Roman Herzig

Roman Herzig
Charles University in Prague | CUNI · Department of Neurology (Hradec Králové)

Prof., MD, PhD, FESO, FEAN

About

305
Publications
24,330
Reads
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3,022
Citations
Additional affiliations
April 2015 - present
University Hospital, Hradec Králové, Czech Republic
Position
  • Head of the Comprehensive Stroke Center
April 2014 - present
Faculty of Medicine, Charles University, Hradec Králové, Czech Republic
Position
  • Senior Researcher
April 2014 - March 2015
University Hospital, Hradec Králové, Czech Republic
Position
  • Consultant

Publications

Publications (305)
Article
Full-text available
Background The benefit of intravenous thrombolysis is time dependent. It remains unclear, however, whether dramatic shortening of door‐to‐needle time (DNT) among different types of hospitals nationwide does not compromise safety and still improves outcome. Methods and Results Multifaceted intervention to shorten DNT was introduced at a national le...
Article
Background Insight in differences in patient outcomes between endovascular thrombectomy (EVT) centers can help to improve stroke care. We assessed between-center variation in functional outcome of patients with acute ischemic stroke who were treated with EVT. We analyzed to what extent this variation may be explained by modifiable center characteri...
Article
Full-text available
Background and aims Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by disease-associated variants in the alpha-galactosidase A gene ( GLA ). FD is a known cause of stroke in younger patients. There are limited data on prevalence of FD and stroke risk in unselected stroke patients. Methods A prospective nationwide study inc...
Article
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Background and aim Carotid plaque progression contributes to increasing stroke risk. The study aims to identify factors influencing carotid plaque thickness progression after changing the preventive treatment to the ‘treating arteries instead of risk factors’ strategy, that is, change in treatment depending on the progression of atherosclerosis. M...
Article
Full-text available
Real-world data report worse 3-month clinical outcomes in elderly patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). The aim was to identify factors influencing clinical outcome in elderly patients with anterior circulation AIS treated with MT (±intravenous thrombolysis (IVT)). In a retrospective, monocentric study...
Article
Objective To test the hypothesis that intravenous thrombolysis (IVT) treatment prior to endovascular thrombectomy (EVT) is associated with better outcomes in patients with anterior circulation large artery occlusion (LAO) stroke, we examined a large real-world database, the SITS-International Stroke Thrombectomy Register (SITS-ISTR). Methods We id...
Article
Full-text available
Background and objective We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS‐ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. Methods We identified centres recording...
Article
Shear-wave elastography (SWE) is a novel ultrasound technique for quantifying tissue elasticity. The aim of this study was to identify differences in atherosclerotic plaque elasticity measured using SWE among individuals with symptomatic, asymptomatic progressive and asymptomatic stable carotid plaques. Consecutive patients from the Atherosclerotic...
Article
Introduction Knowledge of the implementation gap would facilitate the use of intravenous thrombolysis in stroke, which is still low in many countries. The study was conducted to identify national implementation targets for the utilisation and logistics of intravenous thrombolysis. Material and Method Multicomponent interventions by stakeholders in...
Article
Objectives Transcranial color‐coded duplex sonography (TCCS) enables to measure blood flow characteristics in cerebral vessels, including vascular resistance and pulsatility. The study aims to identify factors influencing pulsatility (PI) and resistance (RI) indices measured using TCCS in patients with carotid atherosclerosis. Methods Self‐suffici...
Article
Full-text available
Anterior circulation stroke (ACS) is associated with typical symptoms, while posterior circulation stroke (PCS) may cause a wide spectrum of less specific symptoms. We aim to assess the correlation between the initial presentation of acute ischemic stroke (AIS) symptoms and the treatment timeline. Using a retrospective, observational, single-center...
Article
Aim: Early identification of patients at higher risk of unstable atherosclerotic plaque development is essential for successful preventive treatment. The aim of the study was to identify the duplex sonography carotid atherosclerotic plaque risk characteristics for plaque progression. Methods: All patients who underwent regular sonographic examinati...
Article
Full-text available
The aim of this mini-review is to discuss the main antiplatelet agents that have been successfully used in the secondary prevention of non-cardioembolic ischemic stroke and transient ischemic attacks (TIA). The methodology is based on a literature review of available peer-reviewed English studies listed in PubMed. The findings reveal that aspirin r...
Article
This article describes policy processes that have led to the re-organisation of stroke care in the Czech Republic since 2011, which has been part of a broader process of care concentration in several medical fields. Currently, stroke care is provided by 13 Comprehensive and 32 Primary Stroke Centres. The paper explains factors that supported the re...
Article
Full-text available
We aimed was to assess the factors influencing therapy choice and clinical outcome after 3–4 months in patients with cerebral venous sinus thrombosis (CVST). In a retrospective, bi-centric study, the set consisted of 82 consecutive CVST patients (61 females; mean age 33.5 ± 15.7 years). Following data were collected: baseline characteristics, prese...
Article
Purpose Cerebral blood flow volume is an important factor for the accurate diagnosis of neurovascular diseases and treatment indication. This study aims to assess correlations of blood flow volume measurements in cervical and intracranial arteries between duplex sonography and quantitative magnetic resonance angiography (qMRA). Materials and Method...
Article
Full-text available
A-Study Design, B-Data Collection, C-Statistical Analysis, D-Data Interpretation, E-Manuscript Preparation, F-Literature search, G-Funds Collection Background. The fear of falling (FoF) refers to a lack of self-confidence that normal activities can be performed without falling. FoF represents an important psychological factor at an older age. Objec...
Article
Full-text available
Aim: The aim of a prospective multicenter study was to determine whether the risk of developing a new ischemic brain lesion on control MRI is dependent on some of the characteristics of atherosclerotic plaque detected by duplex sonography, MRI and CTA. Materials and methods: Patients with internal carotid artery stenosis (70–95%) indicated for caro...
Article
Objectives: This study explored the quality of life (QoL) and attitudes to aging in older adults with and without dementia, and ascertained the main factors that predict QoL and attitude to ageing. Methods: A cross-sectional study involving 563 community-dwelling adults with (PwD) and without dementia (PwoD) >60 years of age was conducted in three...
Article
Aim: Intraplaque hemorrhage (IPH) belongs to potential mechanisms of plaque instability subsequently leading to ischemic stroke. Study aims to compare the IPH occurrence in patients with symptomatic (SS), asymptomatic stable (AS) and asymptomatic progressive (AP) internal carotid artery (ICA) stenosis ≥ 50%. Materials and methods: Serial duplex ult...
Article
Full-text available
Introduction: A fear of falling marks an important psychological factor connected with a reduction in the life space of people with dementia. The Czech version of the Falls Efficacy Scale-International (FES-I) has not been validated in patients with early-stage dementia. Methods: The tests were administered to 282 patients with early-stage demen...
Article
Full-text available
Aim: Nerve injuries, wound complications and poor cosmetic results still have an important impact on the patient’s outcome after carotid endarterectomy (CEA). The study aimed to compare 30-day morbidity and cosmetic outcome between patients undergoing CEA using short longitudinal incision (SLI) and transverse skin incision (TSI). Patients and meth...
Article
OBJECTIVE: Silent and symptomatic cerebral infarctions occur in up to 34% of patients after carotid endarterectomy (CEA). This prospective study compared the risk of new brain infarctions detected by magnetic resonance imaging (MRI) in patients with internal carotid artery stenosis undergoing CEA with local anesthesia (LA) vs general anesthesia (G...
Article
Full-text available
Background Cerebral blood flow volume (BFV) is important factor for accurate diagnosis of neurovascular diseases and treatment indication. Study aims to assess correlations of BFV measurements in cervical and intracranial arteries between quantitative magnetic resonance angiography (qMRA) and duplex sonography. Methods Consecutive patients with su...
Article
Full-text available
Background The results of treatment for spinal dural arteriovenous fistula (SDAVF) have been controversial. The goal of this study was to compare results of endovascular and surgical treatments to contribute to determining an optimal treatment strategy. Methods A retrospective analysis of the set of 24 SDAVF patients (11 in the endovascular and 13...
Article
Full-text available
BACKGROUND: The results of treatment for spinal dural arteriovenous fistula (SDAVF) have been controversial. The goal of this study was to compare results of endovascular and surgical treatments to contribute to determining an optimal treatment strategy. METHODS: A retrospective analysis of the set of 24 SDAVF patients (11 in the endovascular and 1...
Article
Full-text available
Aim: To assess the safety and efficacy of mechanical thrombectomy (MT) with stent-retrievers in anterior circulation stroke (ACS) patients due to the occlusion of major cerebral arteries, and to compare the results achieved in patients on oral anticoagulation (OAC) and those not on OAC. Materials and methods: The present retrospective study comp...
Article
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Abstract Introduction:The presence of silent cerebral infarction (SCI) might cause cognitive dysfunction, psychiatric disorders, clinical stroke and increase mortality. Exact incidence and prevalence of SCI is still not clear. The results of previous published clinical trials vary. The aims of our study were to detect acute and subacute SCI using m...
Article
Full-text available
Background and Purpose Experienced multidisciplinary stroke team and well-organized hospital management are considered necessary to achieve good results after mechanical thrombectomy (MT) in acute ischemic stroke patients. We analyzed the technical results of MT performed in the Czech Republic in the year 2016 to provide relevant data for further q...
Article
Background/aims: The aim of this study was to perform a psychometric validation of the Czech version of the Quality of Life - Alzheimer's Disease scale (QoL-AD) for patients with early-stage dementia. Methods: The sample included 212 patient-proxy pairs. For convergent validity, the Czech version of the Bristol Activities of Daily Living Scale (...
Article
Full-text available
Aim: The chance of a good result of mechanical thrombectomy (MT) for a large cerebral artery occlusion is directly proportional to the speed of its execution. The aim was to find differences in outcome in patients transported primarily and secondarily to the Comprehensive Stroke Center (CSC) of the University Hospital Hradec Králové. Patients and M...
Article
Background: Intravenous thrombolysis (IVT) is contraindicated in patients with acute ischemic stroke (AIS) using oral anticoagulants. A specific human monoclonal antibody was introduced to reverse immediately the anticoagulation effect of the direct inhibitor of thrombin, dabigatran. Until now, mostly individual cases presenting with successful IV...
Article
Background: Silent brain infarcts can be detected on magnetic resonance imaging (MRI) in ~22% of patients after coronary angioplasty and stenting (CS). The effect of periprocedural sonolysis on the risk of new brain infarcts during CS was examined. Methods: Patients undergoing elective CS were allocated randomly to a bilateral sonolysis group (7...
Article
Full-text available
Background Quality of life (QoL) is one of the main endpoints in stroke prevention or acute stroke treatment studies. The aim of the current study was to identify risk factors affecting the QoL of patients with carotid stenosis in stroke prevention. Methods Self-sufficient patients (50–80 years of age) with ≥20% carotid artery stenosis followed in...
Poster
Full-text available
The aim of this prospective study was to evaluate the frequency and subtype of microembolic signals (MES) detected using transcranial Doppler monitoring (TCD) in patients undergoing elective coronary angiography, angioplasty, and/or stenting, and examine their correlation with asymptomatic and symptomatic brain ischemic lesions detected on control...
Conference Paper
Full-text available
Background: Silent brain ischemic lesions can bedetected on magnetic resonance imaging (MRI) in as many as 22% of patients after coronary angioplasty and stenting (CS). The effect of periprocedural sonolysis on the risk of new brain ischemic lesions during CS was examined. Material and Methods: Patients undergoing elective CS were allocated randoml...
Article
Full-text available
Background: In randomized clinical trials (RCTs) mechanical thrombectomy (MT) was proved to be a highly effective and safe treatment in acute ischemic stroke. Its efficacy and safety in routine practice needs to be documented. Methods: Available nationwide 2016 data for the Czech Republic (CR) from SITS-TBY registry of patients with terminal intern...
Article
Full-text available
Introduction: Causality of marijuana abuse with development of ischemic stroke has been indicated by numerous case reports and epidemiological studies. As a possible pathophysiological mechanism, the most common consideration is cardiac embolization during paroxysmal atrial fibrillation, systemic hypotension or multifocal intracerebral vasoconstri...
Article
Full-text available
Background: Endovascular therapy (EVT) with stent retrievers has been shown to be superior and safe (in the anterior circulation) in comparison to intravenous thrombolysis (IVT) alone or no specific therapy. We compared clinical outcome between patients undergoing EVT admitted directly to comprehensive stroke centers (CSCs) and patients transferred...
Article
Full-text available
Background:The composition of intra-arterial clots might influence the efficacy of mechanical thrombectomy (MT) in ischemic stroke (IS) due to the acute occlusions within large cerebral arteries. The aims were to assess the factors associated with blood clot structure and the impact of thromboembolus structure on MT using stent-retrievers in patien...
Article
Full-text available
Background – Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. Methods – Available nationwide data for the CR from the year 2016 from th...
Article
Full-text available
Purpose: We aimed to assess the safety and effectiveness of mechanical recanalization in patients with ischemic stroke in the anterior circulation within 8 h since symptoms onset and with unknown onset time. We compared time intervals <6 h vs. 6-8 h/unknown onset time, as only limited data are available for a time window beyond 6 h. Methods: Our...
Article
Full-text available
Introduction: Mechanical thrombectomy (MT) has been established as a standard of care in acute ischaemic stroke. We systematically evaluated all stroke centres conducting MT i. The Czech Republic. Methods: An online questionnaire based. The International Multi-Society Consensus Document was distributed to all such centres to monitor al. The procedu...
Article
Full-text available
Introduction: Mechanical thrombectomy (MT) has been established as a standard of care in acute ischaemic stroke. We systematically evaluated all stroke centres conducting MT in the Czech Republic. Methods: An online questionnaire based on the International Multi-Society Consensus Document was distributed to all such centres to monitor all the proce...
Article
Full-text available
We describe a rare case of a woman, in whom dis section of both carotides, as well as both vertebral arteries occur red i. The period between 2005 and 2015 (f. The first time a. The age of 32 years). Occlusive dis section developed in all occasions excep. The right internal carotid artery that was treated with angioplasty and stenting. In spite of...
Article
Full-text available
Background: Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe...
Article
Full-text available
RNF213/Mysterin has been identified as a susceptibility gene for moyamoya disease, a cerebrovascular disease characterized by occlusive lesions in the circle of Willis. The p.R4810K (rs112735431) variant is a founder polymorphism that is strongly associated with moyamoya disease in East Asia. Many non-p.R4810K rare variants of RNF213 have been iden...
Data
Native brain computed tomography of II-2 in Family 1. (DOCX)
Data
Repeated MRI imaging (DWI) of II-2 in Family 1. (DOCX)