{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T18:41:42Z","timestamp":1793472102292,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Aneurysmal subarachnoid hemorrhage (SAH) frequently triggers systemic inflammatory response syndrome (SIRS). SIRS has been associated with inferior outcomes and, specifically, delayed cerebral infarction after aneurysmal SAH. Here, we assess the impact of intracranial blood clearance through stereotactic catheter ventriculocisternostomy on SIRS in patients with aneurysmal SAH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We assessed daily SIRS criteria (heart rate &gt;\u200990 beats\/min, respiratory rate &gt;\u200920 breaths\/min or abnormal respiratory coefficient, temperature &gt;\u200938\u00a0\u00b0C or &lt;\u200936\u00a0\u00b0C, white blood cell count &lt;\u20094000 or\u2009&gt;\u200912,000\u00a0cells\/mm<jats:sup>3<\/jats:sup>) between admission and day 21 in 80 consecutive patients who underwent cisternal lavage through stereotactic catheter ventriculocisternostomy from 2015 to 2022. These patients were compared with 80 matched controls who received treatment at our institution between 2010 and 2015. We conducted a mixed effects model analysis using restricted maximum likelihood estimation to assess the effects of treatment groups on the SIRS rate while accounting for repeated measures. Additionally, Bonferroni\u2019s correction was employed to examine specific differences between groups at different time points.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The mean percentages of patients meeting SIRS criteria during the first 21\u00a0days after aneurysmal SAH were 23% in the matched cohort group and 14% in patients who underwent cisternal lavage (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Additionally, significant differences were observed in the mean leukocyte count (<jats:italic>p<\/jats:italic>\u2009=\u20090.047), mean heart rate (<jats:italic>p<\/jats:italic>\u2009=\u20090.019), and mean respiratory rate (<jats:italic>p<\/jats:italic>\u2009=\u20090.0018) between the two groups. However, there was no significant difference in mean body temperature (<jats:italic>p<\/jats:italic>\u2009=\u20090.36).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Intracranial blood clearance and cisternal lavage after aneurysmal SAH is associated with a decline in SIRS prevalence and severity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s12028-024-02112-0","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T16:03:10Z","timestamp":1730217790000},"page":"857-863","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cisternal Blood Clearance Attenuates Systemic Inflammatory Response After Subarachnoid Hemorrhage"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5273-8443","authenticated-orcid":false,"given":"Marco","family":"Bissolo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istvan","family":"Cs\u00f3k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scheiwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Grauvogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Rohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus-J\u00fcrgen","family":"Buttler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Reinacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Roelz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"issue":"12","key":"2112_CR1","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1161\/01.STR.29.12.2455","volume":"29","author":"J Castillo","year":"1998","unstructured":"Castillo J, D\u00e1valos A, Marrugat J, Noya M. Timing for fever-related brain damage in acute ischemic stroke. Stroke. 1998;29(12):2455\u201360.","journal-title":"Stroke"},{"issue":"10","key":"2112_CR2","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.1161\/01.STR.31.10.2325","volume":"31","author":"N Vila","year":"2000","unstructured":"Vila N, Castillo J, D\u00e1valos A, Chamorro A. Proinflammatory cytokines and early neurological worsening in ischemic stroke. Stroke. 2000;31(10):2325\u20139.","journal-title":"Stroke"},{"issue":"9","key":"2112_CR3","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1161\/hs0901.095646","volume":"32","author":"Y Yoshimoto","year":"2001","unstructured":"Yoshimoto Y, Tanaka Y, Hoya K. Acute systemic inflammatory response syndrome in subarachnoid hemorrhage. Stroke. 2001;32(9):1989\u201393.","journal-title":"Stroke"},{"issue":"1","key":"2112_CR4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s11910-017-0716-3","volume":"17","author":"R Garg","year":"2017","unstructured":"Garg R, Bar B. Systemic complications following aneurysmal subarachnoid hemorrhage. Curr Neurol Neurosci Rep. 2017;17(1):7.","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"3","key":"2112_CR5","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1007\/s12028-008-9054-2","volume":"8","author":"R Dhar","year":"2008","unstructured":"Dhar R, Diringer MN. The burden of the systemic inflammatory response predicts vasospasm and outcome after subarachnoid hemorrhage. Neurocrit Care. 2008;8(3):404\u201312.","journal-title":"Neurocrit Care"},{"key":"2112_CR6","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.jocn.2019.01.039","volume":"63","author":"R Roelz","year":"2019","unstructured":"Roelz R, Scheiwe C, Coenen VA, Reinacher PC. A novel rescue therapy for cerebral vasospasm: cisternal nimodipine application via stereotactic catheter ventriculocisternostomy. J Clin Neurosci. 2019;63:244\u20138.","journal-title":"J Clin Neurosci"},{"key":"2112_CR7","doi-asserted-by":"crossref","unstructured":"Roelz R, Schaefer JH, Scheiwe C, Sajonz B, Csok I, Steiert C, et al. Impact of stereotactic ventriculocisternostomy on delayed cerebral infarction and outcome after subarachnoid hemorrhage. Stroke. 2020;51(2):431\u20139. Erratum in: Stroke. 2020;51(3):e58.","DOI":"10.1161\/STROKEAHA.119.027424"},{"issue":"10","key":"2112_CR8","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1161\/STROKEAHA.110.589275","volume":"41","author":"MD Vergouwen","year":"2010","unstructured":"Vergouwen MD, Vermeulen M, van Gijn J, Rinkel GJ, Wijdicks EF, Muizelaar JP, et al. Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group. Stroke. 2010;41(10):2391\u20135.","journal-title":"Stroke"},{"key":"2112_CR9","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.jocn.2020.05.055","volume":"78","author":"M Hokari","year":"2020","unstructured":"Hokari M, Uchida K, Shimbo D, Gekka M, Asaoka K, Itamoto K. Acute systematic inflammatory response syndrome and serum biomarkers predict outcomes after subarachnoid hemorrhage. J Clin Neurosci. 2020;78:108\u201313.","journal-title":"J Clin Neurosci"},{"key":"2112_CR10","doi-asserted-by":"publisher","first-page":"3697","DOI":"10.2147\/JIR.S460364","volume":"17","author":"T Li","year":"2024","unstructured":"Li T, Li R, Lin F, Chen X. A mediation analysis of the association between systemic inflammation response index, in-hospital complications, and poor long-term functional outcomes in patients with aneurysmal subarachnoid hemorrhage: insights from a large prospective cohort study. J Inflamm Res. 2024;17:3697\u2013708.","journal-title":"J Inflamm Res"},{"issue":"12","key":"2112_CR11","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.3390\/ijms18122580","volume":"18","author":"SR Chaudhry","year":"2017","unstructured":"Chaudhry SR, Stoffel-Wagner B, Kinfe TM, G\u00fcresir E, Vatter H, Dietrich D, et al. Elevated systemic IL-6 levels in patients with aneurysmal subarachnoid hemorrhage is an unspecific marker for post-SAH complications. Int J Mol Sci. 2017;18(12):2580.","journal-title":"Int J Mol Sci"},{"issue":"2","key":"2112_CR12","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. Early cisternal fibrinolysis is more effective than rescue spasmolysis for the prevention of delayed infarction after subarachnoid haemorrhage. Stroke Vasc Neurol. 2022;7(2):108\u201313.","journal-title":"Stroke Vasc Neurol"},{"issue":"2","key":"2112_CR13","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1007\/s12028-011-9605-9","volume":"15","author":"MN Diringer","year":"2011","unstructured":"Diringer MN, Bleck TP, Claude Hemphill J, Menon D, Shutter L, Vespa P, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society\u2019s Multidisciplinary Consensus Conference. 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