2022
Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage
Vanent KN, Leasure AC, Acosta JN, Kuohn LR, Woo D, Murthy SB, Kamel H, Messé SR, Mullen MT, Cohen JB, Cohen DL, Townsend RR, Petersen NH, Sansing LH, Gill TM, Sheth KN, Falcone GJ. Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage. JAMA Neurology 2022, 79: 911-918. PMID: 35969388, PMCID: PMC9379821, DOI: 10.1001/jamaneurol.2022.2299.Peer-Reviewed Original Research
2021
Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonanceObstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Geer JH, Falcone GJ, Vanent KN, Leasure AC, Woo D, Molano JR, Sansing LH, Langefeld CD, Pisani MA, Yaggi HK, Sheth KN. Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage. Stroke 2021, 52: 1835-1838. PMID: 33827242, PMCID: PMC8085039, DOI: 10.1161/strokeaha.120.033342.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaRisk factorsBerlin questionnaireIntracerebral hemorrhageSleep apneaEthnic/Racial VariationsHigher body mass indexMultivariable logistic regression modelBody mass indexIntracerebral hemorrhage riskCase-control studyExposure of patientsLogistic regression analysisLogistic regression modelsOSA statusHemorrhage riskMass indexHeart diseaseNontraumatic ICHRacial variationApneaHemorrhageRegression analysisICHRegression modelsAssociation of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Leasure AC, Kuohn LR, Vanent KN, Bevers MB, Kimberly WT, Steiner T, Mayer SA, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Stroke 2021, 52: 1733-1740. PMID: 33682454, PMCID: PMC8085132, DOI: 10.1161/strokeaha.120.032888.Peer-Reviewed Original ResearchConceptsIL-6 levelsPerihematomal edema volumeIntracerebral hemorrhageIL-6Edema volumeFunctional outcomeICH locationICH volumeTreatment groupsSerum IL-6 levelsBaseline ICHAcute brain injuryLarge intracerebral hemorrhageSerum IL-6Predictors of outcomeSpontaneous intracerebral hemorrhageRankin ScalePoor outcomeProinflammatory cytokinesTrial populationBrain injurySecondary analysisStrong associationFast trialsOutcomesAdmission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage
Acosta JN, Leasure AC, Kuohn LR, Both CP, Petersen NH, Sansing LH, Matouk CC, Testai F, Langefeld CD, Woo D, Kamel H, Murthy SB, Qureshi A, Mayer SA, Sheth KN, Falcone GJ. Admission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage. Critical Care Medicine 2021, 49: 828-837. PMID: 33591003, PMCID: PMC8611893, DOI: 10.1097/ccm.0000000000004891.Peer-Reviewed Original ResearchConceptsAdmission hemoglobin levelsHemoglobin levelsNontraumatic intracerebral hemorrhageIntracerebral hemorrhageHematoma volumePoor outcomeHematoma expansionIntracerebral hemorrhage patientsPredictors of outcomeSpontaneous intracerebral hemorrhageIndividual patient dataHigher hemoglobin levelsAdmission hematoma volumeExposure of interestDose-response analysisAdmission hemoglobinRankin ScalePrimary outcomeHemorrhage patientsFunctional outcomeRepeat CTClinical trialsObservational studyHemorrhage sizeBetter outcomesIntracerebral Hemorrhage with Intraventricular Extension Associated with Loss of Consciousness at Symptom Onset
Witsch J, Falcone GJ, Leasure AC, Matouk C, Endres M, Sansing L, Woo D, Sheth KN. Intracerebral Hemorrhage with Intraventricular Extension Associated with Loss of Consciousness at Symptom Onset. Neurocritical Care 2021, 35: 418-427. PMID: 33479920, PMCID: PMC8578176, DOI: 10.1007/s12028-020-01180-2.Peer-Reviewed Original ResearchConceptsLoss of consciousnessIntraventricular hemorrhageIntracerebral hemorrhageSymptom onsetICH onsetUnfavorable outcomeAdmission Glasgow Coma ScoreAdmission systolic blood pressureOnset of ICHGlasgow Coma ScoreSystolic blood pressureSpontaneous intracerebral hemorrhageAdmission serum glucoseThousand seven hundredVolumetric CT measurementsBackgroundIn patientsComa ScoreBlood pressureMedical chartsICH volumeMental statusSerum glucoseICH casesInclusion criteriaPatients
2020
Genetically Elevated LDL Associates with Lower Risk of Intracerebral Hemorrhage
Falcone GJ, Kirsch E, Acosta JN, Noche RB, Leasure A, Marini S, Chung J, Selim M, Meschia JF, Brown DL, Worrall BB, Tirschwell DL, Jagiella JM, Schmidt H, Jimenez‐Conde J, Fernandez‐Cadenas I, Lindgren A, Slowik A, Gill D, Holmes M, Phuah C, Petersen NH, Matouk CN, Gunel M, Sansing L, Bennett D, Chen Z, Sun LL, Clarke R, Walters RG, Gill TM, Biffi A, Kathiresan S, Langefeld CD, Woo D, Rosand J, Sheth KN, Anderson CD, Consortium F. Genetically Elevated LDL Associates with Lower Risk of Intracerebral Hemorrhage. Annals Of Neurology 2020, 88: 56-66. PMID: 32277781, PMCID: PMC7523882, DOI: 10.1002/ana.25740.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhagePolygenic risk scoresLDL cholesterolLower riskTotal cholesterolICH riskLow-density lipoprotein cholesterol levelsRisk of ICHLipoprotein cholesterol levelsPotential causal roleMendelian randomization analysisAnn NeurolLDL levelsCholesterol levelsICH casesObservational studySD increaseSignificant single nucleotide polymorphismsRisk scoreSignificant associationCholesterolMR analysisInverse correlationRandomization analysisSingle nucleotide polymorphismsRace/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage.
Miyares LC, Falcone GJ, Leasure A, Adeoye O, Shi FD, Kittner SJ, Langefeld C, Vagal A, Sheth KN, Woo D. Race/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage. Neurology 2020, 94: e1271-e1280. PMID: 31969467, PMCID: PMC7274930, DOI: 10.1212/wnl.0000000000008930.Peer-Reviewed Original ResearchConceptsSupratentorial intracerebral hemorrhageModified Rankin ScaleIntracerebral hemorrhageRace/ethnicityFunctional outcomeYounger patientsPoor outcomeAdmission Glasgow Coma Scale scoreEthnic/Racial VariationsGlasgow Coma Scale scoreHispanic participantsHispanic race/ethnicityAdmission blood pressureDeep ICH locationIntracerebral Hemorrhage (ERICH) studyProspective multicenter studyGood functional outcomeNon-Hispanic blacksBaseline disabilityRankin ScaleBlood pressureICH locationIntraventricular extensionMulticenter studyICH volume
2019
Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy
Gusdon AM, Nyquist PA, Torres-Lopez VM, Leasure AC, Falcone GJ, Sheth KN, Sansing LH, Hanley DF, Malani R. Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy. Stroke 2019, 51: 129-136. PMID: 31744426, PMCID: PMC7048624, DOI: 10.1161/strokeaha.119.027085.Peer-Reviewed Original ResearchConceptsBlood product transfusionThirty-day mortalityIntracerebral hemorrhagePerihematomal edemaActive malignancyProduct transfusionPHE volumeICH volumeActive cancerPHE growthPlatelet transfusionsCentral nervous system involvementRecurrence of malignancyNervous system involvementNontraumatic intracerebral hemorrhageCancer-specific dataPHE expansionRecent chemotherapyChart reviewConclusions PatientsControl patientsMost patientsHematoma volumeInstitutional databaseSystem involvementAssociation of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage
Kuramatsu JB, Biffi A, Gerner ST, Sembill JA, Sprügel MI, Leasure A, Sansing L, Matouk C, Falcone GJ, Endres M, Haeusler KG, Sobesky J, Schurig J, Zweynert S, Bauer M, Vajkoczy P, Ringleb PA, Purrucker J, Rizos T, Volkmann J, Müllges W, Kraft P, Schubert AL, Erbguth F, Nueckel M, Schellinger PD, Glahn J, Knappe UJ, Fink GR, Dohmen C, Stetefeld H, Fisse AL, Minnerup J, Hagemann G, Rakers F, Reichmann H, Schneider H, Rahmig J, Ludolph AC, Stösser S, Neugebauer H, Röther J, Michels P, Schwarz M, Reimann G, Bäzner H, Schwert H, Claßen J, Michalski D, Grau A, Palm F, Urbanek C, Wöhrle JC, Alshammari F, Horn M, Bahner D, Witte OW, Günther A, Hamann GF, Hagen M, Roeder SS, Lücking H, Dörfler A, Testai FD, Woo D, Schwab S, Sheth KN, Huttner HB. Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. JAMA 2019, 322: 1392-1403. PMID: 31593272, PMCID: PMC6784768, DOI: 10.1001/jama.2019.13014.Peer-Reviewed Original ResearchConceptsCerebellar intracerebral hemorrhageSurgical hematoma evacuationHematoma evacuationConservative treatmentIntracerebral hemorrhageIndividual participant dataFunctional outcomePrimary outcomeClinical outcomesFunctional disabilityPropensity score-matched groupsFavorable functional outcomeModified Rankin ScaleImproved functional outcomesSecondary outcomesRankin ScaleHematoma volumeICH studiesMAIN OUTCOMEPatientsCutoff valuePropensity scoreParticipant dataMonthsCovariate adjustmentAssociation of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Woo D, Ziai WC, Hanley DF, Salman R, Matouk CC, Sansing LH, Sheth KN, Falcone GJ. Association of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage. JAMA Neurology 2019, 76: 949-955. PMID: 31081862, PMCID: PMC6515816, DOI: 10.1001/jamaneurol.2019.1141.Peer-Reviewed Original ResearchIntensive Blood Pressure ReductionDeep intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageHematoma expansionStandard treatmentIntensive treatmentPressure reductionMAIN OUTCOMEModified Rankin scale score distributionIntensive blood pressure treatmentRankin Scale score distributionBasal ganglia intracerebral hemorrhageThalamic intracerebral hemorrhageBasal ganglia hemorrhageBlood pressure treatmentStandard treatment groupModified Rankin ScaleRankin Scale scorePrimary intracerebral hemorrhageAcute care settingStrong risk factorSpontaneous intracerebral hemorrhageDeep brain nucleiAntihypertensive treatmentIntensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Walsh KB, Woo D, Shi FD, Huttner HB, Ziai WC, Hanley DF, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Intensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage. Stroke 2019, 50: 2016-2022. PMID: 31272326, PMCID: PMC6646091, DOI: 10.1161/strokeaha.119.024838.Peer-Reviewed Original ResearchConceptsDeep intracerebral hemorrhageIntensive BP reductionBasal ganglia intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageBP reductionPoor outcomeATACH-2Intensive Blood Pressure ReductionPressure reductionPerihematomal edema expansionSecondary brain injurySupratentorial intracerebral hemorrhagePerihematomal edema volumeSpontaneous intracerebral hemorrhageRelevant end pointsDeep locationBaseline characteristicsEdema volumeBasal gangliaBrain injuryClinical trialsTomography scanEdema expansionTreatment groupsIdentification and Validation of Hematoma Volume Cutoffs in Spontaneous, Supratentorial Deep Intracerebral Hemorrhage
Leasure AC, Sheth KN, Comeau M, Aldridge C, Worrall BB, Vashkevich A, Rosand J, Langefeld C, Moomaw CJ, Woo D, Falcone GJ. Identification and Validation of Hematoma Volume Cutoffs in Spontaneous, Supratentorial Deep Intracerebral Hemorrhage. Stroke 2019, 50: 2044-2049. PMID: 31238829, PMCID: PMC6646054, DOI: 10.1161/strokeaha.118.023851.Peer-Reviewed Original ResearchConceptsDeep intracerebral hemorrhageBasal ganglia intracerebral hemorrhageIntracerebral hemorrhagePoor outcomeValidation cohortC-statisticVolume cutoffDeep ICH patientsMultivariable outcome modelsThalamic intracerebral hemorrhageSpontaneous intracerebral hemorrhageATACH-2 trialClinical trial designCharacteristic curve analysisDeep brain nucleiEffects of interventionsATACH-2Complete neuroimagingICH variesICH patientsICH volumeBasal gangliaCandidate therapiesInclusion criteriaOutcome data
2018
Cardioembolic Stroke Risk and Recovery After Anticoagulation-Related Intracerebral Hemorrhage
Murphy MP, Kuramatsu JB, Leasure A, Falcone GJ, Kamel H, Sansing LH, Kourkoulis C, Schwab K, Elm JJ, Gurol ME, Tran H, Greenberg SM, Viswanathan A, Anderson CD, Schwab S, Rosand J, Shi FD, Kittner SJ, Testai FD, Woo D, Langefeld CD, James ML, Koch S, Huttner HB, Biffi A, Sheth KN. Cardioembolic Stroke Risk and Recovery After Anticoagulation-Related Intracerebral Hemorrhage. Stroke 2018, 49: 2652-2658. PMID: 30355194, PMCID: PMC6211810, DOI: 10.1161/strokeaha.118.021799.Peer-Reviewed Original ResearchConceptsCardioembolic stroke riskOral anticoagulation therapyRankin Scale scoreIntracerebral hemorrhageFunctional recoveryStroke riskAnticoagulation resumptionVASc scoreRecurrent strokeAnticoagulation therapyScale scoreAnticoagulation-related intracerebral hemorrhageDecreased likelihoodSurvivors of ICHModified Rankin Scale scoreNonvalvular atrial fibrillationRecurrent intracerebral hemorrhageOral anticoagulation treatmentICH survivorsTherapy resumptionAnticoagulation treatmentCardioembolic strokeIschemic strokeAtrial fibrillationIndex eventMinority Patients are Less Likely to Undergo Withdrawal of Care After Spontaneous Intracerebral Hemorrhage
Ormseth CH, Falcone GJ, Jasak SD, Mampre DM, Leasure AC, Miyares LC, Hwang DY, James ML, Testai FD, Becker KJ, Tirschwell DL, Langefeld CD, Woo D, Sheth KN. Minority Patients are Less Likely to Undergo Withdrawal of Care After Spontaneous Intracerebral Hemorrhage. Neurocritical Care 2018, 29: 419-425. PMID: 29949003, PMCID: PMC6286261, DOI: 10.1007/s12028-018-0554-4.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageHematoma volumeAdmission Glasgow Coma ScaleEthnic/Racial VariationsNon-traumatic intracerebral hemorrhageIntracerebral Hemorrhage (ERICH) studyProspective cohort studyGlasgow Coma ScaleIntensive care unitWithdrawal of careSpontaneous intracerebral hemorrhageSimilar mortality ratesLogistic regression analysisRace/ethnicity modifiesRace/ethnicityCMO patientsHospital mortalityCohort studyRankin ScaleWhite patientsComa ScaleBlack patientsCare unitEndotracheal intubationICH patients
2017
Oral Anticoagulation and Functional Outcome after Intracerebral Hemorrhage
Biffi A, Kuramatsu JB, Leasure A, Kamel H, Kourkoulis C, Schwab K, Ayres AM, Elm J, Gurol ME, Greenberg SM, Viswanathan A, Anderson CD, Schwab S, Rosand J, Testai FD, Woo D, Huttner HB, Sheth KN. Oral Anticoagulation and Functional Outcome after Intracerebral Hemorrhage. Annals Of Neurology 2017, 82: 755-765. PMID: 29028130, PMCID: PMC5730065, DOI: 10.1002/ana.25079.Peer-Reviewed Original ResearchConceptsFavorable functional outcomeFunctional outcomeICH survivorsStroke incidenceEthnic/Racial VariationsIntracerebral Hemorrhage (ERICH) studyLong-term outcomesCox regression modelIndividual patient dataAnn NeurolLobar hemorrhageLobar ICHTreatment resumptionOral anticoagulationHematoma locationICH locationIntracerebral hemorrhageTherapeutic dilemmaICH studiesICH casesMultivariate analysisPropensity scorePatient dataRacial variationMortality
2016
Perihematomal Edema Expansion Rates and Patient Outcomes in Deep and Lobar Intracerebral Hemorrhage
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. Neurocritical Care 2016, 26: 205-212. PMID: 27844466, PMCID: PMC5378491, DOI: 10.1007/s12028-016-0321-3.Peer-Reviewed Original ResearchConceptsLobar intracerebral hemorrhageIntracerebral hemorrhagePoor functional outcomeDeep intracerebral hemorrhageFunctional outcomeIntraventricular hemorrhageWarfarin-related intracerebral hemorrhageSpontaneous supratentorial intracerebral hemorrhagePrimary intraventricular hemorrhageSupratentorial intracerebral hemorrhageGlasgow Coma ScaleSpontaneous intracerebral hemorrhageICH cohortSubsequent surgeryComa ScaleBaseline CTICH volumeFirst CTPatient outcomesOdds ratioInclusion criteriaPHE volumeCT scanExclusion criteriaUnadjusted regressionRate of Perihematomal Edema Expansion Predicts Outcome After Intracerebral Hemorrhage
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. Critical Care Medicine 2016, 44: 790-797. PMID: 26757167, PMCID: PMC4859217, DOI: 10.1097/ccm.0000000000001553.Peer-Reviewed Original ResearchConceptsRankin Scale scorePerihematomal edema volumeIntracerebral hemorrhageEdema volumePerihematomal edemaScale scoreOrdinal shift analysisPerihematomal edema expansionPatients 18 yearsRetrospective cohort studyTertiary medical centerIntracerebral Hemorrhage ScoreNeurologic outcomeCohort studyIndependent predictorsIntraventricular hemorrhageSecondary injuryWorse outcomesCurrent treatmentHemorrhage scoreMedical CenterCT scanDevastating disorderEdema expansionHemorrhageTreatment of Edema Associated With Intracerebral Hemorrhage
Leasure A, Kimberly WT, Sansing LH, Kahle KT, Kronenberg G, Kunte H, Simard JM, Sheth KN. Treatment of Edema Associated With Intracerebral Hemorrhage. Current Treatment Options In Neurology 2016, 18: 9. PMID: 26874842, DOI: 10.1007/s11940-015-0392-z.Peer-Reviewed Original ResearchPerihematomal edemaIntracerebral hemorrhageHypertonic salineFirst-line medical therapyTreatment of ICHWorse clinical outcomesLarge clinical trialsSubsequent continuous infusionTreatment of edemaEdema refractoryClinical deteriorationBrain herniationCommon complicationDecompressive craniectomyMedical therapyClinical outcomesContinuous infusionEdema formationClinical trialsBolus formClinical researchHemorrhageNext major advanceEdemaPilot study