2024
Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage
Rivier C, Renedo D, Marini S, Magid‐Bernstein J, de Havenon A, Rosand J, Hanley D, Ziai W, Mayer S, Woo D, Sansing L, Sheth K, Anderson C, Falcone G. Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage. Annals Of Neurology 2024 PMID: 39499118, DOI: 10.1002/ana.27123.Peer-Reviewed Original ResearchRisk of hematoma expansionHighest risk of hematoma expansionRisk of poor outcomesIntracerebral hemorrhageHematoma expansionHigh riskMale sexPoor outcomeOutcome of spontaneous intracerebral hemorrhageClinical characteristics of patientsStudies of intracerebral hemorrhageNon-traumatic intracerebral hemorrhageIndividual patient data meta-analysisPatient data meta-analysisSpontaneous intracerebral hemorrhageSingle-center studyIntracerebral hemorrhage patientsHigh risk of expansionCharacteristics of patientsIntracerebral hemorrhage severityPoor functional outcomeRandomized clinical trialsData meta-analysisHemorrhage volumeClinical characteristicsRadiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival
Zaman S, Dierksen F, Knapp A, Haider S, Karam G, Qureshi A, Falcone G, Sheth K, Payabvash S. Radiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival. Diagnostics 2024, 14: 944. PMID: 38732358, PMCID: PMC11083693, DOI: 10.3390/diagnostics14090944.Peer-Reviewed Original ResearchInternational Normalized RatioArea under the curveNational Institutes of Health Stroke ScaleIntracerebral hemorrhageRadiomic featuresAntihypertensive Treatment of Acute Cerebral Hemorrhage IINon-contrast head CT scanBaseline International Normalized RatioAssociated with worse survival outcomesAcute intracerebral hemorrhageSupratentorial intracerebral hemorrhageWorse survival outcomesKaplan-Meier analysisHead CT scanCox proportional hazards modelsPredictors of mortalityAcute cerebral hemorrhageReceiver Operating Characteristic (ROC) analysisFirst-order energyHigher mortality riskProportional hazards modelHealth Stroke ScaleCT radiomicsHematoma expansionPost-ICHUncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan
Tran A, Zeevi T, Haider S, Abou Karam G, Berson E, Tharmaseelan H, Qureshi A, Sanelli P, Werring D, Malhotra A, Petersen N, de Havenon A, Falcone G, Sheth K, Payabvash S. Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan. Npj Digital Medicine 2024, 7: 26. PMID: 38321131, PMCID: PMC10847454, DOI: 10.1038/s41746-024-01007-w.Peer-Reviewed Original ResearchDeep learning modelsHematoma expansionIntracerebral hemorrhageICH expansionComputed tomographyNon-contrast head CTNon-contrast head computed tomographyHigh risk of HEHead computed tomographyHigh-confidence predictionsRisk of HENon-contrast headReceiver operating characteristic areaModifiable risk factorsMonte Carlo dropoutOperating characteristics areaPotential treatment targetHead CTVisual markersIdentified patientsAutomated deep learning modelDataset of patientsRisk factorsHigh riskPatientsTime-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome
Karam G, Chen M, Zeevi D, Harms B, Torres-Lopez V, Rivier C, Malhotra A, de Havenon A, Falcone G, Sheth K, Payabvash S. Time-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome. Diagnostics 2024, 14: 308. PMID: 38337824, PMCID: PMC10855868, DOI: 10.3390/diagnostics14030308.Peer-Reviewed Original ResearchPredictors of NDSupratentorial intracerebral hemorrhageHematoma expansionIntracerebral hemorrhageNeurological deteriorationPoor outcomeNIH Stroke ScalePost-ICHFunctional outcomesMild symptomsHematoma expansion ratesIntracerebral hemorrhage onsetAssociation of HEModifiable risk factorsGlasgow Coma ScaleBaseline CTHematoma growthConsecutive patientsHead CTSCAN-3Follow-upRate of HEComa ScaleRisk factorsHematoma
2021
Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials
Magid-Bernstein JR, Li Y, Cho SM, Piran PJ, Roh DJ, Gupta A, Shoamanesh A, Merkler A, Zhang C, Avadhani R, Montano N, Iadecola C, Falcone G, Sheth K, Qureshi AI, Rosand J, Goldstein J, Awad I, Hanley D, Kamel H, Ziai WC, Murthy SB. Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials. Neurology 2021, 98: e1013-e1020. PMID: 34937780, PMCID: PMC8967392, DOI: 10.1212/wnl.0000000000013247.Peer-Reviewed Original ResearchConceptsSmaller ICH volumeCerebral microbleedsSmall vessel diseaseIntracerebral hemorrhageHematoma expansionHematoma characteristicsICH volumeVessel diseaseNumber of CMBsSmaller baseline hematoma volumesUnderlying small vessel diseasePresence of CMBsCerebral small vessel diseaseAdmission ICH volumeMISTIE III trialPresence of microbleedsClass II evidencePhase 3 trialSeverity of leukoaraiosisPrimary intracerebral hemorrhageBaseline hematoma volumeIndividual patient dataBrain MRI scansLogistic regression modelsAntihypertensive treatmentAdmission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage
Acosta JN, Leasure AC, Kuohn LR, Both CP, Petersen NH, Sansing LH, Matouk CC, Testai F, Langefeld CD, Woo D, Kamel H, Murthy SB, Qureshi A, Mayer SA, Sheth KN, Falcone GJ. Admission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage. Critical Care Medicine 2021, 49: 828-837. PMID: 33591003, PMCID: PMC8611893, DOI: 10.1097/ccm.0000000000004891.Peer-Reviewed Original ResearchConceptsAdmission hemoglobin levelsHemoglobin levelsNontraumatic intracerebral hemorrhageIntracerebral hemorrhageHematoma volumePoor outcomeHematoma expansionIntracerebral hemorrhage patientsPredictors of outcomeSpontaneous intracerebral hemorrhageIndividual patient dataHigher hemoglobin levelsAdmission hematoma volumeExposure of interestDose-response analysisAdmission hemoglobinRankin ScalePrimary outcomeHemorrhage patientsFunctional outcomeRepeat CTClinical trialsObservational studyHemorrhage sizeBetter outcomes
2020
Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage
Parikh NS, Kamel H, Navi BB, Iadecola C, Merkler AE, Jesudian A, Dawson J, Falcone GJ, Sheth KN, Roh DJ, Elkind MSV, Hanley DF, Ziai WC, Murthy SB, Hanley D, Butcher K, Davis S, Gregson B, Lees K, Lyden P, Mayer S, Muir K, Steiner T. Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage. Stroke 2020, 51: 830-837. PMID: 31906832, PMCID: PMC7048169, DOI: 10.1161/strokeaha.119.028161.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageNonalcoholic fatty liver disease fibrosis scoreAspartate aminotransferase-platelet ratio indexAminotransferase-platelet ratio indexLiver fibrosis indexIntracerebral hemorrhageAdmission hematoma volumeHematoma volumeHematoma expansionFibrosis-4Fibrosis indexFibrosis scoreLiver diseaseMajor disabilityRatio indexNormal liver chemistriesAdvanced liver diseaseFibrosis-4 scoreRetrospective cohort studyPlatelet ratio indexPoor stroke outcomesSubclinical liver diseaseLogistic regression modelsLiver chemistriesRadiological outcomes
2019
Association of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Woo D, Ziai WC, Hanley DF, Salman R, Matouk CC, Sansing LH, Sheth KN, Falcone GJ. Association of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage. JAMA Neurology 2019, 76: 949-955. PMID: 31081862, PMCID: PMC6515816, DOI: 10.1001/jamaneurol.2019.1141.Peer-Reviewed Original ResearchIntensive Blood Pressure ReductionDeep intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageHematoma expansionStandard treatmentIntensive treatmentPressure reductionMAIN OUTCOMEModified Rankin scale score distributionIntensive blood pressure treatmentRankin Scale score distributionBasal ganglia intracerebral hemorrhageThalamic intracerebral hemorrhageBasal ganglia hemorrhageBlood pressure treatmentStandard treatment groupModified Rankin ScaleRankin Scale scorePrimary intracerebral hemorrhageAcute care settingStrong risk factorSpontaneous intracerebral hemorrhageDeep brain nucleiAntihypertensive treatment
2016
CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage
Morotti A, Jessel MJ, Brouwers HB, Falcone GJ, Schwab K, Ayres AM, Vashkevich A, Anderson CD, Viswanathan A, Greenberg SM, Gurol ME, Romero JM, Rosand J, Goldstein JN. CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage. Neurocritical Care 2016, 25: 79-85. PMID: 26759226, PMCID: PMC4940347, DOI: 10.1007/s12028-016-0241-2.Peer-Reviewed Original ResearchConceptsPrimary pontine hemorrhagePositive predictive valueSupratentorial intracerebral hemorrhageIntracerebral hemorrhageHematoma expansionHospital mortalitySpot signNegative predictive valuePredictive valueNon-contrast CT scanCT angiography spot signAbsolute hematoma growthBrainstem ICHTomography angiography spot signConsecutive ICH patientsComputer-assisted volumetric analysisSpot sign presenceNegative likelihood ratioCTA spot signCollected cohortICH patientsPontine hemorrhagePPH casesHematoma growthHematoma volume
2015
Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage
Brouwers HB, Battey TW, Musial HH, Ciura VA, Falcone GJ, Ayres AM, Vashkevich A, Schwab K, Viswanathan A, Anderson CD, Greenberg SM, Pomerantz SR, Ortiz CJ, Goldstein JN, Gonzalez RG, Rosand J, Romero JM. Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage. Stroke 2015, 46: 2498-2503. PMID: 26243220, PMCID: PMC4550492, DOI: 10.1161/strokeaha.115.009659.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageHematoma expansionContrast extravasationIntracerebral hemorrhageSpot signExtravasation rateTomographic angiographyConsecutive intracerebral hemorrhage patientsML/minContrast extravasation rateAcute intracerebral hemorrhageIntracerebral hemorrhage patientsMultivariable logistic regressionRate of bleedingIntracerebral hemorrhage volumeSpot sign presenceHospital mortalityMultivariable analysisHemorrhage patientsPostcontrast CTHemorrhage volumeSemiautomated softwareMortalityLogistic regressionHemorrhage
2014
Risk Factors for Computed Tomography Angiography Spot Sign in Deep and Lobar Intracerebral Hemorrhage Are Shared
Radmanesh F, Falcone GJ, Anderson CD, Battey TW, Ayres AM, Vashkevich A, McNamara KA, Schwab K, Romero JM, Viswanathan A, Greenberg SM, Goldstein JN, Rosand J, Brouwers HB. Risk Factors for Computed Tomography Angiography Spot Sign in Deep and Lobar Intracerebral Hemorrhage Are Shared. Stroke 2014, 45: 1833-1835. PMID: 24876264, PMCID: PMC4116606, DOI: 10.1161/strokeaha.114.005276.Peer-Reviewed Original ResearchConceptsLobar intracerebral hemorrhageComputed tomography angiographyBaseline ICH volumeIntracerebral hemorrhagePrimary intracerebral hemorrhageSpot signTomography angiographyICH locationICH volumeMultivariable regressionChronic cerebral small vessel diseaseCerebral small vessel diseaseDeep intracerebral hemorrhageSmall vessel diseaseTomography angiography spot signLobar ICH patientsComputed tomography angiography spot signAvailable computed tomography angiographySpot sign presenceSymptom onsetICH patientsPoor outcomeVessel diseaseAcute manifestationsHematoma expansionPredicting Hematoma Expansion After Primary Intracerebral Hemorrhage
Brouwers HB, Chang Y, Falcone GJ, Cai X, Ayres AM, Battey TW, Vashkevich A, McNamara KA, Valant V, Schwab K, Orzell SC, Bresette LM, Feske SK, Rost NS, Romero JM, Viswanathan A, Chou S, Greenberg SM, Rosand J, Goldstein JN. Predicting Hematoma Expansion After Primary Intracerebral Hemorrhage. JAMA Neurology 2014, 71: 158-164. PMID: 24366060, PMCID: PMC4131760, DOI: 10.1001/jamaneurol.2013.5433.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageIndependent validation cohortIntracerebral hemorrhageHematoma expansionValidation cohortHigh riskPrediction scoreUrban academic medical centerBaseline ICH volumeWarfarin sodium useProspective cohort studyAcute intracerebral hemorrhageMultivariable logistic regressionTomography angiography spot signComputed tomography angiography spot signAcademic medical centerPredictors of expansionCohort studyMultivariable analysisDevelopment cohortICH volumeC-statisticClinical trialsIndividualized treatmentMAIN OUTCOME
2012
CTA Spot Sign Predicts Hematoma Expansion in Patients with Delayed Presentation After Intracerebral Hemorrhage
Brouwers HB, Falcone GJ, McNamara KA, Ayres AM, Oleinik A, Schwab K, Romero JM, Viswanathan A, Greenberg SM, Rosand J, Goldstein JN. CTA Spot Sign Predicts Hematoma Expansion in Patients with Delayed Presentation After Intracerebral Hemorrhage. Neurocritical Care 2012, 17: 421-428. PMID: 22878870, PMCID: PMC3707619, DOI: 10.1007/s12028-012-9765-2.Peer-Reviewed Original ResearchConceptsHematoma expansionSymptom onsetSpot signUnknown onset timeCTA spot signIntracerebral hemorrhageCT angiography spot signHematoma expansion ratesUnknown symptom onsetOnset timeAcute intracerebral hemorrhageMajority of patientsSymptom onset timeBackgroundHematoma expansionDelayed PresentationFollowup CTConsecutive patientsInitial CTClinical trialsNovel therapiesPatientsHemorrhageExperienced readersOnsetSigns