sozu, Takashi, Suzuki, Junichiro, Suzuki, Rieko, Takagi, Yasushi, Takizawa, Shunya, Tanahashi, Norio, Tanaka, Eijiro, Tanaka, Ryota, Tateishi, Yohei, Terada, Tomoaki, Terasaki, Tadashi, Todo, Kenichi, Tokunaga, Azusa, Toyoda, Kazunori, Tsujino, Akira, Ueda, Toshihiro, Uesaka, Yoshikazu, Uotani, Mihoko, Urabe, Takao, Watanabe, Masao, Yagita, Yoshiki, Yakushiji, Yusuke, Yamamoto, Haruko, Yasui, Keizo, Yonehara, Toshiro, Yoshimura, Sohei, Yoshimura, Shinichi, Aarnio, K., Alemseged, F., Anderson, C., Ang, T., Archer, M.L., Attia, J., Bailey, P., Balabanski, A., Barber, A., Barber, P.A., Bernhardt, J., Bivard, A., Blacker, D., Bladin, C.F., Brodtmann, A., Cadilhac, D., Campbell, B.C.V., Carey, L., Celestino, S., Chan, L., Chang, W.H., ChangI, A., Chen, C.H., Chen, C.-I., Chen, H.F., Chen, T.C., Chen, W.H., Chen, Y.Y., Cheng, C.A., Cheong, E., Chiou, Y.W., Choi, P.M., Chu, H.J., Chuang, C.S., Chung, T.C., Churilov, L., Clissold, B., Connelly, A., Coote, S., Coulton, B., Cowley, E., Cranefield, J., Curtze, S., D'Este, C., Davis, S.M., Day, S., Desmond, P.M., Dewey, H.M., Ding, C., Donnan, G.A., Drew, R., Eirola, S., Field, D., Frost, T., Garcia-Esperon, C., George, K., Gerraty, R., Grimley, R., Guo, Y.C., Hankey, G., Harvey, J., Ho, S.C., Hogan, K., Howells, D., Hsiao, P.M., Hsu, C.H., Hsu, C.T., Hsu, C.-S., Hsu, J.P., Hsu, Y.D., Hsu, Y.T., Hu, C.J., Huang, C.C., Huang, H.Y., Huang, M.Y., Huang, S.C., Huang, W.S., Jackson, D., Jeng, J.S., Jiang, S.K., Kaauwai, L., Kasari, O., King, J., Kleinig, T.J., Koivu, M., Kolbe, J., Krause, M., Kuan, C.W., Kung, W.L., Kyndt, C., Lau, C.L., Lee, A., Lee, C.Y., Lee, J.T., Lee, Y., Lee, Y.C., Levi, C., Levi, C.R., Lien, L.M., Lim, J.C., Lin, C.C., Lin, C.H., Lin, C.M., Lin, D., Liu, C.H., Liu, J., Lo, Y.C., Loh, P.S., Low, E., Lu, C.H., Lu, C.J., Lu, M.K., Ly, J., Ma, H., Macaulay, L., Macdonnell, R., Mackey, E., Macleod, M., Mahadevan, J., Maxwell, V., McCoy, R., McDonald, A., McModie, S., Meretoja, A., Mishra, S., Mitchell, P.J., Miteff, F., Moore, A., Muller, C., Ng, F., Ng, F.C., Ng, J-L., O'Brian, W., O'Collins, V., Oxley, T.J., Parsons, M.W., Patel, S., Peng, G.S., Pesavento, L., Phan, T., Rodrigues, E., Ross, Z., Sabet, A., Sallaberger, M., Salvaris, P., Shah, D., Sharma, G., Sibolt, G., Simpson, M., Singhal, S., Snow, B., Spratt, N., Stark, R., Sturm, J., Sun, M.C., Sun, Y., Sung, P.S., Sung, Y.F., Suzuki, M., Tan, M., Tang, S.C., Tatlisumak, T., Thijs, V., Tiainen, M., Tsai, C.H., Tsai, C.K., Tsai, C.L., Tsai, H.T., Tsai, L.K., Tseng, C.H., Tseng, L.T., Tsoleridis, J., Tu, H., Tu, H.T-H., Vallat, W., Virta, J., Wang, W.C., Wang, Y.T., Waters, M., Weir, L., Wijeratne, T., Williams, C., Wilson, W., Wong, A.A., Wong, K., Wu, T.Y., Wu, Y.H., Yan, B., Yang, F.C., Yang, Y.W., Yassi, N., Yeh, H.L., Yeh, J.H., Yeh, S.J., Yen, C.H., Young, D., Ysai, C.L., Zhang, W.W., Zhao, H., Zhao, L., Althaus-Knaurer, Katharina, Bendszus, Martin, Berrouschot, Jörg, Bluhmki, Erich, Bovi, Paolo, Chatellier, Gilles, Cove, Lynda, Davis, Stephen, Dixit, A., Donnan, Geoffrey, Ehrenkrona, Christina, Eschenfelder, Christoph, Fatar, Marc, Francisco Arenillas, Juan, Gruber, Franz, Hacke, Werner, Kala, Lalit, Kapeller, Peter, Kaste, Markku, Kessler, Christof, Köhrmann, Martin, Laage, Rico, Lees, Kennedy R., Leys, Didier, Luna Rodriguez, Alain, Mas, Jean-Louis, Mikulik, Robert, Molina, Carlos, Muddegowda, Girish, Muir, Keith, Niederkorn, Kurt, Nuñez, Xavier, Schellinger, Peter, Schwab, Stefan, Serena, Joaquin, Sobesky, Jan, Steiner, Thorsten, Svenson, Ann-Sofie, Toni, Danilo, von Kummer, Rüdiger, Wahlgren, Nils, Wardlaw, Joanna, Betensky, Rebecca A., Boulouis, Gregoire, Carandang, Raphael A., Copen, William A., Cougo, Pedro, Cutting, Shawna, Drake, Kendra, Ford, Andria L., Hallenbeck, John, Harris, Gordon J., Hoesch, Robert, Hsia, Amie, Kase, Carlos, Latour, Lawrence, Lev, Michael H., Muzikansky, Alona, Nagaraja, Nandakumar, Schwamm, Lee H., Searls, Eric, Song, Shlee S., Starkman, Sidney, Warach, Steven, Wu, Ona, Yoo, Albert J., Zand, Ramin, Ma, Henry, Schwamm, Lee H, Bladin, Christopher F, Campbell, Bruce C V, Churilov, Leonid, Fiebach, Jochen B, Kleinig, Timothy J, Latour, Lawrence L, Levi, Christopher R, Molina, Carlos A, Muir, Keith W, Parsons, Mark W, Pedraza, Salvador, Schellinger, Peter D, Simonsen, Claus Z, Song, Shlee S, Hsu, Chung Y, Yassi, Nawaf, Donnan, Geoffrey A, and Davis, Stephen M

Published
2020
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13. Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial

Author

Wolf, Stefan, Mielke, Dorothee, Barner, Christoph, Malinova, Vesna, Kerz, Thomas, Wostrack, Maria, Czorlich, Patrick, Salih, Farid, Engel, Doortje C, Ehlert, Angelika, Staykov, Dimitre, Alturki, Abdulrahman Y, Sure, Ulrich, Bardutzky, Jürgen, Schroeder, Henry W S, Schürer, Ludwig, Beck, Jürgen, Juratli, Tareq A, Fritsch, Michael, Lemcke, Johannes, Pohrt, Anne, Meyer, Bernhard, Schwab, Stefan, Rohde, Veit, and Vajkoczy, Peter

Subjects
610 Medicine & health
Abstract

IMPORTANCE After aneurysmal subarachnoid hemorrhage, the use of lumbar drains has been suggested to decrease the incidence of delayed cerebral ischemia and improve long-term outcome. OBJECTIVE To determine the effectiveness of early lumbar cerebrospinal fluid drainage added to standard of care in patients after aneurysmal subarachnoid hemorrhage. DESIGN, SETTING, AND PARTICIPANTS The EARLYDRAIN trial was a pragmatic, multicenter, parallel-group, open-label randomized clinical trial with blinded end point evaluation conducted at 19 centers in Germany, Switzerland, and Canada. The first patient entered January 31, 2011, and the last on January 24, 2016, after 307 randomizations. Follow-up was completed July 2016. Query and retrieval of data on missing items in the case report forms was completed in September 2020. A total of 20 randomizations were invalid, the main reason being lack of informed consent. No participants meeting all inclusion and exclusion criteria were excluded from the intention-to-treat analysis. Exclusion of patients was only performed in per-protocol sensitivity analysis. A total of 287 adult patients with acute aneurysmal subarachnoid hemorrhage of all clinical grades were analyzable. Aneurysm treatment with clipping or coiling was performed within 48 hours. INTERVENTION A total of 144 patients were randomized to receive an additional lumbar drain after aneurysm treatment and 143 patients to standard of care only. Early lumbar drainage with 5 mL per hour was started within 72 hours of the subarachnoid hemorrhage. MAIN OUTCOMES AND MEASURES Primary outcome was the rate of unfavorable outcome, defined as modified Rankin Scale score of 3 to 6 (range, 0 to 6), obtained by masked assessors 6 months after hemorrhage. RESULTS Of 287 included patients, 197 (68.6%) were female, and the median (IQR) age was 55 (48-63) years. Lumbar drainage started at a median (IQR) of day 2 (1-2) after aneurysmal subarachnoid hemorrhage. At 6 months, 47 patients (32.6%) in the lumbar drain group and 64 patients (44.8%) in the standard of care group had an unfavorable neurological outcome (risk ratio, 0.73; 95% CI, 0.52 to 0.98; absolute risk difference, -0.12; 95% CI, -0.23 to -0.01; P = .04). Patients treated with a lumbar drain had fewer secondary infarctions at discharge (41 patients [28.5%] vs 57 patients [39.9%]; risk ratio, 0.71; 95% CI, 0.49 to 0.99; absolute risk difference, -0.11; 95% CI, -0.22 to 0; P = .04). CONCLUSION AND RELEVANCE In this trial, prophylactic lumbar drainage after aneurysmal subarachnoid hemorrhage lessened the burden of secondary infarction and decreased the rate of unfavorable outcome at 6 months. These findings support the use of lumbar drains after aneurysmal subarachnoid hemorrhage. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01258257.

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

Author

Kuramatsu, Joji B., primary, Gerner, Stefan T., additional, Ziai, Wendy, additional, Bardutzky, Jürgen, additional, Sembill, Jochen A., additional, Sprügel, Maximilian I., additional, Mrochen, Anne, additional, Kölbl, Kathrin, additional, Ram, Malathi, additional, Avadhani, Radhika, additional, Falcone, Guido J., additional, Selim, Magdy H., additional, Lioutas, Vasileios-Arsenios, additional, Endres, Matthias, additional, Zweynert, Sarah, additional, Vajkoczy, Peter, additional, Ringleb, Peter A., additional, Purrucker, Jan C., additional, Volkmann, Jens, additional, Neugebauer, Hermann, additional, Erbguth, Frank, additional, Schellinger, Peter D., additional, Knappe, Ulrich J., additional, Fink, Gereon R., additional, Dohmen, Christian, additional, Minnerup, Jens, additional, Reichmann, Heinz, additional, Schneider, Hauke, additional, Röther, Joachim, additional, Reimann, Gernot, additional, Schwarz, Michael, additional, Bäzner, Hansjörg, additional, Claßen, Joseph, additional, Michalski, Dominik, additional, Witte, Otto W., additional, Günther, Albrecht, additional, Hamann, Gerhard F., additional, Lücking, Hannes, additional, Dörfler, Arnd, additional, Ishfaq, Muhammad Fawad, additional, Chang, Jason J., additional, Testai, Fernando D., additional, Woo, Daniel, additional, Alexandrov, Andrei V., additional, Staykov, Dimitre, additional, Goyal, Nitin, additional, Tsivgoulis, Georgios, additional, Sheth, Kevin N., additional, Awad, Issam A., additional, Schwab, Stefan, additional, Hanley, Daniel F., additional, Huttner, Hagen B., additional, Sansing, Lauren, additional, Matouk, Charles C., additional, Leasure, Audrey, additional, Sobesky, Jan, additional, Bauer, Miriam, additional, Schurig, Johannes, additional, Rizos, Timolaos, additional, Haeusler, Karl Georg, additional, Müllges, Wolfgang, additional, Kraft, Peter, additional, Schubert, Anna-Lena, additional, Stösser, Sebastian, additional, Ludolph, Albert Christian, additional, Nueckel, Martin, additional, Glahn, Jörg, additional, Stetefeld, Henning, additional, Rahmig, Jan, additional, Fisse, Anna Lena, additional, Michels, Peter, additional, Schwert, Henning, additional, Hagemann, Georg, additional, Rakers, Florian, additional, Wöhrle, Johannes C., additional, Alshammari, Fahid, additional, Horn, Markus, additional, Bahner, Dirk, additional, Urbanek, Christian, additional, Palm, Frederick, additional, and Grau, Armin, additional

Published
2022
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17. Minimally-invasive bedside catheter haematoma aspiration followed by local thrombolysis in spontaneous supratentorial intracerebral haemorrhage: a retrospective single-center study.

Author

Hieber, Maren, Lambeck, Johann, Halaby, Amjad, Roelz, Roland, Demerath, Theo, Niesen, Wolf-Dirk, and Bardutzky, Jürgen

Subjects
CEREBRAL hemorrhage, HEMATOMA, CATHETERS, CATHETERIZATION, COMPUTED tomography, THROMBOLYTIC therapy, ASPIRATORS
Abstract

Background and purpose: The role of surgery in the treatment of intracerebral haemorrhage (ICH) remains controversial. Whereas open surgery has failed to show any clinical benefit, recent studies have suggested that minimal invasive procedures can indeed be beneficial, especially when they are applied at an early time point. This retrospective study therefore evaluated the feasibility of a freehand bedside catheter technique with subsequent local lysis for early haematoma evacuation in patients with spontaneous supratentorial ICH. Methods: Patients with spontaneous supratentorial haemorrhage of a volume of >30 mL who were treated with bedside catheter haematoma evacuation were identified from our institutional database. The entry point and evacuation trajectory of the catheter were based on a 3D-reconstructed CT scan. The catheter was inserted bedside into the core of the haematoma, and urokinase (5,000 IE) was administered every 6 h for a maximum of 4 days. Evolution of haematoma volume, perihaemorrhagic edema, midline-shift, adverse events and functional outcome were analyzed. Results: A total of 110 patients with a median initial haematoma volume of 60.6 mL were analyzed. Haematoma volume decreased to 46.1 mL immediately after catheter placement and initial aspiration (with a median time to treatment of 9 h after ictus), and to 21.0 mL at the end of urokinase treatment. Perihaemorrhagic edema decreased significantly from 45.0 mL to 38.9 mL and midline-shift from 6.0 mm to 2.0 mm. The median NIHSS score improved from 18 on admission to 10 at discharge, and the median mRS at discharge was 4; the latter was even lower in patients who reached a target volume ≤ 15 mL at the end of local lysis. The in-hospital mortality rate was 8.2%, and catheter/local lysis-associated complications occurred in 5.5% of patients. Conclusion: Bedside catheter aspiration with subsequent urokinase irrigation is a safe and feasible procedure for treating spontaneous supratentorial ICH, and can immediately reduce the mass effects of haemorrhage. Additional controlled studies that assess the long-term outcome and generalizability of our findings are therefore warranted. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Correspondence

Author

Petrik, Stephan, primary, Lambeck, Johann, additional, and Bardutzky, Jürgen, additional

Published
2022
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20. Association of intraventricular fibrinolysis with clinical outcomes in intracerebral hemorrhage: an individual participant data meta-analysis

Author

Kuramatsu, Joji B, Gerner, Stefan T, 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, Ziai, Wendy, Erbguth, Frank, Schellinger, Peter D, Knappe, Ulrich J, Fink, Gereon R, Dohmen, Christian, Minnerup, Jens, Reichmann, Heinz, Schneider, Hauke, Röther, Joachim, Reimann, Gernot, Bardutzky, Jürgen, Schwarz, Michael, Bäzner, Hansjörg, Claßen, Joseph, Michalski, Dominik, Witte, Otto W, Günther, Albrecht, Hamann, Gerhard F, Lücking, Hannes, Dörfler, Arnd, Ishfaq, Muhammad Fawad, Sembill, Jochen A, 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, Sprügel, Maximilian I, Hanley, Daniel F, Huttner, Hagen B, Collaborators, Sansing, Lauren, Matouk, Charles C, Leasure, Audrey, Sobesky, Jan, Bauer, Miriam, Schurig, Johannes, Rizos, Timolaos, Mrochen, Anne, Haeusler, Karl Georg, Müllges, Wolfgang, Kraft, Peter, Schubert, Anna-Lena, Stösser, Sebastian, Ludolph, Albert, Nueckel, Martin, Glahn, Jörg, Stetefeld, Henning, Rahmig, Jan, Kölbl, Kathrin, Fisse, Anna Lena, Michels, Peter, Schwert, Henning, Hagemann, Georg, Rakers, Florian, Wöhrle, Johannes C, Alshammari, Fahid, Horn, Markus, Bahner, Dirk, Urbanek, Christian, Ram, Malathi, Palm, Frederick, Grau, Armin, and Avadhani, Radhika

Subjects
Advanced and Specialized Nursing, drug therapy [Cerebral Hemorrhage], Fibrinolysis, diagnostic imaging [Cerebral Hemorrhage], intracerebral hemorrhage, mortality, Observational Studies as Topic, Treatment Outcome, Fibrinolytic Agents, standard of care, Drainage, Humans, Neurology (clinical), methods [Drainage], ddc:610, Cardiology and Cardiovascular Medicine, hydrocephalus, Cerebral Hemorrhage, Hydrocephalus
Abstract

Background: In patients with intracerebral hemorrhage (ICH), the presence of intraventricular hemorrhage constitutes a promising therapeutic target. Intraventricular fibrinolysis (IVF) reduces mortality, yet impact on functional disability remains unclear. Thus, we aimed to determine the influence of IVF on functional outcomes. Methods: This individual participant data meta-analysis pooled 1501 patients from 2 randomized trials and 7 observational studies enrolled during 2004 to 2015. We compared IVF versus standard of care (including placebo) in patients treated with external ventricular drainage due to acute hydrocephalus caused by ICH with intraventricular hemorrhage. The primary outcome was functional disability evaluated by the modified Rankin Scale (mRS; range: 0–6, lower scores indicating less disability) at 6 months, dichotomized into mRS score: 0 to 3 versus mRS: 4 to 6. Secondary outcomes included ordinal-shift analysis, all-cause mortality, and intracranial adverse events. Confounding and bias were adjusted by random effects and doubly robust models to calculate odds ratios and absolute treatment effects (ATE). Results: Comparing treatment of 596 with IVF to 905 with standard of care resulted in an ATE to achieve the primary outcome of 9.3% (95% CI, 4.4–14.1). IVF treatment showed a significant shift towards improved outcome across the entire range of mRS estimates, common odds ratio, 1.75 (95% CI, 1.39–2.17), reduced mortality, odds ratio, 0.47 (95% CI, 0.35–0.64), without increased adverse events, absolute difference, 1.0% (95% CI, −2.7 to 4.8). Exploratory analyses provided that early IVF treatment (≤48 hours) after symptom onset was associated with an ATE, 15.2% (95% CI, 8.6–21.8) to achieve the primary outcome. Conclusions: As compared to standard of care, the administration of IVF in patients with acute hydrocephalus caused by intracerebral and intraventricular hemorrhage was significantly associated with improved functional outcome at 6 months. The treatment effect was linked to an early time window

Published
2022
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31. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

Author

Thomalla, Götz, primary, Boutitie, Florent, additional, Ma, Henry, additional, Koga, Masatoshi, additional, Ringleb, Peter, additional, Schwamm, Lee H, additional, Wu, Ona, additional, Bendszus, Martin, additional, Bladin, Christopher F, additional, Campbell, Bruce C V, additional, Cheng, Bastian, additional, Churilov, Leonid, additional, Ebinger, Martin, additional, Endres, Matthias, additional, Fiebach, Jochen B, additional, Fukuda-Doi, Mayumi, additional, Inoue, Manabu, additional, Kleinig, Timothy J, additional, Latour, Lawrence L, additional, Lemmens, Robin, additional, Levi, Christopher R, additional, Leys, Didier, additional, Miwa, Kaori, additional, Molina, Carlos A, additional, Muir, Keith W, additional, Nighoghossian, Norbert, additional, Parsons, Mark W, additional, Pedraza, Salvador, additional, Schellinger, Peter D, additional, Schwab, Stefan, additional, Simonsen, Claus Z, additional, Song, Shlee S, additional, Thijs, Vincent, additional, Toni, Danilo, additional, Hsu, Chung Y, additional, Wahlgren, Nils, additional, Yamamoto, Haruko, additional, Yassi, Nawaf, additional, Yoshimura, Sohei, additional, Warach, Steven, additional, Hacke, Werner, additional, Toyoda, Kazunori, additional, Donnan, Geoffrey A, additional, Davis, Stephen M, additional, Gerloff, Christian, additional, Acosta, Boris Raul, additional, Aegidius, Karen, additional, Albiker, Christian, additional, Alegiani, Anna, additional, Almendrote, Miriam, additional, Alonso, Angelika, additional, Althaus, Katharina, additional, Amarenco, Pierre, additional, Amiri, Hemasse, additional, Anders, Bettina, additional, Aniculaesei, Adriana, additional, Appleton, Jason, additional, Arenillas, Juan, additional, Back, Christina, additional, Bähr, Christian, additional, Bardutzky, Jürgen, additional, Baronnet-Chauvet, Flore, additional, Bathe-Peters, Rouven, additional, Bayer-Karpinska, Anna, additional, Becerra, Juan L., additional, Beck, Christoph, additional, Belchí Guillamon, Olga, additional, Benoit, Amandine, additional, Berhoune, Nadia, additional, Bindila, Daniela, additional, Birchenall, Julia, additional, Blanc-Lasserre, Karine, additional, Blanco Gonzales, Miguel, additional, Bobinger, Tobias, additional, Bodechtel, Ulf, additional, Bodiguel, Eric, additional, Bojaryn, Urszula, additional, Bonnet, Louise, additional, Bouamra, Benjamin, additional, Bourgeois, Paul, additional, Breuer, Lorenz, additional, Breynaert, Ludovic, additional, Broughton, David, additional, Brouns, Raf, additional, Brugirard, Sébastian, additional, Bruneel, Bart, additional, Buggle, Florian, additional, Cakmak, Serkan, additional, Calleja, Ana, additional, Calvet, David, additional, Carrera, David, additional, Chen, Hsin-Chieh, additional, Cheripelli, Bharath, additional, Cho, Tae-Hee, additional, Choe, Chi-un, additional, Choy, Lillian, additional, Christensen, Hanne, additional, Ciatipis, Mareva, additional, Cloud, Geoffrey, additional, Cogez, Julien, additional, Cortijo, Elisa, additional, Crozier, Sophie, additional, Damgaard, Dorte, additional, Dani, Krishna, additional, De Coene, Beatrijs, additional, De Hollander, Isabel, additional, De Keyser, Jacques, additional, De Klippel, Nina, additional, De Maeseneire, Charlotte, additional, De Smedt, Ann, additional, del Mar Castellanos Rodrigo, Maria, additional, Deltour, Sandrine, additional, Demeestere, Jelle, additional, Derex, Laurent, additional, Desfontaines, Philippe, additional, Dittrich, Ralf, additional, Dixit, Anand, additional, Dobbels, Laurens, additional, Domigo, Valérie, additional, Dorado, Laura, additional, Druart, Charlotte, additional, Dupont, Kristina Hougaard, additional, Dusart, Anne, additional, Dziewas, Rainer, additional, Ebner, Matthias, additional, Edjali-Goujon, Myriam, additional, Eisele, Philipp, additional, El Tawil, Salwa, additional, Elhfnawy, Ahmed, additional, Etexberria, Ana, additional, Evans, Nicholas, additional, Fandler, Simon, additional, Fazekas, Franz, additional, Felix, Sandra, additional, Fiebach, Jochen B., additional, Fiehler, Jens, additional, Filipov, Alexandra, additional, Filipski, Katharina, additional, Fleischmann, Robert, additional, Foerch, Christian, additional, Ford, Ian, additional, Gaenslen, Alexandra, additional, Galinovic, Ivana, additional, Gancedo, Elena Meseguer, additional, Ganeshan, Ramanan, additional, García Esperón, Carlos, additional, Garrido, Alicia, additional, Gattringer, Thomas, additional, Geraghty, Olivia, additional, Geran, Rohat, additional, Gerner, Stefan, additional, Godon-Hardy, Sylvie, additional, Göhler, Jos, additional, Golsari, Amir, additional, Gomis, Meritxell, additional, Gorriz, David, additional, Gramse, Verena, additional, Grau, Laia, additional, Griebe, Martin, additional, Guerrero, Cristina, additional, Guerzoglu, Damla, additional, Guettier, Sophie, additional, Guiraud, Vincent, additional, Gumbinger, Christoph, additional, Gunreben, Ignaz, additional, Haertig, Florian, additional, Hametner, Christian, additional, Hanseeuw, Bernard, additional, Hansen, Andreas, additional, Hansen, Jakob, additional, Harbo, Thomas, additional, Harloff, Andreas, additional, Harmel, Peter, additional, Häusler, Karl Georg, additional, Heinen, Florian, additional, Held, Valentin, additional, Hellwig, Simon, additional, Hemelsoet, Dimitri, additional, Hennerici, Michael, additional, Herm, Juliane, additional, Hermans, Sylvia, additional, Hernández, María, additional, Hervas Vicente, Jose, additional, Hjort, Niels, additional, Hobeanu, Cristina, additional, Hobohm, Carsten, additional, Höfner, Elmar, additional, Hohenbichler, Katharina, additional, Hommel, Marc, additional, Hoppe, Julia, additional, Hornberger, Eva, additional, Hoyer, Carolin, additional, Huang, Xuya, additional, Ipsen, Nils, additional, Isern, Irina, additional, Ispierto, Lourdes, additional, Iversen, Helle, additional, Jeppesen, Lise, additional, Jimenez, Marta, additional, Jungehülsing, Jan, additional, Jüttler, Eric, additional, Kalladka, Dheeraj, additional, Kallmünzer, Bernd, additional, Kar, Arindam, additional, Kellert, Lars, additional, Kemmling, André, additional, Kessler, Tobias, additional, Khan, Usman, additional, Klein, Matthias, additional, Kleinschnitz, Christoph, additional, Klockziem, Matti, additional, Knops, Michael, additional, Koehler, Luzie, additional, Koehrmann, Martin, additional, Kohlfürst, Heinz, additional, Kollmar, Rainer, additional, Kraft, Peter, additional, Krause, Thomas, additional, Kristensen, Bo, additional, Kröber, Jan M., additional, Kurka, Natalia, additional, Ladoux, Alexandre, additional, Laloux, Patrice, additional, Lamy, Catherine, additional, Landrault, Emmanuelle, additional, Lauer, Arne, additional, Lebely, Claire, additional, Leempoel, Jonathan, additional, Lees, Kennedy, additional, Leger, Anne, additional, Legrand, Laurence, additional, Li, Lin, additional, Löbbe, Anna-Mareike, additional, London, Frederic, additional, Lopez-cancio, Elena, additional, Lorenz, Matthias, additional, Louw, Stephen, additional, Lovelock, Caroline, additional, Lozano Sánchez, Manuel, additional, Lucente, Giuseppe, additional, Lückl, Janos, additional, Luna, Alain, additional, Macha, Kosmas, additional, Machet, Alexandre, additional, Mackenrodt, Daniel, additional, Madzar, Dominik, additional, Majoie, Charles, additional, Männer, Anika, additional, Maqueda, Vicky, additional, Marstrand, Jacob, additional, Martinez, Alicia, additional, Marzina, Annika, additional, Mechthouff, Laura, additional, Meden, Per, additional, Meersman, Guy, additional, Meier, Julia, additional, Mellerio, Charles, additional, Menn, Oliver, additional, Meyer, Nadja, additional, Michalski, Dominik, additional, Michels, Peter, additional, Michelsen, Lene, additional, Millán Torne, Monica, additional, Minnerup, Jens, additional, Modrau, Boris, additional, Moeller, Sebastian, additional, Møller, Anette, additional, Morel, Nathalie, additional, Moreton, Fiona, additional, Morin, Ludovic, additional, Moulin, Thierry, additional, Moynihan, Barry, additional, Mueller, Anne K., additional, Muir, Keith W., additional, Mulero, Patricia, additional, Mundiyanapurath, Sibu, additional, Mutzenbach, Johannes, additional, Nagel, Simon, additional, Naggara, Oliver, additional, Nallasivan, Arumugam, additional, Navalpotro, Irene, additional, Nave, Alexander H., additional, Nederkoorn, Paul, additional, Neeb, Lars, additional, Neugebauer, Hermann, additional, Neumann-Haefelin, Tobias, additional, Oberndorfer, Stefan, additional, Opherk, Christian, additional, Oppel, Lorenz, additional, Oppenheim, Catherine, additional, Orthgieß, Johannes, additional, Ostergaard, Leif, additional, Paindeville, Perrine, additional, Palomeras, Ernest, additional, Panitz, Verena, additional, Patel, Bhavni, additional, Peeters, Andre, additional, Peeters, Dirk, additional, Pellisé, Anna, additional, Pelz, Johann, additional, Pereira, Anthony, additional, Pérez de la Ossa, Natalia, additional, Perry, Richard, additional, Petraza, Salvador, additional, Peysson, Stéphane, additional, Pfeilschifter, Waltraud, additional, Pichler, Alexander, additional, Pierskalla, Alexandra, additional, Pledl, Hans-Werner, additional, Poli, Sven, additional, Pomrehn, Katrin, additional, Poulsen, Marika, additional, Prats, Luis, additional, Presas, Silvia, additional, Prohaska, Elisabeth, additional, Puetz, Volker, additional, Puig, Josep, additional, Puig Alcántara, Josep, additional, Purrucker, Jan, additional, Quenardelle, Veronique, additional, Ramachandran, Sankaranarayanan, additional, Raphaelle, Soulliard, additional, Raposo, Nicolas, additional, Reiff, Tilman, additional, Remmers, Michel, additional, Renou, Pauline, additional, Ribitsch, Martin, additional, Richter, Hardy, additional, Ritter, Martin, additional, Ritzenthaler, Thomas, additional, Rodier, Gilles, additional, Rodriguez-Regent, Christine, additional, Rodríguez-Yáñez, Manuel, additional, Roennefarth, Maria, additional, Roffe, Christine, additional, Rosenbaum, Sverre, additional, Rosso, Charlotte, additional, Röther, Joachim, additional, Rozanski, Michal, additional, Ruiz de Morales, Noelia, additional, Russo, Francesca, additional, Rutgers, Matthieu, additional, Sagnier, Sharmilla, additional, Samson, Yves, additional, Sánchez, Josep, additional, Sauer, Tamara, additional, Schäfer, Jan H., additional, Schieber, Simon, additional, Schill, Josef, additional, Schlak, Dennis, additional, Schlemm, Ludwig, additional, Schmidt, Sein, additional, Schonewille, Wouter, additional, Schröder, Julian, additional, Schulz, Andreas, additional, Schurig, Johannes, additional, Schwarting, Sönke, additional, Schwarz, Alexander, additional, Schwarzbach, Christopher, additional, Seidel, Matthias, additional, Seiler, Alexander, additional, Sembill, Jochen, additional, Serena Leal, Joaquin, additional, Shetty, Ashit, additional, Sibon, Igor, additional, Simonsen, Claus Z., additional, Singer, Oliver, additional, Sivagnanaratham, Aravinth, additional, Smets, Ide, additional, Smith, Craig, additional, Soors, Peter, additional, Sprigg, Nikola, additional, Spruegel, Maximilian, additional, Stark, David, additional, Steinert, Susanne, additional, Stösser, Sebastian, additional, Stuermlinger, Markus, additional, Swinnen, Bart, additional, Tamazyan, Ruben, additional, Tembl, Jose, additional, Terceno Izaga, Mikel, additional, Thomalla, Götz, additional, Touze, Emmanuel, additional, Truelsen, Thomas, additional, Turc, Guillaume, additional, Turine, Gaetane, additional, Tütüncü, Serdar, additional, Tyrell, Pippa, additional, Ustrell, Xavier, additional, Vadot, Wilfried, additional, Vallet, Anne-Evelyne, additional, Vallet, Pauline, additional, van den Berg, Lucie, additional, van den Berg, Sophie, additional, van Eendenburg, Cecile, additional, Van Hooff, Robbert-Jan, additional, van Sloten, Isabelle, additional, Vanacker, Peter, additional, Vancaester, Evelien, additional, Vanderdonckt, Patrick, additional, Vandermeeren, Yves, additional, Vanhee, Frederik, additional, Veltkamp, Roland, additional, Vestergaard, Karsten, additional, Viguier, Alain, additional, Vilas, Dolores, additional, Villringer, Kersten, additional, Voget, Dieke, additional, von Schrader, Jörg, additional, von Weitzel, Paul, additional, Warburton, Elisabeth, additional, Weber, Claudia, additional, Weber, Jörg, additional, Wegscheider, Karl, additional, Wegscheider, Mirko, additional, Weimar, Christian, additional, Weinstich, Karin, additional, Weise, Christopher, additional, Weise, Gesa, additional, Willems, Chris, additional, Winder, Klemens, additional, Wittayer, Matthias, additional, Wolf, Marc, additional, Wolf, Martin, additional, Wolff, Valerie, additional, Wollboldt, Christian, additional, Wollenweber, Frank, additional, Wouters, Anke, additional, Yalo, Bertrand, additional, Yger, Marion, additional, Younan, Nadia, additional, Yperzeele, Laetita, additional, Zegarac, Vesna, additional, Zeiner, Pia, additional, Ziemann, Ulf, additional, Zonneveld, Thomas, additional, Zuber, Mathieu, additional, Akutsu, Tsugio, additional, Aoki, Junya, additional, Arakawa, Shuji, additional, Doijiri, Ryosuke, additional, Egashira, Yusuke, additional, Enomoto, Yukiko, additional, Furui, Eisuke, additional, Furuta, Konosuke, additional, Gotoh, Seiji, additional, Hamasaki, Toshimitsu, additional, Hasegawa, Yasuhiro, additional, Hirano, Teryuki, additional, Homma, Kazunari, additional, Ichijyo, Masahiko, additional, Ide, Toshihiro, additional, Igarashi, Shuichi, additional, Iguchi, Yasuyuki, additional, Ihara, Masafumi, additional, Ikenouchi, Hajime, additional, Inoue, Tsuyoshi, additional, Itabashi, Ryo, additional, Ito, Yasuhiro, additional, Iwama, Toru, additional, Kamiyama, Kenji, additional, Kamiyoshi, Shoko, additional, Kanai, Haruka, additional, Kanematsu, Yasuhisa, additional, Kanzawa, Takao, additional, Kimura, Kazumi, additional, Kitayama, Jiro, additional, Kitazono, Takanari, additional, Kondo, Rei, additional, Kudo, Kohsuke, additional, Kusumi, Masayoshi, additional, Kuwahara, Ken, additional, Matsumoto, Shoji, additional, Matsuoka, Hideki, additional, Mihara, Ban, additional, Minematsu, Kazuo, additional, Miura, Ken, additional, Morita, Naomi, additional, Mouri, Wataru, additional, Murata, Kayo, additional, Nagakane, Yoshinari, additional, Nakase, Taizen, additional, Ohara, Hiromi, additional, Ohara, Nobuyuki, additional, Ohnishi, Hideyuki, additional, Ohta, Hajime, additional, Ohtaki, Masafumi, additional, Ohtani, Ryo, additional, Ohtsuki, Toshiho, additional, Ohyama, Hideo, additional, Okada, Takashi, additional, Okada, Yasushi, additional, Osaki, Masato, additional, Sakai, Nobuyuki, additional, Sanbongi, Yoshiki, additional, Sasaki, Naoshi, additional, Sasaki, Makoto, additional, Sato, Shoichiro, additional, Seki, Kenta, additional, Shimizu, Wataru, additional, Shiokawa, Yoshiaki, additional, Sozu, Takashi, additional, Suzuki, Junichiro, additional, Suzuki, Rieko, additional, Takagi, Yasushi, additional, Takizawa, Shunya, additional, Tanahashi, Norio, additional, Tanaka, Eijiro, additional, Tanaka, Ryota, additional, Tateishi, Yohei, additional, Terada, Tomoaki, additional, Terasaki, Tadashi, additional, Todo, Kenichi, additional, Tokunaga, Azusa, additional, Tsujino, Akira, additional, Ueda, Toshihiro, additional, Uesaka, Yoshikazu, additional, Uotani, Mihoko, additional, Urabe, Takao, additional, Watanabe, Masao, additional, Yagita, Yoshiki, additional, Yakushiji, Yusuke, additional, Yasui, Keizo, additional, Yonehara, Toshiro, additional, Yoshimura, Shinichi, additional, Aarnio, K., additional, Alemseged, F., additional, Anderson, C., additional, Ang, T., additional, Archer, M.L., additional, Attia, J., additional, Bailey, P., additional, Balabanski, A., additional, Barber, A., additional, Barber, P.A., additional, Bernhardt, J., additional, Bivard, A., additional, Blacker, D., additional, Bladin, C.F., additional, Brodtmann, A., additional, Cadilhac, D., additional, Campbell, B.C.V., additional, Carey, L., additional, Celestino, S., additional, Chan, L., additional, Chang, W.H., additional, ChangI, A., additional, Chen, C.H., additional, Chen, C.-I., additional, Chen, H.F., additional, Chen, T.C., additional, Chen, W.H., additional, Chen, Y.Y., additional, Cheng, C.A., additional, Cheong, E., additional, Chiou, Y.W., additional, Choi, P.M., additional, Chu, H.J., additional, Chuang, C.S., additional, Chung, T.C., additional, Churilov, L., additional, Clissold, B., additional, Connelly, A., additional, Coote, S., additional, Coulton, B., additional, Cowley, E., additional, Cranefield, J., additional, Curtze, S., additional, D'Este, C., additional, Davis, S.M., additional, Day, S., additional, Desmond, P.M., additional, Dewey, H.M., additional, Ding, C., additional, Donnan, G.A., additional, Drew, R., additional, Eirola, S., additional, Field, D., additional, Frost, T., additional, Garcia-Esperon, C., additional, George, K., additional, Gerraty, R., additional, Grimley, R., additional, Guo, Y.C., additional, Hankey, G., additional, Harvey, J., additional, Ho, S.C., additional, Hogan, K., additional, Howells, D., additional, Hsiao, P.M., additional, Hsu, C.H., additional, Hsu, C.T., additional, Hsu, C.-S., additional, Hsu, J.P., additional, Hsu, Y.D., additional, Hsu, Y.T., additional, Hu, C.J., additional, Huang, C.C., additional, Huang, H.Y., additional, Huang, M.Y., additional, Huang, S.C., additional, Huang, W.S., additional, Jackson, D., additional, Jeng, J.S., additional, Jiang, S.K., additional, Kaauwai, L., additional, Kasari, O., additional, King, J., additional, Kleinig, T.J., additional, Koivu, M., additional, Kolbe, J., additional, Krause, M., additional, Kuan, C.W., additional, Kung, W.L., additional, Kyndt, C., additional, Lau, C.L., additional, Lee, A., additional, Lee, C.Y., additional, Lee, J.T., additional, Lee, Y., additional, Lee, Y.C., additional, Levi, C., additional, Levi, C.R., additional, Lien, L.M., additional, Lim, J.C., additional, Lin, C.C., additional, Lin, C.H., additional, Lin, C.M., additional, Lin, D., additional, Liu, C.H., additional, Liu, J., additional, Lo, Y.C., additional, Loh, P.S., additional, Low, E., additional, Lu, C.H., additional, Lu, C.J., additional, Lu, M.K., additional, Ly, J., additional, Ma, H., additional, Macaulay, L., additional, Macdonnell, R., additional, Mackey, E., additional, Macleod, M., additional, Mahadevan, J., additional, Maxwell, V., additional, McCoy, R., additional, McDonald, A., additional, McModie, S., additional, Meretoja, A., additional, Mishra, S., additional, Mitchell, P.J., additional, Miteff, F., additional, Moore, A., additional, Muller, C., additional, Ng, F., additional, Ng, F.C., additional, Ng, J-L., additional, O'Brian, W., additional, O'Collins, V., additional, Oxley, T.J., additional, Parsons, M.W., additional, Patel, S., additional, Peng, G.S., additional, Pesavento, L., additional, Phan, T., additional, Rodrigues, E., additional, Ross, Z., additional, Sabet, A., additional, Sallaberger, M., additional, Salvaris, P., additional, Shah, D., additional, Sharma, G., additional, Sibolt, G., additional, Simpson, M., additional, Singhal, S., additional, Snow, B., additional, Spratt, N., additional, Stark, R., additional, Sturm, J., additional, Sun, M.C., additional, Sun, Y., additional, Sung, P.S., additional, Sung, Y.F., additional, Suzuki, M., additional, Tan, M., additional, Tang, S.C., additional, Tatlisumak, T., additional, Thijs, V., additional, Tiainen, M., additional, Tsai, C.H., additional, Tsai, C.K., additional, Tsai, C.L., additional, Tsai, H.T., additional, Tsai, L.K., additional, Tseng, C.H., additional, Tseng, L.T., additional, Tsoleridis, J., additional, Tu, H., additional, Tu, H.T-H., additional, Vallat, W., additional, Virta, J., additional, Wang, W.C., additional, Wang, Y.T., additional, Waters, M., additional, Weir, L., additional, Wijeratne, T., additional, Williams, C., additional, Wilson, W., additional, Wong, A.A., additional, Wong, K., additional, Wu, T.Y., additional, Wu, Y.H., additional, Yan, B., additional, Yang, F.C., additional, Yang, Y.W., additional, Yassi, N., additional, Yeh, H.L., additional, Yeh, J.H., additional, Yeh, S.J., additional, Yen, C.H., additional, Young, D., additional, Ysai, C.L., additional, Zhang, W.W., additional, Zhao, H., additional, Zhao, L., additional, Althaus-Knaurer, Katharina, additional, Berrouschot, Jörg, additional, Bluhmki, Erich, additional, Bovi, Paolo, additional, Chatellier, Gilles, additional, Cove, Lynda, additional, Davis, Stephen, additional, Dixit, A., additional, Donnan, Geoffrey, additional, Ehrenkrona, Christina, additional, Eschenfelder, Christoph, additional, Fatar, Marc, additional, Francisco Arenillas, Juan, additional, Gruber, Franz, additional, Kala, Lalit, additional, Kapeller, Peter, additional, Kaste, Markku, additional, Kessler, Christof, additional, Köhrmann, Martin, additional, Laage, Rico, additional, Lees, Kennedy R., additional, Luna Rodriguez, Alain, additional, Mas, Jean-Louis, additional, Mikulik, Robert, additional, Molina, Carlos, additional, Muddegowda, Girish, additional, Muir, Keith, additional, Niederkorn, Kurt, additional, Nuñez, Xavier, additional, Schellinger, Peter, additional, Serena, Joaquin, additional, Sobesky, Jan, additional, Steiner, Thorsten, additional, Svenson, Ann-Sofie, additional, von Kummer, Rüdiger, additional, Wardlaw, Joanna, additional, Betensky, Rebecca A., additional, Boulouis, Gregoire, additional, Carandang, Raphael A., additional, Copen, William A., additional, Cougo, Pedro, additional, Cutting, Shawna, additional, Drake, Kendra, additional, Ford, Andria L., additional, Hallenbeck, John, additional, Harris, Gordon J., additional, Hoesch, Robert, additional, Hsia, Amie, additional, Kase, Carlos, additional, Latour, Lawrence, additional, Lev, Michael H., additional, Muzikansky, Alona, additional, Nagaraja, Nandakumar, additional, Schwamm, Lee H., additional, Searls, Eric, additional, Song, Shlee S., additional, Starkman, Sidney, additional, Yoo, Albert J., additional, and Zand, Ramin, additional

Published
2020
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32. Bedside Catheter Hematoma Evacuation in Vitamin K Antagonist-Related Intracerebral Hemorrhage: A Safe and Feasible Approach

Author

Volbers, Bastian, primary, Niesen, Wolf-Dirk, additional, Amiri-Soltani, Samuel, additional, Staykov, Dimitre, additional, Shah, Mukesch Johannes, additional, Lang, Stefan, additional, Lücking, Hannes, additional, Kuramatsu, Joji B., additional, Huttner, Hagen B., additional, Schwab, Stefan, additional, and Bardutzky, Jürgen, additional

Published
2020
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37. Meningitis Caused by Streptococcus agalactiae after Professional Tooth Cleaning: First Case

Author

Hollasch, Heiko, Niesen, Wolf-Dirk, and Bardutzky, Jürgen

Subjects
stomatognathic diseases, Group B streptococcus, Tooth cleaning, Case report, Meningitis, lcsh:Neurology. Diseases of the nervous system, lcsh:RC346-429, Streptococcus agalactiae
Abstract

We report the first case of meningitis caused by Streptococcus agalactiae (group B streptococcus; GBS) after professional tooth cleaning in a previously healthy patient. GBS is a common commensal of the human gastrointestinal and vaginal flora. Although occurrence in the oral flora is unusual, oral transmission and thus occurrence can be assumed.

Published
2019

45. EARLYDRAIN- outcome after early lumbar CSF-drainage in aneurysmal subarachnoid hemorrhage: study protocol for a randomized controlled trial

Author

Schwab Stefan, Jüttler Eric, Witsch Jens, Bardutzky Jürgen, Vajkoczy Peter, and Wolf Stefan

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Aneurysmal subarachnoid hemorrhage (SAH) may be complicated by delayed cerebral ischemia, which is a major cause of unfavorable clinical outcome and death in SAH-patients. Delayed cerebral ischemia is presumably related to the development of vasospasm triggered by the presence of blood in the basal cisterns. To date, oral application of the calcium antagonist nimodipine is the only prophylactic treatment for vasospasm recognized under international guidelines. In retrospective trials lumbar drainage of cerebrospinal fluid has been shown to be a safe and feasible measure to remove the blood from the basal cisterns and decrease the incidence of delayed cerebral ischemia and vasospasm in the respective study populations. However, the efficacy of lumbar drainage has not been evaluated prospectively in a randomized controlled trial yet. Methods/Design This is a protocol for a 2-arm randomized controlled trial to compare an intervention group receiving early continuous lumbar CSF-drainage and standard neurointensive care to a control group receiving standard neurointensive care only. Adults suffering from a first aneurysmal subarachnoid hemorrhage whose aneurysm has been secured by means of coiling or clipping are eligible for trial participation. The effect of early CSF drainage (starting < 72 h after securing the aneurysm) will be measured in the following ways: the primary endpoint will be disability after 6 months, assessed by a blinded investigator during a personal visit or standardized telephone interview using the modified Rankin Scale. Secondary endpoints include mortality after 6 months, angiographic vasospasm, transcranial Doppler sonography (TCD) mean flow velocity in both middle cerebral arteries and rate of shunt insertion at 6 months after hospital discharge. Discussion Here, we present the study design of a multicenter prospective randomized controlled trial to investigate whether early application of a lumbar drainage improves clinical outcome after aneurysmal subarachnoid hemorrhage. Trial registration www.clinicaltrials.gov Identifier: NCT01258257

Published
2011
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47. Prevention, diagnosis, therapy and aftercare of sepsis : The first revision of the S2k guidelines of the German Sepsis Society (DSG) and the German Interdisciplinary Association for Intensive and Emergency Care Medicine (DIVI)

Author

Reinhart, Konrad A., Brunkhorst, Frank Martin, Bone, Hans Georg, Bardutzky, Jürgen, Dempfle, Carl Erik H., Forst, Helmuth, Gastmeier, Petra, Gerlach, Herwig, Gründling, Matthias, John, Stefan, Kern, Winfried V., Kreymann, Georg, Krüger, Wolfgang A., Kujath, Peter, Marggraf, Günter, Martin, Jörg, Mayer, Konstantin, Meier-Hellmann, Andreas, Oppert, Michael, Putensen, Christian, Quintel, Michael I., Ragaller, Maximillian J.R., Rossaint, Rolf, Seifert, Harald, Spies, Claudia D., Stüber, Frank, Weiler, Norbert, Weimann, Arved, Werdan, Karl, and Welte, Tobias

Subjects
Medizin
Published
2010

50. Antibody-Mediated Status Epilepticus: A Retrospective Multicenter Survey

Author

Holzer, Franz Josef, primary, Rossetti, Andrea O., additional, Heritier-Barras, Anne-Chantal, additional, Zumsteg, Dominik, additional, Roebling, Robert, additional, Huber, Roman, additional, Lerche, Holger, additional, Kiphuth, Ines C., additional, Bardutzky, Jürgen, additional, Bien, Christian G., additional, Tröger, Mathias, additional, Schoch, Gaby, additional, Prüss, Harald, additional, and Seeck, Margitta, additional

Published
2012
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