M S Dennis

..Altered retinal vessel fractal dimensions may act as a surrogate marker for diseased cerebral vessels. We used a cross-sectional study to investigate fractal properties of retinal vessels in lacunar stroke...

..IST-3 sought to improve the external validity and precision of the estimates of the overall treatment effects (efficacy and safety) of rtPA in acute ischaemic stroke, and to determine whether a wider range of patients might benefit...

..The CLOTS trial 3 aims to determine whether, compared with best medical care, best medical care plus intermittent pneumatic compression in immobile stroke patients reduces the risk of proximal deep vein thrombosis...

..We tested 2 postal mRS questionnaires and a telephone questionnaire to determine completion rates and intermodality agreement...

..We now wish to pilot a brief intervention aimed at (a) helping patients establish a better medication-taking routine, and (b) eliciting and modifying any erroneous beliefs regarding their medication and their stroke...

..Deep vein thrombosis (DVT) is an important complication of stroke, but the evidence to support commonly used prophylactic strategies is conflicting...

..Guidelines recommend that DVT prophylaxis should be guided by an assessment of the individual patient's risk. The authors aimed to develop and test models to predict DVT risk...

..National stroke guidelines extrapolating from these trials recommend their use in patients with stroke despite insufficient evidence. We assessed the effectiveness of thigh-length GCS to reduce DVT after stroke...

..Undernutrition is common in patients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months...

..Undernutrition is common in hospital patients with stroke, can develop or worsen in hospital, and is associated with poor outcomes. We aimed to establish whether routine oral nutritional supplements improve outcome after stroke...

..Thus, DWI is unlikely to reduce sample sizes in acute stroke trials assessing functional outcome, especially where estimated treatment effects are modest...

..We examined whether visible infarction was associated with a poor outcome after stroke using univariate and multivariate analyses, including easily identifiable clinical baseline variables, and adjusting for time from stroke onset to CT...

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..We measured arterial oxygen saturation (SaO(2)) during eating in acute stroke patients to establish the frequency of any meal-related hypoxemia, which could further damage already vulnerable brain tissue...

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..We therefore investigated their use in patients known to be in AF before a stroke, transient ischaemic attack (either cerebral or ocular) or retinal artery occlusion to assess the influence of trials on clinical practice...

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..We investigated whether the pattern of intracranial vascular abnormalities is related to the clinical syndrome...

..More moderate, but still clinically important, variations in stroke care can only be identified by monitoring the process of care directly...

..Brain imaging should modify the clinical classification and influence patient investigation...

..quot; It is unclear which "semiquantitative" perfusion parameter most closely identifies final infarct volume...

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..To determine the proportion of haemorrhagic strokes misdiagnosed as infarcts on computed tomography (CT) in patients with mild stroke, and the implications for health care...

..We describe the patients' clinical and imaging features, and discuss alternative explanations for the imaging appearance and the implications for gaining insights into the cause of lacunar infarction...

..These results may have implications for current practice and for future patient positioning strategies to improve outcome after stroke...

..We used spectroscopic imaging to measure N-acetyl aspartate (NAA, a marker of normal neurons) and lactate (a marker of ischemia) to compare with diffusion and perfusion values in the diffusion lesion in acute ischemic stroke...

..The pathogenesis of and relationship between small deep (lacunar) infarcts, cerebral white matter disease (leukoaraiosis or white matter hyperintensities), and progressive cognitive impairment or dementia are much debated...

..Hypoxia is frequent in MRI. Patients should be monitored carefully, possibly by an experienced clinician, during scanning...

..Further work is required to investigate what determines the clinical effects of ICA occlusion...

..Stroke patients managed within specialist units are more likely to be alive and living at home a year after the stroke than those managed in general wards. Stroke unit care does not apparently increase the time spent in hospital...

..When collected retrospectively, the model variables are likely to remain reliable and reasonably valid...

..The authors compared N-acetyl aspartate (NAA, found in intact neurons) and lactate (anaerobic metabolism) with diffusion/perfusion parameters...

..However, a simple measure of absolute mean flow velocity might provide a direct assessment of "perfusion reserve" in acute ischemic stroke...

..We sought to evaluate the delays, between-centre variations in practice, and opportunity costs attributable to delays in research governance approval of clinical trials in the United Kingdom...

..An association between microbleeds and clinically defined lacunar stroke might suggest a common causal microangiopathy...

..Retinal vessels show developmental and pathophysiological similarities to cerebral small vessels and microvessel geometry may influence vascular efficiency...

..We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease. Materials and..

..We hypothesized that there would be higher rates of retinopathy in patients with acute lacunar versus cortical stroke...

..The proportion of symptomatic lacunar infarcts that progress to lacunes is unknown. Noncavitating lacunar infarcts may continue to resemble white matter lesions...

..Different risks of recurrent stroke and MI after lacunar versus nonlacunar ischemic stroke may support a distinct lacunar arteriopathy...

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..Pooling of data from community-based studies of haemorrhagic stroke that have used consistent definitions and methods represents the only feasible way to obtain more precise data on prognosis after intracerebral haemorrhage...

..We therefore describe the clinical and pathological features of recent, symptomatic internal carotid artery occlusion to examine the pathogenetic role of plaque instability at both extracranial and intracranial sites...

..60, p = 0.001) and with a general cognitive factor extracted from the mental ability test scores (r = -0.42, p = 0.016). We conclude that informant-rated methods offer a promising approach to measuring cognitive decline after stroke...

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..To seek evidence of potential embolic sources or other stroke mechanisms in patients who, on chance observation, had several apparently recent small subcortical infarcts on diffusion weighted magnetic resonance imaging (DWI)...

..To describe changes in personality after stroke and effects on carers...

..These findings need to be confirmed and any causal relationship between attitude and survival further explored in a randomized controlled trial to "improve" the attitude of stroke patients toward their illness...

..These models provide a well-tested tool for stratification in trials, comparing outcomes in different cohorts and examining the additional predictive power of novel factors...

..In contrast, the high hopes raised by many "high-tech" solutions have largely been dashed or remain promising but unproven...

..We overcame these by pooling individual data on 2875 patients with first-ever ischemic stroke from 5 collaborating prospective stroke registers that used similar, unbiased methods to define risk factors and classify stroke subtypes...

..Further study is required to determine underlying mechanisms and any potential for subacute intervention to improve recovery...

..Stroke patients may have an increased risk of fractures because of weak bones or an increased risk of falling. Our goal was to estimate the frequency of fracture after stroke and to identify those at greatest risk...

..Therefore, our aim was to compare the severity of ipsilateral with contralateral ICA and MCA disease in patients with lacunar ischaemic stroke...

..40-1.40). Other forms of vascular disease in parents were not associated with significant risk either (OR 0.93, 95% CI 0.51-1.68). We conclude that familial factors do not contribute substantially to risk in most cases of PICH...

..To determine whether central periodic breathing (CPB) is associated with acute involvement of any particular part of the brain, or the extent of total damage in patients with acute stroke...

..Further studies are required to determine why early brain temperature elevation is highest in potential penumbral tissue...

..We compared retinal microvessel appearance as a surrogate for cerebral small vessels in patients with lacunar and large artery cortical ischemic stroke...

..Central periodic breathing (CPB) is common following acute stroke, but its prognostic significance is uncertain. We determined the frequency of CPB on admission with stroke and assessed whether it was related to outcome...

..We aimed to measure inter-rater reliability for the clinical assessment of stroke, with emphasis on items of history, timing of symptom onset, and diagnosis of stroke or mimic. We explored reasons for poor reliability...

..001), and raised cholesterol (TIA 27, control 10%, P=0.01), with a weak trend for diabetes mellitus (TIA 10, control 6%, P=0.4). CONCLUSIONS: OSAH does not appear to be strongly associated with TIAs...

..Hypoxaemia in the acute phase of stroke might damage the ischaemic penumbra and worsen clinical outcome. We determined the frequency of hypoxaemia on admission with stroke and assessed whether it was related to outcome...

..6). CONCLUSIONS: These data suggest that there are pathogenetic differences between transient and permanent eye and brain ischemic syndromes. Improved understanding of these mechanisms could lead to more effective stroke prevention...

..There is a need to develop effective means of monitoring GCA activity and to determine the most effective treatment approach in this circumstance...

..Institutionalization, as a proxy for functional outcome, may not reflect this fact. A marked social gradient in case fatality after stroke seems unlikely...

..Blood-brain barrier dysfunction may be an important mechanism for brain damage in cerebral microvascular disease...

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..We aimed to determine the frequency and nature of stroke mimics and to identify the key clinical features that distinguish between stroke and mimic at the bedside...

..Administration is feasible and appears to be safe and well tolerated. The fate of mobilized cells and their effect on functional outcome remain to be determined...

..Little is known of what factors might affect DWI lesion size measurement. We examined morphologic factors that might affect DWI lesion measurement...

..The SSV model comprising easily collected variables can therefore be used to stratify patients in hyper-acute stroke trials, but probably is not accurate enough for decision-making in individual patients...