2023
Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke
Lin D, Hardstone R, DiCarlo J, Mckiernan S, Snider S, Jacobs H, Erler K, Rishe K, Boyne P, Goldsmith J, Ranford J, Finklestein S, Schwamm L, Hochberg L, Cramer S. Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke. Neurology 2023, 101: e347-e357. PMID: 37268437, PMCID: PMC10435065, DOI: 10.1212/wnl.0000000000207417.Peer-Reviewed Original ResearchConceptsDistal motor controlUpper extremity motor deficitsAcute strokeBarthel IndexMotor deficitsMotor controlAcute stroke patientsUpper extremity hemiparesisUpper extremity motor controlRegion of injuryLesion-symptom mappingMotor systemHealthy CNSDays poststrokeDistal injuriesRankin ScaleStroke onsetConsecutive patientsStroke patientsMotor scoresClinical syndromeFunctional outcomeIntact CNSPosterior aspectPrecentral gyrus
2017
Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol
Reeves M, Hughes A, Woodward A, Freddolino P, Coursaris C, Swierenga S, Schwamm L, Fritz M. Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol. BMC Neurology 2017, 17: 115. PMID: 28623892, PMCID: PMC5474297, DOI: 10.1186/s12883-017-0895-1.Peer-Reviewed Original ResearchConceptsAcute stroke patientsCase management programPatient Activation MeasureStroke patientsCaregiver outcomesTransition trialsRehabilitation facilityAdult acute stroke patientsBakas Caregiving Outcomes ScalePrimary caregiversOutcome 3 monthsPrimary patient outcomePatient's primary caregiverEvidence-based standardsHealth-related challengesUsual careHospital dischargeSuperiority trialEligible participantsOutcome ScaleTrial protocolPatient outcomesStudy interventionMichigan hospitalsOutcome dataEarly transition to comfort measures only in acute stroke patients
Prabhakaran S, Cox M, Lytle B, Schulte P, Xian Y, Zahuranec D, Smith E, Reeves M, Fonarow G, Schwamm L. Early transition to comfort measures only in acute stroke patients. Neurology Clinical Practice 2017, 7: 194-204. PMID: 28680764, PMCID: PMC5490382, DOI: 10.1212/cpj.0000000000000358.Peer-Reviewed Original ResearchIntracerebral hemorrhageIschemic strokeStroke patientsHospital characteristicsComfort measuresCMO orderGuidelines-Stroke registryHospital days 0Acute stroke patientsMultivariable logistic regressionRisk-adjusted mortalityLife-sustaining interventionsLife-sustaining treatmentAcute strokeNonambulatory statusHospital factorsMultivariable analysisStudy criteriaFemale sexStroke typeWhite racePatientsDay 0Older ageLogistic regression
2016
Acute management of stroke patients taking non–vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Xian Y, Hernandez A, Harding T, Fonarow G, Bhatt D, Suter R, Khan Y, Schwamm L, Peterson E. Acute management of stroke patients taking non–vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale. American Heart Journal 2016, 182: 28-35. PMID: 27914497, DOI: 10.1016/j.ahj.2016.07.023.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAdultAnticoagulantsAntithrombinsAtrial FibrillationCohort StudiesDabigatranEmergency TreatmentFemaleHumansMaleMedication Therapy ManagementOutcome and Process Assessment, Health CarePyrazolesPyridinesPyridonesQuality ImprovementRegistriesRivaroxabanStrokeThiazolesUnited StatesWarfarinConceptsAcute ischemic strokeAnticoagulation-related intracerebral hemorrhageIntracerebral hemorrhageIschemic strokeStroke patientsOral anticoagulantsAcute ischemic stroke patientsCurrent treatment patternsLongitudinal medication useMulticenter cohort studyAcute stroke patientsIschemic stroke patientsReal-world clinical decisionsChronic anticoagulation therapyPatient-reported outcomesCritical unmet needChronic anticoagulationGuidelines-StrokeStroke prophylaxisAnticoagulation therapyIndex hospitalizationStroke RegistryCohort studyAcute managementMedication use
2015
Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry
Mochari-Greenberger H, Xian Y, Hellkamp A, Schulte P, Bhatt D, Fonarow G, Saver J, Reeves M, Schwamm L, Smith E. Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry. Journal Of The American Heart Association 2015, 4: e002099. PMID: 26268882, PMCID: PMC4599467, DOI: 10.1161/jaha.115.002099.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsianBlack or African AmericanChi-Square DistributionEmergency Medical ServicesFemaleHealth Knowledge, Attitudes, PracticeHispanic or LatinoHospitalizationHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient Acceptance of Health CareRegistriesSex FactorsStrokeTransportation of PatientsUnited StatesWhite PeopleConceptsEmergency medical servicesStroke patientsStroke symptomsEMS useRace/ethnicityHospitalized acute stroke patientsEmergency medical services transportWhite womenGuidelines-Stroke registryAcute stroke patientsMultivariable logistic regressionLevel of consciousnessSex differencesGuidelines-StrokeNational GetIschemic strokeStroke outcomePatient characteristicsPotential confoundersMedical historyEMS transportSex disparitiesPatientsHispanic menLogistic regression
2013
Hospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke
Kemmling A, Lev MH, Payabvash S, Betensky RA, Qian J, Masrur S, Schwamm LH. Hospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke. PLOS ONE 2013, 8: e71141. PMID: 23951094, PMCID: PMC3737185, DOI: 10.1371/journal.pone.0071141.Peer-Reviewed Original ResearchConceptsHemispheric infarctsBrain regionsConsecutive acute stroke patientsConditional logistic regression modelsHospital-Acquired PneumoniaRight hemispheric infarctAcute stroke patientsInsular cortex volumeVolume-based variablesSpecific brain regionsLogistic regression modelsAcquired PneumoniaControl patientsMajor complicationsBrainstem strokeImmune suppressionInfarct sizeStroke patientsAutonomic modulationClinical variablesAdmission imagingInfarct locationUnivariate analysisImmune mechanismsCortex volumeImpact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model
Hunter R, Davie C, Rudd A, Thompson A, Walker H, Thomson N, Mountford J, Schwamm L, Deanfield J, Thompson K, Dewan B, Mistry M, Quoraishi S, Morris S. Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model. PLOS ONE 2013, 8: e70420. PMID: 23936427, PMCID: PMC3731285, DOI: 10.1371/journal.pone.0070420.Peer-Reviewed Original ResearchConceptsAcute stroke careHyper-acute stroke unitLength of stayStroke careStroke patientsReduced hospital lengthAcute stroke patientsNational time trendsDecision analytic modelHospital lengthPatient characteristicsStroke RegisterStroke unitClinical outcomesSpecialist careLocal hospitalPatientsSurvival rateComparative effectivenessCost outcomesSurvival analysisStayTotal cost savingsMortalityCare
2012
Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program
Bettger J, Kaltenbach L, Reeves M, Smith E, Fonarow G, Schwamm L, Peterson E. Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program. Archives Of Physical Medicine And Rehabilitation 2012, 94: 38-45. PMID: 22858797, DOI: 10.1016/j.apmr.2012.06.029.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programStroke patientsAcute hospitalizationAcute strokeAcute hospitalsGWTG-Stroke programAcute stroke patientsProspective cohortStroke unitMultivariable analysisNonwhite raceRehabilitation careAcute assessmentMAIN OUTCOMEStroke diagnosisPatientsRehabilitation servicesHospitalizationRehabilitationHospitalStrokeUnited StatesAssessmentAdmissionCohortVariability in the Perception of Informed Consent for IV-tPA during Telestroke Consultation
Thomas L, Viswanathan A, Cochrane T, Johnson J, O’Brien J, McMahon M, Santimauro J, Schwamm L. Variability in the Perception of Informed Consent for IV-tPA during Telestroke Consultation. Frontiers In Neurology 2012, 3: 128. PMID: 23015805, PMCID: PMC3449489, DOI: 10.3389/fneur.2012.00128.Peer-Reviewed Original ResearchTelestroke consultationIV-tPAStroke patientsConsent processAcute ischemic stroke patientsIntravenous tissue plasminogen activatorInformed consentBenefits of tPAAcute stroke patientsIschemic stroke patientsPatients/familiesTissue plasminogen activatorInformed consent presentationAdequacy of consentEmergency physiciansClinical situationsPatientsPhysician ratersPlasminogen activatorPhysiciansConsentSubgroupsConsultationReviewersLow quality
2011
Prestroke Dementia is Associated With Poor Outcomes After Reperfusion Therapy Among Elderly Stroke Patients
Busl K, Nogueira R, Yoo A, Hirsch J, Schwamm L, Rost N. Prestroke Dementia is Associated With Poor Outcomes After Reperfusion Therapy Among Elderly Stroke Patients. Journal Of Stroke And Cerebrovascular Diseases 2011, 22: 718-724. PMID: 22182760, PMCID: PMC3310930, DOI: 10.1016/j.jstrokecerebrovasdis.2011.11.005.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAged, 80 and overDementiaDisability EvaluationFemaleFibrinolytic AgentsHospicesHospital MortalityHumansInfusions, Intra-ArterialInfusions, IntravenousLogistic ModelsMaleMultivariate AnalysisOdds RatioPatient DischargeRehabilitation CentersRetrospective StudiesRisk FactorsSkilled Nursing FacilitiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial reperfusion therapyTissue plasminogen activatorReperfusion therapyPrestroke dementiaHospital mortalityDischarge destinationPoor outcomeStroke patientsElderly acute stroke patientsMultivariate logistic regression modelAcute reperfusion therapyGuidelines-Stroke databaseSymptomatic intracranial hemorrhageHealth Stroke ScaleHospital mortality rateAcute stroke patientsPowerful independent predictorVascular risk factorsElderly stroke patientsPresence of dementiaLikelihood of deathYears of ageLogistic regression modelsStroke ScaleSecondary outcomesImaging Stroke Patients with Unclear Onset Times
Wu O, Schwamm L, Sorensen A. Imaging Stroke Patients with Unclear Onset Times. Neuroimaging Clinics Of North America 2011, 21: 327-344. PMID: 21640303, PMCID: PMC3109317, DOI: 10.1016/j.nic.2011.02.008.Peer-Reviewed Original Research
2008
Advance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator
Abdullah A, Smith E, Biddinger P, Kalenderian D, Schwamm L. Advance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator. Prehospital Emergency Care 2008, 12: 426-431. PMID: 18924004, DOI: 10.1080/10903120802290828.Peer-Reviewed Original ResearchConceptsEmergency medical servicesTissue plasminogen activatorAcute stroke patientsStroke patientsTertiary care stroke centerIntravenous tissue plasminogen activatorCatheter-based thrombolysisED arrival timeHospital time intervalsIntra-arterial thrombolysisMedian National InstitutesHealth Stroke ScaleUse of thrombolysisEmergency department arrivalTerms of ageHigher baseline ratesPrior strokeTPA useAcute strokeStroke centersStroke ScaleSymptom onsetStroke databaseMild strokeHospital notification
2006
The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes
Reeves M, Broderick J, Frankel M, LaBresh K, Schwamm L, Moomaw C, Weiss P, Katzan I, Arora S, Heinrich J, Hickenbottom S, Karp H, Malarcher A, Mensah G, Reeves M. The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes. American Journal Of Preventive Medicine 2006, 31: s202-s209. PMID: 17178304, DOI: 10.1016/j.amepre.2006.08.007.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorStroke admissionsPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryPlasminogen activatorAcute stroke admissionsAcute Stroke RegistrySmoking cessation counselingPercent of patientsTransient ischemic attackAcute stroke careAcute stroke patientsPercent of admissionsHours of onsetIschemic stroke admissionsHealthcare system levelQuality improvement interventionsYears of ageAntithrombotic treatmentIschemic attackLipid testingStroke RegistryEligible subjectsIschemic strokeFirst-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy.
Schaefer P, Roccatagliata L, Ledezma C, Hoh B, Schwamm L, Koroshetz W, Gonzalez R, Lev M. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. American Journal Of Neuroradiology 2006, 27: 20-5. PMID: 16418350, PMCID: PMC7976067.Peer-Reviewed Original ResearchConceptsCerebral blood volumeAcute stroke patientsCT perfusionStroke patientsCBF ratioGray matterWhite matterAbsolute cerebral blood volumeCBV ratioIntra-arterial therapyIschemic brain tissueQuantitative CT perfusionDynamic CT perfusionIA therapyRecanalization therapyStroke onsetSalvageable penumbraInfarct coreIschemic tissueUninvolved regionsIschemic regionBlood volumeCBF valuesPatientsBrain tissue
2005
Acute Stroke Care in the US
Reeves M, Arora S, Broderick J, Frankel M, Heinrich J, Hickenbottom S, Karp H, LaBresh K, Malarcher A, Mensah G, Moomaw C, Schwamm L, Weiss P. Acute Stroke Care in the US. Stroke 2005, 36: 1232-1240. PMID: 15890989, DOI: 10.1161/01.str.0000165902.18021.5b.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageFemaleFibrinolytic AgentsGeorgiaHospital RecordsHumansInfusions, IntravenousIschemic Attack, TransientMaleMassachusettsMichiganMiddle AgedOhioPilot ProjectsProspective StudiesQuality ControlRecombinant ProteinsRegistriesRetrospective StudiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsRecombinant tissue plasminogen activatorAcute stroke careStroke careStroke admissionsPaul Coverdell National Acute Stroke RegistryIntravenous recombinant tissue plasminogen activatorNational Acute Stroke RegistryHealth care system levelsAcute stroke admissionsAcute Stroke RegistryTransient ischemic attackAcute stroke patientsHours of onsetIschemic stroke admissionsMinutes of arrivalSecondary prevention practicesAge 60 yearsQuality improvement interventionsTissue plasminogen activatorIschemic attackCessation counselingStroke RegistryIschemic strokeIntracerebral hemorrhageStroke patientsArterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment.
Sims J, Rordorf G, Smith E, Koroshetz W, Lev M, Buonanno F, Schwamm L. Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment. American Journal Of Neuroradiology 2005, 26: 246-51. PMID: 15709120, PMCID: PMC7974096.Peer-Reviewed Original ResearchConceptsCT angiographyLocation of occlusionEarly improvementInitial NIHSSArterial occlusionIntravenous tissue-type plasminogen activatorNIH stroke scoreProspective stroke databaseHealth Stroke ScaleAcute stroke patientsMiddle cerebral arteryPatent vasculatureSite of occlusionTissue-type plasminogen activatorLower NIHSSStroke ScaleStroke ScoreSymptomatic hemorrhageRankin ScaleAcute outcomesHemorrhagic riskCerebral arteryClinical outcomesStroke databaseStroke patients
2004
768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis
Hoh B, Roccatagliata L, Lev M, Ledezma C, Schwamm L, Koroshetz W, Schaefer P. 768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis. Neurosurgery 2004, 55: 475. DOI: 10.1097/00006123-200408000-00104.Peer-Reviewed Original ResearchIntra-arterial thrombolysisAcute stroke patientsSalvageable penumbraStroke patientsThrombolysisPatients768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis
Hoh B, Roccatagliata L, Lev M, Ledezma C, Schwamm L, Koroshetz W, Schaefer P. 768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis. Neurosurgery 2004, 55: 475-475. DOI: 10.1227/00006123-200408000-00104.Peer-Reviewed Original ResearchIntra-arterial thrombolysisAcute stroke patientsSalvageable penumbraStroke patientsThrombolysisPatients
2002
CT Angiography With Whole Brain Perfused Blood Volume Imaging
Ezzeddine M, Lev M, McDonald C, Rordorf G, Oliveira-Filho J, Aksoy F, Farkas J, Segal A, Schwamm L, Gonzalez R, Koroshetz W. CT Angiography With Whole Brain Perfused Blood Volume Imaging. Stroke 2002, 33: 959-966. PMID: 11935044, DOI: 10.1161/hs0402.105388.Peer-Reviewed Original ResearchConceptsOxfordshire Community Stroke Project classificationCTA/CTPNoncontrast CTCTP imagingInfarct localizationRapid CT scanningAcute stroke treatmentAcute stroke patientsInitial clinical assessmentMajor intracranial vesselsCTA source imagesVascular phase imagesSteady-state administrationProject classificationParenchymal phase imagesOrg 10172Oxfordshire classificationTOAST classificationAcute strokeStroke neurologistsStroke treatmentStroke patientsBlood volume imagingClinical examinationInfarct location
2001
CT Angiography Use in Acute Stroke Patients Undergoing i.v. TPA
Rordorf G, Koroshetz W, Buonanno F, McDonald C, Greer D, Ougorets I, Rosand J, Schwamm L. CT Angiography Use in Acute Stroke Patients Undergoing i.v. TPA. Stroke 2001, 32: 370-370. DOI: 10.1161/str.32.suppl_1.370-a.Peer-Reviewed Original ResearchRt-PACT angiographyInitial head CT scanAsymptomatic intracranial hemorrhageInitial NIHSS scoreMajor vessel occlusionStroke Study GroupAcute ischemic strokeAcute stroke patientsRisk of hemorrhageSubgroup of patientsHead CT scanChances of recanalizationMajor intracranial arteriesHelical CT angiographyNIHSS scoreNINDS criteriaLacunar strokeOcclusive lesionsStroke teamSystemic complicationsTOAST criteriaAnterior circulationDistal emboliIschemic stroke