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Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316.FindingsBetween Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0·5...
Source: The Lancet Neurology - July 5, 2018 Category: Neurology Source Type: research

Long-Term Prognosis of Patients With Transient Ischemic Attack or Stroke and Symptomatic Vascular Disease in Multiple Arterial Beds Clinical Sciences
Background and Purpose—Cerebrovascular, coronary, and peripheral vascular disease have common underlying arterial pathology and risk factors, but the clinical significance of multiple-territory disease in patients with transient ischemic attack (TIA)/ischemic stroke is unclear, particularly whether the number of clinically affected territories still predicts long-term outcome on current standard secondary prevention therapies.Methods—In a population-based study of 92 728 individuals in Oxfordshire, United Kingdom (Oxford Vascular Study), we studied patients presenting with TIA/ischemic stroke (2002–2014) in relatio...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Mirjam R. Heldner, Linxin Li, Nicola G. Lovett, Magdalena M. Kubiak, Shane Lyons, Peter M. Rothwell Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA), Vascular Disease Original Contributions Source Type: research

Genetic Study of White Matter Integrity in UK Biobank (N=8448) and the Overlap With Stroke, Depression, and Dementia Clinical Sciences
Conclusions—Genetic variants within the VCAN gene may play a role in the mechanisms underlying microstructural integrity of the white matter in the brain measured as FA and MD. Mechanisms underlying white matter alterations are shared with cerebrovascular disease, and inherited differences in white matter microstructure impact on Alzheimer disease and major depressive disorder.
Source: Stroke - May 25, 2018 Category: Neurology Authors: Loes C.A. Rutten-Jacobs, Daniel J. Tozer, Marco Duering, Rainer Malik, Martin Dichgans, Hugh S. Markus, Matthew Traylor Tags: Genetic, Association Studies, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316. Findings Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0Â...
Source: The Lancet Neurology - May 16, 2018 Category: Neurology Source Type: research

Low-dose aspirin and risk of intracranial bleeds: An observational study in UK general practice
Conclusion: Low-dose aspirin is not associated with an increased risk of any type of ICB and is associated with a significantly decreased risk of SAH when used for ≥1 year.
Source: Neurology - November 27, 2017 Category: Neurology Authors: Cea Soriano, L., Gaist, D., Soriano-Gabarro, M., Bromley, S., Garcia Rodriguez, L. A. Tags: All Cerebrovascular disease/Stroke, Case control studies, Risk factors in epidemiology ARTICLE Source Type: research

Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack Clinical Sciences
Conclusions—Statin use was not associated with an increased risk of ICH among patients with a previous history of IS/TIA.
Source: Stroke - November 27, 2017 Category: Neurology Authors: David Gaist, Larry B. Goldstein, Lucia Cea Soriano, Luis Alberto Garcia Rodriguez Tags: Secondary Prevention, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Predictors of Outcome in Aneurysmal Subarachnoid Hemorrhage Patients Clinical Sciences
Background and Purpose—The mortality and morbidity after aneurysmal subarachnoid hemorrhage has improved because of better diagnosis, early treatment to secure the aneurysm, and better management of disease-specific complications. With these improvements in care, it is not clear if the previously identified independent predictors of a negative outcome have changed. The aim of this study was to identify the independent predictors of an unfavorable outcome (Glasgow Outcome Score 1, 2, and 3) in aneurysmal subarachnoid hemorrhage patients.Methods—Univariate and multivariate analysis of prospectively collected data on pati...
Source: Stroke - October 23, 2017 Category: Neurology Authors: James P. Galea, Louise Dulhanty, Hiren C. Patel Tags: Cerebral Aneurysm, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysis
Publication date: November 2017 Source:The Lancet Neurology, Volume 16, Issue 11 Author(s): Barbara Schormair, Chen Zhao, Steven Bell, Erik Tilch, Aaro V Salminen, Benno Pütz, Yves Dauvilliers, Ambra Stefani, Birgit Högl, Werner Poewe, David Kemlink, Karel Sonka, Cornelius G Bachmann, Walter Paulus, Claudia Trenkwalder, Wolfgang H Oertel, Magdolna Hornyak, Maris Teder-Laving, Andres Metspalu, Georgios M Hadjigeorgiou, Olli Polo, Ingo Fietze, Owen A Ross, Zbigniew Wszolek, Adam S Butterworth, Nicole Soranzo, Willem H Ouwehand, David J Roberts, John Danesh, Richard P Allen, Christopher J Earley, William G Ondo, Lan Xiong,...
Source: The Lancet Neurology - October 11, 2017 Category: Neurology Source Type: research

Stenting for symptomatic vertebral artery stenosis: The Vertebral Artery Ischaemia Stenting Trial
Conclusions: Stenting in extracranial stenosis appears safe with low complication rates. Large phase 3 trials are required to determine whether stenting reduces stroke risk. ISRCTN.com identifier: ISRCTN95212240. Classification of evidence: This study provides Class I evidence that for patients with symptomatic vertebral stenosis, angioplasty with stenting does not reduce the risk of stroke. However, the study lacked the precision to exclude a benefit from stenting.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Markus, H. S., Larsson, S. C., Kuker, W., Schulz, U. G., Ford, I., Rothwell, P. M., Clifton, A., For the VIST Investigators Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Clinical trials Randomized controlled (CONSORT agreement) ARTICLE Source Type: research

Vascular Risk Factor Profiles Differ Between Magnetic Resonance Imaging-Defined Subtypes of Younger-Onset Lacunar Stroke Clinical Sciences
Conclusions—In this magnetic resonance imaging–verified lacunar stroke population, we identified a distinct risk factor profile in the group as a whole. However, there were differing risk factor profiles according to the presence of multiple lacunar infarcts and confluent WMH. The association of hypertension, smoking, and renal impairment with the presence of multiple lacunar infarcts and confluent WMH might reflect a diffuse small vessel arteriopathy.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Loes C.A. Rutten-Jacobs, Hugh S. Markus Tags: Risk Factors, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research

A pilot study evaluating the use of ABCD2 score in pre-hospital assessment of patients with suspected transient ischaemic attack: experience and lessons learned
ConclusionsIt is possible to identify, recruit and follow up patients with suspected TIA in the EMS setting. Training large numbers of EMS staff is required as exposure to TIA patients is infrequent. Significant insight was gained into the complexity of NHS research governance mechanisms in the UK. This knowledge will facilitate the planning of a future adequately powered study to validate the ABCD2 tool in a pre-hospital setting.
Source: Experimental and Translational Stroke Medicine - August 20, 2016 Category: Neurology Source Type: research

Evaluation of the Post Stroke Checklist: a pilot study in the United Kingdom and Singapore
ConclusionsThe findings suggest that the Post Stroke Checklist is a feasible and useful measure for identifying long term stroke care needs in a clinical practice setting. Pilot testing indicated that the Post Stroke Checklist is able to identify a wide range of unmet needs, and patient and clinician feedback indicated a high level of satisfaction with the Post Stroke Checklist assessment. The items were generally well understood and considered relevant to stroke survivors, indicating the Post Stroke Checklist is a feasible, useful, and relevant measure of poststroke care.
Source: International Journal of Stroke - August 4, 2014 Category: Neurology Authors: Anthony B. Ward, Christopher Chen, Bo Norrving, Patrick Gillard, Marion F. Walker, Steven Blackburn, Laura Holloway, Michael Brainin, Ian Philp, Tags: Research Source Type: research

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