@article{FabritiusWoelferHerzbergetal.2021,
  author    = {Fabritius, Matthias Philipp and W{\"o}lfer, Teresa A. and Herzberg, Moriz and Tiedt, Steffen and Puhr-Westerheide, Daniel and Grosu, Sergio and Maurus, Stefan and Geyer, Thomas and Curta, Adrian and Kellert, Lars and K{\"u}pper, Clemens and Liebig, Thomas and Ricke, Jens and Dimitriadis, Konstantinos and Kunz, Wolfgang G. and Zimmermann, Hanna and Reidler, Paul},
  title     = {Course of early neurologic symptom severity after endovascular treatment of anterior circulation large vessel occlusion stroke: association with baseline multiparametric CT imaging and clinical parameters},
  series = {Diagnostics},
  volume    = {11},
  journal   = {Diagnostics},
  number    = {7},
  issn      = {2075-4418},
  doi       = {10.3390/diagnostics11071272},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242681},
  year      = {2021},
  abstract  = {Background: Neurologic symptom severity and deterioration at 24 hours (h) predict long-term outcomes in patients with acute large vessel occlusion (LVO) stroke of the anterior circulation. We aimed to examine the association of baseline multiparametric CT imaging and clinical factors with the course of neurologic symptom severity in the first 24 h after endovascular treatment (EVT). Methods: Patients with LVO stroke of the anterior circulation were selected from a prospectively acquired consecutive cohort of patients who underwent multiparametric CT, including non-contrast CT, CT angiography and CT perfusion before EVT. The symptom severity was assessed on admission and after 24 h using the 42-point National Institutes of Health Stroke Scale (NIHSS). Clinical and imaging data were compared between patients with and without early neurological deterioration (END). END was defined as an increase in ≥4 points, and a significant clinical improvement as a decrease in ≥4 points, compared to NIHSS on admission. Multivariate regression analyses were used to determine independent associations of imaging and clinical parameters with NIHSS score increase or decrease in the first 24 h. Results: A total of 211 patients were included, of whom 38 (18.0\%) had an END. END was significantly associated with occlusion of the internal carotid artery (odds ratio (OR), 4.25; 95\% CI, 1.90-9.47) and the carotid T (OR, 6.34; 95\% CI, 2.56-15.71), clot burden score (OR, 0.79; 95\% CI, 0.68-0.92) and total ischemic volume (OR, 1.01; 95\% CI, 1.00-1.01). In a comprehensive multivariate analysis model including periprocedural parameters and complications after EVT, carotid T occlusion remained independently associated with END, next to reperfusion status and intracranial hemorrhage. Favorable reperfusion status and small ischemic core volume were associated with clinical improvement after 24 h. Conclusions: The use of imaging parameters as a surrogate for early NIHSS progression in an acute LVO stroke after EVT reached limited performance with only carotid T occlusion as an independent predictor of END. Reperfusion status and early complications in terms of intracranial hemorrhage are critical factors that influence patient outcome in the acute stroke phase after EVT.},
  language  = {en}
}
@article{SchmidbauerFerseSalihetal.2022,
  author    = {Schmidbauer, Moritz L. and Ferse, Caroline and Salih, Farid and Klingner, Carsten and Musleh, Rita and Kunst, Stefan and Wittstock, Matthias and Neumann, Bernhard and Schebesch, Karl-Michael and B{\"o}sel, Julian and Godau, Jana and Lochner, Piergiorgio and Adam, Elisabeth H. and Jahnke, Kolja and Knier, Benjamin and Schirotzek, Ingo and M{\"u}llges, Wolfgang and Notz, Quirin and Dengl, Markus and G{\"u}ldner, Andreas and Onur, Oezguer A. and Garcia Borrega, Jorge and Dimitriadis, Konstantinos and G{\"u}nther, Albrecht},
  title     = {COVID-19 and intracranial hemorrhage: a multicenter case series, systematic review and pooled analysis},
  series = {Journal of Clinical Medicine},
  volume    = {11},
  journal   = {Journal of Clinical Medicine},
  number    = {3},
  issn      = {2077-0383},
  doi       = {10.3390/jcm11030605},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-255236},
  year      = {2022},
  abstract  = {Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) profoundly impacts hemostasis and microvasculature. In the light of the dilemma between thromboembolic and hemorrhagic complications, in the present paper, we systematically investigate the prevalence, mortality, radiological subtypes, and clinical characteristics of intracranial hemorrhage (ICH) in coronavirus disease (COVID-19) patients. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of the literature by screening the PubMed database and included patients diagnosed with COVID-19 and concomitant ICH. We performed a pooled analysis, including a prospectively collected cohort of critically ill COVID-19 patients with ICH, as part of the PANDEMIC registry (Pooled Analysis of Neurologic Disorders Manifesting in Intensive Care of COVID-19). Results: Our literature review revealed a total of 217 citations. After the selection process, 79 studies and a total of 477 patients were included. The median age was 58.8 years. A total of 23.3\% of patients experienced the critical stage of COVID-19, 62.7\% of patients were on anticoagulation and 27.5\% of the patients received ECMO. The prevalence of ICH was at 0.85\% and the mortality at 52.18\%, respectively. Conclusion: ICH in COVID-19 patients is rare, but it has a very poor prognosis. Different subtypes of ICH seen in COVID-19, support the assumption of heterogeneous and multifaceted pathomechanisms contributing to ICH in COVID-19. Further clinical and pathophysiological investigations are warranted to resolve the conflict between thromboembolic and hemorrhagic complications in the future.},
  language  = {en}
}