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 ResearchMeSH KeywordsAdministration, OralAnticoagulantsCerebral HemorrhageHumansIschemic StrokeMagnetic Resonance ImagingNeuroimagingRisk FactorsSiderosisConceptsCortical 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 riskImproving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage
Das A, Gokcal E, Regenhardt R, Horn M, Schwab K, Daoud N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Rost N, Rosand J, Schwamm L, Greenberg S, Gurol M. Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage. Stroke And Vascular Neurology 2022, 8: 26-33. PMID: 35981809, PMCID: PMC9985798, DOI: 10.1136/svn-2022-001653.Peer-Reviewed Original ResearchMeSH KeywordsCerebral Amyloid AngiopathyCerebral HemorrhageCerebral Small Vessel DiseasesCorpus CallosumHumansHypertensionMagnetic Resonance ImagingConceptsLeft ventricular hypertrophyCerebral amyloid angiopathyLobar intracerebral hemorrhageIntracerebral hemorrhageImaging markerFrequency of LVHCerebral small vessel diseaseSmall vessel diseaseAetiologic groupsLobar lacunesAmyloid angiopathyVentricular hypertrophyVessel diseasePresence/distributionPatientsDisease etiologyHemorrhageLacunesMarkersRegression modelsAngiopathyHigh frequencyHypertrophyEtiologyDisease
2021
Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease
Das A, Regenhardt R, Gokcal E, Horn M, Daoud N, Schwab K, Rost N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Schwamm L, Rosand J, Greenberg S, Gurol M. Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease. International Journal Of Stroke 2021, 17: 645-653. PMID: 34427471, PMCID: PMC10947797, DOI: 10.1177/17474930211043957.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral Amyloid AngiopathyCerebral HemorrhageCerebral Small Vessel DiseasesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedStrokeConceptsCerebral small vessel diseaseCerebral amyloid angiopathyPrimary intraventricular hemorrhageIdiopathic primary intraventricular hemorrhageProbable cerebral amyloid angiopathyAmyloid angiopathySmall vessel diseaseIntraventricular hemorrhageVessel diseaseMean initial blood pressureNon-traumatic intracerebral hemorrhageBrain magnetic resonance imagingInitial blood pressurePrimary intraparenchymal hemorrhageSingle referral centerBrain magnetic resonanceMagnetic resonance imagingCSVD subtypesBoston criteriaReferral centerBlood pressureConsecutive patientsCerebral amyloidIntracerebral hemorrhageIntraparenchymal hemorrhage
2019
Ischaemic stroke
Campbell B, De Silva D, Macleod M, Coutts S, Schwamm L, Davis S, Donnan G. Ischaemic stroke. Nature Reviews Disease Primers 2019, 5: 70. PMID: 31601801, DOI: 10.1038/s41572-019-0118-8.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaComputed Tomography AngiographyHumansMagnetic Resonance ImagingStrokeThrombolytic TherapyTomography, X-Ray ComputedTreatment OutcomeConceptsIschemic strokeIntravenous thrombolysisEndovascular thrombectomyStroke onsetSevere symptomatic carotid artery stenosisSymptomatic carotid artery stenosisSalvageable brain tissueBlood pressure controlCardiovascular risk managementLarge vessel occlusionMajority of strokesMechanism of strokeOnset of strokeCarotid artery stenosisCause of disabilitySecond highest causeSystems of careAntithrombotic medicationRapid reperfusionReperfusion therapySecondary preventionStroke symptomsArterial occlusionArtery stenosisCarotid endarterectomy
2017
Recrudescence of Deficits After Stroke: Clinical and Imaging Phenotype, Triggers, and Risk Factors
Topcuoglu M, Saka E, Silverman S, Schwamm L, Singhal A. Recrudescence of Deficits After Stroke: Clinical and Imaging Phenotype, Triggers, and Risk Factors. JAMA Neurology 2017, 74: 1048-1055. PMID: 28783808, PMCID: PMC5710180, DOI: 10.1001/jamaneurol.2017.1668.Peer-Reviewed Original ResearchConceptsTransient ischemic attackRisk factorsIschemic attackChronic strokeMean ageDiagnostic criteriaPSR groupHealth Stroke Scale scoreIntravenous tissue plasminogen activatorMiddle cerebral artery territoryResearch Patient Data RepositoryCrossover cohort studyHypertensive brain hemorrhagePatients' mean ageStroke Scale scoreFocal neurologic deficitsSmall vessel diseaseCase-control studyPreliminary diagnostic criteriaTissue plasminogen activatorStroke-related deficitsMagnetic resonance imagingWhite matter tractsDiffusion-weighted imagingPatient data repository
2016
Endovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria
Leslie-Mazwi TM, Hirsch JA, Falcone GJ, Schaefer PW, Lev MH, Rabinov JD, Rost NS, Schwamm L, González RG. Endovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria. JAMA Neurology 2016, 73: 1-7. PMID: 26524074, DOI: 10.1001/jamaneurol.2015.3000.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesEndovascular ProceduresFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPatient SelectionProspective StudiesStrokeTreatment OutcomeConceptsMagnetic resonance imagingSelection of patientsClinical criteriaFavorable outcomeSuccessful reperfusionMRS scoreLTB patientsIschemic strokeTerminal internal carotid artery occlusionResonance imagingInternal carotid artery occlusionStroke treatment outcomesEndovascular stroke treatmentAcute ischemic strokeCarotid artery occlusionProspective cohort studyMiddle cerebral arterySpecific magnetic resonance imagingInfarct volume determinationArtery occlusionCohort studyStroke treatmentCerebral arteryEndovascular treatmentPatient selection
2013
Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients
Qian J, Payabvash S, Kemmling A, Lev MH, Schwamm LH, Betensky RA. Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients. Biometrics 2013, 70: 153-163. PMID: 24320930, PMCID: PMC3954429, DOI: 10.1111/biom.12113.Peer-Reviewed Original ResearchConceptsMassachusetts General HospitalCase-control studyStroke patientsAcute ischemic stroke patientsBrain regionsMatched Case-Control StudyHospital-Acquired PneumoniaIschemic stroke patientsLarge prospective studiesUnconditional logistic regressionCase-control designSpecific brain regionsAcquired PneumoniaAcute infarctionClinical featuresProspective studyClinical variablesGeneral HospitalEpidemiologic studiesPatientsModern imagingLarger studyLogistic regressionAppropriate statistical analysisHAP studies
2012
Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy
Chandra R, Leslie-Mazwi T, Oh D, Chaudhry Z, Mehta B, Rost N, Rabinov J, Hirsch J, González R, Schwamm L, Yoo A. Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy. Stroke 2012, 43: 2356-2361. PMID: 22744644, DOI: 10.1161/strokeaha.112.650713.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAngioplasty, BalloonCerebral InfarctionCohort StudiesEndovascular ProceduresEndpoint DeterminationFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesReperfusionRiskStentsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsIntra-arterial therapyParenchymal hematoma type 2Elderly patientsBaseline disabilityClinical outcomesBaseline healthType 2Cerebral infarction 2Worse baseline healthElderly stroke patientsRankin Scale scoreWorse clinical outcomesCoronary artery diseaseAngiographic reperfusionBaseline demographicsStroke severityArtery diseaseStroke patientsAtrial fibrillationPoor outcomeSignificant hemorrhageHigh riskReperfusionPatientsBetter outcomesEconomic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom
Earnshaw S, McDade C, Chapman A, Jackson D, Schwamm L. Economic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom. Clinical Therapeutics 2012, 34: 1544-1558. PMID: 22695225, DOI: 10.1016/j.clinthera.2012.05.004.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingMRI selectionUsual careDiagnostic testsFavorable outcomeIncremental cost-effectiveness ratioAcute stroke treatmentPreferred diagnostic testNumber of patientsAdditional diagnostic testsCost-effectiveness ratioDecision analytic modelCTP selectionIntravenous thrombolysisStroke onsetStroke treatmentPatient selectionUK patientsPenumbral patternPatient outcomesPerfusion CTPatient historyThrombolysisPatientsPerfusion imagingPredictors 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 outcomes
2010
LICORICE-ASSOCIATED REVERSIBLE CEREBRAL VASOCONSTRICTION WITH PRES(CME)
Chatterjee N, Domoto-Reilly K, Fecci P, Schwamm L, Singhal A. LICORICE-ASSOCIATED REVERSIBLE CEREBRAL VASOCONSTRICTION WITH PRES(CME). Neurology 2010, 75: 1939-1941. PMID: 21098410, PMCID: PMC2995386, DOI: 10.1212/wnl.0b013e3181feb299.Peer-Reviewed Original ResearchAdministration, OralBrainCerebral AngiographyCerebrovascular CirculationCerebrovascular DisordersFemaleGlycyrrhizaHeadache Disorders, PrimaryHumansHydrocortisoneHypertensionMagnetic Resonance ImagingMiddle AgedNimodipinePosterior Leukoencephalopathy SyndromeSeizuresTomography, X-Ray ComputedTreatment OutcomeVasoconstrictionVasodilator AgentsVerapamilVision DisordersManagement of Thrombolysis-Associated Symptomatic Intracerebral Hemorrhage
Goldstein J, Marrero M, Masrur S, Pervez M, Barrocas A, Abdullah A, Oleinik A, Rosand J, Smith E, Dzik W, Schwamm L. Management of Thrombolysis-Associated Symptomatic Intracerebral Hemorrhage. JAMA Neurology 2010, 67: 965-969. PMID: 20697046, PMCID: PMC3690951, DOI: 10.1001/archneurol.2010.175.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageIntra-arterial thrombolysisHospital mortalityIntracerebral hemorrhageHealth Stroke Scale scoreIntravenous tissue plasminogen activatorGuidelines-Stroke databaseStroke Scale scoreAcute ischemic strokeMultivariable logistic regressionFresh frozen plasmaTissue plasminogen activatorMulticenter registryAcute strokeDevastating complicationIschemic strokeIndependent predictorsThrombolytic therapyFrozen plasmaAppropriate treatmentRetrospective analysisPatientsScale scoreCoagulopathyThrombolysis
2009
A 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 practiceStrokeCost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis
Earnshaw S, Jackson D, Farkouh R, Schwamm L. Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis. Stroke 2009, 40: 1710-1720. PMID: 19286581, DOI: 10.1161/strokeaha.108.540138.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlgorithmsCerebral HemorrhageCost-Benefit AnalysisDecision Support TechniquesFemaleFibrinolytic AgentsHumansImage Processing, Computer-AssistedInfusions, IntravenousMagnetic Resonance ImagingMalePatient SelectionProportional Hazards ModelsQuality-Adjusted Life YearsStrokeThrombolytic TherapyTomography, X-Ray ComputedTreatment OutcomeConceptsMRI selection
2008
Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study
Hacke W, Furlan A, Al-Rawi Y, Davalos A, Fiebach J, Gruber F, Kaste M, Lipka L, Pedraza S, Ringleb P, Rowley H, Schneider D, Schwamm L, Leal J, Söhngen M, Teal P, Wilhelm-Ogunbiyi K, Wintermark M, Warach S. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. The Lancet Neurology 2008, 8: 141-150. PMID: 19097942, PMCID: PMC2730486, DOI: 10.1016/s1474-4422(08)70267-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageDouble-Blind MethodFemaleFibrinolytic AgentsHumansInjections, IntravenousMagnetic Resonance ImagingMaleMiddle AgedPerfusionPlasminogen ActivatorsProspective StudiesSample SizeStrokeTomography, X-Ray ComputedTreatment FailureYoung AdultConceptsSymptomatic intracranial hemorrhageClinical response rateAcute ischemic strokeDiffusion-weighted imagingResponse rateNIHSS scoreIschemic strokeIntracranial hemorrhageLesion volumeDay 90Mortality ratePerfusion imagingScale scoreHealth Stroke Scale scoreMedian baseline NIHSS scoreModified Rankin Scale scoreMagnetic resonance perfusion imagingComposite of improvementBaseline NIHSS scorePlacebo-controlled studyStroke Scale scoreDose-ranging studyRankin Scale scoreSymptoms of strokeOnset of strokeQuantitative Assessment of Core/Penumbra Mismatch in Acute Stroke
Schaefer P, Barak E, Kamalian S, Gharai L, Schwamm L, Gonzalez R, Lev M. Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke. Stroke 2008, 39: 2986-2992. PMID: 18723425, DOI: 10.1161/strokeaha.107.513358.Peer-Reviewed Original ResearchConceptsCT perfusionPatient selectionInfarct coreAcute middle cerebral artery strokeMiddle cerebral artery strokePreferred imaging methodStroke clinical trialsAcute strokeArtery strokeStroke trialsTrial enrollmentClinical trialsLesion volumeMR perfusionIschemic regionBlood volumeTime abnormalitiesVolume thresholdLesion sizeQuantitative CTPerfusionAdvanced MRCT coverageLesionsMR diffusionAn 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