Silje Holt Jahr

• Jahr, Silje Holt; Koubaa, Nojoud; Hillestad, Vigdis; Larsen, Kristin Tveitan; Selseth, Maiken Nordahl & Lied-Herland, Trine [Show all 10 contributors for this article] (2026). Incidence, clinical characteristics and outcome of spontaneous cerebellar intracerebral haemorrhage in a Norwegian population. European Stroke Journal. ISSN 2396-9873. 11(7). doi: 10.1093/esj/aakag073. Full text in Research Archive
• Jahr, Silje Holt; Selseth, Maiken Nordahl; Larsen, Kristin Tveitan; REICHENBACH, ANTJE; Altmann, Marianne & Sundseth, Antje [Show all 14 contributors for this article] (2026). Diagnostic performance of prehospital large-vessel occlusion detection scales in patients with suspected acute stroke: a retrospective validation study. The Akershus Study of Ischemic Stroke and Thrombolysis. European Stroke Journal. ISSN 2396-9873. 11(6). doi: 10.1093/esj/aakag067. Full text in Research Archive
• Sandset, Else Charlotte; Palaiodimou, Lina; Jahr, Silje Holt; Ho, Leonard; Fischer, Urs & Katsanos, Aristeidis H. [Show all 13 contributors for this article] (2026). 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage. European Stroke Journal. ISSN 2396-9873. 11(5). doi: 10.1093/esj/aakag004. Full text in Research Archive
• Steiner, Thorsten; Purrucker, Jan C.; Sousa, Diana Aguiar de; Apostolaki-Hansson, Trine; Beck, Jürgen & Christensen, Hanne [Show all 22 contributors for this article] (2025). European Stroke Organisation (ESO) and European Association of Neurosurgical Societies (EANS) guideline on stroke due to spontaneous intracerebral haemorrhage. European Stroke Journal. ISSN 2396-9873. 10(4), p. 1007–1086. doi: 10.1177/23969873251340815. Full text in Research Archive
• Jahr, Silje Holt; Sandset, Else Charlotte; Selseth, Maiken Nordahl; Larsen, Kristin Tveitan; Hillestad, Vigdis & Faiz, Kashif Waqar [Show all 8 contributors for this article] (2025). Prehospital blood pressure in acute stroke. Emergency Medicine Journal. ISSN 1472-0205. 42(9), p. 593–598. doi: 10.1136/emermed-2024-214462. Full text in Research Archive Show summary

  Background Blood pressure (BP) is a potential target for early stroke treatment and triage, yet our knowledge about prehospital BP is limited. We aimed to investigate whether prehospital BP differs by stroke type and severity in patients with suspected acute stroke and explore associations between prehospital BP and outcomes. Methods This single-centre retrospective study analysed consecutive patients with suspected stroke admitted to a primary hospital within 4.5 hours of symptom onset, comparing prehospital BP by discharge diagnosis, ischaemic stroke subtypes and stroke severity. Associations between prehospital BP and 90-day modified Rankin Scale and National Institutes of Health Stroke Scale (NIHSS) score changes within 24 hours of admission were analysed using logistic and ordinal regression. Results Of the 1165 patients included, 64% (742) had acute stroke and 36% (423) were stroke mimics. Patients who had an acute stroke had higher mean prehospital systolic BP (SBP) than mimics (162±31 mm Hg vs 152±29 mm Hg, p<0.001). Patients with intracerebral haemorrhage (ICH) had the highest SBP (173±34 mm Hg). Among ischaemic strokes, lacunar stroke had higher SBP than non-lacunar stroke (169±33 vs 158±29 mm Hg, p=0.002), and large vessel occlusion (LVO) had lower SBP than non-LVO (150±28 vs 164±30 mm Hg, p<0.001). Patients with NIHSS score >15 had lower SBP than patients with NIHSS score ≤5 (155±34 vs 165±29 mm Hg, p=0.009). In ischaemic stroke, higher SBP was associated with less chance of early neurological improvement (adjusted OR 0.95, (95% CI, 0.91 to 0.98)). Conclusion Prehospital BP varies by stroke subtype and severity and is associated with outcome. Blood pressure was higher in ICH than in ischaemic stroke, with lacunar infarcts showing the highest BP among ischaemic subtypes. The association between prehospital BP and poor outcomes in observational studies highlights the need for further research on early BP management across different stroke subtypes.

• Larsen, Kristin Tveitan; Jahr, Silje Holt; Selseth, Maiken Nordahl; Lied-Herland, Trine; Hillestad, Vigdis & Ihle-Hansen, Hege Beate [Show all 9 contributors for this article] (2025). Impact of white matter lesions on associations between prehospital blood pressure and outcomes in spontaneous intracerebral hemorrhage. European Stroke Journal. ISSN 2396-9873. 10(4), p. 1402–1412. doi: 10.1177/23969873251343495. Full text in Research Archive Show summary

  Introduction: There are concerns about the safety of intensive blood pressure (BP) lowering in intracerebral hemorrhage (ICH) patients with white matter lesions (WML). We explored the impact of WML on associations between i) prehospital BP, and ii) BP change, and outcomes in acute, spontaneous ICH. Patients and methods: This retrospective study included consecutive patients with acute spontaneous ICH, admitted 2011–2020. WML on non-contrast computed tomography were categorized as none-to-mild (0–1) or moderate-to-severe (2–3) on the Fazekas scale. The first systolic BP (SBP) and mean arterial pressure (MAP) from the ambulance and admission, and absolute BP change between these time points, were collected. The outcomes were in-hospital mortality, mortality at 180 days, modified Rankin Scale (mRS) scores at 3 months, and hematoma expansion. Results: Of 548 patients, 260 (47%) had moderate-to-severe WML. Compared to patients with none-to-mild WML, these patients had a stronger association between higher prehospital MAP and in-hospital mortality (p interaction 0.017). WML did not modify associations between prehospital BP and other outcomes. WML modified associations between MAP change and in-hospital mortality (p interaction 0.049), MAP change and mRS score 3–6 at 3 months (p interaction 0.032), and SBP change and mRS score 3–6 at 3 months (p interaction 0.022). These outcomes were poorer with greater BP decrease in patients with moderate-to-severe compared to none-to-mild WML. Discussion and conclusion: In acute ICH, WML modified the influence of prehospital BP and BP change on clinical outcomes, with a trend toward worse outcomes associated with higher prehospital BP and greater spontaneous BP decrease.

• Larsen, Kristin Tveitan; Sandset, Else Charlotte; Selseth, Maiken Nordahl; Jahr, Silje Holt; Koubaa, Nojoud & Hillestad, Vigdis [Show all 8 contributors for this article] (2023). Antithrombotic Treatment, Prehospital Blood Pressure, and Outcomes in Spontaneous Intracerebral Hemorrhage. Journal of the American Heart Association (JAHA). 12(5), p. 1–12. doi: 10.1161/JAHA.122.028336. Full text in Research Archive Show summary

  Background In acute intracerebral hemorrhage, both elevated blood pressure (BP) and antithrombotic treatment are associated with poor outcome. Our aim was to explore interactions between antithrombotic treatment and prehospital BP. Methods and Results This observational, retrospective study included adult patients with spontaneous intracerebral hemorrhage diagnosed by computed tomography within 24 hours, admitted to a primary stroke center during 2012 to 2019. The first recorded prehospital/ambulance systolic and diastolic BP were analyzed per 5 mm Hg increment. Clinical outcomes were in‐hospital mortality, shift on the modified Rankin Scale at discharge, and mortality at 90 days. Radiological outcomes were initial hematoma volume and hematoma expansion. Antithrombotic (antiplatelet and/or anticoagulant) treatment was analyzed both together and separately. Modification of associations between prehospital BP and outcomes by antithrombotic treatment was explored by multivariable regression with interaction terms. The study included 200 women and 220 men, median age 76 (interquartile range, 68–85) years. Antithrombotic drugs were used by 252 of 420 (60%) patients. Compared with patients without, patients with antithrombotic treatment had significantly stronger associations between high prehospital systolic BP and in‐hospital mortality (odds ratio [OR], 1.14 versus 0.99, P for interaction 0.021), shift on the modified Rankin Scale (common OR, 1.08 versus 0.96, P for interaction 0.001), and hematoma volume (coef. 0.03 versus −0.03, P for interaction 0.011). Conclusions In patients with acute, spontaneous intracerebral hemorrhage, antithrombotic treatment modifies effects of prehospital BP. Compared with patients without, patients with antithrombotic treatment have poorer outcomes with higher prehospital BP. These findings may have implications for future studies on early BP lowering in intracerebral hemorrhage.

• Bergh, Elin; Jahr, Silje Holt; Rønning, Ole Morten; Askim, Torunn; Thommessen, Bente & Kristoffersen, Espen Saxhaug (2022). Reasons and predictors of non-thrombolysis in patients with acute ischemic stroke admitted within 4.5 h. Acta Neurologica Scandinavica. ISSN 0001-6314. 146(1), p. 61–69. doi: 10.1111/ane.13622. Full text in Research Archive Show summary

  Abstract Objectives Thrombolytic treatment in acute ischemic stroke (AIS) reduces stroke-related disability. Nearly 40% of all patients with AIS (<4.5 h) receive thrombolysis, but there is a large variation in the use between hospitals. Little is known about reasons and predictors for not giving thrombolytic treatment. Therefore, we aimed to investigate reasons for non-thrombolysis in patients admitted within 4.5 h. Methods All patients with AIS (<4.5 h) admitted to Akershus University Hospital, Norway, between January 2015 and December 2017 were examined. Patient characteristics and reasons for not giving thrombolysis were registered. Descriptive statistics and logistic regression analyses were performed. Results Of 535 patients admitted with AIS (<4.5 h), 250 (47%) did not receive thrombolysis and of these only 26% had an absolute contraindication to treatment. Among the 74% with relative contraindications, the most common reasons given were mild and improving symptoms. Previous stroke (OR 3.32, 95%CI 1.99–5.52), arriving between 3 h and 4.5 h after onset (OR 7.76, 95%CI 3.73–16.11) or having mild symptoms (OR 2.33, 95%CI 1.56–3.49) were all significant predictors of not receiving thrombolytic treatment in the multivariable logistic regression model. Conclusion A large proportion of patients with AIS do not receive thrombolysis. This study highlights up-to-date findings that arriving late in the time window, mild symptoms, and previous stroke are strong predictors of non-treatment. It is uncertain whether there is an underuse of thrombolysis in AIS. Increasing the utility of thrombolysis in the 4.5 h time window must be weighed against possible harms.

• Larsen, Kristin Tveitan; Selseth, Maiken Nordahl; Jahr, Silje Holt; Hillestad, Vigdis; Koubaa, Nojoud & Sandset, Else Charlotte [Show all 8 contributors for this article] (2022). Prehospital Blood Pressure and Clinical and Radiological Outcomes in Acute Spontaneous Intracerebral Hemorrhage. Stroke. ISSN 0039-2499. 53(12), p. 3633–3641. doi: 10.1161/STROKEAHA.121.038524. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Jahr, Silje Holt; Faiz, Kashif Waqar; Storstein, Anette; Winsvold, Bendik K S & Sandset, Else Charlotte (2021). Acute stroke care during the first phase of COVID-19 pandemic in Norway. Acta Neurologica Scandinavica. ISSN 0001-6314. 143(4), p. 349–354. doi: 10.1111/ane.13392. Full text in Research Archive
• Jahr, Silje Holt; Wahl, Maria Solberg; Majid, Bilal & Samuelsen, Ellen (2021). Herpes zoster oticus. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(15), p. 1–5. doi: 10.4045/tidsskr.21.0036. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Jahr, Silje Holt; Faiz, Kashif Waqar; Thommessen, Bente & Rønning, Ole M. (2021). Stroke admission rates before, during and after the first phase of the COVID-19 pandemic. Neurological Sciences. ISSN 1590-1874. 42(3), p. 791–798. doi: 10.1007/s10072-021-05039-y. Full text in Research Archive
• Kristoffersen, Espen Saxhaug; Jahr, Silje Holt; Thommessen, Bente & Rønning, Ole M. (2020). Effect of COVID-19 pandemic on stroke admission rates in a Norwegian population. Acta Neurologica Scandinavica. ISSN 0001-6314. 142, p. 632–636. doi: 10.1111/ane.13307. Full text in Research Archive Show summary

  Objectives There are concerns that public anxiety around COVID‐19 discourages patients from seeking medical help. The aim of this study was to see how lockdown due to the pandemic affected the number of admissions of acute stroke. Methods All patients discharged from Akershus University Hospital with a diagnosis of transient ischemic attack (TIA) or acute stroke were identified by hospital chart review. January 3 to March 12 was defined as before, and March 13 to April 30 as during lockdown. Results There were 21.8 admissions/week before and 15.0 admissions/week during the lockdown (P < .01). Patients had on average higher NIHSS during the lockdown than before (5.9 vs. 4.2, P = .041). In the multivariable logistic regression model for ischemic stroke (adjusted for sex, age, living alone and NIHSS ≤ 5), there was an increased OR of 2.05 (95% CI 1.10‐3.83, P = .024) for not reaching hospital within 4.5 hours during the lockdown as compared to the period before the lockdown. Conclusion There was a significant reduction in number of admissions for stroke and TIAs during the lockdown due to the COVID‐19 pandemic in Norway.

• Jahr, Silje Holt; Myro, Aija Zuleron; Vegge, Kjetil & Campbell, Patricia (2019). En mann i 40-årene med akutt innsettende talevansker og ensidig lammelse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(18). doi: 10.4045/tidsskr.19.0129. Full text in Research Archive
• Jahr, Silje Holt; Koldeus-Falch, Jannicke & Zarnovicky, Svetozar (2017). Oculomotoriusparese. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(19). doi: 10.4045/tidsskr.17.0431. Full text in Research Archive

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• Larsen, Kristin Tveitan; Selseth, Maiken Nordahl; Jahr, Silje Holt; Hillestad, Vigdis; Koubaa, Nojoud & Sandset, Else Charlotte [Show all 8 contributors for this article] (2022). IMPACT OF ANTITHROMBOTIC TREATMENT ON ASSOCIATIONS BETWEEN PREHOSPITAL SYSTOLIC BLOOD PRESSURE AND OUTCOMES IN ACUTE, SPONTANEOUS INTRACEREBRAL HAEMORRHAGE. Full text in Research Archive
• Koubaa, Nojoud; Larsen, Kristin Tveitan; Hillestad, Vigdis; Selseth, Maiken Nordahl; Jahr, Silje Holt & Faiz, Kashif Waqar [Show all 13 contributors for this article] (2022). EPIDEMIOLOGY AND CLINICAL PRESENTATION OF SPONTANEOUS CEREBELLAR HEMORRHAGE IN A NORWEGIAN POPULATION. Full text in Research Archive
• Bjerkreim, Anna Therese; Jahr, Silje Holt; Faiz, Kashif Waqar; Larsen, Kristin Tveitan; Hillestad, Vigdis & Selseth, Maiken Nordahl [Show all 14 contributors for this article] (2022). TIME ON SCENE BEFORE ADMISSION OF ACUTE STROKE AND STROKE MIMICS: THE AKERSHUS STUDY OF ISCHEMIC STROKE AND THROMBOLYSIS-1. Full text in Research Archive
• Jahr, Silje Holt; Sandset, Else Charlotte; Faiz, Kashif Waqar; Larsen, Kristin Tveitan; Hillestad, Vigdis & Selseth, Maiken Nordahl [Show all 11 contributors for this article] (2022). PRE-HOSPITAL SYSTOLIC BLOOD PRESSURE AND DIAGNOSIS IN SUSPECTED STROKE: THE AKERSHUS STUDY OF ISCHEMIC STROKE AND THROMBOLYSIS-1. Full text in Research Archive
• Jahr, Silje Holt; Rønning, Ole M.; Sundseth, Antje; Skrebelyte-Strøm, Loreta & Thommessen, Bente (2018). En mann i 40-årene med residiverende hjerneinfarkt. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(11), p. 1033–1036. doi: 10.4045/tidsskr.17.0853. Full text in Research Archive

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