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School of Medicine

Dr Pippa Tyrrell MD, FRCP

Senior Lecturer in Stroke Medicine

Stroke Medicine
Clinical Sciences Building
Salford Royal Hospitals' Foundation Trust
Salford
M6 8HD

 

Role

I am Senior Lecturer in Stroke Medicine and Honorary Consultant Stroke Physician at Salford Royal Foundation Hospitals' NHS Trust. I am a member of the Cardiovascular Group within the School of Biomedicine, lead the Brain Injury Research Group, and am Clinical Lead for the NW Stroke Research Network. I was Clinical Advisor to the NICE Acute Stroke Guidelines (2006-8), and am now Associate Director of the Stroke Programme at the Royal College of Physicians with responsibility for the National Stroke Audit (SINAP). I am Clinical Lead for the Greater Manchester and Cheshire Stroke Clinical Network. I was a member of the Stroke Association Scientific Committee from 2006-10, and am a member of the Executive Committee of the British Association of Stroke Physicians. I am Chair of the Stroke Association Scientific Committee (2012-).

 

Memberships of Committees and Professional Bodies

  • Member of the Scientific Committee, The Stroke Association (2006-2010)
  • Member of the Scientific Committee, British Association of Stroke Physicians 2000-2003; 2004-2007
  • Member of the British Association of Stroke Physicians
  • Member of the Executive Committee, British Association of Stroke Physicians
  • Member IDSMC: STASH study
  • Member, IDSMC, NIHR funded DARS study
  • Clinical Lead, SINAP (RCP) and Associate Director, Stroke Programme, Royal College of Physicians
  • Clinical Lead, GM Clinical Stroke Network
  • Steering Committee, Stroke 90-10
  • Chair, Scientific Committee, The Stroke Association, 2012-

Research

I am Clinical Lead for an internationally leading programme of Translational Research with colleagues in Faculty of Life Sciences (Professor Dame Nancy Rothwell, Dr Stuart Allan) and Biomedicine (Dr Stephen Hopkins, Dr Adrian Parry Jones, Mr Andrew King). We are studying the inflammatory response to stroke and subarachnoid haemorrhage, and its modulation by the naturally occurring cytokine antagonist, IL-1RA. Our studies have demonstrated the variability of the immune response to stroke and its association with clinical outcome, the relationship between inflammation and delayed cerebral ischaemic following subarachnoid haemorrhage; the association of the inflammatory response with outcome following TIA; the penetration of IL-1RA administered intravenously into central CSF, the pharmacokinetics of CSF penetration; the effect of iv IL-1RA on CSF biomarkers of inflammation and the impairment of the immune response following stroke and its reversal with IL-1RA. We are currently undertaking a study to evaluate whether subarachnoid haemorrhage is a valid model for stroke, working to ensure that animal and clinical experimental models of stroke and SAH are as closely linked as possible. We have also demonstrated MR evidence of microvascular angiopathy in patients at risk of stroke, together with elevated PK11195 (PET) binding in these patients. This has led to a "reverse translation" study where co-morbid animals have undergone PET studies showing similar  distribution of microglial activation.

I am Clinical Lead for the Stroke Implementation theme of the Greater Manchester CLARHC. We have developed a 6 month post stroke assessment tool, the GM-SAT, which is currently undergoing evaluation. It has been presented at the DH Stroke Improvement Programme and is being evaluated nationally by the Stroke Association. I am working with the systems theme of CLARHC (Prof Iain Buchan) to develop computer modelling of stroke care pathways. As Clinical Lead for the Stroke redesign in GM, and lead nationally for the Stroke Audit (SINAP), I am keen to develop modelling to assess the clinical benefit of service redesign.

I am involved in a number of stroke rehabilitation studies, including studies of stroke dysphagia (with Dr Shaheen Hamdy), of  mirror therapy for stroke (with Dr Sarah Tyson, University of Salford) and orthotics after stroke. These are funded RfPB studies.

 

Methodological Knowledge

As lead for a translational programme of stroke research I have expertise in the design and conduct of difficult clinical trials in vulnerable groups, together with observational studies of inflammatory markers in plasma and CSF. I am aware of many of the pitfalls and difficulties of biomarker studies particularly inflammatory biomarkers. I have expertise in the design of imaging (MR and PET) studies in cerebrovascular disease, and in the basic science underlying the translational aspects of my work.

My role as Clinical Lead for the NW Stroke LRN means that I have experience in the adoption, design and conduct of a wide variety of RCTs and other well designed studies in stroke and subarachnoid haemorrhage. I am able to assess the feasibility of studies in a variety of service providers (Trusts) and understand the relationships between the Comprehensive Local Research Networks and the Topic Specific networks nationally. I have expertise in patient and public involvement through the clinical and research networks, and am frequently asked to talk to public groups about both research and clinical practice.

I have extensive clinical expertise in acute stroke and stroke rehabilitation, with a very active clinical practice including 24/7 cover for acute interventions, and I am nationally recognised as an expert in stroke care. I wrote the NICE Acute Stroke and TIA guideline in 2008, and I am lead for SINAP, the national stroke audit. I am a member of the Steering group for the Stroke 90-10 Improvement Collaborative project, and have expertise in Quality Improvement for clinical practice and research.

I have expertise in stroke rehabilitation studies, particularly dysphagia studies, as well as a specific interest in post stroke pain. I have expertise in implementation research and I am familiar with the role of qulaitative research in rehabilitation studies. I have been involved in the development of functional electrical stimulation studies with Dr laurence Kenney.

I have supervised a PhD student in inflammation and mild cognitive impirment and have expertise in some aspects of degenerative dementias.

 

Teaching

I teach undergraduate and post graduate students in stroke medicine. I am an Academic Advisor to 6 currently year 1 students, supervise year 1 Student Selected Components as part of the PEP programme, and teach year 2 students on the neurosciences module. I organise the year 3 Mind and Movement stroke afternoons, and teach on the year 5 revision course. I supervise 2 year 4 Project Option students each year. I am a tutor on the Pre Foundationer Communication Skills course and undertake ward teaching.

I teach FY1 and FY2 doctors, and lecture to postgraduates in neurology and geriatric medicine. I helped to set up the Stroke speciality training programme in the NW deanery and am Educational Supervisor to 1 trainee per year.

I have helped to develop  the Stroke network organised MSc programme for stroke nurses and AHPs.

 

Biography

I graduated from the University of Cambridge in 1978 with a first in Medical Sciences, and from the University of London (London Hospital Medical College) in 1981. I trained in General Medicine and Neurology in London (St Bartholomew's Hospital and St Mary's). From 1986-90 I was a Research Fellow at the MRC Cyclotron Unit, London and National Hospital Queen Square, where I studied the relationship between clinical features and PET scan appearances in various forms of degenerative dementia. As a Senior Registrar in Geriatric and General Medicine in London I became interested in stroke, and after completing clinical training in Manchester in  1995,  I was  appointed Consultant in Stroke Medicine in Salford. I was the first designated Stroke Physician in Manchester, and set up a nationally leading stroke service singlehandedly. In 1999, I was awarded my first research grant in collaboration with Professor Nancy Rothwell and was appointed Senior Lecturer in the University of Manchester in 2006. I am Clinical Lead to the Greater Manchester Clinical Stroke Network and have led a nationally leading redesign of stroke services. I was Clinical Advisor to the NICE guideline on Acute Stroke and TIA 2006-8, and lead the National Stroke Audit (SINAP) at the RCP. I was  RGL to the Clinical Neurosciences Group 2006-2009; Clinical Neurosciences Clinical Governance Lead 2004-2007;  and am Clinical Lead, NW Stroke Research Network. This is the leading Stroke LRN for recruitment into RCTs and has brought clinicians from across the NW into research. I led the recent successful bid for a Hyperacute Stroke Research Centre at SRFT. I am the Research Lead for the Brain Injury Research Group and undertake  translational research with Professor Nancy Rothwell, Dr Stuart Allan  and Dr Steve Hopkins in neuroinflammation in stroke and subarachnoid haemorrhage. I am involved in studies on stroke dysphagia, quality improvement in stroke and rehabiliatation studies in stroke and brain injury. I  lead  the Stroke Implementation Programme of the GM CLARHC. I am recognised nationally and regionally as an expert in clinical stroke management and lead an exciting and productive research programme. I am also very involved in the delivery of stroke services within SRFT to a high standard, improving delivery of acute services including  thrombolysis and interventional procedures to patients from across the NW.

 

Qualifications

  • BA (Hons) 1st Class University of Cambridge 1978
  • MB. BS (Hons) University of London 1981
  • MA (Cantab) 1982
  • MD (University of London) 1991
  • FRCP (London) 2000
 

Collaborators and affiliated staff

Faculty of Life Sciences:

Professor Dame Nancy Rothwell

Dr Stuart Allan

Dr Herve Boutin

School of Biomedicine:

Dr Stephen Hopkins

Mr Andrew King

Dr Adrian Parry-Jones

School of Translational Medicine:

Professor Anthony Jones

Dr Shaheen Hamdy

Salford Royal Foundation Trust:

Mr Andy Vail

Mr Hiren Patel

Mr James Galea

Mr Navneet Singh

Mrs Sharon Hulme

GM CLARHC

Professor Bonnie Sibbald

Professor Ruth Boaden (MBS)

Dr David Bamford (MBS)

Prof Iain Buchan

Ms Joanne Thomas

Ms Katy Rothwell

Imaging Science:

Professor Alan Jackson

Psychiatry:

Professor Alistair Burns

University of Salford

Dr Sarah Tyson

Dr Laurence Kenney

 University of Sheffield:

Professor David Crossman

University of London

Professor Anthony Rudd

Professor Charles Wolfe

Professor Naomi Fillup

 

Publications

2011

  • Brough, D., Tyrrell, P. & Allan, S (2011). Regulation of interleukin-1 in acute brain injury. Trends Pharmacol Sci, 32(10), 617-22. eScholarID:148156 | PMID:21788085 | DOI:10.1016/j.tips.2011.06.002
  • Dennis, M., Mordi, N., Graham, C., Sandercock, P. & . (2011). The timing, extent, progression and regression of deep vein thrombosis in immobile stroke patients: observational data from the CLOTS multicenter randomized trials. J Thromb Haemost, 9(11), 2193-200. eScholarID:148157 | PMID:21883879 | DOI:10.1111/j.1538-7836.2011.04486.x
  • Drake, C., Boutin, H., Jones, M., Denes, A., McColl, B., Selvarajah, J., Hulme, S., Georgiou, R., Hinz, R., Gerhard, A., Vail, A., Prenant, C., Julyan, P., Maroy, R., Brown, G., Smigova, A., Herholz, K., Kassiou, M., Crossman, D., Francis, S., Proctor, S., Russell, J., Hopkins, S., Tyrrell, P., Rothwell, N. & Allan, S (2011). Brain inflammation is induced by co-morbidities and risk factors for stroke. Brain Behav Immun, 25(6), 1113-22. eScholarID:148132 | PMID:21356305 | DOI:10.1016/j.bbi.2011.02.008
  • Drake, C., Boutin, H., Jones, M., Denes, A., McColl, B., Selvarajah, J., Hulme, S., Georgiou, R., Hinz, R., Gerhard, A., Vail, A., Prenant, C., Julyan, P., Maroy, R., Brown, G., Smigova, A., Herholz, K., Kassiou, M., Crossman, D., Francis, S., Proctor, S., Russell, J., Hopkins, S., Tyrrell, P., Rothwell, N. & Allan, S (2011). Brain inflammation is induced by co-morbidities and risk factors for stroke. Brain Behavior and Immunity, 25(6), 1113-1122. eScholarID:133268 | DOI:10.1016/j.bbi.2011.02.008
  • Galea, J., Ogungbenro, K., Hulme, S., Greenhalgh, A., Aarons, L., Scarth, S., Hutchinson, P., Grainger, S., King, A., Hopkins, S., Rothwell, N. & Tyrrell, P (2011). Intravenous anakinra can achieve experimentally effective concentrations in the central nervous system within a therapeutic time window: results of a dose-ranging study. J Cereb Blood Flow Metab, 31(2), 439-47. eScholarID:148148 | PMID:20628399 | DOI:10.1038/jcbfm.2010.103
  • Galea, J., Ogungbenro, K., Hulme, S., Greenhalgh, A., Aarons, L., Scarth, S., Hutchinson, P., Grainger, S., King, A., Hopkins, S., Rothwell, N. & Tyrrell, P (2011). Intravenous anakinra can achieve experimentally effective concentrations in the central nervous system within a therapeutic time window: results of a dose-ranging study. JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 31(2), 439-447. eScholarID:128415 | DOI:10.1038/jcbfm.2010.103
  • Kirkman, M., Greenwood, N., Singh, N., Tyrrell, P., King, A. & Patel, H (2011). Difficulties with recruiting into neurosurgical clinical trials: the Surgical Trial in IntraCerebral Haemorrhage II as an example. Br J Neurosurg, 25(2), 231-4. eScholarID:148143 | PMID:21344959 | DOI:10.3109/02688697.2010.539718
  • Selvarajah, J., Smith, C., Hulme, S., Georgiou, R., Sherrington, C., Staniland, J., Illingworth, K., Jury, F., Payton, A., Ollier, W., Vail, A., Rothwell, N., Hopkins, S. & Tyrrell, P (2011). Does inflammation predispose to recurrent vascular events after recent transient ischaemic attack and minor stroke? The North West of England transient ischaemic attack and minor stroke (NORTHSTAR) study. Int J Stroke, 6(3), 187-94. eScholarID:148145 | PMID:21557802 | DOI:10.1111/j.1747-4949.2010.00561.x
  • Selvarajah, J., Smith, C., Hulme, S., Georgiou, R., Sherrington, C., Staniland, J., Illingworth, K., Jury, F., Payton, A., Ollier, W., Vail, A., Rothwell, N., Hopkins, S. & Tyrrell, P (2011). Does inflammation predispose to recurrent vascular events after recent transient ischaemic attack and minor stroke? The North West of England transient ischaemic attack and minor stroke (NORTHSTAR) study. International Journal of Stroke, 6(3), 187-194. eScholarID:133266 | DOI:10.1111/j.1747-4949.2010.00561.x

2010

  • Greenhalgh AD, Galea J, Denes A, Tyrrell PJ, Rothwell NJ. (2010). Rapid Brain Penetration of interluekin-1 receptor antagonist in rat cerebral ischaemia: pharmacokinetics, distribution, protection. Br J Pharmacol, 160, 153-159. eScholarID:85130 | DOI:10.1111/j.1476-5381.2010.00684.x
  • Greenhalgh, A., Galea, J., Dénes, A., Tyrrell, P. & Rothwell, N (2010). Rapid brain penetration of interleukin-1 receptor antagonist in rat cerebral ischaemia: pharmacokinetics, distribution, protection. Br J Pharmacol, 160(1), 153-9. eScholarID:148154 | PMID:20412072 | DOI:10.1111/j.1476-5381.2010.00684.x
  • James Galea, Kayode Ogungbenro, Sharon Hulme, Andrew Greenhalgh, Leon Aarons, Sylvia Scarth, Peter Hutchinson, Samantha Grainger, Andrew King, Stephen J Hopkins, Nancy Rothwell, Pippa Tyrrell. (2010). Intravenous anakinra can achieve experimentally effective concentrations in the central nervous system within a therapeutic time window: results of a dose-ranging study. J Cereb Blood Flow Metab, eScholarID:106697 | DOI:10.1038/jcbfm.2010.103
  • Jayasekeran, V., Singh, S., Tyrrell, P., Michou, E., Jefferson, S., Mistry, S., Gamble, E., Rothwell, J., Thompson, D. & Hamdy, S (2010). Adjunctive functional pharyngeal electrical stimulation reverses swallowing disability after brain lesions. Gastroenterology, 138(5), 1737-46. eScholarID:148131 | PMID:20138037 | DOI:10.1053/j.gastro.2010.01.052
  • Jayasekeran, V., Singh, S., Tyrrell, P., Michou, E., Jefferson, S., Mistry, S., Gamble, E., Rothwell, J., Thompson, D. & Hamdy, S (2010). Adjunctive Functional Pharyngeal Electrical Stimulation Reverses Swallowing Disability After Brain Lesions. GASTROENTEROLOGY, 138(5), 1737-U22. eScholarID:128404 | DOI:10.1053/j.gastro.2010.01.052
  • Jayaskeran V, Singh S, Tyrrell P, Michou E, Jefferson S, Mistry S, Gamble E, Rothwell J, Thompson D, Hamdy S. (2010). Adjunctive functional pharyngeal electrical stimulation reverses swallowing disorders following brain lesions. Gastroenterology, 138, 1737-46. eScholarID:85138
  • Parry-Jones, A., Boutin, H., Denes, A., McColl, B., Hopkins, S., Allan, S. & Tyrrell, P (2010). Interleukin-1 Receptor Antagonist in Animal Models of Stroke: A Fair Summing Up? JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 19(6), 512-513. eScholarID:128410 | DOI:10.1016/j.jstrokecerebrovasdis.2010.01.005
  • Robinson, T., Potter, J., Ford, G., Bulpitt, C., Chernova, J., Jagger, C., James, M., Knight, J., Markus, H., Mistri, A., Poulter, N. & . (2010). Effects of antihypertensive treatment after acute stroke in the Continue or Stop Post-Stroke Antihypertensives Collaborative Study (COSSACS): a prospective, randomised, open, blinded-endpoint trial. Lancet Neurol, 9(8), 767-75. eScholarID:148146 | PMID:20621562 | DOI:10.1016/S1474-4422(10)70163-0
  • Smith CJ, Tyrrell PJ. (2010). Current and Emerging Treatments for Stroke: relationships with infection. Infect Disord Drug Targets, 10, 112-121. eScholarID:85137
  • Smith, C. & Tyrrell, P (2010). Current and emerging treatments for acute stroke: relationships with infection. Infect Disord Drug Targets, 10(2), 112-21. eScholarID:148133 | PMID:20166969
  • Tyrrell P, Swain S, Rudd A. (2010). Diagnosis and Management of Transient Ischaemic Attack. Clin Med, 10, 164-167. eScholarID:85129
  • Tyrrell, P., Swain, S., Rudd, A. & . (2010). Diagnosis and initial management of transient ischaemic attack. Clin Med, 10(2), 164-7. eScholarID:148130 | PMID:20437993
  • Tyrrell, P., Swain, S., Rudd, A. & Multidisciplinary Guideline Dev, G (2010). Diagnosis and initial management of transient ischaemic attack. CLINICAL MEDICINE, 10(2), 164-167. eScholarID:128403

2009

  • , , Dennis, M., Sandercock, P., Reid, J., Graham, C., Murray, G., Venables, G., Rudd, A. & Bowler, G (2009). Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet, 373(9679), 1958-65. eScholarID:148144 | PMID:19477503 | DOI:10.1016/S0140-6736(09)60941-7
  • Bousser, M., Amarenco, P., Chamorro, A., Fisher, M., Ford, I., Fox, K., Hennerici, M., Mattle, H., Rothwell, P. & . (2009). Rationale and design of a randomized, double-blind, parallel-group study of terutroban 30 mg/day versus aspirin 100 mg/day in stroke patients: the prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) study. Cerebrovasc Dis, 27(5), 509-18. eScholarID:148155 | PMID:19372653 | DOI:10.1159/000212671
  • Power ML, Hamdy S, Goulermas John, Tyrrell PJ, Turnbull Ian, Thompson DG. (2009). Predicting aspiration after hemispheric stroke using discriminant analysis. Dysphagia, eScholarID:1d27391
  • Power ML, Hamdy S, Goulermas JY, Tyrrell PJ, Turnbull II W, Thompson DG. (2009). Predicting aspiration after hemispheric stroke from timing measures of oropharyngeal bolus flow and laryngeal closure. Dysphagia, eScholarID:1d28304
  • Power, M., Hamdy, S., Goulermas, J., Tyrrell, P., Turnbull, I. & Thompson, D (2009). Predicting aspiration after hemispheric stroke from timing measures of oropharyngeal bolus flow and laryngeal closure. Dysphagia, 24(3), 257-64. eScholarID:148152 | PMID:19252944 | DOI:10.1007/s00455-008-9198-4
  • Selvarajah J, Scott M, Stivaros S, Hulme S, Georgiou R, Rothwell N, Tyrrell PJ, Jackson A. (2009). Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke. Eur Radiol, 19( 4), 1011-8. eScholarID:1d32635 | DOI:10.1007/s00330-008-1202-8
  • Selvarajah JR, Glaves M, Wainwright J, Jha A, Vail A, Tyrrell PJ. (2009). Classification of Minor Stroke: Intra- and Inter-Observer Reliability. Cerebrovasc Dis, 27( 3), 209-214. eScholarID:1d32151 | DOI:10.1159/000196817
  • Selvarajah, J., Glaves, M., Wainwright, J., Jha, A., Vail, A. & Tyrrell, P (2009). Classification of minor stroke: intra- and inter-observer reliability. Cerebrovasc Dis, 27(3), 209-14. eScholarID:148134 | PMID:19176952 | DOI:10.1159/000196817
  • Selvarajah, J., Scott, M., Stivaros, S., Hulme, S., Georgiou, R., Rothwell, N., Tyrrell, P. & Jackson, A (2009). Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke. Eur Radiol, 19(4), 1011-8. eScholarID:148151 | PMID:18987865 | DOI:10.1007/s00330-008-1202-8
  • Selvarajah, J., Smith, C., Hulme, S., Georgiou, R., Jury, F., Payton, A., Illingworth, K., Ollier, W., Vail, A., Rothwell, N., Hopkins, S. & Tyrrell, P (2009). Inflammation and risk of recurrent vascular events after TIA and minor stroke: the NORTHSTAR study. EUROPEAN JOURNAL OF NEUROLOGY, 16, 18-18. eScholarID:128409
  • Tyrrell PJ, S Swain, A Rudd. (2009). Initial Evaluation of causes of stroke in frail older adults. Geriatrics and Ageing, 12, eScholarID:1d19924
  • Tyrrell PJ, S Swain, A Rudd. (2009). NICE Guideline on acute stroke and TIA; commentary. HEART, 95, eScholarID:1d19171
  • Tyrrell, P., Swain, S., Rudd, A. & . (2009). NICE guideline on acute stroke and TIA: commentary. Heart, 95(10), 843-5. eScholarID:148150 | PMID:19401283 | DOI:10.1136/hrt.2009.167684
  • Tyrrell, P., Swain, S., Rudd, A. & Acute Stroke & TIA Guideline Dev, G (2009). NICE guideline on acute stroke and TIA: commentary. HEART, 95(10), 843-845. eScholarID:128416 | DOI:10.1136/hrt.2009.167684
  • Tyrrell, P., Swain, S., Rudd, A., Acute, S. & T I A Guideline Dev, G (2009). NICE guideline on acute stroke and TIA: commentary. Heart, 95(10), 843-845. eScholarID:133267 | DOI:10.1136/hrt.2009.167684

2008

  • Childs C, Jones AK P, Tyrrell PJ. (2008). Long-term temperature-related morbidity after brain damage: survivor-reported experiences. Brain Inj, 22( 7), 603-9. eScholarID:1d17533
  • Childs, C., Jones, A. & Tyrrell, P (2008). Long-term temperature-related morbidity after brain damage: survivor-reported experiences. Brain Inj, 22(7-8), 603-9. eScholarID:148149 | PMID:18568714 | DOI:10.1080/02699050802189719
  • Clark S, McMahon C, Gueorguieva I, Rowland M, Scarth S, Georgiou R, Tyrrell PJ, Hopkins SJ, Rothwell NJ. (2008). Interleukin-1 receptor antagonist penetrates human brain at experimentally therapeutic concentrations. J Cereb Blood Flow Metab, 28( 2), 387-94. eScholarID:1d16879
  • Emsley, H., Smith, C., Tyrrell, P. & Hopkins, S (2008). Inflammation in acute ischemic stroke and its relevance to stroke critical care. Neurocrit Care, 9(1), 125-38. eScholarID:148147 | PMID:18087682 | DOI:10.1007/s12028-007-9035-x
  • Gueorguieva I, Clark SR, McMahon CJ, Scarth S, Rothwell NJ, Tyrrell PJ, Hopkins SJ, Rowland M. (2008). Pharmacokinetic modelling of interleukin-1 receptor antagonist in plasma and cerebrospinal fluid of patients following subarachnoid haemorrhage. Br J Clin Pharmacol, 65(3), 317-25. eScholarID:1d16891
  • Rudd, A., Tyrrell, P., , & . (2008). Rapid assessment vital in stroke and TIA. Practitioner, 252(1712), 32, 34-5. eScholarID:148153 | PMID:19130720
  • Selvarajah JR, Scott M, Stivaros S, Hulme S, Georgiou R, Rothwell NJ, Tyrrell PJ, Jackson A-. (2008). Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke. European Society of Radiology, eScholarID:1d18692 | DOI:10.1007/s00330-008-1202-8
  • Selvarajah JR, Smith CJ, Hulme S, Georgiou R, Vail A, Tyrrell PJ. (2008). Prognosis in patients with transient ischaemic attach (TIA) and minor stroke attending TIA services in the North West of England: The NORTHSTAR Study. J Neurol Neurosurg Psychiatry, 79, 38-43. eScholarID:1d16820 | DOI:10.1136/jnnp.2007.129163
  • Swain S, Turner C, Tyrrell PJ, Rudd A. (2008). Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance. BMJ, 337, eScholarID:1d17647 | DOI:10.1136/bmj.a786
  • Swain, S., Turner, C., Tyrrell, P., Rudd, A. & . (2008). Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance. BMJ, 337, a786. eScholarID:148135 | PMID:18653633 | DOI:10.1136/bmj.a786
  • Swain, S., Turner, C., Tyrrell, P., Rudd, A. & Dev Grp, G (2008). Guidelines - Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance. BRITISH MEDICAL JOURNAL, 337(7664), eScholarID:128407
  • Hinz R, Jones MS, Bloomfield P.M, Boellaard R, Turkheimer F.E, Tyrrell PJ. (2008). Reference tissue kinetics extraction from [<sup>11</sup>C]-(<i>R</i>)-PK11195 scans on the High Resolution Research Tomograph (HRRT). Neuroimage, 41, suppl. 2, eScholarID:17d700 | DOI:10.1016/j.neuroimage.2008.04.035

2007

  • Beech P, Greenhalgh J, Thornton M, Tyrrell PJ. (2007). A survey of the practice of stroke doctors in developing transient ischaemic attack services in the UK. J Eval Clin Pract, 13( 3), 395-9. eScholarID:1d31741
  • Beech, P., Greenhalgh, J., Thornton, M. & Tyrrell, P (2007). A survey of the practice of stroke doctors in developing transient ischaemic attack services in the UK. JOURNAL OF EVALUATION IN CLINICAL PRACTICE, 13(3), 395-399. eScholarID:128406
  • Emsley HC, Smith CJ, Tyrrell PJ, Hopkins SJ. (2007). Inflammation in Acute Ischemic Stroke and its Relevance to Stroke Critical Care. Neurocrit Care, eScholarID:1d16877
  • Emsley, HCA, Smith, CJ, Gavin, CCM, Georgiou, R, Vail, A, Barberan, EM, Illingworth, K, Scarth, S, Wickramasinghe, V, Hoadley, M, Rothwell, NJ, Tyrrell, PJ, Hopkins, SJ. (2007). Clinical outcome following acute ischaemic stroke relates to both activation and autoregulatory inhibition of cytokine production. BMC Neurol, 7, eScholarID:1d16883
  • Muir K, Tyrrell PJ, Sattar N, Warburton E. (2007). Inflammation and ischaemic stroke. Curr Opin Neurol, 20( 3), 334-42. eScholarID:1d31829
  • Muir, K., Tyrrell, P., Sattar, N. & Warburton, E (2007). Inflammation and ischaemic stroke. CURRENT OPINION IN NEUROLOGY, 20(3), 334-342. eScholarID:128408
  • Power ML, Cross S, Roberts S, Tyrrell PJ. (2007). Evaluation of a service development to implement the top three process indicators for quality stroke care. J Eval Clin Pract, 13( 1), 90-4. eScholarID:1d31793
  • Power ML, Hamdy S, Singh S, Tyrrell PJ, Turnbull IIW, Thompson DG. (2007). Deglutitive laryngeal closure in stroke patients. J Neurol Neurosurg Psychiatry, 78( 2), 141-6. eScholarID:1d16885

2006

  • Power, M., Fraser, C., Hobson, A., Singh, S., Tyrrell, P., Nicholson, D., Turnbull, I., Thompson, D. & Hamdy, S (2006). Evaluating oral stimulation as a treatment for dysphagia after stroke. DYSPHAGIA, 21(1), 49-55. eScholarID:128405
  • Power, ML, Fraser, CH, Hobson, AR, Singh, S, Rothwell, John C, Nicholson, D, Tyrrell, PJ, Turnbull, II W, Thompson, DG, Hamdy, S. (2006). Evaluating oral stimulation as a treatment for dysphagia after stroke. Dysphagia, 21( 1), 49-55. eScholarID:1d16887
  • Singh, S., Power, M., Tyrrell, P., Thompson, D. & Hamdy, S (2006). A dose response trial of pharyngeal stimulation for the treatment of dysphagia post stroke. GUT, 55, A21-A22. eScholarID:128402
  • Smith CJ, Emsley HCA, Vail A, Georgiou R, Rothwell NJ, Tyrrell PJ, Hopkins SJ. (2006). Variability of the systemic acute phase response after ischemic stroke. J Neuro Sci, 251(1-2), eScholarID:1d27471 | DOI:10.1016/j.jns.2006.09.011

2005

  • Allan S, Tyrrell PJ, Rothwell NJ. (2005). Interleukin-1 and neuronal injury. Nat Rev Immunol, 5( 8), 629-40. eScholarID:1d31189
  • Bowen, A., Gardener, E., Cross, S., Tyrrell, P. & Graham, J (2005). Developing functional outcome measures for unilateral neglect: A pilot study. NEUROPSYCHOLOGICAL REHABILITATION, 15(2), 97-113. eScholarID:128401
  • Clark, S., McMahon, C., Scarth, S., Hopkins, S., Tyrrell, P., Rothwell, N. & King, A (2005). Penetration of interleukin-1 receptor antagonist into the cerebrospinal fluid of patients with subarachnoid haemorrhage. JOURNAL OF THE NEUROLOGICAL SCIENCES, 238, S478-S478. eScholarID:128417
  • Emsley C A, Smith CJ, Georgiou R, Vail A, Hopkins SJ, Rothwell NJ, Tyrrell PJ. (2005). A randomised phase II study of interleukin-1 receptor antagonist in acute stroke patients. Journal of Neurol. Neurosurg. Psychiatry, 76, 1366-1372. eScholarID:1d11509 | DOI:10.1136/jnnp.2004.054882
  • McMahon, C., Horsfall, D., Clark, S., McDermott, P., Selverajah, J., Vail, A., King, A. & Tyrrell, P (2005). Interobserver and intraobserver reliability of transcranial Doppler middle cerebral artery velocity measurements in healthy volunteers. JOURNAL OF THE NEUROLOGICAL SCIENCES, 238, S417-S418. eScholarID:128411
  • Singh, S., Power, M., Tyrrell, P., Thompson, D. & Hamdy, S (2005). The long-term impact of pharyngeal electrical stimulation in the rehabilitation of dysphagia post stroke: A randomised controlled trial assessing dose response. GASTROENTEROLOGY, 128(4), A376-A376. eScholarID:128414
  • Singh, S., Power, T., Tyrrell, P., Thompson, D. & Hamdy, S (2005). The long-term impact of pharyngeal electrical stimulation in the rehabilitation of dysphagia post stroke: A randomised controlled trial assessing dose response. GASTROENTEROLOGY, 128(4), A376-A376. eScholarID:128413
  • Tyrrell PJ. (2005). Evaluation of a service development to implement the top three process indicators for quality stroke care. Journal of Evaluation in Clinical Practice, eScholarID:1d33864
  • Tyrrell PJ. (2005). Managing Stroke and Transient Ischaemic Attack. The Practitioner, 249, 595-602. eScholarID:1d27519
  • Emsley H, Smith CJ, Georgiu R, Vail A, Barberan EM, Rothwell NJ, Tyrrell PJ, Hopkins SJ. (2005). Interleukin-6 and acute ischaemic stroke. Acta Neurol Scand, 112( 4), 273-4; author reply. eScholarID:17d688
  • Emsley HCA, Craig Smith, Georgiou R, Vail A, Barberan EM, Rothwell NJ, Tyrrell PJ. (2005). Interleukin-6 and acute ischaemic stroke. Acta Neurologica Scandinavica (+suppl), 112, 273-4. eScholarID:17d425
  • Emsley, HCA, Smith, CJ, Georgiou, R, Vail, A, Tyrrell, PJ, Barberan, EM, Rothwell, NJ, Hopkins, SJ, Audebert, H, Haberl, RL. (2005). Correlation of systemic inflammatory response with infarct volume in acute ischemic stroke patients. Stroke, 36( 2), 228-9; author reply. eScholarID:17d789
  • Tyrrell PJ. (2005). Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multi-centre randomised controlled trial. Lancet, 365, 764-772. eScholarID:17d942

2004

  • Gavin C, Smith CJ, Emsley H, Hughes D, Turnbull I, Vail A, Tyrrell PJ. (2004). Reliability of a semi-automated technique of cerebral infarct volume measurement with CT. Cerebrovasc Dis, 18( 3), eScholarID:1d31875
  • GavinCM, Craig Smith, Emsley HCA, Hughes DG, Turnbull IIW, Vail A, Tyrrell PJ. (2004). Reliability of a semi-automated technique of cerebral infarct volume measurement with CT. Cerebrovasc Dis, 18, 220-226. eScholarID:1d8714
  • Parker C, Power ML, Hamdy S, Bowen A, Tyrrell PJ, Thompson DG. (2004). Awareness of dysphagia by patients following stroke, Predicts Swallowing Performance and Clinical Outcome. Dysphagia, 19, 28-35. eScholarID:1d25655
  • Power, M., Hamdy, S., Singh, S., Tyrrell, P. & Thompson, D (2004). The long-term impact of deglutitive aspiration in acute stroke: A 7 year prospective study. GASTROENTEROLOGY, 126(4), A654-A654. eScholarID:128412
  • Power, ML, Fraser, CH, Hobson, AR, Rothwell, JC, Parker, C, Hall, N, Tyrrell, PJ, Nicholson, DA, Thompson, DG, Hamdy, S. (2004). Changes in pharyngeal corticobulbar excitability and swallowing behavior after oral stimulation. Am J Physiol Gastrointest Liver Physiol, 286(1), G45-50. eScholarID:1d6638
  • Smith, CJ, Emsley, HCA, Gavin, C, Georgiou, R, Vail, A, Barberan, EM, Del Zoppo, G, Hallenbeck, J, Rothwell, NJ, Hopkins, SJ, Tyrrell, PJ. (2004). Peak Plasma Interleukin-6 and Other Periperhal Markers of Inflammation in tne first week of Ischaemic Stroke Correlate with Brain Infarct Volume, Stroke Severity and Long-term Outcome. BMC Neurology, Jan 15; 4:2, eScholarID:1d7415 | DOI:10.1186/1471-2377-4-2
  • Power ML, Hamdy S, Singh S, Tyrrell PJ, Thompson DG. (2004). The long-term impact of deglutitive aspiration in acute stroke. A 7 year prospective study. Gastroenterology, 126, A654. eScholarID:17d304

2003

  • Emsley, HCA, Smith, CJ, Gavin,C.M., Georgiou, R, Vail, A, Barberan,E.M., Hallenbeck,J.M., del Zoppo,G.J., Rothwell, NJ, Tyrrell, PJ, Hopkins, SJ. (2003). An early and sustained peripheral inflammatory response in acute ischaemic stroke: relationships with infection and atherosclerosis. Journal of Neuroimmunology, 139, 1-2, 93-101. eScholarID:1d5583 | DOI:10.1016/S0165-5728(03)00134-6

2002

  • Emsley H, Tyrrell PJ. (2002). Inflammation and infection in clinical stroke. J Cereb Blood Flow Metab, 22( 12), eScholarID:1d32224 | DOI:10.1097/00004647-200212000-00001
  • Emsley HCA, Tyrrell PJ. (2002). Review: Inflammation and Infection in Clinical Stroke. J Cereb Blood Flow and Metabolism, 22, 1399-1419. eScholarID:1d32738
  • Fraser, CH, Power, ML, Hamdy, S, Rothwell, JC, Hobday, DDI, Hollander, I, Tyrrell, PJ, Hobson, AR, Williams, SR, Thompson, DG. (2002). Driving plasticity in human adult motor cortex is associated with improved motor function after brain injury. Neuron, 34, 831-840. eScholarID:1d2064 | DOI:10.1016/S0896-6273(02)00705-5
  • Gamble GE, Barberan EM, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK P. (2002). Post stroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. European Journal of Pain, 6, 467-474. eScholarID:1d3115

2001

  • Cordery RJ, Tyrrell PJ, Lantos PL, Rossor MN. (2001). Dementia with lewy bodies studied with positron emission tomography. Arch Neurol, 58, 505 - 508. eScholarID:1d3092
  • Smith CJ, Emsley HCA, Libetta CM, Hughes D, Drennan R, Vail A, Tyrrell PJ. (2001). The Oxfordshire Community Stroke Project classification in the early hours of ischemic stroke and relation to infarct site and size on cranial computed tomography. J Stroke Cerebrovasc Dis, 10( 5), 205-9. eScholarID:1d16881
  • Fraser, CH, Power, ML, Hamdy, S, Hobday, DDI, Hollander, I, Hobson, AR, Tyrrell, PJ, Williams, SR, John Rothwell, Thompson, DG. (2001). Switching on swallowing, switching on the brain - a new approach for the treatment of dysphagia. Gut, 48, 109-110. eScholarID:17d238

2000

  • Fraser CH, Hamdy S, Tyrrell PJ, Rothwell JM, Thompson DG. (2000). Recovery after Dysphagic Stroke - Does sensory-induced reorganisation of human swallowing motor cortex have part to play?. eScholarID:2d1976
  • Giles E Gamble, Barberan EM, David Bowsher, Tyrrell PJ, Jones AK P. (2000). Post Stroke Shoulder Pain: more common than previously realized. European Journal of Pain, 4, 313-315. eScholarID:1d7164
  • Pomeroy V, Dean D, Sykes L, Farragher EB, Yates M, Tyrrell PJ, Moss S, Tallis RC. (2000). The unreliability of clinical measures of muscles tone: implications for stroke therapy. Age and Ageing, 29, 299-233. eScholarID:1d2964
  • Tyrrell PJ. (2000). Thrombolysis: How the NHS can learn from the European Experience. Geriatric Medicine, 10-12. eScholarID:17d460

1999

  • Parker C, Power ML, Hamdy S, Tyrrell PJ, Bowen A, Thompson DG. (1999). Does patient insight into swallowing dysfunction following stroke help predict outcome?. eScholarID:2d1975
  • Burns AS, Russell E M, Stratton-Powell H, Tyrrell PJ, O'Neill PA, Baldwin RC. (1999). Sertraline in Stroke - Associated Lability of Mood. Int J Geriatr Psych, 14, 681-685. eScholarID:1d26696
  • Rossor MN, Tyrrell PJ, Warrington EK, Thompson PD, Marsden CD, Lantos P. (1999). Progressive frontal gait distrubance with atypical Alzheimer's disease and corticobasal degeneration. J Neurol Neurosurg Psychiatry, 67, 345 -352. eScholarID:1d3091

  • Tyrrell PJ. Routine oral nutritional supplementation for stroke patients in hospital (FOOD): a multicentre randomised controlled trial. Lancet, eScholarID:1d33713

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