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2. 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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4. Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data

Author

Hanley, Daniel F, Jr, Butcher, Kenneth S, Davis, Stephen, Gregson, Barbara, Lees, Kennedy R, Lyden, Patrick D, Mayer, Stephan A, Muir, Keith W, Steiner, Thorsten, Xie, Peng, Bakhshayesh, Babak, McDonald, Mark, Brott, Thomas, Pennati, Paolo, Parry-Jones, Adrian R, Smith, Craig J, Hopkins, Stephen J, Slevin, Mark, Campi, Veronica, Singh, Puneetpal, Papa, Francesca, Popa-Wagner, Aurel, Tudorica, Valeria, Takagi, Ryo, Teramoto, Akira, Weissenborn, Karin, Lanfermann, Heinrich, Al-Shahi Salman, Rustam, Frantzias, Joseph, Lee, Robert J, Battey, Thomas W K, Ayres, Alison M, Goldstein, Joshua N, Wang, Xia, Arima, Hisatomi, Hasegawa, Hitoshi, Oishi, Makoto, Godoy, Daniel A, Masotti, Luca, Dowlatshahi, Dar, Rodriguez-Luna, David, Molina, Carlos A, Jang, Dong-Kyu, Davalos, Antonio, Castillo, José, Yao, Xiaoying, Claassen, Jan, Volbers, Bastian, Kazui, Seiji, Okada, Yasushi, Fujimoto, Shigeru, Toyoda, Kazunori, Li, Qi, Khoury, Jane, Delgado, Pilar, Sabín, José Álvarez, Hernández-Guillamon, Mar, Prats-Sánchez, Luis, Cai, Chunyan, Kate, Mahesh P, McCourt, Rebecca, Venkatasubramanian, Chitra, Diringer, Michael N, Ikeda, Yukio, Worthmann, Hans, Ziai, Wendy C, d'Esterre, Christopher D, Aviv, Richard I, Raab, Peter, Murai, Yasuo, Zazulia, Allyson R, Seyedsaadat, Seyed Mohammad, Grotta, James C, Martí-Fàbregas, Joan, Montaner, Joan, Broderick, Joseph, Yamamoto, Haruko, Staykov, Dimitre, Connolly, E Sander, Selim, Magdy, Leira, Rogelio, Moon, Byung Hoo, Demchuk, Andrew M, Di Napoli, Mario, Fujii, Yukihiko, Anderson, Craig S, and Rosand, Jonathan

Published
2018
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5. Iatrogenic cerebral amyloid angiopathy: A multinational case series and individual patient data analysis of the literature

Author

Pikija, Slaven, primary, Pretnar-Oblak, Janja, additional, Frol, Senta, additional, Malojcic, Branko, additional, Gattringer, Thomas, additional, Rak-Frattner, Kinga, additional, Staykov, Dimitre, additional, Salmaggi, Andrea, additional, Milani, Riccardo, additional, Magdic, Jozef, additional, Iglseder, Sarah, additional, Trinka, Eugen, additional, Kraus, Theo, additional, Toma, Andreea, additional, DiFrancesco, Jacopo C., additional, Tabaee Damavandi, Payam, additional, Fabin, Natalia, additional, Bersano, Anna, additional, Albajar, Inés, additional, de la Riva, Patricia, additional, Storti, Benedetta, additional, and Fandler-Höfler, Simon, additional

Published
2023
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6. Iatrogenic cerebral amyloid angiopathy: A multinational case series and individual patient data analysis of the literature.

Author

Pikija, Slaven, Pretnar-Oblak, Janja, Frol, Senta, Malojcic, Branko, Gattringer, Thomas, Rak-Frattner, Kinga, Staykov, Dimitre, Salmaggi, Andrea, Milani, Riccardo, Magdic, Jozef, Iglseder, Sarah, Trinka, Eugen, Kraus, Theo, Toma, Andreea, DiFrancesco, Jacopo C., Tabaee Damavandi, Payam, Fabin, Natalia, Bersano, Anna, de la Riva Juez, Patricia, and Albajar Gomez, Ines

Subjects
CEREBRAL amyloid angiopathy, PRION diseases, DATA analysis, INTRACRANIAL hemorrhage, IATROGENIC diseases, BRAIN surgery
Abstract

Background: The transmission of amyloid β (Aβ) in humans leading to iatrogenic cerebral amyloid angiopathy (iCAA) is a novel concept with analogies to prion diseases. However, the number of published cases is low, and larger international studies are missing. Aims: We aimed to build a large multinational collaboration on iCAA to better understand the clinical spectrum of affected patients. Methods: We collected clinical data on patients with iCAA from Austria, Croatia, Italy, Slovenia, and Spain. Patients were included if they met the proposed Queen Square diagnostic criteria (QSC) for iCAA. In addition, we pooled data on disease onset, latency, and cerebrospinal fluid (CSF) biomarkers from previously published iCAA cases based on a systematic literature review. Results: Twenty-seven patients (22% women) were included in this study. Of these, 19 (70%) met the criteria for probable and 8 (30%) for possible iCAA. Prior neurosurgical procedures were performed in all patients (93% brain surgery, 7% spinal surgery) at median age of 8 (interquartile range (IQR) = 4–18, range = 0–26 years) years. The median symptom latency was 39 years (IQR = 34–41, range = 28–49). The median age at symptom onset was 49 years (IQR = 43–55, range = 32–70). Twenty-one patients (78%) presented with intracranial hemorrhage and 3 (11%) with seizures. Conclusions: Our large international case series of patients with iCAA confirms a wide age boundary for the diagnosis of iCAA. Dissemination of awareness of this rare condition will help to identify more affected patients. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Metabolische Störungen

Author

Straube, Andreas, Klein, Matthias, Erbguth, Frank, Maschke, Matthias, Klawe, Christoph, Sander, Dirk, Hilz, Max-Josef, Ziemssen, Tjalf, Klucken, Jochen, Kohl, Zacharias, Winkler, Jürgen, Bettendorf, Markus, Staykov, Dimitre, Berrouschot, Jörg, Dörfler, Arnd, Schwab, Stefan, editor, Schellinger, Peter, editor, Werner, Christian, editor, Unterberg, Andreas, editor, and Hacke, Werner, editor

Published
2015
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8. Blutungen

Author

Orakcioglu, Berk, Staykov, Dimitre, Unterberg, Andreas, Sakowitz, Oliver, Bendszus, Martin, Steiner, Hans Herbert, Haux, Daniel, Hähnel, Stefan, Schwab, Stefan, editor, Schellinger, Peter, editor, Werner, Christian, editor, Unterberg, Andreas, editor, and Hacke, Werner, editor

Published
2015
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9. Endovascular stroke therapy outside core working hours in a nationwide stroke system.

Author

Fandler-Höfler, Simon, Mikšová, Dominika, Deutschmann, Hannes, Kneihsl, Markus, Mutzenbach, Sebastian, Killer-Oberpfalzer, Monika, Gizewski, Elke R., Knoflach, Michael, Kiechl, Stefan, Sonnberger, Michael, Vosko, Milan R., Weber, Jörg, Hausegger, Klaus A., Serles, Wolfgang, Werner, Philipp, Staykov, Dimitre, Sykora, Marek, Lang, Wilfried, Ferrari, Julia, and Enzinger, Christian

Subjects
STROKE, NURSING, STROKE treatment, ISCHEMIC stroke, TIME, THROMBOLYTIC therapy, TREATMENT effectiveness, WORKFLOW, PSYCHOSOCIAL factors, STROKE patients, THROMBECTOMY, QUESTIONNAIRES, DESCRIPTIVE statistics, RESEARCH funding, ENDOVASCULAR surgery, LONGITUDINAL method, EVALUATION
Abstract

Background Endovascular therapy (EVT) has been established as a major component in the acute treatment of large vessel occlusion stroke. However, it is unclear whether outcome and other treatment-related factors differ if patients are treated within or outside core working hours. Methods We analyzed data from the prospective nationwide Austrian Stroke Unit Registry capturing all consecutive stroke patients treated with EVT between 2016 and 2020. Patients were trichotomized according to the time of groin puncture into treatment within regular working hours (08:00-13:59), afternoon/ evening (14:00-21:59) and night-time (22:00-07:59). Additionally, we analyzed 12 EVT treatment windows with equal patient numbers. Main outcome variables included favorable outcome (modified Rankin Scale scores of 0-2) 3 months post-stroke as well as procedural time metrics, recanalization status and complications. results We analyzed 2916 patients (median age 74 years, 50.7% female) who underwent EVT. Patients treated within core working hours more frequently had a favorable outcome (42.6% vs 36.1% treated in the afternoon/evening vs 35.8% treated at night-time; p=0.007). Similar results were found when analyzing 12 treatment windows. All these differences remained significant in multivariable analysis adjusting for outcome-relevant co-factors. Onset-to-recanalization time was considerably longer outside core working hours, which was mainly explained by longer door-to-groin time (p<0.001). There was no difference in the number of passes, recanalization status, groin-to-recanalization time and EVT-related complications. Conclusions The findings of delayed intrahospital EVT workflows and worse functional outcomes outside core working hours in this nationwide registry are relevant for optimization of stroke care, and might be applicable to other countries with similar settings. [ABSTRACT FROM AUTHOR]

Published
2023
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11. 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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12. Temporal Trends of Functional Outcome in Patients With Acute Ischemic Stroke Treated With Intravenous Thrombolysis

Author

Marko, Martha, primary, Miksova, Dominika, additional, Ebner, Johanna, additional, Lang, Marie, additional, Serles, Wolfgang, additional, Sommer, Peter, additional, Sykora, Marek, additional, Lang, Wilfried, additional, Knoflach, Michael, additional, Kiechl, Stefan, additional, Greisenegger, Stefan, additional, Mutzenbach, Johannes Sebastian, additional, Bubel, Nele, additional, Zellner, Thomas, additional, Krstic, Miroslav, additional, Grandits, Waltraud, additional, Katzenschlager, Regina, additional, Vosko, Milan R., additional, von Örzten, Tim, additional, Struhal, Walter, additional, Brunner, Cornelia, additional, Yilmaz-Kaymaz, Nilguen, additional, Hosseiny, Omid, additional, Krisper, Eva, additional, Säckl, Felix, additional, Baumgartner, Christoph, additional, Rumpl, Elke, additional, Pirker-Kees, Agnes, additional, Berger, Otto, additional, Beirer, Sebastian, additional, Komenda-Lett, Martin, additional, Weber, Jörg R., additional, Höfner, Elmar, additional, Seiler, Stephan, additional, Berek, Klaus, additional, Mayr, Markus, additional, Haaser, Stefan, additional, Asenbaum-Nan, Susanne, additional, Heumesser, Rebecca, additional, Rumpl, Barbara Almut, additional, Rus, Marc, additional, Muellauer, Barbara, additional, Höger, Franz, additional, Lampl, Christian, additional, Bocksrucker, Christof, additional, Lackner, Peter, additional, Schlager, Markus, additional, Mayer, Florian, additional, Fertl, Elisabeth, additional, Steiner, Sandrina, additional, Koller, Herbert, additional, Doppler, Wolfgang, additional, Ferrari, Julia, additional, Krebs, Stefan, additional, Mitrovic, Nenad, additional, Salletmayr, Thomas, additional, Grunenberg, Monika, additional, Bancher, Christian, additional, Pinter, Hajnalka, additional, Karpat, Frantisek, additional, Sellner, Johann, additional, Wolf, Thomas, additional, Schnider, Peter, additional, Wallner-Blazek, Mirja, additional, Enzinger, Christian, additional, Gattringer, Thomas, additional, Poltrum, Birgit, additional, Böhme, Christian, additional, Mayer, Lukas, additional, Hofeneder, Dominik, additional, Daniel, Gerhard, additional, Kaniak, Kitty, additional, Grossmann, Josef, additional, Morgenstern, Gabi, additional, Wendlinger, Nadja, additional, Staykov, Dimitre, additional, Halilovic, Almin, additional, Frattner, Michael, additional, Waiß, Christoph, additional, Tinchon, Alexander, additional, Fischer, Anna, additional, Kapeller, Peter, additional, Luschin, Gerda, additional, Gasser, Sibylle, additional, Heine, Martin, additional, Wurzinger, Harald, additional, Wührer, Susanne, additional, Werner, Philipp, additional, Mayr, Andrea, additional, Matosevic, Benjamin, additional, Gollmer, A., additional, and Kern, R., additional

Published
2022
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15. 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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16. Evidence-Based Guidelines for the Management of Large Hemispheric Infarction: A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine

Author

Torbey, Michel T., Bösel, Julian, Rhoney, Denise H., Rincon, Fred, Staykov, Dimitre, Amar, Arun P., Varelas, Panayiotis N., Jüttler, Eric, Olson, DaiWai, Huttner, Hagen B., Zweckberger, Klaus, Sheth, Kevin N., Dohmen, Christian, Brambrink, Ansgar M., Mayer, Stephan A., Zaidat, Osama O., Hacke, Werner, and Schwab, Stefan

Published
2015
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17. 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, Juergen, Sembill, Jochen A., Spruegel, Maximilian, I, Mrochen, Anne, Koelbl, 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, Roether, Joachim, Reimann, Gernot, Schwarz, Michael, Baezner, Hansjoerg, Classen, Joseph, Michalski, Dominik, Witte, Otto W., Guenther, Albrecht, Hamann, Gerhard F., Luecking, Hannes, Doerfler, 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., Huttner, Hagen B., Kuramatsu, Joji B., Gerner, Stefan T., Ziai, Wendy, Bardutzky, Juergen, Sembill, Jochen A., Spruegel, Maximilian, I, Mrochen, Anne, Koelbl, 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, Roether, Joachim, Reimann, Gernot, Schwarz, Michael, Baezner, Hansjoerg, Classen, Joseph, Michalski, Dominik, Witte, Otto W., Guenther, Albrecht, Hamann, Gerhard F., Luecking, Hannes, Doerfler, 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.

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. T

Published
2022

18. 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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29. EuroHYP-1: European multicenter, randomized, phase III clinical trial of therapeutic hypothermia plus best medical treatment vs. best medical treatment alone for acute ischemic stroke

Author

van der Worp, Bart H., Macleod, Malcolm R., Bath, Philip M. W., Demotes, Jacques, Durand-Zaleski, Isabelle, Gebhardt, Bernd, Gluud, Christian, Kollmar, Rainer, Krieger, Derk W., Lees, Kennedy R., Molina, Carlos, Montaner, Joan, Roine, Risto O., Petersson, Jesper, Staykov, Dimitre, Szabo, Istvan, Wardlaw, Joanna M., and Schwab, Stefan

Published
2014
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45. 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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