2023
Mechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds
Das A, Gokcal E, Biffi A, Regenhardt R, Pasi M, Abramovitz Fouks A, Viswanathan A, Goldstein J, Schwamm L, Rosand J, Greenberg S, Gurol M. Mechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds. Neurology 2023, 101: e636-e644. PMID: 37290968, PMCID: PMC10424843, DOI: 10.1212/wnl.0000000000207476.Peer-Reviewed Original ResearchMeSH KeywordsCerebral Amyloid AngiopathyCerebral HemorrhageHumansHypertensionMagnetic Resonance ImagingNeuroimagingSiderosisConceptsCortical superficial siderosisCerebral microbleedsSuperficial siderosisIntracerebral hemorrhageHypertensive end-organ damagePresence of CMBsCerebral small vessel diseaseAdjusted hazard ratioEnd-organ damageCoronary artery diseaseDeep cerebral microbleedsSmall vessel diseaseImaging-based classificationLogistic regression modelsICH survivorsProspective databaseHazard ratioReferral centerArtery diseaseConsecutive patientsVentricular hypertrophyVessel diseaseICH recurrenceWarrant confirmationICH risk
2022
Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants
Das A, Gökçal E, Regenhardt R, Warren A, Biffi A, Goldstein J, Kimberly W, Viswanathan A, Schwamm L, Rosand J, Greenberg S, Gurol M. Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants. Journal Of Neurology 2022, 269: 6589-6596. PMID: 35997817, PMCID: PMC10947801, DOI: 10.1007/s00415-022-11333-2.Peer-Reviewed Original ResearchConceptsCortical superficial siderosisPrior ischemic strokeDOAC usersCerebral microbleedsWhite matter hyperintensitiesIschemic strokeSevere white matter hyperintensitiesOral anticoagulant usageDirect oral anticoagulantsSingle referral centerHigh hemorrhagic riskCoronary artery diseaseAge-matched controlsMultivariable regression modelsDOAC therapyICH cohortPrior strokeOral anticoagulantsSuperficial siderosisBaseline demographicsReferral centerSmoking historyArtery diseaseConclusionsRisk factorsHemorrhage risk
2018
Implementation of a Rapid, Protocol-based TIA Management Pathway
Jarhult S, Howell M, Barnaure-Nachbar I, Chang Y, White B, Amatangelo M, Brown D, Singhal A, Schwamm L, Silverman S, Goldstein J. Implementation of a Rapid, Protocol-based TIA Management Pathway. Western Journal Of Emergency Medicine 2018, 19: 216-223. PMID: 29560046, PMCID: PMC5851491, DOI: 10.5811/westjem.2017.9.35341.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTotal hospital LOSHospital LOSEmergency departmentED LOSFinal diagnosisRecurrent transient ischemic attacksTertiary care academic centerED observation unitIntermediate-risk patientsHigh-risk patientsProportion of patientsMedian ED LOSInpatient admission ratesNeck CT angiographyBrain magnetic resonanceNeck MR angiographyStandardized clinical protocolUse of neuroimagingIschemic attackCohort studyTIA symptomsConsecutive patientsED lengthSix-month period
2016
Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials
Warach S, Luby M, Albers G, Bammer R, Bivard A, Campbell B, Derdeyn C, Heit J, Khatri P, Lansberg M, Liebeskind D, Majoie C, Marks M, Menon B, Muir K, Parsons M, Vagal A, Yoo A, Alexandrov A, Baron J, Fiorella D, Furlan A, Puig J, Schellinger P, Wintermark M, Ansari S, Aviv R, Barreto A, Broderick J, Christensen S, Davis S, Demchuk A, Dippel D, Donnan G, Fiebach J, Fiehler J, Houser G, Grotta J, Hacke W, Hill M, Hsia A, Jovin T, Köhrmann M, Latour L, Leigh R, Lees K, Lev M, Marshall R, Mocco J, Nadareishvili Z, Nogueira R, Olivot J, Palesch Y, Pedraza S, Sasaki M, Saver J, Savitz S, Schwamm L, Simpkins A, Smith W, Thijs V, Thomalla G, Wechsler L, Wu O, Zaharchuk G, Zaidat O. Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials. Stroke 2016, 47: 1389-1398. PMID: 27073243, PMCID: PMC6058693, DOI: 10.1161/strokeaha.115.012364.Peer-Reviewed Original ResearchMeSH KeywordsClinical Trials as TopicConsensusEducationEndovascular ProceduresHumansNeuroimagingStrokeThrombolytic TherapyConceptsClinical trialsEndovascular trialsImaging Working GroupFinal infarct volumeLarge vessel occlusionProspective clinical trialsImaging sessionAmerican SocietyOptimal imaging methodInfarct volumeStroke neurologistsEndovascular treatmentPooled analysisTherapy clinical trialsVessel occlusionImaging selectionGood collateralsNeurovascular imagingConsensus recommendationsUS FoodDrug AdministrationNeurological disordersPooled dataTrialsNational InstituteChapter 16 Imaging acute ischemic stroke
González R, Schwamm L. Chapter 16 Imaging acute ischemic stroke. Handbook Of Clinical Neurology 2016, 135: 293-315. PMID: 27432672, DOI: 10.1016/b978-0-444-53485-9.00016-7.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeCurrent evidence-based approachesSevere stroke syndromesIschemic stroke patientsPresence of hemorrhageMassachusetts General HospitalEvidence-based approachStroke syndromeAcute strokeAnterior circulationMajor strokeMore patientsArterial occlusionStroke patientsBrain parenchymaGeneral HospitalStroke typeCommon causeClinical valueComputed tomographyModern neuroimagingMagnetic resonance imaging methodLarge arteriesStroke evolution
2013
A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Kidwell C, Jahan R, Gornbein J, Alger J, Nenov V, Ajani Z, Feng L, Meyer B, Olson S, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Guzy J, Starkman S, Saver J. A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke. New England Journal Of Medicine 2013, 368: 914-923. PMID: 23394476, PMCID: PMC3690785, DOI: 10.1056/nejmoa1212793.Peer-Reviewed Original ResearchConceptsFavorable penumbral patternAcute ischemic strokeStandard carePenumbral patternIschemic strokeRankin ScaleNinety-day mortalitySymptomatic intracranial hemorrhageAnterior circulation strokeModified Rankin ScaleMagnetic resonance imagingEligible patientsEmbolectomy groupMechanical embolectomyEndovascular thrombectomyEndovascular therapySuch patientsClinical outcomesEndovascular treatmentIntracranial hemorrhageMean ageImaging selectionImaging patternsEmbolectomyPatientsIschemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis
Ji R, Schwamm L, Pervez M, Singhal A. Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis. JAMA Neurology 2013, 70: 51-57. PMID: 23108720, DOI: 10.1001/jamaneurol.2013.575.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTertiary stroke centerIschemic strokeYoung adultsIschemic attackHospital dischargeStroke centersStroke etiologyRisk factorsIschemic stroke/transient ischemic attackBetter outcomesStroke/transient ischemic attackHealth Stroke Scale scoreTraditional vascular risk factorsDiagnostic testsGuidelines-Stroke databaseMedian National InstitutesSymptomatic brain hemorrhageUndetermined stroke etiologyStroke Scale scoreVascular risk factorsMiddle cerebral arteryShort-term outcomesAge 35 yearsInternal carotid artery
2012
Predictors of Rapid Brain Imaging in Acute Stroke
Kelly A, Hellkamp A, Olson D, Smith E, Schwamm L. Predictors of Rapid Brain Imaging in Acute Stroke. Stroke 2012, 43: 1279-1284. PMID: 22442169, DOI: 10.1161/strokeaha.111.626374.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedDiabetes MellitusEmergency Service, HospitalFemaleFibrinolytic AgentsGuideline AdherenceHumansMagnetic Resonance ImagingMaleMultivariate AnalysisNeuroimagingPractice Guidelines as TopicRacial GroupsRetrospective StudiesSex FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTomography, X-Ray ComputedConceptsEmergency department arrivalBrain imagingSymptom onsetHealth Stroke Scale scoreFuture quality improvement initiativesGuidelines-Stroke programStroke Scale scoreStroke symptom onsetAcute stroke symptomsHistory of diabetesPeripheral vascular diseaseMultivariable logistic regressionQuality improvement initiativesEffectiveness of thrombolysisOverall imaging rateProsthetic heart valvesPredictive variablesAcute strokeMost patientsHospital clusteringIndependent predictorsStroke symptomsNonwhite raceEmergency departmentVascular diseaseInfarct 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 outcomesTelestroke increases use of acute stroke therapy
Müller-Barna P, Schwamm L, Haberl R. Telestroke increases use of acute stroke therapy. Current Opinion In Neurology 2012, 25: 5-10. PMID: 22157105, DOI: 10.1097/wco.0b013e32834d5fe4.Peer-Reviewed Original ResearchMeSH KeywordsEuropeHumansNeuroimagingNorth AmericaStrokeTelemedicineThrombolytic TherapyVideoconferencingConceptsTelestroke networkStroke careUsage of guidelinesAcute stroke careAcute stroke therapyIschemic stroke patientsRate of thrombolysisNew therapeutic modalitiesStroke teamAcute strokeNeurological examinationStroke unitStroke patientsStroke therapyStroke managementImproved outcomesTherapeutic modalitiesTelestroke servicesRemote reviewUnderserved areasHigh-quality videoconferencingCareIncrease useRegular basisThrombolysis