Brain Edema; Neurology; Neurosciences; Neurosurgery; Quality of Health Care; Subarachnoid Hemorrhage; Trauma, Nervous System; Brain Hemorrhage, Traumatic; Infarction, Middle Cerebral Artery; Brain Infarction; Biomarkers, Pharmacological
Public Health Interests
Biomarkers; Clinical Guidelines; Clinical Trials; End-of-Life Issues; Ethics; Neuroepidemiology; Physician decision-making; Quality of care; Stroke; Telemedicine
Dr. Sheth's research focuses on the identification and translation of new therapies for patients with acute neurological injury such as stroke, brain hemorrhage, and trauma. The main focus of his group is to further the understanding of inflammation and swelling after acute central nervous system injury. His group is actively involved in developing new methods, including neuroimaging, to detect and follow brain swelling. He is also involved in leading several national clinical trials testing novel therapies directed at brain swelling. Dr. Sheth also studies medical decision making and prognostication in patients with acute neurological injury.
Specialized Terms: Brain edema; Stroke; Intracranial hemorrhage; Neurocritical Care; Critical care; Prognosis; Biomarkers; Clinical Trials
Extensive Research Description
The central mission of my research program is to 1. Improve our understanding of blood brain barrier injury, inflammation, and swelling after acute central nervous system injury and 2. Translate novel therapies to critically ill neurological patients in the hopes of improving what are all too often devastating outcomes.
For the early part of my career, I have partnered with Marc Simard, a vascular neurosurgeon at the University of Maryland, who discovered a new receptor in the brain, SUR1, expressed on all components of the neurovascular unit. Blockade at the capillary level reduces the formation of the space-occupying edema responsible for cell death. Small molecule-based therapy using the well-known and safe drug glyburide is effective in blocking this channel, thereby significantly reducing edema formation following ischemia.
With the direct purpose of translating this therapy using a novel approach in stroke (prevention of swelling), I have formed a research group working toward solving fundamental gaps in knowledge with the ability to reliably measure brain edema. In order to develop this intermediate endpoint, we have recently validated and published unique neuroimaging measures of brain swelling in patients with large stroke. These imaging endpoints now serve as a primary efficacy endpoint in our phase II NINDS submission. In addition, we are exploring how novel therapies like glyburide may attenuate serum markers of injury at the blood-brain barrier. Early work in human patients suggests that MMP-9 levels are reduced in patients treated with glyburide, and this observation is associated with decreased swelling and hemorrhagic transformation. We continue to search for new pharmacodynamics markers of injury. Both areas of inquiry leverage existing collaborations with groups at Massachusetts General Hospital, Stanford University, and other institutions as well as newly developed groups here at Yale.
SUR1 appears to be implicated broadly after CNS injury, and we are now pursuing new directions with my transition to Yale. One new area of inquiry is a potential collaboration with the Yale PET center to develop a carbon labeled version of glyburide so that we may use the drug as a marker of blood brain barrier integrity and injury, both in terms of spatial and temporal resolution of injury. Another new collaboration has formed with Laura Ment in pediatric neurology to explore the role of SUR1 in blood brain barrier breakdown and hemorrhage in the setting of germinal matrix hemorrhage in preterm infants. These projects are under way and serve as the basis for new grant applications.
In terms of clinical translation, I have had the privilege of leading several phase II studies testing glyburide in ischemic stroke patients at high risk for brain swelling. Initial pilot studies have been completed, submitted for publication and highlighted at the NIH Princeton Stroke Conference and the International Stroke Conference, receiving top awards at both meetings. This work has been internationally recognized in the stroke community as an example of translating an exciting basic science discovery (SUR1) to patients, using a novel target (brain swelling) that has required innovation along the way (imaging and serum biomarkers of inflammation and swelling). I now co-lead one 12 center phase II study (GAMES-RP) in the next stage of this program as well as a complementary phase II study (GAMES) which has submitted to NIH. Both studies involve academic-industry partnerships.
Finally, because outcome assessment is a critical component of successful patient-centered translation, a significant aspect of our program, in patients with intracranial hemorrhage, has focused on prognosis and aggressiveness of care. I currently lead a 4-center prospective observational study where we obtain prognosis predictions from nurses and physicians within 24 hours of hospital admission. These individual estimates are compared against proposed prognosis scores such as the ICH Score. This work builds on prior studies where I examined the association of various interventions in ICH, aggressiveness of care, anti-epileptic drug use, and outcome. Preliminary data from this work is now being used to help support career development awards for junior faculty in this section who have specific interests in this area.
My independent research program has been supported by multiple early career development awards, and now serves as the basis for submitted NIH and other applications. The focus on translation of preclinical science to patients as well as patient centered outcomes directly supports a primary mission of the Neurology Department and Yale Medical School, to further the clinical research enterprise. Recognition of this work is evidenced by several invited reviews in malignant edema and leadership roles in multiple international writing groups for the management of brain swelling and palliative care. I am a member of the steering committee of the Neurocritical Care Society (NCS) Clinical Trial Network, have served as the scientific meeting co-chair for NCS, and sit on several editorial boards for leading journals in this field.
Glyburide Against Malignant Edema and Stroke – RP (GAMES-RP) – I am the national co-PI for this phase II double blind randomized controlled trial. The scientific basis for this study, including pre-clinical collaborations, neuroimaging and serum biomarker development, infrastructure and leadership for this clinical study all capture the central thrust of my research program – to understand the mechanisms of brain swelling and inflammation after injury and to develop and translate novel therapies towards its prevention.
a. Sponsor: Remedy Pharmaceuticals, Inc
b. Data Coordinating Center: Medical University of South Carolina (PI: Jordan J. Elm, PhD)
c. Neuro-Imaging Coordinating Center: Yale Medical School (co-PI: Lauren Beslow, MD – Pediatric Neurology; Gordon Sze, MD – Neuroradiology)
d. Co-PI: W. Taylor Kimberly, M.D.; PhD – Massachusetts General Hospital
e. 12 center study; Yale Site PI: David Hwang; MD
A parallel phase II study (NINDS UO1) has been re-submitted to NIH as a $12 million dollar 25 center study. The submitted proposal uses a different clinical endpoint and tests two dose tiers. I am a co-PI along with Barney Stern, M.D. (University of Maryland) and Gregory del Zoppo, M.D. (University of Washington). The proposal is submitted through NINDS NeuroNext Clinical Trials Network in collaboration with Massachusetts General Hospital.
The basis of both studies was GAMES-Pilot, a multicenter phase IIa study completed one year ago, for which I received the Robert Siekert Investigator Award from the American Heart Association/American Stroke Association as well as the top prize at the NINDS Princeton Stroke Conference.
Prognosis in Intracerebral Hemorrhage (PICH) – I am the national PI for this 5 center study (University of Cincinnati PI: Daniel Woo; Massachusetts General Hospital PI: Jonathan Rosand; University of Miami PI: Sebastian Koch; University of Maryland PI: Steven Kittner; Duke University: Jessica McFarland) aimed at understanding the ability of physicians and bedside nurses to accurately predict functional outcome in patients with intracerebral hemorrhage against the existing prediction scales that are widely used.
a. Sponsor: American Heart Association
b. Data Coordinating Center: Wake Forest University (PI: Carl Langefeld PhD)
c. Parent Study: ERICH (Ethnic & Racial Variation in Intracerebral Hemorrhage)
New England Perihematoma Edema Study – This is a collaborative study between the neurocritical care divisions at Massachusetts General Hospital (MGH) and Yale Medical School. Our group has identified and obtained CT scans from over 500 subjects at MGH with intracerebral hemorrhage. We are performing quantitative assessments of edema volume around the hemorrhage to understand both the timing of edema formation and its potential impact on clinical outcome.
Ethnic & Racial Variation in Intracerebral Hemorrhage (ERICH) – I am an active member of this NINDS funded UO1 consortium (PI Daniel Woo; University of Cincinnati) examining the epidemiology of intracerebral hemorrhage in a cohort enriched with minority populations. The PICH study (PI: Sheth) is a substudy of ERICH, and independently, I have led several analyses through ERICH, two of which have been oral presentations at international conferences (Anti-Epileptic Drug Use in ICH and Withdrawal of Care in ICH)
Neurologic Emergencies Treatment Trials (NETT) – I am the Yale Co-PI along with Chas Wira (Emergency Medicine) for the Yale NETT, a spoke of the Boston NETT Clinical Trials Group. Dr. Wira and I brought NETT to Yale, which is an NINDS funded phase III clinical trials network for neurological emergencies and represents a broad based collaboration between emergency medicine and neurology. We are currently joining POINT (Anti-platelet study in transient ischemic attack) and PROTECT (Progesterone in the Treatment of Traumatic Brain Injury) to Yale through the NETT.
High Dose Deferoxamine for Intracerebral Hemorrhage (Hi-Def) – This phase II study for which I am the Yale Site PI is a NINDS funded phase II study examine the safety and potential efficacy of deferoxamine against inflammation and swelling after ICH.
Germinal Matrix/Intraventricular Hemorrhage (IVH) in Infants – Abcc8, the gene encoding SUR1, the receptor implicated in brain swelling and hemorrhagic transformation, is also associated with germinal matrix hemorrhage in pre-term infants with IVH. Using their existing NIH funded cohort and genetic profiles of pre-term infants with various grade IVH, I have collaborated with Laura Ment (Pediatric Neurology) and Charles Duncan (Neurosurgery) to examine various SNP’s associated with SUR1. This preliminary data is a component of the submitted grant to the Hartwell Foundation, to examine SUR1 and other potential biomarkers in cord blood. This proposal also involves a collaboration with Michael Paidas in Obstetrics & Gynecology.
Glyburide, SUR1, PET – This early stage collaboration is a new direction for my group’s work in brain edema. I am collaborating with Richard Carson PhD in the Yale PET Center to develop a carbon labeled version of glyburide so that we may potentially use the drug as a marker of blood brain barrier integrity and injury, both in terms of spatial and temporal resolution of injury.
A pilot study of intravenous glyburide in patients with a large ischemic stroke.
Sheth KN, Kimberly WT, Elm JJ, Kent TA, Mandava P, Yoo AJ, Thomalla G, Campbell B, Donnan G, Davis SM, Albers GW, Jacobson S, Simard JM, Stern BJ. A pilot study of intravenous glyburide in patients with a large ischemic stroke. Stroke (in press)
Glyburide is associated with attenuated vasogenic edema in stroke patients.
Kimberly WT, Battey T, Pham L, Wu O, Yoo AJ, Furie KL, Singhal AB, Elm JJ, Stern BJ, Sheth KN. Glyburide is associated with attenuated vasogenic edema in stroke patients. Neurocrit Care (in press)
Prediction of Poor Outcomes in Cerebellar Infarction by Diffusion MRI.
Tchopev Z, Hiller M, Zhuo J, Betz J, Gullapalli R, Sheth KN. Prediction of Poor Outcomes in Cerebellar Infarction by Diffusion MRI. Neurocrit Care, Epub ahead of print, 2013.
Validating Imaging Biomarkers of Cerebral Edema in Patients with Severe Ischemic Stroke.
Sheth KN, Yoo AJ, Kimberly WT, Chaudhry ZA, Elm JJ, Jacobson S, Davis SM, Donnan GA, Albers GW, Stern BJ, Gonzalez RG. Validating Imaging Biomarkers of Cerebral Edema in Patients with Severe Ischemic Stroke. J Stroke Cerebrovasc Dis Epub ahead of print, 2012.
No Increased Risk of sICH in tPA Treated Stroke Patients With ECASS Exclusion Criteria.
Cronin CA, Shah N, Morovati T, Hermann LD, Sheth KN. No Increased Risk of sICH in tPA Treated Stroke Patients With ECASS Exclusion Criteria. Stroke. 43(6): 1684-6, 2012.
Intracranial Pressure Dose and Outcome in Traumatic Brain Injury.
Sheth KN, Stein DM, Aarabi B, Hu P, Kufera JA, Scalea TM, Hanley DF. Intracranial Pressure Dose and Outcome in Traumatic Brain Injury. NeuroCritical Care. Epub ahead of print, 2012.
Full List of PubMed Publications
- James ML, Langefeld CD, Sekar P, Moomaw CJ, Elkind MSV, Worrall BB, Sheth KN, Martini SR, Osborne J, Woo D, ERICH Investigators.: Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage. Neurology. 2017 Jul 14; 2017 Jul 14. PMID: 28710330
- Sreekrishnan A, Leasure AC, Shi FD, Hwang DY, Schindler JL, Petersen NH, Gilmore EJ, Kamel H, Sansing LH, Greer DM, Sheth KN: Functional Improvement Among Intracerebral Hemorrhage (ICH) Survivors up to 12 Months Post-injury. Neurocrit Care. 2017 Jul 6; 2017 Jul 6. PMID: 28685394
- Li M, Li Z, Ren H, Jin WN, Wood K, Liu Q, Sheth KN, Shi FD: Colony stimulating factor 1 receptor inhibition eliminates microglia and attenuates brain injury after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2017 Jul; 2016 Jan 1. PMID: 27596835
- Guha R, Boehme A, Demel SL, Li JJ, Cai X, James ML, Koch S, Langefeld CD, Moomaw CJ, Osborne J, Sekar P, Sheth KN, Woodrich E, Worrall BB, Woo D, Chaturvedi S: Aggressiveness of care following intracerebral hemorrhage in women and men. Neurology. 2017 Jun 28; 2017 Jun 28. PMID: 28659419
- Murthy SB, Gupta A, Merkler AE, Navi BB, Mandava P, Iadecola C, Sheth KN, Hanley DF, Ziai WC, Kamel H: Restarting Anticoagulant Therapy After Intracranial Hemorrhage: A Systematic Review and Meta-Analysis. Stroke. 2017 Jun; 2017 Apr 17. PMID: 28416626
- Li M, Ren H, Sheth KN, Shi FD, Liu Q: A TSPO ligand attenuates brain injury after intracerebral hemorrhage. FASEB J. 2017 Apr 17; 2017 Apr 17. PMID: 28416580
- Hayman EG, Wessell A, Gerzanich V, Sheth KN, Simard JM: Mechanisms of Global Cerebral Edema Formation in Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care. 2017 Apr. PMID: 27995510
- Grunwald Z, Beslow LA, Urday S, Vashkevich A, Ayres A, Greenberg SM, Goldstein JN, Leasure A, Shi FD, Kahle KT, Battey TW, Simard JM, Rosand J, Kimberly WT, Sheth KN: Perihematomal Edema Expansion Rates and Patient Outcomes in Deep and Lobar Intracerebral Hemorrhage. Neurocrit Care. 2017 Apr. PMID: 27844466
- Liu Q, Jin WN, Liu Y, Shi K, Sun H, Zhang F, Zhang C, Gonzales RJ, Sheth KN, La Cava A, Shi FD: Brain Ischemia Suppresses Immunity in the Periphery and Brain via Different Neurogenic Innervations. Immunity. 2017 Mar 21; 2017 Mar 14. PMID: 28314594
- Jovin TG, Saver JL, Ribo M, Pereira V, Furlan A, Bonafe A, Baxter B, Gupta R, Lopes D, Jansen O, Smith W, Gress D, Hetts S, Lewis RJ, Shields R, Berry SM, Graves TL, Malisch T, Rai A, Sheth KN, Liebeskind DS, Nogueira RG: Diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo (DAWN) trial methods. Int J Stroke. 2017 Jan 1; 2017 Jan 1. PMID: 28569123
- Sreekrishnan A, Dearborn JL, Greer DM, Shi FD, Hwang DY, Leasure AC, Zhou SE, Gilmore EJ, Matouk CC, Petersen NH, Sansing LH, Sheth KN: Intracerebral Hemorrhage Location and Functional Outcomes of Patients: A Systematic Literature Review and Meta-Analysis. Neurocrit Care. 2016 Dec. PMID: 27160888
- Hayman EG, Kurland DB, Grunwald Z, Urday S, Sheth KN, Simard JM: Decompressive Craniectomy in Neurocritical Care. Semin Neurol. 2016 Dec; 2016 Dec 1. PMID: 27907955
- Sheth KN: Neurocritical Care and Emergency Neurology. Semin Neurol. 2016 Dec; 2016 Dec 1. PMID: 27907951
- Muehlschlegel S, Ayturk D, Ahlawat A, Izzy S, Scalea TM, Stein DM, Emhoff T, Sheth KN: Predicting survival after acute civilian penetrating brain injuries: The SPIN score. Neurology. 2016 Nov 22; 2016 Oct 26. PMID: 27784772
- Murthy SB, Urday S, Beslow LA, Dawson J, Lees K, Kimberly WT, Iadecola C, Kamel H, Hanley DF, Sheth KN, Ziai WC, VISTA ICH Collaborators.: Rate of perihaematomal oedema expansion is associated with poor clinical outcomes in intracerebral haemorrhage. J Neurol Neurosurg Psychiatry. 2016 Nov; 2016 Jul 27. PMID: 27466360
- Irvine HJ, Battey TW, Ostwaldt AC, Campbell BC, Davis SM, Donnan GA, Sheth KN, Kimberly WT: Early neurological stability predicts adverse outcome after acute ischemic stroke. Int J Stroke. 2016 Oct; 2016 Jul 9. PMID: 27334760
- Sheth KN, Elm JJ, Molyneaux BJ, Hinson H, Beslow LA, Sze GK, Ostwaldt AC, Del Zoppo GJ, Simard JM, Jacobson S, Kimberly WT: Safety and efficacy of intravenous glyburide on brain swelling after large hemispheric infarction (GAMES-RP): a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol. 2016 Oct; 2016 Aug 23. PMID: 27567243
- Han L, Cai Q, Tian D, Kong DK, Gou X, Chen Z, Strittmatter SM, Wang Z, Sheth KN, Zhou J: Targeted drug delivery to ischemic stroke via chlorotoxin-anchored, lexiscan-loaded nanoparticles. Nanomedicine. 2016 Oct; 2016 Mar 30. PMID: 27039220
- Gilmore EJ, Maciel CB, Hirsch LJ, Sheth KN: Review of the Utility of Prophylactic Anticonvulsant Use in Critically Ill Patients With Intracerebral Hemorrhage. Stroke. 2016 Oct; 2016 Sep 8. PMID: 27608820
- Koch S, Elkind MS, Testai FD, Brown WM, Martini S, Sheth KN, Chong JY, Osborne J, Moomaw CJ, Langefeld CD, Sacco RL, Woo D, ERICH Study Investigators.: Racial-ethnic disparities in acute blood pressure after intracerebral hemorrhage. Neurology. 2016 Aug 23; 2016 Jul 13. PMID: 27412141
- Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis. Clin Neurol Neurosurg. 2016 Jul; 2016 Apr 23. PMID: 27152469
- Sun N, Shen Y, Han W, Shi K, Wood K, Fu Y, Hao J, Liu Q, Sheth KN, Huang D, Shi FD: Selective Sphingosine-1-Phosphate Receptor 1 Modulation Attenuates Experimental Intracerebral Hemorrhage. Stroke. 2016 Jul; 2016 May 12. PMID: 27174529
- Asuzu D, Nyström K, Sreekrishnan A, Schindler J, Wira C, Greer D, Halliday J, Kimberly WT, Sheth KN: TURN Score Predicts 24-Hour Cerebral Edema After IV Thrombolysis. Neurocrit Care. 2016 Jun. PMID: 26341364
- Urday S, Beslow LA, Dai F, Zhang F, Battey TW, Vashkevich A, Ayres AM, Leasure AC, Selim MH, Simard JM, Rosand J, Kimberly WT, Sheth KN: Rate of Perihematomal Edema Expansion Predicts Outcome After Intracerebral Hemorrhage. Crit Care Med. 2016 Apr. PMID: 26757167
- Morris NA, Merkler AE, Parker WE, Claassen J, Connolly ES, Sheth KN, Kamel H: Adverse Outcomes After Initial Non-surgical Management of Subdural Hematoma: A Population-Based Study. Neurocrit Care. 2016 Apr. PMID: 26160466
- Asuzu D, Nystrӧm K, Schindler J, Wira C, Greer D, Halliday J, Sheth KN: Risk rtPA: An iOS mobile application based on TURN for predicting 90-day outcome after IV thrombolysis. Clin Neurol Neurosurg. 2016 Mar; 2016 Feb 6. PMID: 26875069
- Leasure A, Kimberly WT, Sansing LH, Kahle KT, Kronenberg G, Kunte H, Simard JM, Sheth KN: Treatment of Edema Associated With Intracerebral Hemorrhage. Curr Treat Options Neurol. 2016 Feb. PMID: 26874842
- Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis. J Stroke Cerebrovasc Dis. 2016 Feb; 2015 Nov 30. PMID: 26654664
- Sheth KN, Elm JJ, Beslow LA, Sze GK, Kimberly WT: Glyburide Advantage in Malignant Edema and Stroke (GAMES-RP) Trial: Rationale and Design. Neurocrit Care. 2016 Feb. PMID: 26268138
- Wang W, Shen G, Shahar E, Bidulescu A, Kimberly WT, Sheth KN, Campbell BW, Horbal S, Correa A, Griswold ME: Forced Expiratory Volume in the First Second and Aldosterone as Mediators of Smoking Effect on Stroke in African Americans: The Jackson Heart Study. J Am Heart Assoc. 2016 Jan 27; 2016 Jan 27. PMID: 26819252
- Hwang DY, Dell CA, Sparks MJ, Watson TD, Langefeld CD, Comeau ME, Rosand J, Battey TW, Koch S, Perez ML, James ML, McFarlin J, Osborne JL, Woo D, Kittner SJ, Sheth KN: Clinician judgment vs formal scales for predicting intracerebral hemorrhage outcomes. Neurology. 2016 Jan 12; 2015 Dec 16. PMID: 26674335
- Kimberly WT, Battey TW, Wu O, Singhal AB, Campbell BC, Davis SM, Donnan GA, Sheth KN: Novel Imaging Markers of Ischemic Cerebral Edema and Its Association with Neurological Outcome. Acta Neurochir Suppl. 2016. PMID: 26463953
- Sheth KN, Simard JM, Elm J, Kronenberg G, Kunte H, Kimberly WT: Human Data Supporting Glyburide in Ischemic Stroke. Acta Neurochir Suppl. 2016. PMID: 26463916
- Dearborn JL, Sheth KN: Stroke in Rural Communities: A Need for Continued Surveillance. Neuroepidemiology. 2016; 2016 Mar 15. PMID: 26974152
- Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: Cohort-Based Identification of Predictors of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocrit Care. 2015 Dec. PMID: 25691004
- Sheth KN, Martini SR, Moomaw CJ, Koch S, Elkind MS, Sung G, Kittner SJ, Frankel M, Rosand J, Langefeld CD, Comeau ME, Waddy SP, Osborne J, Woo D, ERICH Investigators.: Prophylactic Antiepileptic Drug Use and Outcome in the Ethnic/Racial Variations of Intracerebral Hemorrhage Study. Stroke. 2015 Dec; 2015 Oct 15. PMID: 26470777
- Asuzu D, Nyström K, Schindler J, Wira C, Greer D, Halliday J, Sheth KN: TURN Score Predicts 90-day Outcome in Acute Ischemic Stroke Patients After IV Thrombolysis. Neurocrit Care. 2015 Oct. PMID: 26032809
- Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocrit Care. 2015 Oct. PMID: 25869481
- Simard JM, Sheth KN: Is Glibenclamide the New Cool in Cardiopulmonary Resuscitation? Crit Care Med. 2015 Sep. PMID: 26274718
- Walsh KB, Sekar P, Langefeld CD, Moomaw CJ, Elkind MS, Boehme AK, James ML, Osborne J, Sheth KN, Woo D, Adeoye O: Monocyte Count and 30-Day Case Fatality in Intracerebral Hemorrhage. Stroke. 2015 Aug; 2015 Jun 30. PMID: 26130090
- Maciel CB, Sheth KN: Malignant MCA Stroke: an Update on Surgical Decompression and Future Directions. Curr Atheroscler Rep. 2015 Jul. PMID: 26017393
- Fountain NB, Van Ness PC, Bennett A, Absher J, Patel AD, Sheth KN, Gloss DS, Morita DA, Stecker M: Quality improvement in neurology: Epilepsy Update Quality Measurement Set. Neurology. 2015 Apr 7. PMID: 25846995
- Kunte H, Farhadi HF, Sheth KN, Simard JM, Kronenberg G: Sulfonylureas--a novel treatment to reduce tissue damage after acute spinal cord injury? Lancet Neurol. 2015 Apr. PMID: 25792091
- Asuzu D, Nystrom K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: Comparison of 8 scores for predicting symptomatic intracerebral hemorrhage after IV thrombolysis. Neurocrit Care. 2015 Apr. PMID: 25168743
- Urday S, Beslow LA, Goldstein DW, Vashkevich A, Ayres AM, Battey TW, Selim MH, Kimberly WT, Rosand J, Sheth KN: Measurement of perihematomal edema in intracerebral hemorrhage. Stroke. 2015 Apr; 2015 Feb 26. PMID: 25721012
- Asuzu D, Nystrom K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN: Modest association between the discharge modified Rankin Scale score and symptomatic intracerebral hemorrhage after intravenous thrombolysis. J Stroke Cerebrovasc Dis. 2015 Mar; 2014 Dec 22. PMID: 25540072
- Sheth KN, Smith EE, Grau-Sepulveda MV, Kleindorfer D, Fonarow GC, Schwamm LH: Drip and ship thrombolytic therapy for acute ischemic stroke: use, temporal trends, and outcomes. Stroke. 2015 Mar; 2015 Feb 11. PMID: 25672784
- Chu SY, Sheth KN: Decompressive craniectomy in neurocritical care. Curr Treat Options Neurol. 2015 Feb. PMID: 25619535
- Urday S, Kimberly WT, Beslow LA, Vortmeyer AO, Selim MH, Rosand J, Simard JM, Sheth KN: Targeting secondary injury in intracerebral haemorrhage--perihaematomal oedema. Nat Rev Neurol. 2015 Feb; 2015 Jan 27. PMID: 25623787
- Yeung JT, Matouk CC, Bulsara KR, Sheth KN: Endovascular revascularization for basilar artery occlusion. Interv Neurol. 2015 Jan. PMID: 25999990
- Sheth KN: Early transfer of patients with stroke to comprehensive centers is necessary. Stroke. 2014 Dec; 2014 Nov 11. PMID: 25388421
- Battey TW, Karki M, Singhal AB, Wu O, Sadaghiani S, Campbell BC, Davis SM, Donnan GA, Sheth KN, Kimberly WT: Brain edema predicts outcome after nonlacunar ischemic stroke. Stroke. 2014 Dec; 2014 Oct 21. PMID: 25336512
- Sheth KN, Rosand J: Targeting the immune system in intracerebral hemorrhage. JAMA Neurol. 2014 Sep. PMID: 25004375
- Cronin CA, Sheth KN, Zhao X, Messé SR, Olson DM, Hernandez AF, Bhatt DL, Schwamm LH, Smith EE: Adherence to Third European Cooperative Acute Stroke Study 3- to 4.5-hour exclusions and association with outcome: data from Get with the Guidelines-Stroke. Stroke. 2014 Sep; 2014 Aug 7. PMID: 25104846
- Sheth KN, Kimberly WT, Elm JJ, Kent TA, Yoo AJ, Thomalla G, Campbell B, Donnan GA, Davis SM, Albers GW, Jacobson S, del Zoppo G, Simard JM, Stern BJ, Mandava P: Exploratory analysis of glyburide as a novel therapy for preventing brain swelling. Neurocrit Care. 2014 Aug. PMID: 24671831
- Walcott BP, Kamel H, Castro B, Kimberly WT, Sheth KN: Tracheostomy after severe ischemic stroke: a population-based study. J Stroke Cerebrovasc Dis. 2014 May-Jun; 2013 Oct 6. PMID: 24103666
- Jha R, Battey TW, Pham L, Lorenzano S, Furie KL, Sheth KN, Kimberly WT: Fluid-attenuated inversion recovery hyperintensity correlates with matrix metalloproteinase-9 level and hemorrhagic transformation in acute ischemic stroke. Stroke. 2014 Apr; 2014 Mar 11. PMID: 24619394
- Arch AE, Sheth KN: Malignant cerebral edema after large anterior circulation infarction: a review. Curr Treat Options Cardiovasc Med. 2014 Jan. PMID: 24390790
- Sheth KN, Kimberly WT, Elm JJ, Kent TA, Mandava P, Yoo AJ, Thomalla G, Campbell B, Donnan GA, Davis SM, Albers GW, Jacobson S, Simard JM, Stern BJ: Pilot study of intravenous glyburide in patients with a large ischemic stroke. Stroke. 2014 Jan; 2013 Nov 5. PMID: 24193798
- Hwang DY, Matouk CC, Sheth KN: Management of the malignant middle cerebral artery syndrome. Semin Neurol. 2013 Nov; 2014 Feb 6. PMID: 24504607
- Sheth KN: Novel approaches to the primary prevention of edema after ischemia. Stroke. 2013 Jun. PMID: 23709712