2024
Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection
Albers G, Jumaa M, Purdon B, Zaidi S, Streib C, Shuaib A, Sangha N, Kim M, Froehler M, Schwartz N, Clark W, Kircher C, Yang M, Massaro L, Lu X, Rippon G, Broderick J, Butcher K, Lansberg M, Liebeskind D, Nouh A, Schwamm L, Campbell B. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. New England Journal Of Medicine 2024, 390: 701-711. PMID: 38329148, DOI: 10.1056/nejmoa2310392.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSymptomatic intracranial hemorrhageInternal carotid arteryMiddle cerebral arteryRankin ScalePlacebo groupTenecteplase groupIntracranial hemorrhageIncidence of symptomatic intracranial hemorrhageCerebral arteryIncidence of symptomatic intracerebral hemorrhageCarotid arteryPlacebo-controlled trialSymptomatic intracerebral hemorrhageEvidence of occlusionSafety populationDouble-blindPerfusion-imagingMedian timeClinical outcomesIntracerebral hemorrhagePlaceboPerfusion imagingPrimary outcomeOdds ratio
2020
Decoding the brain through research—the future of brain health
Wang D, Schwamm L, Qian T, Dai Q. Decoding the brain through research—the future of brain health. The BMJ 2020, 371: m3735. PMID: 33036999, PMCID: PMC7541036, DOI: 10.1136/bmj.m3735.Peer-Reviewed Original Research
2015
In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?
Copen W, Morais L, Wu O, Schwamm L, Schaefer P, González R, Yoo A. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core? PLOS ONE 2015, 10: e0133566. PMID: 26193486, PMCID: PMC4508041, DOI: 10.1371/journal.pone.0133566.Peer-Reviewed Original ResearchConceptsComputed tomography perfusion imagingDiffusion-weighted magnetic resonance imagingCerebral blood volumeInfarct volumeSensitivity/specificityCBV mapsDWI lesionsIschemic coreCore lesionsDWI-positive patientsRegional cerebral blood volumeAcute ischemic strokeFinal infarct volumeTreatment of patientsTomography perfusion imagingPresence of infarctionMagnetic resonance imagingDiffusion-weighted imagingAcute strokeIschemic strokeSymptom onsetLesion volumeIndividual patientsInter-rater agreementPatients
2014
Exposing Hidden Truncation-Related Errors in Acute Stroke Perfusion Imaging
Copen W, Deipolyi A, Schaefer P, Schwamm L, González R, Wu O. Exposing Hidden Truncation-Related Errors in Acute Stroke Perfusion Imaging. American Journal Of Neuroradiology 2014, 36: 638-645. PMID: 25500309, PMCID: PMC7964314, DOI: 10.3174/ajnr.a4186.Peer-Reviewed Original ResearchConceptsPerfusion scanVolume of lesionsScan durationSymptom onsetAcute infarctsHemodynamic measurementsLesion reversalClinical trialsLesion volumePatient managementPerfusion MRPerfusion imagingInjected contrast agentPerfusion imagesPatient CTLesionsDurationMTTCTLong scan durationScansContrast agentsShort scan durationTmaxPerfusion estimatesResponse to Letter Regarding Article, “Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes”
Hakimelahi R, Schwamm L, González R. Response to Letter Regarding Article, “Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes”. Stroke 2014, 45: e306. PMID: 25378428, DOI: 10.1161/strokeaha.114.007766.Peer-Reviewed Original ResearchCombining 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 growth
2013
Neuraxial Anesthesia in Parturients with Intracranial Pathology
Leffert LR, Schwamm LH. Neuraxial Anesthesia in Parturients with Intracranial Pathology. Anesthesiology 2013, 119: 703-718. PMID: 23584382, DOI: 10.1097/aln.0b013e31829374c2.Peer-Reviewed Original ResearchA Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Kidwell C, Jahan R, Gornbein J, Alger J, Nenov V, Ajani Z, Feng L, Meyer B, Olson S, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Guzy J, Starkman S, Saver J. A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke. New England Journal Of Medicine 2013, 368: 914-923. PMID: 23394476, PMCID: PMC3690785, DOI: 10.1056/nejmoa1212793.Peer-Reviewed Original ResearchConceptsFavorable penumbral patternAcute ischemic strokeStandard carePenumbral patternIschemic strokeRankin ScaleNinety-day mortalitySymptomatic intracranial hemorrhageAnterior circulation strokeModified Rankin ScaleMagnetic resonance imagingEligible patientsEmbolectomy groupMechanical embolectomyEndovascular thrombectomyEndovascular therapySuch patientsClinical outcomesEndovascular treatmentIntracranial hemorrhageMean ageImaging selectionImaging patternsEmbolectomyPatients
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
2010
LICORICE-ASSOCIATED REVERSIBLE CEREBRAL VASOCONSTRICTION WITH PRES(CME)
Chatterjee N, Domoto-Reilly K, Fecci P, Schwamm L, Singhal A. LICORICE-ASSOCIATED REVERSIBLE CEREBRAL VASOCONSTRICTION WITH PRES(CME). Neurology 2010, 75: 1939-1941. PMID: 21098410, PMCID: PMC2995386, DOI: 10.1212/wnl.0b013e3181feb299.Peer-Reviewed Original ResearchAdministration, OralBrainCerebral AngiographyCerebrovascular CirculationCerebrovascular DisordersFemaleGlycyrrhizaHeadache Disorders, PrimaryHumansHydrocortisoneHypertensionMagnetic Resonance ImagingMiddle AgedNimodipinePosterior Leukoencephalopathy SyndromeSeizuresTomography, X-Ray ComputedTreatment OutcomeVasoconstrictionVasodilator AgentsVerapamilVision DisordersStroke: working toward a prioritized world agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: working toward a prioritized world agenda. International Journal Of Stroke 2010, 5: 238-256. PMID: 20636706, PMCID: PMC3712839, DOI: 10.1111/j.1747-4949.2010.00442.x.Peer-Reviewed Original ResearchConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStrokeCombining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield
2009
Feasibility of NIRS in the Neurointensive Care Unit: A Pilot Study in Stroke Using Physiological Oscillations
Muehlschlegel S, Selb J, Patel M, Diamond S, Franceschini M, Sorensen A, Boas D, Schwamm L. Feasibility of NIRS in the Neurointensive Care Unit: A Pilot Study in Stroke Using Physiological Oscillations. Neurocritical Care 2009, 11: 288. PMID: 19649749, PMCID: PMC2782535, DOI: 10.1007/s12028-009-9254-4.Peer-Reviewed Original ResearchConceptsCare unitStroke patientsPhysiological oscillationsHemoglobin concentrationMicrovascular hemodynamicsPilot studyIschemic brain injuryNeurointensive care unitNeurocritical care unitPre-hospital settingRespiratory oscillationsWarrants further validationAbsolute hemoglobin concentrationResultsNine patientsCerebral perfusionHemispheric strokeBrain injuryHealthy controlsFuture clinical applicationsPatientsOwn controlClinical feasibilityBedside modalityContinuous-wave NIRSClinical applicationABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes
Sims J, Gharai L, Schaefer P, Vangel M, Rosenthal E, Lev M, Schwamm L. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology 2009, 72: 2104-2110. PMID: 19528517, PMCID: PMC2697964, DOI: 10.1212/wnl.0b013e3181aa5329.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain InfarctionCerebral ArteriesCerebral HemorrhageCerebrovascular CirculationComputer SimulationDiagnosis, DifferentialDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNerve Fibers, MyelinatedPredictive Value of TestsRetrospective StudiesSeverity of Illness IndexTime Factors
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 stroke
2006
First-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
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? Annals Of Neurology 2005, 57: 679-686. PMID: 15852402, DOI: 10.1002/ana.20465.Peer-Reviewed Original ResearchConceptsTransient 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
2004
Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury.
Huisman T, Schwamm L, Schaefer P, Koroshetz W, Shetty-Alva N, Ozsunar Y, Wu O, Sorensen A. Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury. American Journal Of Neuroradiology 2004, 25: 370-6. PMID: 15037457, PMCID: PMC8158566.Peer-Reviewed Original ResearchConceptsGlasgow Coma ScaleDiffusion tensor imagingTraumatic brain injuryRankin scoreInternal capsuleApparent diffusion coefficientADC valuesFA valuesWhite matter injuryHealthy control subjectsDiffuse axonal injuryCorresponding ADC valuesFractional anisotropy valuesNew MR imaging techniquesTBI correlatesComa ScaleClinical scoresAxonal injuryControl subjectsBrain injuryClinical markersMR imaging techniquesTissue injuryBrain ultrastructureWhite matterCase 5-2004 — A 57-Year-Old Man with Slurred Speech and Left Hemiparesis
Cabot R, Harris N, Shepard J, Ebeling S, Ellender S, Peters C, Carter B, Rabinov J, Pfannl R, Schwamm L. Case 5-2004 — A 57-Year-Old Man with Slurred Speech and Left Hemiparesis. New England Journal Of Medicine 2004, 350: 707-716. PMID: 14960747, DOI: 10.1056/nejmcpc030037.Peer-Reviewed Original Research