Two Coarse Spatial Patterns of Altered Brain Microstructure Predict Post-traumatic Amnesia in the Subacute Stage of Severe Traumatic Brain Injury.

Diffuse traumatic axonal injury (TAI) is one of the key mechanisms leading to impaired consciousness after severe traumatic brain injury (TBI). In addition, preferential regional expression of TAI in the brain may also influence clinical outcome. We addressed the question whether the regional expression of microstructural changes as revealed by whole-brain diffusion tensor imaging (DTI) in the subacute stage after severe TBI may predict the duration of post-traumatic amnesia (PTA).

Long-Term Return to Work After Acquired Brain Injury in Young Danish Adults: A Nation-Wide Registry-Based Cohort Study.

(1) To determine patterns of return to work (RTW) after traumatic brain injury and other causes of acquired brain injury (ABI) among young adults aged 19-30 years and (2) to compare the stability of long-term labor-market attachment (LMA) to the background population. Nationwide registry-based inception cohort study of 10 years weekly data of employment status. Patients ( = 8,496) aged 19-30 years with first-ever diagnosis of TBI, stroke, subarachnoid hemorrhage, encephalopathy, brain tumor, or CNS infections during 1999-2015.

Incidence and mortality of acquired brain injury in young Danish adults between 1994 and 2013: a nationwide study.

Background: We estimated the annually incidence and mortality of acquired brain injury (ABI) in people aged 15-30 years during 1994-2013.

Methods: All Danes with a first-ever hospital diagnosis of ABI, including traumatic brain injury (TBI), encephalopathy, CNS-infection or brain tumour, were identified in the Danish National Patient Register. Incidence rates (IRs) and estimated annual percentage changes (EAPC) were estimated by Poisson regression.

Comparison of analytical methods of brain [F]FDG-PET after severe traumatic brain injury.

Background: Loss of consciousness has been shown to reduce cerebral metabolic rates of glucose (CMRglc) measured by brain [F]FDG-PET. Measurements of regional metabolic patterns by normalization to global cerebral metabolism or cerebellum may underestimate widespread reductions.

New Method: The aim of this study was to compare quantification methods of whole brain glucose metabolism, including whole brain [18F]FDG uptake normalized to uptake in cerebellum, normalized to injected activity, normalized to plasma tracer concentration, and two methods for estimating CMRglc.

Alterations in the brain's connectome during recovery from severe traumatic brain injury: protocol for a longitudinal prospective study.

Introduction: Traumatic brain injury (TBI) is considered one of the most pervasive causes of disability in people under the age of 45. TBI often results in disorders of consciousness, and clinical assessment of the state of consciousness in these patients is challenging due to the lack of behavioural responsiveness. Functional neuroimaging offers a means to assess these patients without the need for behavioural signs, indicating that brain connectivity plays a major role in consciousness emergence and maintenance.

Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study.

Background: Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years.

Surviving severe traumatic brain injury in Denmark: incidence and predictors of highly specialized rehabilitation.

Purpose: To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation).

Patients And Methods: Patients surviving severe TBI were identified from The Danish National Patient Registry and The Danish Head Trauma Database. Overall incidence rates of surviving severe TBI and incidence rates of admission to HS-rehabilitation after severe TBI were estimated and compared.

Hydrocephalus during rehabilitation following severe TBI. Relation to recovery, outcome, and length of stay.

Background: Post traumatic hydrocephalus (PTH) is a frequent complication during rehabilitation following severe TBI. However, the diagnosis of PTH is not straightforward and despite shunting recovery may be delayed.

Objective: To study the influence of PTH on recovery and outcome during rehabilitation.

Hydrocephalus following severe traumatic brain injury in adults. Incidence, timing, and clinical predictors during rehabilitation.

Objective: To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI).

Background: Posttraumatic hydrocephalus (PTH) may lead to clinical deterioration and poor outcome if untreated. However, PTH can be successfully treated if detected.

Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study.

The eight papers included in this doctoral thesis were made during my position as a clinical research assistant at the Department of Neurology, Bispebjerg Hospital. All papers are based on the Copenhagen Stroke Study, which comprises a cohort of 1197 patients with acute stroke admitted to a single stroke unit and recruited from a well-defined area in Copenhagen, Denmark. This thesis focuses on the survival after stroke in relation to several baseline clinical characteristics and risk factors for cardiovascular disease.

Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.

Background And Purpose: Stroke patients with hemorrhagic (HS) and ischemic strokes were compared with regard to stroke severity, mortality, and cardiovascular risk factors.

Methods: A registry started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, now holds information for 39,484 patients. The patients underwent an evaluation including stroke severity (Scandinavian Stroke Scale), CT, and cardiovascular risk factors.

Sex differences in stroke survival: 10-year follow-up of the Copenhagen stroke study cohort.

Background: Although diverging, most studies show that sex has no significant influence on stroke survival.

Methods: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using the Scandinavian Stroke Scale (0-58); computed tomography determined stroke type.

Poststroke epilepsy in the Copenhagen stroke study: incidence and predictors.

Poststroke epilepsy (PSE) is a feared complication after stroke and is reported in 3% to 5% of stroke survivors. In this study we sought to identify incidence and predictors of PSE in an unselected stroke population with a follow-up period of 7 years. The study was community-based and comprises a cohort of 1197 consecutively and prospectively admitted patients with stroke.

Strokes attributable to underuse of warfarin and antiplatelets.

Despite their proven efficacy in stroke prevention, warfarin and antiplatelets remain underused. We determined the frequency of ischemic strokes attributable to underuse of warfarin and antiplatelets for stroke prevention in a Danish community. We included all patients with ischemic stroke in a Copenhagen community with 302,000 inhabitants admitted to the hospital between September 1999 and May 2000 (n = 426).

Higher total serum cholesterol levels are associated with less severe strokes and lower all-cause mortality: ten-year follow-up of ischemic strokes in the Copenhagen Stroke Study.

Background And Purpose: Evidence of a causal relation between serum cholesterol and stroke is inconsistent. We investigated the relation between total serum cholesterol and both stroke severity and poststroke mortality to test the hypothesis that hypercholesterolemia is primarily associated with minor stroke.

Methods: In the study, 652 unselected patients with ischemic stroke arrived at the hospital within 24 hours of stroke onset.

Cardiovascular risk factors and 5-year mortality in the Copenhagen Stroke Study.

Background: The treatment of cardiovascular risk factors has improved over the recent years and may have improved survival. The aim of this study was to investigate the up-to-date prognostic significance of cardiovascular risk factors for 5-year survival in a large unselected ischemic stroke population.

Methods: We studied 905 ischemic stroke patients from the community-based Copenhagen Stroke Study.

Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study.

Background And Purpose: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age as an independent predictor of short- and long-term outcome.

Methods: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients.

Therapeutic hypothermia for acute stroke.

Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality.

[Factors of importance for early and late admission of patients with stroke and transient cerebral ischemia].

Introduction: Early admission after stroke and TIA is important in modern stroke treatment. We studied the time delay to admission and explored predictive factors of early/late admission.

Material And Methods: The study was prospective and community-based comprising all patients with stroke or TIA admitted to a Copenhagen hospital from 1 September 1999 to 30 April 2000.

[Thrombolysis in apoplexy. How big is the target group and how many benefit?].

Introduction: At present it is possible to dissolve cerebral blood clots with thrombolysis. This is a standard treatment in the USA and Canada for early onset ischaemic strokes within three hours of the stroke. Acceptance of thrombolysis is based on a single clinical trial.