A5032642622- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- Neurological Disorders and Treatments
- Intracerebral and Subarachnoid Hemorrhage Research
- Cerebrovascular and genetic disorders
- Venous Thromboembolism Diagnosis and Management
- Neurology and Historical Studies
- Atrial Fibrillation Management and Outcomes
- Advanced MRI Techniques and Applications
- Phosphodiesterase function and regulation
- Neurological and metabolic disorders
- Antiplatelet Therapy and Cardiovascular Diseases
- Hemoglobinopathies and Related Disorders
- Innovations in Medical Education
- Migraine and Headache Studies
- Health Systems, Economic Evaluations, Quality of Life
- Neurological Disease Mechanisms and Treatments
- Cerebral Venous Sinus Thrombosis
- Botulinum Toxin and Related Neurological Disorders
- Hallucinations in medical conditions
- Meta-analysis and systematic reviews
- Advanced Neuroimaging Techniques and Applications
St George’s University Hospitals NHS Foundation Trust
2016-2024
St George's, University of London
1999-2023
St. George's University
2021
Atkins (United Kingdom)
2012-2021
St George's Hospital
2010-2021
National Health Service
2019-2021
St George's Hospital
2002-2018
Icahn School of Medicine at Mount Sinai
2018
University of California, Los Angeles
2013-2014
Frimley Park Hospital
2013
Ischemic leukoaraiosis (ILA) refers to diffuse T2-weighted white matter hyperintensity in the context of a previous clinical lacunar stroke. Reduced cerebral blood flow (CBF) has been demonstrated, but it is not known whether hypoperfusion confined lesions or extends into normal-appearing matter. Demonstrating changes would provide clues importance pathogenesis and be an obvious target for therapies aimed at restoring flow.Twenty-one patients with ILA, 16 age-matched control subjects,...
Abstract Background and aim Neutrophil-lymphocyte ratio (NLR) lymphocyte-monocyte (LMR) are associated with clinical outcomes in malignancy, cardiovascular disease stroke. Here we investigate their association outcome after acute ischaemic stroke treated by mechanical thrombectomy (MT). Methods Patients were selected using audit data for MT anterior circulation at a UK centre from May 2016–July 2017. Clinical laboratory including neutrophil, lymphocyte monocyte count tested before 24 h...
Background and Purpose— Carotid Vertebral Artery Transluminal Angioplasty Study (CAVATAS) patients with carotid stenosis were randomized between endovascular treatment endarterectomy. The rates of residual severe restenosis their contribution to recurrent symptoms was unclear. Methods— Endovascular treated by balloon angioplasty alone (88%) or stenting (22%). Patches used in 63% endarterectomy patients. categorized as mild (0% 49%), moderate (50% 69%), (70% 99%), occluded, using standardized...
Abstract Introduction There are few randomized clinical trials in vascular cognitive impairment (VCI). This trial tested the hypothesis that PDE5 inhibitor tadalafil, a widely used vasodilator, increases cerebral blood flow (CBF) older people with symptomatic small vessel disease, main cause of VCI. Methods In double‐blind, placebo‐controlled, cross‐over trial, participants received tadalafil (20 mg) and placebo on two visits ≥7 days apart (randomized to order treatment). The primary...
Spontaneous intracerebral hemorrhage (sICH) is a common form of hemorrhagic stroke, with high mortality and morbidity. Pathophysiological mechanisms in sICH are poorly understood treatments limited. Neuroinflammation driven by microglial-macrophage activation contributes to brain damage post-sICH. We aim test the hypothesis that an anti-inflammatory (repair) process occurs parallel neuroinflammation clinical sICH.
Cerebral small vessel disease (SVD) is common in older people and causes lacunar stroke vascular cognitive impairment. Risk factors include old age, hypertension variants the genes
<h3>ABSTRACT</h3> Stroke services have been centralised in several countries recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to units are diagnosed as non-stroke condition (stroke mimics). This study aims describe the mimic patient group, including their impact on services. We analysed routine clinical data from 2,305 consecutive admissions unit at St George's Hospital, London. Mimic groupings were derived 335 individual codes into 17...
(1)H MR spectroscopy can be used to study biochemical changes occurring in the brain stroke. We it examine relationship between metabolite concentration (N-acetyl aspartate [NAA], lactate, cholines and creatines), size of infarct, clinical deficit, 3-month outcome patients with middle cerebral artery (MCA) territory infarction.Thirty-one acute MCA infarction were recruited within 72 hours onset symptoms. Single-voxel short echo time stimulated acquistion mode was obtain data from infarct...
Abstract Coeliac disease has been associated with a variety of neurological conditions, most frequently cerebellar ataxia and peripheral neuropathy. To date, chorea not coeliac disease. We present the case histories 4 individuals (4 women, average age onset 61 years). Unexpectedly, these patients showed notable improvement in their motor symptoms after introduction gluten‐free diet. © 2003 Movement Disorder Society
Cerebral small vessel disease is a common cause of vascular cognitive impairment in older people, with no licensed treatment. blood flow reduced disease. Tadalafil widely prescribed phosphodiesterase-5 inhibitor that increases other territories. The aim this trial to test the hypothesis tadalafil cerebral people Perfusion by Arterial Spin labelling following Single dose In Small (PASTIS) phase II randomised double-blind crossover trial. two visits, 7-30 days apart, participants undergo...
Hereditary spastic paraplegias (HSPs) are genetically and clinically heterogeneous axonopathies primarily affecting upper motor neurons and, in complex forms, additional neurons. Here, we report two families with distinct recessive mutations TFG, previously suggested to cause HSP based on findings a single small family HSP. The first carried homozygous c.317G>A (p.R106H) variant presented pure second the same c.316C>T (p.R106C) reported displayed similarly phenotype including optic atrophy....
Summary Objectives Audits in the United Kingdom and other countries show that only a small proportion of eligible stroke patients receive thrombolysis. Providing 24-hour thrombolysis cover presents major challenges both infrastructure staffing. One model for improving access is to provide out-of-hours regional centre but this may present problems including greater delays hospital admissions. Design Evaluation introduction ‘hub-and-spoke’ increase south west London. One-year data are...
Abstract Cerebral small vessel disease (SVD) is common in older people and associated with lacunar stroke, white matter hyperintensities (WMH) vascular cognitive impairment. blood flow (CBF) reduced SVD, particularly within matter. Here we quantified test–retest reliability CBF measurements using pseudo-continuous arterial spin labelling (pCASL) adults clinical radiological evidence of SVD (N=54, mean (SD): 66.9 (8.7) years, 15 females/39 males). We generated whole-brain maps on two visits...
Abstract Introduction Radiolabeled ligands for fibrillar amyloid beta (Aβ) peptides are used in positron emission tomography (PET) dementia diagnosis. Current do not discriminate parenchymal plaques from cerebral angiopathy (CAA). Methods We undertook neuropathological examination of 65 older people (81.6 ± 7.96 (mean SD) years, 27F/38M): 15 with diagnosis AD, 25 other neurodegenerative dementias (Lewy body and Parkinson disease dementia), without significant pathology. Results observed CAA...
Better methods of identifying patients with asymptomatic carotid artery stenosis who are at high risk stroke required. It has been suggested that proton magnetic resonance spectroscopy (MRS) may allow the identification ongoing ischaemia in this patient group by detection a potentially reversible reduction N-acetyl aspartate (NAA), presumed marker neuronal integrity, and presence lactate, anaerobic metabolism. Previous studies have reported metabolite ratios rather than absolute...