2019
Intravenous Tissue Plasminogen Activator in Stroke Mimics
Ali-Ahmed F, Federspiel J, Liang L, Xu H, Sevilis T, Hernandez A, Kosinski A, Prvu Bettger J, Smith E, Bhatt D, Schwamm L, Fonarow G, Peterson E, Xian Y. Intravenous Tissue Plasminogen Activator in Stroke Mimics. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005609. PMID: 31412730, PMCID: PMC6699639, DOI: 10.1161/circoutcomes.119.005609.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdultAgedAged, 80 and overBrain IschemiaDiagnosis, DifferentialFemaleFibrinolytic AgentsHumansIntracranial HemorrhagesMaleMiddle AgedPredictive Value of TestsRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeUnited StatesUnnecessary ProceduresConceptsTransient ischemic attackStroke mimicsIschemic strokeIschemic attackPrior stroke/transient ischemic attackStroke/transient ischemic attackIntravenous tissue plasminogen activatorGuidelines-Stroke registrySymptomatic intracranial hemorrhageCardiovascular risk factorsHealth Stroke ScaleHospital mortality rateAcute ischemic strokeStroke-like symptomsTissue plasminogen activatorUse of tPANonstroke diagnosisThrombolysis safetyIntravenous tPAStroke ScaleComplication rateIntracranial hemorrhagePresumed strokeRisk factorsFunctional disorders
2015
Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals
Reeves M, Smith E, Fonarow G, Zhao X, Thompson M, Peterson E, Schwamm L, Olson D. Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2015, 8: s90-s98. PMID: 26515215, DOI: 10.1161/circoutcomes.115.001775.Peer-Reviewed Original ResearchConceptsGWTG-Stroke hospitalsHealth Stroke ScaleNIHSS scoreDocumentation ratesNIHSS dataStroke ScaleMultivariable logistic regression modelAcute ischemic strokeHospital-level factorsPrimary stroke centerImportant prognostic variablesPatient-level predictorsNational InstituteLogistic regression modelsMedian NIHSSIschemic strokeStroke centersThrombolysis candidatesClinical registryPrognostic variablesNIHSSHospitalPatientsStrokeLow documentationQuality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack
O'Brien E, Zhao X, Fonarow G, Schulte P, Dai D, Smith E, Schwamm L, Bhatt D, Xian Y, Saver J, Reeves M, Peterson E, Hernandez A. Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack. Circulation Cardiovascular Quality And Outcomes 2015, 8: s117-s124. PMID: 26515199, DOI: 10.1161/circoutcomes.115.002048.Peer-Reviewed Original ResearchConceptsTransient ischemic attackDefect-free careIschemic strokeIschemic stroke riskQuality of careIschemic attackStroke riskCare measuresRisk scoreOverall hospital admission rateRisk score quintilesYear post dischargeLow-risk patientsHospital admission ratesIschemic stroke admissionsPrevious myocardial infarctionAbsence of strokeMedicare inpatient claimsCox proportional hazardsModerate discriminative performanceTIA patientsCause mortalityCessation counselingStroke admissionsBaseline demographics
2013
A Risk Score for In‐Hospital Death in Patients Admitted With Ischemic or Hemorrhagic Stroke
Smith E, Shobha N, Dai D, Olson D, Reeves M, Saver J, Hernandez A, Peterson E, Fonarow G, Schwamm L. A Risk Score for In‐Hospital Death in Patients Admitted With Ischemic or Hemorrhagic Stroke. Journal Of The American Heart Association 2013, 2: e005207. PMID: 23525444, PMCID: PMC3603253, DOI: 10.1161/jaha.112.005207.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCerebral HemorrhageChi-Square DistributionDecision Support TechniquesFemaleHospital MortalityHumansInpatientsLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsRegistriesReproducibility of ResultsRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeSubarachnoid HemorrhageUnited StatesConceptsStroke typeIschemic strokeIntracerebral hemorrhageRisk scoreGuidelines-Stroke databaseHealth Stroke ScaleIn-Hospital DeathRisk of deathHospital mortalityHospital deathStroke ScaleStroke admissionsIndependent predictorsHemorrhagic strokeStroke patientsC-statisticSingle risk scoreOverall populationLogistic regressionPatientsValidation sampleMortalityDeathPoint scorePrediction score
2012
Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator
Menon B, Saver J, Prabhakaran S, Reeves M, Liang L, Olson D, Peterson E, Hernandez A, Fonarow G, Schwamm L, Smith E. Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator. Stroke 2012, 43: 2293-2299. PMID: 22811458, DOI: 10.1161/strokeaha.112.660415.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlood PressureCerebral HemorrhageCohort StudiesData Interpretation, StatisticalEthnicityFemaleFibrinolytic AgentsHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsRisk AssessmentRisk FactorsStrokeTissue Plasminogen ActivatorTreatment OutcomeConceptsIntravenous tissue-type plasminogen activatorSymptomatic intracranial hemorrhageTissue-type plasminogen activatorSICH riskIschemic strokeSymptom onsetIntracranial hemorrhageValidation cohortC-statisticPlasminogen activatorIntravenous tissue-type plasminogen activator treatmentRisk of sICHTissue-type plasminogen activator treatmentHigher baseline National InstitutesHigher systolic blood pressureDerivation sampleBaseline National InstitutesHealth Stroke ScaleStroke symptom onsetAcute ischemic strokeSystolic blood pressurePlasminogen activator treatmentMultivariable logistic regressionHigh blood glucoseNational InstituteInfarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Yoo A, Chaudhry Z, Nogueira R, Lev M, Schaefer P, Schwamm L, Hirsch J, González R. Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy. Stroke 2012, 43: 1323-1330. PMID: 22426317, DOI: 10.1161/strokeaha.111.639401.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkersBrain InfarctionCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPredictive Value of TestsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsFinal infarct volumeIntra-arterial therapyAcute ischemic strokeInfarct volumeFunctional outcomeBetter outcomesIschemic strokePoor outcomeAnterior circulation acute ischemic strokeScale scoreHealth Stroke Scale scoreMedian admission National InstitutesMedian final infarct volumesLong-term functional outcomeIntra-arterial stroke therapyAdmission National InstitutesProximal artery occlusionStroke Scale scoreOnly independent predictorRankin Scale scoreArtery occlusionProspective cohortRankin ScaleIndependent predictorsClinical outcomes
2011
Prediction of Early Stroke Risk in Transient Symptoms With Infarction
Arsava E, Furie K, Schwamm L, Sorensen A, Ay H. Prediction of Early Stroke Risk in Transient Symptoms With Infarction. Stroke 2011, 42: 2186-2190. PMID: 21680907, PMCID: PMC3144273, DOI: 10.1161/strokeaha.110.604280.Peer-Reviewed Original ResearchConceptsTransient ischemic attackReceiver-operating characteristic curveIschemic attackStroke riskTransient symptomsDiffusion-weighted imagesStroke prevention strategiesHigh-risk patientsRisk of strokeEarly stroke riskCharacteristic curveNew infarctionRecurrent strokeClinical deteriorationConsecutive patientsIschemic strokeSymptom onsetIndex lesionRetrospective seriesPrevention strategiesPatientsEarly interventionInfarctionStrokeSubsequent strokePredictors of Hospital Length of Stay in Heart Failure: Findings from Get With the Guidelines
Whellan D, Zhao X, Hernandez A, Liang L, Peterson E, Bhatt D, Heidenreich P, Schwamm L, Fonarow G. Predictors of Hospital Length of Stay in Heart Failure: Findings from Get With the Guidelines. Journal Of Cardiac Failure 2011, 17: 649-656. PMID: 21807326, DOI: 10.1016/j.cardfail.2011.04.005.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesFemaleHeart FailureHospitalizationHumansLength of StayMaleMiddle AgedPractice Guidelines as TopicPredictive Value of TestsProspective StudiesConceptsStandard laboratory evaluationBrain natriuretic peptideHospital characteristicsPatient characteristicsMore comorbiditiesHospital lengthLonger LOSGuidelines-Heart FailureAdmission vital signsHeart failure patientsTime of admissionBNP levelsHF patientsFailure patientsHeart failureNatriuretic peptideClinical variablesPatient admissionsPatientsDisease severityVital signsHigher disease severityAdmissionLOS variationAdmission predictors
2010
Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield
2009
Frequency and Determinants of Lipid Testing in Ischemic Stroke and Transient Ischemic Attack
Smith E, Pan W, Olson D, Reeves M, Ovbiagele B, Peterson E, Fonarow G, Schwamm L. Frequency and Determinants of Lipid Testing in Ischemic Stroke and Transient Ischemic Attack. Stroke 2009, 41: 232-238. PMID: 20035071, DOI: 10.1161/strokeaha.109.567693.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackLDL measurementIschemic strokeLipid testingLarger quality improvement programmesLow-density lipoprotein testingTransient ischemic attack admissionsAdditional calendar yearConsecutive ischemic strokeGuidelines-Stroke hospitalsNationwide stroke registryLipid-lowering therapyHistory of strokeQuality Improvement ProgramLogistic regression modelsStroke RegistryHospitalized patientsLipoprotein testingAtrial fibrillationLDL levelsClinical managementHospital characteristicsNational guidelinesPatientsA score to predict early risk of recurrence after ischemic strokeSYMBOLSYMBOL
Ay H, Gungor L, Arsava E, Rosand J, Vangel M, Benner T, Schwamm L, Furie K, Koroshetz W, Sorensen A. A score to predict early risk of recurrence after ischemic strokeSYMBOLSYMBOL. Neurology 2009, 74: 128-135. PMID: 20018608, PMCID: PMC2809031, DOI: 10.1212/wnl.0b013e3181ca9cff.Peer-Reviewed Original ResearchConceptsRecurrent strokeEarly riskPrognostic scoreConsecutive ischemic stroke patientsComprehensive prognostic scoreTIA/strokeAcute stroke careIschemic stroke patientsPredictors of recurrenceRisk of recurrenceCox regression modelEtiologic stroke subtypesPatient management algorithmsBrain infarctsAcute settingIschemic strokeStroke subtypesIndependent predictorsStroke careStroke patientsImaging featuresPrior historySeparate cohortClinical practiceStrokeABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes
Sims J, Gharai L, Schaefer P, Vangel M, Rosenthal E, Lev M, Schwamm L. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology 2009, 72: 2104-2110. PMID: 19528517, PMCID: PMC2697964, DOI: 10.1212/wnl.0b013e3181aa5329.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain InfarctionCerebral ArteriesCerebral HemorrhageCerebrovascular CirculationComputer SimulationDiagnosis, DifferentialDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNerve Fibers, MyelinatedPredictive Value of TestsRetrospective StudiesSeverity of Illness IndexTime Factors
2008
Clinical- and Imaging-Based Prediction of Stroke Risk After Transient Ischemic Attack
Ay H, Arsava E, Johnston S, Vangel M, Schwamm L, Furie K, Koroshetz W, Sorensen A. Clinical- and Imaging-Based Prediction of Stroke Risk After Transient Ischemic Attack. Stroke 2008, 40: 181-186. PMID: 18948609, DOI: 10.1161/strokeaha.108.521476.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrainComorbidityComputer SimulationDiffusion Magnetic Resonance ImagingDisease ProgressionEarly DiagnosisEmergency Medical ServicesFemaleHumansIncidenceIschemic Attack, TransientLogistic ModelsMaleMiddle AgedNeurologic ExaminationPredictive Value of TestsPrognosisReproducibility of ResultsRisk FactorsStrokeConceptsTransient ischemic attackIschemic attackStroke riskClinical featuresDiffusion-weighted imagingAcute infarctsClinical transient ischemic attackDiffusion-weighted imaging findingsEarly stroke riskRelevant clinical settingsCharacteristic curveLogistic regression modelsConsecutive patientsSymptom onsetIndependent predictorsRisk stratificationImaging findingsTherapeutic measuresHospital resourcesEarly riskClinical settingResponse criteriaPredictive instrumentStrokeSubsequent stroke
2005
Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy.
Schwamm L, Rosenthal E, Swap C, Rosand J, Rordorf G, Buonanno F, Vangel M, Koroshetz W, Lev M. Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy. American Journal Of Neuroradiology 2005, 26: 1798-803. PMID: 16091532, PMCID: PMC7975152.Peer-Reviewed Original ResearchMeSH KeywordsAgedArterial Occlusive DiseasesBasilar ArteryCerebral AngiographyCerebral HemorrhageCerebral InfarctionFemaleFibrinolytic AgentsHematomaHumansMaleMiddle AgedMiddle Cerebral ArteryPredictive Value of TestsRetrospective StudiesRisk AssessmentTissue Plasminogen ActivatorTomography, X-Ray ComputedConceptsIntra-arterial reperfusion therapyHemorrhagic transformationPoor clinical outcomeCTA source imagesReperfusion therapyClinical outcomesCT angiographic source imagesCatheter-based reperfusionReal-time risk stratificationSymptomatic hemorrhagic transformationReceiver operator characteristic curveBlood glucose levelsOperator characteristic curveAxial source imagesNormal contralateral tissueConsecutive patientsVascular insufficiencyIntracerebral hemorrhageRisk stratificationStroke patientsPoor outcomeSignificant complicationsRisk factorsContralateral tissueLesion volume
2003
Whole-Brain CT Perfusion Measurement of Perfused Cerebral Blood Volume in Acute Ischemic Stroke: Probability Curve for Regional Infarction
Hunter G, Silvennoinen H, Hamberg L, Koroshetz W, Buonanno F, Schwamm L, Rordorf G, Gonzalez R. Whole-Brain CT Perfusion Measurement of Perfused Cerebral Blood Volume in Acute Ischemic Stroke: Probability Curve for Regional Infarction. Radiology 2003, 227: 725-30. PMID: 12728181, DOI: 10.1148/radiol.2273012169.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCerebral blood volumeIschemic strokeBlood volumeMajor arterial occlusionLikelihood of infarctionLogistic regression analysisPositive predictive valueCT perfusion measurementsAcute strokeCerebral infarctionArterial occlusionIntracranial hemorrhagePerfusion scanCore infarctionPCBVInfarctionPositive followProbability of survivalRegional infarctionPredictive valuePatientsStrokePerfusion measurementsRegression analysis
2002
CT or MRI for Imaging Patients with Acute Stroke: Visualization of “Tissue at Risk”?
Lev M, Koroshetz W, Schwamm L, Gonzalez R. CT or MRI for Imaging Patients with Acute Stroke: Visualization of “Tissue at Risk”? Stroke 2002, 33: 2736-2737. PMID: 12468762, DOI: 10.1161/01.str.0000041999.64363.b2.Peer-Reviewed Original ResearchCT Angiography With Whole Brain Perfused Blood Volume Imaging
Ezzeddine M, Lev M, McDonald C, Rordorf G, Oliveira-Filho J, Aksoy F, Farkas J, Segal A, Schwamm L, Gonzalez R, Koroshetz W. CT Angiography With Whole Brain Perfused Blood Volume Imaging. Stroke 2002, 33: 959-966. PMID: 11935044, DOI: 10.1161/hs0402.105388.Peer-Reviewed Original ResearchConceptsOxfordshire Community Stroke Project classificationCTA/CTPNoncontrast CTCTP imagingInfarct localizationRapid CT scanningAcute stroke treatmentAcute stroke patientsInitial clinical assessmentMajor intracranial vesselsCTA source imagesVascular phase imagesSteady-state administrationProject classificationParenchymal phase imagesOrg 10172Oxfordshire classificationTOAST classificationAcute strokeStroke neurologistsStroke treatmentStroke patientsBlood volume imagingClinical examinationInfarct locationPredicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging.
Schaefer P, Hunter G, He J, Hamberg L, Sorensen A, Schwamm L, Koroshetz W, Gonzalez R. Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging. American Journal Of Neuroradiology 2002, 23: 1785-94. PMID: 12427640, PMCID: PMC8185825.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBlood Flow VelocityBrain IschemiaCerebral InfarctionCerebrovascular CirculationDiffusion Magnetic Resonance ImagingFalse Positive ReactionsFemaleFollow-Up StudiesHumansIschemic Attack, TransientMagnetic Resonance AngiographyMaleMiddle AgedObserver VariationPredictive Value of TestsSensitivity and SpecificityTime FactorsConceptsCerebral blood flowCerebral blood volumeFinal infarct volumeInfarct volumeDW imagingLesion growthAcute ischemic stroke symptomsHemodynamic imagesAcute ischemic infarctionIschemic infarct volumeInitial clinical assessmentFinal discharge diagnosisFinal infarct sizeHours of onsetIschemic stroke symptomsPerfusion MR imagingPerfusion-weighted imagesAcute strokeIschemic infarctionStroke symptomsAcute infarctionAcute lesionsDischarge diagnosisInfarct sizeAltered perfusion
2001
Utility of Perfusion-Weighted CT Imaging in Acute Middle Cerebral Artery Stroke Treated With Intra-Arterial Thrombolysis:
Lev M, Segal A, Farkas J, Hossain S, Putman C, Hunter G, Budzik R, Harris G, Buonanno F, Ezzeddine M, Chang Y, Koroshetz W, Gonzalez R, Schwamm L. Utility of Perfusion-Weighted CT Imaging in Acute Middle Cerebral Artery Stroke Treated With Intra-Arterial Thrombolysis:. Stroke 2001, 32: 2021-2028. PMID: 11546891, DOI: 10.1161/hs0901.095680.Peer-Reviewed Original ResearchConceptsFinal infarct volumeAcute middle cerebral artery strokeNIH Stroke Scale scoreMiddle cerebral artery strokeMCA stem occlusionIntra-arterial thrombolysisStroke Scale scoreComplete recanalizationClinical outcomesInfarct volumeLesion volumeArtery strokeOutcome groupAdmission NIH Stroke Scale scoreInitial NIH Stroke Scale scoreScale scoreEarly complete recanalizationFinal lesion volumeUtility of perfusionPoor outcome groupModified Rankin ScalePoor clinical outcomeRankin ScaleStroke onsetConsecutive patientsFever in subarachnoid hemorrhage
Oliveira–Filho J, Ezzeddine M, Segal A, Buonanno F, Chang Y, Ogilvy C, Rordorf G, Schwamm L, Koroshetz W, McDonald C. Fever in subarachnoid hemorrhage. Neurology 2001, 56: 1299-1304. PMID: 11376177, DOI: 10.1212/wnl.56.10.1299.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhagePoor outcomeTranscranial DopplerNeurologic intensive care unitOlder ageDaily transcranial DopplerGlasgow Coma ScoreHunt-Hess gradeRankin Scale scoreCause of feverIntensive care unitPresence of infectionNontraumatic subarachnoid hemorrhageSymptomatic vasospasmCerebral ischemiaComa ScoreConsecutive patientsAngiographic criteriaCare unitBrain injuryHemorrhage severityVasospasmPatientsFeverScale score