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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 10, 2018 Category: Neurology Source Type: research

Prevention of cardiovascular events in Asian patients with ischaemic stroke at high risk of cerebral haemorrhage (PICASSO): a multicentre, randomised controlled trial
Publication date: June 2018Source: The Lancet Neurology, Volume 17, Issue 6Author(s): Bum Joon Kim, Eun-Jae Lee, Sun U Kwon, Jong-Ho Park, Yong-Jae Kim, Keun-Sik Hong, Lawrence K S Wong, Sungwook Yu, Yang-Ha Hwang, Ji Sung Lee, Juneyoung Lee, Joung-Ho Rha, Sung Hyuk Heo, Sung Hwan Ahn, Woo-Keun Seo, Jong-Moo Park, Ju-Hun Lee, Jee-Hyun Kwon, Sung-Il Sohn, Jin-Man JungSummaryBackgroundThe optimal treatment for patients with ischaemic stroke with a high risk of cerebral haemorrhage is unclear. We assessed the efficacy and safety of cilostazol versus aspirin, with and without probucol, in these patients.MethodsIn this randomis...
Source: The Lancet Neurology - July 10, 2018 Category: Neurology 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.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

Prevention of cardiovascular events in Asian patients with ischaemic stroke at high risk of cerebral haemorrhage (PICASSO): a multicentre, randomised controlled trial
Publication date: June 2018Source: The Lancet Neurology, Volume 17, Issue 6Author(s): Bum Joon Kim, Eun-Jae Lee, Sun U Kwon, Jong-Ho Park, Yong-Jae Kim, Keun-Sik Hong, Lawrence K S Wong, Sungwook Yu, Yang-Ha Hwang, Ji Sung Lee, Juneyoung Lee, Joung-Ho Rha, Sung Hyuk Heo, Sung Hwan Ahn, Woo-Keun Seo, Jong-Moo Park, Ju-Hun Lee, Jee-Hyun Kwon, Sung-Il Sohn, Jin-Man JungSummaryBackgroundThe optimal treatment for patients with ischaemic stroke with a high risk of cerebral haemorrhage is unclear. We assessed the efficacy and safety of cilostazol versus aspirin, with and without probucol, in these patients.MethodsIn this randomis...
Source: The Lancet Neurology - July 5, 2018 Category: Neurology 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

The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study
Publication date: Available online 10 January 2018 Source:The Lancet Neurology Author(s): Mark A Rodrigues, Neshika Samarasekera, Christine Lerpiniere, Catherine Humphreys, Mark O McCarron, Philip M White, James A R Nicoll, Cathie L M Sudlow, Charlotte Cordonnier, Joanna M Wardlaw, Colin Smith, Rustam Al-Shahi Salman Background Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a predict...
Source: The Lancet Neurology - January 12, 2018 Category: Neurology Source Type: research

Mobile stroke units for prehospital thrombolysis, triage, and beyond: benefits and challenges
Publication date: March 2017 Source:The Lancet Neurology, Volume 16, Issue 3 Author(s): Klaus Fassbender, James C Grotta, Silke Walter, Iris Q Grunwald, Andreas Ragoschke-Schumm, Jeffrey L Saver In acute stroke management, time is brain. Bringing swift treatment to the patient, instead of the conventional approach of awaiting the patient's arrival at the hospital for treatment, is a potential strategy to improve clinical outcomes after stroke. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and ap...
Source: The Lancet Neurology - February 15, 2017 Category: Neurology Source Type: research

Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial
Publication date: Available online 23 August 2016 Source:The Lancet Neurology Author(s): Serge Bracard, Xavier Ducrocq, Jean Louis Mas, Marc Soudant, Catherine Oppenheim, Thierry Moulin, Francis Guillemin Background Intravenous thrombolysis with alteplase alone cannot reperfuse most large-artery strokes. We aimed to determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in patients with acute ischaemic stroke. Methods THRACE is a randomised controlled trial done in 26 centres in France. Patients aged 18–80 years with acute ischaemic stroke and proximal cerebral artery...
Source: The Lancet Neurology - August 23, 2016 Category: Neurology Source Type: research

Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial
Publication date: September 2016 Source:The Lancet Neurology, Volume 15, Issue 10 Author(s): Gustavo Saposnik, Leonardo G Cohen, Muhammad Mamdani, Sepideth Pooyania, Michelle Ploughman, Donna Cheung, Jennifer Shaw, Judith Hall, Peter Nord, Sean Dukelow, Yongchai Nilanont, Felipe De los Rios, Lisandro Olmos, Mindy Levin, Robert Teasell, Ashley Cohen, Kevin Thorpe, Andreas Laupacis, Mark Bayley Background Non-immersive virtual reality is an emerging strategy to enhance motor performance for stroke rehabilitation. There has been rapid adoption of non-immersive virtual reality as a rehabilitation strategy despite the limited ...
Source: The Lancet Neurology - August 8, 2016 Category: Neurology Source Type: research

Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study
This study is registered with ClinicalTrials.gov, number NCT02358772. Findings Between Feb 5, 2011, and March 5, 2015, 427 patients were treated within the STEMO vehicle and their data were entered into a pre-hospital registry. 505 patients received conventional care and their data were entered into an in-hospital thrombolysis registry. Of these, 305 patients in the STEMO group and 353 in the conventional care group met inclusion criteria and were included in the analysis. 161 (53%) patients in the STEMO group versus 166 (47%) in the conventional care group had an mRS score of 1 or lower (p=0·14). Compared with conventio...
Source: The Lancet Neurology - July 15, 2016 Category: Neurology Source Type: research

Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis
Publication date: Available online 8 June 2016 Source:The Lancet Neurology Author(s): William N Whiteley, Jonathan Emberson, Kennedy R Lees, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Rüdiger von Kummer, Maarten G Lansberg, Richard I Lindley, Patrick Lyden, Jean Marc Olivot, Mark Parsons, Danilo Toni, Kazunori Toyoda, Nils Wahlgren, Joanna Wardlaw, Gregory J del Zoppo, Peter Sandercock, Werner Hacke, Colin Baigent Background Randomised trials have shown that alteplase impr...
Source: The Lancet Neurology - June 8, 2016 Category: Neurology Source Type: research

Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study
Publication date: July 2016 Source:The Lancet Neurology, Volume 15, Issue 8 Author(s): Solène Moulin, Julien Labreuche, Stéphanie Bombois, Costanza Rossi, Gregoire Boulouis, Hilde Hénon, Alain Duhamel, Didier Leys, Charlotte Cordonnier Background Dementia occurs in at least 10% of patients within 1 year after stroke. However, the risk of dementia after spontaneous intracerebral haemorrhage that accounts for about 15% of all strokes has not been investigated in prospective studies. We aimed to determine the incidence of dementia and risk factors after an intracerebral haemorrhage. Methods We did a prospective...
Source: The Lancet Neurology - June 6, 2016 Category: Neurology Source Type: research

Dementia after stroke due to intracerebral haemorrhage
Publication date: July 2016 Source:The Lancet Neurology, Volume 15, Issue 8 Author(s): Rustam Al-Shahi Salman, Katie McGoohan, Mark Rodrigues, Martin Dichgans
Source: The Lancet Neurology - June 6, 2016 Category: Neurology Source Type: research

Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial
Publication date: May 2016 Source:The Lancet Neurology, Volume 15, Issue 6 Author(s): Thorsten Steiner, Sven Poli, Martin Griebe, Johannes Hüsing, Jacek Hajda, Anja Freiberger, Martin Bendszus, Julian Bösel, Hanne Christensen, Christian Dohmen, Michael Hennerici, Jennifer Kollmer, Henning Stetefeld, Katja E Wartenberg, Christian Weimar, Werner Hacke, Roland Veltkamp Background Haematoma expansion is a major cause of mortality in intracranial haemorrhage related to vitamin K antagonists (VKA-ICH). Normalisation of the international normalised ratio (INR) is recommended, but optimum haemostatic managemen...
Source: The Lancet Neurology - April 19, 2016 Category: Neurology Source Type: research

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