232 results on '"Gattringer, T."'
Search Results
2. Correction to: Features of intracranial hemorrhage in cerebral venous thrombosis
- Author
-
Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Garcia-Esperon, C., Barboza, M. A., Costa, P., Escudero, I., Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Jimenez-Conde, J., Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P., and Thijs, V.
- Published
- 2020
- Full Text
- View/download PDF
3. Global Effect of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events A 1-Year Follow-up
- Author
-
Nguyen, T.N. Qureshi, M.M. Klein, P. Yamagami, H. Mikulik, R. Czlonkowska, A. Abdalkader, M. Sedova, P. Sathya, A. Lo, H.C. Mansour, O.Y. Vanguru, H.R. Lesaine, E. Tsivgoulis, G. Loochtan, A.I. Demeestere, J. Uchino, K. Inoa, V. Goyal, N. Charidimou, A. Siegler, J.E. Yaghi, S. Aguiar de Sousa, D. Mohammaden, M.H. Haussen, D.C. Kristoffersen, E.S. Lereis, V.P. Scollo, S.D. Campbell, B.C.V. Ma, A. Thomas, J.O. Parsons, M.W. Singhal, S. Slater, L.-A. Tomazini Martins, R. Enzinger, C. Gattringer, T. Rahman, A. Bonnet, T. Ligot, N. De Raedt, S. Lemmens, R. Vanacker, P. Vandervorst, F. Conforto, A.B. Hidalgo, R.C.T. de Oliveira Neves, L. Martins, R.T. Cuervo, D.L.M. Rebello, L.C. Santiago, I.B. da Silva, I.L. Sakelarova, T. Kalpachki, R. Alexiev, F. Catanese, L. Cora, E.A. Goyal, M. Hill, M.D. Kelly, M.E. Khosravani, H. Lavoie, P. Peeling, L. Pikula, A. Rivera, R. Chen, H.-S. Chen, Y. Huo, X. Miao, Z. Yang, S. Bedekovic, M.R. Bralic, M. Budincevic, H. Corredor-Quintero, A.B. Lara-Sarabia, O.E. Cabal, M. Tenora, D. Fibrich, P. Herzig, R. Hlaváčová, H. Hrabanovska, E. Hlinovsky, D. Jurak, L. Kadlcikova, J. Karpowicz, I. Klecka, L. Kovar, M. Lauer, D. Neumann, J. Palouskova, H. Reiser, M. Rekova, P. Rohan, V. Skoda, O. Skorna, M. Sobotková, L. Sramek, M. Zakova, L. Christensen, H. Drenck, N. Iversen, H.K. Truelsen, T.C. Wienecke, T. Sobh, K. Ylikotila, P. Alpay, K. Strbian, D. Bernady, P. Casenave, P. Dan, M. Faucheux, J.-M. Gentric, J.-C. Magro, E. Sabben, C. Reiner, P. Rouanet, F. Bohmann, F.O. Boskamp, S. Mbroh, J. Nagel, S. Nolte, C.H. Ringleb, P.A. Rosenkranz, M. Poli, S. Thomalla, G. Karapanayiotides, T. Koutroulou, I. Kargiotis, O. Palaiodimou, L. Guerra, J.D.B. Huded, V. Menon, B. Nagendra, S. Prajapati, C. Sylaja, P.N. Pramana, N.A.K. Sani, A.F. Ghoreishi, A. Farhoudi, M. Hokmabadi, E.S. Raya, T.A. Kalmanovich, S.A. Ronen, L. Sabetay, S.I. Acampa, M. Adami, A. Castellan, L. Longoni, M. Ornello, R. Renieri, L. Bigliani, C.R. Romoli, M. Sacco, S. Salmaggi, A. Sangalli and Nguyen, T.N. Qureshi, M.M. Klein, P. Yamagami, H. Mikulik, R. Czlonkowska, A. Abdalkader, M. Sedova, P. Sathya, A. Lo, H.C. Mansour, O.Y. Vanguru, H.R. Lesaine, E. Tsivgoulis, G. Loochtan, A.I. Demeestere, J. Uchino, K. Inoa, V. Goyal, N. Charidimou, A. Siegler, J.E. Yaghi, S. Aguiar de Sousa, D. Mohammaden, M.H. Haussen, D.C. Kristoffersen, E.S. Lereis, V.P. Scollo, S.D. Campbell, B.C.V. Ma, A. Thomas, J.O. Parsons, M.W. Singhal, S. Slater, L.-A. Tomazini Martins, R. Enzinger, C. Gattringer, T. Rahman, A. Bonnet, T. Ligot, N. De Raedt, S. Lemmens, R. Vanacker, P. Vandervorst, F. Conforto, A.B. Hidalgo, R.C.T. de Oliveira Neves, L. Martins, R.T. Cuervo, D.L.M. Rebello, L.C. Santiago, I.B. da Silva, I.L. Sakelarova, T. Kalpachki, R. Alexiev, F. Catanese, L. Cora, E.A. Goyal, M. Hill, M.D. Kelly, M.E. Khosravani, H. Lavoie, P. Peeling, L. Pikula, A. Rivera, R. Chen, H.-S. Chen, Y. Huo, X. Miao, Z. Yang, S. Bedekovic, M.R. Bralic, M. Budincevic, H. Corredor-Quintero, A.B. Lara-Sarabia, O.E. Cabal, M. Tenora, D. Fibrich, P. Herzig, R. Hlaváčová, H. Hrabanovska, E. Hlinovsky, D. Jurak, L. Kadlcikova, J. Karpowicz, I. Klecka, L. Kovar, M. Lauer, D. Neumann, J. Palouskova, H. Reiser, M. Rekova, P. Rohan, V. Skoda, O. Skorna, M. Sobotková, L. Sramek, M. Zakova, L. Christensen, H. Drenck, N. Iversen, H.K. Truelsen, T.C. Wienecke, T. Sobh, K. Ylikotila, P. Alpay, K. Strbian, D. Bernady, P. Casenave, P. Dan, M. Faucheux, J.-M. Gentric, J.-C. Magro, E. Sabben, C. Reiner, P. Rouanet, F. Bohmann, F.O. Boskamp, S. Mbroh, J. Nagel, S. Nolte, C.H. Ringleb, P.A. Rosenkranz, M. Poli, S. Thomalla, G. Karapanayiotides, T. Koutroulou, I. Kargiotis, O. Palaiodimou, L. Guerra, J.D.B. Huded, V. Menon, B. Nagendra, S. Prajapati, C. Sylaja, P.N. Pramana, N.A.K. Sani, A.F. Ghoreishi, A. Farhoudi, M. Hokmabadi, E.S. Raya, T.A. Kalmanovich, S.A. Ronen, L. Sabetay, S.I. Acampa, M. Adami, A. Castellan, L. Longoni, M. Ornello, R. Renieri, L. Bigliani, C.R. Romoli, M. Sacco, S. Salmaggi, A. Sangalli
- Abstract
Background and Objectives Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). Methods We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations. Discussion There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volum
- Published
- 2023
4. Impact of Cerebral Microbleeds in Stroke Patients with Atrial Fibrillation.
- Author
-
Soo, Y., Zietz, A., Yiu, B., Mok, V.C.T., Polymeris, A.A., Seiffge, D., Ambler, G., Wilson, D., Leung, T.W.H., Tsang, S.F., Chu, W., Abrigo, J., Cheng, C., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H., Collet, R., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Demirelli, D.S., Bornstein, N.M., Assayag, E.B., Hallevi, H., Molad, J., Nishihara, M., Tanaka, J., Coutts, S.B., Kappelle, L.J., Al-Shahi Salman, R., Jager, Rolf, Lip, G.Y.H., Goeldlin, M.B., Panos, L.D., Mas, J.L., Legrand, Laurence, Karayiannis, C., Phan, T., Bellut, M., Chappell, F., Makin, S., Hayden, D., Williams, D., Dam-Nolen, D.H.K. Van, Nederkoorn, P.J., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Mendyk, A.M., Köhler, S., Oostenburgge, R. van, Zhou, Ying, Xu, Chao, Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Hendrikse, Jeroen, Wardlaw, J., Kelly, P., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Smith, E.E., Hara, H., Yakushiji, Y., Orken, D.N., Fazekas, F., Thijs, V., Heo, J.H., Veltkamp, R., Ay, H., Imaizumi, T., Lau, K.K., Jouvent, E., Toyoda, K., Yoshimura, S., Bae, H.J., Martí-Fàbregas, J., Prats-Sánchez, L., Lyrer, P., Best, J. de, Werring, D., Engelter, S.T., Peters, Nils, Soo, Y., Zietz, A., Yiu, B., Mok, V.C.T., Polymeris, A.A., Seiffge, D., Ambler, G., Wilson, D., Leung, T.W.H., Tsang, S.F., Chu, W., Abrigo, J., Cheng, C., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H., Collet, R., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Demirelli, D.S., Bornstein, N.M., Assayag, E.B., Hallevi, H., Molad, J., Nishihara, M., Tanaka, J., Coutts, S.B., Kappelle, L.J., Al-Shahi Salman, R., Jager, Rolf, Lip, G.Y.H., Goeldlin, M.B., Panos, L.D., Mas, J.L., Legrand, Laurence, Karayiannis, C., Phan, T., Bellut, M., Chappell, F., Makin, S., Hayden, D., Williams, D., Dam-Nolen, D.H.K. Van, Nederkoorn, P.J., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Mendyk, A.M., Köhler, S., Oostenburgge, R. van, Zhou, Ying, Xu, Chao, Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Hendrikse, Jeroen, Wardlaw, J., Kelly, P., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Smith, E.E., Hara, H., Yakushiji, Y., Orken, D.N., Fazekas, F., Thijs, V., Heo, J.H., Veltkamp, R., Ay, H., Imaizumi, T., Lau, K.K., Jouvent, E., Toyoda, K., Yoshimura, S., Bae, H.J., Martí-Fàbregas, J., Prats-Sánchez, L., Lyrer, P., Best, J. de, Werring, D., Engelter, S.T., and Peters, Nils
- Abstract
01 juli 2023, Contains fulltext : 294348.pdf (Publisher’s version ) (Open Access), OBJECTIVES: Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate the risks of intracranial hemorrhage and ischemic stroke associated with microbleeds in patients with atrial fibrillation treated with vitamin K antagonists, direct oral anticoagulants, antiplatelets, and combination therapy (i.e. concurrent oral anticoagulant and antiplatelet). METHODS: We included patients with documented atrial fibrillation from the pooled individual patient data analysis by the Microbleeds International Collaborative Network. Risks of subsequent intracranial hemorrhage and ischemic stroke were compared between patients with and without microbleeds, stratified by antithrombotic use. RESULTS: A total of 7,839 patients were included. The presence of microbleeds was associated with an increased relative risk of intracranial hemorrhage (adjusted hazard ratio [aHR] = 2.74, 95% confidence interval = 1.76-4.26) and ischemic stroke (aHR = 1.29, 95% confidence interval = 1.04-1.59). For the entire cohort, the absolute incidence of ischemic stroke was higher than intracranial hemorrhage regardless of microbleed burden. However, for the subgroup of patients taking combination of anticoagulant and antiplatelet therapy, the absolute risk of intracranial hemorrhage exceeded that of ischemic stroke in those with 2 to 4 microbleeds (25 vs 12 per 1,000 patient-years) and ≥ 11 microbleeds (94 vs 48 per 1,000 patient-years). INTERPRETATION: Patients with atrial fibrillation and high burden of microbleeds receiving combination therapy have a tendency of higher rate of intracranial hemorrhage than ischemic stroke, with potential for net harm. Further studies are needed to help optimize stroke preventive strategies in this high-risk group. ANN NEUROL 2023;94:61-74.
- Published
- 2023
5. An exploratory intervention study suggests clinical benefits of training in chronic stroke to be paralleled by changes in brain activity using repeated fMRI
- Author
-
Landsmann B, Pinter D, Pirker E, Pichler G, Schippinger W, Weiss EM, Mathie G, Gattringer T, Fazekas F, and Enzinger C
- Subjects
mobility ,cognition ,lacunar stroke ,training ,rehabilitation ,neuronal plasticity ,Geriatrics ,RC952-954.6 - Abstract
Barbara Landsmann,1,2 Daniela Pinter,2 Eva Pirker,1,2 Gerald Pichler,3 Walter Schippinger,3 Elisabeth M Weiss,1 Gabriel Mathie,2 Thomas Gattringer,2 Franz Fazekas,2 Christian Enzinger2,4 1Institute of Psychology, University of Graz, Graz, Austria; 2Department of Neurology, Medical University of Graz, Graz, Austria; 3Albert Schweitzer Clinic Graz, Graz, Austria; 4Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria Purpose: Previous studies demonstrated changes in sensorimotor network activation over time after stroke that have been interpreted as partly compensatory. Locomotor and balance trainings may improve both mobility and cognition even in chronic stroke and thereby impact on cerebral activation patterns. We here aimed at testing these assumptions in an exploratory study to inform subsequent larger intervention studies. Patients and methods: Eight patients (73.3±4.4 years) with a chronic lacunar stroke (mean interval 3.7 years after the acute event with a range from 2 to 4 years) and residual leg paresis leading to gait disturbance received a guided 5-week training focusing on mobility, endurance, and coordination. Before and afterward, they underwent clinical, neuropsychological, and gait assessments and brain MRI at 3 T including a functional ankle movement paradigm. Sixteen healthy controls (HCs; 68.8±5.4 years) followed the same protocol without intervention. Results: After training, patients had improved in mobility, memory, and delayed recall of memory. While cerebral activations in HC remained completely unaltered, patients showed increased activations in the right precentral gyrus, the right and left superior frontal gyri, and the right frontal lobe, with bipedal ankle movements after training. Conclusion: In this exploratory study of chronic stroke, we found not only significant effects of physical training on mobility but also distinct aspects of cognition already with a small number of highly selected patients. These improvements were paralleled by alterations in cerebral activity possibly reflecting neuronal plasticity. Larger studies including randomization are needed. Keywords: mobility, cognition, lacunar stroke, training, rehabilitation, neuronal plasticity
- Published
- 2016
6. Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
- Author
-
Nguyen, T.N. Qureshi, M.M. Klein, P. Yamagami, H. Abdalkader, M. Mikulik, R. Sathya, A. Mansour, O.Y. Czlonkowska, A. Lo, H. Field, T.S. Charidimou, A. Banerjee, S. Yaghi, S. Siegler, J.E. Sedova, P. Kwan, J. de Sousa, D.A. Demeestere, J. Inoa, V. Omran, S.S. Zhang, L. Michel, P. Strambo, D. Marto, J.P. Nogueira, R.G. Lereis, V.P. Ma, A. Enzinger, C. Gattringer, T. Rahman, A. Bonnet, T. De Raedt, S. Lemmens, R. Ligot, N. Vandervorst, F. Conforto, A.B. Hidalgo, R.C.T. Cuervo, D.L.M. Neves, L.O. da Silva, I.L. Martins, R.T. Rebello, L.C. Santiago, I.B. Alexiev, F. Sakelarova, T. Kalpachki, R. Cora, E.A. Kelly, M.E. Pikula, A. Chen, H.-S. Chen, Y. Yang, S. Bedekovic, M.R. Čabal, M. Tenora, D. Dušek, P. Fibrich, P. Hrabanovska, E. Hlaváčová, H. Jurák, L. Kadlckova, J. Karpowicz, I. Klečka, L. Kovář, M. Neumann, J. Paloušková, H. Reiser, M. Rohan, V. Skoda, O. Škorňa, M. Šimůnek, L. Šrámek, M. Drenck, N. Sobh, K. Strbian, D. Lesaine, E. Reiner, P. Rouanet, F. Sabben, C. Boskamp, S. Mbroh, J. Nagel, S. Poli, S. Rosenkranz, M. Thomalla, G. Karapanayiotides, T. Kargiotis, O. Koutroulou, I. Palaiodimou, L. Tsivgoulis, G. Guerra, J.D.B. Huded, V. Nagendra, S. Prajapati, C. Sylaja, P.N. Sani, A.F. Ghoreishi, A. Hashemilar, M. Sadeghi-Hokmabadi, E. Rahal, F. Sabetay, S.I. Acampa, M. Adami, A. Longoni, M. Ornello, R. Renieri, L. Romoli, M. Sacco, S. Salmaggi, A. Sangalli, D. Zini, A. Fujita, K. Fukuda, H. Matsumaru, Y. Miyake, K. Ohara, N. Sakaguchi, M. Sakai, K. Shindo, S. Sonoda, K. Sugiura, Y. Takenobu, Y. Toyoda, K. Uwatoko, T. Yamamoto, R. Yazawa, Y. Yoshimoto, T. Baek, J.-H. Lee, J.S. Lee, S.B. Seo, K.-D. Sohn, S.-I. Arsovska, A.A. Chieh, C.Y. Zaidi, W.A.W. Yahya, W.N.N.W. Gongora-Rivera, F. Martinez-Marino, M. Infante-Valenzuela, A. Dippel, D. van Dam-Nolen, D.H.K. Punter, M. Wu, T.Y. Sunmonu, T.A. Adebayo, T.T. Wahab, K.W. Bello, A.H. Sundseth, A. Kristoffersen, E.S. Al Hashmi, A.M. Ahmad, S. Rashid, U. Rodriguez-Kadota, L. Vences, M.Á. Yalung, P.M. Brola, W. Dębiec, A. and Nguyen, T.N. Qureshi, M.M. Klein, P. Yamagami, H. Abdalkader, M. Mikulik, R. Sathya, A. Mansour, O.Y. Czlonkowska, A. Lo, H. Field, T.S. Charidimou, A. Banerjee, S. Yaghi, S. Siegler, J.E. Sedova, P. Kwan, J. de Sousa, D.A. Demeestere, J. Inoa, V. Omran, S.S. Zhang, L. Michel, P. Strambo, D. Marto, J.P. Nogueira, R.G. Lereis, V.P. Ma, A. Enzinger, C. Gattringer, T. Rahman, A. Bonnet, T. De Raedt, S. Lemmens, R. Ligot, N. Vandervorst, F. Conforto, A.B. Hidalgo, R.C.T. Cuervo, D.L.M. Neves, L.O. da Silva, I.L. Martins, R.T. Rebello, L.C. Santiago, I.B. Alexiev, F. Sakelarova, T. Kalpachki, R. Cora, E.A. Kelly, M.E. Pikula, A. Chen, H.-S. Chen, Y. Yang, S. Bedekovic, M.R. Čabal, M. Tenora, D. Dušek, P. Fibrich, P. Hrabanovska, E. Hlaváčová, H. Jurák, L. Kadlckova, J. Karpowicz, I. Klečka, L. Kovář, M. Neumann, J. Paloušková, H. Reiser, M. Rohan, V. Skoda, O. Škorňa, M. Šimůnek, L. Šrámek, M. Drenck, N. Sobh, K. Strbian, D. Lesaine, E. Reiner, P. Rouanet, F. Sabben, C. Boskamp, S. Mbroh, J. Nagel, S. Poli, S. Rosenkranz, M. Thomalla, G. Karapanayiotides, T. Kargiotis, O. Koutroulou, I. Palaiodimou, L. Tsivgoulis, G. Guerra, J.D.B. Huded, V. Nagendra, S. Prajapati, C. Sylaja, P.N. Sani, A.F. Ghoreishi, A. Hashemilar, M. Sadeghi-Hokmabadi, E. Rahal, F. Sabetay, S.I. Acampa, M. Adami, A. Longoni, M. Ornello, R. Renieri, L. Romoli, M. Sacco, S. Salmaggi, A. Sangalli, D. Zini, A. Fujita, K. Fukuda, H. Matsumaru, Y. Miyake, K. Ohara, N. Sakaguchi, M. Sakai, K. Shindo, S. Sonoda, K. Sugiura, Y. Takenobu, Y. Toyoda, K. Uwatoko, T. Yamamoto, R. Yazawa, Y. Yoshimoto, T. Baek, J.-H. Lee, J.S. Lee, S.B. Seo, K.-D. Sohn, S.-I. Arsovska, A.A. Chieh, C.Y. Zaidi, W.A.W. Yahya, W.N.N.W. Gongora-Rivera, F. Martinez-Marino, M. Infante-Valenzuela, A. Dippel, D. van Dam-Nolen, D.H.K. Punter, M. Wu, T.Y. Sunmonu, T.A. Adebayo, T.T. Wahab, K.W. Bello, A.H. Sundseth, A. Kristoffersen, E.S. Al Hashmi, A.M. Ahmad, S. Rashid, U. Rodriguez-Kadota, L. Vences, M.Á. Yalung, P.M. Brola, W. Dębiec, A.
- Abstract
Background and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT i
- Published
- 2022
7. Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase
- Author
-
Van De Munckhof, A. Lindgren, E. Kleinig, T.J. Field, T.S. Cordonnier, C. Krzywicka, K. Poli, S. Sánchez Van Kammen, M. Borhani-Haghighi, A. Lemmens, R. Scutelnic, A. Ciccone, A. Gattringer, T. Wittstock, M. Dizonno, V. Devroye, A. Elkady, A. Günther, A. Cervera, A. Mengel, A. Chew, B.L.A. Buck, B. Zanferrari, C. Garcia-Esperon, C. Jacobi, C. Soriano, C. Michalski, D. Zamani, Z. Blacquiere, D. Johansson, E. Cuadrado-Godia, E. Vuillier, F. Bode, F.J. Caparros, F. Maier, F. Tsivgoulis, G. Katzberg, H.D. Duan, J. Burrow, J. Pelz, J. Mbroh, J. Oen, J. Schouten, J. Zimmermann, J. Ng, K. Garambois, K. Petruzzellis, M. Carvalho Dias, M. Ghiasian, M. Romoli, M. Miranda, M. Wronski, M. Skjelland, M. Almasi-Dooghaee, M. Cuisenier, P. Murphy, S. Timsit, S. Coutts, S.B. Schönenberger, S. Nagel, S. Hiltunen, S. Chatterton, S. Cox, T. Bartsch, T. Shaygannejad, V. Mirzaasgari, Z. Middeldorp, S. Levi, M.M. Kremer Hovinga, J.A. Jood, K. Tatlisumak, T. Putaala, J. Heldner, M.R. Arnold, M. Aguiar De Sousa, D. Ferro, J.M. Coutinho, J.M. and Van De Munckhof, A. Lindgren, E. Kleinig, T.J. Field, T.S. Cordonnier, C. Krzywicka, K. Poli, S. Sánchez Van Kammen, M. Borhani-Haghighi, A. Lemmens, R. Scutelnic, A. Ciccone, A. Gattringer, T. Wittstock, M. Dizonno, V. Devroye, A. Elkady, A. Günther, A. Cervera, A. Mengel, A. Chew, B.L.A. Buck, B. Zanferrari, C. Garcia-Esperon, C. Jacobi, C. Soriano, C. Michalski, D. Zamani, Z. Blacquiere, D. Johansson, E. Cuadrado-Godia, E. Vuillier, F. Bode, F.J. Caparros, F. Maier, F. Tsivgoulis, G. Katzberg, H.D. Duan, J. Burrow, J. Pelz, J. Mbroh, J. Oen, J. Schouten, J. Zimmermann, J. Ng, K. Garambois, K. Petruzzellis, M. Carvalho Dias, M. Ghiasian, M. Romoli, M. Miranda, M. Wronski, M. Skjelland, M. Almasi-Dooghaee, M. Cuisenier, P. Murphy, S. Timsit, S. Coutts, S.B. Schönenberger, S. Nagel, S. Hiltunen, S. Chatterton, S. Cox, T. Bartsch, T. Shaygannejad, V. Mirzaasgari, Z. Middeldorp, S. Levi, M.M. Kremer Hovinga, J.A. Jood, K. Tatlisumak, T. Putaala, J. Heldner, M.R. Arnold, M. Aguiar De Sousa, D. Ferro, J.M. Coutinho, J.M.
- Abstract
Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up. © 2022 Lippincott Williams and Wilkins. All rights reserved.
- Published
- 2022
8. Global Differences in Risk Factors, Etiology, and Outcome of Ischemic Stroke in Young Adults-A Worldwide Meta-analysis: The GOAL Initiative
- Author
-
Jacob, M.A., Ekker, M.S., Allach, Y., Cai, M., Aarnio, Karoliina, Arauz, A., Arnold, M., Bae, H.J., Bandeo, L., Barboza, M.A., Bolognese, M., Bonardo, P., Brouns, R., Chuluun, B., Chuluunbatar, E., Cordonnier, C., Dagvajantsan, B., Debette, S., Don, A., Enzinger, C., Ekizoglu, E., Fandler-Höfler, S., Fazekas, F., Fromm, A., Gattringer, T., Hora, T.F., Jern, C., Jood, K., Kim, Y.S., Kittner, S., Kleinig, T., Klijn, C.J.M., Kõrv, J., Kumar, V., Lee, K.J., Lee, Theo A.J. van der, Maaijwee, N.A.M.M., Martinez-Majander, N., Marto, J.P., Mehndiratta, M.M., Mifsud, V., Montanaro, V., Pacio, G., Patel, V.B., Phillips, M.C., Piechowski-Jozwiak, B., Pikula, A., Ruiz-Sandoval, J., Sarnowski, B., Swartz, R.H., Tan, K.S., Tanne, D., Tatlisumak, T., Thijs, V., Viana-Baptista, M., Vibo, R., Wu, T.Y., Yesilot, N., Waje-Andreassen, U., Pezzini, A., Putaala, J., Tuladhar, A.M., Leeuw, F.E. de, Jacob, M.A., Ekker, M.S., Allach, Y., Cai, M., Aarnio, Karoliina, Arauz, A., Arnold, M., Bae, H.J., Bandeo, L., Barboza, M.A., Bolognese, M., Bonardo, P., Brouns, R., Chuluun, B., Chuluunbatar, E., Cordonnier, C., Dagvajantsan, B., Debette, S., Don, A., Enzinger, C., Ekizoglu, E., Fandler-Höfler, S., Fazekas, F., Fromm, A., Gattringer, T., Hora, T.F., Jern, C., Jood, K., Kim, Y.S., Kittner, S., Kleinig, T., Klijn, C.J.M., Kõrv, J., Kumar, V., Lee, K.J., Lee, Theo A.J. van der, Maaijwee, N.A.M.M., Martinez-Majander, N., Marto, J.P., Mehndiratta, M.M., Mifsud, V., Montanaro, V., Pacio, G., Patel, V.B., Phillips, M.C., Piechowski-Jozwiak, B., Pikula, A., Ruiz-Sandoval, J., Sarnowski, B., Swartz, R.H., Tan, K.S., Tanne, D., Tatlisumak, T., Thijs, V., Viana-Baptista, M., Vibo, R., Wu, T.Y., Yesilot, N., Waje-Andreassen, U., Pezzini, A., Putaala, J., Tuladhar, A.M., and Leeuw, F.E. de
- Abstract
Item does not contain fulltext, BACKGROUND AND OBJECTIVES: There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide. METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression. RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36). DISCUSSION: Ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve h
- Published
- 2022
9. Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase
- Author
-
Munckhof, A. van de, Lindgren, E., Kleinig, T.J., Field, T.S., Cordonnier, C., Krzywicka, K., Poli, S., Sanchez van Kammen, M., Borhani-Haghighi, A., Lemmens, R., Scutelnic, A., Ciccone, A., Gattringer, T., Wittstock, M., Dizonno, V., Devroye, A., Elkady, A., Günther, A., Cervera, A., Mengel, A., Chew, B.L.A., Buck, B., Zanferrari, C., Garcia-Esperon, C., Jacobi, C., Soriano, C., Michalski, D., Zamani, Z., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Vuillier, F., Bode, F.J., Caparros, F., Maier, F., Tsivgoulis, G., Katzberg, H.D., Duan, J., Burrow, J., Pelz, J., Mbroh, J., Oen, J., Schouten, J., Zimmermann, J., Ng, K., Garambois, K., Petruzzellis, M., Dias, M., Ghiasian, M., Romoli, M., Miranda, M., Wronski, M., Skjelland, M., Almasi-Dooghaee, M., Cuisenier, P., Murphy, S., Timsit, S., Coutts, S.B., Schönenberger, S., Nagel, S., Hiltunen, S., Chatterton, S., Cox, T., Bartsch, T., Shaygannejad, V., Mirzaasgari, Z., Middeldorp, S., Levi, M.M., Kremer Hovinga, J.A., Jood, K., Tatlisumak, T., Putaala, J., Heldner, M.R., Arnold, M., Aguiar de Sousa, D., Ferro, J.M., Coutinho, J.M., Munckhof, A. van de, Lindgren, E., Kleinig, T.J., Field, T.S., Cordonnier, C., Krzywicka, K., Poli, S., Sanchez van Kammen, M., Borhani-Haghighi, A., Lemmens, R., Scutelnic, A., Ciccone, A., Gattringer, T., Wittstock, M., Dizonno, V., Devroye, A., Elkady, A., Günther, A., Cervera, A., Mengel, A., Chew, B.L.A., Buck, B., Zanferrari, C., Garcia-Esperon, C., Jacobi, C., Soriano, C., Michalski, D., Zamani, Z., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Vuillier, F., Bode, F.J., Caparros, F., Maier, F., Tsivgoulis, G., Katzberg, H.D., Duan, J., Burrow, J., Pelz, J., Mbroh, J., Oen, J., Schouten, J., Zimmermann, J., Ng, K., Garambois, K., Petruzzellis, M., Dias, M., Ghiasian, M., Romoli, M., Miranda, M., Wronski, M., Skjelland, M., Almasi-Dooghaee, M., Cuisenier, P., Murphy, S., Timsit, S., Coutts, S.B., Schönenberger, S., Nagel, S., Hiltunen, S., Chatterton, S., Cox, T., Bartsch, T., Shaygannejad, V., Mirzaasgari, Z., Middeldorp, S., Levi, M.M., Kremer Hovinga, J.A., Jood, K., Tatlisumak, T., Putaala, J., Heldner, M.R., Arnold, M., Aguiar de Sousa, D., Ferro, J.M., and Coutinho, J.M.
- Abstract
Item does not contain fulltext, BACKGROUND: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. METHODS: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). RESULTS: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). CONCLUSIONS: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.
- Published
- 2022
10. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination
- Author
-
Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., Heldner, M.R., Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., and Heldner, M.R.
- Abstract
Contains fulltext : 282309.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). CONCLUSIONS: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL
- Published
- 2022
11. Endovascular stroke therapy in Austria: a nationwide 1-year experience
- Author
-
Serles, W., Gattringer, T., Mutzenbach, S., Seyfang, L., Trenkler, J., Killer-Oberpfalzer, M., Deutschmann, H., Niederkorn, K., Wolf, F., Gruber, A., Hausegger, K., Weber, J., Thurnher, S., Gizewski, E., Willeit, J., Karaic, R., Fertl, E., Našel, C., Brainin, M., Erian, J., Oberndorfer, S., Karnel, F., Grisold, W., Auff, E., Fazekas, F., Haring, H.-P., and Lang, W.
- Published
- 2016
- Full Text
- View/download PDF
12. Gender aspects of acute stroke care: results from the Austrian Stroke Unit Registry: OS3104
- Author
-
Gattringer, T., Ferrari, J., Knoflach, M., Seyfang, L., Horner, S., Niederkorn, K., Culea, V., Beitzke, M., Lang, W., Enzinger, C., and Fazekas, F.
- Published
- 2014
13. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
- Author
-
Nogueira, R.G. Qureshi, M.M. Abdalkader, M. Martins, S.O. Yamagami, H. Qiu, Z. Mansour, O.Y. Sathya, A. Czlonkowska, A. Tsivgoulis, G. Aguiar de Sousa, D. Demeestere, J. Mikulik, R. Vanacker, P. Siegler, J.E. Kõrv, J. Biller, J. Liang, C.W. Sangha, N.S. Zha, A.M. Czap, A.L. Holmstedt, C.A. Turan, T.N. Ntaios, G. Malhotra, K. Tayal, A. Loochtan, A. Ranta, A. Mistry, E.A. Alexandrov, A.W. Huang, D.Y. Yaghi, S. Raz, E. Sheth, S.A. Mohammaden, M.H. Frankel, M. Bila Lamou, E.G. Aref, H.M. Elbassiouny, A. Hassan, F. Menecie, T. Mustafa, W. Shokri, H.M. Roushdy, T. Sarfo, F.S. Alabi, T.O. Arabambi, B. Nwazor, E.O. Sunmonu, T.A. Wahab, K. Yaria, J. Mohammed, H.H. Adebayo, P.B. Riahi, A.D. Sassi, S.B. Gwaunza, L. Ngwende, G.W. Sahakyan, D. Rahman, A. Ai, Z. Bai, F. Duan, Z. Hao, Y. Huang, W. Li, G. Li, W. Liu, G. Luo, J. Shang, X. Sui, Y. Tian, L. Wen, H. Wu, B. Yan, Y. Yuan, Z. Zhang, H. Zhang, J. Zhao, W. Zi, W. Leung, T.W. Chugh, C. Huded, V. Menon, B. Pandian, J.D. Sylaja, P.N. Usman, F.S. Farhoudi, M. Hokmabadi, E.S. Horev, A. Reznik, A. Sivan Hoffmann, R. Ohara, N. Sakai, N. Watanabe, D. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Kondybayeva, A. Faizullina, K. Kamenova, S. Zhanuzakov, M. Baek, J.-H. Hwang, Y. Lee, J.S. Lee, S.B. Moon, J. Park, H. Seo, J.H. Seo, K.-D. Sohn, S.I. Young, C.J. Ahdab, R. Wan Zaidi, W.A. Aziz, Z.A. Basri, H.B. Chung, L.W. Ibrahim, A.B. Ibrahim, K.A. Looi, I. Tan, W.Y. Yahya, N.W. Groppa, S. Leahu, P. Al Hashmi, A.M. Imam, Y.Z. Akhtar, N. Pineda-Franks, M.C. Co, C.O. Kandyba, D. Alhazzani, A. Al-Jehani, H. Tham, C.H. Mamauag, M.J. Venketasubramanian, N. Chen, C.-H. Tang, S.-C. Churojana, A. Akil, E. Aykaç, Ö. Ozdemir, A.O. Giray, S. Hussain, S.I. John, S. Le Vu, H. Tran, A.D. Nguyen, H.H. Nhu Pham, T. Nguyen, T.H. Nguyen, T.Q. Gattringer, T. Enzinger, C. Killer-Oberpfalzer, M. Bellante, F. De Blauwe, S. Vanhooren, G. De Raedt, S. Dusart, A. Lemmens, R. Ligot, N. Pierre Rutgers, M. Yperzeele, L. Alexiev, F. Sakelarova, T. Bedeković, M.R. Budincevic, H. Cindric, I. Hucika, Z. Ozretic, D. Saric, M.S. Pfeifer, F. Karpowic, I. Cernik, D. Sramek, M. Skoda, M. Hlavacova, H. Klecka, L. Koutny, M. Vaclavik, D. Skoda, O. Fiksa, J. Hanelova, K. Nevsimalova, M. Rezek, R. Prochazka, P. Krejstova, G. Neumann, J. Vachova, M. Brzezanski, H. Hlinovsky, D. Tenora, D. Jura, R. Jurák, L. Novak, J. Novak, A. Topinka, Z. Fibrich, P. Sobolova, H. Volny, O. Krarup Christensen, H. Drenck, N. Klingenberg Iversen, H. Simonsen, C.Z. Truelsen, T.C. Wienecke, T. Vibo, R. Gross-Paju, K. Toomsoo, T. Antsov, K. Caparros, F. Cordonnier, C. Dan, M. Faucheux, J.-M. Mechtouff, L. Eker, O. Lesaine, E. Ondze, B. Peres, R. Pico, F. Piotin, M. Pop, R. Rouanet, F. Gubeladze, T. Khinikadze, M. Lobjanidze, N. Tsiskaridze, A. Nagel, S. Ringleb, P.A. Rosenkranz, M. Schmidt, H. Sedghi, A. Siepmann, T. Szabo, K. Thomalla, G. Palaiodimou, L. Sagris, D. Kargiotis, O. Klivenyi, P. Szapary, L. Tarkanyi, G. Adami, A. Bandini, F. Calabresi, P. Frisullo, G. Renieri, L. Sangalli, D. Pirson, A. Uyttenboogaart, M. van den Wijngaard, I. Kristoffersen, E.S. Brola, W. Fudala, M. Horoch-Lyszczarek, E. Karlinski, M. Kazmierski, R. Kram, P. Rogoziewicz, M. Kaczorowski, R. Luchowski, P. Sienkiewicz-Jarosz, H. Sobolewski, P. Fryze, W. Wisniewska, A. Wiszniewska, M. Ferreira, P. Ferreira, P. Fonseca, L. Marto, J.P. Pinho E Melo, T. Nunes, A.P. Rodrigues, M. Tedim Cruz, V. Falup-Pecurariu, C. Krastev, G. Mako, M. de Leciñana, M.A. Arenillas, J.F. Ayo-Martin, O. Cruz Culebras, A. Tejedor, E.D. Montaner, J. Pérez-Sánchez, S. Tola Arribas, M.A. Rodriguez Vasquez, A. Mayza, M. Bernava, G. Brehm, A. Machi, P. Fischer, U. Gralla, J. Michel, P.L. Psychogios, M.-N. Strambo, D. Banerjee, S. Krishnan, K. Kwan, J. Butt, A. Catanese, L. Demchuk, A.M. Field, T. Haynes, J. Hill, M.D. Khosravani, H. Mackey, A. Pikula, A. Saposnik, G. Scott, C.A. Shoamanesh, A. Shuaib, A. Yip, S. Barboza, M.A. Barrientos, J.D. Portillo Rivera, L.I. Gongora-Rivera, F. Novarro-Escudero, N. Blanco, A. Abraham, M. Alsbrook, D. Altschul, D. Alvarado-Ortiz, A.J. Bach, I. Badruddin, A. Barazangi, N. Brereton, C. Castonguay, A. Chaturvedi, S. Chaudry, S.A. Choe, H. Choi, J.H. Dharmadhikari, S. Desai, K. Devlin, T.G. Doss, V.T. Edgell, R. Etherton, M. Farooqui, M. Frei, D. Gandhi, D. Grigoryan, M. Gupta, R. Hassan, A.E. Helenius, J. Kaliaev, A. Kaushal, R. Khandelwal, P. Khawaja, A.M. Khoury, N.N. Kim, B.S. Kleindorfer, D.O. Koyfman, F. Lee, V.H. Leung, L.Y. Linares, G. Linfante, I. Lutsep, H.L. Macdougall, L. Male, S. Malik, A.M. Masoud, H. McDermott, M. Mehta, B.P. Min, J. Mittal, M. Morris, J.G. Multani, S.S. Nahab, F. Nalleballe, K. Nguyen, C.B. Novakovic-White, R. Ortega-Gutierrez, S. Rahangdale, R.H. Ramakrishnan, P. Romero, J.R. Rost, N. Rothstein, A. Ruland, S. Shah, R. Sharma, M. Silver, B. Simmons, M. Singh, A. Starosciak, A.K. Strasser, S.L. Szeder, V. Teleb, M. Tsai, J.P. Voetsch, B. Balaguera, O. Pujol Lereis, V.A. Luraschi, A. Almeida, M.S. Cardoso, F.B. Conforto, A. De Deus Silva, L. Varrone Giacomini, L. Oliveira Lima, F. Longo, A.L. Magalhães, P.S.C. Martins, R.T. Mont'alverne, F. Mora Cuervo, D.L. Costa Rebello, L. Valler, L. Zetola, V.F. Lavados, P.M. Navia, V. Olavarría, V.V. Almeida Toro, J.M. Amaya, P.F.R. Bayona, H. Corredor, A. Rivera Ordonez, C.E. Mantilla Barbosa, D.K. Lara, O. Patiño, M.R. Diaz Escobar, L.F. Dejesus Melgarejo Fariña, D.E. Cardozo Villamayor, A. Zelaya Zarza, A.J. Barrientos Iman, D.M. Rodriguez Kadota, L. Campbell, B. Hankey, G.J. Hair, C. Kleinig, T. Ma, A. Tomazini Martins, R. Sahathevan, R. Thijs, V. Salazar, D. Yuan-Hao Wu, T. Haussen, D.C. Liebeskind, D. Yavagal, D.R. Jovin, T.G. Zaidat, O.O. Nguyen, T.N. SVIN COVID-19 Global Stroke Registry SVIN COVID-19 Global Stroke Registry
- Abstract
OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology.
- Published
- 2021
14. European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment
- Author
-
Quinn, T.J., Richard, E., Teuschl, Y., Gattringer, T., Hafdi, M., O'Brien, J.T., Merriman, N., Gillebert, C., Huyglier, H., Verdelho, A., Schmidt, R., Ghaziani, E., Forchammer, H., Pendlebury, S.T., Bruffaerts, R., Mijajlovic, M., Drozdowska, B.A., Ball, E., Markus, H.S., Quinn, T.J., Richard, E., Teuschl, Y., Gattringer, T., Hafdi, M., O'Brien, J.T., Merriman, N., Gillebert, C., Huyglier, H., Verdelho, A., Schmidt, R., Ghaziani, E., Forchammer, H., Pendlebury, S.T., Bruffaerts, R., Mijajlovic, M., Drozdowska, B.A., Ball, E., and Markus, H.S.
- Abstract
Contains fulltext : 244230.pdf (Publisher’s version ) (Open Access), The optimal management of post-stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment and prognosis. These guidelines were developed according to ESO standard operating procedure and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and, where possible, 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. There was limited randomised controlled trial evidence regarding single or multicomponent interventions to prevent post-stroke cognitive decline. Interventions to improve lifestyle and treat vascular risk factors may have many health benefits but a beneficial effect on cognition is not proven. We found no evidence around routine cognitive screening following stroke but recognise the importance of targeted cognitive assessment. We described the accuracy of various cognitive screening tests but found no clearly superior approach to testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine nootropics or cognitive rehabilitation. There was limited evidence on the use of prediction tools for post-stroke cognitive syndromes (cognitive impairment, dementia and delirium). The association between post-stroke cognitive impairment and most acute structural brain imaging features was unclear, although the presence of substantial white matter hyperintensities of presumed vascular origin on acute MRI brain may help predict cognitive outcomes. These guidelines have highlighted fundamental ar
- Published
- 2021
15. Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
- Author
-
Best, J.G., Ambler, G., Wilson, D., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Li, L, Lovelock, C., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H.K.F., Prats-Sanchez, L., Martínez-Domeño, A., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Tanriverdi, Z., Bornstein, N.M., Assayag, E. Ben, Hallevi, H., Molad, J., Nishihara, M., Tanaka, J., Coutts, S.B., Polymeris, A., Wagner, B., Seiffge, D.J., Lyrer, P., Algra, A., Kappelle, L.J., Al-Shahi Salman, R., Jäger, H.R., Lip, G.Y.H., Fischer, U., El-Koussy, M., Mas, J.L., Legrand, Laurence, Karayiannis, C., Phan, T., Gunkel, S., Christ, N., Abrigo, J., Leung, T., Chu, W., Chappell, F., Makin, S., Hayden, D., Williams, D.J., Mess, W.H., Nederkoorn, P.J., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Maaijwee, N., Guevarra, A.C., Yatawara, C., Mendyk, A.M., Delmaire, C., Köhler, S., Oostenbrugge, R van, Zhou, Y, Xu, Chao, Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Hendrikse, Jeroen, Kelly, P.J., Wardlaw, J., Soo, Y., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Engelter, S.T., Peters, Nils, Smith, E.E., Hara, H., Yakushiji, Y., Orken, D.N., Best, J.G., Ambler, G., Wilson, D., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Li, L, Lovelock, C., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H.K.F., Prats-Sanchez, L., Martínez-Domeño, A., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Tanriverdi, Z., Bornstein, N.M., Assayag, E. Ben, Hallevi, H., Molad, J., Nishihara, M., Tanaka, J., Coutts, S.B., Polymeris, A., Wagner, B., Seiffge, D.J., Lyrer, P., Algra, A., Kappelle, L.J., Al-Shahi Salman, R., Jäger, H.R., Lip, G.Y.H., Fischer, U., El-Koussy, M., Mas, J.L., Legrand, Laurence, Karayiannis, C., Phan, T., Gunkel, S., Christ, N., Abrigo, J., Leung, T., Chu, W., Chappell, F., Makin, S., Hayden, D., Williams, D.J., Mess, W.H., Nederkoorn, P.J., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Maaijwee, N., Guevarra, A.C., Yatawara, C., Mendyk, A.M., Delmaire, C., Köhler, S., Oostenbrugge, R van, Zhou, Y, Xu, Chao, Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Hendrikse, Jeroen, Kelly, P.J., Wardlaw, J., Soo, Y., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Engelter, S.T., Peters, Nils, Smith, E.E., Hara, H., Yakushiji, Y., and Orken, D.N.
- Abstract
Item does not contain fulltext, BACKGROUND: Balancing the risks of recurrent ischaemic stroke and intracranial haemorrhage is important for patients treated with antithrombotic therapy after ischaemic stroke or transient ischaemic attack. However, existing predictive models offer insufficient performance, particularly for assessing the risk of intracranial haemorrhage. We aimed to develop new risk scores incorporating clinical variables and cerebral microbleeds, an MRI biomarker of intracranial haemorrhage and ischaemic stroke risk. METHODS: We did a pooled analysis of individual-patient data from the Microbleeds International Collaborative Network (MICON), which includes 38 hospital-based prospective cohort studies from 18 countries. All studies recruited participants with previous ischaemic stroke or transient ischaemic attack, acquired baseline MRI allowing quantification of cerebral microbleeds, and followed-up participants for ischaemic stroke and intracranial haemorrhage. Participants not taking antithrombotic drugs were excluded. We developed Cox regression models to predict the 5-year risks of intracranial haemorrhage and ischaemic stroke, selecting candidate predictors on biological relevance and simplifying models using backward elimination. We derived integer risk scores for clinical use. We assessed model performance in internal validation, adjusted for optimism using bootstrapping. The study is registered on PROSPERO, CRD42016036602. FINDINGS: The included studies recruited participants between Aug 28, 2001, and Feb 4, 2018. 15 766 participants had follow-up for intracranial haemorrhage, and 15 784 for ischaemic stroke. Over a median follow-up of 2 years, 184 intracranial haemorrhages and 1048 ischaemic strokes were reported. The risk models we developed included cerebral microbleed burden and simple clinical variables. Optimism-adjusted c indices were 0·73 (95% CI 0·69-0·77) with a calibration slope of 0·94 (0·81-1·06) for the intracranial haemorrhage model and 0·63 (0·62-0·65) with
- Published
- 2021
16. Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.
- Author
-
Best J.G., Ambler G., Wilson D., Lee K.-J., Lim J.-S., Shiozawa M., Koga M., Li L., Lovelock C., Chabriat H., Hennerici M., Wong Y.K., Mak H.K.F., Prats-Sanchez L., Martinez-Domeno A., Inamura S., Yoshifuji K., Arsava E.M., Horstmann S., Purrucker J., Lam B.Y.K., Wong A., Kim Y.D., Song T.-J., Lemmens R., Eppinger S., Gattringer T., Uysal E., Tanriverdi Z., Bornstein N.M., Ben Assayag E., Hallevi H., Molad J., Nishihara M., Tanaka J., Coutts S.B., Polymeris A., Wagner B., Seiffge D.J., Lyrer P., Algra A., Kappelle L.J., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Fischer U., El-Koussy M., Mas J.-L., Legrand L., Karayiannis C., Phan T., Gunkel S., Christ N., Abrigo J., Leung T., Chu W., Chappell F., Makin S., Hayden D., Williams D.J., Mess W.H., Nederkoorn P.J., Barbato C., Browning S., Wiegertjes K., Tuladhar A.M., Maaijwee N., Guevarra A.C., Yatawara C., Mendyk A.-M., Delmaire C., Kohler S., van Oostenbrugge R., Zhou Y., Xu C., Hilal S., Gyanwali B., Chen C., Lou M., Staals J., Bordet R., Kandiah N., de Leeuw F.-E., Simister R., Hendrikse J., Kelly P.J., Wardlaw J., Soo Y., Fluri F., Srikanth V., Calvet D., Jung S., Kwa V.I.H., Engelter S.T., Peters N., Smith E.E., Hara H., Yakushiji Y., Orken D.N., Fazekas F., Thijs V., Heo J.H., Mok V., Veltkamp R., Ay H., Imaizumi T., Gomez-Anson B., Lau K.K., Jouvent E., Rothwell P.M., Toyoda K., Bae H.-J., Marti-Fabregas J., Werring D.J., Harkness K., Shaw L., Sword J., Mohd Nor A., Sharma P., Kelly D., Harrington F., Randall M., Smith M., Mahawish K., Elmarim A., Esisi B., Cullen C., Nallasivam A., Price C., Barry A., Roffe C., Coyle J., Hassan A., Birns J., Cohen D., Sekaran L., Parry-Jones A., Parry A., Hargroves D., Proschel H., Datta P., Darawil K., Manoj A., Burn M., Patterson C., Giallombardo E., Smyth N., Mansoor S., Anwar I., Marsh R., Ispoglou S., Chadha D., Prabhakaran M., Meenakishundaram S., O'Connell J., Scott J., Krishnamurthy V., Aghoram P., McCormick M., Sprigg N., O'Mahony P., Cooper M., Choy L., Wilkinson P., Leach S., Caine S., Burger I., Gunathilagan G., Guyler P., Emsley H., Davis M., Manawadu D., Pasco K., Mamun M., Luder R., Sajid M., Okwera J., Warburton E., Saastamoinen K., England T., Putterill J., Flossman E., Power M., Dani K., Mangion D., Suman A., Corrigan J., Lawrence E., Vahidassr D., Shakeshaft C., Brown M., Charidimou A., Cohen H., Banerjee G., Houlden H., White M., Yousry T., Flossmann E., Muir K., Gratz P., Mattle H., Panos L., Korczyn A., Kliper E., Maeder P., Gass A., Pachai C., Bracoub L., Douste-Blazy M.-Y., Fratacci M.D., Vicaut E., Sato S., Miwa K., Fujita K., Ide T., Ma H., Ly J., Singhal S., Chandra R., Slater L.-A., Soufan C., Moran C., Traenka C., Thilemann S., Fladt J., Gensicke H., Bonati L., Kim B.J., Han M.-K., Kang J., Ko E., Yang M.H., Jang M.S., Murphy S., Carty F., Akijian L., Thornton J., Schembri M., Douven E., Delgado-Mederos R., Marin R., Camps-Renom P., Guisado-Alonso D., Nunez F., Medrano-Martorell S., Merino E., Iida K., Ikeda S., Irie H., Demirelli D.S., Medanta J.M., Zerna C., Hernandez M.V., Armitage P., Heye A., Munoz-Maniega S., Sakka E., Thrippleton M., Dennis M., Beigneux Y., Silva M., Venketasubramanian N., Ho S.L., Cheung R.T.F., Chan K.H., Teo K.C., Hui E., Kwan J.S.K., Chang R., Tse M.Y., Hoi C.P., Chan C.Y., Chan O.L., Cheung R.H.K., Wong E.K.M., Leung K.T., Tsang S.F., Ip H.L., Ma S.H., Ma K., Fong W.C., Li S.H., Li R., Ng P.W., Wong K.K., Liu W., Wong L., Ramos L., De Schryver E., Jobsis J., van der Sande J., Brouwers P., Roos Y., Stam J., Bakker S., Verbiest H., Schoonewille W., Linn C., Hertzberger L., van Gemert M., Berntsen P., Van Dam-Nolen D., Kooi M.E., Van der Lugt A., Koudstaal P., Leff A., Ward N., Nachev P., Perry R., Ozkan H., Mitchell J., Best J.G., Ambler G., Wilson D., Lee K.-J., Lim J.-S., Shiozawa M., Koga M., Li L., Lovelock C., Chabriat H., Hennerici M., Wong Y.K., Mak H.K.F., Prats-Sanchez L., Martinez-Domeno A., Inamura S., Yoshifuji K., Arsava E.M., Horstmann S., Purrucker J., Lam B.Y.K., Wong A., Kim Y.D., Song T.-J., Lemmens R., Eppinger S., Gattringer T., Uysal E., Tanriverdi Z., Bornstein N.M., Ben Assayag E., Hallevi H., Molad J., Nishihara M., Tanaka J., Coutts S.B., Polymeris A., Wagner B., Seiffge D.J., Lyrer P., Algra A., Kappelle L.J., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Fischer U., El-Koussy M., Mas J.-L., Legrand L., Karayiannis C., Phan T., Gunkel S., Christ N., Abrigo J., Leung T., Chu W., Chappell F., Makin S., Hayden D., Williams D.J., Mess W.H., Nederkoorn P.J., Barbato C., Browning S., Wiegertjes K., Tuladhar A.M., Maaijwee N., Guevarra A.C., Yatawara C., Mendyk A.-M., Delmaire C., Kohler S., van Oostenbrugge R., Zhou Y., Xu C., Hilal S., Gyanwali B., Chen C., Lou M., Staals J., Bordet R., Kandiah N., de Leeuw F.-E., Simister R., Hendrikse J., Kelly P.J., Wardlaw J., Soo Y., Fluri F., Srikanth V., Calvet D., Jung S., Kwa V.I.H., Engelter S.T., Peters N., Smith E.E., Hara H., Yakushiji Y., Orken D.N., Fazekas F., Thijs V., Heo J.H., Mok V., Veltkamp R., Ay H., Imaizumi T., Gomez-Anson B., Lau K.K., Jouvent E., Rothwell P.M., Toyoda K., Bae H.-J., Marti-Fabregas J., Werring D.J., Harkness K., Shaw L., Sword J., Mohd Nor A., Sharma P., Kelly D., Harrington F., Randall M., Smith M., Mahawish K., Elmarim A., Esisi B., Cullen C., Nallasivam A., Price C., Barry A., Roffe C., Coyle J., Hassan A., Birns J., Cohen D., Sekaran L., Parry-Jones A., Parry A., Hargroves D., Proschel H., Datta P., Darawil K., Manoj A., Burn M., Patterson C., Giallombardo E., Smyth N., Mansoor S., Anwar I., Marsh R., Ispoglou S., Chadha D., Prabhakaran M., Meenakishundaram S., O'Connell J., Scott J., Krishnamurthy V., Aghoram P., McCormick M., Sprigg N., O'Mahony P., Cooper M., Choy L., Wilkinson P., Leach S., Caine S., Burger I., Gunathilagan G., Guyler P., Emsley H., Davis M., Manawadu D., Pasco K., Mamun M., Luder R., Sajid M., Okwera J., Warburton E., Saastamoinen K., England T., Putterill J., Flossman E., Power M., Dani K., Mangion D., Suman A., Corrigan J., Lawrence E., Vahidassr D., Shakeshaft C., Brown M., Charidimou A., Cohen H., Banerjee G., Houlden H., White M., Yousry T., Flossmann E., Muir K., Gratz P., Mattle H., Panos L., Korczyn A., Kliper E., Maeder P., Gass A., Pachai C., Bracoub L., Douste-Blazy M.-Y., Fratacci M.D., Vicaut E., Sato S., Miwa K., Fujita K., Ide T., Ma H., Ly J., Singhal S., Chandra R., Slater L.-A., Soufan C., Moran C., Traenka C., Thilemann S., Fladt J., Gensicke H., Bonati L., Kim B.J., Han M.-K., Kang J., Ko E., Yang M.H., Jang M.S., Murphy S., Carty F., Akijian L., Thornton J., Schembri M., Douven E., Delgado-Mederos R., Marin R., Camps-Renom P., Guisado-Alonso D., Nunez F., Medrano-Martorell S., Merino E., Iida K., Ikeda S., Irie H., Demirelli D.S., Medanta J.M., Zerna C., Hernandez M.V., Armitage P., Heye A., Munoz-Maniega S., Sakka E., Thrippleton M., Dennis M., Beigneux Y., Silva M., Venketasubramanian N., Ho S.L., Cheung R.T.F., Chan K.H., Teo K.C., Hui E., Kwan J.S.K., Chang R., Tse M.Y., Hoi C.P., Chan C.Y., Chan O.L., Cheung R.H.K., Wong E.K.M., Leung K.T., Tsang S.F., Ip H.L., Ma S.H., Ma K., Fong W.C., Li S.H., Li R., Ng P.W., Wong K.K., Liu W., Wong L., Ramos L., De Schryver E., Jobsis J., van der Sande J., Brouwers P., Roos Y., Stam J., Bakker S., Verbiest H., Schoonewille W., Linn C., Hertzberger L., van Gemert M., Berntsen P., Van Dam-Nolen D., Kooi M.E., Van der Lugt A., Koudstaal P., Leff A., Ward N., Nachev P., Perry R., Ozkan H., and Mitchell J.
- Abstract
Background: Balancing the risks of recurrent ischaemic stroke and intracranial haemorrhage is important for patients treated with antithrombotic therapy after ischaemic stroke or transient ischaemic attack. However, existing predictive models offer insufficient performance, particularly for assessing the risk of intracranial haemorrhage. We aimed to develop new risk scores incorporating clinical variables and cerebral microbleeds, an MRI biomarker of intracranial haemorrhage and ischaemic stroke risk. Method(s): We did a pooled analysis of individual-patient data from the Microbleeds International Collaborative Network (MICON), which includes 38 hospital-based prospective cohort studies from 18 countries. All studies recruited participants with previous ischaemic stroke or transient ischaemic attack, acquired baseline MRI allowing quantification of cerebral microbleeds, and followed-up participants for ischaemic stroke and intracranial haemorrhage. Participants not taking antithrombotic drugs were excluded. We developed Cox regression models to predict the 5-year risks of intracranial haemorrhage and ischaemic stroke, selecting candidate predictors on biological relevance and simplifying models using backward elimination. We derived integer risk scores for clinical use. We assessed model performance in internal validation, adjusted for optimism using bootstrapping. The study is registered on PROSPERO, CRD42016036602. Finding(s): The included studies recruited participants between Aug 28, 2001, and Feb 4, 2018. 15 766 participants had follow-up for intracranial haemorrhage, and 15 784 for ischaemic stroke. Over a median follow-up of 2 years, 184 intracranial haemorrhages and 1048 ischaemic strokes were reported. The risk models we developed included cerebral microbleed burden and simple clinical variables. Optimism-adjusted c indices were 0.73 (95% CI 0.69-0.77) with a calibration slope of 0.94 (0.81-1.06) for the intracranial haemorrhage model and 0.63 (0.62-0.65) w
- Published
- 2021
17. Konvexale Subarachnoidalblutung: Akute diskrete Monoparese des Armes bei einem 80-jährigen Patienten mit leichter kognitiver Beeinträchtigung
- Author
-
Gattringer, T., Beitzke, M., Enzinger, C., Wurm, W., Lechner, A., and Fazekas, F.
- Published
- 2011
- Full Text
- View/download PDF
18. NO EVIDENCE FOR INCREASED IRON DEPOSITION IN DEEP GRAY MATTER REGIONS IN SUBJECTS WITH MRI FINDINGS SUGGESTIVE OF CEREBRAL SMALL VESSEL DISEASE: 4
- Author
-
Jehna, M., Enzinger, C., Langkammer, C., Linortner, P., Aspeck, E., Pendl, B., Gattringer, T., Petrovic, K., Ropele, S., and Fazekas, F.
- Published
- 2011
19. CLINICAL PRESENTATION, AETIOLOGY AND LONG-TERM PROGNOSIS IN PATIENTS WITH ATRAUMATIC CONVEXAL SUBARACHNOID HEMORRHAGE: 6
- Author
-
Gattringer, T., Beitzke, M., Enzinger, C., Wagner, G., Niederkorn, K., and Fazekas, F.
- Published
- 2011
20. Baseline white matter hyperintensities affect the course of cognitive function after small vessel disease‐related stroke: a prospective observational study
- Author
-
Fruhwirth, V., primary, Enzinger, C., additional, Fandler‐Höfler, S., additional, Kneihsl, M., additional, Eppinger, S., additional, Ropele, S., additional, Schmidt, R., additional, Gattringer, T., additional, and Pinter, D., additional
- Published
- 2020
- Full Text
- View/download PDF
21. Ventilation time and prognosis after stroke thrombectomy: the shorter, the better!
- Author
-
Fandler‐Höfler, S., primary, Heschl, S., additional, Kneihsl, M., additional, Argüelles‐Delgado, P., additional, Niederkorn, K., additional, Pichler, A., additional, Deutschmann, H., additional, Fazekas, F., additional, Berghold, A., additional, Enzinger, C., additional, and Gattringer, T., additional
- Published
- 2020
- Full Text
- View/download PDF
22. Features of intracranial hemorrhage in cerebral venous thrombosis (Jun, 10.1007/s00415-020-10008-0, 2020)
- Author
-
Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Garcia-Esperon, C., Barboza, M. A., Costa, P., Escudero, I., Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Jimenez-Conde, J., Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P., Thijs, V., Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Garcia-Esperon, C., Barboza, M. A., Costa, P., Escudero, I., Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Jimenez-Conde, J., Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P., and Thijs, V.
- Abstract
The original version of this article unfortunately contained mistakes. The correct information is given below.
- Published
- 2020
23. Morphological MRI phenotypes of multiple sclerosis differ in resting-state brain function
- Author
-
Pinter, D., Beckmann, C.F., Fazekas, F., Khalil, M., Pichler, A., Gattringer, T., Ropele, S., Fuchs, S., Enzinger, C., Pinter, D., Beckmann, C.F., Fazekas, F., Khalil, M., Pichler, A., Gattringer, T., Ropele, S., Fuchs, S., and Enzinger, C.
- Abstract
Contains fulltext : 215278.pdf (publisher's version ) (Open Access), We aimed to assess differences in resting-state functional connectivity (FC) between distinct morphological MRI-phenotypes in multiple sclerosis (MS). Out of 180 MS patients, we identified those with high T2-hyperintense lesion load (T2-LL) and high normalized brain volume (NBV; a predominately white matter damage group, WMD; N = 37) and patients with low T2-LL and low NBV (N = 37; a predominately grey matter damage group; GMD). Independent component analysis of resting-state fMRI was used to test for differences in the sensorimotor network (SMN) between MS MRI-phenotypes and compared to 37 age-matched healthy controls (HC). The two MS groups did not differ regarding EDSS scores, disease duration and distribution of clinical phenotypes. WMD compared to GMD patients showed increased FC in all sub-units of the SMN (sex- and age-corrected). WMD patients had increased FC compared to HC and GMD patients in the central SMN (leg area). Only in the WMD group, higher EDSS scores and T2-LL correlated with decreased connectivity in SMN sub-units. MS patients with distinct morphological MRI-phenotypes also differ in brain function. The amount of focal white matter pathology but not global brain atrophy affects connectivity in the central SMN (leg area) of the SMN, consistent with the notion of a disconnection syndrome.
- Published
- 2019
24. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
- Author
-
Wilson, D., Ambler, G., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Li, L, Lovelock, C., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H.K.F., Prats-Sanchez, L., Martinez-Domeno, A., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Schrooten, M., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Tanriverdi, Z., Bornstein, N.M., Assayag, E.B., Hallevi, H., Tanaka, J., Hara, H., Coutts, S.B., Hert, L., Polymeris, A., Seiffge, D.J., Lyrer, P., Algra, A., Kappelle, J., Al-Shahi Salman, R., Jager, H.R., Lip, G.Y.H., Mattle, H.P., Panos, L.D., Mas, J.L., Legrand, L., Karayiannis, C., Phan, T., Gunkel, S., Christ, N., Abrigo, J., Leung, T., Chu, W., Chappell, F., Makin, S., Hayden, D., Williams, D.J., Kooi, M.E., Dam-Nolen, D.H.K., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Maaijwee, N., Guevarra, C., Yatawara, C., Mendyk, A.M., Delmaire, C., Kohler, S., Oostenbrugge, R van, Zhou, Y, Xu, C., Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Lugt, A. van der, Kelly, P.J., Wardlaw, J.M., Soo, Y., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Engelter, S.T., Peters, N, Smith, E.E., Yakushiji, Y., Orken, D.N., Fazekas, F., Marti-Fabregas, J., Werring, D.J., Wilson, D., Ambler, G., Lee, K.J., Lim, J.S., Shiozawa, M., Koga, M., Li, L, Lovelock, C., Chabriat, H., Hennerici, M., Wong, Y.K., Mak, H.K.F., Prats-Sanchez, L., Martinez-Domeno, A., Inamura, S., Yoshifuji, K., Arsava, E.M., Horstmann, S., Purrucker, J., Lam, B.Y.K., Wong, A., Kim, Y.D., Song, T.J., Schrooten, M., Lemmens, R., Eppinger, S., Gattringer, T., Uysal, E., Tanriverdi, Z., Bornstein, N.M., Assayag, E.B., Hallevi, H., Tanaka, J., Hara, H., Coutts, S.B., Hert, L., Polymeris, A., Seiffge, D.J., Lyrer, P., Algra, A., Kappelle, J., Al-Shahi Salman, R., Jager, H.R., Lip, G.Y.H., Mattle, H.P., Panos, L.D., Mas, J.L., Legrand, L., Karayiannis, C., Phan, T., Gunkel, S., Christ, N., Abrigo, J., Leung, T., Chu, W., Chappell, F., Makin, S., Hayden, D., Williams, D.J., Kooi, M.E., Dam-Nolen, D.H.K., Barbato, C., Browning, S., Wiegertjes, K., Tuladhar, A.M., Maaijwee, N., Guevarra, C., Yatawara, C., Mendyk, A.M., Delmaire, C., Kohler, S., Oostenbrugge, R van, Zhou, Y, Xu, C., Hilal, S., Gyanwali, B., Chen, C, Lou, M., Staals, J., Bordet, R., Kandiah, N., Leeuw, F.E. de, Simister, R., Lugt, A. van der, Kelly, P.J., Wardlaw, J.M., Soo, Y., Fluri, F., Srikanth, V., Calvet, D., Jung, S., Kwa, V.I.H., Engelter, S.T., Peters, N, Smith, E.E., Yakushiji, Y., Orken, D.N., Fazekas, F., Marti-Fabregas, J., and Werring, D.J.
- Abstract
Contains fulltext : 208975.pdf (publisher's version ) (Open Access), BACKGROUND: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. METHODS: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. FINDINGS: Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1.34 years [IQR 0.19-2.44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1.35 (95% CI 1.20-1.50) for the composite outcome of intr
- Published
- 2019
25. Global Outcome Assessment Life-long after stroke in young adults initiative-the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis
- Author
-
Ekker, M.S., Jacob, M.A., Dongen, M.M.E. van, Aarnio, K., Annamalai, A., Arauz, A., Arnold, M., Barboza, M., Bolognese, M., Brouns, R., Chuluun, B., Chuluunbaatar, E., Dagvajantsan, B., Debette, S., Don, A., Enzinger, C., Ekizoglu, E., Fandler-Hofler, S., Fazekas, F., Fromm, A., Gattringer, T., Gulli, G., Hoffmann, M., Hora, T., Jern, C., Jood, K., Kamouchi, M., Kim, Y.S., Kitazono, T., Kittner, S., Kleinig, T., Klijn, K., Korv, J., Lee, T.H., Leys, D., Maaijwee, N., Martinez-Majander, N., Marto, J.P., Mehndiratta, M., Mifsud, V., Montanaro, V., Owolabi, M.O., Patel, V., Phillips, M., Piechowski-Iozwiak, B., Pikula, A., Ruiz-Sandoval, J.L., Sarnowski, B., Schreuder, F.H.B.M., Swartz, R., Tan, K.S., Tanne, D., Tatlisumak, T., Thijs, V., Tuladhar, A., Viana-Baptista, M., Vibo, R., Wu, T., Yesilot, N., Waje-Andreassen, U., Pezzini, A., Putaala, J., Leeuw, F.E. de, Ekker, M.S., Jacob, M.A., Dongen, M.M.E. van, Aarnio, K., Annamalai, A., Arauz, A., Arnold, M., Barboza, M., Bolognese, M., Brouns, R., Chuluun, B., Chuluunbaatar, E., Dagvajantsan, B., Debette, S., Don, A., Enzinger, C., Ekizoglu, E., Fandler-Hofler, S., Fazekas, F., Fromm, A., Gattringer, T., Gulli, G., Hoffmann, M., Hora, T., Jern, C., Jood, K., Kamouchi, M., Kim, Y.S., Kitazono, T., Kittner, S., Kleinig, T., Klijn, K., Korv, J., Lee, T.H., Leys, D., Maaijwee, N., Martinez-Majander, N., Marto, J.P., Mehndiratta, M., Mifsud, V., Montanaro, V., Owolabi, M.O., Patel, V., Phillips, M., Piechowski-Iozwiak, B., Pikula, A., Ruiz-Sandoval, J.L., Sarnowski, B., Schreuder, F.H.B.M., Swartz, R., Tan, K.S., Tanne, D., Tatlisumak, T., Thijs, V., Tuladhar, A., Viana-Baptista, M., Vibo, R., Wu, T., Yesilot, N., Waje-Andreassen, U., Pezzini, A., Putaala, J., and Leeuw, F.E. de
- Abstract
Contains fulltext : 215629.pdf (publisher's version ) (Open Access), INTRODUCTION: Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients. METHODS AND ANALYSIS: The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence. ETHICS AND DISSEMINATION: Ethical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.
- Published
- 2019
26. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.
- Author
-
Jung S., van Dam-Nolen D.H.K., Douven E., Delgado-Mederos, R., Marin R., Camps-Renom P., Guisado-Alonso D., Nunez F., Medrano-Martorell S., Merino E., Iida K., Ikeda S., Nishihara M., Irie H., Demirelli D.S., Medanta J.M., Zerna C., Hernandez M.V., Armitage P., Heye A., Munoz-Maniega S., Sakka E., Thrippleton M., Dennis M., Beigneux Y., Silva M., Venketasubramanian N., Ho S.L., Cheung R.T.F., Chan K.H., Teo K.C., Hui E., Kwan J.S.K., Chang R., Tse M.Y., Hoi C.P., Chan C.Y., Chan O.L., Cheung R.H.K., Wong E.K.M., Leung K.T., Tsang S.F., Ip H.L., Ma S.H., Ma K., Fong W.C., Li S.H., Li R., Ng P.W., Wong K.K., Liu W., Wong L., Ramos L., De Schryver E., Jobsis J., van der Sande J., Brouwers P., Roos Y., Stam J., Bakker S., Verbiest H., Schoonewille W., Linn C., Hertzberger L., van Gemert M., Berntsen P., Hendrikse J., Nederkoorn P., Mess W., Koudstaal P., Leff A., Ward N., Nachev P., Perry R., Ozkan H., Mitchell J., Wilson D., Ambler G., Lee K.-J., Lim J.-S., Shiozawa M., Koga M., Li L., Lovelock C., Chabriat H., Hennerici M., Wong Y.K., Mak H.K.F., Prats-Sanchez L., Martinez-Domeno A., Inamura S., Yoshifuji K., Arsava E.M., Horstmann S., Purrucker J., Lam B.Y.K., Wong A., Kim Y.D., Song T.-J., Schrooten M., Lemmens R., Eppinger S., Gattringer T., Uysal E., Tanriverdi Z., Bornstein N.M., Assayag E.B., Hallevi H., Tanaka J., Hara H., Coutts S.B., Hert L., Polymeris A., Seiffge D.J., Lyrer P., Algra A., Kappelle J., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Mattle H.P., Panos L.D., Mas J.-L., Legrand L., Karayiannis C., Phan T., Gunkel S., Christ N., Abrigo J., Leung T., Chu W., Chappell F., Makin S., Hayden D., Williams D.J., Kooi M.E., Barbato C., Browning S., Wiegertjes K., Tuladhar A.M., Maaijwee N., Guevarra C., Yatawara C., Mendyk A.-M., Delmaire C., Kohler S., van Oostenbrugge R., Zhou Y., Xu C., Hilal S., Gyanwali B., Chen C., Lou M., Staals J., Bordet R., Kandiah N., de Leeuw F.-E., Simister R., van der Lugt A., Kelly P.J., Wardlaw J.M., Soo Y., Fluri F., Srikanth V., Calvet D., Kwa V.I.H., Engelter S.T., Peters N., Smith E.E., Yakushiji Y., Orken D.N., Fazekas F., Thijs V., Heo J.H., Mok V., Veltkamp R., Ay H., Imaizumi T., Gomez-Anson B., Lau K.K., Jouvent E., Rothwell P.M., Toyoda K., Bae H.-J., Marti-Fabregas J., Werring D.J., Harkness K., Shaw L., Sword J., Mohd Nor A., Sharma P., Kelly D., Harrington F., Randall M., Smith M., Mahawish K., Elmarim A., Esisi B., Cullen C., Nallasivam A., Price C., Barry A., Roffe C., Coyle J., Hassan A., Birns J., Cohen D., Sekaran L., Parry-Jones A., Parry A., Hargroves D., Proschel H., Datta P., Darawil K., Manoj A., Burn M., Patterson C., Giallombardo E., Smyth N., Mansoor S., Anwar I., Marsh R., Ispoglou S., Chadha D., Prabhakaran M., Meenakishundaram S., O'Connell J., Scott J., Krishnamurthy V., Aghoram P., McCormick M., Sprigg N., O'Mahony P., Cooper M., Choy L., Wilkinson P., Leach S., Caine S., Burger I., Gunathilagan G., Guyler P., Emsley H., Davis M., Manawadu D., Pasco K., Mamun M., Luder R., Sajid M., Okwera J., Warburton E., Saastamoinen K., England T., Putterill J., Flossman E., Power M., Dani K., Mangion D., Suman A., Corrigan J., Lawrence E., Vahidassr D., Shakeshaft C., Brown M., Charidimou A., Cohen H., Banerjee G., Houlden H., White M., Yousry T., Flossmann E., Muir K., El-Koussy M., Gratz P., Molad J., Korczyn A., Kliper E., Maeder P., Gass A., Pachai C., Bracoub L., Douste-Blazy M.-Y., Fratacci M.D., Vicaut E., Sato S., Miwa K., Fujita K., Ide T., Ma H., Ly J., Singhal S., Chandra R., Slater L.-A., Soufan C., Moran C., Traenka C., Thilemann S., Fladt J., Gensicke H., Bonati L., Kim B.J., Han M.-K., Kang J., Ko E., Yang M.H., Jang M.S., Murphy S., Carty F., Akijian L., Thornton J., Schembri M., Jung S., van Dam-Nolen D.H.K., Douven E., Delgado-Mederos, R., Marin R., Camps-Renom P., Guisado-Alonso D., Nunez F., Medrano-Martorell S., Merino E., Iida K., Ikeda S., Nishihara M., Irie H., Demirelli D.S., Medanta J.M., Zerna C., Hernandez M.V., Armitage P., Heye A., Munoz-Maniega S., Sakka E., Thrippleton M., Dennis M., Beigneux Y., Silva M., Venketasubramanian N., Ho S.L., Cheung R.T.F., Chan K.H., Teo K.C., Hui E., Kwan J.S.K., Chang R., Tse M.Y., Hoi C.P., Chan C.Y., Chan O.L., Cheung R.H.K., Wong E.K.M., Leung K.T., Tsang S.F., Ip H.L., Ma S.H., Ma K., Fong W.C., Li S.H., Li R., Ng P.W., Wong K.K., Liu W., Wong L., Ramos L., De Schryver E., Jobsis J., van der Sande J., Brouwers P., Roos Y., Stam J., Bakker S., Verbiest H., Schoonewille W., Linn C., Hertzberger L., van Gemert M., Berntsen P., Hendrikse J., Nederkoorn P., Mess W., Koudstaal P., Leff A., Ward N., Nachev P., Perry R., Ozkan H., Mitchell J., Wilson D., Ambler G., Lee K.-J., Lim J.-S., Shiozawa M., Koga M., Li L., Lovelock C., Chabriat H., Hennerici M., Wong Y.K., Mak H.K.F., Prats-Sanchez L., Martinez-Domeno A., Inamura S., Yoshifuji K., Arsava E.M., Horstmann S., Purrucker J., Lam B.Y.K., Wong A., Kim Y.D., Song T.-J., Schrooten M., Lemmens R., Eppinger S., Gattringer T., Uysal E., Tanriverdi Z., Bornstein N.M., Assayag E.B., Hallevi H., Tanaka J., Hara H., Coutts S.B., Hert L., Polymeris A., Seiffge D.J., Lyrer P., Algra A., Kappelle J., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Mattle H.P., Panos L.D., Mas J.-L., Legrand L., Karayiannis C., Phan T., Gunkel S., Christ N., Abrigo J., Leung T., Chu W., Chappell F., Makin S., Hayden D., Williams D.J., Kooi M.E., Barbato C., Browning S., Wiegertjes K., Tuladhar A.M., Maaijwee N., Guevarra C., Yatawara C., Mendyk A.-M., Delmaire C., Kohler S., van Oostenbrugge R., Zhou Y., Xu C., Hilal S., Gyanwali B., Chen C., Lou M., Staals J., Bordet R., Kandiah N., de Leeuw F.-E., Simister R., van der Lugt A., Kelly P.J., Wardlaw J.M., Soo Y., Fluri F., Srikanth V., Calvet D., Kwa V.I.H., Engelter S.T., Peters N., Smith E.E., Yakushiji Y., Orken D.N., Fazekas F., Thijs V., Heo J.H., Mok V., Veltkamp R., Ay H., Imaizumi T., Gomez-Anson B., Lau K.K., Jouvent E., Rothwell P.M., Toyoda K., Bae H.-J., Marti-Fabregas J., Werring D.J., Harkness K., Shaw L., Sword J., Mohd Nor A., Sharma P., Kelly D., Harrington F., Randall M., Smith M., Mahawish K., Elmarim A., Esisi B., Cullen C., Nallasivam A., Price C., Barry A., Roffe C., Coyle J., Hassan A., Birns J., Cohen D., Sekaran L., Parry-Jones A., Parry A., Hargroves D., Proschel H., Datta P., Darawil K., Manoj A., Burn M., Patterson C., Giallombardo E., Smyth N., Mansoor S., Anwar I., Marsh R., Ispoglou S., Chadha D., Prabhakaran M., Meenakishundaram S., O'Connell J., Scott J., Krishnamurthy V., Aghoram P., McCormick M., Sprigg N., O'Mahony P., Cooper M., Choy L., Wilkinson P., Leach S., Caine S., Burger I., Gunathilagan G., Guyler P., Emsley H., Davis M., Manawadu D., Pasco K., Mamun M., Luder R., Sajid M., Okwera J., Warburton E., Saastamoinen K., England T., Putterill J., Flossman E., Power M., Dani K., Mangion D., Suman A., Corrigan J., Lawrence E., Vahidassr D., Shakeshaft C., Brown M., Charidimou A., Cohen H., Banerjee G., Houlden H., White M., Yousry T., Flossmann E., Muir K., El-Koussy M., Gratz P., Molad J., Korczyn A., Kliper E., Maeder P., Gass A., Pachai C., Bracoub L., Douste-Blazy M.-Y., Fratacci M.D., Vicaut E., Sato S., Miwa K., Fujita K., Ide T., Ma H., Ly J., Singhal S., Chandra R., Slater L.-A., Soufan C., Moran C., Traenka C., Thilemann S., Fladt J., Gensicke H., Bonati L., Kim B.J., Han M.-K., Kang J., Ko E., Yang M.H., Jang M.S., Murphy S., Carty F., Akijian L., Thornton J., and Schembri M.
- Abstract
Background: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. Method(s): We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. Finding(s): Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1.34 years [IQR 0.19-2.44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1.35 (95% CI 1.20-1.50) for the composite outcome of
- Published
- 2019
27. Diagnostic accuracy of noncontrast CT imaging markers in cerebral venous thrombosis.
- Author
-
Pezzini A., Lemmens R., Hinteregger N., Fazekas F., Conde J.J., Giralt-Steinhauer E., Hiltunen S., Arauz A., Montaner J., Thijs V., Demaerel P., Coutinho J.M., Tatlisumak T., Asadi H., Gattringer T., Churilov L., Weimar C., Putaala J., Buyck P.-J., Zuurbier S.M., Garcia-Esperon C., Barboza M.A., Costa P., Escudero I., Renard D., Pezzini A., Lemmens R., Hinteregger N., Fazekas F., Conde J.J., Giralt-Steinhauer E., Hiltunen S., Arauz A., Montaner J., Thijs V., Demaerel P., Coutinho J.M., Tatlisumak T., Asadi H., Gattringer T., Churilov L., Weimar C., Putaala J., Buyck P.-J., Zuurbier S.M., Garcia-Esperon C., Barboza M.A., Costa P., Escudero I., and Renard D.
- Abstract
ObjectiveTo assess the added diagnostic value of semiquantitative imaging markers on noncontrast CT scans in cerebral venous thrombosis (CVT).MethodsIn a retrospective, multicenter, blinded, case-control study of patients with recent onset (<2 weeks) CVT, 3 readers assessed (1) the accuracy of the visual impression of CVT based on a combination of direct and indirect signs, (2) the accuracy of attenuation values of the venous sinuses in Hounsfield units (with adjustment for hematocrit levels), and (3) the accuracy of attenuation ratios of affected vs unaffected sinuses in comparison with reference standard MRI or CT angiography. Controls were age-matched patients with (sub)acute neurologic presentations.ResultsWe enrolled 285 patients with CVT and 303 controls from 10 international centers. Sensitivity of visual impression of thrombosis ranged from 41% to 73% and specificity ranged from 97% to 100%. Attenuation measurement had an area under the curve (AUC) of 0.78 (95% confidence interval [CI] 0.74-0.81). After adjustment for hematocrit, the AUC remained 0.78 (95% CI 0.74-0.81). The analysis of attenuation ratios of affected vs unaffected sinuses had AUC of 0.83 (95% CI 0.8-0.86). Adding this imaging marker significantly improved discrimination, but sensitivity when tolerating a false-positive rate of 20% was not higher than 76% (95% CI 0.70-0.81).ConclusionSemiquantitative analysis of attenuation values for diagnosis of CVT increased sensitivity but still failed to identify 1 out of 4 CVT.Classification of evidenceThis study provides Class II evidence that visual analysis of plain CT with or without attenuation measurements has high specificity but only moderate sensitivity for CVT.Copyright © 2019 American Academy of Neurology.
- Published
- 2019
28. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
- Author
-
Wilson, D. (Duncan), Ambler, G. (Gareth), Lee, K.-J. (Keon-Joo), Lim, J.-S. (Jae-Sung), Shiozawa, M. (Masayuki), Koga, M. (Masatoshi), Li, L. (Linxin), Lovelock, C. (Caroline), Chabriat, H. (Hugues), Hennerici, M.G. (Michael), Wong, Y.K. (Yuen Kwun), Mak, H.K.F. (Henry Ka Fung), Prats-Sánchez, L. (Luis), Martínez-Domeño, A. (Alejandro), Inamura, S. (Shigeru), Yoshifuji, K. (Kazuhisa), Arsava, E.M. (Ethem Murat), Horstmann, S. (Solveig), Purrucker, J. (Jan), Lam, B.Y.K. (Bonnie Yin Ka), Wong, A. (Adrian), Kim, Y.D. (Young Dae), Song, T.-J. (Tae-Jin), Schrooten, M. (Maarten), Lemmens, R. (Robin), Eppinger, S. (Sebastian), Gattringer, T. (Thomas), Uysal, E. (Ender), Tanriverdi, Z. (Zeynep), Bornstein, S.R. (Stefan), Assayag, E.B. (Einor Ben), Hallevi, H. (Hen), Tanaka, J. (Jun), Hara, H. (Hideo), Coutts, S.B. (Shelagh B), Hert, L. (Lisa), Polymeris, A. (Alexandros), Seiffge, D.J. (David J), Lyrer, P.A. (Philippe), Algra, A. (Ale), Kappelle, L.J. (Jaap), Al-Shahi Salman, R. (Rustam), Jäger, H.R. (Rolf), Lip, G.Y.H. (Gregory Y H), Mattle, H., Panos, L.D. (Leonidas D), Mas, J.L. (J.), Legrand, L. (Laurence), Karayiannis, C. (Christopher), Phan, T.G. (Thanh), Gunkel, S. (Sarah), Christ, N. (Nicolas), Abrigo, J. (Jill), Leung, T. (Thomas), Chu, W. (Winnie), Chappell, F. (Francesca), Makin, S. (Stephen), Hayden, D. (Derek), Williams, D.J. (David J), Kooi, M.E. (M. Eline), van Dam-Nolen, D.H.K. (Dianne H K), Barbato, C. (Carmen), Browning, S. (Simone), Wiegertjes, K. (Kim), Tuladhar, A.M. (Anil M.), Maaijwee, N. (Noortje), Guevarra, C. (Christine), Yatawara, C. (Chathuri), Mendyk, A.-M. (Anne-Marie), Delmaire, C. (Christine), Köhler, S. (Sebastian), Oostenbrugge, R.J. (Robert) van, Zhou, Y. (Ying), Xu, C. (Chao), Hilal, S. (Saima), Gyanwali, B. (Bibek), Chen, C. (Christopher), Lou, M. (Min), Staals, J. (Julie), Bordet, R. (Régis), Kandiah, N. (Nagaendran), Leeuw, H.F. (Frank) de, Simister, R. (Robert), Lugt, A. (Aad) van der, Kelly, P.J. (Peter J), Wardlaw, J.M. (J.), Soo, Y. (Yannie), Fluri, F. (Felix), Srikanth, V. (Velandai), Calvet, D. (David), Jung, S. (Simon), Kwa, V.I.H., Engelter, S.T. (Stefan), Peters, N. (Nils), Smith, E.E. (Eric), Yakushiji, Y. (Yusuke), Orken, D.N. (Dilek Necioglu), Fazekas, F. (Franz), Thijs, V. (Vincent), Heo, J.H. (Ji Hoe), Mok, V. (Vincent), Veltkamp, R. (Roland), Ay, H. (Hakan), Imaizumi, T. (Toshio), Gomez-Anson, B. (Beatriz), Lau, K.K. (Kui Kai), Jouvent, E. (Eric), Rothwell, P.M. (Peter), Toyoda, K. (Kazunori), Bae, H.-J. (Hee-Joon), Marti-Fabregas, J. (Joan), Werring, D.J. (David), Harkness, K. (Kirsty), Shaw, L. (Louise), Sword, J. (Jane), Mohd Nor, A. (Azlisham), Sharma, P. (Pankaj), Kelly, D. (Deborah), Harrington, F. (Frances), Randall, M. (Marc), Smith, M. (Matthew), Mahawish, K. (Karim), Elmarim, A. (Abduelbaset), Esisi, B. (Bernard), Cullen, C. (Claire), Nallasivam, A. (Arumug), Price, C. (Christopher), Barry, A. (Adrian), Roffe, C. (Christine), Coyle, J. (John), Hassan, A. (Ahamad), Birns, J. (Jonathan), Cohen, D. (David), Sekaran, L. (Lakshmanan), Parry-Jones, A. (Adrian), Parry, A. (Anthea), Hargroves, D. (David), Proschel, H. (Harald), Datta, P. (Prabel), Darawil, K. (Khaled), Manoj, A. (Aravindakshan), Burn, M. (Mathew), Patterson, C. (Chris), Giallombardo, E. (Elio), Smyth, N. (Nigel), Mansoor, S. (Syed), Anwar, I. (Ijaz), Marsh, R. (Rachel), Ispoglou, S. (Sissi), Chadha, D. (Dinesh), Prabhakaran, M. (Mathuri), Meenakishundaram, S. (Sanjeevikumar), O'Connell, J. (Janice), Scott, J. (Jon), Krishnamurthy, V. (Vinodh), Aghoram, P. (Prasanna), McCormick, M. (Michael), Sprigg, N. (Nikola), O'Mahony, P. (Paul), Cooper, M. (Martin), Choy, L. (Lillian), Wilkinson, P. (Peter), Leach, S. (Simon), Caine, S. (Sarah), Burger, I. (Ilse), Gunathilagan, G. (Gunaratam), Guyler, P. (Paul), Emsley, H. (Hedley), Davis, M. (Michelle), Manawadu, D. (Dulka), Pasco, K. (Kath), Mamun, M. (Maam), Luder, R. (Robert), Sajid, M. (Mahmud), Okwera, J. (James), Warburton, E. (Elizabeth), Saastamoinen, K. (Kari), England, T. (Timothy), Putterill, J. (Janet), Flossman, E. (Enrico), Power, M. (Michael), Dani, K. (Krishna), Mangion, D. (David), Suman, A. (Appu), Corrigan, J. (John), Lawrence, E. (Enas), Vahidassr, D. (Djamil), Shakeshaft, C. (Clare), Brown, M. (Martin), Charidimou, A. (Andreas), Cohen, H. (Hannah), Banerjee, G. (Gargi), Houlden, H. (Henry), White, M. (Mark), Yousry, T. (Tarek), Flossmann, E. (Enrico), Muir, K. (Keith), El-Koussy, M. (Marwan), Gratz, P. (Pascal), Molad, J. (Jeremy), Korczyn, A.D. (A.), Kliper, E. (Efrat), Maeder, P. (Philippe), Gass, A. (Achim), Pachai, C. (Chahin), Bracoub, L. (Luc), Douste-Blazy, M.-Y. (Marie-Yvonne), Fratacci, M.D. (Marie Dominique), Vicaut, E. (Eric), Sato, S. (Shoichiro), Miwa, K. (Kaori), Fujita, K. (Kyohei), Ide, T. (Toshihiro), Ma, H. (Henry), Ly, J. (John), Singhal, S. (Shahoo), Chandra, R. (Ronil), Slater, L.-A. (Lee-Anne), Soufan, C. (Cathy), Moran, C. (Christopher), Traenka, C. (Christopher), Thilemann, S. (Sebastian), Fladt, J. (Joachim), Gensicke, H. (Henrik), Bonati, L. (Leo), Kim, B.J. (Beom Joon), Han, M.-K. (Moon-Ku), Kang, J. (Jihoon), Ko, E. (Eunbin), Yang, M.H. (Mi Hwa), Jang, M.S. (Myung Suk), Murphy, S. (Sean), Carty, F. (Fiona), Akijian, L. (Layan), Thornton, J. (John), Schembri, M. (Mark), Douven, E. (Elles), Delgado-Mederos;, R. (Raquel), Marín, R. (Rebeca), Camps-Renom, P. (Pol), Guisado-Alonso, D. (Daniel), Nuñez, F. (Fidel), Medrano-Martorell, S. (Santiago), Merino, E. (Elisa), Iida, K. (Kotaro), Ikeda, S. (Syuhei), Nishihara, M. (Masashi), Irie, H. (Hiroyuki), Demirelli, D.S. (Derya Selcuk), Medanta, J.M. (Jayesh Modi), Zerna, C. (Charlotte), Hernández, M.V. (Maria Valdés), Armitage, P. (Paul), Heye, A. (Anna), Muñoz Maniega, S. (Susana), Sakka, E. (Eleni), Thrippleton, M. (Michael), Dennis, M.S. (M.), Beigneux, Y. (Ysoline), Silva, M. (Mauro), Venketasubramanian, N. (Narayanaswamy), Ho, S.L. (Shu Leung), Cheung, R.T.F. (Raymond Tak Fai), Chan, K.H. (Koon Ho), Teo, K.C. (Kay Cheong), Hui, E. (Edward), Kwan, J.S.K. (Joseph Shiu Kwong), Chang, R. (Richard), Tse, M.Y. (Man Yu), Hoi, C.P. (Chu Peng), Chan, C.Y. (Chung Yan), Chan, O.L. (Oi Ling), Cheung, R.H.K. (Ryan Hoi Kit), Wong, E.K.M. (Edmund Ka Ming), Leung, K.T. (Kam Tat), Tsang, S.F. (Suk Fung), Ip, H.L. (Hing Lung), Ma, S.H. (Sze Ho), Ma, K. (Karen), Fong, W.C. (Wing Chi), Li, S.H. (Siu Hung), Li, R. (Richard), Ng, P.W. (Ping Wing), Wong, K.K. (Kwok Kui), Liu, W. (Wenyan), Wong, L. (Lawrence), Ramos, L. (Lino), Schryver, E.L.L.M. (Els) de, Jöbsis, J. (Joost), van der Sande, J. (Jaap), Brouwers, P.J. (Paul), Roos, Y.B.W.E.M. (Yvo), Stam, J. (Jan), Bakker, S.L.M. (Stef), Verbiest, H. (Henk), Schoonewille, W. (Wouter), Linn, C. (Cisca), Hertzberger, L., Gemert, M. (Maarten) van, Berntsen, P. (Paul), Hendrikse, J. (Jeroen), Nederkoorn, P.J. (Paul), Mess, W.H. (Werner), Koudstaal, P.J. (Peter), Leff, A. (Alexander), Ward, N. (Nicholas), Nachev, P. (Parashkev), Perry, R. (Richard), Ozkan, H. (Hatice), Mitchell, J. (John), Wilson, D. (Duncan), Ambler, G. (Gareth), Lee, K.-J. (Keon-Joo), Lim, J.-S. (Jae-Sung), Shiozawa, M. (Masayuki), Koga, M. (Masatoshi), Li, L. (Linxin), Lovelock, C. (Caroline), Chabriat, H. (Hugues), Hennerici, M.G. (Michael), Wong, Y.K. (Yuen Kwun), Mak, H.K.F. (Henry Ka Fung), Prats-Sánchez, L. (Luis), Martínez-Domeño, A. (Alejandro), Inamura, S. (Shigeru), Yoshifuji, K. (Kazuhisa), Arsava, E.M. (Ethem Murat), Horstmann, S. (Solveig), Purrucker, J. (Jan), Lam, B.Y.K. (Bonnie Yin Ka), Wong, A. (Adrian), Kim, Y.D. (Young Dae), Song, T.-J. (Tae-Jin), Schrooten, M. (Maarten), Lemmens, R. (Robin), Eppinger, S. (Sebastian), Gattringer, T. (Thomas), Uysal, E. (Ender), Tanriverdi, Z. (Zeynep), Bornstein, S.R. (Stefan), Assayag, E.B. (Einor Ben), Hallevi, H. (Hen), Tanaka, J. (Jun), Hara, H. (Hideo), Coutts, S.B. (Shelagh B), Hert, L. (Lisa), Polymeris, A. (Alexandros), Seiffge, D.J. (David J), Lyrer, P.A. (Philippe), Algra, A. (Ale), Kappelle, L.J. (Jaap), Al-Shahi Salman, R. (Rustam), Jäger, H.R. (Rolf), Lip, G.Y.H. (Gregory Y H), Mattle, H., Panos, L.D. (Leonidas D), Mas, J.L. (J.), Legrand, L. (Laurence), Karayiannis, C. (Christopher), Phan, T.G. (Thanh), Gunkel, S. (Sarah), Christ, N. (Nicolas), Abrigo, J. (Jill), Leung, T. (Thomas), Chu, W. (Winnie), Chappell, F. (Francesca), Makin, S. (Stephen), Hayden, D. (Derek), Williams, D.J. (David J), Kooi, M.E. (M. Eline), van Dam-Nolen, D.H.K. (Dianne H K), Barbato, C. (Carmen), Browning, S. (Simone), Wiegertjes, K. (Kim), Tuladhar, A.M. (Anil M.), Maaijwee, N. (Noortje), Guevarra, C. (Christine), Yatawara, C. (Chathuri), Mendyk, A.-M. (Anne-Marie), Delmaire, C. (Christine), Köhler, S. (Sebastian), Oostenbrugge, R.J. (Robert) van, Zhou, Y. (Ying), Xu, C. (Chao), Hilal, S. (Saima), Gyanwali, B. (Bibek), Chen, C. (Christopher), Lou, M. (Min), Staals, J. (Julie), Bordet, R. (Régis), Kandiah, N. (Nagaendran), Leeuw, H.F. (Frank) de, Simister, R. (Robert), Lugt, A. (Aad) van der, Kelly, P.J. (Peter J), Wardlaw, J.M. (J.), Soo, Y. (Yannie), Fluri, F. (Felix), Srikanth, V. (Velandai), Calvet, D. (David), Jung, S. (Simon), Kwa, V.I.H., Engelter, S.T. (Stefan), Peters, N. (Nils), Smith, E.E. (Eric), Yakushiji, Y. (Yusuke), Orken, D.N. (Dilek Necioglu), Fazekas, F. (Franz), Thijs, V. (Vincent), Heo, J.H. (Ji Hoe), Mok, V. (Vincent), Veltkamp, R. (Roland), Ay, H. (Hakan), Imaizumi, T. (Toshio), Gomez-Anson, B. (Beatriz), Lau, K.K. (Kui Kai), Jouvent, E. (Eric), Rothwell, P.M. (Peter), Toyoda, K. (Kazunori), Bae, H.-J. (Hee-Joon), Marti-Fabregas, J. (Joan), Werring, D.J. (David), Harkness, K. (Kirsty), Shaw, L. (Louise), Sword, J. (Jane), Mohd Nor, A. (Azlisham), Sharma, P. (Pankaj), Kelly, D. (Deborah), Harrington, F. (Frances), Randall, M. (Marc), Smith, M. (Matthew), Mahawish, K. (Karim), Elmarim, A. (Abduelbaset), Esisi, B. (Bernard), Cullen, C. (Claire), Nallasivam, A. (Arumug), Price, C. (Christopher), Barry, A. (Adrian), Roffe, C. (Christine), Coyle, J. (John), Hassan, A. (Ahamad), Birns, J. (Jonathan), Cohen, D. (David), Sekaran, L. (Lakshmanan), Parry-Jones, A. (Adrian), Parry, A. (Anthea), Hargroves, D. (David), Proschel, H. (Harald), Datta, P. (Prabel), Darawil, K. (Khaled), Manoj, A. (Aravindakshan), Burn, M. (Mathew), Patterson, C. (Chris), Giallombardo, E. (Elio), Smyth, N. (Nigel), Mansoor, S. (Syed), Anwar, I. (Ijaz), Marsh, R. (Rachel), Ispoglou, S. (Sissi), Chadha, D. (Dinesh), Prabhakaran, M. (Mathuri), Meenakishundaram, S. (Sanjeevikumar), O'Connell, J. (Janice), Scott, J. (Jon), Krishnamurthy, V. (Vinodh), Aghoram, P. (Prasanna), McCormick, M. (Michael), Sprigg, N. (Nikola), O'Mahony, P. (Paul), Cooper, M. (Martin), Choy, L. (Lillian), Wilkinson, P. (Peter), Leach, S. (Simon), Caine, S. (Sarah), Burger, I. (Ilse), Gunathilagan, G. (Gunaratam), Guyler, P. (Paul), Emsley, H. (Hedley), Davis, M. (Michelle), Manawadu, D. (Dulka), Pasco, K. (Kath), Mamun, M. (Maam), Luder, R. (Robert), Sajid, M. (Mahmud), Okwera, J. (James), Warburton, E. (Elizabeth), Saastamoinen, K. (Kari), England, T. (Timothy), Putterill, J. (Janet), Flossman, E. (Enrico), Power, M. (Michael), Dani, K. (Krishna), Mangion, D. (David), Suman, A. (Appu), Corrigan, J. (John), Lawrence, E. (Enas), Vahidassr, D. (Djamil), Shakeshaft, C. (Clare), Brown, M. (Martin), Charidimou, A. (Andreas), Cohen, H. (Hannah), Banerjee, G. (Gargi), Houlden, H. (Henry), White, M. (Mark), Yousry, T. (Tarek), Flossmann, E. (Enrico), Muir, K. (Keith), El-Koussy, M. (Marwan), Gratz, P. (Pascal), Molad, J. (Jeremy), Korczyn, A.D. (A.), Kliper, E. (Efrat), Maeder, P. (Philippe), Gass, A. (Achim), Pachai, C. (Chahin), Bracoub, L. (Luc), Douste-Blazy, M.-Y. (Marie-Yvonne), Fratacci, M.D. (Marie Dominique), Vicaut, E. (Eric), Sato, S. (Shoichiro), Miwa, K. (Kaori), Fujita, K. (Kyohei), Ide, T. (Toshihiro), Ma, H. (Henry), Ly, J. (John), Singhal, S. (Shahoo), Chandra, R. (Ronil), Slater, L.-A. (Lee-Anne), Soufan, C. (Cathy), Moran, C. (Christopher), Traenka, C. (Christopher), Thilemann, S. (Sebastian), Fladt, J. (Joachim), Gensicke, H. (Henrik), Bonati, L. (Leo), Kim, B.J. (Beom Joon), Han, M.-K. (Moon-Ku), Kang, J. (Jihoon), Ko, E. (Eunbin), Yang, M.H. (Mi Hwa), Jang, M.S. (Myung Suk), Murphy, S. (Sean), Carty, F. (Fiona), Akijian, L. (Layan), Thornton, J. (John), Schembri, M. (Mark), Douven, E. (Elles), Delgado-Mederos;, R. (Raquel), Marín, R. (Rebeca), Camps-Renom, P. (Pol), Guisado-Alonso, D. (Daniel), Nuñez, F. (Fidel), Medrano-Martorell, S. (Santiago), Merino, E. (Elisa), Iida, K. (Kotaro), Ikeda, S. (Syuhei), Nishihara, M. (Masashi), Irie, H. (Hiroyuki), Demirelli, D.S. (Derya Selcuk), Medanta, J.M. (Jayesh Modi), Zerna, C. (Charlotte), Hernández, M.V. (Maria Valdés), Armitage, P. (Paul), Heye, A. (Anna), Muñoz Maniega, S. (Susana), Sakka, E. (Eleni), Thrippleton, M. (Michael), Dennis, M.S. (M.), Beigneux, Y. (Ysoline), Silva, M. (Mauro), Venketasubramanian, N. (Narayanaswamy), Ho, S.L. (Shu Leung), Cheung, R.T.F. (Raymond Tak Fai), Chan, K.H. (Koon Ho), Teo, K.C. (Kay Cheong), Hui, E. (Edward), Kwan, J.S.K. (Joseph Shiu Kwong), Chang, R. (Richard), Tse, M.Y. (Man Yu), Hoi, C.P. (Chu Peng), Chan, C.Y. (Chung Yan), Chan, O.L. (Oi Ling), Cheung, R.H.K. (Ryan Hoi Kit), Wong, E.K.M. (Edmund Ka Ming), Leung, K.T. (Kam Tat), Tsang, S.F. (Suk Fung), Ip, H.L. (Hing Lung), Ma, S.H. (Sze Ho), Ma, K. (Karen), Fong, W.C. (Wing Chi), Li, S.H. (Siu Hung), Li, R. (Richard), Ng, P.W. (Ping Wing), Wong, K.K. (Kwok Kui), Liu, W. (Wenyan), Wong, L. (Lawrence), Ramos, L. (Lino), Schryver, E.L.L.M. (Els) de, Jöbsis, J. (Joost), van der Sande, J. (Jaap), Brouwers, P.J. (Paul), Roos, Y.B.W.E.M. (Yvo), Stam, J. (Jan), Bakker, S.L.M. (Stef), Verbiest, H. (Henk), Schoonewille, W. (Wouter), Linn, C. (Cisca), Hertzberger, L., Gemert, M. (Maarten) van, Berntsen, P. (Paul), Hendrikse, J. (Jeroen), Nederkoorn, P.J. (Paul), Mess, W.H. (Werner), Koudstaal, P.J. (Peter), Leff, A. (Alexander), Ward, N. (Nicholas), Nachev, P. (Parashkev), Perry, R. (Richard), Ozkan, H. (Hatice), and Mitchell, J. (John)
- Abstract
Background: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. Methods: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or
- Published
- 2019
- Full Text
- View/download PDF
29. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
- Author
-
Wilson, D, Ambler, G, Lee, K-J, Lim, J-S, Shiozawa, M, Koga, M, Li, L, Lovelock, C, Chabriat, H, Hennerici, M, Wong, YK, Mak, HKF, Prats-Sanchez, L, Martinez-Domeno, A, Inamura, S, Yoshifuji, K, Arsava, EM, Horstmann, S, Purrucker, J, Lam, BYK, Wong, A, Kim, YD, Song, T-J, Schrooten, M, Lemmens, R, Eppinger, S, Gattringer, T, Uysal, E, Tanriverdi, Z, Bornstein, NM, Ben Assayag, E, Hallevi, H, Tanaka, J, Hara, H, Coutts, SB, Hert, L, Polymeris, A, Seiffge, DJ, Lyrer, P, Algra, A, Kappelle, J, Salman, RA-S, Jager, HR, Lip, GYH, Mattle, HP, Panos, LD, Mas, J-L, Legrand, L, Karayiannis, C, Phan, T, Gunkel, S, Christ, N, Abrigo, J, Leung, T, Chu, W, Chappell, F, Makin, S, Hayden, D, Williams, DJ, Kooi, ME, van Dam-Nolen, DHK, Barbato, C, Browning, S, Wiegertjes, K, Tuladhar, AM, Maaijwee, N, Guevarra, C, Yatawara, C, Mendyk, A-M, Delmaire, C, Kohler, S, van Oostenbrugge, R, Zhou, Y, Xu, C, Hilal, S, Gyanwali, B, Chen, C, Lou, M, Staals, J, Bordet, R, Kandiah, N, de Leeuw, F-E, Simister, R, van der Lugt, A, Kelly, PJ, Wardlaw, JM, Soo, Y, Fluri, F, Srikanth, V, Calvet, D, Jung, S, Kwa, VIH, Engelter, ST, Peters, N, Smith, EE, Yakushiji, Y, Orken, DN, Fazekas, F, Thijs, V, Heo, JH, Mok, V, Veltkamp, R, Ay, H, Imaizumi, T, Gomez-Anson, B, Lau, KK, Jouvent, E, Rothwell, PM, Toyoda, K, Bae, H-J, Marti-Fabregas, J, Werring, DJ, Wilson, D, Ambler, G, Lee, K-J, Lim, J-S, Shiozawa, M, Koga, M, Li, L, Lovelock, C, Chabriat, H, Hennerici, M, Wong, YK, Mak, HKF, Prats-Sanchez, L, Martinez-Domeno, A, Inamura, S, Yoshifuji, K, Arsava, EM, Horstmann, S, Purrucker, J, Lam, BYK, Wong, A, Kim, YD, Song, T-J, Schrooten, M, Lemmens, R, Eppinger, S, Gattringer, T, Uysal, E, Tanriverdi, Z, Bornstein, NM, Ben Assayag, E, Hallevi, H, Tanaka, J, Hara, H, Coutts, SB, Hert, L, Polymeris, A, Seiffge, DJ, Lyrer, P, Algra, A, Kappelle, J, Salman, RA-S, Jager, HR, Lip, GYH, Mattle, HP, Panos, LD, Mas, J-L, Legrand, L, Karayiannis, C, Phan, T, Gunkel, S, Christ, N, Abrigo, J, Leung, T, Chu, W, Chappell, F, Makin, S, Hayden, D, Williams, DJ, Kooi, ME, van Dam-Nolen, DHK, Barbato, C, Browning, S, Wiegertjes, K, Tuladhar, AM, Maaijwee, N, Guevarra, C, Yatawara, C, Mendyk, A-M, Delmaire, C, Kohler, S, van Oostenbrugge, R, Zhou, Y, Xu, C, Hilal, S, Gyanwali, B, Chen, C, Lou, M, Staals, J, Bordet, R, Kandiah, N, de Leeuw, F-E, Simister, R, van der Lugt, A, Kelly, PJ, Wardlaw, JM, Soo, Y, Fluri, F, Srikanth, V, Calvet, D, Jung, S, Kwa, VIH, Engelter, ST, Peters, N, Smith, EE, Yakushiji, Y, Orken, DN, Fazekas, F, Thijs, V, Heo, JH, Mok, V, Veltkamp, R, Ay, H, Imaizumi, T, Gomez-Anson, B, Lau, KK, Jouvent, E, Rothwell, PM, Toyoda, K, Bae, H-J, Marti-Fabregas, J, and Werring, DJ
- Abstract
BACKGROUND: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. METHODS: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. FINDINGS: Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19-2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20-1·50) for the composite outcome of intr
- Published
- 2019
30. Global Outcome Assessment Life-long after stroke in young adults initiative-the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis
- Author
-
Ekker, MS, Jacob, MA, van Dongen, MME, Aarnio, K, Annamalai, AK, Arauz, A, Arnold, M, Barboza, MA, Bolognese, M, Brouns, R, Chuluun, B, Chuluunbaatar, E, Dagvajantsan, B, Debette, S, Don, A, Enzinger, C, Ekizoglu, E, Fandler-Hoefler, S, Fazekas, F, Fromm, A, Gattringer, T, Gulli, G, Hoffmann, M, Hora, TF, Jern, C, Jood, K, Kamouchi, M, Kim, YS, Kitazono, T, Kittner, SJ, Kleinig, TJ, Klijn, CJM, Korv, J, Lee, T-H, Leys, D, Maaijwee, NAM, Martinez-Majander, N, Marto, JP, Mehndiratta, MM, Mifsud, V, Montanaro, VV, Owolabi, MO, Patel, VB, Phillips, MC, Piechowski-Iozwiak, B, Pikula, A, Luis Ruiz-Sandoval, J, Sarnowski, B, Schreuder, FHBM, Swartz, RH, Tan, KS, Tanne, D, Tatlisumak, T, Thijs, V, Tuladhar, AM, Viana-Baptista, M, Vibo, R, Wu, TY, Yesilot, N, Waje-Andreassen, U, Pezzini, A, Putaala, J, de Leeuw, F-E, Ekker, MS, Jacob, MA, van Dongen, MME, Aarnio, K, Annamalai, AK, Arauz, A, Arnold, M, Barboza, MA, Bolognese, M, Brouns, R, Chuluun, B, Chuluunbaatar, E, Dagvajantsan, B, Debette, S, Don, A, Enzinger, C, Ekizoglu, E, Fandler-Hoefler, S, Fazekas, F, Fromm, A, Gattringer, T, Gulli, G, Hoffmann, M, Hora, TF, Jern, C, Jood, K, Kamouchi, M, Kim, YS, Kitazono, T, Kittner, SJ, Kleinig, TJ, Klijn, CJM, Korv, J, Lee, T-H, Leys, D, Maaijwee, NAM, Martinez-Majander, N, Marto, JP, Mehndiratta, MM, Mifsud, V, Montanaro, VV, Owolabi, MO, Patel, VB, Phillips, MC, Piechowski-Iozwiak, B, Pikula, A, Luis Ruiz-Sandoval, J, Sarnowski, B, Schreuder, FHBM, Swartz, RH, Tan, KS, Tanne, D, Tatlisumak, T, Thijs, V, Tuladhar, AM, Viana-Baptista, M, Vibo, R, Wu, TY, Yesilot, N, Waje-Andreassen, U, Pezzini, A, Putaala, J, and de Leeuw, F-E
- Abstract
INTRODUCTION: Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients. METHODS AND ANALYSIS: The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence. ETHICS AND DISSEMINATION: Ethical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.
- Published
- 2019
31. Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patients
- Author
-
Pinter, D., primary, Enzinger, C., additional, Gattringer, T., additional, Eppinger, S., additional, Niederkorn, K., additional, Horner, S., additional, Fandler, S., additional, Kneihsl, M., additional, Krenn, K., additional, Bachmaier, G., additional, and Fazekas, F., additional
- Published
- 2019
- Full Text
- View/download PDF
32. Baseline white matter hyperintensities affect the course of cognitive function after small vessel disease‐related stroke: a prospective observational study.
- Author
-
Fruhwirth, V., Enzinger, C., Fandler‐Höfler, S., Kneihsl, M., Eppinger, S., Ropele, S., Schmidt, R., Gattringer, T., and Pinter, D.
- Subjects
CEREBRAL small vessel diseases ,WHITE matter (Nerve tissue) ,COGNITIVE ability ,MAGNETIC resonance imaging ,LONGITUDINAL method ,SCIENTIFIC observation - Abstract
Background and purpose: Cognitive impairment is a common sequel of recent small subcortical infarction (RSSI) and might be negatively affected by preexisting cerebral small vessel disease (SVD). We investigated whether the course of cognitive function in patients with RSSI is influenced by the severity of white matter hyperintensities (WMH), an important imaging feature of SVD. Methods: Patients with magnetic resonance imaging (MRI)‐proven single RSSI were tested neuropsychologically concerning global cognition, processing speed, attention, and set‐shifting. Deep and periventricular WMH severity was assessed using the Fazekas scale, and total WMH lesion volume was calculated from T1‐weighted MRI images. We compared baseline function and course of cognition 15 months after the acute event in patients with absent, mild, and moderate‐to‐severe WMH. Results: The study cohort comprised 82 RSSI patients (mean age: 61 ± 10 years, 23% female). At baseline, 40% had cognitive impairment (1.5 standard deviations below standardized mean), and deficits persisted in one‐third of the sample after 15 months. After age correction, there were no significant differences in set‐shifting between WMH groups at baseline. However, although patients without WMH (deep: p < 0.001, periventricular: p = 0.067) or only mild WMH (deep: p = 0.098, periventricular: p = 0.001) improved in set‐shifting after 15 months, there was no improvement in patients with moderate‐to‐severe WMH (deep: p = 0.980, periventricular: p = 0.816). Baseline total WMH volume (p = 0.002) was the only significant predictor for attention 15 months poststroke. Conclusions: This longitudinal study demonstrates that preexisting moderate‐to‐severe WMH negatively affect the restoration of cognitive function after RSSI, suggesting limited functional reserve in patients with preexisting SVD. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
33. Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients - A Clinical Intervention Study
- Author
-
Palli, C, Fandler, S, Doppelhofer, K, Niederkorn, K, Enzinger, C, Vetta, C, Trampusch, E, Schmidt, R, Fazekas, F, Gattringer, T, Palli, C, Fandler, S, Doppelhofer, K, Niederkorn, K, Enzinger, C, Vetta, C, Trampusch, E, Schmidt, R, Fazekas, F, and Gattringer, T
- Published
- 2018
34. SOP Prähospitale neurologische Untersuchung
- Author
-
Fandler, S., additional, Fandler, M., additional, and Gattringer, T., additional
- Published
- 2017
- Full Text
- View/download PDF
35. Intravenous thrombolysis in wake‐up stroke: real‐world data from the Austrian Stroke Unit Registry.
- Author
-
Krebs, S., Posekany, A., Ferrari, J., Lang, W., Sommer, P., Gattringer, T., Boehme, C., and Sykora, M.
- Subjects
STROKE units ,THROMBOLYTIC therapy ,STROKE ,STROKE patients ,ODDS ratio - Abstract
Background and purpose: Data on real‐world experience with intravenous thrombolysis (IV tPA) in wake‐up stroke (WUS) are limited. The aim of this study was to examine the efficacy and safety of IV tPA in patients with WUS included in the Austrian Stroke Unit Registry. Methods: Data from a large nationwide stroke unit registry including initial stroke severity, vascular risk factors, comorbidities, treatment with IV tPA, symptomatic intracerebral haemorrhage (sICH) and functional outcome were extracted and analysed. Patients with WUS were compared with patients with known‐onset stroke (KOS) regarding the frequency of IV tPA treatment, neurological improvement (National Institutes of Health Stroke Scale score ≥4), sICH and 3‐month functional outcome by modified Rankin Scale score using standard statistical tests. Results: A total of 107 895 stroke patients entered the analysis, including 12 534 with WUS and 91 899 with KOS. Altogether, 904 (7.2%) patients with WUS received IV tPA as compared with 16 694 (18.2%) patients with KOS. Patients with WUS who received IV tPA treatment had twofold higher initial National Institutes of Health Stroke Scale score (median 8 vs. median 4) as compared with patients with KOS. There was no statistical difference in functional outcome by modified Rankin Scale score 0–1 at 3 months between patients with WUS and patients with KOS treated with IV tPA (adjusted odds ratio, 1.08; 95% confidence interval, 0.9–1.31). Also, the rate of sICH did not differ (4.1% vs. 4%, P = 0.852). Conclusions: In this large non‐randomized comparison, the safety and efficacy of IV tPA in patients with WUS in the real‐world setting seems to be comparable to patients with KOS. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
36. P-277: An exploratory study on the effects of mobility training in chronic stroke patients using repeated fMRI
- Author
-
de Campo, A., primary, Landsmann, B., additional, Pinter, D., additional, Pichler, G., additional, Pirker, E., additional, Schippinger, W.M., additional, Gattringer, T., additional, Fazekas, F., additional, and Enzinger, C., additional
- Published
- 2015
- Full Text
- View/download PDF
37. Dynamics of brain iron levels in multiple sclerosis: A longitudinal 3T MRI study
- Author
-
Khalil, M., primary, Langkammer, C., additional, Pichler, A., additional, Pinter, D., additional, Gattringer, T., additional, Bachmaier, G., additional, Ropele, S., additional, Fuchs, S., additional, Enzinger, C., additional, and Fazekas, F., additional
- Published
- 2015
- Full Text
- View/download PDF
38. Zerebrale Marklagerhyperintensitäten in der Magnetresonanztomografie und deren klinische Relevanz
- Author
-
Gattringer, T., additional and Fazekas, F., additional
- Published
- 2014
- Full Text
- View/download PDF
39. Plasma neutrophil gelatinase-associated lipocalin and functional outcome in ischemic stroke
- Author
-
Pekar, T., primary, Stojakovic, T., additional, Haas, J., additional, Simmet, N.E., additional, Scharnagl, H., additional, Gattringer, T., additional, Fazekas, F., additional, Storch, M.K., additional, and Seifert-Held, T., additional
- Published
- 2013
- Full Text
- View/download PDF
40. Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke
- Author
-
Seifert-Held, T., primary, Pekar, T., additional, Gattringer, T., additional, Simmet, N.E., additional, Scharnagl, H., additional, Bocksrucker, C., additional, Lampl, C., additional, Storch, M.K., additional, Stojakovic, T., additional, and Fazekas, F., additional
- Published
- 2013
- Full Text
- View/download PDF
41. Myocardial Infarction as an early complication in acute stroke patients: Results from the Austrian Stroke Unit Registry
- Author
-
Gattringer, T., primary, Niederkorn, K., additional, Seyfang, L., additional, Ferrari, J., additional, Lang, W., additional, Brainin, M., additional, Willeit, J., additional, Fazekas, F., additional, and Enzinger, C., additional
- Published
- 2013
- Full Text
- View/download PDF
42. Konvexale Subarachnoidalblutung
- Author
-
Gattringer, T., primary, Beitzke, M., additional, Enzinger, C., additional, Wurm, W., additional, Lechner, A., additional, and Fazekas, F., additional
- Published
- 2011
- Full Text
- View/download PDF
43. Brain vascular lesions, gait and balance
- Author
-
Pinter, D., Ritchie, S., Doubal, F., Gattringer, T., Morris, Z., Bastin, M., Hernandez, M. Del C. Valdes, Royle, N., Corley, J., Maniega, S. Munoz, Pattie, A., Dickie, D. A., Gow, A., Staals, J., Starr, J., Ian Deary, Enzinger, C., Fazekas, F., and Wardlaw, J.
44. Early versus Later Anticoagulation for Stroke with Atrial Fibrillation.
- Author
-
Fischer, U., Koga, M., Strbian, D., Branca, M., Abend, S., Trelle, S., Paciaroni, M., Thomalla, G., Michel, P., Nedeltchev, K., Bonati, L. H., Ntaios, G., Gattringer, T., Sandset, E.-C., Kelly, P., Lemmens, R., Sylaja, P. N., Aguiar de Sousa, D., Bornstein, N. M., and Gdovinova, Z.
- Subjects
- *
ATRIAL fibrillation , *ISCHEMIC stroke , *INTRACRANIAL hemorrhage , *ANTICOAGULANTS , *ORAL medication - Abstract
BACKGROUND The effect of early as compared with later initiation of direct oral anticoagulants (DOACs) in persons with atrial fibrillation who have had an acute ischemic stroke is unclear. METHODS We performed an investigator-initiated, open-label trial at 103 sites in 15 countries. Participants were randomly assigned in a 1:1 ratio to early anticoagulation (within 48 hours after a minor or moderate stroke or on day 6 or 7 after a major stroke) or later anticoagulation (day 3 or 4 after a minor stroke, day 6 or 7 after a moderate stroke, or day 12, 13, or 14 after a major stroke). Assessors were unaware of the trial-group assignments. The primary outcome was a composite of recurrent ischemic stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage, or vascular death within 30 days after randomization. Secondary outcomes included the components of the composite primary outcome at 30 and 90 days. RESULTS Of 2013 participants (37% with minor stroke, 40% with moderate stroke, and 23% with major stroke), 1006 were assigned to early anticoagulation and 1007 to later anticoagulation. A primary-outcome event occurred in 29 participants (2.9%) in the early-treatment group and 41 participants (4.1%) in the later-treatment group (risk difference, -1.18 percentage points; 95% confidence interval [CI], -2.84 to 0.47) by 30 days. Recurrent ischemic stroke occurred in 14 participants (1.4%) in the early-treatment group and 25 participants (2.5%) in the later-treatment group (odds ratio, 0.57; 95% CI, 0.29 to 1.07) by 30 days and in 18 participants (1.9%) and 30 participants (3.1%), respectively, by 90 days (odds ratio, 0.60; 95% CI, 0.33 to 1.06). Symptomatic intracranial hemorrhage occurred in 2 participants (0.2%) in both groups by 30 days. CONCLUSIONS In this trial, the incidence of recurrent ischemic stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage, or vascular death at 30 days was estimated to range from 2.8 percentage points lower to 0.5 percentage points higher (based on the 95% confidence interval) with early than with later use of DOACs. (Funded by the Swiss National Science Foundation and others; ELAN ClinicalTrials.gov number, NCT03148457.) [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
45. Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries
- Author
-
István Szikora, Diana Aguiar de Sousa, Sònia Abilleira, Urs Fischer, Adam Kobayashi, Valeria Caso, Thomas Gattringer, Rascha von Martial, Valery L. Feigin, Franz Fazekas, Miquel Gallofré, [Aguiar-de-Sousa D] Department of Neurology, University of Lisbon, Hospital de Santa Maria, Lisbon, Portugal. [Von-Martial R, Fischer U] Department of Neurology, University of Bern, Inselspital, Bern, Switzerland. [Abilleira-Castells S] Pla Director de la Malaltia Vascular Cerebral, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Gattringer T, Fazekas F] Department of Neurology, Medical University of Graz, Graz, Austria. [Kobayashi A] Interventional Stroke and Cerebrovascular Disease Treatment Centre, Department of Neuroradiology, Institute of Psychiatry and Neurology, Warsaw, Poland. [Gallofré M] Pla Director de la Malaltia Vascular Cerebral, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Szikora I] National Institute of Clinical Neurosciences, Budapest, Hungary. [Feigin V] National Institute for Stroke & Applied Neurosciences, Auckland, New Zealand. [Caso V] Stroke Unit, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy., and Departament de Salut
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular [ENFERMEDADES] ,030204 cardiovascular system & hematology ,Geographic Locations::Europe [GEOGRAPHICALS] ,03 medical and health sciences ,Other subheadings::/statistics & numerical data [Other subheadings] ,0302 clinical medicine ,Malalties cerebrovasculars - Tractament - Enquestes ,Ischaemic stroke ,medicine ,cardiovascular diseases ,Otros calificadores::/estadística & datos numéricos [Otros calificadores] ,Endovascular treatment ,610 Medicine & health ,Stroke ,Therapeutics::Drug Therapy::Thrombolytic Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] ,business.industry ,Thrombolysis ,Stroke unit care ,medicine.disease ,Terapéutica::Tratamiento Farmacológico::Terapia Trombolítica [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,terapéutica::farmacoterapia::tratamiento trombolítico [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Europa - Registres mèdics ,Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke [DISEASES] ,Emergency medicine ,Neurology (clinical) ,Teràpia trombolítica ,localizaciones geográficas::Europa (continente) [DENOMINACIONES GEOGRÁFICAS] ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Introduction Acute stroke unit care, intravenous thrombolysis and endovascular treatment significantly improve the outcome for patients with ischaemic stroke, but data on access and delivery throughout Europe are lacking. We assessed best available data on access and delivery of acute stroke unit care, intravenous thrombolysis and endovascular treatment throughout Europe. Methods A survey, drafted by stroke professionals (ESO, ESMINT, EAN) and a patient organisation (SAFE), was sent to national stroke societies and experts in 51 European countries (World Health Organization definition) requesting experts to provide national data on stroke unit, intravenous thrombolysis and endovascular treatment rates. We compared both pooled and individual national data per one million inhabitants and per 1000 annual incident ischaemic strokes with highest country rates. Population estimates were based on United Nations data, stroke incidences on the Global Burden of Disease Report. Results We obtained data from 44 European countries. The estimated mean number of stroke units was 2.9 per million inhabitants (95% CI 2.3–3.6) and 1.5 per 1000 annual incident strokes (95% CI 1.1–1.9), highest country rates were 9.2 and 5.8. Intravenous thrombolysis was provided in 42/44 countries. The estimated mean annual number of intravenous thrombolysis was 142.0 per million inhabitants (95% CI 107.4–176.7) and 72.7 per 1000 annual incident strokes (95% CI 54.2–91.2), highest country rates were 412.2 and 205.5. Endovascular treatment was provided in 40/44 countries. The estimated mean annual number of endovascular treatments was 37.1 per million inhabitants (95% CI 26.7–47.5) and 19.3 per 1000 annual incident strokes (95% CI 13.5–25.1), highest country rates were 111.5 and 55.9. Overall, 7.3% of incident ischaemic stroke patients received intravenous thrombolysis (95% CI 5.4–9.1) and 1.9% received endovascular treatment (95% CI 1.3–2.5), highest country rates were 20.6% and 5.6%. Conclusion We observed major inequalities in acute stroke treatment between and within 44 European countries. Our data will assist decision makers implementing tailored stroke care programmes for reducing stroke-related morbidity and mortality in Europe.
- Published
- 2021
46. Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries
- Author
-
[Aguiar-de-Sousa D] Department of Neurology, University of Lisbon, Hospital de Santa Maria, Lisbon, Portugal. [Von-Martial R, Fischer U] Department of Neurology, University of Bern, Inselspital, Bern, Switzerland. [Abilleira-Castells S] Pla Director de la Malaltia Vascular Cerebral, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Gattringer T, Fazekas F] Department of Neurology, Medical University of Graz, Graz, Austria. [Kobayashi A] Interventional Stroke and Cerebrovascular Disease Treatment Centre, Department of Neuroradiology, Institute of Psychiatry and Neurology, Warsaw, Poland. [Gallofré M] Pla Director de la Malaltia Vascular Cerebral, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Szikora I] National Institute of Clinical Neurosciences, Budapest, Hungary. [Feigin V] National Institute for Stroke & Applied Neurosciences, Auckland, New Zealand. [Caso V] Stroke Unit, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy. and Departament de Salut
- Subjects
Europa - Registres mèdics ,Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke [DISEASES] ,Therapeutics::Drug Therapy::Thrombolytic Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] ,Other subheadings::/statistics & numerical data [Other subheadings] ,Malalties cerebrovasculars - Tractament - Enquestes ,Teràpia trombolítica ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular [ENFERMEDADES] ,Otros calificadores::/estadística & datos numéricos [Otros calificadores] ,localizaciones geográficas::Europa (continente) [DENOMINACIONES GEOGRÁFICAS] ,Geographic Locations::Europe [GEOGRAPHICALS] ,Terapéutica::Tratamiento Farmacológico::Terapia Trombolítica [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] - Published
- 2021
47. Clinical-radiological presentation and natural history of iatrogenic cerebral amyloid angiopathy.
- Author
-
Fandler-Höfler S, Kaushik K, Storti B, Pikija S, Mallon D, Ambler G, Damavandi PT, Panteleienko L, Canavero I, van Walderveen MAA, van Etten ES, DiFrancesco JC, Enzinger C, Gattringer T, Bersano A, Wermer MJH, Banerjee G, and Werring DJ
- Abstract
Background: We aimed to describe neuroimaging features, clinical profiles and long-term outcomes in patients with iatrogenic cerebral amyloid angiopathy (iCAA)., Methods: We performed a systematic literature search for case series of iCAA and included individual patients and their longitudinal clinical and neuroimaging data in this pooled cohort study. Patients meeting a modified version of the Queen Square criteria for iCAA were included. Baseline and follow-up MRIs were centrally analysed for markers of CAA using validated rating scales., Results: We included 51 patients (68.6% male, median age at presentation 48 years), 51.0% with probable and 49.0% with possible iCAA. We evaluated 219 MRIs acquired over a median follow-up time of 3.7 years (IQR 1.8-6.4). There were 43 symptomatic intracerebral haemorrhages (ICH) in 24 patients during follow-up, a rate of 16.7 per 100 patient-years.Patients with previous supratentorial brain surgery had an ipsilateral-dominant distribution and spread of haemorrhagic markers on MRI. 14/51 (27.5%) patients had transient inflammatory changes (cortical or parenchymal oedema, sulcal hyperintensities). Haemorrhagic markers progressed during follow-up. In addition to 43 symptomatic ICH, 36 asymptomatic ICH (mostly smaller intragyral haemorrhages) were detected on follow-up scans. Besides numerous lobar microbleeds (median 16 at baseline, 53 at last follow-up), deep microbleeds were present in 19.6% of patients at baseline and 44.4% at follow-up. Severe perivascular spaces in centrum semiovale were common at baseline (64.7%) and follow-up (95.6%)., Conclusions: Patients with iCAA appear to have distinctive MRI characteristics, which might differentiate iCAA from other CAA subtypes and provide new insights into underlying disease mechanisms., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)
- Published
- 2025
- Full Text
- View/download PDF
48. Early vs Late Anticoagulation After Ischemic Stroke in Patients With Atrial Fibrillation and Covert Brain Infarcts.
- Author
-
Kneihsl M, Hakim A, Goeldlin MB, Meinel TR, Branca M, Rohner R, Fenzl S, Abend S, Shim GC, Gumbinger C, Zhang L, Kristoffersen ES, Desfontaines P, Vanacker P, Alonso A, Poli S, Nunes AP, Caracciolo NG, Gattringer T, Kahles T, Giudici D, Demeestere J, Dawson J, and Fischer U
- Subjects
- Humans, Female, Male, Aged, Middle Aged, Aged, 80 and over, Time Factors, Recurrence, Atrial Fibrillation drug therapy, Atrial Fibrillation complications, Ischemic Stroke drug therapy, Ischemic Stroke etiology, Anticoagulants administration & dosage, Anticoagulants therapeutic use, Brain Infarction etiology
- Abstract
Background and Objectives: Covert brain infarcts (CBIs) in patients with first-ever ischemic stroke (IS) and atrial fibrillation (AF) are associated with an increased risk of stroke recurrence. We aimed to assess whether CBIs modify the treatment effect of early vs late initiation of direct oral anticoagulants (DOACs) in patients with IS and AF., Methods: We conducted a post hoc analysis of the international, multicenter, randomized-controlled ELAN trial, which compared early (<48 hours after ischemic stroke for minor and moderate stroke, 6-7 days for major stroke) vs late (>48 hours for minor, 3-4 days for moderate, 12-14 days for major stroke) initiation of DOACs in patients with IS and AF. The primary outcome was a composite of recurrent IS, symptomatic intracranial hemorrhage (sICH), major extracranial bleeding, systemic embolism, or vascular death within 30 days after stroke; secondary outcomes were the individual components. We estimated outcomes based on the presence of CBIs (any CBI vs no CBI) on prerandomization imaging (core-lab rating) using adjusted risk differences (aRDs) between treatment arms. Point estimates and 95% CIs are presented without reporting p values., Results: Of the 1,694 participants with first-ever IS included (median age: 77 years, 45.9% female), 678 (40.0%) had CBI. The imaging core-lab interrater reliability for the presence of CBI was 0.87 (0.81-0.94). The primary outcome occurred in 8 (2.3%; recurrent IS: 3/342) of 342 participants with CBI assigned to the early treatment arm vs 20 (6.0%; recurrent IS: 12/336) of 336 assigned to the late treatment arm (aRD: -3.6%, 95% CI -6.6 to -0.6) ( p for interaction: 0.063). With early DOAC treatment, IS recurrence risk was lower in participants with CBI (aRD: -2.7%, 95% CI -5.0 to -0.4), but not in participants without CBI (aRD: -0.4, 95% CI -2.1 to 1.2). No sICH was observed in the early treatment group., Discussion: The presence of CBI may indicate a subgroup of patients with first-ever IS and AF who particularly benefits from early DOAC initiation to prevent ischemic event recurrence, without increasing harm. Our findings should be considered in clinical decision making regarding timely DOAC treatment in patients with stroke and AF., Classification of Evidence: This study provides Class II evidence that in patients with covert brain infarcts, atrial fibrillation, and first-ever ischemic stroke, early (vs late) initiation of DOACs is associated with lower risk of recurrent stroke with no increase in harm., Trial Registration Information: URL: clinicaltrials.gov/study/NCT03148457; Unique identifier: NCT03148457; submitted : April 7, 2017; first patient enrolled : November 6, 2017.
- Published
- 2025
- Full Text
- View/download PDF
49. Net Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.
- Author
-
Polymeris AA, Branca M, Sylaja PN, Sandset EC, de Sousa DA, Thomalla G, Paciaroni M, Gattringer T, Strbian D, Trelle S, Michel P, Nedeltchev K, Bonati LH, Ntaios G, Koga M, Gdovinova Z, Lemmens R, Bornstein NM, Kelly P, Goeldlin MB, Abend S, Selim M, Katan M, Horvath T, Dawson J, and Fischer U
- Subjects
- Humans, Male, Female, Aged, Stroke etiology, Stroke prevention & control, Middle Aged, Aged, 80 and over, Administration, Oral, Ischemic Stroke drug therapy, Ischemic Stroke prevention & control, Ischemic Stroke etiology, Time-to-Treatment statistics & numerical data, Treatment Outcome, Hemorrhage chemically induced, Atrial Fibrillation drug therapy, Atrial Fibrillation complications, Anticoagulants therapeutic use
- Abstract
Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear., Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB)., Design, Setting, and Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up. Participants included patients with atrial fibrillation-associated acute ischemic stroke, excluding those with therapeutic anticoagulation at stroke onset or with severe hemorrhagic transformation of the ischemic infarct., Intervention: Early DOAC initiation (<48 hours after minor and moderate stroke, 6-7 days after major stroke) vs later initiation (3-4 days after minor stroke, 6-7 days after moderate stroke, and 12-14 days after major stroke)., Main Outcomes and Measures: The main measure was the NCB of early treatment over later treatment, calculated by subtracting the weighted rate of excess bleeding events (major extracranial or intracranial hemorrhage) attributable to early treatment from the rate of excess ischemic events (recurrent stroke or systemic embolism) possibly prevented by early treatment within 30 days (main analysis) or 90 days (ancillary analysis). An established weighting scheme was used to account for the different clinical impact of bleeding relative to ischemic outcomes. Event rates were derived from adjusted logistic models. The analysis included all evaluable randomized ELAN participants., Results: Of the original 2013 ELAN participants, 1966 were eligible for analysis (977 [49.7%] assigned to early DOAC initiation, 989 [50.3%] assigned to later DOAC initiation; median [IQR] age 77 [70-84] years; 1075 [54.7%] male). The 30-day NCB of early treatment over later treatment ranged from 1.73 (95% CI, 0.06-3.40) to 1.72 (95% CI, -0.63 to 3.98) weighted events possibly prevented per 100 participants for intracranial hemorrhage weights 1.5 to 3.3. The 90-day NCB ranged from 2.16 (95% CI, 0.30-3.87) to 2.14 (95% CI, -0.26 to 4.41) weighted events per 100 participants., Conclusions and Relevance: This post hoc analysis of a randomized clinical trial estimated a sizeable NCB of early anticoagulation for patients after atrial fibrillation-associated ischemic stroke. Although estimates cannot exclude the possibility of no benefit or small net harm, the findings suggest that early treatment may be more favorable., Trial Registration: ClinicalTrials.gov Identifier: NCT03148457.
- Published
- 2025
- Full Text
- View/download PDF
50. Dual antiplatelet therapy after minor strokes or high-risk TIA: Evidence from the Austrian stroke registry.
- Author
-
Krebs S, Miksova D, Knoflach M, Gattringer T, Fandler-Höfler S, Marlen F, Marko M, Greisenegger S, Lang W, Ferrari J, and Sykora M
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Austria epidemiology, Aged, 80 and over, Risk Factors, Treatment Outcome, Ischemic Attack, Transient drug therapy, Ischemic Attack, Transient epidemiology, Registries, Stroke drug therapy, Stroke epidemiology, Dual Anti-Platelet Therapy methods, Platelet Aggregation Inhibitors therapeutic use
- Abstract
Background and Purpose: Three large, randomized trials demonstrated the benefit of short-term dual antiplatelet therapy (DAPT) versus monotherapy after non-cardioembolic minor stroke or high-risk transient ischemic attack (TIA). The aim of this study was to evaluate effects of DAPT versus monotherapy on functional outcomes and safety in a real-life setting., Methods: Patients with minor stroke (NIHSS <4) or high-risk TIA (ABCD2 score ≥4) of non-cardioembolic origin without major vessel occlusion or revascularization therapy (thrombolysis or thrombectomy) treated between 2018 and 2023 were analyzed based on a prospective nationwide stroke unit registry. Data on risk factors, stroke etiology, admission stroke severity (NIHSS), functional status at 3 months (mRS), and mortality were extracted. Excellent functional outcome (mRS 0-1) at 3 months, early neurological deterioration (END), symptomatic intracranial hemorrhage (SICH) and major extracranial bleeds were defined as study endpoints and adjusted for covariates using inverse probability of treatment weighted regression models., Results: Two Thousand Two Hundred Fifty-four of 8546 patients with non-cardioembolic minor stroke or high-risk TIA received DAPT. Patients treated with DAPT had significantly more risk factors and comorbidities compared to those treated with monotherapy. After robust statistical adjustment, DAPT was significantly associated with lower occurrence of END (OR 0.50 95% CI 0.35-0.72), increased odds of excellent outcome at 3 months (aOR 1.59; 95% CI 1.20-2.09) and equivalent frequencies of SICH (aOR 1.19, 95% CI 0.30-4.73) or major extracranial bleeding (aOR 0.84; 95% CI 0.16-4.56)., Conclusions: DAPT in non-cardioembolic minor stroke or high-risk TIA in a real-life setting appears to be safe and associated with improved functional outcome., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
- Published
- 2025
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.