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 documentationIn Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?
Copen W, Morais L, Wu O, Schwamm L, Schaefer P, González R, Yoo A. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core? PLOS ONE 2015, 10: e0133566. PMID: 26193486, PMCID: PMC4508041, DOI: 10.1371/journal.pone.0133566.Peer-Reviewed Original ResearchConceptsComputed tomography perfusion imagingDiffusion-weighted magnetic resonance imagingCerebral blood volumeInfarct volumeSensitivity/specificityCBV mapsDWI lesionsIschemic coreCore lesionsDWI-positive patientsRegional cerebral blood volumeAcute ischemic strokeFinal infarct volumeTreatment of patientsTomography perfusion imagingPresence of infarctionMagnetic resonance imagingDiffusion-weighted imagingAcute strokeIschemic strokeSymptom onsetLesion volumeIndividual patientsInter-rater agreementPatients
2014
Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection
Schaefer P, Pulli B, Copen W, Hirsch J, Leslie-Mazwi T, Schwamm L, Wu O, González R, Yoo A. Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection. American Journal Of Neuroradiology 2014, 36: 259-264. PMID: 25258369, PMCID: PMC4462135, DOI: 10.3174/ajnr.a4103.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainBrain IschemiaCerebral InfarctionDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Patient SelectionPrognosisReperfusionROC CurveSensitivity and SpecificitySeverity of Illness IndexStrokeUnited StatesConceptsPositive predictive valueAcute ischemic strokeLarge patient cohortReperfusion therapyPoor outcomeStroke sidePredictive valueNIHSS scoreIschemic strokeClinical outcomesPatient cohortPrognostic yieldAnterior circulation acute ischemic strokeAcute ischemic stroke patientsImaging thresholdsBeneficial treatment responseDiffusion-perfusion mismatchHigh positive predictive valueIschemic stroke patientsRight-sided strokeLeft-sided strokeUntreated patientsStroke onsetConsecutive patientsPatient selection
2012
Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke
Hakimelahi R, Yoo A, He J, Schwamm L, Lev M, Schaefer P, González R. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke. BMC Neurology 2012, 12: 132. PMID: 23121836, PMCID: PMC3519648, DOI: 10.1186/1471-2377-12-132.Peer-Reviewed Original ResearchConceptsDiffusion/perfusion mismatchDWI lesion volumeInternal carotid arteryLesion volumePerfusion mismatchConsecutive patientsCarotid arteryMiddle cerebral artery ischemic strokeDiffusion/perfusion MRITerminal internal carotid arteryProximal middle cerebral arteryDistal internal carotid arteryLarger mismatch volumeProximal MCA occlusionMiddle cerebral arteryDiffusion lesion volumeSame inclusion criteriaTerminal ICAArtery occlusionIschemic strokeMCA occlusionStroke onsetCerebral arteryStroke patientsPatient assessmentReliability of cerebral blood volume maps as a substitute for diffusion‐weighted imaging in acute ischemic stroke
deIpolyi A, Wu O, Macklin E, Schaefer P, Schwamm L, Gonzalez R, Copen W. Reliability of cerebral blood volume maps as a substitute for diffusion‐weighted imaging in acute ischemic stroke. Journal Of Magnetic Resonance Imaging 2012, 36: 1083-1087. PMID: 22761110, PMCID: PMC4110961, DOI: 10.1002/jmri.23740.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood VolumeBlood Volume DeterminationBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansMaleReproducibility of ResultsSensitivity and SpecificityStrokeConceptsDiffusion-weighted MRIAcute ischemic strokeCerebral blood volume mapsBlood volume mapsCBV mapsDWI lesionsIschemic strokeProportion of lesionsScan durationDiffusion-weighted imagingAcute strokeStroke onsetInfarct coreContralateral hemisphereRegional CBVMR perfusionVolume mapsLesion centerLesionsCBVStrokeShort durationPerfusionDurationLinear regression
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 stroke
2009
Existence of the Diffusion-Perfusion Mismatch within 24 Hours after Onset of Acute Stroke: Dependence on Proximal Arterial Occlusion
Copen W, Rezai Gharai L, Barak E, Schwamm L, Wu O, Kamalian S, Gonzalez R, Schaefer P. Existence of the Diffusion-Perfusion Mismatch within 24 Hours after Onset of Acute Stroke: Dependence on Proximal Arterial Occlusion. Radiology 2009, 250: 878-86. PMID: 19164120, DOI: 10.1148/radiol.2503080811.Peer-Reviewed Original ResearchConceptsProximal arterial occlusionAcute ischemic stroke trialsIschemic stroke trialsAcute strokeArterial occlusionStroke trialsLesion volumePerfusion-weighted magnetic resonance imagesDiffusion-perfusion mismatchMean transit time mapsTransit time mapsHIPAA-compliant studyPAO patientsAngiographic evidenceStroke onsetDose escalationTomographic angiographyEligibility criteriaPatientsInstitutional reviewMagnetic resonance imagesMR angiographyDesmoteplaseSignificant differencesAngiography
2008
Role of Recanalization in Acute Stroke Outcome: Rationale for a CT Angiogram-Based “Benefit of Recanalization” Model
Rosenthal E, Schwamm L, Roccatagliata L, Coutts S, Demchuk A, Schaefer P, Gonzalez R, Hill M, Halpern E, Lev M. Role of Recanalization in Acute Stroke Outcome: Rationale for a CT Angiogram-Based “Benefit of Recanalization” Model. American Journal Of Neuroradiology 2008, 29: 1471-1475. PMID: 18599577, PMCID: PMC8119059, DOI: 10.3174/ajnr.a1153.Peer-Reviewed Original ResearchConceptsOnly independent predictorLesion volumeComplete recanalizationRecanalization statusClinical outcomesNIHSS scoreIndependent predictorsIncomplete recanalizationCTA-SI Alberta Stroke Program Early CT ScoreAcute middle cerebral artery strokeAlberta Stroke Program Early CT ScoreHealth Stroke Scale scoreMedian admission NIHSS scoreMiddle cerebral artery strokeCT angiographic source imagesAcute stroke outcomeAdmission National InstitutesBenefit of recanalizationEarly successful recanalizationMCA M1 occlusionRole of recanalizationStroke Scale scoreAdmission NIHSS scoreMRS score 0CT/CTAAn Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale
Torres-Mozqueda F, He J, Yeh I, Schwamm L, Lev M, Schaefer P, González R. An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale. American Journal Of Neuroradiology 2008, 29: 1111-1117. PMID: 18467521, PMCID: PMC8118840, DOI: 10.3174/ajnr.a1000.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic strokeMinor stroke groupIschemic strokeMajor strokeMinor strokeStroke groupNoncontrast CTBoston Acute Stroke Imaging ScaleProximal cerebral artery occlusionMR angiographyCerebral artery occlusionLength of hospitalizationClassification instrumentCTA patientsArtery occlusionDischarge dispositionConsecutive patientsParenchymal ischemiaCT scorePatient outcomesStroke survivorsRehabilitation facilityPatientsStrokeFunctional CT and MR Imaging for Evaluation of Acute Stroke
Miller J, Lev M, Schwamm L, Thrall J, Lee S. Functional CT and MR Imaging for Evaluation of Acute Stroke. Journal Of The American College Of Radiology 2008, 5: 67-70. PMID: 18180014, DOI: 10.1016/j.jacr.2007.07.018.Peer-Reviewed Original Research
2004
Virtual TeleStroke Support for the Emergency Department Evaluation of Acute Stroke
Schwamm L, Rosenthal E, Hirshberg A, Schaefer P, Little E, Kvedar J, Petkovska I, Koroshetz W, Levine S. Virtual TeleStroke Support for the Emergency Department Evaluation of Acute Stroke. Academic Emergency Medicine 2004, 11: 1193-1197. PMID: 15528584, DOI: 10.1197/j.aem.2004.08.014.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorAcute strokeTelestroke consultationNeedle timeSymptom onsetEmergency departmentHealth Stroke Scale scoreIntravenous tissue plasminogen activatorMean National InstitutesPossible acute strokeEmergency department evaluationStroke Scale scoreAcute ischemic strokeEvaluation of patientsEligible patientsStroke neurologistsIschemic strokeDepartment evaluationNeurologic examinationRandomized trialsStroke expertiseProtocol violationsEmergency physiciansInter-rater reliabilityPatient management
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
Anatomy of Stroke, Part II
Caviness V, Makris N, Montinaro E, Sahin N, Bates J, Schwamm L, Caplan D, Kennedy D. Anatomy of Stroke, Part II. Stroke 2002, 33: 2557-2564. PMID: 12411642, DOI: 10.1161/01.str.0000036084.82955.c7.Peer-Reviewed Original ResearchPredicting 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
CT Angiography in the Rapid Triage of Patients with Hyperacute Stroke to Intraarterial Thrombolysis: Accuracy in the Detection of Large Vessel Thrombus
Lev M, Farkas J, Rodriguez V, Schwamm L, Hunter G, Putman C, Rordorf G, Buonanno F, Budzik R, Koroshetz W, Gonzalez R. CT Angiography in the Rapid Triage of Patients with Hyperacute Stroke to Intraarterial Thrombolysis: Accuracy in the Detection of Large Vessel Thrombus. Journal Of Computer Assisted Tomography 2001, 25: 520-528. PMID: 11473180, DOI: 10.1097/00004728-200107000-00003.Peer-Reviewed Original ResearchPredicting Tissue Outcome in Acute Human Cerebral Ischemia Using Combined Diffusion- and Perfusion-Weighted MR Imaging
Wu O, Koroshetz W, Østergaard L, Buonanno F, Copen W, Gonzalez R, Rordorf G, Rosen B, Schwamm L, Weisskoff R, Sorensen A. Predicting Tissue Outcome in Acute Human Cerebral Ischemia Using Combined Diffusion- and Perfusion-Weighted MR Imaging. Stroke 2001, 32: 933-942. PMID: 11283394, DOI: 10.1161/01.str.32.4.933.Peer-Reviewed Original Research
1999
Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset
González R, Schaefer P, Buonanno F, Schwamm L, Budzik R, Rordorf G, Wang B, Sorensen A, Koroshetz W. Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset. Radiology 1999, 210: 155-62. PMID: 9885601, DOI: 10.1148/radiology.210.1.r99ja02155.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrainCerebrovascular DisordersFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedSensitivity and SpecificityTime FactorsTomography, X-Ray ComputedConceptsFinal clinical diagnosisDiffusion-weighted imagesDiffusion-weighted MR imagingDiffusion-weighted imagingConventional MR imagingMR imagingSymptom onsetBlinded reviewClinical diagnosisDiagnostic accuracyStroke symptom onsetDiffusion-weighted magnetic resonance imagingMagnetic resonance imagingT2-weighted MR imagingAcute strokeStroke symptomsFinal diagnosisTomographic scanStrokelike symptomsPatientsPatient recordsResonance imagingStrokeDiagnosisCT