Ale Algra

..In explanatory trials patient selection is strict and treatment is double-blind and pathophysiologically pure. Often proxy outcome measures are used and emphasis is on per protocol ('on treatment') analysis...

..In patients with cerebral ischaemia of presumed arterial origin, anticoagulation with an achieved intensity of 3.0--4.5 proved not to be safe. Results from trials with more moderate anticoagulation regimes are awaited...

..Current publications suggest increased risk of sudden death in experimental animals with acute right insular lesions and in patients with recent right-sided brain infarction, particularly if the insula is involved...

..It is not yet clear how many questions are needed to obtain a reliable estimate of the ALDS and therefore the time needed to complete the instrument is still uncertain...

..The risk of new vascular events and mortality is high. Direct comparisons of vascular event rates are scarce...

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..In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts...

..This study provided a detailed insight in the course of PAD long after peripheral bypass surgery and enables individual risk assessment of major fatal and non-fatal ischaemic events by means of cumulative incidences and a risk chart...

..We compared incidences of vascular diseases, vascular death, and all-cause death after SAH with those in the general population...

..Stratifying PAD patients according to their risk of secondary events could aid in achieving optimal therapy compliance. To this end we developed a prediction model for secondary cardiovascular events in PAD patients...

..Also, progression and regression of the metabolic syndrome after follow-up are not extensively studied...

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..Common carotid artery intima-media thickness (CCA IMT) is a marker of atherosclerosis. Our aim was to compare CCA IMT between SVD and LVD patients...

..Recent case reports have suggested that aneurysms grow fast in a short period of time. The authors of the present report investigated the plausibility of a constant growth rate for intracranial aneurysms...

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..To estimate brain volumes, white matter lesion (WML) volume and asymptomatic infarcts on MRI in a large cohort of patients with atherosclerotic disease...

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..However, an elevated C-reactive protein level and several types of symptomatic infection were associated with peripheral arterial disease...

..Effective therapy might stabilize, albeit not improve, quality of life in this specific patient population...

..Therefore, the planned primary analysis of the PAIS study has been changed from fixed dichotomization of the mRS to a sliding dichotomy analysis...

..It is unknown whether this also applies to patients with a disabling stroke...

..There is a strong synergistic effect between hyperhomocysteinemia and all traditional vascular risk factors. Our findings may have implications for risk management in these young women...

..Why women and patients with aneurysms larger than 5 mm or posterior circulation aneurysms have a higher risk of rupture remains to be settled...

..The risk of ischemic stroke in patients with asymptomatic vertebral artery stenosis is unknown. We examined the incidence of posterior circulation ischemic stroke in patients with asymptomatic stenosis of the vertebral artery origin (VAo)...

..The relationship between metabolic syndrome and infrarenal aortic diameter was also assessed in this patient group...

..We updated our previous review from 1996 on the risk of rupture of unruptured intracranial aneurysms, aiming to include the newly published articles...

..Our objective was to assess whether this is also the case in patients with peripheral arterial disease...

..To investigate time trends in vascular risk factors and medication use for patients referred to a vascular specialist with manifest vascular disease or type 2 diabetes mellitus (DM2)...

..30; 95% CI 1.05-1.63) and death (aOR 1.51; 95% CI 1.15-1.98). An early rise in body temperature rather than high body temperature on admission is a risk factor for unfavorable outcome in patients with acute stroke...

..We investigated the relationship between time to recanalization therapy and functional outcome in BAO with data from the Basilar Artery International Cooperation Study (BASICS)...

..Impact of DCI on poor outcome did not differ between clipped and coiled patients, except for patients treated within 4 days, in whom DCI resulted more often in poor outcome after coiling than after clipping...

..To guide fluid management, regular assessments of volume status must be conducted. We studied the ability of nursing staff to predict hypovolaemia or hypervolaemia, based on their interpretation of available haemodynamic data...

..We studied the risk of rebleeding in patients with subarachnoid hemorrhage during treatment for acute hydrocephalus...

..We assessed the relationship between serum magnesium concentrations achieved with magnesium sulphate therapy 64 mmol/day and the occurrence of DCI and poor outcome in patients with SAH...

..The authors investigated whether brain natriuretic peptide (BNP) is related to hypovolemia and hyponatremia after SAH and whether it can differentiate between hypovolemic and non-hypovolemic hyponatremia...

..It has been suggested that cognitive impairments are more pronounced in DM2 than in DM1, but studies that directly compare the effects of these 2 types of DM on cognition are lacking...

..The influence of the method of aneurysm treatment was studied in our randomised MASH trial, which assessed in a factorial design the efficacy of magnesium and aspirin in preventing delayed cerebral ischaemia (DCI) and poor outcome...

..This strategy is based on uncontrolled case series including also patients with unruptured aneurysms or other lesions. We collected data on effectiveness of antiplatelets in patients with SAH...

..We assessed the validity of a telephone interview in patients who had had an aneurysmal subarachnoid haemorrhage (SAH) by comparing it with a face-to-face assessment...

..We investigated the interobserver variation of the Hijdra and Fisher scales for the amount of extravasated blood and the predictive values of these scales for delayed cerebral ischemia and outcome...

..The positive relation between 'infection burden' and PAD was only found in women with a high CRP level, which indicates that inflammation might be involved in the process that leads to PAD...

..The presence of vascular and obstetrical risk factors did not affect the strength of the association. Pregnancy loss could be the first sign of insufficient aortic circulation in these patients...

..Because atherosclerosis is considered a systemic disease, we hypothesized that one single atherosclerotic plaque contains ample molecular information that predicts future cardiovascular events in all vascular territories...

..Standard screening for asymptomatic atherosclerotic disease identified a limited number of vascular abnormalities that necessitated immediate medical attention in patients already identified as high-risk patients...

..Risk factors for the development of an aSDH from aneurysmal rupture are unknown and may help our understanding of how an aSDH develops...

..Within the International Subarachnoid Aneurysm Trial we assessed differences in incidence of delayed cerebral ischemia and clinical outcome between different timings of treatment...

..We compared the effects of CAS and CEA on BP up to 1 year after treatment in the International Carotid Stenting Study...

..We assessed whether lacunar infarcts and white matter lesions on MRI increased the risk of vascular and nonvascular death and future vascular events in patients with atherosclerotic disease...

..We studied the incidence of and risk factors for recurrent SAH in patients who regained independence after SAH and in whom all aneurysms were occluded by means of clipping...

..Hypocalcaemia is associated with an increased risk of DCI and poor outcome and may therefore reduce the potential beneficial effect of magnesium treatment in SAH...

..Outcomes following treatment of brain arteriovenous malformations (AVMs) with microsurgery, embolization, stereotactic radiosurgery (SRS), or combinations vary greatly between studies...

..Cerebral perfusion is a predictor for DCI. Because acute hydrocephalus may impair cerebral perfusion, we evaluated the predictive value of the extent of acute hydrocephalus on the development of DCI...

..We therefore aimed to identify and quantify trigger factors for aneurysmal rupture and to gain insight into the pathophysiology...

..We examined the prevalence of the minor Cx40 allele in patients with cerebral ischemia and no other cardiovascular disease (CVD), as an indication of underlying idiopathic AF...

..Thus claims about genetic associations with specific subtypes of ischemia should be interpreted with caution. The association between F13B His95Arg and LVD requires replication...

..To evaluate the feasibility of a web-based coaching programme for vascular risk factor treatment, to describe the patterns of use and to measure changes in risk factors...

..Type 2 diabetes mellitus is associated with an increased risk of cognitive decline and dementia. We examined brain imaging correlates and vascular and metabolic risk factors of accelerated cognitive decline in patients with type 2 diabetes...

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..We hypothesized that such gene variants may also be associated with mortality after cerebral ischemia of arterial origin because of an increased risk of fatal vascular events...

..We did a trial to test whether magnesium therapy improves outcome after aneurysmal subarachnoid haemorrhage...

..We prospectively studied intravascular volume in SAH patients with and without PED...

..Whether impaired glucose tolerance increases the risk of stroke in patients with transient ischemic attack (TIA) or minor ischemic stroke is unknown...

..The recent PRoFESS trial found no differences in the efficacy of aspirin plus dipyridamole and clopidogrel, hence there is no need for major adaptation of the guidelines...

..Although this study was not designed to compare conservative treatment with surgical intervention, the favourable outcome suggests that a policy of medical therapy and control of risk factors may be justified in these patients...

..In this review, we aimed to provide an overview of the gender-specific characteristics causing these perioperative and long-term outcome differences between men and women after CEA...

..Information on outcome of patients with occlusion of the internal carotid artery (ICA) is limited by the short duration of follow-up and lack of haemodynamic studies on the brain...

..We assessed whether antiplatelet drugs were more efficacious in large than in small vessel cerebrovascular disease...

..We aimed to assess the incidence, case fatality, and functional outcome of intracerebral haemorrhage in relation to age, sex, ethnic origin, and time period in studies published since 1980...

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..To study long-term outcome in patients with aneurysmal subarachnoid hemorrhage (SAH) who are relatively young...

..76 to 1.85). CONCLUSIONS: Our data indicate that antiplatelet drugs reduce the risk of DCI in patients with subarachnoid hemorrhage. A randomized clinical trial is warranted to assess the effect on overall outcome...

..Between the 5 and the 12.5 years follow-up, the improvement in mRS had decreased but patients reported overall a better QoL. Among long-time survivors, QoL may improve more than a decade after SAH...

..We assessed the frequency and time distribution of hypomagnesemia after aneurysmal subarachnoid hemorrhage (SAH) and its relationship to the severity of SAH, delayed cerebral ischemia (DCI), and outcome after 3 months...

..Because hypomagnesemia is associated with several ECG abnormalities, we studied whether hypomagnesemia mediates ECG abnormalities after SAH...

..Sound evidence on the best timing of surgery is still lacking. Observational studies with better methods--and ideally a new randomized trial--are needed...

..The authors assessed the complications of this procedure and clinical outcomes after the construction of high-flow bypasses in patients with intracranial aneurysms...

..The authors assessed the magnitude of the reduction in poor outcomes that accompanies a strategy aimed at surgery...

..Our limited knowledge on the outcome in patients with basilar artery occlusion comes from small case series of selected patients...

..The aim of this study was to gain insight into the prevalence, cause, and outcome of VSR in patients with symptomatic CAO...

..CONCLUSIONS: Most studies on treatment strategies in SAH suffer from methodological weaknesses. This implies that current management of patients with SAH is based on weak evidence...

..0, 95% CI 0.6 to 1.8). CONCLUSIONS: Third-generation oral contraceptives (containing desogestrel or gestodene) confer the same risk of first ischemic stroke as second-generation oral contraceptives (containing levonorgestrel)...

..In a prospective observational study we assessed the effectiveness of fluid administration based on regular evaluation of the fluid balance in maintaining normovolemia...

..A systematic review of the available literature has been undertaken to assess the overall outcome of epilepsy surgery and identify risk factors of seizure recurrence...

..CONCLUSION: Common CIMT is associated with the occurrence of new vascular events, mostly for ischaemic stroke, in patients with manifest arterial disease. This relation does not appear to depend on the presence of plaques...

..We examined the relationship between asymptomatic CAS and the risk of subsequent events in this specific group of patients...

..To investigate the development of mobility status during the second year after stroke in patients who had had inpatient rehabilitation, and to evaluate risk factors for mobility decline...

..We also make suggestions about the design of genetic association studies in ischaemic stroke with regard to stroke subtype classification, candidate pathways, subgroups, intermediate phenotypes and potential clinical impact...

..It is unclear whether the risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased during pregnancy, labor, and the puerperium. We compared the risk of aSAH during this period with the risk outside this period...

..Therefore, we studied the prevalence of anosmia in patients with nonaneurysmal perimesencephalic hemorrhage...

..In conclusion, the F13A1 204Phe allele was strongly associated with ischemic stroke in young women. Oral contraceptive use further increased the risk of ischemic stroke...

..In a prospective controlled study we assessed whether fluid management guided by daily measurements of blood volume (BV) reduces the incidence of severe hypovolemia compared to conventional fluid balance guided fluid therapy...

..We studied whether configuration of the circle of Willis, direction of flow towards the aneurysm, and shape of the aneurysm are risk factors for rupture...

..However, in patients with low SBP, decreased carotid stiffness may indicate a decreased risk of vascular events...

..After a 1996 review from our group on risk factors for subarachnoid hemorrhage (SAH), much new information has become available. This article provides an updated overview of risk factors for SAH...

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..This may explain the only moderate predictive value of these prognosticators. We assessed the prognostic value of the simplified acute physiology score (SAPS) II in SAH patients...

..With many risk factors, these patients had a risk high enough to warrant cardiac investigations...