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The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial. (2024)
Journal Article
Hollingworth, M., Woodhouse, L. J., Law, Z. K., Ali, A., Krishnan, K., Dineen, R. A., …Bath, P. M. (in press). The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial. Neurosurgery, https://doi.org/10.1227/neu.0000000000002961

An important proportion of patients with spontaneous intracerebral hemorrhage (ICH) undergo neurosurgical intervention to reduce mass effect from large hematomas and control the complications of bleeding, including hematoma expansion and hydrocephalu... Read More about The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial..

Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a diagnostic challenge (2024)
Journal Article
Acquaah, J., Ferdinand, P., & Roffe, C. (2024). Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a diagnostic challenge. BMJ Case Reports, 17(2), Article e256306. https://doi.org/10.1136/bcr-2023-256306

Rare causes of stroke-like presentations can be difficult to diagnose. We report a case of a man in his 40s who first presented with stroke symptoms, but whose clinical course was not typical for a stroke. A detailed investigation of the patient’s me... Read More about Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a diagnostic challenge.

Evaluating methods of detecting and determining the type of urinary incontinence in adults after stroke: A systematic review (2023)
Journal Article
Gordon, C., Davidson, C. E., Roffe, C., Clegg, A., Booth, J., Lightbody, C. E., …Watkins, C. (in press). Evaluating methods of detecting and determining the type of urinary incontinence in adults after stroke: A systematic review. Neurourology and Urodynamics, 43(2), 364-381. https://doi.org/10.1002/nau.25330

Introduction: Urinary incontinence (UI) affects over half of people with stroke. It is unclear which methods are accurate in assessing presence and type of UI to inform clinical management. Diagnosis of UI based on inaccurate methods may lead to unne... Read More about Evaluating methods of detecting and determining the type of urinary incontinence in adults after stroke: A systematic review.

Is intraprocedural intravenous aspirin safe for patients who require emergent extracranial stenting during mechanical thrombectomy? (2023)
Journal Article
Ingleton, A., Raseta, M., Chung, R., Kow, K. J. H., Weddell, J., Nayak, S., …Roffe, C. (2023). Is intraprocedural intravenous aspirin safe for patients who require emergent extracranial stenting during mechanical thrombectomy?. Stroke and Vascular Neurology, https://doi.org/10.1136/svn-2022-002267

Background: Intraoperative antiplatelet therapy is recommended for emergent stenting during mechanical thrombectomy (MT). Most patients undergoing MT are also given thrombolysis. Antiplatelet agents are contraindicated within 24 hours of thrombolysis... Read More about Is intraprocedural intravenous aspirin safe for patients who require emergent extracranial stenting during mechanical thrombectomy?.

Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials (2023)
Journal Article
Krishnan, K., Campos, P. B., Nguyen, T. N., Tan, C. W., Chan, S. L., Appleton, J. P., …Bath, P. M. (in press). Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials. Frontiers in Stroke, 2, 1256664. https://doi.org/10.3389/fstro.2023.1256664

Acute intracerebral hemorrhage is the most devastating stroke subtype and is associated with significant morbidity and mortality. Poor prognosis is associated with primary brain injury from the presenting hematoma, and despite advances in clinical tr... Read More about Cerebral edema in intracerebral hemorrhage: pathogenesis, natural history, and potential treatments from translation to clinical trials.

The effect of distal aspiration catheter position on collateral flow in mechanical thrombectomy - an in vitro study (2023)
Journal Article
Jakobek, W., Gravino, G., Nayak, S., Yang, Y., Ranjbar, J., & Roffe, C. (in press). The effect of distal aspiration catheter position on collateral flow in mechanical thrombectomy - an in vitro study. Interventional Neuroradiology, https://doi.org/10.1177/15910199231201518

Endovascular mechanical thrombectomy for ischaemic stroke is one of the most effective treatments. Despite the devices and techniques that have been developed, thrombi are not always successfully retrieved. The incidence of futile reperfusion after s... Read More about The effect of distal aspiration catheter position on collateral flow in mechanical thrombectomy - an in vitro study.

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial. (2023)
Journal Article
Woodhouse, L. J., Appleton, J. P., Ankolekar, S., England, T. J., Mair, G., Muir, K., …Bath, P. M. (in press). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial. BMJ Open Neurology, 5(1), e000424. https://doi.org/10.1136/bmjno-2023-000424

The Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) reported no overall treatment difference between glyceryl trinitrate (GTN) and sham at day 90. Here we assess participants' outcomes 1 year after randomisation.... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): effects on outcomes at day 365 in a randomised, sham-controlled, blinded, phase III, superiority ambulance-based trial..

Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: a secondary analysis of a large randomised controlled trial. (2023)
Journal Article
Appleton, J. P., Law, Z. K., Woodhouse, L. J., Al-Shahi Salman, R., Beridze, M., Christensen, H., …Sprigg, N. (2023). Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: a secondary analysis of a large randomised controlled trial. BMJ Open Neurology, 5(1), Article e000423. https://doi.org/10.1136/bmjno-2023-000423

BackgroundTranexamic acid reduced haematoma expansion and early death, but did not improve functional outcome in the tranexamic acid for hyperacute spontaneous intracerebral haemorrhage-2 (TICH-2) trial. In a predefined subgroup, there was a statisti... Read More about Effects of blood pressure and tranexamic acid in spontaneous intracerebral haemorrhage: a secondary analysis of a large randomised controlled trial..

IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY? (2021)
Journal Article
Ingleton, A., Raseta, M., & Roffe, C. (2021). IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY?. International Journal of Stroke, 16(3),

Introduction: Intraoperative stenting is used during mechanical thrombectomy (MT) to manage severe stenosis or dissection. Antiplatelet agents are required intraoperatively to maintain patency of the stent. However, antiplatelets are contraindicated... Read More about IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY?.

Cerebral venous thrombosis after vaccination against COVID-19 in the UK: a multicentre cohort study (2021)
Journal Article
Perry, R. J., Tamborska, A., Singh, B., Craven, B., Marigold, R., Arthur-Farraj, P., …Zambreanu, L. (2021). Cerebral venous thrombosis after vaccination against COVID-19 in the UK: a multicentre cohort study. The Lancet, 398(10306), 1147-1156. https://doi.org/10.1016/s0140-6736%2821%2901608-1

Background A new syndrome of vaccine-induced immune thrombotic thrombocytopenia (VITT) has emerged as a rare side-effect of vaccination against COVID-19. Cerebral venous thrombosis is the most common manifestation of this syndrome but, to our knowle... Read More about Cerebral venous thrombosis after vaccination against COVID-19 in the UK: a multicentre cohort study.

Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study (2021)
Journal Article
Roffe. (2021). Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study. Clinical Neurology and Neurosurgery, 106796 - 106796. https://doi.org/10.1016/j.clineuro.2021.106796

Objective: Uncertainty exists over the prognostic significance of low arterial oxygen saturation (SaO(2)) in acute stroke. We aimed to determine the strength of association of SaO(2) and adverse outcomes among participants of the international Head P... Read More about Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study.

Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial (2021)
Journal Article
Law, Z. K., Desborough, M., Roberts, I., Al‐Shahi Salman, R., England, T. J., Werring, D. J., …Sprigg, N. (2021). Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial. Journal of the American Heart Association, 10(5), https://doi.org/10.1161/jaha.120.019130

BackgroundAntiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain.Methods and ResultsThis is an exploratory analysis of the TICH‐2 (Tranexamic Acid in Intrace... Read More about Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial.

Characteristics and outcomes of COVID-19 associated stroke: a UK multicentre case-control study (2020)
Journal Article
Perry, R. J., Smith, C. J., Roffe, C., Simister, R., Narayanamoorthi, S., Marigold, R., …Werring, D. J. (2021). Characteristics and outcomes of COVID-19 associated stroke: a UK multicentre case-control study. Journal of Neurology, Neurosurgery and Psychiatry, 92(3), 242-248. https://doi.org/10.1136/jnnp-2020-324927

Objective We set out to determine which characteristics and outcomes of stroke are associated with COVID-19. Methods This case-control study included patients admitted with stroke to 13 hospitals in England and Scotland between 9 March and 5 July... Read More about Characteristics and outcomes of COVID-19 associated stroke: a UK multicentre case-control study.

Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study (2020)
Journal Article
Ihama, F., Pandyan, A., & Roffe, C. (2020). Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study. European Geriatric Medicine, 12, 79-89. https://doi.org/10.1007/s41999-020-00383-2

Background Fragility fractures are common in care home residents but established tools have not been tested in this population. Aim: To identify the most practicable tool for use. Methods Design Multicentre prospective observational cohort pilo... Read More about Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study.

Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom (2020)
Journal Article
Roffe. (2020). Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom. Neurological Sciences, https://doi.org/10.1007/s10072-020-04775-x

Introduction The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients. Methods This retrospective observational study included all pat... Read More about Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom.

Mechanical thrombectomy: can it be safely delivered out of hours in the UK? (2020)
Journal Article
Weddell, J., Parr, E., Knight, S., Muddegowda, G., Natarajan, I., Chembala, J., …Roffe, C. (2020). Mechanical thrombectomy: can it be safely delivered out of hours in the UK?. BMC Neurology, 20, Article 326. https://doi.org/10.1186/s12883-020-01909-8

BACKGROUND: Mechanical thrombectomy was approved by NICE as a treatment for stroke in 2016. However, most of the evidence is from studies conducted during working hours. Only few centres in the UK perform thrombectomies out-of-hours. The Royal Stoke... Read More about Mechanical thrombectomy: can it be safely delivered out of hours in the UK?.

Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial (2020)
Journal Article
Ouyang, M., Billot, L., Song, L., Wang, X., Roffe, C., Arima, H., …Anderson, C. S. (2021). Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial. International Journal of Stroke, 16(2), 200-206. https://doi.org/10.1177/1747493020908140

Background An indwelling urinary catheter (IUC) is often inserted to manage bladder dysfunction, but its impact on prognosis is uncertain. We aimed to determine the association of IUC use on clinical outcomes after acute stroke in the international,... Read More about Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial.

Continuous or intermittent? Which regiment of enteral nutrition is better for acute stroke patients? A systematic review and meta-analysis (2019)
Journal Article
Di Paolo, G., Twomlow, E., Hanna, F., Farmer, A., Lancaster, J., Sim, J., & Roffe, C. (2019). Continuous or intermittent? Which regiment of enteral nutrition is better for acute stroke patients? A systematic review and meta-analysis. https://doi.org/10.32474/OJNBD.2019.03.000163

Background and purpose: Enteral nutrition via nasogastric tube in acute stroke patients with dysphagia is an important determinant of patient outcomes. It is unclear whether intermittent or continuous feeding is more efficacious. The aim of this revi... Read More about Continuous or intermittent? Which regiment of enteral nutrition is better for acute stroke patients? A systematic review and meta-analysis.

Management of Acute Stroke in the Older Person. (2017)
Journal Article
Parr, E., Ferdinand, P., & Roffe, C. (2017). Management of Acute Stroke in the Older Person. Geriatrics, 2(3), Article 27. https://doi.org/10.3390/geriatrics2030027

The majority of people who suffer a stroke are older adults. The last two decades have brought major progress in the diagnosis and management of stroke, which has led to significant reductions in mortality, long-term disability, and the need for inst... Read More about Management of Acute Stroke in the Older Person..

Hypoxia after stroke: a review of experimental and clinical evidence (2016)
Journal Article
Ferdinand, P., & Roffe, C. (2016). Hypoxia after stroke: a review of experimental and clinical evidence. Experimental and Translational Stroke Medicine, 8, Article 9. https://doi.org/10.1186/s13231-016-0023-0

Background Hypoxia is a common occurrence following stroke and associated with poor clinical and functional outcomes. Normal oxygen physiology is a finely controlled mechanism from the oxygenation of haemoglobin in the pulmonary capillaries to its d... Read More about Hypoxia after stroke: a review of experimental and clinical evidence.

Validation and Recalibration of Two Multivariable Prognostic Models for Survival and Independence in Acute Stroke (2016)
Journal Article
Sim, J., Teece, L., Dennis, M. S., & Roffe, C. (2016). Validation and Recalibration of Two Multivariable Prognostic Models for Survival and Independence in Acute Stroke. PloS one, 11(5), Article ARTN e0153527. https://doi.org/10.1371/journal.pone.0153527

Introduction Various prognostic models have been developed for acute stroke, including one based on age and five binary variables (‘six simple variables’ model; SSVMod) and one based on age plus scores on the National Institutes of Health Stroke Sca... Read More about Validation and Recalibration of Two Multivariable Prognostic Models for Survival and Independence in Acute Stroke.

Early Diagnosis of Pneumonia in Severe Stroke: Clinical Features and the Diagnostic Role of C-Reactive Protein (2016)
Journal Article
Warusevitane, A., Karunatilake, D., Sim, J., Smith, C., & Roffe, C. (2016). Early Diagnosis of Pneumonia in Severe Stroke: Clinical Features and the Diagnostic Role of C-Reactive Protein. PloS one, 0150269-?. https://doi.org/10.1371/journal.pone.0150269

Background Accurate diagnosis of pneumonia complicating severe stroke is challenging due to difficulties in physical examination, altered immune responses and delayed manifestations of radiological changes. The aims of this study were to describe ea... Read More about Early Diagnosis of Pneumonia in Severe Stroke: Clinical Features and the Diagnostic Role of C-Reactive Protein.

Abstract W MP9: Preliminary Results from the Survival and Outcome After Stroke (SOS) Trial: Natural History of Acute Ischemic Stroke from Large Vessel Occlusion (2015)
Journal Article
Grunwald, I. Q., Sneade, M., Clarke, A., Yarnold, J., Warburton, E., Nagel, S., …Trial Investigators, S. (2015). Abstract W MP9: Preliminary Results from the Survival and Outcome After Stroke (SOS) Trial: Natural History of Acute Ischemic Stroke from Large Vessel Occlusion. Stroke, 46(suppl_1), https://doi.org/10.1161/str.46.suppl_1.wmp9

Extending the role of peritoneal dialysis: can we win hearts and minds? (2014)
Journal Article
Davies, S., Lally, F., Satchithananda, D., Kadam, U., & Roffe, C. (2014). Extending the role of peritoneal dialysis: can we win hearts and minds?. Nephrology Dialysis Transplantation, 29(9), 1648-1654. https://doi.org/10.1093/ndt/gfu001

Background The ability of peritoneal dialysis (PD) to achieve low-molecular weight solute clearance and ultrafiltration at low haemodynamic cost makes it an attractive therapy in situations where more aggressive therapy may be undesirable due to sud... Read More about Extending the role of peritoneal dialysis: can we win hearts and minds?.

Incidence of Venous Thromboembolism in the Wake of the Clots in Legs Or sTockings after Stroke (CLOTS) Study (2013)
Journal Article
Jain, P., Ward, E., Nevatte, T., & Roffe, C. (2013). Incidence of Venous Thromboembolism in the Wake of the Clots in Legs Or sTockings after Stroke (CLOTS) Study. Stroke, 44(10), 2910-2912. https://doi.org/10.1161/strokeaha.113.001458

Background and Purpose— In the United Kingdom, compressive stockings were standard care in all stroke units until the publication of the Clots in Legs Or sTockings after Stroke (CLOTS) trial results in May 2009, which concluded that stockings were i... Read More about Incidence of Venous Thromboembolism in the Wake of the Clots in Legs Or sTockings after Stroke (CLOTS) Study.