{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:07:59Z","timestamp":1787789279815,"version":"build-2784847793"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001652","name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001652","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perihemorrhagic edema (PHE) is an independent predictor of functional outcome after intracerebral hemorrhage (ICH). Although smaller studies have shown an association between prolonged prophylactic mannitol administration (PPMA) and PHE volume reduction, its therapeutic effect remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included patients with spontaneous ICH from the UKER-ICH database. The primary outcome was defined as the change in PHE volume from admission to its maximum extent (PHE growth). We used linear regression models adjusted for peak ICH volume to estimate associations of PPMA with PHE, and multivariable logistic regression models to evaluate functional outcome (day-90; modified Rankin-Scale 4\u20136\u2009=\u2009poor).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      826 patients were included. Ninety-five patients received mannitol. The treated patients had larger median peak ICH volumes (42 (IQR 19.2\u201370.4) vs. 11.7 (IQR 4.6\u201327.7) mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Linear regression demonstrated an association between PPMA and increased PHE growth and peak PHE volume (adjusted b\u2009=\u20096.2, 95%CI 2.16\u201310.63 and b\u2009=\u20098.4, 95%CI 3.16\u201313.6, respectively). After PS-matching (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116), the peak ICH volume was evenly distributed, while PPMA was associated with larger median peak PHE volumes (45.7 (IQR 24-78.2) vs. 35.2 (IQR 19.7\u201352.7) mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and growth (21.5 (IQR 9.2-42-8) vs. 11.9 (IQR 1.4\u201325.8) mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). PPMA was associated with poor outcome (adjusted OR\u2009=\u20092.09, 95%CI 1.01-4.00; PS-matched cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009114): 45 (79%) vs. 36 (65%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.097 (trend)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found no association between PPMA and reduced PHE volume or improved outcomes, and cannot exclude potential harm. However, we also cannot exclude a potential benefit of short-term mannitol administration up to 72\u00a0h after onset in reducing PHE volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/study\/NCT03183167\" ext-link-type=\"uri\">https:\/\/www.clinicaltrials.gov\/study\/NCT03183167<\/jats:ext-link>\n                      (2017-06-09)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-04858-w","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T03:39:16Z","timestamp":1775014756000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of prophylactic mannitol administration with perihemorrhagic edema and long-term outcome in patients with intracerebral hemorrhage"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2093-8438","authenticated-orcid":false,"given":"Maximilian","family":"Kaertner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosmas","family":"Macha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Sembill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Mrochen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Knott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"L\u00fccking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joji B.","family":"Kuramatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0453-1530","authenticated-orcid":false,"given":"Bastian","family":"Volbers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"4858_CR1","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1161\/STROKEAHA.119.024965","volume":"50","author":"N Ironside","year":"2019","unstructured":"Ironside N, Chen CJ, Ding D, Mayer SA, Connolly ES Jr. Perihematomal Edema After Spontaneous Intracerebral Hemorrhage. 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Accordingly, informed consent was not needed for this retrospective study. This study was conducted in accordance with the principles of the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not Applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. Mrochen reports personal fees from Alexion Pharma Germany GmbH, outside the submitted work; Dr. Volbers reports personal fees from Ipsen Pharma, personal fees from CSL Behring, personal fees from AstraZeneca, non-financial support from AbbVie, personal fees from Boehringer Ingelheim GmbH, personal fees from AbbVie, grants from Bangerter Rhyner Foundation, personal fees from Athersys, Inc., personal fees from Sivantos GmbH, personal fees from Bristol-Myers Squibb GmbH & Co. KGaA, personal fees from University of Bern, outside the submitted work;","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"230"}}