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13. Impact of COVID-19 pandemic on treatment management and clinical outcome of aneurysmal subarachnoid haemorrhage – a single centre experience

Author

Kashefiolasl, Sepide, Qasem, Lina-Elisabeth, Brawanski, Nina, Funke, Moritz, Keil, Fee, Hattingen, Elke, Foerch, Christian, Seifert, Volker, Prinz, Vincent, Czabanka, Marcus, and Konczalla, Jürgen

Subjects
Medicine and health, cardiovascular diseases, nervous system diseases
Abstract

Objective: During the COVID-19 pandemic, decreased volumes of acute stroke admissions were reported. We aimed to examine whether subarachnoid hemorrhage (SAH) volumes demonstrated similar declines in our department. Furthermore, the impact of pandemic on disease progression should be analyzed. [for full text, please go to the a.m. URL]

Published
2022
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14. Impact of COVID-19 pandemic on treatment management and clinical outcome of aneurysmal subarachnoid hemorrhage – A single center experience

Author

European Congress of Neurosurgery (2022 : Belgrad), Kashefiolasl, Sepide, Qasem, Lina-Elisabeth, Brawanski, Nina, Funke, Moritz, Keil, Fee, Hattingen, Elke, Förch, Christian, Seifert, Volker, Prinz, Vincent Matthias, Czabanka, Marcus Alexander, Konczalla, Jürgen, European Congress of Neurosurgery (2022 : Belgrad), Kashefiolasl, Sepide, Qasem, Lina-Elisabeth, Brawanski, Nina, Funke, Moritz, Keil, Fee, Hattingen, Elke, Förch, Christian, Seifert, Volker, Prinz, Vincent Matthias, Czabanka, Marcus Alexander, and Konczalla, Jürgen

Abstract

Background: During the COVID-19 pandemic, decreased volumes of acute stroke admissions were reported. We aimed to examine whether subarachnoid hemorrhage (SAH) volumes demonstrated similar declines in our department. Furthermore, the impact of pandemic on disease progression should be analyzed. Methods: We conducted a retrospective study in neurosurgical department of university hospital Frankfurt including patients with the diagnosis of aneurysmal SAH during the first year of COVID-pandemic. One year cumulative volume for SAH hospitalization procedures were compared to the one-year period before (03/2020–02/2021 versus 03/2019–02/2020) and the last 5 pre-COVID-pandemic years (2015-2020). All relevant patient characteristics concerning family history, disease history, clinical condition at admission, active/past COVID-infection, treatment management, complications and outcome were analyzed. Results: There was a decline in SAH hospitalizations, with 84 admissions in the year immediately before and 56 admissions during the pandemic, without reaching a significance. No significant difference in analyzed patient characteristics including clinical condition at onset, treatment, complications and outcome, between 56 SAH patients admitted during COVID pandemic and treated patients in the last 5 years in pre-COVID period were found. Using a multivariable analysis, we detected young age (p<0.05;OR4,2) and no existence of early hydrocephalus (p<0.05;OR0,13) as important factors for a favorable outcome (mRS≤0-2) after aSAH during the COVID-pandemic. A past COVID-infection was detected in young patients suffering from aSAH (Age< 50years, p<0.05;OR10,5) with increased rate of cerebral vasospasm after SAH onset (p<0.05;OR26). Nevertheless, past COVID-infection did not reach a significance as a high risk factor for unfavorable outcome. Conclusion: There was a relative decrease in the volume of SAH during the COVID-19 pandemic. Despite of extremely different conditions of hospitali

Published
2022

15. Impact of COVID-19 Pandemic on Treatment Management and Clinical Outcome of Aneurysmal Subarachnoid Hemorrhage – A Single-Center Experience

Author

Kashefiolasl, Sepide, primary, Qasem, Lina Elisabeth, additional, Brawanski, Nina, additional, Funke, Moritz, additional, Keil, Fee, additional, Hattingen, Elke, additional, Foerch, Christian, additional, Seifert, Volker, additional, Prinz, Vincent Matthias, additional, Czabanka, Marcus, additional, and Konczalla, Juergen, additional

Published
2022
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17. Statins improve clinical outcome after non-aneurysmal subarachnoid hemorrhage: a translational insight from a systematic review of experimental studies

Author

Kashefiolasl, Sepide, Wagner, Marlies, Brawanski, Nina, Seifert, Volker, Wanderer, Stefan, Andereggen, Lukas, and Konczalla, Juergen

Subjects
statin treatment, recovery, Neurology, regenerative medicine, non-aneurysmal SAH, Neurology (clinical), Systematic Review, cardiovascular diseases, ddc:610, stroke, translational study
Abstract

The efficacy of statin-treatment in aneurysmal subarachnoid hemorrhage (SAH) remains controversial. We aimed to investigate the effects of statin-treatment in non-aneurysmal (na)SAH in accordance with animal research data illustrating the pathophysiology of naSAH. We systematically searched PubMed using PRISMA-guidelines and selected experimental studies assessing the statin-effect on SAH. Detecting the accordance of the applied experimental models with the pathophysiology of naSAH, we analyzed our institutional database of naSAH patients between 1999 and 2018, regarding the effect of statin treatment in these patients and creating a translational concept. Patient characteristics such as statin-treatment (simvastatin 40 mg/d), the occurrence of cerebral vasospasm (CVS), delayed infarction (DI), delayed cerebral ischemia (DCI), and clinical outcome were recorded. In our systematic review of experimental studies, we found 13 studies among 18 titles using blood-injection-animal-models to assess the statin-effect in accordance with the pathophysiology of naSAH. All selected studies differ on study-setting concerning drug-administration, evaluation methods, and neurological tests. Patients from the Back to Bedside project, including 293 naSAH-patients and 51 patients with simvastatin-treatment, were recruited for this analysis. Patients under treatment were affected by a significantly lower risk of CVS (p < 0.01; OR 3.7), DI (p < 0.05; OR 2.6), and DCI (p < 0.05; OR 3). Furthermore, there was a significant association between simvastatin-treatment and favorable-outcome (p < 0.05; OR 3). However, dividing patients with statin-treatment in pre-SAH (n = 31) and post-SAH (n = 20) treatment groups, we only detected a tenuously significant higher chance for a favorable outcome (p < 0.05; OR 0.05) in the small group of 20 patients with statin post-SAH treatment. Using a multivariate-analysis, we detected female gender (55%; p < 0.001; OR 4.9), Hunt&Hess ≤III at admission (p < 0.002; OR 4), no anticoagulant-therapy (p < 0.0001; OR 0.16), and statin-treatment (p < 0.0001; OR 24.2) as the main factors improving the clinical outcome. In conclusion, we detected a significantly lower risk for CVS, DCI, and DI in naSAH patients under statin treatment. Additionally, a significant association between statin treatment and favorable outcome 6 months after naSAH onset could be confirmed. Nevertheless, unified animal experiments should be considered to create the basis for developing new therapeutic schemes.

Published
2021

18. Short- and long-term effects of rehabilitation after perimesencephalic subarachnoid hemorrhage

Author

Schmitz, Jens, Kashefiolasl, Sepide, Brawanski, Nina, Dinc, Nazife, Geßler, Florian, Senft, Christian, Tritt, Stephanie, Seifert, Volker, Konczalla, Jürgen, Schmitz, Jens, Kashefiolasl, Sepide, Brawanski, Nina, Dinc, Nazife, Geßler, Florian, Senft, Christian, Tritt, Stephanie, Seifert, Volker, and Konczalla, Jürgen

Abstract

n about 25% of patients with spontaneous subarachnoid hemorrhage (SAH), a bleeding source cannot be identified during radiological diagnostics. Generally, the outcome of perimesencephalic or prepontine (PM) SAH is known to be significantly better than after non-PM SAH. Data about long-term follow-up concerning physical and mental health are scarce, so this study is reports on long-term results. We measured the influence of PM SAH on a quality-of-life modified Rankin (mRs) scale after six months. For long-term follow-up, a SF-36 questionnaire was used. Questionnaires were sent out between 18 and 168 months after ictus. In 37 patients, a long-term follow-up was available (up to 14 years after SAH). Data detected with the SF-36 questionnaire are compared to reference applicability to the standard population. In total, 37 patients were included for further analysis and divided in 2 subgroups; 13 patients (35%) received subsequent rehabilitation after clinical stay and 24 (65%) did not. In the short-term outcome, a significant improvement from discharge until follow-up was identified in patients with subsequent rehabilitation, but not in the matched pair group without rehabilitation. When PM SAH was compared to the standard population, a reduction in quality of life was identified in physical items (role limitations because of physical health problems, physical functioning) as well as in psychological items (role limitations because of emotional problems). Subsequent rehabilitation on PM SAH patients probably leads to an increase in independence and better mRs. While better mRs was shown at discharge in patients without subsequent rehabilitation, the mRs of rehabilitants was nearly identical after rehabilitation. Patients with good mRs also reached high levels of health-related quality of life (HRQoL) without rehabilitation. Thus, subsequent rehabilitation needs to be encouraged on an individual basis. Indication criteria for subsequent rehabilitation should be defined i

Published
2021

21. Saisonale Variation aneurysmatischer Subarachnoidalblutung aus einer neuen Perspektive

Author

Kashefiolasl, Sepide, Brawanski, Nina, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine
Abstract

Objective: Assessed data about the relationships between seasonal determinants and the occurrence of aneurysmal subarachnoid hemorrhage (aSAH) are conflicting. Because hypovitaminosis D has been identified as a risk factor for other vascular diseases, according to seasonal difference of vitaminD level,[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Published
2020

22. Does aneurysm side influence the infarction side and patients´ outcome after subarachnoid hemorrhage?

Author

Brawanski, Nina, Kashefiolasl, Sepide, Won, Sae-Yeon, Tritt, Stephanie, Berkefeld, Joachim, Senft, Christian, Seifert, Volker, Konczalla, Jürgen, and Meckel, Stephan

Subjects
Male, Science, Hemorrhage, Aneurysm, Ruptured, Pathology and Laboratory Medicine, Research and Analysis Methods, Vascular Medicine, Brain Ischemia, Signs and Symptoms, Mathematical and Statistical Techniques, Diagnostic Medicine, Medicine and Health Sciences, Humans, ddc:610, cardiovascular diseases, Vascular Diseases, Left Hemisphere, Statistical Methods, Retrospective Studies, Statistics, Biology and Life Sciences, Brain, Middle Aged, Subarachnoid Hemorrhage, Prognosis, Treatment Outcome, Neurology, Infarction, Multivariate Analysis, Physical Sciences, cardiovascular system, Lesions, Medicine, Female, Anatomy, Aneurysms, Cerebral Hemispheres, Mathematics, Research Article, Hydrocephalus
Abstract

Background: The prognostic factors and outcome of aneurysms appear to be dependent on its locations. Therefore, we compared left- and right- sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in terms of differences in outcome and prognostic factors. Methods: Patients with SAH were entered into a prospectively collected database. A total of 509 patients with aneurysmal subarachnoid hemorrhage were retrospectively selected and stratified in two groups depending on side of ruptured aneurysm (right n = 284 vs. left n = 225). Midline aneurysms of the basilar and anterior communicating arteries were excluded from the analysis. Outcomes were assessed using the modified Rankin Scale (mRS; favorable (mRS 0–2) vs. unfavorable (mRS 3–6)) six months after SAH. Results: We did not identify any differences in outcome depending on left- and right-sided ruptured aneurysms. In both groups, the significant negative predictive factors included clinical admission status (WFNS IV+V), Fisher 3- bleeding pattern in CT, the occurrence of delayed cerebral ischemia (DCI), early hydrocephalus and later shunt-dependence. The side of the ruptured aneurysm does not seem to influence patients´ outcome. Interestingly, the aneurysm side predicts the side of infarction, with a significant influence on patients´ outcome in case of left-sided infarctions. In addition, the in multivariate analysis side of aneurysm was an independent predictor for the side of cerebral infarctions. Conclusion: The side of the ruptured aneurysms (right or left) did not influence patients’ outcome. However, the aneurysm-side predicts the side of delayed infarctions and outcome appear to be worse in patients with left-sided infarctions.

Published
2019

26. Mikrochirurgisches Clipping unrupturierter Aneurysmen unter Rapid Ventricular Pacing (RVP) reduziert signifikant MRI DWI-Läsionen - eine prospektive Studie

Author

Konczalla, Jürgen, Wagner, Marlies, Brawanski, Nina, Kahefiolasl, Sepide, Platz, Johannes, Berkefeld, Joachim, Hattingen, Elke, and Seifert, Volker

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine
Abstract

Objective: Magnetic resonance (MR) diffusion-weighted imaging (DWI) was used to assess periprocedural lesion load. Methods: For this prospective study patients with microsurgical clipping (MC) of complex unruptured intracranial aneurysm (UIA) received pre- and postoperatively MR DWI. The primary[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019

27. Der modifizierte Subarachnoid Hemorrhage Early Brain Edema Score (mSEBES)

Author

Eibach, Michael, Kashefiolasl, Sepide, Brawanski, Nina, Bruder, Markus, Herrmann, Eva, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Despite cerebral vasospasm early brain injury (EBI) is a major cause of high mortality and poor prognosis in patients with subarachnoid hemorrhage (SAH). A key feature of EBI is cerebral edema. The Subarachnoid hemorrhage Early Brain Edema Score (SEBES) is a semiquantitative score to measure[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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28. Chirurgisches Outcome der breitbasigen Aneurysmen, Part 1 - Rupturierte Aneurysmen

Author

Won, Sae-Yeon, Dubinski, Daniel, Dinc, Nazife, Brawanski, Nina, Seifert, Volker, Berkefeld, Joachim, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular system, macromolecular substances, cardiovascular diseases, 610 Medical sciences, Medicine
Abstract

Objective: To clip or coil has been matter of debates for several years and is the domain of interdisciplinary decision making. Regarding wide neck aneurysm (WNA), there has been several studies presenting outcome of endovascular treatment, however, the surgical outcome has still been elusive. The aim[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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29. Differences in bleeding patterns and outcome after intracerebral hemorrhage due to vascular malformations

Author

Dinc, Nazife, Won, Sae-Yeon, Brawanski, Nina, Eibach, Michael, Quick-Weller, Johanna, Konczalla, Jürgen, Berkefeld, Joachim, Seifert, Volker, Marquardt, Gerhard, and Meckel, Stephan

Subjects
Male, Vascular Malformations, Cardiovascular Medicine, Pathology and Laboratory Medicine, Antiplatelet Therapy, Vascular Medicine, Neurosurgical Procedures, Diagnostic Radiology, Mathematical and Statistical Techniques, Medicine and Health Sciences, Prospective Studies, Cardiovascular Imaging, Aged, 80 and over, Hematoma, Pharmaceutics, Radiology and Imaging, Statistics, Angiography, Middle Aged, Magnetic Resonance Imaging, Physical Sciences, Medicine, Female, Research Article, Adult, Death Rates, Imaging Techniques, Science, Hemorrhage, Neuroimaging, Research and Analysis Methods, Young Adult, Signs and Symptoms, Drug Therapy, Population Metrics, Diagnostic Medicine, Humans, ddc:610, Statistical Methods, Aged, Cerebral Hemorrhage, Retrospective Studies, Population Biology, Biology and Life Sciences, ROC Curve, Multivariate Analysis, Mathematics, Neuroscience
Abstract

Background: Atypical intracerebral hemorrhage is a common form of primary manifestation of vascular malformations. Objective: The aim of the present study is to determine clues to the cause of bleeding according to hemorrhage pattern (lobar, basal ganglia, infratentorial). Methods: We retrospectively evaluated 343 consecutive neurosurgical patients with intracerebral hemorrhage (ICH), who were admitted to our neurosurgical department between 2006 and 2016. The study cohort includes only neurosurgical patients. Patients who underwent treatment by neurologists are not represented in this study. We assessed location of hemorrhage, hematoma volumes to rule out differences and predicitve variables for final outcome. Results: In 171 cases (49.9%) vascular malformations, such as arteriovenous malformations (AVMs), cavernomas, dural fistulas and aneurysms were the cause of bleeding. 172 (50.1%) patients suffered from an intracerebral hemorrhage due to amyloid angiopathy or long standing hypertension. In patients with infratentorial hemorrhage a malformation was more frequently detected as in patients with supratentorial hemorrhage (36% vs. 16%, OR 2.9 [1.8;4.9], p

Published
2019

30. Does aneurysm side influence the infarction side and patients' outcome after subarachnoid hemorrhage?

Author

Meckel, Stephan, Brawanski, Nina, Kashefiolasl, Sepide, Won, Sae-Yeon, Tritt, Stephanie, Berkefeld, Joachim, Senft, Christian, Seifert, Volker, Konczalla, Jürgen, Meckel, Stephan, Brawanski, Nina, Kashefiolasl, Sepide, Won, Sae-Yeon, Tritt, Stephanie, Berkefeld, Joachim, Senft, Christian, Seifert, Volker, and Konczalla, Jürgen

Abstract

Background: The prognostic factors and outcome of aneurysms appear to be dependent on its locations. Therefore, we compared left- and right- sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in terms of differences in outcome and prognostic factors. Methods: Patients with SAH were entered into a prospectively collected database. A total of 509 patients with aneurysmal subarachnoid hemorrhage were retrospectively selected and stratified in two groups depending on side of ruptured aneurysm (right n = 284 vs. left n = 225). Midline aneurysms of the basilar and anterior communicating arteries were excluded from the analysis. Outcomes were assessed using the modified Rankin Scale (mRS; favorable (mRS 0–2) vs. unfavorable (mRS 3–6)) six months after SAH. Results: We did not identify any differences in outcome depending on left- and right-sided ruptured aneurysms. In both groups, the significant negative predictive factors included clinical admission status (WFNS IV+V), Fisher 3- bleeding pattern in CT, the occurrence of delayed cerebral ischemia (DCI), early hydrocephalus and later shunt-dependence. The side of the ruptured aneurysm does not seem to influence patients´ outcome. Interestingly, the aneurysm side predicts the side of infarction, with a significant influence on patients´ outcome in case of left-sided infarctions. In addition, the in multivariate analysis side of aneurysm was an independent predictor for the side of cerebral infarctions. Conclusion: The side of the ruptured aneurysms (right or left) did not influence patients’ outcome. However, the aneurysm-side predicts the side of delayed infarctions and outcome appear to be worse in patients with left-sided infarctions.

Published
2019

31. Differences in bleeding patterns and outcome after intracerebral hemorrhage due to vascular malformations

Author

Meckel, Stephan, Dinc, Nazife, Won, Sae-Yeon, Brawanski, Nina, Eibach, Michael Bernd, Quick-Weller, Johanna, Konczalla, Jürgen, Berkefeld, Joachim, Seifert, Volker, Marquardt, Gerhard, Meckel, Stephan, Dinc, Nazife, Won, Sae-Yeon, Brawanski, Nina, Eibach, Michael Bernd, Quick-Weller, Johanna, Konczalla, Jürgen, Berkefeld, Joachim, Seifert, Volker, and Marquardt, Gerhard

Abstract

Background: Atypical intracerebral hemorrhage is a common form of primary manifestation of vascular malformations. Objective: The aim of the present study is to determine clues to the cause of bleeding according to hemorrhage pattern (lobar, basal ganglia, infratentorial). Methods: We retrospectively evaluated 343 consecutive neurosurgical patients with intracerebral hemorrhage (ICH), who were admitted to our neurosurgical department between 2006 and 2016. The study cohort includes only neurosurgical patients. Patients who underwent treatment by neurologists are not represented in this study. We assessed location of hemorrhage, hematoma volumes to rule out differences and predicitve variables for final outcome. Results: In 171 cases (49.9%) vascular malformations, such as arteriovenous malformations (AVMs), cavernomas, dural fistulas and aneurysms were the cause of bleeding. 172 (50.1%) patients suffered from an intracerebral hemorrhage due to amyloid angiopathy or long standing hypertension. In patients with infratentorial hemorrhage a malformation was more frequently detected as in patients with supratentorial hemorrhage (36% vs. 16%, OR 2.9 [1.8;4.9], p<0.001). Among the malformations AVMs were most common (81%). Hematoma expansion was smaller in vascular malformation than non-malformation caused bleeding (24.1 cm3 vs. 64.8 cm3, OR 0.5 [0.4;0.7], p < 0.001,). In 6 (2.1%) cases diagnosis remained unclear. Final outcome was more favorable in patients with vascular malformations (63% vs. 12%, OR 12.8 [4.5;36.2], p<0.001). Conclusion: Localization and bleeding patterns are predictive factors for origin of the hemorrhage. These predictive factors should quickly lead to appropriate vascular diagnostic measures. However, due to the inclusion criteria the validity of the study is limited and multicentre studies with further testing in general ICH patients are required.

Published
2019

32. Statins in non-aneurysmal subarachnoid hemorrhage

Author

Kashefiolasl, Sepide, Brawanski, Nina, Bruder, Markus, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular system, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Being proved in several animal SAH models, the efficacy of statin treatment in aneurysmal subarachnoid hemorrhage, remains controversial. Multiple studies, meta-analyses inclusively, indicated that the use of statins significantly decreases the occurrence of cerebral vasospasm (CVS) in aneurysmal[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018

33. Hemorrhage risk management of cavernous malformations

Author

Kashefiolasl, Sepide, Bruder, Markus, Brawanski, Nina, Herrmann, Eva, Seifert, Volker, Tritt, Stephanie, and Konczalla, Jürgen

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Despite of the low annual risk of hemorrhage associated with a cavernous malformation (CM) (0,6% to 1,1% per year), the risk of rehemorrhage rate and severity of neurological deficits is significantly higher. We aimed to evaluate different hemorrhage risk factors, particularly in[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018

34. Outcome and prognostic factors in poor grade patients (WFNS IV-V) with aneurysmal subarachnoid hemorrhage

Author

Brawanski, Nina, Kashefiolasl, Sepide, Dubinski, Daniel, Senft, Christian, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Patients with aneurysmal subarachnoid hemorrhage (SAH) are graded in five groups according to WFNS depending on admission status. We questioned, whether there are differences in outcome and prognostic factors and divided patients with aneurysmal SAH into two groups (good admission status [for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018

35. The clinical relevance of ABO blood type in 100 patients with acute subdural hematoma

Author

Dubinski, Daniel, Won, Sae-Yeon, Behmanesh, Bedjan, Brawanski, Nina, Geisen, Christof, Seifert, Volker, Senft, Christian, Konczalla, Juergen, and Patnaik, Santosh Kumar

Subjects
Male, Physiology, Epidemiology, Anticoagulant Therapy, Glasgow Outcome Scale, lcsh:Medicine, Pathology and Laboratory Medicine, Vascular Medicine, Postoperative Complications, Recurrence, Risk Factors, Medicine and Health Sciences, Prevalence, lcsh:Science, Nootropic Agents, Aged, 80 and over, Pharmaceutics, Incidence, Body Fluids, Cardiovascular Therapy, Blood, Treatment Outcome, Neurology, Disease Progression, Female, Anatomy, Research Article, Patients, Death Rates, Hemorrhage, Signs and Symptoms, Drug Therapy, Population Metrics, Diagnostic Medicine, Seizures, Hematoma, Subdural, Acute, Humans, Glasgow Coma Scale, ddc:610, Aged, Retrospective Studies, Epilepsy, Population Biology, lcsh:R, Biology and Life Sciences, Epileptic Seizures, Health Care, Blood Grouping and Crossmatching, Medical Risk Factors, lcsh:Q, Blood Groups
Abstract

Objective: The correlation of depleted blood through midline shift in acute subdural hematoma remains the most reliable clinical predictor to date. On the other hand, patient’s ABO blood type has a profound impact on coagulation and hemostasis. We conducted this study to evaluate the role of patient’s blood type in terms of incidence, clinical course and outcome after acute subdural hematoma bleeding. Methods: 100 patients with acute subdural hematoma treated between 2010 and 2015 at the author’s institution were included. Baseline characteristics and clinical findings including Glasgow coma scale, Glasgow outcome scale, hematoma volume, rebleeding, midline shift, postoperative seizures and the presence of anticoagulation were analyzed for their association with ABO blood type. Results: Patient’s with blood type O were found to have a lower midline shift (p

Published
2018

37. The clinical relevance of ABO blood type in 100 patients with acute subdural hematoma

Author

Patnaik, Santosh Kumar, Dubinski, Daniel, Won, Sae-Yeon, Behmanesh, Bedjan, Brawanski, Nina, Geisen, Christof, Seifert, Volker, Senft, Christian, Konczalla, Jürgen, Patnaik, Santosh Kumar, Dubinski, Daniel, Won, Sae-Yeon, Behmanesh, Bedjan, Brawanski, Nina, Geisen, Christof, Seifert, Volker, Senft, Christian, and Konczalla, Jürgen

Abstract

Objective: The correlation of depleted blood through midline shift in acute subdural hematoma remains the most reliable clinical predictor to date. On the other hand, patient’s ABO blood type has a profound impact on coagulation and hemostasis. We conducted this study to evaluate the role of patient’s blood type in terms of incidence, clinical course and outcome after acute subdural hematoma bleeding. Methods: 100 patients with acute subdural hematoma treated between 2010 and 2015 at the author’s institution were included. Baseline characteristics and clinical findings including Glasgow coma scale, Glasgow outcome scale, hematoma volume, rebleeding, midline shift, postoperative seizures and the presence of anticoagulation were analyzed for their association with ABO blood type. Results: Patient’s with blood type O were found to have a lower midline shift (p<0.01) and significantly less seizures (OR: 0.43; p<0.05) compared to non-O patients. Furthermore, patients with blood type A had the a significantly higher midline shift (p<0.05) and a significantly increased risk for postoperative seizures (OR: 4.01; p<0.001). There was no difference in ABO blood type distribution between acute subdural hematoma patients and the average population. Conclusion: The ABO blood type has significant influence on acute subdural hematoma sequelae. Patient’s with blood type O benefit in their clinical course after acute subdural hematoma whereas blood type A patients are at highest risk for increased midline shift and postoperative seizures. Further studies elucidating the biological mechanisms of blood type depended hemostaseology and its role in acute subdural hematoma are required for the development of an appropriate intervention.

Published
2018

38. Diagnostic accuracy of spontaneous intracerebral hemorrhage. Are there predictive factors for bleeding origins?

Author

Dinc, Nazife, Won, Sae-Yon, Brawanski, Nina, Quick-Weller, Johanna, Konczalla, Jürgen, Seifert, Volker, and Marquardt, Gerhard

Subjects
body regions, ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Atypical intracerebral hemorrhage is a common form of primary manifestation of vascular malformations. Hematoma location (lobar, brain stem, cerebellar) can give a clue to the cause of the bleeding. Methods: We retrospectively evaluated 279 consecutive patients with spontaneous intracerebral[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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42. MRI-detection rate and incidence of lumbar bleeding sources in 190 patients with non-aneurysmal SAH

Author

Meckel, Stephan, Kashefiolasl, Sepide, Brawanski, Nina, Platz, Johannes, Bruder, Markus, Senft, Christian, Marquardt, Gerhard, Seifert, Volker, Tritt, Stephanie, Konczalla, Jürgen, Meckel, Stephan, Kashefiolasl, Sepide, Brawanski, Nina, Platz, Johannes, Bruder, Markus, Senft, Christian, Marquardt, Gerhard, Seifert, Volker, Tritt, Stephanie, and Konczalla, Jürgen

Abstract

Background: Up to 15% of all spontaneous subarachnoid hemorrhages (SAH) have a non-aneurysmal SAH (NASAH). The evaluation of SAH patients with negative digital subtraction angiography (DSA) is sometimes a diagnostic challenge. Our goal in this study was to reassess the yield of standard MR-imaging of the complete spinal axis to rule out spinal bleeding sources in patients with NASAH. Methods: We retrospectively analyzed the spinal MRI findings in 190 patients with spontaneous NASAH, containing perimesencephalic (PM) and non-perimesencephalic (NPM) SAH, diagnosed by computer tomography (CT) and/or lumbar puncture (LP), and negative 2nd DSA. Results: 190 NASAH patients were included in the study, divided into PM-SAH (n = 87; 46%) and NPM-SAH (n = 103; 54%). Overall, 23 (22%) patients had a CT negative SAH, diagnosed by positive LP. MR-imaging of the spinal axis detected two patients with lumbar ependymoma (n = 2; 1,05%). Both patients complained of radicular sciatic pain. The detection rate raised up to 25%, if only patients with radicular sciatic pain received an MRI. Conclusion: Routine radiological investigation of the complete spinal axis in NASAH patients is expensive and can not be recommended for standard procedure. However, patients with clinical signs of low-back/sciatic pain should be worked up for a spinal pathology.

Published
2017

43. Subarachnoid hemorrhage in patients with anticoagulant or antiplatelet drugs

Author

Bruder, Markus, Platz, Johannes, Brawanski, Nina, Dinc, Nazife, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, Subarachnoid hemorrhage, cardiovascular diseases, 610 Medical sciences, Medicine, anticoagulation, antiplatelet, nervous system diseases
Abstract

Objective: Demographic changes are leading to an aging society with a growing number of patients relying on antiplatelet or anticoagulant drugs (AAD). Therefore, the number of patients suffering from subarachnoid hemorrhage (SAH) while treated with these drugs is rising. Although antiplatelets are suspected[for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Published
2016

44. Effect of heparin on secondary brain injury in subarachnoid hemorrhage

Author

Won, Sae-Yeon, Bruder, Markus, Kashefiolasl, Sepide, Brawanski, Nina, Seifert, Volker, and Konczalla, Jürgen

Subjects
delayed cerebral infarction, ddc: 610, subarachnoid hemorrhage, cardiovascular system, cardiovascular diseases, 610 Medical sciences, Medicine, vasospasm, nervous system diseases
Abstract

Objective: Cerebral vasospasm (CVS) and delayed cerebral infarctions (DCI) after aneurysmal subarachnoid hemorrhage (SAH) are associated with poor neurological outcome. Besides the anticoagulatory effect, heparin is suspected to influence SAH associated DCI, implicating a possible treatment option. [for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Published
2016

45. Subarachnoid hemorrhage (SAH) in advanced age: Comparison of patients aged '70-79' years and '80 years and older'

Author

Brawanski, Nina, Platz, Johannes, Kunze, Franziska, Senft, Christian, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, subarachnoid hemorrhage, outcome, cardiovascular diseases, 610 Medical sciences, Medicine, elderly patients, humanities
Abstract

Objective: According to actual demographic changes nowadays clinical routine shows an increasing admission rate of elderly patients suffering from aneurysmal subarachnoid hemorrhage (SAH). We retrospectively compared patients aged from ‘70-79’ and patients aged ‘80 years and older’.[for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Published
2016

48. Spinal ependymoma as bleeding-source in non-aneurysmal subarachnoid hemorrhage: a retrospective study

Author

Kashefiolasl, Sepide, Brawanski, Nina, Platz, Johannes, Senft, Christian, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, non-aneurysmal SAH, cardiovascular diseases, 610 Medical sciences, Medicine, spinal ependymoma, nervous system diseases, MRI
Abstract

Objective: In up to 15% of all spontaneous subarachnoid hemorrhages (SAH), there is no intracranial vascular pathology found. The evaluation of patients with subarachnoid hemorrhage with negative digital subtraction angiography (DSA) is a diagnostic challenge. These cases of non-aneurysmal hemorrhages[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015

49. Localisation of aneurysm rupture in subarachnoid hemorrhage and possible implication for translational research? 'From bedside to bench?!'

Author

Brawanski, Nina, Platz, Johannes, Senft, Christian, Seifert, Volker, and Konczalla, Jürgen

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Prognostic factors of favorable or unfavorable clinical outcome after aneurysmal subarachnoid hemorrhage are still not completely known. We retrospectively analyzed factors associated with good clinical outcome of patients with subarachnoid hemorrhage (SAH) caused by aneurysms of the internal[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015
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50. Outcome and risk factors of patients with long lasting cerebral vasospasm after subarachnoid hemorrhage

Author

Konczalla, Jürgen, Brawanski, Nina, Senft, Christian, Seifert, Volker, and Platz, Johannes

Subjects
fluids and secretions, ddc: 610, subarachnoid hemorrhage, cerebral vasospasm, cardiovascular diseases, 610 Medical sciences, Medicine, equipment and supplies, long lasting CVS, nervous system diseases
Abstract

Objective: In general, cerebral vasospasm (CVS) is thought to occur between days 7 and 21 after subarachnoid hemorrhage (SAH). Yet, some patients suffering from SAH have long lasting CVS. The outcome of these patients with a very long treatment on an intensive care unit is unknown. Therefore, we reviewed[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2014
Full Text
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