A5022196917- Cerebrovascular and Carotid Artery Diseases
- Acute Ischemic Stroke Management
- Cardiovascular Health and Disease Prevention
- Intracranial Aneurysms: Treatment and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Oropharyngeal Anatomy and Pathologies
- Neurosurgical Procedures and Complications
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Atrial Fibrillation Management and Outcomes
- Moyamoya disease diagnosis and treatment
- Peripheral Artery Disease Management
- Antiplatelet Therapy and Cardiovascular Diseases
- Advanced MRI Techniques and Applications
- Neurological Disorders and Treatments
- Neurological Disease Mechanisms and Treatments
- Herpesvirus Infections and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Platelet Disorders and Treatments
- Renal and Vascular Pathologies
- Cerebrospinal fluid and hydrocephalus
- S100 Proteins and Annexins
- Cerebrovascular and genetic disorders
- Cerebral Venous Sinus Thrombosis
National Hospital for Neurology and Neurosurgery
2015-2024
University College London
2015-2024
James Hutton Institute
2024
University of Toronto
2022-2024
Public Health Ontario
2022-2024
Keck Hospital of USC
2024
Health and Education Research Management and Epidemiologic Services (United States)
2021-2023
University of Louisville
2022-2023
NIHR Newcastle Biomedical Research Centre
2023
Newcastle University
2004-2023
Brain microbleeds on gradient-recalled echo (GRE) T2*-weighted MRI may be a useful biomarker for bleeding-prone small vessel diseases, with potential relevance diagnosis, prognosis (especially antithrombotic-related bleeding risk), and understanding mechanisms of symptoms, including cognitive impairment. To address these questions, it is necessary to reliably measure their presence distribution in the brain. We designed systematically validated Microbleed Anatomical Rating Scale (MARS)....
Recovery of motor function after stroke may occur over weeks or months and is often attributed to neuronal reorganization. Functional imaging studies investigating patients who have made a good recovery suggested that recruitment other motor-related networks underlies this recovery. However, with less complete rarely been studied, else the degree has not taken into account. We set out investigate relationship between pattern brain regions during task as measured using functional MRI....
Remdesivir improves clinical outcomes in patients hospitalized with moderate-to-severe coronavirus disease 2019 (Covid-19). Whether the use of remdesivir symptomatic, nonhospitalized Covid-19 who are at high risk for progression prevents hospitalization is uncertain.We conducted a randomized, double-blind, placebo-controlled trial involving had symptom onset within previous 7 days and least one factor (age ≥60 years, obesity, or certain coexisting medical conditions). Patients were randomly...
BackgroundThe International Carotid Stenting Study (ICSS) of stenting and endarterectomy for symptomatic carotid stenosis found a higher incidence stroke within 30 days compared with endarterectomy.We aimed to compare the rate ischaemic brain injury detectable on MRI between two groups.Methods Patients recently artery enrolled in ICSS were randomly assigned 1:1 ratio receive or endarterectomy.Of 50 centres ICSS, seven took part substudy.The protocol specifi ed that was done 1-7 before...
Stenting is an alternative to endarterectomy for treatment of carotid artery stenosis, but long-term efficacy uncertain. We report data from the randomised International Carotid Study comparison these treatments.Patients with symptomatic stenosis were randomly assigned 1:1 open stenting or at 50 centres worldwide. Randomisation was computer generated centrally and allocated by telephone call fax. Major outcomes assessed independent endpoint committee unaware assignment. The primary fatal...
The Pragmatic Ischaemic Thrombectomy Evaluation (PISTE) trial was a multicentre, randomised, controlled clinical comparing intravenous thrombolysis (IVT) alone with IVT and adjunctive intra-arterial mechanical thrombectomy (MT) in patients who had acute ischaemic stroke large artery occlusive anterior circulation confirmed on CT angiography (CTA).Eligible started within 4.5 hours of symptom onset. Those randomised to additional MT underwent using any Conformité Européene (CE)-marked device,...
Recent randomized trials have proven the benefit of intra-arterial treatment (IAT) with retrievable stents in acute ischemic stroke. Patients poor or absent collaterals (preexistent anastomoses to maintain blood flow case a primary vessel occlusion) may gain less clinical from IAT. In this post hoc analysis, we aimed assess whether effect IAT was modified by collateral status on baseline computed tomographic angiography Multicenter Randomized Clinical Trial Endovascular Treatment Acute...
Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that prone to intracranial bleeding. We aimed determine whether presence can identify patients at high risk symptomatic haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient attack.
It is not known whether patients with atrial fibrillation (AF) ischemic stroke despite oral anticoagulant therapy are at increased risk for further recurrent strokes or how ongoing secondary prevention should be managed.
BackgroundThe International Liaison Committee on Resuscitation has called for a randomised trial of delivery to cardiac arrest centre. We aimed assess whether expedited centre compared with current standard care following resuscitated reduces deaths.MethodsARREST is prospective, parallel, multicentre, open-label, superiority trial. Patients (aged ≥18 years) return spontaneous circulation out-of-hospital without ST elevation were randomly assigned (1:1) at the scene their by London Ambulance...
<b><i>Background:</i></b> Triptans are widely used to treat migraine but have been associated with stroke, myocardial infarction (MI), and ischemic heart disease (IHD) in case reports. <b><i>Objective:</i></b> To estimate the incidence of cardiovascular events, death a cohort, stratified by triptan prescription, investigate whether risk these events was increased those treated triptans. <b><i>Methods:</i></b> Migraine patients matched nonmigraine control subjects were identified from General...
The relationships between cerebral blood flow (CBF), arterial oxygen content, whole viscosity and the transport of to brain have been studied in 54 subjects with variations content resulting from alterations haemoglobin concentration ranging 5.7 19.1 g/dl. A highly significant relationship was found CBF altering maintain rate within certain limits. No effect changes evident. In a multiple regression analysis emerged as major determinant after this had taken into account there no influence...
The detection of circulating particulate cerebral emboli using transcranial Doppler ultrasonography has been recently reported. It suggested that this method might allow discrimination between different embolic materials; would be very useful for selecting specific pharmacological treatment in individual patients. This study was designed to identify those parameters the signal prove discriminating types and sizes emboli. An extracorporeal circuit filled with a saline/Tween solution driven by...
<h3>Objective</h3> To ascertain the utility values associated with age-related macular degeneration and varying degrees of visual loss. <h3>Design</h3> A cross-sectional study. <h3>Participants</h3> Eighty white patients unilateral or bilateral in 1 both eyes, loss to a minimum 20/40 level at least eye. <h3>Main Outcome Measures</h3> Utility were measured 5 groups according acuity better-seeing eye, (20/20 20/25), 2 (20/30 20/50), 3 (20/60 20/100), 4 (20/200 20/400), (counting fingers light...
In the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), early recurrent carotid stenosis was more common in patients assigned to endovascular treatment than it endarterectomy (CEA), raising concerns about long-term effectiveness of treatment. We aimed investigate risks restenosis included CAVATAS.413 who were randomly CAVATAS completed for (200 had 213 endarterectomy) prospective clinical follow-up at a median 5 years duplex ultrasound 4 years. investigated cumulative...
<i>Background:</i> Carotid stenting avoids general anaesthesia, cranial nerve injury and the discomforts of surgical treatment carotid stenosis. A systematic review randomised trials showed no overall difference in major risks endovascular for stenosis compared with surgery, but confidence intervals were wide both methods carried a significant risk stroke. The use protection devices appears to improve safety treatment, there are little data available about long-term outcomes. We...