Trial reportNeurology2024
Ultra-Early and Short-Term Tranexamic Acid Treatment in Patients With Good- and Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02684812 (Ultra-early Tranexamic Acid After Subarachnoid Hemorrhage. A Prospective, Randomized, Multicenter Study.), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Ultra-early Tranexamic Acid After Subarachnoid Hemorrhage. A Prospective, Randomized, Multicenter Study.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Stroke Organisation (ESO), European Association of Neurosurgical Societies (EANS) and European Society for Minimally Invasive Neurological Therapy (ESMINT) guideline on aneurysmal subarachnoid haemorrhage.European stroke journal · 2026Guideline
- Tranexamic acid after aneurysmal subarachnoid hemorrhage is associated with worse outcome in males: post hoc analysis of the ULTRA trial.Journal of neurology · 2026Trial
- Cost-Effectiveness of Ultra-Early Tranexamic Acid as Add-On to Standard Care After Subarachnoid Hemorrhage (ULTRA Trial).European journal of neurology · 2025Trial
- Tranexamic Acid for Acute Bleeding in Severely Traumatized Patients: Mortality, Neurological Outcomes, and Thromboembolic Risk.Deutsches Arzteblatt international · 2026Review
- Beyond the bleed: complications after aneurysmal subarachnoid hemorrhage. Pathophysiology, clinical implications, and management strategies: a review.Critical care (London, England) · 2025Review
- Endovascular Treatment of Mirror Aneurysms in Subarachnoid Hemorrhage Patients: Single Stage or Multiple Stage?Brain and behavior · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors.
Maud A TjerkstraFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-9060-3435
René PostFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-7844-6262
Menno R GermansFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0003-2185-4526
Mervyn D I VergouwenFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-6823-1628
Korne JellemaFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Radboud W KootFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Nyika D KruytFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-2320-0932
Jasper F C WolfsFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Frits C De BeerFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0003-4725-7156
Hans H KieftFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0003-2083-710X
Dharmin NandaFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Bram Van Der PolFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-5173-9989
Gerwin RoksFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-1393-9848
Frank De BeerFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Loes J A ReichmanFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Paul J A M BrouwersFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Vincent I H KwaFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-0942-6206
Taco C Van Der ReeFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Henri P BienfaitFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-5698-0031
Hieronymus D BoogaartsFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-5855-2447
Catharina J KlijnFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-8495-4578
Victoria VisserFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
René van den BergFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Bert A CoertFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Janneke HornFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-3788-7675
Charles B L M MajoieFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-7600-9568
Gabriël J E RinkelFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Yvo B W E M RoosFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-9205-5882
W Peter VandertopFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0001-5417-0265
Dagmar VerbaanFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.ORCID 0000-0002-9212-5470
ULTRA trial study groupFrom the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe results of the ULTRA trial showed that ultra-early and short-term treatment with tranexamic acid (TXA) does not improve clinical outcome after aneurysmal subarachnoid hemorrhage (aSAH). Possibly, the lack of a beneficial effect in all patients with aSAH is masked by antagonistic effects of TXA in certain subgroups. In this post hoc subgroup analysis, we investigated the effect of TXA on clinical outcome in patients with good-grade and poor-grade aSAH.
methodsThe ULTRA trial was a multicenter, prospective, randomized, controlled, open-label trial with blinded outcome assessment. Participants received ultra-early and short-term TXA in addition to usual care or usual care only. This post hoc subgroup analysis included only ULTRA participants with confirmed aSAH and available World Federation of Neurosurgical Societies (WFNS) grade on admission. Patients were categorized into those with good-grade (WFNS 1-3) and poor-grade (WFNS 4-5) aSAH. The primary outcome was clinical outcome assessed by the modified Rankin scale (mRS). Odds ratios (ORs) and adjusted ORs (aORs) with 95% CIs were calculated using ordinal regression analyses. Analyses were performed using the as-treated principle. In all patients with aSAH, no significant effect modification of TXA on clinical outcome was observed for admission WFNS grade (
resultsOf the 812 ULTRA participants, 473 patients had (58%; N = 232 TXA, N = 241 usual care) good-grade and 339 (42%; N = 162 TXA, N = 176 usual care) patients had poor-grade aSAH. In patients with good-grade aSAH, the TXA group had worse clinical outcomes (OR: 0.67, 95% CI 0.48-0.94, aOR 0.68, 95% CI 0.48-0.94) compared with the usual care group. In patients with poor-grade aSAH, clinical outcomes were comparable between treatment groups (OR: 1.04, 95% CI 0.70-1.55, aOR 1.05, 95% CI 0.70-1.56). DISCUSSION: This post hoc subgroup analysis provides another important argument against the use of TXA treatment in patients with aSAH, by showing worse clinical outcomes in patients with good-grade aSAH treated with TXA and no clinical benefit of TXA in patients with poor-grade aSAH, compared with patients treated with usual care. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov (NCT02684812; submission date February 18, 2016, first patient enrollment on July 24, 2013). CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that tranexamic acid, given for <24 hours within the first 24 hours, does not improve the 6-month outcome in good-grade or poor initial-grade aneurysmal SAH.
Indexed as
Antifibrinolytic AgentsSubarachnoid HemorrhageTranexamic AcidAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAntifibrinolytic AgentsTranexamic Acid
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NCT02684812ClinicalTrials.gov
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