5 research outputs found
10Kin1day: a bottom-up neuroimaging initiative
We organized 10Kin1day, a pop-up scientific event with the goal to bring together neuroimaging groups from around the world to jointly analyze 10,000+ existing MRI connectivity datasets during a 3-day workshop. In this report, we describe the motivation and principles of 10Kin1day, together with a public release of 8,000+ MRI connectome maps of the human brain
European Stroke Organisation (ESO) guidelines on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage
The optimal blood pressure (BP) management in acute ischaemic stroke
(AIS) and acute intracerebral haemorrhage (ICH) remains controversial.
These European Stroke Organisation (ESO) guidelines provide
evidence-based recommendations to assist physicians in their clinical
decisions regarding BP management in acute stroke. The guidelines were
developed according to the ESO standard operating procedure and Grading
of Recommendations, Assessment, Development, and Evaluation (GRADE)
methodology. The working group identified relevant clinical questions,
performed systematic reviews and meta-analyses of the literature,
assessed the quality of the available evidence, and made specific
recommendations. Expert consensus statements were provided where
insufficient evidence was available to provide recommendations based on
the GRADE approach. Despite several large randomised-controlled clinical
trials, quality of evidence is generally low due to inconsistent results
of the effect of blood pressure lowering in AIS. We recommend early and
modest blood pressure control (avoiding blood pressure levels >180/105
mm Hg) in AIS patients undergoing reperfusion therapies. There is more
high-quality randomised evidence for BP lowering in acute ICH, where
intensive blood pressure lowering is recommended rapidly after hospital
presentation with the intent to improve recovery by reducing haematoma
expansion. These guidelines provide further recommendations on blood
pressure thresholds and for specific patient subgroups. There is ongoing
uncertainty regarding the most appropriate blood pressure management in
AIS and ICH. Future randomised-controlled clinical trials are needed to
inform decision making on thresholds, timing and strategy of blood
pressure lowering in different acute stroke patient subgroups
Routine assessment of cognitive function in older patients with hypertension seen by primary care physicians : why and how : a decision-making support from the working group on ‘hypertension and the brain’ of the European Society of Hypertension and from the European Geriatric Medicine Society
The guidelines on hypertension recently published by the European Societies of Hypertension and Cardiology, have
acknowledged cognitive function (and its decline) as a hypertension-mediated organ damage. In fact, brain damage
can be the only hypertension-mediated organ damage in more than 30% of hypertensive patients, evolving undetected
for several years if not appropriately screened; as long as undetected it cannot provide either corrective measures, nor adequate risk stratification of the hypertensive patient.
The medical community dealing with older hypertensive patients should have a simple and pragmatic approach to
early identify and precisely treat these patients. Both hypertension and cognitive decline are undeniably growing
pandemics in developed or epidemiologically transitioning societies. Furthermore, there is a clear-cut connection
between exposure to the increased blood pressure and development of cognitive decline.
Therefore, a group of experts in the field from the European Society of Hypertension and from the European
Geriatric Medicine Society gathered together to answer practical clinical questions that often face the physician
when dealing with their hypertensive patients in a routine clinical practice. They elaborated a decision-making
approach to help standardize such clinical evaluation