2024
Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient dataPeri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage
Dierksen F, Tran A, Zeevi T, Maier I, Qureshi A, Sanelli P, Werring D, Malhotra A, Falcone G, Sheth K, Payabvash S. Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage. European Stroke Journal 2024, 9: 383-390. PMID: 38179883, PMCID: PMC11318427, DOI: 10.1177/23969873231223814.Peer-Reviewed Original ResearchNIH Stroke ScaleGlasgow Coma ScaleAssociation of baselineIntracerebral hemorrhagePerihematomal edemaHematoma volumeAcute supratentorial intracerebral hemorrhageNon-traumatic intracerebral hemorrhageSecondary brain injuryAcute ICH patientsIndependent prognostic factorSupratentorial intracerebral hemorrhageAdmission NIH Stroke ScalePotential treatment targetRankin scoreStroke ScaleIndependent predictorsPatient agePrognostic factorsComa ScaleMultivariable analysisICH patientsPrognostic valueBrain injuryFavorable outcome
2022
Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage
Bevers M, Booraem C, Li K, Sreekrishnan A, Sastre C, Falcone G, Sheth K, Sansing L, Kimberly W. Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage. Neurology 2022, 100: e1329-e1338. PMID: 36549913, PMCID: PMC10065211, DOI: 10.1212/wnl.0000000000206764.Peer-Reviewed Original ResearchConceptsSoluble ST2Deep intraparenchymal hemorrhageIntraparenchymal hemorrhagePerihematomal edemaImmune responseHematoma volumePoor outcomeFunctional outcomeMedian admission Glasgow Coma Scale scoreScale scoreAdmission Glasgow Coma Scale scorePeripheral innate immune responseModified Rankin Scale scoreGlasgow Coma Scale scoreHours of ictusPeripheral immune responseSecondary brain injuryRankin Scale scoreInnate immune cellsImmune cell populationsIntracerebral Hemorrhage ScoreSerial CT scansInnate immune responseHuman brain tissueSST2 levels
2021
Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonanceAdmission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH‐2 trial intracerebral hemorrhage population
Haider SP, Qureshi AI, Jain A, Tharmaseelan H, Berson ER, Zeevi T, Majidi S, Filippi CG, Iseke S, Gross M, Acosta JN, Malhotra A, Kim JA, Sansing LH, Falcone GJ, Sheth KN, Payabvash S. Admission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH‐2 trial intracerebral hemorrhage population. European Journal Of Neurology 2021, 28: 2989-3000. PMID: 34189814, PMCID: PMC8818333, DOI: 10.1111/ene.15000.Peer-Reviewed Original ResearchConceptsAdmission Glasgow Coma ScaleGlasgow Coma ScaleRadiomics signatureMRS scoreHematoma volumeICH volumeClinical severityNoncontrast head CT scansAdmission National InstitutesHealth Stroke ScaleRankin Scale scoreStrong associationBaseline clinical severityMedium-term outcomesIndependent validation cohortHead CT scanATACH-2 trialStroke ScaleAdmission NIHSSIndependent predictorsClinical presentationComa ScaleBaseline CTICH patientsValidation cohortAdmission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage
Acosta JN, Leasure AC, Kuohn LR, Both CP, Petersen NH, Sansing LH, Matouk CC, Testai F, Langefeld CD, Woo D, Kamel H, Murthy SB, Qureshi A, Mayer SA, Sheth KN, Falcone GJ. Admission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage. Critical Care Medicine 2021, 49: 828-837. PMID: 33591003, PMCID: PMC8611893, DOI: 10.1097/ccm.0000000000004891.Peer-Reviewed Original ResearchConceptsAdmission hemoglobin levelsHemoglobin levelsNontraumatic intracerebral hemorrhageIntracerebral hemorrhageHematoma volumePoor outcomeHematoma expansionIntracerebral hemorrhage patientsPredictors of outcomeSpontaneous intracerebral hemorrhageIndividual patient dataHigher hemoglobin levelsAdmission hematoma volumeExposure of interestDose-response analysisAdmission hemoglobinRankin ScalePrimary outcomeHemorrhage patientsFunctional outcomeRepeat CTClinical trialsObservational studyHemorrhage sizeBetter outcomesAndexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage
Ammar AA, Ammar MA, Owusu KA, Brown SC, Kaddouh F, Elsamadicy AA, Acosta JN, Falcone GJ. Andexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage. Neurocritical Care 2021, 35: 255-261. PMID: 33403588, PMCID: PMC10273779, DOI: 10.1007/s12028-020-01161-5.Peer-Reviewed Original ResearchConceptsFactor Xa inhibitorsSpontaneous intracranial hemorrhageSpontaneous intraparenchymal hemorrhageAndexanet alfaIntracranial hemorrhageProthrombin complex concentrateThrombotic eventsIntraparenchymal hemorrhageFunctional outcomeComplex concentrateXa inhibitorsFour-factor prothrombin complex concentrateOnset of ICHConsecutive adult patientsGood functional outcomeModified Rankin scoreSubgroup of patientsNumber of patientsThromboembolic eventsRankin scoreAdult patientsMedian ageRetrospective reviewHematoma volumeResultsA total
2020
Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage
Parikh NS, Kamel H, Navi BB, Iadecola C, Merkler AE, Jesudian A, Dawson J, Falcone GJ, Sheth KN, Roh DJ, Elkind MSV, Hanley DF, Ziai WC, Murthy SB, Hanley D, Butcher K, Davis S, Gregson B, Lees K, Lyden P, Mayer S, Muir K, Steiner T. Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage. Stroke 2020, 51: 830-837. PMID: 31906832, PMCID: PMC7048169, DOI: 10.1161/strokeaha.119.028161.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageNonalcoholic fatty liver disease fibrosis scoreAspartate aminotransferase-platelet ratio indexAminotransferase-platelet ratio indexLiver fibrosis indexIntracerebral hemorrhageAdmission hematoma volumeHematoma volumeHematoma expansionFibrosis-4Fibrosis indexFibrosis scoreLiver diseaseMajor disabilityRatio indexNormal liver chemistriesAdvanced liver diseaseFibrosis-4 scoreRetrospective cohort studyPlatelet ratio indexPoor stroke outcomesSubclinical liver diseaseLogistic regression modelsLiver chemistriesRadiological outcomes
2019
Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy
Gusdon AM, Nyquist PA, Torres-Lopez VM, Leasure AC, Falcone GJ, Sheth KN, Sansing LH, Hanley DF, Malani R. Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy. Stroke 2019, 51: 129-136. PMID: 31744426, PMCID: PMC7048624, DOI: 10.1161/strokeaha.119.027085.Peer-Reviewed Original ResearchConceptsBlood product transfusionThirty-day mortalityIntracerebral hemorrhagePerihematomal edemaActive malignancyProduct transfusionPHE volumeICH volumeActive cancerPHE growthPlatelet transfusionsCentral nervous system involvementRecurrence of malignancyNervous system involvementNontraumatic intracerebral hemorrhageCancer-specific dataPHE expansionRecent chemotherapyChart reviewConclusions PatientsControl patientsMost patientsHematoma volumeInstitutional databaseSystem involvementAssociation of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage
Kuramatsu JB, Biffi A, Gerner ST, Sembill JA, Sprügel MI, Leasure A, Sansing L, Matouk C, Falcone GJ, Endres M, Haeusler KG, Sobesky J, Schurig J, Zweynert S, Bauer M, Vajkoczy P, Ringleb PA, Purrucker J, Rizos T, Volkmann J, Müllges W, Kraft P, Schubert AL, Erbguth F, Nueckel M, Schellinger PD, Glahn J, Knappe UJ, Fink GR, Dohmen C, Stetefeld H, Fisse AL, Minnerup J, Hagemann G, Rakers F, Reichmann H, Schneider H, Rahmig J, Ludolph AC, Stösser S, Neugebauer H, Röther J, Michels P, Schwarz M, Reimann G, Bäzner H, Schwert H, Claßen J, Michalski D, Grau A, Palm F, Urbanek C, Wöhrle JC, Alshammari F, Horn M, Bahner D, Witte OW, Günther A, Hamann GF, Hagen M, Roeder SS, Lücking H, Dörfler A, Testai FD, Woo D, Schwab S, Sheth KN, Huttner HB. Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. JAMA 2019, 322: 1392-1403. PMID: 31593272, PMCID: PMC6784768, DOI: 10.1001/jama.2019.13014.Peer-Reviewed Original ResearchConceptsCerebellar intracerebral hemorrhageSurgical hematoma evacuationHematoma evacuationConservative treatmentIntracerebral hemorrhageIndividual participant dataFunctional outcomePrimary outcomeClinical outcomesFunctional disabilityPropensity score-matched groupsFavorable functional outcomeModified Rankin ScaleImproved functional outcomesSecondary outcomesRankin ScaleHematoma volumeICH studiesMAIN OUTCOMEPatientsCutoff valuePropensity scoreParticipant dataMonthsCovariate adjustment
2018
Minority Patients are Less Likely to Undergo Withdrawal of Care After Spontaneous Intracerebral Hemorrhage
Ormseth CH, Falcone GJ, Jasak SD, Mampre DM, Leasure AC, Miyares LC, Hwang DY, James ML, Testai FD, Becker KJ, Tirschwell DL, Langefeld CD, Woo D, Sheth KN. Minority Patients are Less Likely to Undergo Withdrawal of Care After Spontaneous Intracerebral Hemorrhage. Neurocritical Care 2018, 29: 419-425. PMID: 29949003, PMCID: PMC6286261, DOI: 10.1007/s12028-018-0554-4.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageHematoma volumeAdmission Glasgow Coma ScaleEthnic/Racial VariationsNon-traumatic intracerebral hemorrhageIntracerebral Hemorrhage (ERICH) studyProspective cohort studyGlasgow Coma ScaleIntensive care unitWithdrawal of careSpontaneous intracerebral hemorrhageSimilar mortality ratesLogistic regression analysisRace/ethnicity modifiesRace/ethnicityCMO patientsHospital mortalityCohort studyRankin ScaleWhite patientsComa ScaleBlack patientsCare unitEndotracheal intubationICH patients
2016
CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage
Morotti A, Jessel MJ, Brouwers HB, Falcone GJ, Schwab K, Ayres AM, Vashkevich A, Anderson CD, Viswanathan A, Greenberg SM, Gurol ME, Romero JM, Rosand J, Goldstein JN. CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage. Neurocritical Care 2016, 25: 79-85. PMID: 26759226, PMCID: PMC4940347, DOI: 10.1007/s12028-016-0241-2.Peer-Reviewed Original ResearchConceptsPrimary pontine hemorrhagePositive predictive valueSupratentorial intracerebral hemorrhageIntracerebral hemorrhageHematoma expansionHospital mortalitySpot signNegative predictive valuePredictive valueNon-contrast CT scanCT angiography spot signAbsolute hematoma growthBrainstem ICHTomography angiography spot signConsecutive ICH patientsComputer-assisted volumetric analysisSpot sign presenceNegative likelihood ratioCTA spot signCollected cohortICH patientsPontine hemorrhagePPH casesHematoma growthHematoma volume
2013
Predictors of Hematoma Volume in Deep and Lobar Supratentorial Intracerebral Hemorrhage
Falcone GJ, Biffi A, Brouwers HB, Anderson CD, Battey TW, Ayres AM, Vashkevich A, Schwab K, Rost NS, Goldstein JN, Viswanathan A, Greenberg SM, Rosand J. Predictors of Hematoma Volume in Deep and Lobar Supratentorial Intracerebral Hemorrhage. JAMA Neurology 2013, 70: 988-994. PMID: 23733000, PMCID: PMC3808840, DOI: 10.1001/jamaneurol.2013.98.Peer-Reviewed Original ResearchConceptsLobar intracerebral hemorrhageIntensity of anticoagulationIntracerebral hemorrhageICH volumeHematoma volumeIndependent predictorsLobar supratentorial intracerebral haemorrhageProspective cohort studyCoronary artery diseaseSupratentorial intracerebral hemorrhageMedian ICH volumePrimary ICH patientsComputed tomography scanMultivariable linear regressionAcademic medical centerIntracerebral hemorrhage volumeLobar hemorrhageAntiplatelet treatmentRadiological outcomesArtery diseaseCohort studyDeep hemorrhagesICH locationICH patientsMale sexWarfarin and Statins are Associated with Hematoma Volume in Primary Infratentorial Intracerebral Hemorrhage
Falcone GJ, Brouwers HB, Biffi A, Anderson CD, Battey TW, Ayres AM, Vashkevich A, Schwab KM, Rost NS, Goldstein JN, Viswanathan A, Greenberg SM, Rosand J. Warfarin and Statins are Associated with Hematoma Volume in Primary Infratentorial Intracerebral Hemorrhage. Neurocritical Care 2013, 21: 192-199. PMID: 23839705, PMCID: PMC4107188, DOI: 10.1007/s12028-013-9839-9.Peer-Reviewed Original ResearchConceptsInfratentorial intracerebral hemorrhageIntracerebral hemorrhageICH volumeSurgical evacuationHematoma volumeBrainstem ICHSingle-center studySupratentorial intracerebral hemorrhageWarfarin treatmentStatin treatmentEmergency departmentICH casesRetrospective analysisCT scanLogistic regressionWarfarinICH subjectsLimited dataHemorrhageStatinsFurther studiesComputer-assisted methodTreatmentInverse relationLinear regressionBurden of Blood Pressure–Related Alleles Is Associated With Larger Hematoma Volume and Worse Outcome in Intracerebral Hemorrhage
Falcone GJ, Biffi A, Devan WJ, Brouwers HB, Anderson CD, Valant V, Ayres AM, Schwab K, Rost NS, Goldstein JN, Viswanathan A, Greenberg SM, Selim M, Meschia JF, Brown DL, Worrall BB, Silliman SL, Tirschwell DL, Rosand J. Burden of Blood Pressure–Related Alleles Is Associated With Larger Hematoma Volume and Worse Outcome in Intracerebral Hemorrhage. Stroke 2013, 44: 321-326. PMID: 23321443, PMCID: PMC3560332, DOI: 10.1161/strokeaha.112.675181.Peer-Reviewed Original ResearchConceptsPoor clinical outcomeBaseline hematoma volumeIntracerebral hemorrhageClinical outcomesHematoma volumeGenetic risk scoreBlood pressureICH volumeRisk scoreHypertension-related end-organ damageRisk of ICHAdmission ICH volumeEnd-organ damageLarger hematoma volumeSupratentorial intracerebral hemorrhageHigh blood pressureCerebral small vesselsDeep intracerebral hemorrhageSmall vesselsSingle nucleotide polymorphismsMultivariate regression analysisProgressive diseaseProspective studyAcute manifestationsWorse outcomes