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Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review (2019)
Journal Article
Krishnan, K., Bassilious, K., Eriksen, E., Bath, P. M., Sprigg, N., Brækken, S. K., …Sandset, E. C. (2019). Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review. European Stroke Journal, 4(3), 233-239. https://doi.org/10.1177/2396987319843701

Purpose Acute vestibular syndrome – vertigo, nausea/vomiting, nystagmus and gait unsteadiness – is common, and differentiating posterior circulation stroke from a peripheral cause can be challenging. The National Institute of Health Stroke Scale (NI... Read More about Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review.

Women in the European Stroke Organisation: one, two, many… – A Top Down and Bottom Up approach (2019)
Journal Article
Sandset, E. C., de Sousa, D. A., Christensen, H., Cordonnier, C., Fischer, U., Katan, M., …Caso, V. (2019). Women in the European Stroke Organisation: one, two, many… – A Top Down and Bottom Up approach. European Stroke Journal, 4(3), 247-253. https://doi.org/10.1177/2396987319841979

Background: An increasing proportion of physicians are women, yet they still face challenges with career advancement. In 2014, the European Stroke Organisation established the goal of increasing the number and participation of women within the societ... Read More about Women in the European Stroke Organisation: one, two, many… – A Top Down and Bottom Up approach.

Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry (2019)
Journal Article
S Anderson, C., Robinson, T. G., Bray, B. D., Paley, L., Sprigg, N., Wang, X., …for the ENCHANTED Investigators and the SSNAP Collaboration. (2019). Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry. International Journal of Stroke, 14(7), 678-685. https://doi.org/10.1177/1747493019841246

© 2019 World Stroke Organization. Background: Randomized controlled trials provide high-level evidence, but the necessity to include selected patients may limit the generalisability of their results. Methods: Comparisons were made of baseline and out... Read More about Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry.

Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial (2018)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2018). Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet, 391(10135), 2107-2115. https://doi.org/10.1016/S0140-6736%2818%2931033-X

Background Tranexamic acid (TXA) reduces death due to bleeding after trauma and post-partum haemorrhage. The aim was to assess if tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral 6 haemorrha... Read More about Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.

Protocol for a prospective collaborative systematic review and meta-analysis of individual patient data from randomised controlled trials of vasoactive drugs in acute stroke: the Blood pressure in Acute Stroke Collaboration, stage-3 (2018)
Journal Article
Sandset, E. C., Sanossian, N., Woodhouse, L. J., Anderson, C., Berge, E., Lees, K. R., …Bath, P. M. (2018). Protocol for a prospective collaborative systematic review and meta-analysis of individual patient data from randomised controlled trials of vasoactive drugs in acute stroke: the Blood pressure in Acute Stroke Collaboration, stage-3. International Journal of Stroke, 13(7), 759-765. https://doi.org/10.1177/1747493018772733

Rationale Despite several large clinical trials assessing blood pressure lowering in acute stroke, equipoise remains, particularly for ischaemic stroke. The ‘Blood pressure in Acute Stroke Collaboration’ (BASC) commenced in the mid 1990s focusing on... Read More about Protocol for a prospective collaborative systematic review and meta-analysis of individual patient data from randomised controlled trials of vasoactive drugs in acute stroke: the Blood pressure in Acute Stroke Collaboration, stage-3.

Haemostatic therapies for acute spontaneous intracerebral haemorrhage (2018)
Journal Article
Al-Shahi Salman, R., Law, Z. K., Bath, P. M., Steiner, T., & Sprigg, N. (2018). Haemostatic therapies for acute spontaneous intracerebral haemorrhage. Cochrane Database of Systematic Reviews, Article CD005951. https://doi.org/10.1002/14651858.CD005951.pub4

Background: Outcome after spontaneous (non-traumatic) intracerebral haemorrhage (ICH) is influenced by haematoma volume; up to one-third of ICHs enlarge within 24 hours of onset. Early haemostatic therapy might improve outcome by limiting haematoma g... Read More about Haemostatic therapies for acute spontaneous intracerebral haemorrhage.

The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial (2018)
Journal Article
Al-Shahi Salman, R., Dennis, M. S., Murray, G. D., Innes, K., Drever, J., Dinsmore, L., …Werring, D. J. (2018). The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial. Trials, 19(1), Article 162. https://doi.org/10.1186/s13063-018-2542-6

Background For adults surviving stroke due to spontaneous (non-traumatic) intracerebral haemorrhage (ICH) who had taken an antithrombotic (i.e. anticoagulant or antiplatelet) drug for the prevention of vaso-occlusive disease before the ICH, it is... Read More about The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial.

The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved] (2018)
Journal Article
Ker, K., Prieto-Merino, D., Sprigg, N., Mahmood, A., Bath, P. M., Kang Law, Z., …Roberts, I. (2018). The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved]. Wellcome Open Research, Article 120. https://doi.org/10.12688/wellcomeopenres.13262.2

© 2018 Ker K et al. Introduction: The Antifibrinolytic Trialists Collaboration aims to increase knowledge about the effectiveness and safety of antifibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials.... Read More about The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 2; peer review: 2 approved].

Stroke in women — from evidence to inequalities (2017)
Journal Article
Cordonnier, C., Sprigg, N., Sandset, E. C., Pavlovic, A., Sunnerhagen, K. S., Caso, V., & Christensen, H. (in press). Stroke in women — from evidence to inequalities. Nature Reviews Neurology, 13(9), https://doi.org/10.1038/nrneurol.2017.95

Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ bet... Read More about Stroke in women — from evidence to inequalities.

Cerebral misery perfusion due to carotid occlusive disease (2017)
Journal Article
Maddula, M., Sprigg, N., Bath, P. M., & Munshi, S. K. (in press). Cerebral misery perfusion due to carotid occlusive disease. Stroke and Vascular Neurology, Article e000067. https://doi.org/10.1136/svn-2017-000067

Purpose Cerebral misery perfusion (CMP) is a condition where cerebral autoregulatory capacity is exhausted, and cerebral blood supply in insufficient to meet metabolic demand. We present an educational review of this important condition, which has a... Read More about Cerebral misery perfusion due to carotid occlusive disease.

Increasing value and reducing waste in stroke research (2017)
Journal Article
Berge, E., Al-Shahi Salman, R., van der Worp, H. B., Stapf, C., Sandercock, P., Sprigg, N., …Ford, G. A. (2017). Increasing value and reducing waste in stroke research. Lancet Neurology, 16(5), 399-408. https://doi.org/10.1016/S1474-4422%2817%2930078-9

Stroke represents a major burden to patients and society, and resources spent on stroke research must be used efficiently and produce good value in terms of improvements in human health. However, there are many examples of poor value from stroke rese... Read More about Increasing value and reducing waste in stroke research.

Continuing or temporarily stopping prestroke antihypertensive medication in acute stroke: an individual patient data meta-analysis (2017)
Journal Article
Woodhouse, L. J., Manning, L., Potter, J. F., Berge, E., Sprigg, N., Wardlaw, J., …Robinson, T. G. (2017). Continuing or temporarily stopping prestroke antihypertensive medication in acute stroke: an individual patient data meta-analysis. Hypertension, 69(5), https://doi.org/10.1161/HYPERTENSIONAHA.116.07982

Over 50% of patients are already taking blood pressure–lowering therapy on hospital admission for acute stroke. An individual patient data meta-analysis from randomized controlled trials was undertaken to determine the effect of continuation versus t... Read More about Continuing or temporarily stopping prestroke antihypertensive medication in acute stroke: an individual patient data meta-analysis.

The Nottingham Fatigue After Stroke (NotFAST) study: factors associated with severity of fatigue in stroke patients without depression (2017)
Journal Article
Drummond, A. E., Hawkins, L., Sprigg, N., Ward, N. S., Mistri, A., Tyrrell, P., …Lincoln, N. (in press). The Nottingham Fatigue After Stroke (NotFAST) study: factors associated with severity of fatigue in stroke patients without depression. Clinical Rehabilitation, https://doi.org/10.1177/0269215517695857

Objective: To identify factors associated with post-stroke fatigue in a sample of stroke survivors without depression. Design: Cross-sectional cohort study. Setting: Recruitment was from four stroke units in the UK. Subjects: Participants were as... Read More about The Nottingham Fatigue After Stroke (NotFAST) study: factors associated with severity of fatigue in stroke patients without depression.

Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis (2016)
Journal Article
England, T. J., Sprigg, N., Alasheev, A. M., Belkin, A. A., Kumar, A., Prasad, K., & Bath, P. M. (in press). Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis. Scientific Reports, 6, Article 36567. https://doi.org/10.1038/srep36567

Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are un... Read More about Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis.

Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730) (2016)
Journal Article
Sprigg, N., O’Connor, R., Woodhouse, L. J., Krishnan, K., England, T. J., Connell, L. A., …Bath, P. M. (2016). Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730). PLoS ONE, 11(9), Article e0161359. https://doi.org/10.1371/journal.pone.0161359

Background Granulocyte-colony stimulating factor (G-CSF) mobilises endogenous haematopoietic stem cells and enhances recovery in experimental stroke. Recovery may also be dependent on an enriched environment and physical activity. G-CSF may have the... Read More about Granulocyte Colony Stimulating Factor and Physiotherapy after Stroke: Results of a Feasibility Randomised Controlled Trial: Stem Cell Trial of Recovery EnhanceMent after Stroke-3 (STEMS-3 ISRCTN16714730).

The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research (2016)
Journal Article
Bath, P. M., Appleton, J. P., & Sprigg, N. (in press). The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research. International Journal of Stroke, https://doi.org/10.1177/1747493016660099

The prevention of recurrent events after ischaemic stroke and transient ischaemic attack is well established and based on lifestyle changes, antithrombotics, statins, antihypertensives and carotid surgery. The international IRIS trial assessed whethe... Read More about The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research.

Intravenous tranexamic acid for hyperacute primary intracerebral hemorrhage: protocol for a randomized, placebo-controlled trial (2016)
Journal Article
Sprigg, N., Robson, K., Bath, P. M., Dineen, R. A., Roberts, I., Robinson, T., …Beredzie, M. (2016). Intravenous tranexamic acid for hyperacute primary intracerebral hemorrhage: protocol for a randomized, placebo-controlled trial. International Journal of Stroke, 11(6), https://doi.org/10.1177/1747493016641960

Rationale: Outcome after intracerebral hemorrhage remains poor. Tranexamic acid is easy to administer, readily available, inexpensive, and effective in other hemorrhagic conditions. Aim: This randomized trial aims to test the hypothesis that intra... Read More about Intravenous tranexamic acid for hyperacute primary intracerebral hemorrhage: protocol for a randomized, placebo-controlled trial.

ESCAPS study protocol: a feasibility randomised controlled trial of ‘Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm’ (2016)
Journal Article
Fletcher-Smith, J. C., Walker, D.-M., Sprigg, N., James, M., Walker, M. F., Allatt, K., …Pandyan, A. D. (2016). ESCAPS study protocol: a feasibility randomised controlled trial of ‘Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm’. BMJ Open, 6(1), Article e010079. https://doi.org/10.1136/bmjopen-2015-010079

Introduction Approximately 70% of patients with stroke experience impaired arm function, which is persistent and disabling for an estimated 40%. Loss of function reduces independence in daily activities and impacts on quality of life. Muscles in thos... Read More about ESCAPS study protocol: a feasibility randomised controlled trial of ‘Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm’.

Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials (2016)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Anderson, C., Berge, E., Ford, G. A., …Wardlaw, J. M. (2016). Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials. Stroke Research and Treatment, 2016, https://doi.org/10.1155/2016/9706720

Background. Nitric oxide (NO) donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using ind... Read More about Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials.