{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:16:28Z","timestamp":1788232588160,"version":"build-2803163510"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"DOI":"10.1007\/s10143-026-04463-y","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:06:36Z","timestamp":1788231996000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pressure-controlled active CSF irrigation versus non-pressure-controlled management following aneurysmal subarachnoid hemorrhage: a systematic review and comparative meta-analysis of DCI and safety outcomes"],"prefix":"10.1007","volume":"49","author":[{"given":"Ramtin","family":"Pourahmad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrad","family":"Zare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouria","family":"Delbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimia","family":"Rasouli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4346-3657","authenticated-orcid":false,"given":"Mohammad Mehdi","family":"Hajiabadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"4463_CR1","doi-asserted-by":"publisher","unstructured":"Fistouris P, Scheiwe C, Grauvogel J, Csok I, Beck J, Reinacher PC, Roelz R (2026) The impact of intracranial blood clearance on brain edema as a predictor of delayed cerebral infarction following subarachnoid hemorrhage. Cerebrovascular Diseases (Basel, Switzerland) 55(3):318\u2013325.\u00a0https:\/\/doi.org\/10.1159\/000547091. https:\/\/pubmed.ncbi.nlm.nih.gov\/40582356\/","DOI":"10.1159\/000547091"},{"issue":"3","key":"4463_CR2","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1007\/s12028-024-02112-0","volume":"42","author":"M Bissolo","year":"2025","unstructured":"Bissolo M, Cs\u00f3k I, Scheiwe C, Grauvogel J, Beck J, Rohr E et al (2025) Cisternal Blood Clearance Attenuates Systemic Inflammatory Response After Subarachnoid Hemorrhage. Neurocrit Care 42(3):857\u2013863","journal-title":"Neurocrit Care"},{"issue":"4","key":"4463_CR3","doi-asserted-by":"publisher","first-page":"928","DOI":"10.3171\/2025.2.JNS242828","volume":"143","author":"R Roelz","year":"2025","unstructured":"Roelz R, Cs\u00f3k I, Overstijns M, Bissolo M, Demerath T, Cimflova P et al (2025) Decreasing delayed cerebral infarction after aneurysmal subarachnoid hemorrhage using active blood clearance and prevention of delayed cerebral ischemia: results of a 16-year patient registry. J Neurosurg 143(4):928\u2013938","journal-title":"J Neurosurg"},{"issue":"8","key":"4463_CR4","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1016\/j.clineuro.2008.05.001","volume":"110","author":"D H\u00e4nggi","year":"2008","unstructured":"H\u00e4nggi D, Beseoglu K, Turowski B, Steiger HJ (2008) Feasibility and safety of intrathecal nimodipine on posthaemorrhagic cerebral vasospasm refractory to medical and endovascular therapy. Clin Neurol Neurosurg 110(8):784\u2013790","journal-title":"Clin Neurol Neurosurg"},{"issue":"2","key":"4463_CR5","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/S0090-3019(99)00183-4","volume":"53","author":"N Kodama","year":"2000","unstructured":"Kodama N, Sasaki T, Kawakami M, Sato M, Asari J (2000) Cisternal irrigation therapy with urokinase and ascorbic acid for prevention of vasospasm after aneurysmal subarachnoid hemorrhage. Outcome in 217 patients. Surg Neurol 53(2):110-7 discussion 7\u20138","journal-title":"Surg Neurol"},{"issue":"6","key":"4463_CR6","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.3171\/JNS\/2008\/108\/6\/1192","volume":"108","author":"D H\u00e4nggi","year":"2008","unstructured":"H\u00e4nggi D, Liersch J, Turowski B, Yong M, Steiger HJ (2008) The effect of lumboventricular lavage and simultaneous low-frequency head-motion therapy after severe subarachnoid hemorrhage: results of a single center prospective Phase II trial. J Neurosurg 108(6):1192\u20131199","journal-title":"J Neurosurg"},{"issue":"1","key":"4463_CR7","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s10143-024-02589-5","volume":"47","author":"L Chen","year":"2024","unstructured":"Chen L, Meng Y, Xue Q, Zhao Y, Zhou X, Hu K et al (2024) Risk factors of shunt-dependent hydrocephalus after subarachnoid hemorrhage: a systematic review and meta-analysis based on observational cohort studies. Neurosurg Rev 47(1):421","journal-title":"Neurosurg Rev"},{"issue":"1","key":"4463_CR8","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s12028-025-02310-4","volume":"44","author":"F Ebel","year":"2026","unstructured":"Ebel F, Westarp E, Poretti M, von Rotz M, Stohler S, Chen R et al (2026) Impact of Hemorrhage Extent on External Ventricular Drain-Associated Infections in Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 44(1):191\u2013202","journal-title":"Neurocrit Care"},{"issue":"6","key":"4463_CR9","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.wneu.2010.04.002","volume":"73","author":"T Yamamoto","year":"2010","unstructured":"Yamamoto T, Esaki T, Nakao Y, Mori K (2010) Efficacy of low-dose tissue-plasminogen activator intracisternal administration for the prevention of cerebral vasospasm after subarachnoid hemorrhage. World Neurosurg 73(6):675\u2013682","journal-title":"World Neurosurg"},{"issue":"5","key":"4463_CR10","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1227\/neu.0000000000003587","volume":"97","author":"BR Jahromi","year":"2025","unstructured":"Jahromi BR, Monachello G, Khan MB, Hodge JO, Garavaglia J, Turner RC et al (2025) Active Cerebrospinal Fluid Exchange vs External Ventricular Drainage in the Neurocritical Care Unit: An International, Retrospective Cohort Study. Neurosurgery 97(5):1208\u20131214","journal-title":"Neurosurgery"},{"issue":"5","key":"4463_CR11","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1227\/neu.0000000000003756","volume":"98","author":"Manou Overstijns","year":"2026","unstructured":"Overstijns Manou, Cs\u00f3k Istv\u00e1n, Bissolo Marco, Scheiwe Christian, Reinacher Peter, Beck J\u00fcrgen, Roelz Roland (2026) Active Blood Clearance and Delayed Cerebral Ischemia Prevention Therapy Reduces Shunt-Dependent Hydrocephalus in Patients With Aneurysmal Subarachnoid Hemorrhage. Neurosurgery 98(5):1129\u20131138. https:\/\/doi.org\/10.1227\/neu.0000000000003756","journal-title":"Neurosurgery"},{"issue":"1","key":"4463_CR12","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/s10143-023-02241-8","volume":"47","author":"M Umekawa","year":"2023","unstructured":"Umekawa M, Yoshikawa G (2023) Impact of ventriculo-cisternal irrigation on prevention of delayed cerebral infarction in aneurysmal subarachnoid hemorrhage: a single-center retrospective study and literature review. Neurosurg Rev 47(1):6","journal-title":"Neurosurg Rev"},{"key":"4463_CR13","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.clineuro.2017.10.012","volume":"163","author":"PC Reinacher","year":"2017","unstructured":"Reinacher PC, Coenen VA, Kraeutle R, Scheiwe C, Jabbarli R, Roelz R (2017) Feasibility of stereotactic catheter ventriculocisternostomy for cisternal lavage therapy in patients with subarachnoid hemorrhage. Clin Neurol Neurosurg 163:94\u2013102","journal-title":"Clin Neurol Neurosurg"},{"issue":"10","key":"4463_CR14","doi-asserted-by":"publisher","first-page":"2704","DOI":"10.1161\/STROKEAHA.117.018397","volume":"48","author":"R Roelz","year":"2017","unstructured":"Roelz R, Coenen VA, Scheiwe C, Niesen WD, Egger K, Csok I et al (2017) Stereotactic Catheter Ventriculocisternostomy for Clearance of Subarachnoid Hemorrhage: A Matched Cohort Study. Stroke 48(10):2704\u20132709","journal-title":"Stroke"},{"issue":"3","key":"4463_CR15","first-page":"e00049","volume":"4","author":"C Scheiwe","year":"2023","unstructured":"Scheiwe C, Grauvogel J, Cs\u00f3k I, Fistouris P, Fung C, Beck J et al (2023) Cisterno-Ventricular Lavage After Aneurysm Clipping for the Prevention of Delayed Infarction in Patients With Subarachnoid Hemorrhage. Neurosurg Pract 4(3):e00049","journal-title":"Neurosurg Pract"},{"issue":"2","key":"4463_CR16","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1136\/svn-2021-001146","volume":"7","author":"R Roelz","year":"2022","unstructured":"Roelz R, Scheiwe C, Grauvogel J, Csok I, Coenen VA, Beck J et al (2022) Early cisternal fibrinolysis is more effective than rescue spasmolysis for the prevention of delayed infarction after subarachnoid haemorrhage. Stroke Vasc Neurol 7(2):108\u2013113","journal-title":"Stroke Vasc Neurol"},{"key":"4463_CR17","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1002\/9781119536604.ch7","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Isabelle Boutron","year":"2019","unstructured":"Boutron I, Page MJ, Higgins JPT, Altman DG, Lundh A, Hr\u00f3bjartsson A et al Considering bias and conflicts of interest among the included studies. Cochrane Handbook for Systematic Reviews of Interventions2019. pp. 177\u2013204","edition":"2"},{"key":"4463_CR18","doi-asserted-by":"publisher","unstructured":"McKenzie JE, Brennan SE (2019) Synthesizing and presenting findings using other methods. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (eds) Cochrane handbook for systematic reviews of interventions, 2nd edn. John Wiley & Sons, Chichester, pp 321\u2013347. https:\/\/doi.org\/10.1002\/9781119536604.ch12","DOI":"10.1002\/9781119536604.ch12"},{"key":"4463_CR19","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1002\/9781119536604.ch9","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Joanne E. McKenzie","year":"2019","unstructured":"McKenzie JE, Brennan SE, Ryan RE, Thomson HJ, Johnston RV (2019) Summarizing study characteristics and preparing for synthesis. Cochrane Handbook for Systematic Reviews of Interventions pp. 229\u2009\u2013\u200940.\u00a0https:\/\/doi.org\/10.1002\/9781119536604.ch9","edition":"2"},{"issue":"5","key":"4463_CR20","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1007\/s10072-013-1589-0","volume":"35","author":"JH Kim","year":"2014","unstructured":"Kim JH, Yi HJ, Ko Y, Kim YS, Kim DW, Kim JM (2014) Effectiveness of papaverine cisternal irrigation for cerebral vasospasm after aneurysmal subarachnoid hemorrhage and measurement of biomarkers. Neurol Sci 35(5):715\u2013722","journal-title":"Neurol Sci"},{"issue":"2","key":"4463_CR21","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1055\/s-0028-1087214","volume":"70","author":"D H\u00e4nggi","year":"2009","unstructured":"H\u00e4nggi D, Eicker S, Beseoglu K, Behr J, Turowski B, Steiger HJ (2009) A multimodal concept in patients after severe aneurysmal subarachnoid hemorrhage: results of a controlled single centre prospective randomized multimodal phase I\/II trial on cerebral vasospasm. Cent Eur Neurosurg 70(2):61\u201367","journal-title":"Cent Eur Neurosurg"},{"issue":"2","key":"4463_CR22","doi-asserted-by":"publisher","first-page":"236","DOI":"10.3171\/jns.2004.100.2.0236","volume":"100","author":"S Kawamoto","year":"2004","unstructured":"Kawamoto S, Tsutsumi K, Yoshikawa G, Shinozaki MH, Yako K, Nagata K et al (2004) Effectiveness of the head-shaking method combined with cisternal irrigation with urokinase in preventing cerebral vasospasm after subarachnoid hemorrhage. J Neurosurg 100(2):236\u2013243","journal-title":"J Neurosurg"},{"issue":"1","key":"4463_CR23","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3171\/2015.1.JNS142757","volume":"124","author":"T Yamamoto","year":"2016","unstructured":"Yamamoto T, Mori K, Esaki T, Nakao Y, Tokugawa J, Watanabe M (2016) Preventive effect of continuous cisternal irrigation with magnesium sulfate solution on angiographic cerebral vasospasms associated with aneurysmal subarachnoid hemorrhages: a randomized controlled trial. J Neurosurg 124(1):18\u201326","journal-title":"J Neurosurg"},{"key":"4463_CR24","doi-asserted-by":"publisher","unstructured":"Demir S, Erkan B, Akpinar E, Postalci LS (2026) Cerebral vasospasm after spontaneous subarachnoid hemorrhage: pathophysiology, diagnosis, and contemporary management. Adv Neurol 5(3):025190049. https:\/\/doi.org\/10.36922\/AN025190049","DOI":"10.36922\/AN025190049"},{"issue":"11","key":"4463_CR25","doi-asserted-by":"publisher","first-page":"3000","DOI":"10.1177\/0271678X211020629","volume":"41","author":"K Akeret","year":"2021","unstructured":"Akeret K, Buzzi RM, Schaer CA, Thomson BR, Vallelian F, Wang S et al (2021) Cerebrospinal fluid hemoglobin drives subarachnoid hemorrhage-related secondary brain injury. J Cereb Blood Flow Metab 41(11):3000\u20133015","journal-title":"J Cereb Blood Flow Metab"},{"issue":"1","key":"4463_CR26","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s12975-024-01238-9","volume":"16","author":"S Bandyopadhyay","year":"2025","unstructured":"Bandyopadhyay S, Schwendinger N, Jahromi BR, Lad SP, Blackburn S, Wolf S et al (2025) Red Blood Cells in the Cerebrospinal Fluid Compartment After Subarachnoid Haemorrhage: Significance and Emerging Therapeutic Strategies. Transl Stroke Res 16(1):133\u2013146","journal-title":"Transl Stroke Res"},{"issue":"11","key":"4463_CR27","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13111580","volume":"13","author":"Alberto Vandenbulcke","year":"2023","unstructured":"Vandenbulcke A, Messerer M, Daniel RT, Cossu G (2023) The Role of Cisternostomy and Cisternal Drainage in the Treatment of Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review. Brain Sci 13(11).\u00a0https:\/\/doi.org\/10.3390\/brainsci13111580","journal-title":"Brain Sciences"},{"issue":"3","key":"4463_CR28","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1093\/ons\/opx129","volume":"14","author":"R Roelz","year":"2018","unstructured":"Roelz R, Scheiwe C, Urbach H, Coenen VA, Reinacher P (2018) Stereotactic Catheter Ventriculocisternostomy for Clearance of Subarachnoid Hemorrhage in Patients with Coiled Aneurysms. Oper Neurosurg 14(3):231\u2013235","journal-title":"Oper Neurosurg"},{"issue":"1","key":"4463_CR29","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1227\/neu.0000000000003284","volume":"97","author":"M Overstijns","year":"2024","unstructured":"Overstijns M, Cs\u00f3k I, Watzlawick R, Scheiwe C, Reinacher P, Beck J et al (2024) Outcome of Fourth Ventricular Hemorrhage in Ruptured Brain Aneurysms: Impact of Active Blood Clearance and Delayed Cerebral Ischemia Prevention. Neurosurgery 97(1):191\u2013203","journal-title":"Neurosurgery"},{"issue":"15","key":"4463_CR30","doi-asserted-by":"publisher","first-page":"6053","DOI":"10.7150\/thno.100982","volume":"14","author":"J Wang","year":"2024","unstructured":"Wang J, Lv T, Jia F, Li Y, Ma W, Xiao ZP et al (2024) Subarachnoid hemorrhage distinctively disrupts the glymphatic and meningeal lymphatic systems in beagles. Theranostics 14(15):6053\u20136070","journal-title":"Theranostics"},{"key":"4463_CR31","doi-asserted-by":"publisher","first-page":"1138769","DOI":"10.3389\/fnmol.2023.1138769","volume":"16","author":"Y Gao","year":"2023","unstructured":"Gao Y, Liu K, Zhu J (2023) Glymphatic system: an emerging therapeutic approach for neurological disorders. Front Mol Neurosci 16:1138769","journal-title":"Front Mol Neurosci"},{"issue":"8","key":"4463_CR32","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1001\/jamaneurol.2023.1792","volume":"80","author":"S Wolf","year":"2023","unstructured":"Wolf S, Mielke D, Barner C, Malinova V, Kerz T, Wostrack M et al (2023) Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial. JAMA Neurol 80(8):833\u2013842","journal-title":"JAMA Neurol"}],"container-title":["Neurosurgical Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-026-04463-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10143-026-04463-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-026-04463-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:06:42Z","timestamp":1788232002000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10143-026-04463-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4463"],"URL":"https:\/\/doi.org\/10.1007\/s10143-026-04463-y","relation":{},"ISSN":["1437-2320"],"issn-type":[{"value":"1437-2320","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"7 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable. This study is a systematic review and comparative meta-analysis based exclusively on data extracted from previously published studies. No new human participants were recruited, no intervention was performed, and no identifiable individual-level patient data were collected or analyzed by the authors. Therefore, ethics approval by an institutional review board or research ethics committee was not required.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This study did not involve direct participation of human subjects by the authors and used only previously published aggregate data.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This manuscript does not contain any individual person\u2019s identifiable data, images, videos, or case-specific information requiring consent for publication.","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":5,"name":"Ethics","label":"Clinical trial number","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"544"}}