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Acute Stroke Research

OVERVIEW

The research group focuses on the acute diagnosis and early management of acute stroke patients and other neurological emergencies as well as on the management of patients with cerebral sinus venous thrombosis. The group works closely together with the Department of Neuroradiology (PD Dr. Christian Herweh) and cooperates with the award winning medtech company Brainomix (Oxford, UK) to develop and establish automated imaging analysis tools for acute stroke diagnosis. Two recent publications of the group demonstrated that the innovative e-ASPECTS software, a tool to automate the most abundantly used stroke imaging scale ASPECTS (Alberta Stroke Program Early CT Score), is superior to junior stroke physicians and non-inferior to expert neuroradiologist in interpreting CTs scan of acute stroke patients with ASPECTS (Herweh IJS 2016, Nagel IJS 2016). Over the past few years the group published severel studies on cerebral sinus thrombosis with regard to predictors of outcome and frequency and extent of vessel recanalization under oral anticoagulation (Herweh EJN 2016, Geisbüsch Nervenarzt 2014). Morever, the group published the first successful experience of treatment with one of the newer oral anticoagulants (factor Xa inhibitor Rivaroxaban) in this disease (Geisbüsch Stroke 2014). More recent work of the group aims at developing and validating a new triage system (ETNNA) for nurses and doctors in emergency departments in order to correctly and rapidly identify patients with neurological emergency disorders (Hanna Meesmann).

Prof. Dr. med. Simon Nagel

Arbeitsgruppenleiter (AG Akute Schlaganfall- und neurologische Notfallversorgung)


06221 56-7504
06221 56-5461

Future work will entail the participation in a pharmacy sponsored international, multicentric and randomized therapy study on cerebral sinus thrombosis (National Coordinator: Simon Nagel) and the setup of a national register for patients with severe cerebral sinus thrombosis requiring intensive care management (in cooperation with Prof. Dohmen, Cologne).

[left] Receiver-operated-curve curve (area under the curve=0.91) for ASPECTS score-based analysis for e-ASPECTS (green dashed line) and performance of stroke trainees (cyan) and stroke experts (blue). Operating point #3 was significantly better than all stroke trainees and one stroke expert in detecting the correct ASPECTS score (Herweh et. al, IJS, 2016). [right, top] CT scan highlighting the different ASPECTS regions. [right, bottom] example of an unprocessed and processed scan by e-ASPECTS: red indicates acute ischemic damage and the respective regions are marked, stripy orange highlights old ischemic damage not contributing to the ASPECTS.

Team

Arbeitsgruppenleiter

Wiss. Mitarbeiter/-innen

Aktuelle Doktoranden

Linda Harrenberg, Kevin Ohnhäuser, Nicole Mattern

Kooperationen

  • PD Dr. Christian Herweh (Neuroradiologie)
  • Dr. Klaus Hess (Neuropsychologie)
  • Prof. Dr. Christian Szabo (Neurologie Mannheim)
  • Prof. Dr. Christian Wolf (Universitätsklinikum Saarland)
  • Prof. Dr. Alastair Buchan (University of Oxford, UK)
  • Prof. Dr. Iris Grunwald (Anglia Ruskin University, UK)
  • Prof. Dr. Perttu Lindsberg (Helsinki University, Finnland)
  • Prof. Dr. Craig Anderson (University of Sydney, AUS)
  • Fa. Brainomix Ltd (Oxford, UK)

SELECTED PUBLICATIONS

  • Nagel S, Sinha D, Day D, Reith W, Chapot R, Papanagiotou P, Warburton EA, Guyler P, Tysoe S, Fassbender K, Walter S, Essig M, Heidenrich J, Konstas AA, Harrison M, Papadakis M, Greveson E, Joly O, Gerry S, Maguire H, Roffe C, Hampton-Till J, Buchan AM, Grunwald IQ. e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients. Int J Stroke. 2016 Nov 29.
  • Herweh C, Ringleb PA, Rauch G, Gerry S, Behrens L, Möhlenbruch M, Gottorf R, Richter D, Schieber S, Nagel S. Performance of e-ASPECTS software in comparison to that of stroke physicians on assessing CT scans of acute ischemic stroke patients. Int J Stroke. 2016 Jun;11(4):438-45
  • Herweh C, Griebe M, Geisbüsch C, Szabo K, Neumaier-Probst E, Hennerici MG, Bendszus M, Ringleb PA, Nagel S. Frequency and temporal profile of recanalization after cerebral vein and sinus thrombosis. Eur J Neurol. 2016 Apr;23(4):
  • Geisbüsch C, Richter D, Herweh C, Ringleb PA, Nagel S. Novel factor Xa inhibitor for the treatment of cerebral venous and sinus thrombosis – first experience in seven patients. Stroke 2014 Aug;45(8):2469-71
  • Geisbüsch C, Lichy C, Richter D, Herweh C, Hacke W, Nagel S. Course of cerebral sinus and/or venous thrombosis – data from a monocentric cohort study over 15 years. Der Nervenarzt 2014, 85:205-210.