Neurosciences Network

Stroke

The Stroke team is a multi-disciplinary service that includes Medical, Nursing, Allied Health, Neuro-Technicians, Neuropsychology Administration Services and students, with research undertaken across the service. Our research focuses on time critical treatments (within first few hours of onset of stroke symptoms), and the service participates in research in acute stroke treatments and secondary prevention studies. Our research team meets fortnightly and is currently working on the development of real-time recording of our stroke performance parameters to aid the improvement in the care of stroke patients.

The Stroke Service was responsible for establishing a Stroke Research Database, in 1997, which currently includes data from more than 10,000 patients. Examples of current research include a trial studying a novel blood thinning medication with the aim to reduce recurrent strokes. This would significantly benefit stroke patients, who are at higher risk of experiencing future strokes. Also currently underway is an investigator-led trial in the treatment of fatigue after stroke, and a further five clinical trials.

We have partnerships with other departments within the hospital such as Radiology, Interventional Radiology, Emergency, Paramedics, Intensive Care Unit, Pharmacy, and Pathology Services, and with other stroke centres across Australia, for example Royal Melbourne Hospital. We work closely together with other institutions including Macquarie University, George Institute and the Florey Institute. We collaborate with international pharmaceutical companies in projects for the development of new treatments.

Key staff members include Associate Professor Martin Krause, Dr Miriam Priglinger-Coorey, Sheila Jala, Elizabeth O’Brien, Carin Bertmar, Susan Day & Rita Marando.

Selected publications

https://pubmed.ncbi.nlm.nih.gov/31067369/

Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke.

Campbell BCV, et al. Among authors: Krause m. N Engl J Med. 2018. PMID: 29694815 Clinical Trial.

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke.

Ma H, et al. Among authors: Krause m. N Engl J Med. 2019. PMID: 31067369 Clinical Trial.

https://pubmed.ncbi.nlm.nih.gov/25671797/

Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source.

Diener HC, et al. N Engl J Med. 2019.

Jala, S. and O'Brien, E.2019. Treatment With Intravenous Alteplase for Acute Ischaemic Stroke After reversal of Dabigatran With Idarucizumab: A Case Study Journal of Neuroscience Nursing https://journals.lww.com/jnnonline/Fulltext/2019/02000/Treatment_With_Intravenous_Alteplase_for_Acute.7.aspx

Leung, KY/ 2018. Malignant middle cerebral artery infarct: A clinical case report, Australasian Journal of Neuroscience https://www.anna.asn.au/wp-content/uploads/AJoN-May-2018.pdf

Jala, S. et al, 2019. “In Safe Hands" – A costly integrated care program with limited benefits in stroke unit care. Journal of Clinical Neuroscience https://doi.org/10.1016/j.jocn.2018.10.135

Neurology

The Neurology team at NSLHD has interest in a broad range of research, ranging from the laboratory to clinical research. The Neurogenetics Team has a proven track record of successful NHMRC grants, with research ranging from the mitochondrial disorders to Parkinson’s disease. The unit has recently commenced a world first placebo controlled drug trial in Dominant Optic Atrophy. Stroke research is world class, with studies on clot busting and clot retrieval therapies. Our Neurophysiology research has lead to multiple prizes from academic institutes, and includes some novel techniques not available elsewhere in the country. Migraine has recently become a major research interest, with novel international trials commencing.

Our tertiary referral clinics for Parkinson’s Disease and mitochondrial diseases are the largest in NSW, and the Multiple Sclerosis Clinic has one of the largest databases in Sydney. These clinics provide an opportunity to integrate research with clinical care by our teams of neurologists, trainees, nurses and Allied Health Staff.

Key partners in this research include the University of Sydney, Macquarie University, NHMRC, MITO Foundation and many other colleagues, industry groups and supporters.