Halvor Naess | University of Bergen (original) (raw)
Papers by Halvor Naess
Nevrologisk avdeling Radiologisk avdeling Haukeland Universitetssjukehus 5021 Bergen Nevrokirurgi... more Nevrologisk avdeling Radiologisk avdeling Haukeland Universitetssjukehus 5021 Bergen Nevrokirurgisk avdeling We report a patient with acute encephalitis of unknown causation who underwent hemicraniectomy because of threatening herniation. The patient recovered uneventfully and three weeks later, findings on neurological examination were normal. Hemicraniectomy should be considered in all patients with encephalitis and threatening herniation. En 44 år gammel kvinne ble innlagt i nevrologisk avdeling etter en tre dagers sykehistorie med personlighetsendring (ofte irrelevante svar og lang latenstid) og hodepine. Før det hadde hun hatt lette luftveissymptomer i 14 dager. Ved innkomst var hun våken og orientert, men svarte med lang latenstid. Høyre arm var lett paretisk. Pasienten var febril (38,4 °C) og respiratorisk og sirkulatorisk stabil. De mest aktuelle differensialdiagnosene var hjerneslag, sinusvenetrombose og encefali .
Acta Neurologica Scandinavica, 2010
Tidsskrift for Den norske legeforening
BMC Neurology, 2015
Background: Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the ab... more Background: Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the absence of tPA also accelerates clot break-up (sonolysis). Adding intravenous gaseous microbubbles may potentiate the effect of ultrasound in both sonothrombolysis and sonolysis. The Norwegian Sonothrombolysis in Acute Stroke Study aims in a pragmatic approach to assess the effect and safety of contrast enhanced ultrasound treatment in unselected acute ischaemic stroke patients.
In vivo (Athens, Greece)
We aimed to compare patients reporting acute infection with those reporting no infection at onset... more We aimed to compare patients reporting acute infection with those reporting no infection at onset of chronic fatigue syndrome (CFS). This study includes 873 patients with CFS referred to a tertiary centre on average 4.8 years after symptom onset. Assessment was by both observer query and self-reports. Antibody analyses against infectious agents including Epstein-Barr virus and enterovirus were performed in a majority of patients. Females comprised 75.3% of the patient group, and the mean age was 33 years. Initial infection was reported by 77%. There was no difference as to antibody analyses. Logistic regression showed that initial infection was independently associated with acute onset of fatigue, improvement of fatigue at referral, and the following symptoms at referral: fever, tender lymph nodes, and myalgia. CFS patients with initial infection as a precipitating factor more often report acute onset of fatigue, more frequent accompanying symptoms, and more frequent improvement on ...
International Journal of Stroke
RATIONALE: As a result of demographic changes with a presumed rapidly increasing number of older ... more RATIONALE: As a result of demographic changes with a presumed rapidly increasing number of older people during the coming decades, a strong increase in the incidence and prevalence of stroke should be expected. Early supported discharge implies that the patients are discharged to their homes as soon as feasible and that rehabilitative treatment is offered after the discharge, with the patients being home-dwelling. This has proved beneficial in previous studies. AIMS: The main objective of this study is to further characterize the important components of early supported discharge and to confirm superiority of early supported discharge over conventional treatment. The secondary aim will be to compare two different early supported discharge schemes. These early supported discharge schemes are composed of intensive rehabilitation treatment given by a multidisciplinary team in a day unit and, alternatively, the same treatment given in the patients' homes. DESIGN: The study is conduct...
BMC neurology, 2015
Family history (FH) is a risk factor for cardiovascular disease, especially coronary artery disea... more Family history (FH) is a risk factor for cardiovascular disease, especially coronary artery disease (CAD). The impact on risk of stroke is less clear. This study investigated young and middle-aged ischemic stroke patients' knowledge on FH of stroke, CAD, and peripheral artery disease (PAD) with a special regard to sex differences. From September 2010 to February 2014, all ischemic stroke patients aged 15-60 years were prospectively included in the Norwegian Stroke in the Young Study (NOR-SYS). FH of stroke, CAD and PAD in offspring, siblings, parents, and grandparents was assessed using a standardized face-to-face interview. In addition to 'yes' and 'no', the optional reply 'don't know' was included to improve accuracy. McNemar's test was used to compare paired proportions, i.e. FH in male vs. female relatives. Multiple logistic regression analyses were used to test the influence of patient sex on FH reporting and to adjust for possible confoundin...
Cerebrovascular diseases extra, 2014
This study aims to evaluate the implementation of a rapid response treatment protocol for patient... more This study aims to evaluate the implementation of a rapid response treatment protocol for patients presenting with acute onset ischemic stroke. Improvements of routines surrounding the admission and treatment of patients with intravenous thrombolysis (IVT), such as door-to-needle (DTN) times, and increasing the numbers of patients treated are discussed. We conducted a retrospective analysis of all patients (n = 320) treated with IVT for acute onset ischemic stroke at the Stavanger University Hospital, Norway, between 2003 and 2012. In 2009, a succession of changes to pre- and intra-hospital routines were made as well as an improvement in the education of primary health care physicians, nurses and paramedics involved in the treatment of acute onset stroke patients (rapid response treatment protocol). Analyses of DTN times, onset-to-needle times and the number of patients treated per year were carried out to ascertain the effect of the changes made. The primary aim was to analyze DTN ...
BMJ open, 2014
To compare the effects on balance and walking of three models of stroke rehabilitation: early sup... more To compare the effects on balance and walking of three models of stroke rehabilitation: early supported discharge with rehabilitation in a day unit or at home, and traditional uncoordinated treatment (control). Group comparison study within a randomised controlled trial. Hospital stroke unit and primary healthcare. a score of 2-26 on National Institutes of Health Stroke Scale, assessed with Postural Assessment Scale for Stroke (PASS), and discharge directly home from the hospital stroke unit. Two intervention groups were given early supported discharge with treatment in either a day unit or the patient's own home. The controls were offered traditional, uncoordinated treatment. Primary: PASS. Secondary: Trunk Impairment Scale-modified Norwegian version; timed Up-and-Go; 5 m timed walk; self-reports on problems with walking, balance, ADL, physical activity, pain and tiredness. The patients were tested before randomisation and 3 months after inclusion. From a total of 306 randomise...
Dementia and geriatric cognitive disorders extra, 2011
A pattern characterizing cognitive deficits in mild stroke could help in differential diagnosis a... more A pattern characterizing cognitive deficits in mild stroke could help in differential diagnosis and rehabilitation planning. Fifty patients with mild stroke (modified Rankin scale ≤2 at discharge) aged >60 years were given the Mini Mental State Examination (MMSE), the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Stroop test. On HVLT-R, significant impairments were found in learning and recall, but not in delayed recall. The Stroop test revealed significant impairments in reading speed, but not in color-word interference. Using the MMSE, significant deficits were only found in the youngest age group. Elderly patients with mild stroke show deficits in verbal learning/recall and in reading speed, but not in the MMSE, delayed recall or color-word interference. The deficits are consistent with a mild-to-moderate brain dysfunction, with relative sparing of medial brain structures.
Stroke Research and Treatment, 2013
Background. Migraine is prevalent in young patients and a frequent stroke mimic. To distinguish s... more Background. Migraine is prevalent in young patients and a frequent stroke mimic. To distinguish stroke mimics from true stroke can be difficult, and there is a possibility of misdiagnosing a stroke as a migrainous attack in patients with migraine. We aimed to investigate if a history of migraine affects the rate of thrombolytic therapy in young stroke patients. Methods. All patients below 50 years of age admitted in the period 2006-2013 to the Bergen Stroke Centre with acute ischaemic stroke were included. The rate of thrombolytic therapy in patients with migraine was compared to patients with no history of migraine. A multivariate analysis was performed to adjust confounding factors. Results. A total of 170 young stroke patients were enrolled, 49 with migraine and 121 with no migraine. In total, 10.2% of young patients with migraine received thrombolytic therapy, compared with 26.5% of young patients with nomigraine ( = 0.02). Migraine was associated with a low rate of thrombolytic therapy when adjusting for possible confounding factors (OR 0.19 CI: 0.05-0.72, = 0.02). Conclusion. Migraine is associated with a low rate of thrombolytic therapy in young patients admitted with acute ischaemic stroke. Migraine patients admitted with acute ischaemic stroke are at risk of maltreatment.
ISRN Cardiology, 2012
Background: MAZE IV surgery is effective in restoring sinus rhythm (SR) and atrial contraction (A... more Background: MAZE IV surgery is effective in restoring sinus rhythm (SR) and atrial contraction (AC) in patients with nonrheumatic persistent atrial fibrillation (AF). However, there is less information on its effectiveness to restore AC in patients with rheumatic disease. Aims: To assess the effectiveness of the MAZE IV surgery in restoring AC in patients with rheumatic disease and long persistent AF. Methods: Prospective, consecutive study in patients who underwent cardiovascular surgery and had long persistent AF in whom MAZE IV surgery was performed. The presence of AC was assessed by lateral mitral annulus tissue Doppler. Results: A total of 75 patients were included. Mean age 60 years (±11.7); 27 men (36%). AF duration was 63 months (±34.1). Primary indication for surgery: rheumatic mitral stenosis 67 patients and mitral insufficiency eight patients. Mean left ventricular ejection fraction (LVEF) was 51.8% (±12.1) and mean left atrial area was 37 cm 2 (±10.
Cerebrovascular Diseases, 2014
MR diffusion-weighted imaging (DWI) has revolutionized neuroimaging and contributed to a tissue-b... more MR diffusion-weighted imaging (DWI) has revolutionized neuroimaging and contributed to a tissue-based redefinition of transient ischemic attack (TIA). Stroke patients with DWI lesions may have neurological symptoms that resolve completely within 24 h, suggesting successful vessel recanalization. Prior studies of stroke patients with transient symptoms have not found any predilection for DWI lesions in any specific territory. Other studies have, however, reported an association between higher brain dysfunction and presence of DWI lesions in patients with transient ischemic symptoms, suggesting a high rate of cortical affection in these patients. We sought to see whether DWI location in stroke patients with transient symptoms <24 h differed from those with persistent symptoms ≥ 24 h. We hypothesized an association between transient symptoms <24 h and cortical DWI lesion localization due to a possible higher rate of vessel recanalization in patients with transient symptoms causing distal cortical infarctions. Ischemic stroke patients examined with DWI and admitted within 24 h after symptom onset between February 2006 and November 2013 were prospectively registered in a database (The Bergen NORSTROKE Registry). Based on neurological examination 24 h after admission, patients were classified as having either transient symptoms <24 h (DWI <24) or persistent symptoms ≥ 24 h (DWI ≥ 24). DWI lesions were classified into different groups depending on lesion location: cortical lesions, confined to the supratentorial cortex; large subcortical lesions, located in the hemispheric white matter, basal ganglia, internal capsule, thalamus or corona radiate with a diameter ≥ 15 mm; lacunar lesions, located in the same territory as large subcortical lesions with a diameter <15 mm; mixed cortical-subcortical lesions, located in both supratentorial cortex and subcortex; cerebellar lesions, confined to the cerebellum; brain stem lesions, confined to the brain stem; multiple locations, located in more than one of the above defined areas. A total of 142 ischemic stroke patients had DWI <24 and 830 DWI ≥ 24. Cortical DWI location was more frequent in patients with DWI <24 (54.2% vs. 29.5%, p < 0.001), while proportions of mixed cortical-subcortical lesions (13.4% vs. 26.5%, p = 0.001) and lesions with multiple locations (5.6% vs. 11.1%, p = 0.048) were less frequent as compared to DWI ≥ 24. Cortical DWI location was independently associated with DWI <24 when adjusted for confounders in multiple regression analyses (OR 1.89, 95% CI 1.28-2.81, p = 0.001). Cortical DWI location was independently associated with transient stroke symptoms <24 h. This may be explained by vessel recanalization, resulting in upstream transportation of remaining particles and distal cortical lesions.
Tidsskrift for Den norske legeforening, 2011
PLoS ONE, 2014
Background: Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality ev... more Background: Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.
BMC Neurology, 2014
Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The ove... more Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The overall benefit from alteplase is substantial, but some evidence indicates that alteplase also has negative effects on the ischaemic brain. Tenecteplase may be more effective and less harmfull than alteplase, but large randomised controlled phase 3 trials are lacking. The Norwegian Tenecteplase Stroke Trial (NOR-TEST) aims to compare efficacy and safety of tenecteplase vs. alteplase.
BMC Neurology, 2010
BACKGROUND: To report the clinical course of PML in an apparently immunocompetent patient treated... more BACKGROUND: To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir. CASE PRESENTATION: A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and
Vascular Health and Risk Management, 2014
Stroke, 2002
Background and Purpose-We sought to determine the incidence and short-term outcome of people aged... more Background and Purpose-We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988 -1997 in Hordaland County, Norway. Methods-Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). Results-A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000.
Nevrologisk avdeling Radiologisk avdeling Haukeland Universitetssjukehus 5021 Bergen Nevrokirurgi... more Nevrologisk avdeling Radiologisk avdeling Haukeland Universitetssjukehus 5021 Bergen Nevrokirurgisk avdeling We report a patient with acute encephalitis of unknown causation who underwent hemicraniectomy because of threatening herniation. The patient recovered uneventfully and three weeks later, findings on neurological examination were normal. Hemicraniectomy should be considered in all patients with encephalitis and threatening herniation. En 44 år gammel kvinne ble innlagt i nevrologisk avdeling etter en tre dagers sykehistorie med personlighetsendring (ofte irrelevante svar og lang latenstid) og hodepine. Før det hadde hun hatt lette luftveissymptomer i 14 dager. Ved innkomst var hun våken og orientert, men svarte med lang latenstid. Høyre arm var lett paretisk. Pasienten var febril (38,4 °C) og respiratorisk og sirkulatorisk stabil. De mest aktuelle differensialdiagnosene var hjerneslag, sinusvenetrombose og encefali .
Acta Neurologica Scandinavica, 2010
Tidsskrift for Den norske legeforening
BMC Neurology, 2015
Background: Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the ab... more Background: Ultrasound accelerates thrombolysis with tPA (sonothrombolysis). Ultrasound in the absence of tPA also accelerates clot break-up (sonolysis). Adding intravenous gaseous microbubbles may potentiate the effect of ultrasound in both sonothrombolysis and sonolysis. The Norwegian Sonothrombolysis in Acute Stroke Study aims in a pragmatic approach to assess the effect and safety of contrast enhanced ultrasound treatment in unselected acute ischaemic stroke patients.
In vivo (Athens, Greece)
We aimed to compare patients reporting acute infection with those reporting no infection at onset... more We aimed to compare patients reporting acute infection with those reporting no infection at onset of chronic fatigue syndrome (CFS). This study includes 873 patients with CFS referred to a tertiary centre on average 4.8 years after symptom onset. Assessment was by both observer query and self-reports. Antibody analyses against infectious agents including Epstein-Barr virus and enterovirus were performed in a majority of patients. Females comprised 75.3% of the patient group, and the mean age was 33 years. Initial infection was reported by 77%. There was no difference as to antibody analyses. Logistic regression showed that initial infection was independently associated with acute onset of fatigue, improvement of fatigue at referral, and the following symptoms at referral: fever, tender lymph nodes, and myalgia. CFS patients with initial infection as a precipitating factor more often report acute onset of fatigue, more frequent accompanying symptoms, and more frequent improvement on ...
International Journal of Stroke
RATIONALE: As a result of demographic changes with a presumed rapidly increasing number of older ... more RATIONALE: As a result of demographic changes with a presumed rapidly increasing number of older people during the coming decades, a strong increase in the incidence and prevalence of stroke should be expected. Early supported discharge implies that the patients are discharged to their homes as soon as feasible and that rehabilitative treatment is offered after the discharge, with the patients being home-dwelling. This has proved beneficial in previous studies. AIMS: The main objective of this study is to further characterize the important components of early supported discharge and to confirm superiority of early supported discharge over conventional treatment. The secondary aim will be to compare two different early supported discharge schemes. These early supported discharge schemes are composed of intensive rehabilitation treatment given by a multidisciplinary team in a day unit and, alternatively, the same treatment given in the patients' homes. DESIGN: The study is conduct...
BMC neurology, 2015
Family history (FH) is a risk factor for cardiovascular disease, especially coronary artery disea... more Family history (FH) is a risk factor for cardiovascular disease, especially coronary artery disease (CAD). The impact on risk of stroke is less clear. This study investigated young and middle-aged ischemic stroke patients' knowledge on FH of stroke, CAD, and peripheral artery disease (PAD) with a special regard to sex differences. From September 2010 to February 2014, all ischemic stroke patients aged 15-60 years were prospectively included in the Norwegian Stroke in the Young Study (NOR-SYS). FH of stroke, CAD and PAD in offspring, siblings, parents, and grandparents was assessed using a standardized face-to-face interview. In addition to 'yes' and 'no', the optional reply 'don't know' was included to improve accuracy. McNemar's test was used to compare paired proportions, i.e. FH in male vs. female relatives. Multiple logistic regression analyses were used to test the influence of patient sex on FH reporting and to adjust for possible confoundin...
Cerebrovascular diseases extra, 2014
This study aims to evaluate the implementation of a rapid response treatment protocol for patient... more This study aims to evaluate the implementation of a rapid response treatment protocol for patients presenting with acute onset ischemic stroke. Improvements of routines surrounding the admission and treatment of patients with intravenous thrombolysis (IVT), such as door-to-needle (DTN) times, and increasing the numbers of patients treated are discussed. We conducted a retrospective analysis of all patients (n = 320) treated with IVT for acute onset ischemic stroke at the Stavanger University Hospital, Norway, between 2003 and 2012. In 2009, a succession of changes to pre- and intra-hospital routines were made as well as an improvement in the education of primary health care physicians, nurses and paramedics involved in the treatment of acute onset stroke patients (rapid response treatment protocol). Analyses of DTN times, onset-to-needle times and the number of patients treated per year were carried out to ascertain the effect of the changes made. The primary aim was to analyze DTN ...
BMJ open, 2014
To compare the effects on balance and walking of three models of stroke rehabilitation: early sup... more To compare the effects on balance and walking of three models of stroke rehabilitation: early supported discharge with rehabilitation in a day unit or at home, and traditional uncoordinated treatment (control). Group comparison study within a randomised controlled trial. Hospital stroke unit and primary healthcare. a score of 2-26 on National Institutes of Health Stroke Scale, assessed with Postural Assessment Scale for Stroke (PASS), and discharge directly home from the hospital stroke unit. Two intervention groups were given early supported discharge with treatment in either a day unit or the patient's own home. The controls were offered traditional, uncoordinated treatment. Primary: PASS. Secondary: Trunk Impairment Scale-modified Norwegian version; timed Up-and-Go; 5 m timed walk; self-reports on problems with walking, balance, ADL, physical activity, pain and tiredness. The patients were tested before randomisation and 3 months after inclusion. From a total of 306 randomise...
Dementia and geriatric cognitive disorders extra, 2011
A pattern characterizing cognitive deficits in mild stroke could help in differential diagnosis a... more A pattern characterizing cognitive deficits in mild stroke could help in differential diagnosis and rehabilitation planning. Fifty patients with mild stroke (modified Rankin scale ≤2 at discharge) aged >60 years were given the Mini Mental State Examination (MMSE), the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Stroop test. On HVLT-R, significant impairments were found in learning and recall, but not in delayed recall. The Stroop test revealed significant impairments in reading speed, but not in color-word interference. Using the MMSE, significant deficits were only found in the youngest age group. Elderly patients with mild stroke show deficits in verbal learning/recall and in reading speed, but not in the MMSE, delayed recall or color-word interference. The deficits are consistent with a mild-to-moderate brain dysfunction, with relative sparing of medial brain structures.
Stroke Research and Treatment, 2013
Background. Migraine is prevalent in young patients and a frequent stroke mimic. To distinguish s... more Background. Migraine is prevalent in young patients and a frequent stroke mimic. To distinguish stroke mimics from true stroke can be difficult, and there is a possibility of misdiagnosing a stroke as a migrainous attack in patients with migraine. We aimed to investigate if a history of migraine affects the rate of thrombolytic therapy in young stroke patients. Methods. All patients below 50 years of age admitted in the period 2006-2013 to the Bergen Stroke Centre with acute ischaemic stroke were included. The rate of thrombolytic therapy in patients with migraine was compared to patients with no history of migraine. A multivariate analysis was performed to adjust confounding factors. Results. A total of 170 young stroke patients were enrolled, 49 with migraine and 121 with no migraine. In total, 10.2% of young patients with migraine received thrombolytic therapy, compared with 26.5% of young patients with nomigraine ( = 0.02). Migraine was associated with a low rate of thrombolytic therapy when adjusting for possible confounding factors (OR 0.19 CI: 0.05-0.72, = 0.02). Conclusion. Migraine is associated with a low rate of thrombolytic therapy in young patients admitted with acute ischaemic stroke. Migraine patients admitted with acute ischaemic stroke are at risk of maltreatment.
ISRN Cardiology, 2012
Background: MAZE IV surgery is effective in restoring sinus rhythm (SR) and atrial contraction (A... more Background: MAZE IV surgery is effective in restoring sinus rhythm (SR) and atrial contraction (AC) in patients with nonrheumatic persistent atrial fibrillation (AF). However, there is less information on its effectiveness to restore AC in patients with rheumatic disease. Aims: To assess the effectiveness of the MAZE IV surgery in restoring AC in patients with rheumatic disease and long persistent AF. Methods: Prospective, consecutive study in patients who underwent cardiovascular surgery and had long persistent AF in whom MAZE IV surgery was performed. The presence of AC was assessed by lateral mitral annulus tissue Doppler. Results: A total of 75 patients were included. Mean age 60 years (±11.7); 27 men (36%). AF duration was 63 months (±34.1). Primary indication for surgery: rheumatic mitral stenosis 67 patients and mitral insufficiency eight patients. Mean left ventricular ejection fraction (LVEF) was 51.8% (±12.1) and mean left atrial area was 37 cm 2 (±10.
Cerebrovascular Diseases, 2014
MR diffusion-weighted imaging (DWI) has revolutionized neuroimaging and contributed to a tissue-b... more MR diffusion-weighted imaging (DWI) has revolutionized neuroimaging and contributed to a tissue-based redefinition of transient ischemic attack (TIA). Stroke patients with DWI lesions may have neurological symptoms that resolve completely within 24 h, suggesting successful vessel recanalization. Prior studies of stroke patients with transient symptoms have not found any predilection for DWI lesions in any specific territory. Other studies have, however, reported an association between higher brain dysfunction and presence of DWI lesions in patients with transient ischemic symptoms, suggesting a high rate of cortical affection in these patients. We sought to see whether DWI location in stroke patients with transient symptoms <24 h differed from those with persistent symptoms ≥ 24 h. We hypothesized an association between transient symptoms <24 h and cortical DWI lesion localization due to a possible higher rate of vessel recanalization in patients with transient symptoms causing distal cortical infarctions. Ischemic stroke patients examined with DWI and admitted within 24 h after symptom onset between February 2006 and November 2013 were prospectively registered in a database (The Bergen NORSTROKE Registry). Based on neurological examination 24 h after admission, patients were classified as having either transient symptoms <24 h (DWI <24) or persistent symptoms ≥ 24 h (DWI ≥ 24). DWI lesions were classified into different groups depending on lesion location: cortical lesions, confined to the supratentorial cortex; large subcortical lesions, located in the hemispheric white matter, basal ganglia, internal capsule, thalamus or corona radiate with a diameter ≥ 15 mm; lacunar lesions, located in the same territory as large subcortical lesions with a diameter <15 mm; mixed cortical-subcortical lesions, located in both supratentorial cortex and subcortex; cerebellar lesions, confined to the cerebellum; brain stem lesions, confined to the brain stem; multiple locations, located in more than one of the above defined areas. A total of 142 ischemic stroke patients had DWI <24 and 830 DWI ≥ 24. Cortical DWI location was more frequent in patients with DWI <24 (54.2% vs. 29.5%, p < 0.001), while proportions of mixed cortical-subcortical lesions (13.4% vs. 26.5%, p = 0.001) and lesions with multiple locations (5.6% vs. 11.1%, p = 0.048) were less frequent as compared to DWI ≥ 24. Cortical DWI location was independently associated with DWI <24 when adjusted for confounders in multiple regression analyses (OR 1.89, 95% CI 1.28-2.81, p = 0.001). Cortical DWI location was independently associated with transient stroke symptoms <24 h. This may be explained by vessel recanalization, resulting in upstream transportation of remaining particles and distal cortical lesions.
Tidsskrift for Den norske legeforening, 2011
PLoS ONE, 2014
Background: Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality ev... more Background: Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.
BMC Neurology, 2014
Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The ove... more Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The overall benefit from alteplase is substantial, but some evidence indicates that alteplase also has negative effects on the ischaemic brain. Tenecteplase may be more effective and less harmfull than alteplase, but large randomised controlled phase 3 trials are lacking. The Norwegian Tenecteplase Stroke Trial (NOR-TEST) aims to compare efficacy and safety of tenecteplase vs. alteplase.
BMC Neurology, 2010
BACKGROUND: To report the clinical course of PML in an apparently immunocompetent patient treated... more BACKGROUND: To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir. CASE PRESENTATION: A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and
Vascular Health and Risk Management, 2014
Stroke, 2002
Background and Purpose-We sought to determine the incidence and short-term outcome of people aged... more Background and Purpose-We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988 -1997 in Hordaland County, Norway. Methods-Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). Results-A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000.