2024
Cervical Dissection in Patients With Tandem Lesions Is Associated With Distal Embolism and Lower Recanalization Success
Galecio-Castillo M, Guerrero W, Hassan A, Farooqui M, Jumaa M, Divani A, Abraham M, Petersen N, Fifi J, Malik A, Siegler J, Nguyen T, Sheth S, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Olivé-Gadea M, Tekle W, Zaidi S, Sabbagh S, Barkley T, Prasad A, De Leacy R, Abdalkader M, Salazar-Marioni S, Soomro J, Gordon W, Turabova C, Rodriguez-Calienes A, Dibas M, Mokin M, Yavagal D, Ribo M, Jovin T, Ortega-Gutierrez S. Cervical Dissection in Patients With Tandem Lesions Is Associated With Distal Embolism and Lower Recanalization Success. Stroke 2024, 55: 1808-1817. PMID: 38913799, DOI: 10.1161/strokeaha.123.046148.Peer-Reviewed Original ResearchConceptsInternal carotid arteryCervical internal carotid arteryDistal embolizationModified ThrombolysisTandem lesionsMulticenter retrospective cohort studyParenchymal hematoma type 2Internal carotid artery stenosis/occlusionModified Rankin Scale scoreSymptomatic intracranial hemorrhageInverse probability of treatment weightingCerebral Infarction scoreCervical ICA dissectionRetrospective cohort studyProbability of treatment weightingRankin Scale scoreAssociated with higher ratesFunctional independenceRates of hypertensionAssociated with distal embolizationSelf-expanding stentsDissection etiologyRisk of distal embolizationICA occlusionCervical dissectionAutomated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortImpact of sleep quality and physical activity on blood pressure variability
de Havenon A, Falcone G, Rivier C, Littig L, Petersen N, de Villele P, Prabhakaran S, Kimberly W, Mistry E, Sheth K. Impact of sleep quality and physical activity on blood pressure variability. PLOS ONE 2024, 19: e0301631. PMID: 38625967, PMCID: PMC11020843, DOI: 10.1371/journal.pone.0301631.Peer-Reviewed Original ResearchConceptsSleep qualityPhysical activityOdds ratioCohort of community-dwelling adultsCommunity-dwelling adultsExcess relative riskBlood pressure variabilityExamined sleep qualityPoor sleep qualitySystolic blood pressure standard deviationSleep interruptionBody mass indexPhysical inactivityPrimary study outcomeStep countsImpact of sleep qualityLowest tertileRelative riskHigh blood pressure variabilityHome measurement devicesActivity levelsExposure statusPoor sleepMass indexStudy outcomesDeviation From Personalized Blood Pressure Targets Correlates With Worse Outcome After Successful Recanalization
Zhang Z, Pu Y, Yu L, Bai H, Duan W, Liu X, Nie X, Wen Z, Zheng L, Hu X, Leng X, Pan Y, Petersen N, Liu L. Deviation From Personalized Blood Pressure Targets Correlates With Worse Outcome After Successful Recanalization. Journal Of The American Heart Association 2024, 13: e033633. PMID: 38533955, PMCID: PMC11179781, DOI: 10.1161/jaha.123.033633.Peer-Reviewed Original ResearchConceptsBlood pressure targetsBlood pressureAutoregulatory limitsWorse outcomesAssociated with symptomatic intracranial hemorrhageAssociated with unfavorable clinical outcomesPressure targetsAssociated with worse outcomesAssociated with poor outcomesSignificant infarction growthSymptomatic intracranial hemorrhageUnfavorable clinical outcomeLarge vessel occlusion strokeAcute ischemic strokeMean velocity indexIntracranial hemorrhageBP management strategiesNeurological deteriorationClinical outcomesInfarct growthPoor outcomeEndovascular thrombectomyOcclusion strokeRecanalizationIschemic stroke
2023
Detection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke
Mazurek M, Parasuram N, Peng T, Beekman R, Yadlapalli V, Sorby-Adams A, Lalwani D, Zabinska J, Gilmore E, Petersen N, Falcone G, Sujijantarat N, Matouk C, Payabvash S, Sze G, Schiff S, Iglesias J, Rosen M, de Havenon A, Kimberly W, Sheth K. Detection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke. Stroke 2023, 54: 2832-2841. PMID: 37795593, PMCID: PMC11103256, DOI: 10.1161/strokeaha.123.043146.Peer-Reviewed Original ResearchSafety Outcomes of Mechanical Thrombectomy Versus Combined Thrombectomy and Intravenous Thrombolysis in Tandem Lesions
Rodriguez-Calienes A, Galecio-Castillo M, Farooqui M, Hassan A, Jumaa M, Divani A, Ribo M, Abraham M, Petersen N, Fifi J, Guerrero W, Malik A, Siegler J, Nguyen T, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Tekle W, Alhajala H, Ikram A, Rizzo F, Qureshi A, Begunova L, Matsoukas S, Vigilante N, Salazar-Marioni S, Abdalkader M, Gordon W, Soomro J, Turabova C, Vivanco-Suarez J, Mokin M, Yavagal D, Jovin T, Sheth S, Ortega-Gutierrez S. Safety Outcomes of Mechanical Thrombectomy Versus Combined Thrombectomy and Intravenous Thrombolysis in Tandem Lesions. Stroke 2023, 54: 2522-2533. PMID: 37602387, PMCID: PMC10599264, DOI: 10.1161/strokeaha.123.042966.Peer-Reviewed Original ResearchConceptsRisk of sICHParenchymal hematoma type 2Symptomatic intracranial hemorrhageRankin Scale score 0Intravenous antiplatelet therapyIntravenous thrombolysisFavorable functional outcomeMechanical thrombectomyHemorrhagic transformationFunctional outcomeType 2Antiplatelet therapyHospital mortalitySuccessful reperfusionComplete reperfusionScore 0Tandem lesionsAnterior circulation tandem lesionsExcellent functional outcomeIVT treatmentStroke centersMulticenter cohortPrimary outcomeRevascularization techniquesAlone groupDynamic cerebral autoregulation in postpartum individuals with and without preeclampsia
Miller E, Katsidoniotaki M, Haghighi N, Dos Santos K, Booker W, Petersen N, Wapner R, Bello N, Kougioumtzoglou I, Marshall R. Dynamic cerebral autoregulation in postpartum individuals with and without preeclampsia. Pregnancy Hypertension 2023, 33: 39-45. PMID: 37524001, PMCID: PMC10528950, DOI: 10.1016/j.preghy.2023.07.176.Peer-Reviewed Original ResearchConceptsDynamic cerebral autoregulationFirst week postpartumPostpartum individualsSevere featuresCerebral autoregulationPostpartum groupPreeclampsia diagnosisWeeks postpartumHistorical controlsFemale volunteersNon-pregnant female volunteersContinuous arterial blood pressureArterial blood pressureNon-pregnant volunteersDiagnosis of preeclampsiaHealthy non-pregnant female volunteersCerebrovascular complicationsBlood pressureTranscranial DopplerPostpartum participantsAutoregulatory responseFinger plethysmographyKruskal-Wallis testPreeclampsiaAutoregulation parametersAssociation of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke
Stulberg E, Harris B, Zheutlin A, Delic A, Sheibani N, Anadani M, Yaghi S, Petersen N, de Havenon A. Association of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke. Neurology 2023, 101: e1145-e1157. PMID: 37487742, PMCID: PMC10513881, DOI: 10.1212/wnl.0000000000207599.Peer-Reviewed Original ResearchConceptsAverage real variabilityNonstroke patientsDischarge destinationHospital deathIschemic strokeIll patientsIllness severityWorse outcomesAdult intensive care unit patientsMinimum mean arterial pressureIntensive care unit patientsIntensive Care III databaseBlood pressure goalsAcute ischemic strokeMean arterial pressureBlood pressure variabilityCare unit patientsRisk of deathMedical Information MartUnit patientsArterial pressureIntracerebral hemorrhageSubarachnoid hemorrhageRisk factorsEffect modificationImaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes
Dhar R, Kumar A, Chen Y, Begunova Y, Olexa M, Prasad A, Carey G, Gonzalez I, Bhatia K, Hamed M, Heitsch L, Mainali S, Petersen N, Lee J. Imaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes. Journal Of Neuroimaging 2023, 33: 606-616. PMID: 37095592, PMCID: PMC10524672, DOI: 10.1111/jon.13109.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeMidline shiftCSF ratioMalignant edemaCerebral edemaOcclusion strokeCerebrospinal fluidAlberta Stroke Program Early CT ScoreCSF volumeTissue plasminogen activator treatmentHealth Stroke ScalePlasminogen activator treatmentRoutine CT scansNet water uptakeDecompressive surgeryInfarct volumeStroke ScaleOsmotic therapyBaseline CTCT scoreHemispheric volumeRoutine CTSerial CTContralateral regionsCT scanReduced-order modeling and analysis of dynamic cerebral autoregulation via diffusion maps
dos Santos K, Katsidoniotaki M, Miller E, Petersen N, Marshall R, Kougioumtzoglou I. Reduced-order modeling and analysis of dynamic cerebral autoregulation via diffusion maps. Physiological Measurement 2023, 44: 044001. PMID: 36963111, PMCID: PMC11271258, DOI: 10.1088/1361-6579/acc780.Peer-Reviewed Original ResearchConceptsDiffusion mapsState-space descriptionReduced-order modelingIntrinsic dynamicsTime derivativeLow-dimensional representationRandom walkMarkov matrixParsimonious modelingSignificant eigenvaluesEigenvalue ratioFurther dimension reductionEigenvalue analysisTransfer function analysisDimension reductionData-driven techniquesMain resultsDynamicsEigenvaluesFlow velocityModelingSuperior performanceMap techniqueGraphWalkPrecision Medicine in Neurocritical Care for Cerebrovascular Disease Cases
Petersen N, Sheth K, Jha R. Precision Medicine in Neurocritical Care for Cerebrovascular Disease Cases. Stroke 2023, 54: 1392-1402. PMID: 36789774, PMCID: PMC10348371, DOI: 10.1161/strokeaha.122.036402.Peer-Reviewed Original ResearchConceptsStroke careCerebrovascular diseaseTreatment targetsPrecision medicineCerebrovascular disease casesAcute stroke careCritical care managementClinical decision-making processNeurocritical careClinical examinationPractice guidelinesClinical phenotypingIndividual patientsCare managementClinical practiceTreatment planDisease casesPhysiologic monitoringBiomarker developmentCarePatientsDiseaseIndividual casesMedicineICUEmergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patientsFuture of Neurology & Technology: Neuroimaging Made Accessible Using Low-Field, Portable MRI
Parasuram N, Crawford A, Mazurek M, Chavva I, Beekman R, Gilmore E, Petersen N, Payabvash S, Sze G, Eugenio Iglesias J, Omay S, Matouk C, Longbrake E, de Havenon A, Schiff S, Rosen M, Kimberly W, Sheth K. Future of Neurology & Technology: Neuroimaging Made Accessible Using Low-Field, Portable MRI. Neurology 2023, 100: 1067-1071. PMID: 36720639, PMCID: PMC10259275, DOI: 10.1212/wnl.0000000000207074.Peer-Reviewed Original ResearchPolygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors
Acosta J, Both C, Demarais Z, Conlon C, Leasure A, Torres-Lopez V, de Havenon A, Petersen N, Gill T, Sansing L, Sheth K, Falcone G. Polygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors. Neurology 2023, 100: e1587-e1597. PMID: 36690452, PMCID: PMC10103110, DOI: 10.1212/wnl.0000000000206763.Peer-Reviewed Original ResearchConceptsWorse BP controlUncontrolled blood pressureDiastolic blood pressureBlood pressureStroke survivorsPolygenic risk scoresBP controlPolygenic susceptibilityMean diastolic blood pressureMean systolic blood pressureStroke Prevention TrialBlood pressure controlSystolic blood pressureResistant hypertensionVascular eventsHemorrhagic strokePrevention trialsVitamin InterventionMultivariable modelRisk scoreGenetic predispositionPressure controlLogistic regressionSurvivorsHypertension
2022
Interaction of Mean Arterial Pressure and Blood Pressure Variability in Critically Ill Brain Injured Patients
de Havenon A, Petersen N, Stulberg E, Anadani M, Biffi A, Sheth K. Interaction of Mean Arterial Pressure and Blood Pressure Variability in Critically Ill Brain Injured Patients. Stroke 2022, 53: e512-e514. PMID: 36367101, PMCID: PMC9712254, DOI: 10.1161/strokeaha.122.041274.Peer-Reviewed Original Research
2021
Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome
Nogueira R, Aries M, Minhas J, Petersen N, Xiong L, Kainerstorfer J, Castro P. Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome. Cerebrovascular And Brain Metabolism Reviews 2021, 42: 430-453. PMID: 34515547, PMCID: PMC8985432, DOI: 10.1177/0271678x211045222.Peer-Reviewed Original ResearchConceptsDynamic cerebral autoregulationAcute phaseClinical outcomesCerebral autoregulationAcute ischemic strokeCerebral hemodynamic parametersPotential therapeutic targetCerebrovascular disease statesAcute strokeIschemic strokeStroke onsetCerebral perfusionCerebral circulationIntracerebral hemorrhageHigh morbidityHemodynamic parametersIndividual patientsPerfusion interventionsNew therapiesTherapeutic targetHemodynamic aspectsPatientsAdditional treatmentDisease statesRelevant studies
2020
Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke
Petersen NH, Silverman A, Strander SM, Kodali S, Wang A, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Jasne AS, Cord B, Hebert RM, Johnson M, Matouk CC, Sheth KN. Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke. Stroke 2020, 51: 914-921. PMID: 32078493, PMCID: PMC7050651, DOI: 10.1161/strokeaha.119.026596.Peer-Reviewed Original ResearchConceptsSystolic BP thresholdMean arterial pressureArterial pressureEndovascular thrombectomyIschemic strokeSystolic BPFunctional outcomePercent timeFurther brain injuryModified Rankin ScaleBlood pressure changesPoor functional outcomeBP thresholdAutoregulatory indexHemorrhagic transformationMechanical thrombectomyRankin ScaleBlood pressureBP targetsHemodynamic managementAcute phaseBP managementStroke patientsCerebral autoregulationWorse outcomes
2019
Deviation From Personalized Blood Pressure Targets Is Associated With Worse Outcome After Subarachnoid Hemorrhage
Silverman A, Kodali S, Strander S, Gilmore EJ, Kimmel A, Wang A, Cord B, Falcone G, Hebert R, Matouk C, Sheth KN, Petersen NH. Deviation From Personalized Blood Pressure Targets Is Associated With Worse Outcome After Subarachnoid Hemorrhage. Stroke 2019, 50: 2729-2737. PMID: 31495332, PMCID: PMC6756936, DOI: 10.1161/strokeaha.119.026282.Peer-Reviewed Original ResearchConceptsLimits of autoregulationAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageFunctional outcomeArterial pressureIntracranial pressureBP targetsWorse outcomesPercent timeBlood pressure targetsBlood pressure managementMean arterial pressureModified Rankin ScalePotential neuroprotective strategiesWorse functional outcomePoor functional outcomeCerebral blood flowMultivariate logistic regressionTotal monitoring periodAutoregulatory indexPressure targetsCerebral ischemiaNeuroprotective strategiesRankin ScaleCerebral autoregulationChanges on Dynamic Cerebral Autoregulation Are Associated with Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage
Ortega-Gutierrez S, Samaniego E, Reccius A, Huang A, Zheng-Lin B, Masukar A, Marshall R, Petersen N. Changes on Dynamic Cerebral Autoregulation Are Associated with Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement 2019, 127: 149-153. PMID: 31407076, DOI: 10.1007/978-3-030-04615-6_22.Peer-Reviewed Original ResearchConceptsDynamic cerebral autoregulationAneurysmal subarachnoid hemorrhageCerebral blood flow velocityBlood pressureSymptomatic vasospasmCerebral ischemiaSAH patientsCerebral autoregulationSubarachnoid hemorrhageCerebral blood flow regulationGlasgow Coma ScoreSystemic blood pressureDelayed Cerebral IschemiaLarge cohort studyBlood flow regulationBlood flow velocityRecording periodDCA assessmentCohort studyComa ScoreEntire recording periodSymptom onsetMedian timeDay 3Early identificationDecreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic stroke