2024
APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation
Renedo D, Rivier C, Koo A, Sujijantarat N, Clocchiatti-Tuozzo S, Wu K, Torres-Lopez V, Huo S, Gunel M, de Havenon A, Sheth K, Matouk C, Falcone G. APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation. JAMA Network Open 2024, 7: e2355368. PMID: 38363572, PMCID: PMC10873768, DOI: 10.1001/jamanetworkopen.2023.55368.Peer-Reviewed Original ResearchConceptsApolipoprotein E e4Participants of European ancestryRisk of intracerebral hemorrhageHigh risk of intracerebral hemorrhageCross-sectional studyUK BiobankEuropean ancestryHigh riskUs Research ProgramUK Biobank participantsInternational Classification of DiseasesAssociated with higher risk of ICHCross-sectional study of patientsAPOE e4 statusClassification of DiseasesApolipoprotein ENinth Revision and Tenth RevisionAssociated with higher riskIndividual-level dataMultivariate logistic regressionIntracerebral hemorrhage riskBrain arteriovenous malformationsIntracerebral hemorrhageBiobank participantsTenth RevisionAssociation 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 ResearchMeSH KeywordsAntihypertensive AgentsCerebral HemorrhageFemaleHematomaHumansIschemic StrokeMaleMiddle AgedStrokeTissue Plasminogen ActivatorTreatment OutcomeConceptsIntracerebral 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 dataCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatients
2023
A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage
Myserlis E, Georgakis M, Demel S, Sekar P, Chung J, Malik R, Hyacinth H, Comeau M, Falcone G, Langefeld C, Rosand J, Woo D, Anderson C. A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage. Stroke 2023, 54: 973-982. PMID: 36799223, PMCID: PMC10050100, DOI: 10.1161/strokeaha.122.041701.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageFibrinolytic AgentsGenome-Wide Association StudyGenomicsHumansRisk FactorsConceptsClinical risk factorsIncident intracerebral hemorrhageIntracerebral hemorrhageHigh-risk populationRisk factorsGenomic risk scoresRisk scoreHigher oddsHigh riskRisk factor-adjusted modelsStandard clinical risk factorsVascular risk factorsLobar intracerebral hemorrhageLow-risk populationNonlobar intracerebral hemorrhageUse of anticoagulantsPopulation-based UK Biobank cohortUK Biobank cohortEuropean ancestryAntithrombotic treatmentClinical predictorsSD incrementMedication usersLifetime riskMetaGRSEmergent 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 patients
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 ResearchMeSH KeywordsBrain EdemaCerebral HemorrhageEdemaHematomaHumansImmunityInterleukin-1 Receptor-Like 1 ProteinRetrospective StudiesConceptsSoluble 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 levelsAssociation of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage
Vanent KN, Leasure AC, Acosta JN, Kuohn LR, Woo D, Murthy SB, Kamel H, Messé SR, Mullen MT, Cohen JB, Cohen DL, Townsend RR, Petersen NH, Sansing LH, Gill TM, Sheth KN, Falcone GJ. Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage. JAMA Neurology 2022, 79: 911-918. PMID: 35969388, PMCID: PMC9379821, DOI: 10.1001/jamaneurol.2022.2299.Peer-Reviewed Original ResearchOne-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability
Shah VA, Thompson RE, Yenokyan G, Acosta JN, Avadhani R, Dlugash R, McBee N, Li Y, Hansen BM, Ullman N, Falcone G, Awad IA, Hanley DF, Ziai WC. One-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability. JAMA Neurology 2022, 79: 856-868. PMID: 35877105, PMCID: PMC9316056, DOI: 10.1001/jamaneurol.2022.1991.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageFemaleHematomaHumansIschemic StrokeMaleMiddle AgedSurvivorsTissue Plasminogen ActivatorConceptsSevere intracerebral hemorrhagePhase 3 trialIntracerebral hemorrhageIntraventricular hemorrhagePoor functional outcomeHospital eventsBetter outcomesDay 30Functional recoveryPoor outcomeFunctional outcomeLong-term functional recoverySevere disabilityMultivariable logistic regression modelHealth Stroke ScaleAcute ischemic strokeCerebral perfusion pressureRankin Scale scoreStandard medical careIndividual patient dataOverall mean ageIntracranial pressure monitoringLogistic regression modelsIntraventricular alteplaseMISTIE IIIGenetically‐Proxied Levels of Vitamin D and Risk of Intracerebral Hemorrhage
Szejko N, Acosta JN, Both CP, Leasure A, Matouk C, Sansing L, Gill TM, Hongyu Z, Sheth K, Falcone GJ. Genetically‐Proxied Levels of Vitamin D and Risk of Intracerebral Hemorrhage. Journal Of The American Heart Association 2022, 11: e024141. PMID: 35730641, PMCID: PMC9333362, DOI: 10.1161/jaha.121.024141.Peer-Reviewed Original ResearchAssociation of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis
Kuramatsu JB, Gerner ST, Ziai W, Bardutzky J, Sembill JA, Sprügel MI, Mrochen A, Kölbl K, Ram M, Avadhani R, Falcone GJ, Selim MH, Lioutas VA, Endres M, Zweynert S, Vajkoczy P, Ringleb PA, Purrucker JC, Volkmann J, Neugebauer H, Erbguth F, Schellinger PD, Knappe UJ, Fink GR, Dohmen C, Minnerup J, Reichmann H, Schneider H, Röther J, Reimann G, Schwarz M, Bäzner H, Claßen J, Michalski D, Witte OW, Günther A, Hamann GF, Lücking H, Dörfler A, Ishfaq MF, Chang JJ, Testai FD, Woo D, Alexandrov AV, Staykov D, Goyal N, Tsivgoulis G, Sheth KN, Awad IA, Schwab S, Hanley DF, Huttner HB, Sansing L, Matouk C, Leasure A, Sobesky J, Bauer M, Schurig J, Rizos T, Haeusler K, Müllges W, Kraft P, Schubert A, Stösser S, Ludolph A, Nueckel M, Glahn J, Stetefeld H, Rahmig J, Fisse A, Michels P, Schwert H, Hagemann G, Rakers F, Wöhrle J, Alshammari F, Horn M, Bahner D, Urbanek C, Palm F, Grau A. Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis. Stroke 2022, 53: 2876-2886. PMID: 35521958, PMCID: PMC9398945, DOI: 10.1161/strokeaha.121.038455.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageDrainageFibrinolysisFibrinolytic AgentsHumansHydrocephalusObservational Studies as TopicTreatment OutcomeConceptsAbsolute treatment effectStandard of careIntraventricular fibrinolysisIntracerebral hemorrhageIntraventricular hemorrhagePrimary outcomeAcute hydrocephalusAdverse eventsFunctional disabilityIVF treatmentFunctional outcomeOdds ratioOrdinal shift analysisIndividual Participant Data Meta-AnalysisModified Rankin ScaleExternal ventricular drainageImproved functional outcomesData Meta-AnalysisPromising therapeutic targetTreatment effectsIndividual participant dataCause mortalityRankin ScaleSecondary outcomesSymptom onset
2021
Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials
Magid-Bernstein JR, Li Y, Cho SM, Piran PJ, Roh DJ, Gupta A, Shoamanesh A, Merkler A, Zhang C, Avadhani R, Montano N, Iadecola C, Falcone G, Sheth K, Qureshi AI, Rosand J, Goldstein J, Awad I, Hanley D, Kamel H, Ziai WC, Murthy SB. Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials. Neurology 2021, 98: e1013-e1020. PMID: 34937780, PMCID: PMC8967392, DOI: 10.1212/wnl.0000000000013247.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageCerebral Small Vessel DiseasesHematomaHumansLeukoaraiosisMagnetic Resonance ImagingConceptsSmaller ICH volumeCerebral microbleedsSmall vessel diseaseIntracerebral hemorrhageHematoma expansionHematoma characteristicsICH volumeVessel diseaseNumber of CMBsSmaller baseline hematoma volumesUnderlying small vessel diseasePresence of CMBsCerebral small vessel diseaseAdmission ICH volumeMISTIE III trialPresence of microbleedsClass II evidencePhase 3 trialSeverity of leukoaraiosisPrimary intracerebral hemorrhageBaseline hematoma volumeIndividual patient dataBrain MRI scansLogistic regression modelsAntihypertensive treatmentThe coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume
Haider SP, Qureshi AI, Jain A, Tharmaseelan H, Berson ER, Majidi S, Filippi CG, Mak A, Werring DJ, Acosta JN, Malhotra A, Kim JA, Sansing LH, Falcone G, Sheth K, Payabvash S. The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume. International Journal Of Stroke 2021, 17: 777-784. PMID: 34569877, PMCID: PMC9005571, DOI: 10.1177/17474930211050749.Peer-Reviewed Original ResearchPortable, 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 ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainCerebral HemorrhageFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingConceptsMagnetic 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 cohortIntracerebral Hemorrhage in Patients With COVID-19
Leasure AC, Khan YM, Iyer R, Elkind MSV, Sansing LH, Falcone GJ, Sheth KN. Intracerebral Hemorrhage in Patients With COVID-19. Stroke 2021, 52: e321-e323. PMID: 34082576, PMCID: PMC8238884, DOI: 10.1161/strokeaha.121.034215.Peer-Reviewed Original ResearchAdolescentAdultAge FactorsAgedAnticoagulantsCerebral HemorrhageCOVID-19C-Reactive ProteinExtracorporeal Membrane OxygenationFemaleHeart Disease Risk FactorsHospital MortalityHospitalizationHumansIntensive Care UnitsInterleukin-6MaleMiddle AgedRegistriesRespiration, ArtificialRisk FactorsSARS-CoV-2Sex FactorsUnited StatesYoung AdultGenetic determinants of LDL cholesterol and risk of intracerebral haemorrhage
Szejko N, Kirsch E, Falcone GJ. Genetic determinants of LDL cholesterol and risk of intracerebral haemorrhage. Current Opinion In Lipidology 2021, 32: 244-248. PMID: 34010223, PMCID: PMC10273781, DOI: 10.1097/mol.0000000000000761.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageCholesterol, LDLClinical Trials as TopicHumansHydroxymethylglutaryl-CoA Reductase InhibitorsObservational Studies as TopicConceptsRisk of ICHIntracerebral hemorrhageLDL levelsLDL cholesterolInverse associationClinical trialsLipid levelsObservational studyCerebral small vessel diseaseWhite matter hyperintensity volumeLDL cholesterol levelsLow LDL levelsNontraumatic intracerebral hemorrhageSmall vessel diseaseElevated LDL levelsElevated lipid levelsVessel diseaseCholesterol levelsHigh burdenHyperintensity volumeHigh riskRole of lipidsHemorrhageStatinsRiskObstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Geer JH, Falcone GJ, Vanent KN, Leasure AC, Woo D, Molano JR, Sansing LH, Langefeld CD, Pisani MA, Yaggi HK, Sheth KN. Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage. Stroke 2021, 52: 1835-1838. PMID: 33827242, PMCID: PMC8085039, DOI: 10.1161/strokeaha.120.033342.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaRisk factorsBerlin questionnaireIntracerebral hemorrhageSleep apneaEthnic/Racial VariationsHigher body mass indexMultivariable logistic regression modelBody mass indexIntracerebral hemorrhage riskCase-control studyExposure of patientsLogistic regression analysisLogistic regression modelsOSA statusHemorrhage riskMass indexHeart diseaseNontraumatic ICHRacial variationApneaHemorrhageRegression analysisICHRegression modelsAssociation of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Leasure AC, Kuohn LR, Vanent KN, Bevers MB, Kimberly WT, Steiner T, Mayer SA, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Stroke 2021, 52: 1733-1740. PMID: 33682454, PMCID: PMC8085132, DOI: 10.1161/strokeaha.120.032888.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain EdemaCerebral HemorrhageDouble-Blind MethodFactor VIIaFemaleHumansInterleukin-6MaleMiddle AgedPatient AcuityRecombinant ProteinsConceptsIL-6 levelsPerihematomal edema volumeIntracerebral hemorrhageIL-6Edema volumeFunctional outcomeICH locationICH volumeTreatment groupsSerum IL-6 levelsBaseline ICHAcute brain injuryLarge intracerebral hemorrhageSerum IL-6Predictors of outcomeSpontaneous intracerebral hemorrhageRankin ScalePoor outcomeProinflammatory cytokinesTrial populationBrain injurySecondary analysisStrong associationFast trialsOutcomesAdmission 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 outcomesIntracerebral Hemorrhage with Intraventricular Extension Associated with Loss of Consciousness at Symptom Onset
Witsch J, Falcone GJ, Leasure AC, Matouk C, Endres M, Sansing L, Woo D, Sheth KN. Intracerebral Hemorrhage with Intraventricular Extension Associated with Loss of Consciousness at Symptom Onset. Neurocritical Care 2021, 35: 418-427. PMID: 33479920, PMCID: PMC8578176, DOI: 10.1007/s12028-020-01180-2.Peer-Reviewed Original ResearchMeSH KeywordsBlood PressureCerebral HemorrhageHumansLogistic ModelsSeverity of Illness IndexUnconsciousnessConceptsLoss of consciousnessIntraventricular hemorrhageIntracerebral hemorrhageSymptom onsetICH onsetUnfavorable outcomeAdmission Glasgow Coma ScoreAdmission systolic blood pressureOnset of ICHGlasgow Coma ScoreSystolic blood pressureSpontaneous intracerebral hemorrhageAdmission serum glucoseThousand seven hundredVolumetric CT measurementsBackgroundIn patientsComa ScoreBlood pressureMedical chartsICH volumeMental statusSerum glucoseICH casesInclusion criteriaPatients