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1. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization.

Author

Mead, Gillian, Sposato, Luciano, Sampaio Silva, Gisele, Yperzeele, Laetitia, Wu, Simiao, Kutlubaev, Mansur, Cheyne, Joshua, Wahab, Kolawole, Urrutia, Victor, Sharma, Vijay, Sylaja, P, Hill, Kelvin, Steiner, Thorsten, Liebeskind, David, and Rabinstein, Alejandro

Subjects
Stroke rehabilitation, acute stroke care, guidelines, secondary stroke prevention, stroke care, Humans, Stroke, Ischemic Stroke, Hypertension, Exercise, Atrial Fibrillation
Abstract

BACKGROUND: There are multiple stroke guidelines globally. To synthesize these and summarize what existing stroke guidelines recommend about the management of people with stroke, the World Stroke Organization (WSO) Guideline committee, under the auspices of the WSO, reviewed available guidelines. AIMS: To systematically review the literature to identify stroke guidelines (excluding primary stroke prevention and subarachnoid hemorrhage) since 1 January 2011, evaluate quality (The international Appraisal of Guidelines, Research and Evaluation (AGREE II)), tabulate strong recommendations, and judge applicability according to stroke care available (minimal, essential, advanced). SUMMARY OF REVIEW: Searches identified 15,400 titles; 911 texts were retrieved, 200 publications scrutinized by the three subgroups (acute, secondary prevention, rehabilitation), and recommendations extracted from most recent version of relevant guidelines. For acute treatment, there were more guidelines about ischemic stroke than intracerebral hemorrhage; recommendations addressed pre-hospital, emergency, and acute hospital care. Strong recommendations were made for reperfusion therapies for acute ischemic stroke. For secondary prevention, strong recommendations included establishing etiological diagnosis; management of hypertension, weight, diabetes, lipids, and lifestyle modification; and for ischemic stroke, management of atrial fibrillation, valvular heart disease, left ventricular and atrial thrombi, patent foramen ovale, atherosclerotic extracranial large vessel disease, intracranial atherosclerotic disease, and antithrombotics in non-cardioembolic stroke. For rehabilitation, there were strong recommendations for organized stroke unit care, multidisciplinary rehabilitation, task-specific training, fitness training, and specific interventions for post-stroke impairments. Most recommendations were from high-income countries, and most did not consider comorbidity, resource implications, and implementation. Patient and public involvement was limited. CONCLUSION: The review identified a number of areas of stroke care where there was strong consensus. However, there was extensive repetition and redundancy in guideline recommendations. Future guideline groups should consider closer collaboration to improve efficiency, include more people with lived experience in the development process, consider comorbidity, and advise on implementation.

Published
2023

4. Predicting Intracerebral Hemorrhage Growth With the Spot Sign

Author

Dowlatshahi, Dar, Brouwers, H Bart, Demchuk, Andrew M, Hill, Michael D, Aviv, Richard I, Ufholz, Lee-Anne, Reaume, Michael, Wintermark, Max, Hemphill, J Claude, Murai, Yasuo, Wang, Yongjun, Zhao, Xingquan, Wang, Yilong, Li, Na, Sorimachi, Takatoshi, Matsumae, Mitsunori, Steiner, Thorsten, Rizos, Timolaos, Greenberg, Steven M, Romero, Javier M, Rosand, Jonathan, Goldstein, Joshua N, and Sharma, Mukul

Subjects
Biomedical Imaging, Stroke, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Cerebral Angiography, Cerebral Hemorrhage, Disease Progression, Hematoma, Humans, Predictive Value of Tests, Time Factors, Tomography, X-Ray Computed, cerebral hemorrhage, hematoma expansion, CT angiography, spot sign, intracerebral hemorrhage, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Neurosciences, Neurology & Neurosurgery
Abstract

Background and purposeHematoma expansion after acute intracerebral hemorrhage is common and is associated with early deterioration and poor clinical outcome. The computed tomographic angiography (CTA) spot sign is a promising predictor of expansion; however, frequency and predictive values are variable across studies, possibly because of differences in onset-to-CTA time. We performed a patient-level meta-analysis to define the relationship between onset-to-CTA time and frequency and predictive ability of the spot sign.MethodsWe completed a systematic review for studies of CTA spot sign and hematoma expansion. We subsequently pooled patient-level data on the frequency and predictive values for significant hematoma expansion according to 5 predefined categorized onset-to-CTA times. We calculated spot-sign frequency both as raw and frequency-adjusted rates.ResultsAmong 2051 studies identified, 12 met our inclusion criteria. Baseline hematoma volume, spot-sign status, and time-to-CTA were available for 1176 patients, and 1039 patients had follow-up computed tomographies for hematoma expansion analysis. The overall spot sign frequency was 26%, decreasing from 39% within 2 hours of onset to 13% beyond 8 hours (P

Published
2016

5. Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement

Author

Parry-Jones, Adrian R, primary, Järhult, Susann J, additional, Kreitzer, Natalie, additional, Morotti, Andrea, additional, Toni, Danilo, additional, Seiffge, David, additional, Mendelow, Alexander David, additional, Patel, Hiren, additional, Brouwers, Hens Bart, additional, Klijn, Catharina JM, additional, Steiner, Thorsten, additional, Gibler, Walter Brian, additional, and Goldstein, Joshua N, additional

Published
2023
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7. Recommendations for Clinical Trials in ICH: The Second Hemorrhagic Stroke Academia Industry Roundtable

Author

Selim, Magdy, Hanley, Daniel, Steiner, Thorsten, Christensen, Hanne Krarup, Lafuente, Jesus, Rodriguez, David, Selim, Magdy, Keep, Richard, Steiner, Thorsten, Anderson, Craig, Hanley, Daniel, Keep, Richard, Parry-Jones, Adrian, Nilsson, Michael, Sunnerhagen, Katharina Stibrant, Novick, Elizabeth, Aronowski, Jaroslaw, Lawson, Brooke, Chaudhary, Neeraj, Zhou-Ping, Tang, Steiner, Thorsten, Christensen, Hanne Krarup, Zuccarello, Mario, Woo, Daniel, Shoamanesh, Ashkan, Qureshi, Adnan I., Cordonnier, Charlotte, Anderson, Craig, Klijn, Karin, Salman, Rustam Al-Shahi, Sprigg, Nikola, Gregson, Barbara, Mendelow, David, Gaudin, Christophe, Pandey, Aditya, Ziai, Wendy, Alcázar-Romero, Pedro Pablo, Montaner, Joan, Marti-Fabregas, Joan, Nilsson, Sara, Schenk, Bettina, Riess, Hanno, You, Chao, Gaist, David, and Broderick, Joseph

Published
2020
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8. Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants

Author

Meinel, Thomas R., Wilson, Duncan, Gensicke, Henrik, Scheitz, Jan F., Ringleb, Peter, Goganau, Ioana, Kaesmacher, Johannes, Bae, Hee-Joon, Kim, Do Yeon, Kermer, Pawel, Suzuki, Kentaro, Kimura, Kazumi, Macha, Kosmas, Koga, Masatoshi, Wada, Shinichi, Altersberger, Valerian, Salerno, Alexander, Palanikumar, Logesh, Zini, Andrea, Forlivesi, Stefano, Kellert, Lars, Wischmann, Johannes, Kristoffersen, Espen S., Beharry, James, Barber, P. Alan, Hong, Jae Beom, Cereda, Carlo, Schlemm, Eckhard, Yakushiji, Yusuke, Poli, Sven, Leker, Ronen, Romoli, Michele, Zedde, Marialuisa, Curtze, Sami, Ikenberg, Benno, Uphaus, Timo, Giannandrea, David, Portela, Pere Cardona, Veltkamp, Roland, Ranta, Annemarei, Arnold, Marcel, Fischer, Urs, Cha, Jae-Kwan, Wu, Teddy Y., Purrucker, Jan C., Seiffge, David J., Kägi, Georg, Engelter, Stefan, Nolte, Christian H., Kallmünzer, Bernd, Michel, Patrik, Kleinig, Timothy J., Fink, John, Rønning, Ole Morten, Campbell, Bruce, Nederkoorn, Paul J., Thomalla, G. tz, Kunieda, Takenobu, Poli, Khouloud, Béjot, Yannick, Soo, Yannie, Garcia-Esperon, Carlos, Ntaios, Georges, Cordonnier, Charlotte, Marto, João Pedro, Bigliardi, Guido, Lun, François, Choi, Philip M. C., Steiner, Thorsten, Ustrell, Xavier, Werring, David, Wegener, Susanne, Pezzini, Alessandro, du, Houwei, Martí-Fàbregas, Joan, Cánovas-Vergé, David, Strbian, Daniel, Padjen, Visnja, Yaghi, Shadi, Stretz, Christoph, Kim, Joon-Tae, HUS Neurocenter, Neurologian yksikkö, Department of Neurosciences, Neurology, ACS - Atherosclerosis & ischemic syndromes, and ANS - Neurovascular Disorders

Subjects
Rivaroxaban, Plasma-levels, Idarucizumab, 3112 Neurosciences, Intracranial hemorrhage, Recanalization therapies, Endovascular treatment, Neurology (clinical), Reperfusion therapy, 3124 Neurology and psychiatry, Tissue-plasminogen activator, Dabigatran, Management
Abstract

ImportanceInternational guidelines recommend avoiding intravenous thrombolysis (IVT) in patients with ischemic stroke who have a recent intake of a direct oral anticoagulant (DOAC).ObjectiveTo determine the risk of symptomatic intracranial hemorrhage (sICH) associated with use of IVT in patients with recent DOAC ingestion.Design, Setting, and ParticipantsThis international, multicenter, retrospective cohort study included 64 primary and comprehensive stroke centers across Europe, Asia, Australia, and New Zealand. Consecutive adult patients with ischemic stroke who received IVT (both with and without thrombectomy) were included. Patients whose last known DOAC ingestion was more than 48 hours before stroke onset were excluded. A total of 832 patients with recent DOAC use were compared with 32 375 controls without recent DOAC use. Data were collected from January 2008 to December 2021.ExposuresPrior DOAC therapy (confirmed last ingestion within 48 hours prior to IVT) compared with no prior oral anticoagulation.Main Outcomes and MeasuresThe main outcome was sICH within 36 hours after IVT, defined as worsening of at least 4 points on the National Institutes of Health Stroke Scale and attributed to radiologically evident intracranial hemorrhage. Outcomes were compared according to different selection strategies (DOAC-level measurements, DOAC reversal treatment, IVT with neither DOAC-level measurement nor idarucizumab). The association of sICH with DOAC plasma levels and very recent ingestions was explored in sensitivity analyses.ResultsOf 33 207 included patients, 14 458 (43.5%) were female, and the median (IQR) age was 73 (62-80) years. The median (IQR) National Institutes of Health Stroke Scale score was 9 (5-16). Of the 832 patients taking DOAC, 252 (30.3%) received DOAC reversal before IVT (all idarucizumab), 225 (27.0%) had DOAC-level measurements, and 355 (42.7%) received IVT without measuring DOAC plasma levels or reversal treatment. The unadjusted rate of sICH was 2.5% (95% CI, 1.6-3.8) in patients taking DOACs compared with 4.1% (95% CI, 3.9-4.4) in control patients using no anticoagulants. Recent DOAC ingestion was associated with lower odds of sICH after IVT compared with no anticoagulation (adjusted odds ratio, 0.57; 95% CI, 0.36-0.92). This finding was consistent among the different selection strategies and in sensitivity analyses of patients with detectable plasma levels or very recent ingestion.Conclusions and RelevanceIn this study, there was insufficient evidence of excess harm associated with off-label IVT in selected patients after ischemic stroke with recent DOAC ingestion.

Published
2023

9. Cigarette Smoking as a Risk Factor for Hematoma Expansion in Primary Intracerebral Hemorrhage: Analysis From a Randomized Clinical Trial

Author

Schupper, Alexander J., primary, Khorasanizadeh, Mirhojjat, additional, Rossitto, Christina P., additional, Foster, Lydia D., additional, Kellner, Christopher P., additional, Suarez, Jose I., additional, Qureshi, Adnan I., additional, Majidi, Shahram, additional, Palesch, Yuko Y., additional, Martin, Renee L., additional, Barsan, William G., additional, Silbergleit, Robert, additional, Hanley, Daniel F., additional, Moy, Claudia S., additional, Hsu, Chung Y., additional, Steiner, Thorsten, additional, Toyoda, Kazunori, additional, Wang, Yongjun, additional, Yamamoto, Haruko, additional, and Yoon, Byung‐Woo, additional

Published
2023
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13. Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage

Author

Parikh, Neal S., Kamel, Hooman, Navi, Babak B., Iadecola, Costantino, Merkler, Alexander E., Jesudian, Arun, Dawson, Jesse, Falcone, Guido J., Sheth, Kevin N., Roh, David J., Elkind, Mitchell S.V., Hanley, Daniel F., Ziai, Wendy C., Murthy, Santosh B., Hanley, Daniel F., Butcher, Kenneth, Davis, Stephen M., Gregson, Barbara, Lees, Kennedy R., Lyden, Patrick D., Mayer, Stephan A., Muir, Keith, and Steiner, Thorsten

Published
2020
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15. Corrigendum: Sex-differences in oral anticoagulant-related intracerebral hemorrhage

Author

Grundtvig, Josefine, primary, Ovesen, Christian, additional, Steiner, Thorsten, additional, Carcel, Cheryl, additional, Gaist, David, additional, Christensen, Louisa, additional, Marstrand, Jacob, additional, Meden, Per, additional, Rosenbaum, Sverre, additional, Iversen, Helle K., additional, Kruuse, Christina, additional, Christensen, Thomas, additional, Ægidius, Karen, additional, Havsteen, Inger, additional, and Christensen, Hanne, additional

Published
2022
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17. Basic and Translational Research in Intracerebral Hemorrhage: Limitations, Priorities, and Recommendations

Author

Selim, Magdy, Hanley, Daniel, Broderick, Joseph, Goldstein, Joshua N., Gregson, Barbara A., Falcione, Guido, Gonzales, Nicole R., Gurol, Edip, Kersten, Jocelyn, Lewkowicz, Henry, Mendelow, A. David, Muehlschlegel, Susanne, Neuman, Richey, Palesch, Yuko, Rosenblum, Michael, Sheth, Kevin N., Singh, Vineeta, Ziai, Wendy, Keep, Richard F., Aronowski, Jaroslaw, Genstler, Curtis, James, Michael L., Ratan, Rajiv, Sansing, Lauren, Youd, Anna, Xi, Guohua, Zille, Marietta, Anderson, Craig, Awad, Issam, Bastings, Eric, Bednar, Martin, Coon, Alexander L., Gottesman, Rebecca, Katz, Bryan, Khan, Saima, Koenig, James, Koroshetz, Walter, Ling, Shari, Loftus, Christopher, Lockhardt, John, Louis, Thomas, Marler, John, Moy, Claudia, Peña, Carlos, Pollack, Charles, Omert, Laurel, Shah, Monica, Shoamanesh, Ashkan, Singer, Michael, Steiner, Thorsten, Torbey, Michel, Tymianski, Mike, Wakhloo, Ajay, Vespa, Paul, Zuccarello, Mario, and Zheng, Xiaolin

Published
2018
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18. Unmet Needs and Challenges in Clinical Research of Intracerebral Hemorrhage

Author

Selim, Magdy, Hanley, Daniel, Broderick, Joseph, Goldstein, Joshua N., Gregson, Barbara A., Falcione, Guido, Gonzales, Nicole R., Gurol, Edip, Kersten, Jocelyn, Lewkowicz, Henry, Mendelow, A. David, Muehlschlegel, Susanne, Neuman, Richey, Palesch, Yuko, Rosenblum, Michael, Sheth, Kevin N., Singh, Vineeta, Ziai, Wendy, Keep, Richard F., Aronowski, Jaroslaw, Genstler, Curtis, James, Michael L., Ratan, Rajiv, Sansing, Lauren, Youd, Anna, Xi, Guohua, Zille, Marietta, Anderson, Craig, Awad, Issam, Bastings, Eric, Bednar, Martin, Coon, Alexander L., Gottesman, Rebecca, Katz, Bryan, Khan, Saima, Koenig, James, Koroshetz, Walter, Ling, Shari, Loftus, Christopher, Lockhardt, John, Louis, Thomas, Marler, John, Moy, Claudia, Peña, Carlos, Pollack, Charles, Omert, Laurel, Shah, Monica, Shoamanesh, Ashkan, Singer, Michael, Steiner, Thorsten, Torbey, Michel, Tymianski, Mike, Wakhloo, Ajay, Vespa, Paul, Zuccarello, Mario, and Zheng, Xiaolin

Published
2018
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23. SARS-CoV-2 and Stroke Characteristics

Author

Shahjouei, Shima, Tsivgoulis, Georgios, Farahmand, Ghasem, Koza, Eric, Mowla, Ashkan, Vafaei Sadr, Alireza, Kia, Arash, Vaghefi Far, Alaleh, Mondello, Stefania, Cernigliaro, Achille, Ranta, Annemarei, Punter, Martin, Khodadadi, Faezeh, Naderi, Soheil, Sabra, Mirna, Ramezani, Mahtab, Amini Harandi, Ali, Olulana, Oluwaseyi, Chaudhary, Durgesh, Lyoubi, Aicha, Campbell, Bruce C.V., Arenillas, Juan F., Bock, Daniel, Montaner, Joan, Aghayari Sheikh Neshin, Saeideh, Aguiar de Sousa, Diana, Tenser, Matthew S., Aires, Ana, Alfonso, Mercedes de Lera, Alizada, Orkhan, Azevedo, Elsa, Goyal, Nitin, Babaeepour, Zabihollah, Banihashemi, Gelareh, Bonati, Leo H., Cereda, Carlo W., Chang, Jason J., Crnjakovic, Miljenko, De Marchis, Gian Marco, Del Sette, Massimo, Ebrahimzadeh, Seyed Amir, Farhoudi, Mehdi, Gandoglia, Ilaria, Gonçalves, Bruno, Griessenauer, Christoph J., Murat Hanci, Mehmet, Katsanos, Aristeidis H., Krogias, Christos, Leker, Ronen R., Lotman, Lev, Mai, Jeffrey, Male, Shailesh, Malhotra, Konark, Malojcic, Branko, Mesquita, Teresa, Mir Ghasemi, Asadollah, Mohamed Aref, Hany, Mohseni Afshar, Zeinab, Moon, Jusun, Niemelä, Mika, Rezai Jahromi, Behnam, Nolan, Lawrence, Pandhi, Abhi, Park, Jong-Ho, Marto, João Pedro, Purroy, Francisco, Ranji-Burachaloo, Sakineh, Carreira, Nuno Reis, Requena, Manuel, Rubiera, Marta, Sajedi, Seyed Aidin, Sargento-Freitas, João, Sharma, Vijay K., Steiner, Thorsten, Tempro, Kristi, Turc, Guillaume, Ahmadzadeh, Yasaman, Almasi-Dooghaee, Mostafa, Assarzadegan, Farhad, Babazadeh, Arefeh, Baharvahdat, Humain, Cardoso, Fabricio Buchadid, Dev, Apoorva, Ghorbani, Mohammad, Hamidi, Ava, Hasheminejad, Zeynab Sadat, Hojjat-Anasri Komachali, Sahar, Khorvash, Fariborz, Kobeissy, Firas, Mirkarimi, Hamidreza, Mohammadi-Vosough, Elahe, Misra, Debdipto, Noorian, Ali Reza, Nowrouzi-Sohrabi, Peyman, Paybast, Sepideh, Poorsaadat, Leila, Roozbeh, Mehrdad, Sabayan, Behnam, Salehizadeh, Saeideh, Saberi, Alia, Sepehrnia, Mercedeh, Vahabizad, Fahimeh, Yasuda, Thomas Alexandre, Ghabaee, Mojdeh, Rahimian, Nasrin, Harirchian, Mohammad Hossein, Borhani-Haghighi, Afshin, Azarpazhooh, Mahmoud Reza, Arora, Rohan, Ansari, Saeed, Avula, Venkatesh, Li, Jiang, Abedi, Vida, and Zand, Ramin

Subjects
Adult, Male, Risk, Original Contributions, International Cooperation, intracranial hemorrhages, Clinical and Population Sciences, Sinus Thrombosis, Intracranial, Young Adult, Humans, Prospective Studies, Aged, Ischemic Stroke, Venous Thrombosis, neuroimaging, Geography, COVID-19, cerebrovascular disorders, Middle Aged, stroke, Treatment Outcome, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Health Expenditures
Abstract

Supplemental Digital Content is available in the text., Background and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were

Published
2021

25. Sex-Differences in Oral Anticoagulant-Related Intracerebral Hemorrhage

Author

Grundtvig, Josefine, Ovesen, Christian, Steiner, Thorsten, Carcel, Cheryl, Gaist, David, Christensen, Louisa, Marstrand, Jacob, Meden, Per, Rosenbaum, Sverre, Iversen, Helle K., Kruuse, Christina, Christensen, Thomas, Ægidius, Karen, Havsteen, Inger, Christensen, Hanne, Grundtvig, Josefine, Ovesen, Christian, Steiner, Thorsten, Carcel, Cheryl, Gaist, David, Christensen, Louisa, Marstrand, Jacob, Meden, Per, Rosenbaum, Sverre, Iversen, Helle K., Kruuse, Christina, Christensen, Thomas, Ægidius, Karen, Havsteen, Inger, and Christensen, Hanne

Abstract

Introduction and Aim: Data remain limited on sex-differences in patients with oral anticoagulant (OAC)-related intracerebral hemorrhage (ICH). We aim to explore similarities and differences in risk factors, acute presentation, treatments, and outcome in men and women admitted with OAC-related ICH. Method: This study was a retrospective observational study based on 401 consecutive patients with OAC-related ICH admitted within 24 h of symptom onset. The study was registered on osf.io. We performed logarithmic regression and cox-regression adjusting for age, hematoma volume, Charlson Comorbidity Index (CCI), and pre-stroke modified Ranking Scale (mRS). Gender and age were excluded from CHA2DS2-VASc and CCI was not adjusted for age. Results: A total of 226 men and 175 women were identified. More men were pre-treated with vitamin K-antagonists (73.5% men vs. 60.6% women) and more women with non-vitamin K-antagonist oral anticoagulants (26.5% men vs. 39.4% women), p = 0.009. Women were older (mean age 81.9 vs. 76.9 years, p < 0.001). CHA2DS2-VASc and CCI were similar in men and women. Hematoma volumes (22.1 ml in men and 19.1 ml in women) and National Institute of Health Stroke Scale (NIHSS) scores (13 vs. 13) were not statistically different, while median Glasgow Coma Scale (GCS) was lower in women, (14 [8;15] vs. 14 [10;15] p = 0.003). Women's probability of receiving reversal agents was significantly lower (adjusted odds ratio [aOR] = 0.52, p = 0.007) but not for surgical clot removal (aOR = 0.56, p = 0.25). Women had higher odds of receiving do-not-resuscitate (DNR) orders within a week (aOR = 1.67, p = 0.04). There were no sex-differences in neurological deterioration (aOR = 1.48, p = 0.10), ability to walk at 3 months (aOR = 0.69, p = 0.21) or 1-year mortality (adjusted hazard ratio = 1.18, p = 0.27). Conclusion: Significant sex-differences were observed in age, risk factors, access to treatment, and DNRs while no si

Published
2022

26. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

Author

Easton, J. Donald, Aunes, Maria, Albers, Gregory W., Amarenco, Pierre, Bokelund-Singh, Sara, Denison, Hans, Evans, Scott R., Held, Peter, Jahreskog, Marianne, Jonasson, Jenny, Minematsu, Kazuo, Molina, Carlos A., Wang, Yongjun, Wong, K.S. Lawrence, Johnston, S. Claiborne, Ameriso, Sebastiá F., Donnan, Geoffrey, Lemmens, Robin, Massaro, Ayrton, Titianova, Ekaterina, Hill, Michael D., Lavados, Pablo, Skoloudik, David, Röther, Joachim, Norbert, Szegedi, Agnelli, Giancarlo, Bornstein, Natan, Tanahashi, Norio, Góngora, Angel Arauz, Pretell, Edwin, San Jose, Maria Cristina Z., Czlonkowska, Anna, Bajenaru, Ovidiu, Stakhovskaya, Ludmila, Brozman, Miroslav, Kim, Jong-Sung, Wahlgren, Nils, Michel, Patrik, Lee, Tsong Hai, Suwanwela, Nijasri Charnnarong, Kutluk, Kursad, Moskovko, Sergii, Kasner, Scott, Laskowitz, Daniel, Clark, Wayne, Nguyen, Huy Thang, Ameriso, Sebastian, Lepera, Sandra, Romano, Marina, Paulon, David, Ioli, Pablo, Zurru, Cristina, Bruera, Guadalupe, Jure, Lorena, Klein, Francisco, Povedano, Guillermo, Levi, Christopher, Phan, Thanh, Markus, Romesh, Anderson, Craig, Sabet, Arman, Davis, Stephen, Lee, Andrew, Kleinig, Timothy, Wong, Andrew, Krause, Martin, Jannes, Jim, Wijeratne, Tissa, Lemmens, Robin, Hemelsoet, Dimitri, Peeters, André, Tack, Philippe, Vanacker, Peter, Laloux, Patrice, Van Landegem, William, Vanhooren, Geert, Desfontaines, Philippe, Van Orshoven, Marc, Oliveira, Fabio, Friedrich, Mauricio, Brondani, Rosane, Gagliardi, Rubens, Fabio, Soraia, Dracoulakis, Marianna, Bazan, Rodrigo, Marrone, Luiz, Pontes Neto, Octavio, Silva, Gisele, Kowacs, Pedro, Titianova, Ekaterina, Stamenova, Paraskeva, Daskalov, Marin, Staikov, Ivan, Baldaranov, Dimo, Maslarov, Dimitar, Lilovski, Hristo, Petkov, Plamen, Petrova, Neli, Mavrov, Radoslav, Markova, Veska, Petrova, Valeria, Beleva, Tanya, Kralev, Borislav, Sotirov, Nikolay, Lekova, Veska, Hristov, Dimcho, Ermenkova, Vera, Mateev, Lyudmil, Mitkova, Rumeliya, Haralanov, Liybomir, Ikonomov, Rosen, Mihailova, Margarita, Georgiev, Ivan, Shuaib, Ashfaq, Hachinski, Vladimir, Boulanger, Jean-Martin, Mann, Sharan, Hassan, Ayman, Mackey, Ariane, Menon, Bijoy, Minuk, Jeffrey, Siddiqui, Muzaffar, Eustace, Marsha, Vieira, Lucia, Selchen, Daniel, Beaudry, Michel, Stotts, Grant, Lavados, Pablo, Castro, Angel, Gasic, Kristo, Rivas, Rodrigo, Sanchez, Pablo, Roldan, Andres, Grossmann, Ingrid, Figueroa, Christian, Li, Jimei, Xu, Xiaolin, Chen, Huisheng, Li, Xiaohong, Yang, Yi, Zhang, Chunsheng, Wang, Baojun, Li, Guanglai, Wang, Dong, Lin, Hong, Tang, Yamei, Xu, Anding, Wang, Yanjiang, Hong, Wenke, Song, Zhi, Zhang, Xu, Jin, Xiaoping, Xu, Yun, Yan, Fuling, Zheng, Weihong, Wang, Xiaoping, Dong, Qiang, Zhao, Zhongxin, Zhang, Baorong, Zhong, Wangtao, Wen, Guoqiang, Xu, Jun, Li, Guozhong, Dong, Xueshuang, Tian, Xiangyang, Zhang, Zhaohui, Xu, En, Liu, Kaixiang, Chen, Jun, Skoda, Ondrej, Skoloudik, David, Ehler, Edvard, Vaclavik, Daniel, Sanak, Daniel, Klimosova, Sylva, Vitkova, Eva, Fiksa, Jan, Mikulik, Robert, Neumann, Jiri, Plny, Richard, Leys, Didier, Sibon, Igor, Mas, Jean-Louis, Alamowitch, Sonia, Pico, Fernando, Hosseini, Hassan, Mahagne, Marie-Hélène, Touze, Emmanuel, Vadot, Wilfried, Vannier, Stéphane, Nighoghossian, Norbert, Samson, Yves, Garnier, Pierre, Ellie, Emmanuel, Guillon, Benoît, Timsit, Serge, Giroud, Maurice, Philippeau, Frédéric, Bagan-Triquenot, Aude, Wolff, Valérie, Raposo, Nicolas, Obadia, Michel, Debiais, Severine, Grimaud, Jérôme, Illouz, Stéphane, Smadja, Didier, Urbanczyk, Cédric, Röther, Joachim, Berrouschot, Jörg, Weimar, Christian, Gahn, Georg, Soda, Hassan, Klimpe, Sven, Nabavi, Darius, Glahn, Jörg, Köhrmann, Martin, Krause, Lars, Terborg, Christoph, Urban, Peter, Steiner, Thorsten, Ferbert, Andreas, Dziewas, Rainer, Seidel, Günter, Thomalla, Götz, Li, Richard, Fong, Wing Chi, Cheung, Raymond, Szegedi, Norbert, Pozsegovits, Krisztián, Valikovics, Attila, Pánczél, Gyula, Rózsa, Csilla, Németh, László, Diószeghy, Péter, Óváry, Csaba, Csányi, Attila, Kerényi, Levente, Nagy, Valéria, Komoly, Sámuel, Bereczki, Dániel, Molnár, Sándor, Kondákor, István, Tanne, David, Raphaeli, Guy, Telman, Gregory, Bornstein, Natan, Leker, Ronen, Lampl, Yair, Agnelli, Giancarlo, Corea, Francesco, Ricci, Stefano, Guidetti, Donata, Malferrari, Giovanni, Marcheselli, Simona, Micieli, Giuseppe, Zini, Andrea, Di Lazzaro, Vincenzo, Gandolfo, Carlo, Salmaggi, Andrea, Tassi, Rossana, Rasura, Maurizia, Orlandi, Giovanni, Comi, Giancarlo, Ricci, Stefano, Mancuso, Michelangelo, Delodovici, Marialuisa, Bovi, Paolo, Consoli, Domenico, Utsugisawa, Kimiaki, Fujita, Tsuneo, Kurihara, Hideyuki, Maruki, Chikashi, Hayashi, Takeshi, Ogiichi, Tsuneaki, Kumagai, Morio, Takenaka, Katsunobu, Toyoda, Kazunori, Takamatsu, Kazuhiro, Ogami, Ryo, Kin, Shigenari, Aoki, Takeshi, Takizawa, Katsumi, Omori, Shigehiro, Umezawa, Takehiko, Toba, Yasuyuki, Nonoyama, Yutaka, Nakagawa, Hidemitsu, Naka, Takashi, Morimoto, Masanori, Matsumoto, Shuichi, Hitotsumatsu, Tsutomu, Shingaki, Tatsuya, Okuda, Satoshi, Ota, Mamoru, Sakai, Nobuyuki, Yamada, Takeshi, Niwa, Jun, Fujita, Hitoshi, Moriki, Akihito, Yoshino, Kimihiro, Fukushima, Yoshihisa, Mori, Takahisa, Sato, Atsushi, Kusano, Yoshikazu, Kubo, Michiya, Yamazaki, Masashi, Ooasa, Takao, Nishizaki, Takafumi, Kitagawa, Naoki, Yasaka, Masahiro, Manabe, Yasuhiro, Yoshioka, Akira, Ishihara, Masayuki, Kagawa, Takato, Ichihashi, Toshikazu, Matsuoka, Hideki, Ito, Yasuhiro, Yamasaki, Masahiro, Takaba, Hitonori, Saito, Hisatoshi, Sato, Masahiro, Fukuda, Kazumasa, Endo, Sumio, Kidooka, Minoru, Umemura, Toshitaka, Kikkawa, Yuriko, Toru, Shuta, Yamada, Kentaro, Sakai, Hideki, Asari, Jun, Ezura, Masayuki, Nitta, Hisashi, Nagano, Keiko, Ochiai, Jun, Sakai, Keiichi, Kobayashi, Yasutaka, Yoshii, Yasuhiro, Miake, Hirotomo, Takita, Tomohiro, Taniguchi, Hidekazu, Kuroki, Kazuhiko, Mizota, Takamitsu, Yamamoto, Kenichi, Nakane, Hiroshi, Iwanaga, Takeshi, Chiba, Kei, Yoshimoto, Tetsuyuki, Torii, Tsuyoshi, Kitagawa, Takeo, Takashima, Hiroshi, Shirasaki, Naoki, Dehara, Makoto, Wada, Naomichi, Hamada, Kensuke, Kato, Noriyuki, Go, Yoshinori, Izumi, Ichiro, Ninomiya, Hirotomo, Kumai, Junichiro, Nakajima, Yoshikazu, Kaku, Yasuhiko, Isayama, Yukihiro, Kawanishi, Masahiro, Noda, Shinya, Yamamoto, Kazuhide, Hazama, Takanori, Takahashi, Hiroshi, Tanaka, Yohei, Hata, Takashi, Kazekawa, Kiyoshi, Furui, Eisuke, Hondo, Hideki, Sato, Nobuyuki, Kusunoki, Katsusuke, Nanri, Kazunori, Abe, Satoshi, Sasaoka, Noboru, Kuroyanagi, Takayuki, Suzuki, Hisahiko, Fukuyama, Kouzou, Nakahara, Kimihiro, Gongora, Fernando, Góngora, Angel Arauz, Cantú Brito, Carlos, Villarreal Careaga, Jorge, Vazquez Alfaro, Rosalia, Aguayo Leytte, Geronimo, Berrospi, Percy, Chavez, Carlos, Pretell, Edwin, Rodriguez, Liliana, Custodio, Nilton, Castañeda, Cesar, Perez, Julio, San Jose, Maria Cristina, Baroque, Alejandro, Collantes, Epifania, Aquino, Abdias, Díaz, Alejandro, Roxas, Artemio, Jr, Lokin, Johnny, Advincula, Joel, Calderon, Emerito, Navarro, Jose, Hiyadan, John, Surdilla, Arturo, Czlonkowska, Anna, Ryglewicz, Danuta, Krychowiak, Grzegorz, Fryze, Waldemar, Sobolewski, Piotr, Nowak, Ryszard, Fiszer, Urszula, Papierowska, Beata, Zielińska-Turek, Justyna, Lasek-Bal, Anetta, Kołodziejska, Ewa, Kamińska, Anna, Adamkiewicz, Bożena, Tutaj, Andrzej, Szkopek, Dorota, Musiatowicz, Krzysztof, Bąk, Zbigniew, Brzozowski, Sławomir, Brola, Waldemar, Ferens, Antoni, Zalisz, Marek, Rejdak, Konrad, Rudzińska, Monika, Bajenaru, Ovidiu, Panea, Cristina, Simu, Mihaela, Balasa, Rodica, Cuciureanu, Iulian, Popescu, Bogdan, Sabau, Monica, Roman-Filip, Corina, Pimenov, Leonid, Gekht, Alla, Milto, Anna, Shchukin, Ivan, Parfenov, Vladimir, Stakhovskaya, Liudmila, Arkhipov, Mikhail, Sokolova, Nadezhda, Bogdanov, Enver, Esin, Radiy, Khasanova, Dina, Golikov, Konstantin, Melnikova, Elena, Zaslavskiy, Leonid, Voznyuk, Igor, Nazarov, Alexander, Akhmadeeva, Leila, Iakupova, Aida, Shamalov, Nikolay, Belskaya, Galina, Chuprina, Svetlana, Denisova, Olga, Drozdova, Ekaterina, Karakulova, Yuliya, Sholomov, Ilya, Spirin, Nikolay, Vostrikova, Elena, Mordvintseva, Elena, Grigoryeva, Vera, Zateyshchikov, Dmitry, Gorbachev, Vladimir, Chefranova, Zhanna, Dudarev, Mikhail, Nilk, Rostislav, Rozhdestvenskiy, Alexey, Gurcik, Ladislav, Dvorak, Miloslav, Krastev, Georgi, Kurca, Egon, Vyletelka, Juraj, Brozman, Miroslav, Kim, Jong Sung, Bae, Hee-Joon, Kim, Yong-Won, Kim, Joon-Tae, Cha, Jae-Kwan, Nam, Hyo Suk, Chang, Dae-Il, Lee, Yong-Seok, Oh, Kyungmi, Yu, Sung-Wook, Sohn, Sung-Il, Lee, Jun, Cho, Han Jin, Kim, Eung-Gyu, Rha, Joung-Ho, Kim, Seo Hyun, Molina Cateriano, Carlos, Serena Leal, Joaquín, Vivancos Mora, José, Rodríguez Yañez, Manuel, Roquer González, Jaume, Purroy García, Francisco, Gomis Cortina, Meritxell, Masjuan Vallejo, Jaime, Arenillas Lara, Juan, Segura Martín, Tomás, Herrero, José Antonio Egido, Tembl Ferrairó, Jose Ignacio, Gállego Culleré, Jaime, Moniche Álvarez, Francisco, Steinberg, Anna, Callander, Margarita, Laska, Ann Charlotte, Bokemark, Lena, Mooe, Thomas, Käll, Tor-Björn, Welin, Lennart, Sjöblom, Lars, Hambraeus, Joakim, Teichert, Jörg, Wannberg, Hans, Sanner, Johan, Ramströmer, Bo, Ziedén, Bo, Hau, Stefan Olsson, Gustafsson, Claes, Michel, Patrik, Kahles, Timo, Lyrer, Philippe, Arnold, Marcel, Liesch, Martin, Medlin, Friedrich, Cereda, Carlo, Kägi, Georg, Luft, Andreas, Carrera, Emmanuel, Lee, Tsong-Hai, Po, Helen L., Chern, Chang-Ming, Lien, Li-Ming, Chan, Lung, Liu, Chung-Hsiang, Wu, Shey-Lin, Lee, Jiann-Der, Chen, Chih-Hung, Lin, Huey-Juan, Lin, Ruey-Tay, Chen, Wei-Hsi, Sun, Yu, Suwanwela, Nijasri Charnnarong, Tantirittisak, Tasanee, Muengtaweepongsa, Sombat, Nilanont, Yongchai, Tiamkao, Somsak, Udommongkol, Chesda, Watcharasaksilp, Kanokwan, Jantararotai, Witoon, Kutluk, Kursad, Sirin, Hadiye, Ince, Birsen, Asil, Talip, Arsava, Murat, Incesu, Tulay Kurt, Tireli, Hulya, Kucukoglu, Hayriye, Ak, Fikri, Unal, Ali, Ozturk, Serefnur, Uzuner, Nevzat, Chmyr, Galyna, Lebedynets, Volodymyr, Nikonov, Vadym, Shulga, Lyudmyla, Smolanka, Volodymyr, Moskovko, Sergii, Khavunka, Marta, Yavorska, Valentyna, Tomakh, Nataliya, Kozyolkin, Olexandr, Litovaltseva, Galyna, Lansberg, Maarten, Bernstein, Richard, Brown, David, Clark, Wayne, Dissin, Jonathan, Graffagnino, Carmelo, Harris, Jonathan, Hicks, William, Kasner, Scott, Katzan, Irene, Kramer, Jeffrey, Willey, Joshua, Silliman, Scott, Starkman, Sidney, Thaler, David, Tremwel, Margaret, Concha, Mauricio, Rajamani, Kumar, Dandapani, Bhuvaneswari, Silver, Brian, Deal, Nathan, Chang, Ira, Hassan, Ameer, Rudolph, Steven, Fischer, Kenneth, Kirshner, Howard, Logan, William, Mallenbaum, Sidney, Hefzy, Hebah, Latorre, Julius, Levine, Steven, Ciabarra, Anthony, Dafer, Rima, Anyanwu, Benjamin, Cherian, Laurel, Panezai, Spozhmy, Khanna, Anna, Dodds, Jodi, Torbey, Michel, Gebel, James, Woo, Henry, Chiu, David, Androulakis, Xiao, Burgin, William, Pineda, Maria, Yilmaz, Engin, Altafullah, Irfan, Boutwell, Christine, Cruz-Flores, Salvador, Sapkota, Biggya, Fayad, Pierre, Jacoby, Michael, Rafiq, Shahid, Salgado, Efrain, Lafranchise, Eugene, Felton, Warren, Madhavan, Ramesh, Zaidat, Osama, Pieper, Connie, Riviello, Ralph, Burnett, Aaron, Fischer, Michelle, Gentile, Nina, Calder, Christopher, Dietrich, Dennis, Cross, Jonathan, Blankenship, Larry, Dafer, Rima, Montoya, Liliana, Grogan, Wendell, Young, Mark, Khan, Farrukh, Campbell, Duane, Daboul, Nizar, Espinoza, Andrey, Cullis, Paul, Concepcion, Gilberto, Wulff, John, Afzal, Haider, Jaffrani, Naseem, Reiter, William, Arshad, Tamjeed, Lukovits, Timothy, Welker, James, Chang, Fen Lei, Badruddin, Aamir, Babikian, Viken, Menon, Ravi, Sander, James, Springer, Mellanie, Nanda, Ashish, Mas, Luis, Rajan, Raj, Silverman, Bruce, Hefzy, Hebah, Huang, David, Carpenter, David, Clark, Joni, Ching, Marilou, Santhakumar, Sunitha, Gould, Jeffrey, Bansal, Vibhav, Vidal, Gabriel, Mikesell, Timothy, Brick, John, French, William, Shah, Qaisar, Holmstedt, Christine, Ishag-Osman, Nadir, Kostis, John, Shehadeh, Abbas, Sethi, Pramodkumak, Imam, Asher, Mccomas, Carl, Tran, Duc, Gebreyohanns, Mehari, Wiseman, Brian, Malik, Maheen, Schwarcz, Aron, Altschul, Dorothea, Castaldo, John, Alshekhlee, Amer, Gancher, Stephen, Krish, Nagesh, Nguyen-Huynh, Mai, Tremwell, Margaret, Sharma, Jitendra, Lee, Lance, Neil, William, Siddiqui, Fazeel, Malek, Ali, Romero, Charles, Huy, Thang Nguyen, Hoang, Hoa, Nguyen, Thang, Nguyen, Anh, and Nguyen, Hung

Published
2017
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29. Sex-Differences in Oral Anticoagulant-Related Intracerebral Hemorrhage

Author

Grundtvig, Josefine, primary, Ovesen, Christian, additional, Steiner, Thorsten, additional, Carcel, Cheryl, additional, Gaist, David, additional, Christensen, Louisa, additional, Marstrand, Jacob, additional, Meden, Per, additional, Rosenbaum, Sverre, additional, Iversen, Helle K., additional, Kruuse, Christina, additional, Christensen, Thomas, additional, Ægidius, Karen, additional, Havsteen, Inger, additional, and Christensen, Hanne, additional

Published
2022
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30. sj-pdf-1-eso-10.1177_23969873221079413 ��� Supplemental Material for European Stroke Organisation (ESO) guidelines on mobile stroke units for prehospital stroke management

Author

Walter, Silke, Audebert, Heinrich J, Katsanos, Aristeidis H, Larsen, Karianne, Sacco, Simona, Steiner, Thorsten, Turc, Guillaume, and Tsivgoulis, Georgios

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental Material, sj-pdf-1-eso-10.1177_23969873221079413 for European Stroke Organisation (ESO) guidelines on mobile stroke units for prehospital stroke management by Silke Walter, Heinrich J Audebert, Aristeidis H Katsanos, Karianne Larsen, Simona Sacco, Thorsten Steiner, Guillaume Turc and Georgios Tsivgoulis in European Stroke Journal

Published
2022
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32. Abstract TP20: Intravenous Glibenclamide For Large Hemispheric Infarction: Baseline Data From Initial Enrollees In The Charm Phase 3 Study

Author

Sheth, Kevin N, primary, Kimberly, W Taylor, additional, Albers, Gregory W, additional, Campbell, Bruce C, additional, Cordonnier, Charlotte, additional, Hinson, H E, additional, Molyneaux, Bradley J, additional, Nogueira, Raul G, additional, Saver, Jeffrey L, additional, Steiner, Thorsten, additional, Toyoda, Kazunori, additional, Wintermark, Max, additional, Hareedy, Randa, additional, Wald, Michael, additional, Zhang, Ray, additional, Ziogas, Nikolaos K, additional, and Rizzo, Marco, additional

Published
2022
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33. Multicenter prospective analysis of hypertrophic olivary degeneration following infratentorial stroke (HOD-IS): evaluation of disease epidemiology, clinical presentation, and MR-imaging aspects

Author

Schaller-Paule, Martin A., Steidl, Eike, Shrestha, Manoj, Deichmann, Ralf, Steinmetz, Helmuth, Seiler, Alexander, Lapa, Sriramya, Steiner, Thorsten, Thonke, Sven, Weidauer, Stefan, Konczalla, Jürgen, Hattingen, Elke, and Förch, Christian

Subjects
ddc:610
Abstract

Introduction: Ischemic and hemorrhagic strokes in the brainstem and cerebellum with injury to the functional loop of the Guillain-Mollaret triangle (GMT) can trigger a series of events that result in secondary trans-synaptic neurodegeneration of the inferior olivary nucleus. In an unknown percentage of patients, this leads to a condition called hypertrophic olivary degeneration (HOD). Characteristic clinical symptoms of HOD progress slowly over months and consist of a rhythmic palatal tremor, vertical pendular nystagmus, and Holmes tremor of the upper limbs. Diffusion Tensor Imaging (DTI) with tractography is a promising method to identify functional pathway lesions along the cerebello-thalamo-cortical connectivity and to generate a deeper understanding of the HOD pathophysiology. The incidence of HOD development following stroke and the timeline of clinical symptoms have not yet been determined in prospective studies—a prerequisite for the surveillance of patients at risk. Methods and Analysis: Patients with ischemic and hemorrhagic strokes in the brainstem and cerebellum with a topo-anatomical relation to the GMT are recruited within certified stroke units of the Interdisciplinary Neurovascular Network of the Rhine-Main. Matching lesions are identified using a predefined MRI template. Eligible patients are prospectively followed up and present at 4 and 8 months after the index event. During study visits, a clinical neurological examination and brain MRI, including high-resolution T2-, proton-density-weighted imaging, and DTI tractography, are performed. Fiberoptic endoscopic evaluation of swallowing is optional if palatal tremor is encountered. Study Outcomes: The primary endpoint of this prospective clinical multicenter study is to determine the frequency of radiological HOD development in patients with a posterior fossa stroke affecting the GMT at 8 months after the index event. Secondary endpoints are identification of (1) the timeline and relevance of clinical symptoms, (2) lesion localizations more prone to HOD occurrence, and (3) the best MR-imaging regimen for HOD identification. Additionally, (4) DTI tractography data are used to analyze individual pathway lesions. The aim is to contribute to the epidemiological and pathophysiological understanding of HOD and hereby facilitate future research on therapeutic and prophylactic measures.

Published
2021

34. Association of Serum IL-6 with Functional Outcome after Intracerebral Hemorrhage

Author

Leasure, Audrey C., Kuohn, Lindsey R., Vanent, Kevin N., Bevers, Matthew B., Kimberly, W. Taylor, Steiner, Thorsten, Mayer, Stephan A., Matouk, Charles C., Sansing, Lauren H., Falcone, Guido J., and Sheth, Kevin N.

Subjects
Male, Interleukin-6, Patient Acuity, Brain Edema, Factor VIIa, Middle Aged, Article, Recombinant Proteins, nervous system diseases, Double-Blind Method, Humans, Female, Aged, Cerebral Hemorrhage
Abstract

BACKGROUND AND OBJECTIVES: Interleukin 6 (IL-6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH). METHODS: We performed an exploratory analysis of the recombinant activated factor VII for acute ICH (FAST) trial. Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin scale (mRS). In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema (PHE) volumes. RESULTS: Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (mRS 4–6) (per additional 1 ng/L, OR 1.30; 95% CI 1.04–1.63; p=0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex and ICH location, and this association was modified by location (multivariable interaction p=0.002), with a stronger association seen in lobar (β 12.51, 95% CI 6.47–18.55, p

Published
2021

35. Multicenter Prospective Analysis of Hypertrophic Olivary Degeneration Following Infratentorial Stroke (HOD-IS): Evaluation of Disease Epidemiology, Clinical Presentation, and MR-Imaging Aspects

Author

Schaller-Paule, Martin A., primary, Steidl, Eike, additional, Shrestha, Manoj, additional, Deichmann, Ralf, additional, Steinmetz, Helmuth, additional, Seiler, Alexander, additional, Lapa, Sriramya, additional, Steiner, Thorsten, additional, Thonke, Sven, additional, Weidauer, Stefan, additional, Konczalla, Juergen, additional, Hattingen, Elke, additional, and Foerch, Christian, additional

Published
2021
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36. Clinical Outcome After Endovascular Thrombectomy in 3 Triage Concepts: A Prospective, Observational Study (NEUROSQUAD)

Author

Seker, Fatih, primary, Fiehler, Jens, additional, Möhlenbruch, Markus A., additional, Herweh, Christian, additional, Flottmann, Fabian, additional, Ringleb, Peter A., additional, Thomalla, Götz, additional, Steiner, Thorsten, additional, Kraemer, Christoffer, additional, Brekenfeld, Caspar, additional, and Bendszus, Martin, additional

Published
2021
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38. European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage

Author

Sandset, Else Charlotte, primary, Anderson, Craig S, additional, Bath, Philip M, additional, Christensen, Hanne, additional, Fischer, Urs, additional, Gąsecki, Dariusz, additional, Lal, Avtar, additional, Manning, Lisa S, additional, Sacco, Simona, additional, Steiner, Thorsten, additional, and Tsivgoulis, Georgios, additional

Published
2021
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39. sj-pdf-1-eso-10.1177_23969873211014112 - Supplemental material for European Stroke Organisation (ESO) guidelines on the management of space-occupying brain infarction

Author

H Bart Van Der Worp, Hofmeijer, Jeannette, Jüttler, Eric, Lal, Avtar, Michel, Patrik, Santalucia, Paola, Schönenberger, Silvia, Steiner, Thorsten, and Thomalla, Götz

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-1-eso-10.1177_23969873211014112 for European Stroke Organisation (ESO) guidelines on the management of space-occupying brain infarction by H Bart van der Worp, Jeannette Hofmeijer, Eric Jüttler, Avtar Lal, Patrik Michel, Paola Santalucia, Silvia Schönenberger, Thorsten Steiner and Götz Thomalla in European Stroke Journal

Published
2021
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40. sj-pdf-1-eso-10.1177_23969873211008770 - Supplemental material for Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017

Author

Grundtvig, Josefine, Ovesen, Christian, Havsteen, Inger, Christensen, Thomas, Gaist, David, Iversen, Helle K, Kruuse, Christina, Lilja-Cyron, Alexander, Ægidius, Karen, Rosenbaum, Sverre, Meden, Per, Marstrand, Jacob, Christensen, Louisa, Steiner, Thorsten, and Christensen, Hanne

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-1-eso-10.1177_23969873211008770 for Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017 by Josefine Grundtvig, Christian Ovesen, Inger Havsteen, Thomas Christensen, David Gaist, Helle K Iversen, Christina Kruuse, Alexander Lilja-Cyron, Karen Ægidius, Sverre Rosenbaum, Per Meden, Jacob Marstrand, Louisa Christensen, Thorsten Steiner and Hanne Christensen: ; for the PHYS-Stroke study group in European Stroke Journal

Published
2021
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41. European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage

Author

Sandset, Else Charlotte Anderson, Craig S. Bath, Philip M. and Christensen, Hanne Fischer, Urs Gasecki, Dariusz Lal, Avtar and Manning, Lisa S. Sacco, Simona Steiner, Thorsten and Tsivgoulis, Georgios

Abstract

The optimal blood pressure (BP) management in acute ischaemic stroke (AIS) and acute intracerebral haemorrhage (ICH) remains controversial. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist physicians in their clinical decisions regarding BP management in acute stroke. The guidelines were developed according to the ESO standard operating procedure and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. Despite several large randomised-controlled clinical trials, quality of evidence is generally low due to inconsistent results of the effect of blood pressure lowering in AIS. We recommend early and modest blood pressure control (avoiding blood pressure levels >180/105 mm Hg) in AIS patients undergoing reperfusion therapies. There is more high-quality randomised evidence for BP lowering in acute ICH, where intensive blood pressure lowering is recommended rapidly after hospital presentation with the intent to improve recovery by reducing haematoma expansion. These guidelines provide further recommendations on blood pressure thresholds and for specific patient subgroups. There is ongoing uncertainty regarding the most appropriate blood pressure management in AIS and ICH. Future randomised-controlled clinical trials are needed to inform decision making on thresholds, timing and strategy of blood pressure lowering in different acute stroke patient subgroups.

Published
2021

42. sj-pdf-1-eso-10.1177_23969873211012133 - Supplemental material for European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage

Author

Sandset, Else Charlotte, Anderson, Craig S, Bath, Philip M, Christensen, Hanne, Fischer, Urs, Gąsecki, Dariusz, Lal, Avtar, Manning, Lisa S, Sacco, Simona, Steiner, Thorsten, and Tsivgoulis, Georgios

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-1-eso-10.1177_23969873211012133 for European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage by Else Charlotte Sandset, Craig S Anderson, Philip M Bath, Hanne Christensen, Urs Fischer, Dariusz Gąsecki, Avtar Lal, Lisa S Manning, Simona Sacco, Thorsten Steiner and Georgios Tsivgoulis in European Stroke Journal

Published
2021
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43. Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients with or without Spot Sign

Author

Ovesen, Christian, Jakobsen, Janus Christian, Gluud, Christian, Steiner, Thorsten, Law, Zhe, Flaherty, Katie, Dineen, Rob A., Christensen, Louisa M., Overgaard, Karsten, Rasmussen, Rune S., Bath, Philip M., Sprigg, Nikola, Christensen, Hanne, Ovesen, Christian, Jakobsen, Janus Christian, Gluud, Christian, Steiner, Thorsten, Law, Zhe, Flaherty, Katie, Dineen, Rob A., Christensen, Louisa M., Overgaard, Karsten, Rasmussen, Rune S., Bath, Philip M., Sprigg, Nikola, and Christensen, Hanne

Abstract

Background and Purpose: The computed tomography angiography or contrast-enhanced computed tomography based spot sign has been proposed as a biomarker for identifying on-going hematoma expansion in patients with acute intracerebral hemorrhage. We investigated, if spot-sign positive participants benefit more from tranexamic acid versus placebo as compared to spot-sign negative participants. Methods: TICH-2 trial (Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage) was a randomized, placebo-controlled clinical trial recruiting acutely hospitalized participants with intracerebral hemorrhage within 8 hours after symptom onset. Local investigators randomized participants to 2 grams of intravenous tranexamic acid or matching placebo (1:1). All participants underwent computed tomography scan on admission and on day 2 (24±12 hours) after randomization. In this sub group analysis, we included all participants from the main trial population with imaging allowing adjudication of spot sign status. Results: Of the 2325 TICH-2 participants, 254 (10.9%) had imaging allowing for spot-sign adjudication. Of these participants, 64 (25.2%) were spot-sign positive. Median (interquartile range) time from symptom onset to administration of the intervention was 225.0 (169.0 to 310.0) minutes. The adjusted percent difference in absolute day-2 hematoma volume between participants allocated to tranexamic versus placebo was 3.7% (95% CI,-12.8% to 23.4%) for spot-sign positive and 1.7% (95% CI,-8.4% to 12.8%) for spot-sign negative participants (Pheterogenity=0.85). No difference was observed in significant hematoma progression (dichotomous composite outcome) between participants allocated to tranexamic versus placebo among spot-sign positive (odds ratio, 0.85 [95% CI, 0.29 to 2.46]) and negative (odds ratio, 0.77 [95% CI, 0.41 to 1.45]) participants (Pheterogenity=0.88). Conclusions: Data from the TICH-2 trial do not support that admission spot sign status

Published
2021

44. Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017

Author

Grundtvig, Josefine, Ovesen, Christian, Havsteen, Inger, Christensen, Thomas, Gaist, David, Iversen, Helle K., Kruuse, Christina, Lilja-Cyron, Alexander, Ægidius, Karen, Rosenbaum, Sverre, Meden, Per, Marstrand, Jacob, Christensen, Louisa, Steiner, Thorsten, Christensen, Hanne, Grundtvig, Josefine, Ovesen, Christian, Havsteen, Inger, Christensen, Thomas, Gaist, David, Iversen, Helle K., Kruuse, Christina, Lilja-Cyron, Alexander, Ægidius, Karen, Rosenbaum, Sverre, Meden, Per, Marstrand, Jacob, Christensen, Louisa, Steiner, Thorsten, and Christensen, Hanne

Abstract

Introduction: Non-vitamin K-antagonist oral anticoagulants (NOAC) have become first choice oral anticoagulant (OAC) with decreasing use of vitamin K antagonists (VKA), partly due to lower risk of intracerebral hemorrhage (ICH). Aim: to identify trends in sale of OACs and relate them to trends in OAC-related ICH (OAC-ICH). Patients and methods: Study was based on the population in the Capital Region of Denmark (1.8 million inhabitants). We identified all patients admitted with a non-traumatic OAC-ICH in 2010–2017 and ascertained diagnosis and drug use through medical charts. We used information available in the public domain on sale of defined daily doses (DDD) of OAC in the Capital Region of Denmark. Results: 453 patients with OAC-ICH out of a total of 2877 ICH-events were identified. From 2010 to 2017 sale of NOAC rose from 0.1 to 11.8 DDD/1000 inhabitants/day (p < 0.001); while VKA sale decreased from 7.6 to 5.2 DDD/1000 inhabitants/day (p < 0.001). The total number of ICH events was stable between 2010 and 2017, but the proportion of OAC-ICH events increased from 13% in 2010 to 22% in 2017 (p < 0.001). The proportion of ICH events related to NOAC had a significant increasing trend (p < 0.001), whereas a decreasing trend was observed for VKA (p = 0.04). Discussion: In Denmark, the population on OACs has increased; resulting from increased use of NOACs. Parallel to this development, the proportion of OAC-ICH overall has increased based on an increasing trend in NOAC-related ICH. Conclusion: Our findings document a need for further research on prevention and treatment of this complication.

Published
2021

45. European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage

Author

Sandset, Else Charlotte, Anderson, Craig S., Bath, Philip M., Christensen, Hanne, Fischer, Urs, Gąsecki, Dariusz, Lal, Avtar, Manning, Lisa S., Sacco, Simona, Steiner, Thorsten, Tsivgoulis, Georgios, Sandset, Else Charlotte, Anderson, Craig S., Bath, Philip M., Christensen, Hanne, Fischer, Urs, Gąsecki, Dariusz, Lal, Avtar, Manning, Lisa S., Sacco, Simona, Steiner, Thorsten, and Tsivgoulis, Georgios

Abstract

The optimal blood pressure (BP) management in acute ischaemic stroke (AIS) and acute intracerebral haemorrhage (ICH) remains controversial. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist physicians in their clinical decisions regarding BP management in acute stroke. : The guidelines were developed according to the ESO standard operating procedure and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. Despite several large randomised-controlled clinical trials, quality of evidence is generally low due to inconsistent results of the effect of blood pressure lowering in AIS. We recommend early and modest blood pressure control (avoiding blood pressure levels >180/105 mm Hg) in AIS patients undergoing reperfusion therapies. There is more high-quality randomised evidence for BP lowering in acute ICH, where intensive blood pressure lowering is recommended rapidly after hospital presentation with the intent to improve recovery by reducing haematoma expansion. These guidelines provide further recommendations on blood pressure thresholds and for specific patient subgroups. : There is ongoing uncertainty regarding the most appropriate blood pressure management in AIS and ICH. Future randomised-controlled clinical trials are needed to inform decision making on thresholds, timing and strategy of blood pressure lowering in different acute stroke patient subgroups.

Published
2021

46. Transcranial Laser Therapy in Acute Stroke Treatment: Results of Neurothera Effectiveness and Safety Trial 3, a Phase III Clinical End Point Device Trial

Author

Hacke, Werner, Schellinger, Peter D., Albers, Gregory W., Bornstein, Natan M., Dahlof, Bjorn L., Fulton, Rachael, Kasner, Scott E., Shuaib, Ashfaq, Richieri, Steven P., Dilly, Stephen G., Zivin, Justin, Lees, Kennedy R., Broderick, Joseph, Ivanova, Anastasia, Johnston, Karen, Norrving, Bo, Alexandrov, Andrei, Brown, David, Capone, Patrick, Chiu, David, Clark, Wayne, Cochran, Jack, Deredyn, Colin, Devlin, Thomas, Hickling, William, Howell, George, Huang, David, Hussain, Shazam, Mallenbaum, Sidney, Moonis, Majaz, Nash, Marshall, Rymer, Marilyn, Taylor, Reid, Tremwel, Margaret, Buck, Brian, Perez, Julio, Gerloff, Christian, Greiwing, Bernd, Grond, Martin, Hamman, Gerhard, Haarmeiter, Thomas, Jander, Sebastian, Köhrmann, Martin, Ritter, Martin, Schneider, Dietmar, Sobesky, Jan, Steiner, Thorsten, Steinmetz, Helmuth, Veltkamp, Roland, Weimar, Christian, Gruber, Franz, Andersson, Bjorn, Welin, Lennart, Leys, Didier, Tatlisumak, Turgut, Luft, Andreas, Lyrer, Philippe, Michel, Patrik, Molina, Carlos, and Segura, Tomas

Published
2014
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47. The Story of Intracerebral Hemorrhage

Author

Broderick, Joseph P., primary, Grotta, James C., additional, Naidech, Andrew M., additional, Steiner, Thorsten, additional, Sprigg, Nikola, additional, Toyoda, Kazunori, additional, Dowlatshahi, Dar, additional, Demchuk, Andrew M., additional, Selim, Magdy, additional, Mocco, J, additional, and Mayer, Stephan, additional

Published
2021
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49. Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017

Author

Grundtvig, Josefine, primary, Ovesen, Christian, additional, Havsteen, Inger, additional, Christensen, Thomas, additional, Gaist, David, additional, Iversen, Helle K, additional, Kruuse, Christina, additional, Lilja-Cyron, Alexander, additional, Ægidius, Karen, additional, Rosenbaum, Sverre, additional, Meden, Per, additional, Marstrand, Jacob, additional, Christensen, Louisa, additional, Steiner, Thorsten, additional, and Christensen, Hanne, additional

Published
2021
Full Text
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