Featured Publications
Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions
Kuohn LR, Herman AL, Soto AL, Brown SC, Gilmore EJ, Hirsch LJ, Matouk CC, Sheth KN, Kim JA. Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions. Journal Of Stroke And Cerebrovascular Diseases 2021, 31: 106155. PMID: 34688213, PMCID: PMC8766898, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106155.Peer-Reviewed Original ResearchConceptsIschemic stroke survivorsIV-tPADecompressive craniectomyHospital revisitsStroke survivorsAcute stroke interventionAcute ischemic strokeAcute stroke careProportional hazards regressionImpact of therapyHistory of epilepsyAcute seizuresHospital seizuresIschemic strokeStroke severityPrimary outcomeStroke interventionStroke treatmentStroke careHazards regressionMultivariable modelRetrospective analysisCumulative rateClaims dataPatients
2022
Bedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest
Beekman R, Crawford A, Mazurek MH, Prabhat AM, Chavva IR, Parasuram N, Kim N, Kim JA, Petersen N, de Havenon A, Khosla A, Honiden S, Miller PE, Wira C, Daley J, Payabvash S, Greer DM, Gilmore EJ, Kimberly W, Sheth KN. Bedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest. Resuscitation 2022, 176: 150-158. PMID: 35562094, PMCID: PMC9746653, DOI: 10.1016/j.resuscitation.2022.05.002.Peer-Reviewed Original ResearchConceptsCardiac arrestBrain injuryHypoxic-ischemic brain injuryAdverse neurological outcomesIschemic brain injurySingle-center studyBrain magnetic resonanceBrain injury severityBoard-certified neuroradiologistsLow-field MRIFLAIR signal intensityNeurological outcomeCA patientsIll patientsMRI findingsCA survivorsCenter studyMRI examinationsClinical careHigh riskInjury severityPatientsSignal intensityBedside monitoringMR imagingBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Association of Posttraumatic Epilepsy With 1-Year Outcomes After Traumatic Brain Injury
Burke J, Gugger J, Ding K, Kim JA, Foreman B, Yue JK, Puccio AM, Yuh EL, Sun X, Rabinowitz M, Vassar MJ, Taylor SR, Winkler EA, Deng H, McCrea M, Stein MB, Robertson CS, Levin HS, Dikmen S, Temkin NR, Barber J, Giacino JT, Mukherjee P, Wang KKW, Okonkwo DO, Markowitz AJ, Jain S, Lowenstein D, Manley GT, Diaz-Arrastia R, , Badjatia N, Duhaime AC, Feeser VR, Gaudette E, Gopinath S, Keene CD, Korley FK, Madden C, Merchant R, Schnyer D, Zafonte R. Association of Posttraumatic Epilepsy With 1-Year Outcomes After Traumatic Brain Injury. JAMA Network Open 2021, 4: e2140191. PMID: 34964854, PMCID: PMC8717106, DOI: 10.1001/jamanetworkopen.2021.40191.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryGlasgow Coma Scale scorePosttraumatic epilepsyBrief Symptom Inventory-18Positive screening resultsCohort studyBrain injuryScreening resultsGlasgow Outcome Scale Extended scoreScale scoreInitial Glasgow Coma Scale scoreGlasgow Outcome Scale-ExtendedTraumatic Brain Injury (CENTER-TBI) studyProspective cohort studyLong-term outcomesUS trauma centersNegative screening resultsTBI common data elementsBrain Injury StudyHigher BSI scoresAntiepileptogenic therapiesPrimary outcomeTBI cohortIdentified patientsTrauma centerPortable, 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 resonanceElectroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes
Lin L, Al‐Faraj A, Ayub N, Bravo P, Das S, Ferlini L, Karakis I, Lee JW, Mukerji SS, Newey CR, Pathmanathan J, Abdennadher M, Casassa C, Gaspard N, Goldenholz DM, Gilmore EJ, Jing J, Kim JA, Kimchi EY, Ladha HS, Tobochnik S, Zafar S, Hirsch LJ, Westover MB, Shafi MM. Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes. Annals Of Neurology 2021, 89: 872-883. PMID: 33704826, PMCID: PMC8104061, DOI: 10.1002/ana.26060.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusElectrographic seizuresClinical outcomesEpileptiform abnormalitiesRisk factorsPresence of NCSEMultivariate Cox proportional hazards analysisMulticenter retrospective cohort studyCox proportional hazards analysisCOVID-19Retrospective cohort studyClinical risk factorsContinuous electroencephalogram monitoringAdverse clinical outcomesProportional hazards analysisCoronavirus disease 2019Ann NeurolHospital mortalityHospital lengthClinical seizuresCohort studyIndependent predictorsStatus epilepticusEEG findingsElectroencephalographic abnormalities
2020
Association of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma.
Brown SC, King ZA, Kuohn L, Kamel H, Gilmore EJ, Frontera JA, Murthy S, Kim JA, Omay SB, Falcone GJ, Sheth KN. Association of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma. Neurology 2020, 95: e2890-e2899. PMID: 32907969, PMCID: PMC7734738, DOI: 10.1212/wnl.0000000000010742.Peer-Reviewed Original ResearchConceptsSubdural hematomaEmergency departmentMultivariable Cox regressionRetrospective cohort studyMedical risk factorsDevelopment of epilepsyNontraumatic subdural hematomaAssociation of raceDiagnosis of epilepsyCohort studyPrimary outcomeRenal diseaseStatus epilepticusWhite patientsBlack patientsHospital revisitsCox regressionBlack raceDiagnosis codesRisk factorsClaims dataInjury severityEpilepsyDrug useSurvival analysisSoluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage
Lissak IA, Zafar SF, Westover MB, Schleicher RL, Kim JA, Leslie-Mazwi T, Stapleton CJ, Patel AB, Kimberly WT, Rosenthal ES. Soluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage. Stroke 2020, 51: 1128-1134. PMID: 32156203, PMCID: PMC7123848, DOI: 10.1161/strokeaha.119.028515.Peer-Reviewed Original ResearchConceptsPlasma sST2 levelsSoluble ST2Epileptiform abnormalitiesNontraumatic subarachnoid hemorrhageSubarachnoid hemorrhageSST2 levelsNeurophysiologic changesCerebral ischemiaIL-6Continuous electroencephalographyMeasures mixed-effects modelsInnate immune response pathwaysAdmission risk factorsPlasma soluble ST2Secondary brain injurySubgroup of patientsSubarachnoid hemorrhage patientsSerial plasma samplesAssociation of biomarkersInnate immune responseWilcoxon rank sum testImmune response pathwaysMixed-effects modelingRank sum testInflammatory biomarkers
2018
Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage
Zafar SF, Postma EN, Biswal S, Boyle EJ, Bechek S, O'Connor K, Shenoy A, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage. Clinical Neurophysiology 2018, 129: 2219-2227. PMID: 30212805, PMCID: PMC6478499, DOI: 10.1016/j.clinph.2018.08.015.Peer-Reviewed Original ResearchConceptsAnti-epileptic drugsAneurysmal subarachnoid hemorrhageEpileptiform abnormalitiesWorse outcomesSubarachnoid hemorrhageHigh-grade aSAH patientsEvidence-based treatment protocolsGlasgow Outcome ScoreAntiepileptic drug managementStandard prophylaxisNeurologic outcomeProphylactic protocolASAH patientsOutcome scoresDrug managementHigh burdenRetrospective analysisTreatment protocolOutcome measuresPatientsDaily burdenRhythmic activityFirst dayOutcomesBurdenEpileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy
Kim JA, Boyle EJ, Wu AC, Cole AJ, Staley KJ, Zafar S, Cash SS, Westover MB. Epileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy. Annals Of Neurology 2018, 83: 858-862. PMID: 29537656, PMCID: PMC5912971, DOI: 10.1002/ana.25211.Peer-Reviewed Original Research
2017
Electronic Health Data Predict Outcomes After Aneurysmal Subarachnoid Hemorrhage
Zafar SF, Postma EN, Biswal S, Fleuren L, Boyle EJ, Bechek S, O’Connor K, Shenoy A, Jonnalagadda D, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Electronic Health Data Predict Outcomes After Aneurysmal Subarachnoid Hemorrhage. Neurocritical Care 2017, 28: 184-193. PMID: 28983801, PMCID: PMC5886829, DOI: 10.1007/s12028-017-0466-8.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageGlasgow Outcome ScaleWhite blood cellsIntracranial pressureAPACHE IIElectronic health dataSubarachnoid hemorrhageBetter outcomesSingle-center retrospective cohort studyDischarge Glasgow Outcome ScaleEarly goal-directed therapyAPACHE II scoreGoal-directed therapyRetrospective cohort studyMean arterial pressureRisk stratification scoresAdmission APACHE IIPredictors of outcomeMultivariate analysis predictorsLogistic regression modelsHealth dataAdmission dayII scoreNeurologic outcomeArterial pressure