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Book ; Thesis: Effekt der minimalinvasiven fibrinolytischen Therapie und Aspiration intrazerebraler Blutungen auf das perifokale Ödem

Gröschel, Klaus

eine tierexperimentelle Langzeitstudie

2002

Author's details	vorgelegt von Klaus Gröschel
Language	German
Size	71 S. : Ill., graph. Darst.
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Aachen, Techn. Hochsch., Diss., 2002
HBZ-ID	HT013399307
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Association of Delirium Incidence with Visitation Restrictions due to COVID-19 Pandemic in Patients with Acute Cerebrovascular Disease in a Stroke-Unit Setting: A Retrospective Cohort Study.

Hahn, Marianne / Gröschel, Sonja / Gröschel, Klaus / Uphaus, Timo

Gerontology

2022 Volume 69, Issue 3, Page(s) 273–281

Abstract: Introduction: Hospitals around the world introduced considerable visitation restrictions to reduce risk of infection during epidemic spread of SARS-CoV2. Understanding of negative impacts of visitation restrictions on subgroups of patients may help to ... ...

Abstract	Introduction: Hospitals around the world introduced considerable visitation restrictions to reduce risk of infection during epidemic spread of SARS-CoV2. Understanding of negative impacts of visitation restrictions on subgroups of patients may help to balance and adjust policies accordingly or introduce further measures to mitigate their impact. We aimed to investigate the association of visitation restrictions with delirium incidence in stroke-unit patients. Methods: In a non-randomized observational design, data from 5,779 stroke-unit cases with transient ischemic attack or stroke (ischemic/hemorrhagic) admitted between January 2017 and November 2021 were compared between three groups depending on visitation policy implemented at time of admission: pandemic-associated absolute visitation restriction (n = 1,087), limited visitation policy (n = 862), and pre-pandemic visitation policy (n = 3,830). Univariate comparison and multiple logistic regression analyses were conducted to evaluate the association of delirium with visitation restrictions. Results: We observed delirium incidences of 6.3% during pandemic-associated absolute visitation restriction, 5.8% with limited visitation policy, and 5.1% with pre-pandemic visitation policy (p = 0.239). In multiple logistic regression analyses adjusting for clinically relevant variables, we found the presence of any pandemic-associated visitation restriction (odds ratio [OR] 1.363, 95% confidence interval [CI]: 1.066-1.744, p = 0.014) and specifically absolute visitation restriction (OR 1.368, 95% CI: 1.016-1.843, p = 0.039) independently associated with delirium in patients with acute cerebrovascular disease. Other factors independently associated with delirium were older age, male sex, stroke versus transient ischemic attack, acute infection, history of dementia, and longer duration of hospital stay. Conclusion: Pandemic-associated visitation restrictions and specifically absolute visitation restrictions are associated with a higher incidence of delirium among stroke-unit patients with acute cerebrovascular disease. Benefit and harm of visitation restrictions should be carefully weighed and adjustments considered for patients otherwise at increased risk for delirium.
MeSH term(s)	Humans ; Male ; COVID-19/epidemiology ; COVID-19/complications ; Delirium/epidemiology ; Delirium/etiology ; Incidence ; Intensive Care Units ; Ischemic Attack, Transient/epidemiology ; Ischemic Attack, Transient/complications ; Pandemics ; Retrospective Studies ; RNA, Viral ; SARS-CoV-2 ; Stroke/epidemiology
Chemical Substances	RNA, Viral
Language	English
Publishing date	2022-10-06
Publishing country	Switzerland
Document type	Journal Article ; Observational Study
ZDB-ID	193798-4
ISSN	1423-0003 ; 0304-324X
ISSN (online)	1423-0003
ISSN	0304-324X
DOI	10.1159/000526165
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Article ; Online: Real world data in mechanical thrombectomy: who are we losing to follow-up?

Hahn, Marianne / Gröschel, Sonja / Othman, Ahmed / Brockstedt, Lavinia / Civelek, Arda / Brockmann, Marc A / Gröschel, Klaus / Uphaus, Timo

Journal of neurointerventional surgery

2024 Volume 16, Issue 5, Page(s) 471–477

Abstract: Background: Missing outcome data (MOD) is a common problem in clinical trials and registries, and a potential bias when drawing conclusions from these data. Identifying factors associated with MOD may help to increase follow-up rates and assess the need ...

Abstract	Background: Missing outcome data (MOD) is a common problem in clinical trials and registries, and a potential bias when drawing conclusions from these data. Identifying factors associated with MOD may help to increase follow-up rates and assess the need for imputation strategies. We investigated MOD in a multicenter, prospective registry study of mechanical thrombectomy (MT) in large vessel occlusion ischemic stroke. Methods: 13 082 patients enrolled in the German Stroke Registry-Endovascular Treatment from May 2015 to December 2021 were analyzed with regard to MOD (90 day modified Rankin Scale, mRS). Univariate logistic regression analyses identified factors unbalanced between patients with and without MOD. Subgroup analyses were performed to identify patients for whom increased efforts to perform clinical follow-up after hospital discharge are needed. Results: We identified 19.7% (2580/13 082) of patients with MOD at the 90 day follow-up. MOD was more common with higher pre-stroke disability (mRS 3-5, 32.2% vs mRS 0-2, 13.7%; P<0.001), absence of bridging intravenous thrombolysis, longer time to treatment, and in patients with high post-stroke disability at discharge (mRS 3-5 vs 0-2: OR 1.234 (95% CI 1.107 to 1.375); P<0.001). In contrast, MOD was less common with futile recanalization (thrombolysis in cerebral infarction (TICI) score of 0-2a, 12.4% vs TICI 2b-3, 15.0%; P=0.001). In patients discharged alive with well documented baseline characteristics, shorter hospital stay (OR 0.992 (95% CI 0.985 to 0.998); P=0.010) and discharge to institutional care or hospital (OR 1.754 (95% CI 1.558 to 1.976); P<0.001) were associated with MOD. Conclusion: MOD in routine care MT registry data was not random. Increased efforts to perform clinical follow-up are needed, especially in the case of higher pre-stroke and post-stroke disability and discharge to hospital or institutional care. Trial registration: NCT03356392.
MeSH term(s)	Humans ; Male ; Female ; Aged ; Registries ; Thrombectomy/methods ; Middle Aged ; Ischemic Stroke/surgery ; Ischemic Stroke/therapy ; Prospective Studies ; Follow-Up Studies ; Lost to Follow-Up ; Aged, 80 and over ; Endovascular Procedures/methods ; Treatment Outcome ; Germany/epidemiology
Language	English
Publishing date	2024-04-23
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/jnis-2023-020435
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Article: The Bigger the Better? Center Volume Dependent Effects on Procedural and Functional Outcome in Established Endovascular Stroke Centers.

Hahn, Marianne / Gröschel, Sonja / Tanyildizi, Yasemin / Brockmann, Marc A / Gröschel, Klaus / Uphaus, Timo

Frontiers in neurology

2022 Volume 13, Page(s) 828528

Abstract: Background: Mechanical thrombectomy (MT) rates for the treatment of acute ischaemic stroke due to large vessel occlusion are steadily increasing, but are delivered in heterogenic settings. We aim to investigate effects of procedural load in centers with ...

Abstract	Background: Mechanical thrombectomy (MT) rates for the treatment of acute ischaemic stroke due to large vessel occlusion are steadily increasing, but are delivered in heterogenic settings. We aim to investigate effects of procedural load in centers with established MT-structures by comparing high- vs. low-volume centers with regard to procedural characteristics and functional outcomes. Methods: Data from 5,379 patients enrolled in the German Stroke Registry Endovascular Treatment (GSR-ET) between June 2015 and December 2019 were compared between three groups: high volume: ≥180 MTs/year, 2,342 patients; medium volume: 135-179 MTs/year, 2,202 patients; low volume: <135 MTs/year, 835 patients. Univariate analysis and multiple linear and logistic regression analyses were performed to identify differences between high- and low-volume centers. Results: We identified high- vs. low-volume centers to be an independent predictor of shorter intra-hospital (admission to groin puncture: 60 vs. 82 min, β = -26.458; Conclusion: Differences in efficiency measured by procedural times call for analysis and optimization of in-house procedural workflows at regularly used but comparatively low procedural volume MT centers.
Language	English
Publishing date	2022-03-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.828528
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Article ; Online: Ultrasound assessment of brain supplying arteries (transcranial).

Gröschel, Klaus / Harrer, Judith U / Schminke, Ulf / Stegemann, Emilia / Allendörfer, Jens

Ultraschall in der Medizin (Stuttgart, Germany : 1980)

2023 Volume 44, Issue 5, Page(s) 468–486

Abstract: Ultrasonography of intracranial arteries is a non-invasive and highly efficient method for the diagnosis and follow-up of patients with cerebrovascular diseases, also in the bedside setting of the critically ill. For reliable assessment and ... ...

Title translation	Die Ultraschalluntersuchung der hirnversorgenden Arterien (transkraniell).
Abstract	Ultrasonography of intracranial arteries is a non-invasive and highly efficient method for the diagnosis and follow-up of patients with cerebrovascular diseases, also in the bedside setting of the critically ill. For reliable assessment and interpretation of sonographic findings, the technique requires - apart from dedicated anatomic and pathophysiological knowledge of cerebral arteries and their hemodynamics - the comprehension of alternative imaging modalities such as CT or MR angiography. This article reviews the transcranial color-coded duplex sonographic (TCCS) examination technique including the transcranial Doppler sonography (TCD) for a standardized ultrasound assessment of the intracranial arteries and typical pathological cases. As a complementary tool, transorbital ultrasound for the assessment of the optic nerve sheath diameter and adjacent structures is also described in this article.
MeSH term(s)	Humans ; Cerebrovascular Disorders/diagnostic imaging ; Ultrasonography, Doppler, Transcranial/methods ; Ultrasonography, Doppler, Duplex ; Cerebrovascular Circulation/physiology ; Arteries ; Brain/diagnostic imaging ; Ultrasonography, Doppler, Color
Language	German
Publishing date	2023-10-13
Publishing country	Germany
Document type	Review ; Journal Article
ZDB-ID	801064-x
ISSN	1438-8782 ; 1439-0914 ; 1431-4894 ; 0172-4614
ISSN (online)	1438-8782
ISSN	1439-0914 ; 1431-4894 ; 0172-4614
DOI	10.1055/a-2103-4981
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Zs.A 1572: Show issues

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Article ; Online: Ultrasound assessment of brain supplying arteries (extracranial).

Gröschel, Klaus / Harrer, Judith U / Schminke, Ulf / Stegemann, Emilia / Allendörfer, Jens

Ultraschall in der Medizin (Stuttgart, Germany : 1980)

2023 Volume 45, Issue 1, Page(s) 14–35

Abstract: Ultrasonography of the brain-supplying arteries is a non-invasive and highly efficient technique for the assessment of a stenosis or a vessel occlusion in patients with cerebrovascular diseases. This article reviews the examination technique for a ... ...

Title translation	Die Ultraschalluntersuchung der hirnversorgenden Arterien (extrakraniell).
Abstract	Ultrasonography of the brain-supplying arteries is a non-invasive and highly efficient technique for the assessment of a stenosis or a vessel occlusion in patients with cerebrovascular diseases. This article reviews the examination technique for a standardized ultrasound assessment of the extracranial carotid and vertebral arteries. It further describes the multiparametric grading criteria of internal carotid artery stenosis and it gives recommendations for a standardised documentation of findings. Additionally, it proposes recommendations for intima-media thickness measurement and for classifying atherosclerotic plaques with B-mode ultrasonography. Moreover, criteria for the diagnosis of in-stent stenoses, vertebral artery dissections and subclavian steal syndrome are provided.
MeSH term(s)	Humans ; Carotid Intima-Media Thickness ; Carotid Arteries/diagnostic imaging ; Ultrasonography ; Carotid Stenosis/diagnostic imaging ; Brain/diagnostic imaging ; Carotid Artery Diseases
Language	German
Publishing date	2023-11-14
Publishing country	Germany
Document type	Review ; Journal Article
ZDB-ID	801064-x
ISSN	1438-8782 ; 1439-0914 ; 1431-4894 ; 0172-4614
ISSN (online)	1438-8782
ISSN	1439-0914 ; 1431-4894 ; 0172-4614
DOI	10.1055/a-2158-9629
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Zs.A 1572: Show issues

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Article ; Online: Doppler-Duplex-Sonografie der hirnversorgenden Gefäße – Fallstricke.

Uphaus, Timo / Gröschel, Klaus

Fortschritte der Neurologie-Psychiatrie

2019 Volume 86, Issue 11, Page(s) 718–730

Abstract: This CME article presents a structured examination of duplex sonography of the brain-supplying arteries, especially focusing on difficulties and pitfalls. Criteria for stenosis grading and common mistakes as well as anatomical and methodical ... ...

Title translation	Duplex Sonography of the Brain-Supplying Arteries - Pitfalls.
Abstract	This CME article presents a structured examination of duplex sonography of the brain-supplying arteries, especially focusing on difficulties and pitfalls. Criteria for stenosis grading and common mistakes as well as anatomical and methodical characteristics are described in detail.
MeSH term(s)	Cerebral Arteries/diagnostic imaging ; Cerebrovascular Disorders/diagnostic imaging ; Humans ; Intracranial Arterial Diseases/diagnostic imaging ; Ultrasonography
Language	German
Publishing date	2019-01-17
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	625328-3
ISSN	1439-3522 ; 0720-4299
ISSN (online)	1439-3522
ISSN	0720-4299
DOI	10.1055/a-0749-5862
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Article: Stroke Care Within the COVID-19 Pandemic-Increasing Awareness of Transient and Mild Stroke Symptoms Needed.

Uphaus, Timo / Gröschel, Sonja / Hayani, Eyad / Hahn, Marianne / Steffen, Falk / Gröschel, Klaus

Frontiers in neurology

2020 Volume 11, Page(s) 581394

Abstract: Background: ...

Abstract	Background:
Keywords	covid19
Language	English
Publishing date	2020-10-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2020.581394
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Article ; Online: Sex Disparities in Re-Employment in Stroke Patients With Large Vessel Occlusion Undergoing Mechanical Thrombectomy.

Hahn, Marianne / Gröschel, Sonja / Hayani, Eyad / Brockmann, Marc A / Muthuraman, Muthuraman / Gröschel, Klaus / Uphaus, Timo

Stroke

2022 Volume 53, Issue 8, Page(s) 2528–2537

Abstract: Background: Strokes in the working-age population represent a relevant share of ischemic strokes and re-employment is a major factor for well-being in these patients. Income differences by sex have been suspected a barrier for women in returning to paid ...

Abstract	Background: Strokes in the working-age population represent a relevant share of ischemic strokes and re-employment is a major factor for well-being in these patients. Income differences by sex have been suspected a barrier for women in returning to paid work following ischemic stroke. We aim to identify predictors of (not) returning to paid work in patients with large vessel occlusion treated with mechanical thrombectomy (MT) to identify potential areas of targeted vocational rehabilitation. Methods: From 6635 patients enrolled in the German Stroke Registry Endovascular Treatment between 2015 and 2019, data of 606 patients of the working population who survived large vessel occlusion at least 90 days past MT were compared based on employment status at day 90 follow-up. Univariate analysis, multiple logistic regression and analyses of area under the curve were performed to identify predictors of re-employment. Results: We report 35.6% of patients being re-employed 3 months following MT (median age 54.0 years; 36.1% of men, 34.5% of women [ Conclusions: There is more to re-employment after MT than functional outcome alone. In particular, attention should be paid to possible systemic barriers deterring women from resuming paid work. Registration: URL: https://www. Clinicaltrials: gov; Unique identifier: NCT03356392.
MeSH term(s)	Brain Ischemia ; Employment ; Endovascular Procedures/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Stroke/epidemiology ; Thrombectomy/adverse effects ; Treatment Outcome
Language	English
Publishing date	2022-04-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.121.037386
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Zs.A 448: Show issues

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Article ; Online: Diagnostische Lumbalpunktion.

Gröschel, Klaus / Gröschel, Sonja

Deutsche medizinische Wochenschrift (1946)

2015 Volume 140, Issue 10, Page(s) 738–740

Abstract: The diagnostic lumbar puncture is an important diagnostic tool in various neurological diseases, such as inflammatory processes of the central nervous system. Considering relevant contraindications and performed in a standardised manner, the lumbar ... ...

Title translation	How to do: The diagnostic lumbar puncture.
Abstract	The diagnostic lumbar puncture is an important diagnostic tool in various neurological diseases, such as inflammatory processes of the central nervous system. Considering relevant contraindications and performed in a standardised manner, the lumbar puncture can be regarded as a safe procedure with few side effects. The additional diagnostic yield is also of relevance in numerous non-neurological conditions.
MeSH term(s)	Algorithms ; Humans ; Nervous System Diseases/diagnosis ; Nervous System Diseases/pathology ; Patient Positioning/methods ; Spinal Puncture/instrumentation ; Spinal Puncture/methods
Language	German
Publishing date	2015-05
Publishing country	Germany
Document type	English Abstract ; Journal Article
ZDB-ID	200446-x
ISSN	1439-4413 ; 0012-0472
ISSN (online)	1439-4413
ISSN	0012-0472
DOI	10.1055/s-0041-102251
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