2024
Automated 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 cohort
2021
Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS score
2020
Plasma neurofilament light predicts mortality in patients with stroke
Gendron TF, Badi MK, Heckman MG, Jansen-West KR, Vilanilam GK, Johnson PW, Burch AR, Walton RL, Ross OA, Brott TG, Miller TM, Berry JD, Nicholson KA, Wszolek ZK, Oskarsson BE, Sheth KN, Sansing LH, Falcone GJ, Cucchiara BL, Meschia JF, Petrucelli L. Plasma neurofilament light predicts mortality in patients with stroke. Science Translational Medicine 2020, 12 PMID: 33177179, PMCID: PMC9534269, DOI: 10.1126/scitranslmed.aay1913.Peer-Reviewed Original ResearchConceptsBlood neurofilament lightNeurofilament lightStroke typeNeuroaxonal injuryHigher NfL concentrationsMini-Mental State ExaminationStroke brain injuryAcute cerebral infarctionModified Rankin ScaleEarly ischemic injuryNontraumatic intracerebral hemorrhageNIH Stroke ScaleBrain tissue damagePlasma neurofilament lightIntracranial hemorrhage volumeClinical trial efficiencyBlood biomarker studiesStroke therapeuticsCause mortalityStroke ScaleCerebral infarctionRankin ScaleFunctional disabilityIntracerebral hemorrhageIschemic injuryStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsGenetic underpinnings of cerebral edema in acute brain injury: an opportunity for pathway discovery
Kirsch E, Szejko N, Falcone GJ. Genetic underpinnings of cerebral edema in acute brain injury: an opportunity for pathway discovery. Neuroscience Letters 2020, 730: 135046. PMID: 32464484, PMCID: PMC7372633, DOI: 10.1016/j.neulet.2020.135046.Peer-Reviewed Original ResearchConceptsAcute brain injuryCerebral edemaBrain injuryEdema formationIntracerebral hemorrhageWorse outcomesBlood-brain barrier disruptionSecondary brain injuryBrain edema formationTraumatic brain injuryApolipoprotein E geneSecondary injuryBarrier disruptionVasogenic edemaCytotoxic edemaInflammatory processUseful intermediate phenotypeEdemaTherapeutic targetAquaporin-4Haptoglobin geneInjuryHp 2Novel susceptibility genesNon-white populationsNon-Traumatic Subdural Hemorrhage and Risk of Arterial Ischemic Events
Murthy SB, Wu X, Diaz I, Parasram M, Parikh NS, Iadecola C, Merkler AE, Falcone GJ, Brown S, Biffi A, Ch'ang J, Knopman J, Stieg PE, Navi BB, Sheth KN, Kamel H. Non-Traumatic Subdural Hemorrhage and Risk of Arterial Ischemic Events. Stroke 2020, 51: 1464-1469. PMID: 32178587, PMCID: PMC7188584, DOI: 10.1161/strokeaha.119.028510.Peer-Reviewed Original ResearchConceptsArterial ischemic eventsAcute ischemic strokeIschemic eventsIschemic strokeSubdural hemorrhageMyocardial infarctionAntithrombotic therapyMedicare beneficiariesSDH diagnosisPatient riskSecondary analysisRetrospective cohort studyAcute myocardial infarctionCohort studyHazard ratioSecondary outcomesVascular comorbiditiesPrimary outcomeCox regressionDiagnosis codesClaims dataInternational ClassificationPrimary analysisInfarctionStrokeFixed 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
Decreases 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
2016
Low-frequency and common genetic variation in ischemic stroke
Malik R, Traylor M, Pulit SL, Bevan S, Hopewell JC, Holliday EG, Zhao W, Abrantes P, Amouyel P, Attia JR, Battey TW, Berger K, Boncoraglio GB, Chauhan G, Cheng YC, Chen WM, Clarke R, Cotlarciuc I, Debette S, Falcone GJ, Ferro JM, Gamble DM, Ilinca A, Kittner SJ, Kourkoulis CE, Lemmens R, Levi CR, Lichtner P, Lindgren A, Liu J, Meschia JF, Mitchell BD, Oliveira SA, Pera J, Reiner AP, Rothwell PM, Sharma P, Slowik A, Sudlow CL, Tatlisumak T, Thijs V, Vicente AM, Woo D, Seshadri S, Saleheen D, Rosand J, Markus HS, Worrall BB, Dichgans M. Low-frequency and common genetic variation in ischemic stroke. Neurology 2016, 86: 1217-1226. PMID: 26935894, PMCID: PMC4818561, DOI: 10.1212/wnl.0000000000002528.Peer-Reviewed Original ResearchConceptsIndividual genome-wide association studiesLow-frequency genetic variantsGenome-wide association studiesCommon genetic variationHigh-frequency variantsGenomes Phase ILow-frequency variantsGenetic variationAssociation studiesFrequency variantsSignificant enrichmentGenetic variantsAllele frequenciesPITX2Rare variantsSouth Asian sampleWider significanceVariantsEnrichmentLociDiscovery phaseHDAC9P-value distributionsHeritabilityZFHX3