Publications by authors named "Thomalla G"
Background: We aimed to assess impairments on health-related quality of life, and mental health resulting from Retinal artery occlusion (RAO) with monocular visual field loss and posterior circulation ischemic stroke (PCIS) with full or partial hemianopia using patient-reported outcome measures (PROMs).
Methods: In a prospective study, consecutive patients with acute RAO on fundoscopy and PCIS on imaging were recruited during their surveillance on a stroke unit over a period of 15 months. Baseline characteristics were determined from medical records and interviews.
Background: Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention).
Methods: As part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees.
Background: Excessive supraventricular ectopic activity (ESVEA) is regarded as a risk marker for later atrial fibrillation (AF) detection.
Methods And Results: The investigator-initiated, prospective, open, multicenter MonDAFIS (Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke) study randomized 3465 patients with acute ischemic stroke without known AF 1:1 to usual diagnostic procedures for AF detection or additive Holter monitoring in hospital for up to 7 days, analyzed in a core laboratory. Secondary study objectives include the comparison of recurrent stroke, myocardial infarction, major bleeding, and all-cause death within 24 months in patients with ESVEA (defined as ectopic supraventricular beats ≥480/day or atrial runs of 10-29 seconds or both) versus patients with newly diagnosed AF versus patients without ESVEA or AF (non-ESVEA/AF), randomized to the intervention group.
Aims: Atrial fibrillation (AF) accounts for about 20% of all ischemic strokes worldwide. It is known that AF impairs health-related quality of life (HRQOL) in the general population, but data on HRQOL in stroke patients with newly diagnosed AF are sparse.
Methods: Post hoc analysis of the prospective, investigator-initiated, multicenter MonDAFIS study (NCT02204267) to analyze whether AF-related oral anticoagulation (OAC), and/or AF-symptom severity are associated with HRQOL after ischemic stroke or transient ischemic attack (TIA).
Background: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.
Aim: Our aim was to determine the key challenges for MT implementation and access worldwide.
Methods: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network, and as invited by co-authors between December 2022 and March 2023.
Introduction: The effects of imaging-based intravenous thrombolysis on outcomes based on patient sex remain unclear. We aimed to investigate whether outcomes among patients with stroke with an unknown onset time and treated with imaging-based intravenous thrombolysis are influenced by their sex.
Patients And Methods: This study was a pooled analysis of individual patient-level data acquired from the Evaluation of unknown Onset Stroke thrombolysis trials.
Background And Objectives: Data from randomized trials on the treatment effect of pure thrombolysis in patients with vessel occlusion are lacking. We examined data from a corresponding subsample of patients from the multicenter, randomized, placebo-controlled WAKE-UP trial to determine whether MRI-guided IV thrombolysis with alteplase in unknown-onset ischemic stroke benefits patients presenting with vessel occlusion.
Methods: Patients with an acute ischemic lesion visible on MRI diffusion-weighted imaging but no marked parenchymal hyperintensity on fluid-attenuated inversion recovery images were randomized to treatment with IV alteplase or placebo.
Article Synopsis
- Blood-brain barrier disruption in acute ischemic stroke is linked to complications, with GLOS indicating issues in the blood-ocular barrier.
- In a study of WAKE-UP trial patients, 29% showed GLOS, significantly more than the 7% with HARM.
- GLOS presence was associated with factors like age, renal function, and white matter hyperintensity but did not correlate with hemorrhagic transformation or functional outcomes.
Article Synopsis
- White matter hyperintensities (WMH) increase with age and vary significantly between individuals, prompting the need for age- and sex-specific data for better assessment.
- This study pooled data from nearly 15,000 healthy individuals aged 18-97 to analyze WMH volumes using MRI and established centile curves based on age and sex.
- Findings reveal that WMH volumes increase significantly with age, with females having larger volumes, and these changes follow different patterns based on specific white matter locations, providing valuable normative data for clinical interpretations.
Background: Atrial fibrillation is associated with cognitive dysfunction. Atrial cardiomyopathy has been correlated with both entities. We aimed to characterize the association of echocardiographic parameters of atrial cardiomyopathy with cognitive function and cerebral changes.
View Article and Find Full Text PDFBackground: Cerebral venous thrombosis (CVT) accounts for 0.5-1% of all strokes. The role of endovascular therapy (EVT) in the management of CVT remains controversial and variations in practice patterns are not well known.
View Article and Find Full Text PDFIntroduction: In Parkinson's disease (PD), axial symptom response to deep brain stimulation of the subthalamic nucleus (STN-DBS) is heterogeneous. This single-center, retrospective study aimed to assess imaging biomarkers of routine magnetic resonance imaging (MRI) to predict axial symptom response to STN-DBS, specifically by using an index of volumes of mesencephalon, pons, middle, and superior peduncle ("MR PIGD index").
Methods: We investigated 94 PD patients pre- and three to six months postoperatively by using MDS-UPDRS III, Berg Balance Scale, Freezing of Gait Questionnaire (FOG-Q) and Ziegler Course, which were related to regional brain volumetry information using regression analysis and partial least squares correlation analysis.
Structural disconnectome analyses have provided valuable insights into how a stroke lesion results in widespread network disturbances and how these relate to deficits, recovery patterns, and outcomes. Previous analyses have primarily focused on patients with relatively mild to moderate deficits. However, outcomes vary among survivors of severe strokes, and the mechanisms of recovery remain poorly understood.
View Article and Find Full Text PDFArticle Synopsis
- * Patients are categorized into anemic and nonanemic groups, as well as hyperglycemic and normoglycemic groups, to see how these factors affect the underestimation of ischemic core volume (ICuV).
- * Results showed that hyperglycemic patients had a higher rate of "perfusion scotoma" (65%) and a larger ICuV compared to normoglycemic patients, suggesting metabolic factors can significantly influence stroke outcomes.
Article Synopsis
- White matter hyperintensities (WMH) are linked to cognitive impairment but solely measuring their volume doesn't fully explain the cognitive deficits.
- Lesion network mapping (LNM) offers a new way to assess how WMH connects with brain networks, potentially improving our understanding of their impact on cognition.
- In a study of 3,485 patients, LNM scores outperformed WMH volumes in predicting cognitive performance, especially in attention, processing speed, and verbal memory, but not for language functions.
Article Synopsis
- Mechanical thrombectomy using the SOFIA/SOFIA PLUS catheters is being evaluated as a primary treatment for acute ischemic stroke with large vessel occlusion, focusing on its safety and efficacy in a multi-center study involving 246 patients.
- Results show that primary aspiration with the catheters achieved 72.8% complete recanalization and 63.8% of patients were functionally independent after 90 days, with acceptable complication rates.
- The study supports using this technique as a first-line approach in stroke treatment, reinforcing the effectiveness of direct aspiration thrombectomy in managing acute ischemic strokes.
Article Synopsis
- The study investigates factors leading to early stopping during mechanical thrombectomy (MT) in acute ischemic stroke patients, focusing on those that do not achieve a successful recanalization score (mTICI ≥2b).
- An analysis of 2,977 patients revealed that factors such as higher age, worse pre-stroke conditions, and certain complications during the procedure were linked to early stopping without successful recanalization.
- The findings suggest that decisions to stop the procedure often correspond to the patient's overall prognosis, indicating that both favorable and unfavorable conditions can influence the likelihood of early intervention cessation.
Background And Purpose: Guidelines help physicians to provide optimal care for stroke patients, but implementation is challenging due to the quantity of recommendations. Therefore a practical overview related to applicability of recommendations can be of assistance.
Methods: A systematic review was performed on ischaemic stroke guidelines published in scientific journals, covering the whole acute care process for patients with ischaemic stroke.
Background: Acute ischaemic stroke (AIS) after percutaneous coronary intervention (PCI) is a rare, but debilitating, complication. However, contemporary data from real-world unselected patients are scarce.
Aims: We aimed to explore the temporal trends, outcomes and variables associated with AIS as well as in-hospital all-cause mortality in a nationwide cohort.
Characterizing cortical plasticity becomes increasingly important for identifying compensatory mechanisms and structural reserve in the ageing population. While cortical thickness (CT) largely contributed to systems neuroscience, it incompletely informs about the underlying neuroplastic pathophysiology. In turn, microstructural characteristics may correspond to atrophy mechanisms in a more sensitive way.
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- The study aimed to find out what information people who had a stroke need to prevent getting another one.
- Researchers looked at many studies to see what these people wanted to know about treatment, causes, and life after a stroke.
- They found that most wanted to get their information from healthcare professionals, especially about treatment and causes, and they believe more support is needed for them.
Study Objectives: The association of shift work (SW) and disrupted circadian rhythm with markers of large artery atherosclerosis and cerebral small vessel disease is uncertain. We aimed to study the separate association of current and former SW with these markers.
Methods: We included participants from the population-based Hamburg City Health Study.
Introduction: Endovascular thrombectomy stands as a pivotal component in the standard care for patients experiencing acute ischemic stroke with large vessel occlusion. Subsequent care for patients often extends to a neurological intensive care unit. While fluid management is integral to intensive care, the association between early fluid balance and neurological and functional outcomes post-thrombectomy has not yet been thoroughly investigated.
View Article and Find Full Text PDFBackground: The superiority of endovascular thrombectomy (EVT) over medical management was not established in two early basilar artery occlusion (BAO) randomized controlled trials. Despite this, many clinicians recommended EVT for acute BAO under certain circumstances. This paper aims to compare physicians' diagnostic and management strategies of BAO according to gender.
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