2023
Mechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds
Das A, Gokcal E, Biffi A, Regenhardt R, Pasi M, Abramovitz Fouks A, Viswanathan A, Goldstein J, Schwamm L, Rosand J, Greenberg S, Gurol M. Mechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds. Neurology 2023, 101: e636-e644. PMID: 37290968, PMCID: PMC10424843, DOI: 10.1212/wnl.0000000000207476.Peer-Reviewed Original ResearchConceptsCortical superficial siderosisCerebral microbleedsSuperficial siderosisIntracerebral hemorrhageHypertensive end-organ damagePresence of CMBsCerebral small vessel diseaseAdjusted hazard ratioEnd-organ damageCoronary artery diseaseDeep cerebral microbleedsSmall vessel diseaseImaging-based classificationLogistic regression modelsICH survivorsProspective databaseHazard ratioReferral centerArtery diseaseConsecutive patientsVentricular hypertrophyVessel diseaseICH recurrenceWarrant confirmationICH riskDistinguishing 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
2021
Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease
Das A, Regenhardt R, Gokcal E, Horn M, Daoud N, Schwab K, Rost N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Schwamm L, Rosand J, Greenberg S, Gurol M. Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease. International Journal Of Stroke 2021, 17: 645-653. PMID: 34427471, PMCID: PMC10947797, DOI: 10.1177/17474930211043957.Peer-Reviewed Original ResearchConceptsCerebral small vessel diseaseCerebral amyloid angiopathyPrimary intraventricular hemorrhageIdiopathic primary intraventricular hemorrhageProbable cerebral amyloid angiopathyAmyloid angiopathySmall vessel diseaseIntraventricular hemorrhageVessel diseaseMean initial blood pressureNon-traumatic intracerebral hemorrhageBrain magnetic resonance imagingInitial blood pressurePrimary intraparenchymal hemorrhageSingle referral centerBrain magnetic resonanceMagnetic resonance imagingCSVD subtypesBoston criteriaReferral centerBlood pressureConsecutive patientsCerebral amyloidIntracerebral hemorrhageIntraparenchymal hemorrhageUsefulness of Rhythm Monitoring Following Acute Ischemic Stroke
Khurshid S, Li X, Ashburner J, Lipsanopoulos A, Lee P, Lin A, Ko D, Ellinor P, Schwamm L, Benjamin E, Atlas S, Singer D, Anderson C, Trinquart L, Lubitz S. Usefulness of Rhythm Monitoring Following Acute Ischemic Stroke. The American Journal Of Cardiology 2021, 147: 44-51. PMID: 33617814, DOI: 10.1016/j.amjcard.2021.01.038.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeCryptogenic strokeCause-specific hazards regressionCHARGE-AF scoreAtrial fibrillation riskRisk of deathFine-Gray modelCHARGE-AFIncident AFPrevalent AFDischarge dispositionStroke subtypesConsecutive patientsAF riskHazards regressionStroke survivorsAssessed associationsRhythm monitoringStrokeAF scorePatientsIncidenceOne-thirdRisk
2019
Resource utilisation among patients transferred for intracerebral haemorrhage
Zachrison K, Aaronson E, Mahmood S, Rosand J, Viswanathan A, Schwamm L, Goldstein J. Resource utilisation among patients transferred for intracerebral haemorrhage. Stroke And Vascular Neurology 2019, 4: 223. PMID: 32030206, PMCID: PMC6979870, DOI: 10.1136/svn-2019-000255.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAge FactorsAgedAged, 80 and overCerebral HemorrhageCritical CareFemaleGlasgow Coma ScaleHumansIntensive Care UnitsMaleMiddle AgedNeurosurgical ProceduresPatient AdmissionPatient TransferProspective StudiesRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsGlasgow Coma ScoreIntracerebral hemorrhageSurgical interventionICH scoreAcademic hospitalBaseline Glasgow Coma ScoreIntensive care unit admissionCare unit admissionSingle academic hospitalPrimary intracerebral hemorrhageUrban academic hospitalLess frequent useCollected registryICU stayUnit admissionComa ScoreConsecutive patientsIntraventricular hemorrhagePrimary outcomePrimary patientsPatientsHospitalLogistic regressionHemorrhageResource utilisation
2018
Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care
Raymond S, Akbik F, Stapleton C, Mehta B, Chandra R, Gonzalez R, Rabinov J, Schwamm L, Patel A, Hirsch J, Leslie-Mazwi T. Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care. Frontiers In Neurology 2018, 9: 1106. PMID: 30619062, PMCID: PMC6305592, DOI: 10.3389/fneur.2018.01106.Peer-Reviewed Original ResearchTime of presentationTreatment latencyTreatment intervalEndovascular stroke treatmentProspective observational cohortOff-hour careAcute strokeMedian doorObservational cohortConsecutive patientsEndovascular therapyStroke treatmentStroke carePuncture timeFunctional outcomeProtocol adherenceThrombolysis candidatesInstitutional protocolPatient outcomesWeekend effectProtocol experienceStudy periodOutcomesPatientsRegular work hoursImplementation of a Rapid, Protocol-based TIA Management Pathway
Jarhult S, Howell M, Barnaure-Nachbar I, Chang Y, White B, Amatangelo M, Brown D, Singhal A, Schwamm L, Silverman S, Goldstein J. Implementation of a Rapid, Protocol-based TIA Management Pathway. Western Journal Of Emergency Medicine 2018, 19: 216-223. PMID: 29560046, PMCID: PMC5851491, DOI: 10.5811/westjem.2017.9.35341.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTotal hospital LOSHospital LOSEmergency departmentED LOSFinal diagnosisRecurrent transient ischemic attacksTertiary care academic centerED observation unitIntermediate-risk patientsHigh-risk patientsProportion of patientsMedian ED LOSInpatient admission ratesNeck CT angiographyBrain magnetic resonanceNeck MR angiographyStandardized clinical protocolUse of neuroimagingIschemic attackCohort studyTIA symptomsConsecutive patientsED lengthSix-month periodPrestroke selective serotonin reuptake inhibitor use and functional outcomes after ischaemic stroke
Etherton M, Siddiqui K, Schwamm L. Prestroke selective serotonin reuptake inhibitor use and functional outcomes after ischaemic stroke. Stroke And Vascular Neurology 2018, 3: 9. PMID: 29600002, PMCID: PMC5870643, DOI: 10.1136/svn-2017-000119.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsAcute ischemic strokeIschemic strokeLength of staySSRI useFunctional outcomeSelective serotonin reuptake inhibitor useSerotonin reuptake inhibitor useGuidelines-Stroke registrySerotonin reuptake inhibitorsMultivariate regression analysisAmbulatory statusSymptomatic hemorrhageConsecutive patientsInhibitor useMotor recoveryReuptake inhibitorsFunctional recoveryStroke recoveryUnivariate analysisData registryDrug listMultivariate analysisStrokeLower likelihood
2017
Clinical Imaging Factors Associated With Infarct Progression in Patients With Ischemic Stroke During Transfer for Mechanical Thrombectomy
Boulouis G, Lauer A, Siddiqui A, Charidimou A, Regenhardt R, Viswanathan A, Rost N, Leslie-Mazwi T, Schwamm L. Clinical Imaging Factors Associated With Infarct Progression in Patients With Ischemic Stroke During Transfer for Mechanical Thrombectomy. JAMA Neurology 2017, 74: 1361-1367. PMID: 28973081, PMCID: PMC5710581, DOI: 10.1001/jamaneurol.2017.2149.Peer-Reviewed Original ResearchConceptsThrombectomy-capable stroke centersCollateral blood flowIschemic strokeInfarct progressionMechanical thrombectomyCT angiographyMAIN OUTCOMEVessel statusBlood flowImaging factorsHigher adjusted odds ratioVascular imagingFavorable imaging profileHealth Stroke ScoreAcute ischemic strokeHigher National InstitutesAdjusted odds ratioRegional stroke networkStroke care networksStroke centersStroke ScoreConsecutive patientsStroke NetworkClinical severityFutile transfers
2015
Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke
Ali S, Smith E, Reeves M, Zhao X, Xian Y, Hernandez A, Bhatt D, Fonarow G, Schwamm L. Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2015, 8: s73-s80. PMID: 26515213, DOI: 10.1161/circoutcomes.114.001244.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCoronary artery diseaseVascular risk factorsAdjusted odds ratioHospital mortalityRisk factorsIschemic strokeArtery diseaseOdds ratioProspective population-based studyPast-year smokersResidual unmeasured confoundingPopulation-based studyAge-stratified analysisPotent risk factorPast-year smokingConsecutive patientsMultivariable modelSmokersSmokingPatientsSignificant associationMortalitySubstantial confoundingUnmeasured confounding
2014
Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection
Schaefer P, Pulli B, Copen W, Hirsch J, Leslie-Mazwi T, Schwamm L, Wu O, González R, Yoo A. Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection. American Journal Of Neuroradiology 2014, 36: 259-264. PMID: 25258369, PMCID: PMC4462135, DOI: 10.3174/ajnr.a4103.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainBrain IschemiaCerebral InfarctionDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Patient SelectionPrognosisReperfusionROC CurveSensitivity and SpecificitySeverity of Illness IndexStrokeUnited StatesConceptsPositive predictive valueAcute ischemic strokeLarge patient cohortReperfusion therapyPoor outcomeStroke sidePredictive valueNIHSS scoreIschemic strokeClinical outcomesPatient cohortPrognostic yieldAnterior circulation acute ischemic strokeAcute ischemic stroke patientsImaging thresholdsBeneficial treatment responseDiffusion-perfusion mismatchHigh positive predictive valueIschemic stroke patientsRight-sided strokeLeft-sided strokeUntreated patientsStroke onsetConsecutive patientsPatient selectionTime and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes
Hakimelahi R, Vachha B, Copen W, Papini G, He J, Higazi M, Lev M, Schaefer P, Yoo A, Schwamm L, González R. Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes. Stroke 2014, 45: 2936-2941. PMID: 25190444, DOI: 10.1161/strokeaha.114.005644.Peer-Reviewed Original ResearchConceptsAnterior circulation ischemic strokeMiddle cerebral artery occlusionDiffusion-weighted imagingCerebral artery occlusionStroke onsetIschemic strokeInfarct sizeDWI lesionsInfarct volumeArtery occlusionIntravenous tissue-type plasminogen activatorProximal middle cerebral arteryDistal internal carotid arteryAcute infarct volumeDWI lesion volumeMajority of patientsMiddle cerebral arteryInternal carotid arteryAcute infarct sizeSame inclusion criteriaTraditional time windowTissue-type plasminogen activatorCerebral perfusionConsecutive patientsInfarct growthThe TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network
Ali SF, Viswanathan A, Singhal AB, Rost NS, Forducey PG, Davis LW, Schindler J, Likosky W, Schlegel S, Solenski N, Schwamm LH, Network O. The TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network. Journal Of The American Heart Association 2014, 3: e000838. PMID: 24958778, PMCID: PMC4309074, DOI: 10.1161/jaha.114.000838.Peer-Reviewed Original ResearchConceptsStroke mimicsIschemic cerebrovascular diseaseTelestroke networkReceiver-operating characteristic curve analysisCurve analysisHealth Stroke ScaleVascular risk profileVascular risk factorsAcute stroke evaluationExternal validation cohortFinal clinical diagnosisLower mean ageROC curve analysisCharacteristic curve analysisStepwise logistic regressionTelestroke consultationStroke ScaleFacial weaknessConsecutive patientsDerivation cohortPrior seizuresStroke evaluationAlternate diagnosisCerebrovascular diseaseValidation cohort
2012
Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke
Hakimelahi R, Yoo A, He J, Schwamm L, Lev M, Schaefer P, González R. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke. BMC Neurology 2012, 12: 132. PMID: 23121836, PMCID: PMC3519648, DOI: 10.1186/1471-2377-12-132.Peer-Reviewed Original ResearchConceptsDiffusion/perfusion mismatchDWI lesion volumeInternal carotid arteryLesion volumePerfusion mismatchConsecutive patientsCarotid arteryMiddle cerebral artery ischemic strokeDiffusion/perfusion MRITerminal internal carotid arteryProximal middle cerebral arteryDistal internal carotid arteryLarger mismatch volumeProximal MCA occlusionMiddle cerebral arteryDiffusion lesion volumeSame inclusion criteriaTerminal ICAArtery occlusionIschemic strokeMCA occlusionStroke onsetCerebral arteryStroke patientsPatient assessment
2011
Prediction of Early Stroke Risk in Transient Symptoms With Infarction
Arsava E, Furie K, Schwamm L, Sorensen A, Ay H. Prediction of Early Stroke Risk in Transient Symptoms With Infarction. Stroke 2011, 42: 2186-2190. PMID: 21680907, PMCID: PMC3144273, DOI: 10.1161/strokeaha.110.604280.Peer-Reviewed Original ResearchConceptsTransient ischemic attackReceiver-operating characteristic curveIschemic attackStroke riskTransient symptomsDiffusion-weighted imagesStroke prevention strategiesHigh-risk patientsRisk of strokeEarly stroke riskCharacteristic curveNew infarctionRecurrent strokeClinical deteriorationConsecutive patientsIschemic strokeSymptom onsetIndex lesionRetrospective seriesPrevention strategiesPatientsEarly interventionInfarctionStrokeSubsequent stroke
2008
Clinical- and Imaging-Based Prediction of Stroke Risk After Transient Ischemic Attack
Ay H, Arsava E, Johnston S, Vangel M, Schwamm L, Furie K, Koroshetz W, Sorensen A. Clinical- and Imaging-Based Prediction of Stroke Risk After Transient Ischemic Attack. Stroke 2008, 40: 181-186. PMID: 18948609, DOI: 10.1161/strokeaha.108.521476.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrainComorbidityComputer SimulationDiffusion Magnetic Resonance ImagingDisease ProgressionEarly DiagnosisEmergency Medical ServicesFemaleHumansIncidenceIschemic Attack, TransientLogistic ModelsMaleMiddle AgedNeurologic ExaminationPredictive Value of TestsPrognosisReproducibility of ResultsRisk FactorsStrokeConceptsTransient ischemic attackIschemic attackStroke riskClinical featuresDiffusion-weighted imagingAcute infarctsClinical transient ischemic attackDiffusion-weighted imaging findingsEarly stroke riskRelevant clinical settingsCharacteristic curveLogistic regression modelsConsecutive patientsSymptom onsetIndependent predictorsRisk stratificationImaging findingsTherapeutic measuresHospital resourcesEarly riskClinical settingResponse criteriaPredictive instrumentStrokeSubsequent strokeAn Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale
Torres-Mozqueda F, He J, Yeh I, Schwamm L, Lev M, Schaefer P, González R. An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale. American Journal Of Neuroradiology 2008, 29: 1111-1117. PMID: 18467521, PMCID: PMC8118840, DOI: 10.3174/ajnr.a1000.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic strokeMinor stroke groupIschemic strokeMajor strokeMinor strokeStroke groupNoncontrast CTBoston Acute Stroke Imaging ScaleProximal cerebral artery occlusionMR angiographyCerebral artery occlusionLength of hospitalizationClassification instrumentCTA patientsArtery occlusionDischarge dispositionConsecutive patientsParenchymal ischemiaCT scorePatient outcomesStroke survivorsRehabilitation facilityPatientsStrokeLow-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions
Nogueira R, Schwamm L, Buonanno F, Koroshetz W, Yoo A, Rabinov J, Pryor J, Hirsch J. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions. Neuroradiology 2008, 50: 331-340. PMID: 18172631, DOI: 10.1007/s00234-007-0340-z.Peer-Reviewed Original ResearchConceptsRecanalization rateIntracranial arteriesLow-pressure balloon angioplastyGlycoprotein IIb-IIIa inhibitorsInternal carotid artery terminusT-PAAdjuvant pharmacological therapyIntravenous t-PAOverall recanalization rateAcute ischemic strokeIIb-IIIa inhibitorsIntracranial arterial occlusionProcedure-related morbidityHigher recanalization ratesChances of recanalizationIA urokinaseSymptomatic hemorrhageAcute strokeCerebral infarctionCoronary balloonIschemic strokeConsecutive patientsPharmacological therapyArterial occlusionMechanical thrombolysis
2006
Transient ischemic attack with infarction: A unique syndrome?
Ay H, Koroshetz W, Benner T, Vangel M, Wu O, Schwamm L, Sorensen A. Transient ischemic attack with infarction: A unique syndrome? International Congress Series 2006, 1290: 45-55. DOI: 10.1016/j.ics.2006.04.007.Peer-Reviewed Original ResearchTransient ischemic attackIschemic strokeIschemic attackSymptom durationDistinct prognostic featuresSeparate clinical syndromesRecurrent ischemic strokeMinor ischemic strokeUnderwent diffusion-weighted imagingDiffusion-weighted imagingInfarct volumeConsecutive patientsTIA ratePrognostic featuresTransient symptomsBrain syndromeClinical syndromeUnique syndromeInfarctionPatientsStrokeSyndromeSymptomsDurationInfarcts
2005
Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy.
Schwamm L, Rosenthal E, Swap C, Rosand J, Rordorf G, Buonanno F, Vangel M, Koroshetz W, Lev M. Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy. American Journal Of Neuroradiology 2005, 26: 1798-803. PMID: 16091532, PMCID: PMC7975152.Peer-Reviewed Original ResearchMeSH KeywordsAgedArterial Occlusive DiseasesBasilar ArteryCerebral AngiographyCerebral HemorrhageCerebral InfarctionFemaleFibrinolytic AgentsHematomaHumansMaleMiddle AgedMiddle Cerebral ArteryPredictive Value of TestsRetrospective StudiesRisk AssessmentTissue Plasminogen ActivatorTomography, X-Ray ComputedConceptsIntra-arterial reperfusion therapyHemorrhagic transformationPoor clinical outcomeCTA source imagesReperfusion therapyClinical outcomesCT angiographic source imagesCatheter-based reperfusionReal-time risk stratificationSymptomatic hemorrhagic transformationReceiver operator characteristic curveBlood glucose levelsOperator characteristic curveAxial source imagesNormal contralateral tissueConsecutive patientsVascular insufficiencyIntracerebral hemorrhageRisk stratificationStroke patientsPoor outcomeSignificant complicationsRisk factorsContralateral tissueLesion volume