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19 results on '"Kwa V.I.H."'

1. Participation in daily life activities at two months after stroke predicts long-term health-related quality of life

Author

Slenders, J.P.L., de Graaf, J.A., Post, M.W.M., van Heugten, C.M., van den Berg-vos, R.M., Kwa, V.I.H., Visser-Meily, J.M.A., Slenders, J.P.L., de Graaf, J.A., Post, M.W.M., van Heugten, C.M., van den Berg-vos, R.M., Kwa, V.I.H., and Visser-Meily, J.M.A.

Abstract

Background: After stroke, many patients experience problems with participation in daily activities. Improving participation is the main goal in stroke rehabilitation. However, the longitudinal relationship between participation and health-related quality of life (HRQoL) remains unclear.Objectives: This study aimed to examine (1) the predictive value of participation at two months on long-term HRQoL and (2) the longitudinal relationship between participation and HRQoL.Methods: In this multicenter, prospective cohort study, patients were assessed at two and 12 months after stroke. Participation was measured with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation - Participation. HRQoL was assessed with the three-level version of the EuroQoL five dimensions questionnaire index score.Results: This study included 291 patients. Mean age was 66.6 +/- 12.4 years, 64.3% were male and mean National Institutes of Health Stroke Scale (NIHSS) was 2.5 +/- 2.9. Multivariable linear regression, adjusted for demographic characteristics, stroke characteristics, physical and cognitive impairment, showed that a higher level of participation at two months correlated with a higher HRQoL at one year (B = .004; 95% CI =.002-.005). Patients whose participation improved had a greater increase in HRQoL, compared to patients without improvement (0.080 +/- .21 versus -.054 +/- .21; p < .001).Conclusions: The level of participation at two months post-stroke predicts HRQoL at one year. Improvement in participation during the first year after stroke is associated with improvement in HRQoL. We recommend including the assessment of participation in daily activities at follow-up visits.

Published
2024

2. 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

3. Prehospital transdermal glyceryl trinitrate in patients with presumed acute stroke (MR ASAP): an ambulance-based, multicentre, randomised, open-label, blinded endpoint, phase 3 trial

Author

Berg, S.A. van den, Venema, S.M. Uniken, Reinink, H., Hofmeijer, J., Schonewille, W.J., Miedema, I., Fransen, P.S., Pruissen, D.M.O., Raaijmakers, T.W.M., Dijk, G.W. van, Leeuw, F.E. de, Vliet, Jorien A. van der, Kwa, V.I.H., Kerkhoff, H., Net, A. van 't, Boomars, R., Siegers, A., Lok, T., Caminada, K., Cuevas, L.M. Esteve, Visser, M.C, Zwetsloot, C.P., Boomsma, J.M.F., Schipper, M.H., Eijkelenburg, R.P.J. van, Berkhemer, O.A., Nieboer, D., Lingsma, H.F., Emmer, B.J., Oostenbrugge, R.J. van, Lugt, A. van der, Roos, Y., Majoie, C., Dippel, D.W., Nederkoorn, P.J., Worp, H.B. van der, Berg, S.A. van den, Venema, S.M. Uniken, Reinink, H., Hofmeijer, J., Schonewille, W.J., Miedema, I., Fransen, P.S., Pruissen, D.M.O., Raaijmakers, T.W.M., Dijk, G.W. van, Leeuw, F.E. de, Vliet, Jorien A. van der, Kwa, V.I.H., Kerkhoff, H., Net, A. van 't, Boomars, R., Siegers, A., Lok, T., Caminada, K., Cuevas, L.M. Esteve, Visser, M.C, Zwetsloot, C.P., Boomsma, J.M.F., Schipper, M.H., Eijkelenburg, R.P.J. van, Berkhemer, O.A., Nieboer, D., Lingsma, H.F., Emmer, B.J., Oostenbrugge, R.J. van, Lugt, A. van der, Roos, Y., Majoie, C., Dippel, D.W., Nederkoorn, P.J., and Worp, H.B. van der

Abstract

Item does not contain fulltext, BACKGROUND: Pooled analyses of previous randomised studies have suggested that very early treatment with glyceryl trinitrate (also known as nitroglycerin) improves functional outcome in patients with acute ischaemic stroke or intracerebral haemorrhage, but this finding was not confirmed in a more recent trial (RIGHT-2). We aimed to assess whether patients with presumed acute stroke benefit from glyceryl tr initrate started within 3 h after symptom onset. METHODS: MR ASAP was a phase 3, randomised, open-label, blinded endpoint trial done at six ambulance services serving 18 hospitals in the Netherlands. Eligible participants (aged ≥18 years) had a probable diagnosis of acute stroke (as assessed by a paramedic), a face-arm-speech-time test score of 2 or 3, systolic blood pressure of at least 140 mm Hg, and could start treatment within 3 h of symptom onset. Participants were randomly assigned (1:1) by ambulance personnel, using a secure web-based electronic application with random block sizes stratified by ambulance service, to receive either transdermal glyceryl trinitrate 5 mg/day for 24 h plus standard care (glyceryl trinitrate group) or to standard care alone (control group) in the prehospital setting. Informed consent was deferred until after arrival at the hospital. The primary outcome was functional outcome assessed with the modified Rankin Scale (mRS) at 90 days. Safety outcomes included death within 7 days, death within 90 days, and serious adverse events. Analyses were based on modified intention to treat, and treatment effects were expressed as odds ratios (ORs) or common ORs, with adjustment for baseline prognostic factors. We separately analysed the total population and the target population (ie, patients with intracerebral haemorrhage, ischaemic stroke, or transient ischaemic attack). The target sample size was 1400 patients. The trial is registered as ISRCTN99503308. FINDINGS: On June 24, 2021, the MR ASAP trial was prematurely terminated on the advice o

Published
2022

4. Triage voor revalidatie na een beroerte: De ontwikkeling van een leidraad voor meetinstrumenten

Author

van Weperen, P.W., van den Akker-van Marle, M.E., de Groot, A.J., van Heugten, Caroline M., Kwa, V.I.H., Kwakkel, G., Lindhout, M., Nouwens, F., Steultjens, E.M.J., Treuren-Van Utrecht, J., Schiemanck, S.K., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, and Psychiatrie & Neuropsychologie

Published
2021

5. 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

6. 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

7. Accelerated long-term forgetting after TIA or minor stroke: A more sensitive measure for detecting subtle memory dysfunction?

Author

Geurts, S., Werf, S.P. van der, Kwa, V.I.H., Kessels, R.P.C., Geurts, S., Werf, S.P. van der, Kwa, V.I.H., and Kessels, R.P.C.

Abstract

Item does not contain fulltext, Cognitive changes after minor stroke or TIA have been reported, with studies describing a 'vascular' cognitive profile with spared episodic memory. Still, many patients also report memory complaints. Studies using long-term forgetting paradigms have detected memory impairment after prolonged intervals in contrast to standard delayed testing in other patient groups. This study examined whether accelerated long-term forgetting (ALF) is present in patients with minor stroke or TIA by comparing one-week delayed recall and recognition with the performance of a healthy control group. Results revealed that the patients' performance after one week was worse than the controls, in the absence of an impairment after a short delay. Patients did, however, not report more memory worries than controls. Possibly, reduced effort, attention or mnemonic strategies may contribute to subtle consolidation problems, which go undetected in daily functioning.

Published
2019

8. 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

9. 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

10. 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
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11. Temporal profile of body temperature in acute ischemic stroke: Relation to infarct size and outcome

Author

Geurts, Marjolein, Scheijmans, Féline E.V., van Seeters, Tom, Biessels, Geert Jan, Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., van der Lugt, A., Dippel, D.W., Greve, Droogh de, Bienfait, H.P., van Walderveen, Marianne A. A., Wermer, M.J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D.A., Kwa, V.I.H., Meijer, Frederick J. A., van Dijk, E. J., Kesselring, F.O., Hofmeijer, J., Vos, J. A., Schonewille, Wouter J., van Rooij, W.J.J., de Kort, P.L., Pleiter, C. Constantijn, Bakker, S. L., Bot, J., Visser, M. C., van der Schaaf, Irene C., Dankbaar, J.W., Mali, W.P., van Seeters, T., Horsch, Alexander D., Niesten, Joris M., Biessels, G.J., Luitse, M.J., van der Graaf, Y., Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, ACS - Microcirculation, Neurology, ACS - Atherosclerosis & ischemic syndromes, Public and occupational health, Molecular cell biology and Immunology, Radiology and nuclear medicine, and Pathology

Subjects
Male, medicine.medical_specialty, Time Factors, Neurology, Clinical Neurology, Hypothermia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Hypothermia, Induced, Modified Rankin Scale, Journal Article, medicine, Humans, Body temperature, cardiovascular diseases, Stroke, Aged, medicine.diagnostic_test, business.industry, Cerebral infarction, Magnetic resonance imaging, Recovery of Function, General Medicine, Prognosis, medicine.disease, Magnetic Resonance Imaging, Confidence interval, Relative risk, Anesthesia, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Research Article
Abstract

Background: High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. Methods: In 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: Body temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04-0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83-1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48-1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17-1.99) and 1.47 (95% CI, 1.22-1.77), respectively). Conclusions: Higher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.

Published
2016
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12. The Preventive Antibiotics in Stroke Study (PASS): a pragmatic randomised open-label masked endpoint clinical trial

Author

Westendorp, W.F., Vermeij, J.D., Zock, E., Hooijenga, I.J., Kruyt, N.D., Bosboom, H.J.L.W., Kwa, V.I.H., Weisfelt, M., Remmers, M.J.M., Houten, R. ten, Schreuder, A.H.C.M., Vermeer, S.E., Dijk, E.J. van, Dippel, D.W.J., Dijkgraaf, M.G.W., Spanjaard, L., Vermeulen, M., Poll, T. van der, Prins, J.M., Vermeij, F.H., Roos, Y.B.W.E.M., Kleyweg, R.P., Kerkhoff, H., Brouwer, M.C., Zwinderman, A.H., Beek, D. van de, Nederkoorn, P.J., PASS Investigators, Erasmus MC other, Neurology, Anesthesiology, Neurosciences, Graduate School, Other departments, Clinical Research Unit, AII - Amsterdam institute for Infection and Immunity, Medical Microbiology and Infection Prevention, ANS - Amsterdam Neuroscience, Infectious diseases, Center of Experimental and Molecular Medicine, ACS - Amsterdam Cardiovascular Sciences, APH - Amsterdam Public Health, and Epidemiology and Data Science

Subjects
Male, medicine.medical_specialty, THERAPY, Modified Rankin Scale, Internal medicine, INFECTION, Clinical endpoint, medicine, Humans, Prospective Studies, ACUTE ISCHEMIC-STROKE, Prospective cohort study, Stroke, Aged, Netherlands, Aged, 80 and over, OUTCOMES, Intention-to-treat analysis, business.industry, Standard treatment, Ceftriaxone, MINOCYCLINE, General Medicine, Pneumonia, Recovery of Function, Length of Stay, Middle Aged, CARE, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Anti-Bacterial Agents, Intention to Treat Analysis, Clinical trial, Treatment Outcome, Urinary Tract Infections, Physical therapy, UPDATE, Female, Quality-Adjusted Life Years, business, medicine.drug, Follow-Up Studies
Abstract

Item does not contain fulltext BACKGROUND: In adults with acute stroke, infections occur commonly and are associated with an unfavourable functional outcome. In the Preventive Antibiotics in Stroke Study (PASS) we aimed to establish whether or not preventive antimicrobial therapy with a third-generation cephalosporin, ceftriaxone, improves functional outcome in patients with acute stroke. METHODS: In this multicentre, randomised, open-label trial with masked endpoint assessment, patients with acute stroke were randomly assigned to intravenous ceftriaxone at a dose of 2 g, given every 24 h intravenously for 4 days, in addition to stroke unit care, or standard stroke unit care without preventive antimicrobial therapy; assignments were made within 24 h after symptom onset. The primary endpoint was functional outcome at 3 months, defined according to the modified Rankin Scale and analysed by intention to treat. The primary analysis was by ordinal regression of the primary outcome. Secondary outcomes included death, infection rates, antimicrobial use, and length of hospital stay. Participants and caregivers were aware of treatment allocation but assessors of outcome were masked to group assignment. This trial is registered with controlled-trials.com, number ISRCTN66140176. FINDINGS: Between July 6, 2010, and March 23, 2014, a total of 2550 patients from 30 sites in the Netherlands, including academic and non-academic medical centres, were randomly assigned to the two treatment groups: 1275 patients to ceftriaxone and 1275 patients to standard treatment (control group). 12 patients (seven in the ceftriaxone group and five in the control group) withdrew consent immediately after randomisation, leaving 2538 patients available for the intention-to-treat-analysis (1268 in the ceftriaxone group and 1270 in the control group). 2514 (99%) of 2538 patients (1257 in each group) completed 3-month follow-up. Preventive ceftriaxone did not affect the distribution of functional outcome scores on the modified Rankin Scale at 3 months (adjusted common odds ratio 0.95 [95% CI 0.82-1.09], p=0.46). Preventive ceftriaxone did not result in an increased occurrence of adverse events. Overgrowth infection with Clostridium difficile occurred in two patients (

Published
2015

13. Temporal profile of body temperature in acute ischemic stroke: Relation to infarct size and outcome

Author

Geurts, M. (Marjolein), Scheijmans, F.E.V. (Féline E.V.), Seeters, T. (Tom) van, Biessels, G.J., Kappelle, L.J. (Jaap), Velthuis, B.K. (Birgitta K.), Worp, H.B. (Bart) van der, Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Greve, D. (Droogh-de), Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J., Visser, M.C. (Marieke), Velthuis, B.K. (Birgitta), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), van Seeters, T., Horsch, A.D. (Alexander D.), Niesten, J.M. (Joris), Biessels, G.J. (Geert Jan), Luitse, J.S.K., Graaf, Y. (Yolanda) van der, Geurts, M. (Marjolein), Scheijmans, F.E.V. (Féline E.V.), Seeters, T. (Tom) van, Biessels, G.J., Kappelle, L.J. (Jaap), Velthuis, B.K. (Birgitta K.), Worp, H.B. (Bart) van der, Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Greve, D. (Droogh-de), Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J., Visser, M.C. (Marieke), Velthuis, B.K. (Birgitta), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), van Seeters, T., Horsch, A.D. (Alexander D.), Niesten, J.M. (Joris), Biessels, G.J. (Geert Jan), Luitse, J.S.K., and Graaf, Y. (Yolanda) van der

Abstract

Background: High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. Methods: In 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: Body temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04-0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83-1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48-1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17-1.99) and 1.47 (95% CI, 1.22-1.77), respectively). Conclusions: Higher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.

Published
2016
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14. Door-to-needle time bij intraveneuze trombolyse: interpretatie en registratie

Author

Kruyt, N.D., Beenen, L.F.M., van den Berg Vos, R.M., Dippel, D.W.J., Imanse, G., Kwa, V.I.H., de Leeuw, F.E., Luijckx, G., Nederkoorn, P.J., van Oostenbrugge, R.J., Visser, M.C., van der Worp, H.B., Wermer, M.J., Zinkstok, S.M., Roos, Y.B., Neurology, Other Research, Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Neuroscience, and NCA - Neurodegeneration

Published
2011

15. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage: Prospective, multicentre cohort study

Author

Van Asch, C.J.J. (Charlotte J.J.), Velthuis, B.K. (Birgitta K.), Rinkel, G.J.E. (Gabriël J.E.), Algra, A. (Ale), Kort, G.A.P. (G. A P) de, Witkamp, T.D. (Theo), De Ridder, J.C.M. (Johanna C.M.), Van Nieuwenhuizen, K.M. (Koen M.), De Leeuw, F.-E. (Frank-Erik), Schonewille, W.J. (Wouter), Kort, P.L.M. (Paul) de, Dippel, D.W.J. (Diederik), Raaymakers, T.W.M. (Theodora W.M.), Hofmeijer, J., Wermer, M.J.H. (Marieke), Kerkhoff, H. (Henk), Jellema, K. (Korné), Bronner, I.M. (Irene M.), Remmers, M.J.M. (Michel ), Bienfait, H.P. (Henri), Witjes, R.J.G.M. (Ron J.G.M.), Greving, J.P. (Jacoba), Klijn, C.J.M. (Catharina J.M.), Leeuw, H.F. (Frank) de, Boogaarts, H.B., Dijk, E.J. (Ewoud) van, Schonewille, W.J., Pellikaan, W.M.J., Puppels-De Waard, C., De Kort, P.L.M., Peluso, J.P., Tuijl, J. (Jordie) van, Joosten, F.B.M. (Frank), Khajeh, L. (Ladbon), Raaijmakers, T.W.M., Wermer, M.J., Walderveen, M.A.A. (Marianne) van, Kerkhoff, H., Zock, E., Lycklama à Nijeholt, G.J. (Geert), Bronner, I.M., Remmers, M.J.M., Witjes, R.J.G.M., Bienfait, H.P., Droogh-Greve, K.E., Donders, R. (Rogier), Kwa, V.I.H., Schreuder, T.H.C.M.L. (Tobien H. C. M. L.), Franke, C.L. (Cees), Straver, J.S., Jansen, C., Bakker, S.L.M. (Stef), Pleiter, C.C. (C.), Visser, M.C. (Marieke), Van Asch, C.J.J., Velthuis, B.K. (Birgitta), Rinkel, G.J.E. (Gabriel), Van Nieuwenhuizen, K.M., Van Asch, C.J.J. (Charlotte J.J.), Velthuis, B.K. (Birgitta K.), Rinkel, G.J.E. (Gabriël J.E.), Algra, A. (Ale), Kort, G.A.P. (G. A P) de, Witkamp, T.D. (Theo), De Ridder, J.C.M. (Johanna C.M.), Van Nieuwenhuizen, K.M. (Koen M.), De Leeuw, F.-E. (Frank-Erik), Schonewille, W.J. (Wouter), Kort, P.L.M. (Paul) de, Dippel, D.W.J. (Diederik), Raaymakers, T.W.M. (Theodora W.M.), Hofmeijer, J., Wermer, M.J.H. (Marieke), Kerkhoff, H. (Henk), Jellema, K. (Korné), Bronner, I.M. (Irene M.), Remmers, M.J.M. (Michel ), Bienfait, H.P. (Henri), Witjes, R.J.G.M. (Ron J.G.M.), Greving, J.P. (Jacoba), Klijn, C.J.M. (Catharina J.M.), Leeuw, H.F. (Frank) de, Boogaarts, H.B., Dijk, E.J. (Ewoud) van, Schonewille, W.J., Pellikaan, W.M.J., Puppels-De Waard, C., De Kort, P.L.M., Peluso, J.P., Tuijl, J. (Jordie) van, Joosten, F.B.M. (Frank), Khajeh, L. (Ladbon), Raaijmakers, T.W.M., Wermer, M.J., Walderveen, M.A.A. (Marianne) van, Kerkhoff, H., Zock, E., Lycklama à Nijeholt, G.J. (Geert), Bronner, I.M., Remmers, M.J.M., Witjes, R.J.G.M., Bienfait, H.P., Droogh-Greve, K.E., Donders, R. (Rogier), Kwa, V.I.H., Schreuder, T.H.C.M.L. (Tobien H. C. M. L.), Franke, C.L. (Cees), Straver, J.S., Jansen, C., Bakker, S.L.M. (Stef), Pleiter, C.C. (C.), Visser, M.C. (Marieke), Van Asch, C.J.J., Velthuis, B.K. (Birgitta), Rinkel, G.J.E. (Gabriel), and Van Nieuwenhuizen, K.M.

Abstract

Study question What are the diagnostic yield and accuracy of early computed tomography (CT) angiography followed by magnetic resonance imaging/angiography (MRI/MRA) and digital subtraction angiography (DSA) in patients with non-traumatic intracerebral haemorrhage? Methods This prospective diagnostic study enrolled 298 adults (18-70 years) treated in 22 hospitals in the Netherlands over six years. CT angiography was performed within seven days of haemorrhage. If the result was negative, MRI/MRA was performed four to eight weeks later. DSA was performed when the CT angiography or MRI/MRA results were inconclusive or negative. The main outcome was a macrovascular cause, including arteriovenous malformation, aneurysm, dural arteriovenous fistula, and cavernoma. Three blinded neuroradiologists independently evaluated the images for macrovascular causes of haemorrhage. The reference standard was the best available evidence from all findings during one year's follow-up. Study answer and limitations A macrovascular cause was identified in 69 patients (23%). 291 patients (98%) underwent CT angiography; 214 with a negative result underwent additional MRI/MRA and 97 with a negative result for both CT angiography and MRI/MRA underwent DSA. Early CT angiography detected 51 macrovascular causes (yield 17%, 95% confidence interval 13% to 22%). CT angiography with MRI/MRA identified two additional macrovascular causes (18%, 14% to 23%) and these modalities combined with DSA another 15 (23%, 18% to 28%). This last extensive strategy failed to detect a cavernoma, which was identified on MRI during follow-up (reference strategy). The positive predictive value of CT angiography was 72% (60% to 82%), of additional MRI/MRA was 35% (14% to 62%), and of additional DSA was 100% (75% to 100%). None of the patients experienced complications with CT angiography or MRI/MRA; 0.6% of patients who underwent DSA experienced permanent sequelae. Not all patients with negative CT angiography and MRI/M

Published
2015
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16. No relation between body temperature and arterial recanalization at three days in patients with acute ischaemic stroke

Author

Geurts, M. (Marjolein), Worp, H.B. (Bart) van der, Horsch, A.D. (Alexander D.), Kappelle, L.J. (Jaap), Biessels, G.J. (Geert Jan), Velthuis, B.K. (Birgitta), Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Droogh-De Greve, K.E., Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J. (Joseph), Visser, M.C. (Marieke), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), Seeters, T. (Tom) van, Niesten, J.M. (Joris), Biessels, G.J., Kappelle, L.J., Luitse, J.S.K., Graaf, Y. (Yolanda) van der, Geurts, M. (Marjolein), Worp, H.B. (Bart) van der, Horsch, A.D. (Alexander D.), Kappelle, L.J. (Jaap), Biessels, G.J. (Geert Jan), Velthuis, B.K. (Birgitta), Majoie, C.B. (Charles), Roos, Y.B.W.E.M. (Yvo), Duijm, L.E.M. (Lucien), Keizer, K. (Koos), Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), Droogh-De Greve, K.E., Bienfait, H.P. (Henri), Walderveen, M.A.A. (Marianne) van, Wermer, M.J.H. (Marieke), Lycklama à Nijeholt, G.J. (Geert), Boiten, J. (Jelis), Duyndam, A. (Anita), Kwa, V.I.H., Meijer, F.J. (F.), Dijk, E.J. (Ewoud) van, Kesselring, A.M. (Anouk), Hofmeijer, J., Vos, J.A. (Jan Albert), Schonewille, W.J. (Wouter), Rooij, W.J. (W.) van, Kort, P.L.M. (Paul) de, Pleiter, C.C. (C.), Bakker, S.L.M. (Stef), Bot, J. (Joseph), Visser, M.C. (Marieke), Schaaf, I.C. (Irene) van der, Dankbaar, J.W. (Jan), Mali, W.P. (Willem), Seeters, T. (Tom) van, Niesten, J.M. (Joris), Biessels, G.J., Kappelle, L.J., Luitse, J.S.K., and Graaf, Y. (Yolanda) van der

Abstract

Background: Recanalization of an occluded intracranial artery is influenced by temperature-dependent enzymes, including alteplase. We assessed the relation between body temperature on admission and recanalization. Methods: We included 278 patients with acute ischaemic stroke within nine hours after symptom onset, who had an intracranial arterial occlusion on admission CT angiography, in 13 participating centres. We calculated the relation per every 0.1°Celsius increase in admission body temperature and recanalization at three days. Results: Recanalization occurred in 80% of occluded arteries. There was no relation between body temperature and recanalization at three days after adjustments for age, NIHSS score on admission and treatment with alteplase (adjusted odds ratio per 0.1°Celsius, 0.99; 95% confidence interval, 0.94-1.05; p = 0.70). Results for patients treated or not treated with alteplase were essentially the same. Conclusions: Our findings suggest that in patients with acute ischaemic stroke there is no relation between body temperature on admission and recanalization of an occluded intracranial artery three days later, irrespective of treatment with alteplase.

Published
2015
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17. Clinical and magnetic resonance observations in cerebral small-vessel disease

Author

Kwa, V.I.H., Stam, J., and Faculteit der Geneeskunde

Subjects
cardiovascular system
Abstract

The study reported in this thesis tried to address the following questions: 1. Is it possible to detect genetic factors and vascular risk factors that are specifically associated with the development of small- or large-vessel disease? 2. Are the different clinical and MRI manifestations, that are attributed to small-vessel disease, like lacunar infarcts, white matter lesions and intracerebral hemorrhages, mutually related? Do the various results of small-vessel disease occur in one patient? Are there clinical and MRI manifestations of small-vessel disease that have been unnoticed until now? 3. What differences exist in the evolution of early clinical signs and symptoms between cerebral infarcts caused by small- or large-vessel disease?

Published
1999

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