Cerebrovascular Diseases

Akershus university hospital has the largest stroke unit in Norway and is also the only hospital that provide subacute in-hospital stroke rehabilitation within an integrated rehabilitation unit in the neurology department. Our research focuses on epidemiology, risk factors, management, and prognosis of various cerebrovascular diseases, including acute ischemic stroke, small vessel disease, intracerebral haemorrhage, and cerebral venous thrombosis. We cover the entire stroke survival journey, from selection and prehospital diagnosis through the acute hospital phase, rehabilitation clinic, and further primary care follow-up. Additionally, we actively participate in numerous national and international randomized trials in collaboration with partners worldwide.

Cerebrovascular Diseases

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Research interests

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JPND/Horizon 2020-funded project including patients with pre-demented Alzheimer’s disease to find biomarkers for small vessel damage in the brain.

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Highlighted work

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2024

ACHE

AcuteHeadache Evaluation Study. (PIEspen Saxhaug Kristoffersen). Funding by Ahus.

2023

MultiHead

Multidisciplinary HeadacheTreatment. (PI Kjersti Grøtta Vetvik). Effect of headache treatment in amultidisciplinary team on headache burden and work participation. A cooperationwith the Norwegian Labour and welfare administration (NAV).

2024

Resolution

(PI Christofer Lundqvist) –Treatmentwith Eptinezumab in medication overuse headache. Sponsor Lundbeck AS.

2024

CandMig

PIChristofer Lundqvist). Candesartan for migraine. CandMig III:Kandesartan som forebyggende medisin ved hyppig migrene - Cristin. Fundedby Klinbeforsk.

2023

BioCer

(PIEspen Saxhaug Kristoffersen). Home-basedbiofeedback as a migraine treatment. Funded by the Norwegian Headache researchcenter (NorHead) and Nordic Brain tech.

www.biocer.no

Publications

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Read more

Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis

PubMed↗
Sanner J, Ström JO, von Euler M, Thommessen B, Fure B
...
May 18, 2024

Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19

PubMed↗
Scutelnic A, van de Munckhof A, Miraclin AT, ... , Heldner MR
...
April 4, 2024

Intracerebral haemorrhage in patients taking different types of oral anticoagulants: a pooled individual patient data analysis from two national stroke registries

PubMed↗
Siepen BM, Forfang E, Branca M, ... , Seiffge DJ
...
February 8, 2024

Highlighted work

Prehospital Blood Pressure and Clinical and Radiological Outcomes in Acute Spontaneous Intracerebral Hemorrhage.
Larsen KT, Selseth MN, Jahr SH, Hillestad V, Koubaa N, Sandset EC, Rønning OM, Kristoffersen ES. Stroke 2022. PMID: 36252098

Incidence and Mortality of Cerebral Venous Thrombosis in a Norwegian Population.
Kristoffersen ES, Harper CE, Vetvik KG, Zarnovicky S, Hansen JM, Faiz KW. Stroke. 2020. PMID: 32883194

Does implementation of a standardized pathway of stroke care affect functional outcome after stroke?
Bergh E, Askim T, Rønning OM, Šaltytė Benth J, Fjærtoft H, Thommessen B. Int J Stroke. 2023. PMID: 36300753.

Early versus Later Anticoagulation for Stroke with Atrial Fibrillation.
ELAN Investigators including Kristoffersen ES and Rønning OM. N. Engl. J. Med 2023. PMID: 37222476

Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants.
Meinel TR, Wilson D, Gensicke H, Scheitz JF, Ringleb P, Goganau I, Kaesmacher J, Bae HJ, Kim DY, Kermer P, Suzuki K, Kimura K, Macha K, Koga, Wada S, Altersberger V, Salerno A, Palanikumar L, Zini A, Forlivesi S, Kellert L, Wischmann J, Kristoffersen ES, Beharry J, Barber A, Hong JB, Creda C, Schlemm E, Yakushiji Y, Poli S, Leker R, Romoli M, Zedde M, Curtze S, Ikenberg B, Uphaus T, Giannandrea D, Portela PC, Veltkamp R, Ranta A, Arnold M, Fischer U, Cha JK, Wu TY, Purrucker JC, Seiffge DJ. Jama Neurol 2023. PMID: 36807495

Antithrombotic treatment after stroke due to intracerebral haemorrhage.
Cochrane A, Chen C, Stephen J, Rønning OM, Anderson CS, Hankey GJ, Al-Shahi Salman R. Cochrane Database Syst Rev 2023. PMID: 9878977

Prediction of occult atrial fibrillation in patients after cryptogenic stroke and transient ischaemic attack: PROACTIA.
Skrebelyte-Strøm L, Rønning OM, Dahl FA, Steine K, Kjekshus H. Europace 2022. PMID: 35819199

Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials.
Al-Shahi Salman R, Stephen J, Tierney JF, Lewis SC, Newby DE, Parry-Jones AR, White PM, Connolly S, Benavente OR, Dowlatshahi D, Cordonnier C, Viscoli CM, Sheth KN, Kamel H, Veltkamp R, Larsen KT, Hofmeijer J, Kerkhoff H, Schreuder F, Shoamanesh A, Klijn CJM, Van der Worp B.
Lancet Neurol 2023. PMID: 37839434

Iselin -The Norwegian Cerebral Venous Thrombosis study (NoCVT) - a long-term follow-up

Silje - Fast track ischemic stroke patients. A study of prehospital and intrahospital predictors of thrombolysis and functional outcome. The Akershus Study of Ischemic Stroke and Thrombolysis-1 (ASIST-1)

Maiken - Large vessel occlusion in a Norwegian population, imaging-based treatment selection and functional prognosis after stroke. The Akershus Study of Ischemic Stroke and Thrombolysis-1 (ASIST-1)

Ongoing projects and clinical studies

  • 2016- STATICH Study of Antithrombotic Treatment after Intracerebral Haemorrhage Multisenterstudie (Ahus, OUS). Prosjektansvarlige: Ole Morten Rønning/Torgeir Brun Wyller. (Sponsor: Oslo University Hospital)
  • 2022- OCEANIC-STROKE Oral faCtor Eleven A iNhibitor asundexIan as novel anti-thrombotiC –STROKE study (Sponsor: Bayer)
  • 2022- Cerebral venous thrombosis i en norsk populasjon (NoCVT) (Sponsor: Ahus)
  • 2017- The Akershus aCute Headache Evaluation 1 (ACHE-1) study. Epidemiology, clinical presentation, treatment and follow-up of subarachnoid haemorrhage in a Norwegian population
  • 2017- Epidemiology, clinical and radiological presentation of cerebral venous thrombosis in a Norwegian population
  • 2017- The Akershus Study of Ischemic Stroke and Thrombolysis 1 (ASIST-1)
  • 2013-2016 NOR-TEST The Norwegian Tenecteplase Stroke Trial 2 Randomised Trial of Tenecteplase vs. Alteplase in Acute Ischemic Stroke (Sponsor: Haukeland University Hospital)
  • 2017-2021 TWIST Tenecteplase in Wake-up Ischaemic Stroke Trial (Sponsor: University of Northern Norway)
  • 2020-2022 AXIOMATIC Oral Factor XIa Inhibitor, for the Prevention of New Ischemic Stroke or New Covert Brain Infarction in Patients Receiving Aspirin and Clopidogrel Following Acute Ischemic Stroke or Transient Ischemic Attack (Sponsor: Bristol Myers Squibb)
  • 2021-2023 ELAN Early versus Late initiation of direct oral Anticoagulants in post-Ischaemic stroke patients with atrial fibrillatioN (Sponsor: University Hospital Bern)

Other ongoing projects and clinical studies

  • 2016 - Joint analysis of the Swiss and Norwegian Stroke Registries, led by Ole Morten Rønning, Norway and David Seiffge, Bern, Switzerland
  • 2017 - Collaboration of Controlled Randomised Trials of Long-Term Oral Antithrombotic Agents After Spontaneous Intracranial Haemorrhage (COCROACH), led by Rustam Al-Shahi Salman, Edinburgh, UK. Participation by Rønning and Larsen
  • 2017 – ACHE-1 The Akershus aCute Headache Evaluation 1 study. Epidemiology, clinical presentation, treatment and follow-up of subarachnoid haemorrhage in a Norwegian population (Sponsor: Akershus University Hospital)
  • 2018 - NoCVT Epidemiology, clinical and radiological presentation and prognosis of cerebral venous thrombosis in a Norwegian population (NoCVT) (Sponsor: Akershus University Hospital)
  • 2020 – NoICH Intracerebral Haemorrhage in a Norwegian population - a prospective long-term follow-up study (Sponsor: Akershus University Hospital)
  • 2021- ExBiCVT Exploring the biology, treatment and prognosis of cerebral venous thrombosis (Sponsor: Akershus University Hospital)
  • 2021 – ICVTC International Cerebral Venous Thrombosis Consortium led by Jonathan Couthino, Netherland
  • 2021 – CVT-VITT Study Group CVT post-vaccine studies led by Jonathan Couthino, Netherland
  • 2021 - CVT-AIM CVT and Autoimmune diseases, led by Dr. Sini Hiltunen, Helsinki, Finland
  • 2022 – ICEBERG Imaging to CharacterizE Brain spontaneous & trauma hemorrhage, led by Prof. Bradley MacIntosh, Oslo, Norway and Toronto, Canada
  • 2023 - READOUT-ICH (Real-time radiology support to treat intracerebral hemorrhage), led by Prof. Bradley MacIntosh, Oslo, Norway and Toronto, Canada
  • 2023 - DO-IT target trial A retrospective follow-up study of thrombolysis in patients with recent DOAC ingestion, led by Thomas Meinel and prof. David Seiffge, Bern, Switzerland. National lead by Kristoffersen
  • 2023 - DO-IT registry, an international prospective academic registry to capture consecutive patients on DOACs qualifying for IVT, led by Thomas Meinel and prof. David Seiffge, Bern, Switzerland. National lead by Kristoffersen
  • 2023 - HEURECA Intracerebral Hemorrhage Recurrence Alliance, led by prof. David Seiffge, Bern, Switzerland

Recently completed randomized clinical trials

  • 2013-2016 NOR-TEST The Norwegian Tenecteplase Stroke Trial 2 Randomised Trial of Tenecteplase vs. Alteplase in Acute Ischemic Stroke (Sponsor: Haukeland University Hospital)

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(17)30253-3/fulltext

  • 2017-2021 TWIST Tenecteplase in Wake-up Ischaemic Stroke Trial. A multicentre, open-label, randomised controlled trial. (Sponsor: University of Northern Norway)

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00484-7/fulltext

  • 2019-2021 NOR-TEST 2 Tenecteplase versus alteplase for the management of acute ischaemic stroke in Norway (NOR-TEST 2, part A): a phase 3, randomised, open-label, blinded endpoint, non-inferiority trial (Sponsor: Haukeland University Hospital)

https://www.thelancet.com/article/S1474-4422(22)00124-7/fulltext

  • 2020-2022 AXIOMATIC Oral Factor XIa Inhibitor, for the Prevention of New Ischemic Stroke or New Covert Brain Infarction in Patients Receiving Aspirin and Clopidogrel Following Acute Ischemic Stroke or Transient Ischemic Attack (Sponsor: Bristol Myers Squibb)

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(23)00403-9/fulltext

  • 2021-2023 ELAN Early versus Later initiation of direct oral anticoagulants in post-ischaemic stroke patients with atrial fibrillation (Sponsor: University Hospital Bern)

https://www.nejm.org/doi/10.1056/NEJMoa2303048

Recently completed projects

  • 2020-2023 StrokePan Stroke during a pandemic, PI Kristoffersen, (Sponsor: Akershus University Hospital)
  • 2020-2023 The Global COVID-19 Stroke Registry led by Raul Nogueira, Pittsburg and Thanh Nguyen, Boston, US. PI Kristoffersen
  • 2021 – 2022 The Global COVID-19 CVT Registry led by Thanh Nguyen, Boston, US. PI Kristoffersen
  • 2022 – International DOAC-IVT, led by David Seiffge, Bern, Switzerland. PI Kristoffersen

Ongoing PhD projects

Jannicke Koldeus-Falch - Stroke of unknown cause: The impact of long-term heart monitoring on stroke recurrence in women. 2024-

Iselin T. S. Dahl -The Norwegian Cerebral Venous Thrombosis study (NoCVT) - a long-term follow-up. 2024-

Silje Holt Jahr - Fast track ischemic stroke patients. A study of prehospital and intrahospital predictors of thrombolysis and functional outcome. The Akershus Study of Ischemic Stroke and Thrombolysis-1 (ASIST-1). 2019-

Maiken N. Selseth - Large vessel occlusion in a Norwegian population, imaging-based treatment selection and functional prognosis after stroke. The Akershus Study of Ischemic Stroke and Thrombolysis-1 (ASIST-1). 2021-

Kristin Tveitan Larsen – Prehospital blood pressure in intracerebral hemorrhage. The Akershus Study of Ischemic Stroke and Thrombolysis-1 (ASIST-1). 2017-

Elin J Bergh - The introduction of the pathway of stroke care from onset of symptoms until 3 months poststroke. Life after stroke study. A Norwegian long-term follow-up project (LAST-long). 2020-

Loreta Skrebelyte-Strøm - PRediction and detection of Occult Atrial fibrillation in patients after acute Cryptogenic stroke and Transient Ischemic Attack. 2015-

Elisabeth Forfang – Study of antithrombotic treatment after intracerebral haemorrhage. 2016-

Societetal Contributions

Chapter in Medisinsk ultralyddiagnostikk, 2016 ISBN: 9788205490178

Utarbeidelse av Nasjonal retningslinjer for hjerneslag (arbeidsgruppeleder)

Fagansvarlig for kapittel om Hjerneslag i NEVRONEL

Slagskole for slagpasienter med nylig gjennomgått hjerneslag og deres pårørende i Ahus’ opptaksområde

Infrastructure

We provide the highest level of stroke services (comprehensive stroke center) according to criteria set by the European Stroke Organisation, except for neurosurgery, and serve a catchment area of 600.000 inhabitants, and for thrombectomy a 24/7 service for 1.000.000 inhabitants.

The senior consultants are all experts in stroke medicine, and most have done and are doing research in cerebrovascular projects.

The number of stroke patients, the size of the hospital, the competent staff and the standardized path of stroke treatment facilitates research in stroke. In addition the hospital provides biobank service and a large research department to assist in stroke studies.

Members

Leader

Ole Morten Rønning

Ole Morten Rønning

MD, PhD

Professor II

Associate Professor

Espen Saxhaug Kristoffersen

Espen Saxhaug Kristoffersen

MD, PhD

Ass. professor

Researchers

No researchers

Post.doc.

Marianne Altmann

Marianne Altmann

MD, PhD

Post.doc.

PhD Students

Elin Bergh

Elin Bergh

MD

PhD student

Elisabeth Forfang

Elisabeth Forfang

MD

PhD student

Iselin Dahl

Iselin Dahl

MD

PhD student

Jannicke Koldeus-Falch

Jannicke Koldeus-Falch

MD

PhD student

Kristin Larsen

Kristin Larsen

MD

PhD student

Loreta Skrebelyte-Strøm

Loreta Skrebelyte-Strøm

MD

PhD student

Maiken Selseth

Maiken Selseth

MD

PhD student

Silje H. Jahr

Silje H. Jahr

MD

PhD student

Doctors in research

No doctors in research.

Other

No other roles.

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