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
2023
Role of Inflammatory Processes in Hemorrhagic Stroke
Ohashi S, DeLong J, Kozberg M, Mazur-Hart D, van Veluw S, Alkayed N, Sansing L. Role of Inflammatory Processes in Hemorrhagic Stroke. Stroke 2023, 54: 605-619. PMID: 36601948, DOI: 10.1161/strokeaha.122.037155.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHemorrhagic strokeIntracerebral hemorrhageInflammatory processCerebral amyloid angiopathy-related haemorrhageAngiopathy-related hemorrhageRole of inflammationCerebral amyloid angiopathyInflammatory immune responseEffective therapeutic strategyCentral nervous systemBrain residentAmyloid angiopathyImmune cellsTissue injuryCommon causeImmune responseHemorrhageTherapeutic strategiesNervous systemMajor subtypesDisease pathologyStrokeOlder individualsTissue recoveryDeadliest form
2022
The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results
Lyden PD, Bosetti F, Diniz MA, Rogatko A, Koenig JI, Lamb J, Nagarkatti KA, Cabeen RP, Hess DC, Kamat PK, Khan MB, Wood K, Dhandapani K, Arbab AS, Leira EC, Chauhan AK, Dhanesha N, Patel RB, Kumskova M, Thedens D, Morais A, Imai T, Qin T, Ayata C, Boisserand LSB, Herman AL, Beatty HE, Velazquez SE, Diaz-Perez S, Sanganahalli BG, Mihailovic JM, Hyder F, Sansing LH, Koehler RC, Lannon S, Shi Y, Karuppagounder SS, Bibic A, Akhter K, Aronowski J, McCullough LD, Chauhan A, Goh A, Siddiqui S, Sheth K, Matouk C, Cruz C, Zhou J, Dawson V, Dawson T, Liang J, van Zijl P, Zeiler S, Taylor Kimberly W, Erdogan T, Yu L, Mandeville J, Whittier J. The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results. Stroke 2022, 53: 1802-1812. PMID: 35354299, PMCID: PMC9038686, DOI: 10.1161/strokeaha.121.038047.Peer-Reviewed Original ResearchConceptsPreclinical assessmentStroke treatmentCandidate treatmentMiddle cerebral artery occlusion (MCAO) surgeryClinical stroke trialsSuccessful stroke treatmentInclusion/exclusion criteriaStroke clinical trialsClinical trial designYoung male animalsComorbid diseasesOcclusion surgeryCerebral ischemiaNeurological disabilityComorbid conditionsStroke trialsProtocol adherenceBlinded assessmentSuch therapyClinical trialsClinical studiesExclusion criteriaTrial designAged animalsOutcome assessmentBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Assessment of Discrepancies Between Follow-up Infarct Volume and 90-Day Outcomes Among Patients With Ischemic Stroke Who Received Endovascular Therapy
Ganesh A, Ospel J, Menon B, Demchuk A, McTaggart R, Nogueira R, Poppe A, Almekhlafi M, Hanel R, Thomalla G, Holmin S, Puetz V, van Adel B, Tarpley J, Tymianski M, Hill M, Goyal M, Barber P, Smith E, Bal S, Subramanian S, Peters S, Couillard P, Klein G, Stys P, Coutts S, Wong J, Mitha A, Eesa M, Morrish W, Alqatani S, Kashani N, Venkatesan P, Teleg E, Sitaram A, Graham B, Gaal S, Moussaddy A, Chakraborty D, Maraj N, Lockey A, Chen S, Singh R, Alsultan A, Asunsian R, Tse D, Doshi D, Volny O, Ojha P, Wadhwa A, Marko M, Singh N, Wasyliw S, Ryckborst K, Kenney C, Save S, Jambula A, Newcommon N, Hull G, Blackstock D, Kiszczak S, Zimmel L, Wright M, Jahraus C, Andersen L, Bohn S, Paul J, Buck B, Butcher K, Shuaib A, Jeerakathil T, Jickling G, Emery D, Rempel J, Ower R, Ashforth R, Yeo T, Kotylak T, O;Kelly C, Chow M, Siddiqui M, Saqqur M, D'Souza A, Lloret M, Butt A, Nomani A, Kalashyan H, Thirunavukkarasu S, Jabs J, Fairall P, Piquette L, Phillips S, Green A, Gubitz G, Heidenreich J, Huynh T, Shankar J, Maloney W, Vandorpe R, Schmidt M, Pickett G, Weeks A, Jarrett J, MacDonald D, Arsenault J, Kinnear R, Mandzia J, Mayich M, Boulton M, Bullrich M, Fridman S, Kiwan R, Lee D, Lownie S, Khaw A, Pandey S, Sharma M, Sposato L, Wade K, Beauchamp B, Lambourn L, Amato-Marziali B, Roy D, Deneault N, Deschaintre Y, Gioia L, Jacquin G, Odier C, Stapf C, Iancu D, Raymond J, Weill A, Lapierre M, Jadil N, Jolteus J, Teitelbaum J, Angle M, Hannouche M, Badawy M, Letourneau J, Cortes M, Linnell G, Tampieri D, Vieira L, Legault C, Durcan L, Moore A, Cole E, Magnussen C, Salmon K, Khalil S, Desloges I, Waxman L, Abdon W, Lai S, Dowlatshahi D, Shamy M, Stotts G, Blacquiere D, Lesiuk H, Quateen A, Drake B, Dewar B, Daham Z, Kelly M, Hunter G, Peeling L, Graham B, Whelan R, Garner A, Urroz L, Maley S, Silver F, Casaubon L, Pikula A, Campo M, Schaafsma J, Jaigobin C, Krings T, Pereira V, Agid R, Farb R, Kalman L, Cayley A, Williams J, Stewart T, Misquitta K, Bharatha A, Selchen D, Marotta T, Sarma D, Montanera W, Spears J, Saposnik G, Kostyrko P, Li Y, Parra-Farinas C, Diestro J, Camden M, Verreault S, Mackey A, Audet M, Milot G, Lavoie P, Gariépy J, Collard K, Haché A, Sahlas D, Alshanbari A, Baldwin J, Catanese L, Chen B, Sa Boasquevisque D, Deshmukh A, Knapman J, Lamers S, Larrazabal R, MacMillan S, Mai L, Mattai A, Nayar S, Ng K, Oczkowski W, Perera K, Shawawrah M, Shoamanesh A, Sobhi G, Syed N, Yaher N, Vandervelde C, Wang D, Field T, Van Gaal S, Teal P, Benavente O, Wilson L, Mann S, Yip S, Murphy C, Heran M, Rohr A, Settecase F, Redekop G, Haw C, Maclean G, Murray K, Chiu R, Flexman A, Strecha E, Gayton Y, Yip J, Swartz R, Boulos M, Gladstone D, Yu A, Hopyan J, Khosravani H, Manosalva Alzate H, Southwell A, Kamra M, Lopes K, Kapoor A, da Costa L, Yang V, Dyer E, Shah R, Knowles B, Nichols J, Patterson J, Cope K, Dickerson L, Barton K, Gray K, Massengale T, Miller M, Simpson C, Walker S, Tennyson-Yemm C, Frei D, Bellon R, Atchie B, Kaminsky I, Wilson D, Schraeder N, Arias E, Kodis L, Talley M, Edinger A, Talley T, Dempsey I, Williams L, Williams S, Kupniewski S, Fasbinder B, Snead J, Choe H, Mackenzie L, Weisman D, Kozak O, Shah Q, Gzesh D, Kulandaivel K, Khoury J, Klein B, Bussinger P, Griffin L, DePalmo A, Oliva C, Jadhav A, Jovin T, Kenmuir C, Jankowitz B, Gross B, Rocha M, Starr M, Brown M, Hawkes C, Shah K, Tememe D, Walker G, Patel P, Klein B, Ziayee H, Limaye K, Baxendell L, Glichrist V, Feineigle P, Toseki Haibach K, Van Every C, Desai S, Zulfiqar M, Gibson L, Barrett S, Turkel-Parrella D, Arcot K, DiCrescento S, Farkas J, Filipowski G, Frontera J, Joset D, Liff J, Scher E, McDougall C, Kelly C, Patel A, Monteith S, Starkman S, Atchaneeyasakul K, Burgos A, Anne Y. Chua J, Gaines N, Grunberg I, Guzy J, Liu Z, Maluste N, Ramirez L, Sharma L, Heck D, Brown M, McDonald C, Calderon M, Hargis M, Roels C, Emmady P, Alvi T, Jayaraman M, Cutting S, Smith W, Foley S, Paolucci G, Haas R, Quinn K, Fuller L, Brierley R, Watkins C, Demir N, Lopez G, Vargas A, Osteraas N, Holtz B, Sauvageau E, Aghaebrahim A, Chmayssani M, Naval N, Day J, Dellorso S, Ludwig B, Schemmel D, Ebreo N, Bell K, Lewis L, Delucia M, Haussen D, Frankel M, Bhatt N, Bianchi N, Anderson A, Belagaje S, Liberato B, Rangaraju S, Al-Bayati A, Grossber J, Craft L, Schindler K, Schaad E, Schultz M, Sutherly L, Doppelheuer S, Charlton J, Faggard J, Barbret Z, DukSoo Han E, Walters R, Dolia J, El-Jamal S, Eby B, Saleem Y, Pearl H, Patel K, Rahman H, Butt R, English S, Puri A, Howk M, Singh J, Massari F, DeMacedo Rodrigues K, Kuhn A, English J, Barazangi N, Telischak N, Kim W, Ross J, DeVole N, Redford J, Ferreira M, Ponting K, Shen H, Bedenk A, Patel S, Fernandess J, Ke M, Spokoyny I, Gao B, Tong D, Chen C, Wong C, Choe J, Martin C, Summers D, Boutwell C, Olds K, Crandall S, Eatman J, Akhtar N, Holloway W, Halpin J, Donegan B, Schindler J, Hwang D, Gilmore E, Petersen N, Sheth K, Brown S, Beekman R, George B, Kaddouh F, Falcone G, Wira C, Matouk C, Loomis C, Amin H, Stretz H, Narula R, Jasne A, Sansing L, Agarwal T, Jasak S, Fontaine B, King Z, Kouhn L, Orgass H, Leary M, Nye J, Halbert K, Nystrom K, Neuschatz K, Petrucci D, Coppola A, Joyce T, Hou S, Umekubo M, Nakamura C, Ovando R, Zuniga D, Nien Y, Basto F, Arch A, Jong L, Conrad W, Abbott T, Yao J, Caganap S, Jordan J, Teitelbaum G, Darflinger R, Kelly D, Gupta R, Budzik R, Czerniak J, Groezinger K, Hicks W, Kaskar O, Katz B, Loochtan A, Pema P, Rai V, Vora N, Brown A, Goodman D, Danenbergs B, Gossett M, Bang O, Chung J, Jeon P, Kim K, Lim Y, Hoe Heo J, Nam H, Kim Y, Park H, Hwang I, Ha W, Choi J, Jeong K, Rha J, Park H, Yoon C, Kim B, Sohn S, Kim C, Yoo J, Hong J, Park H, Kim S, Choi M, Bae H, Lee J, Lee J, Jun G, Jeon S, Campbell B, Mitchell P, Yassi N, Davis S, Donnan G, Parsons M, Yan B, Dowling R, Bush S, Wu T, Shan D, Zhao H, Salvaris P, Alemseged F, Ng F, Williams C, Balabanski A, dos Santos A, Ng J, McDonald A, Jackson D, Tsoleridis J, Pesavento L, Kleinig T, Drew R, Cranefield J, Scroop R, Cagi L, Harvey J, Waters M, Thornton J, Brennan R, O'Hare A, Power S, Williams D, Boyle K, Moynihan B, Liddy A, Large M, Cullen A, Walsh R, Martin E, Lynch J, McElroy S, Murphy S, Coveney S, Deegan C, Horgan G, Kelly P, Laffan A, Llamas-Osorio Y, Lynch C, Mac Mahon P, Marnane M, McCabe J, Burns P, Tauro S, Cuddy S, Rennie I, Smyth G, Flynn P, Wiggam I, Kerr E, Gordon P, Fearon P, Roberts G, Patterson C, Adams K, Wells B, McFarland M, Moreira T, Sjöstrand C, Mazya M, Almqvist H, Wahlgren N, Steinberg A, Cooray C, Eriksson E, Thorén M, Keselman B, Ahmed N, Holmberg Å, Axelsson M, Berglund A, Golsari A, Hoppe J, Deb-Chatterji M, Cheng B, Barow E, Schlemm E, Lettow I, Jensen M, Otto D, Jaramillo K, Appelbohm H, Fiehler J, Bester M, Schönfeld M, Brekenfeld C, Holst B, Wortmann G, Koch F, Gerber J, Abramyuk A, Kaiser D, Winzer S, Prakapenia A, Pallesen L, Siepmann T, Barlinn K, Haase K, Sauer A, Psychogios M, Liman J, Brehm A, Maus V, Hollstein N, Reinke A, Neitz G, Schnieder M, Schwarz M, Ibrahim A, Müller J, Meister S, Bäumle B, Chapot R, Pilgram-Pastor S, Wallocha M, Stauder M, Celik E, Stracke P, Müller N, Weber R, Veltkamp R, Nagel S, Ringleb P, Heyse M, Amiri H, Mundiyanapurath S, Chen M, Beyrle E, Beck P, Möhlenbruch M. Assessment of Discrepancies Between Follow-up Infarct Volume and 90-Day Outcomes Among Patients With Ischemic Stroke Who Received Endovascular Therapy. JAMA Network Open 2021, 4: e2132376. PMID: 34739060, PMCID: PMC8571657, DOI: 10.1001/jamanetworkopen.2021.32376.Peer-Reviewed Original ResearchConceptsSerious adverse eventsHigher mRS scoreLower mRS scoresMRS scoreInfarct volumeEndovascular therapyPretreatment factorsPosttreatment factorsBlood pressureHemoglobin levelsFunctional outcomeAnterior Circulation Proximal OcclusionDiscrepant casesHighest FIVTomography/magnetic resonance imagingHigher baseline hemoglobinRecanalization Times (ESCAPE) trialAbsence of diabetesStroke unit careSymptomatic intracerebral hemorrhageCongestive heart failureDiastolic blood pressureRankin Scale scoreMagnetic resonance imagingStepwise modelCardiovascular Health Disparities in Racial and Other Underrepresented Groups: Initial Results From the All of Us Research Program
Acosta JN, Leasure AC, Both CP, Szejko N, Brown S, Torres‐Lopez V, Abdelhakim S, Schindler J, Petersen N, Sansing L, Gill TM, Sheth KN, Falcone GJ. Cardiovascular Health Disparities in Racial and Other Underrepresented Groups: Initial Results From the All of Us Research Program. Journal Of The American Heart Association 2021, 10: e021724. PMID: 34431358, PMCID: PMC8649271, DOI: 10.1161/jaha.121.021724.Peer-Reviewed Original ResearchPortable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonanceEarly Inflammatory Cytokine Expression in Cerebrospinal Fluid of Patients with Spontaneous Intraventricular Hemorrhage
Ziai WC, Parry-Jones AR, Thompson CB, Sansing LH, Mullen MT, Murthy SB, Mould A, Nekoovaght-Tak S, Hanley DF. Early Inflammatory Cytokine Expression in Cerebrospinal Fluid of Patients with Spontaneous Intraventricular Hemorrhage. Biomolecules 2021, 11: 1123. PMID: 34439789, PMCID: PMC8394793, DOI: 10.3390/biom11081123.Peer-Reviewed Original ResearchConceptsIL-10IL-6IL-1βIL-8Cerebrospinal fluidIntraventricular hemorrhageDay 1IVH volumeCerebral inflammatory responsePerihematomal edema volumePro-inflammatory markersExternal ventricular drainageInflammatory cytokine expressionSpontaneous intraventricular hemorrhageChemokine ligands CCL2Tumor necrosis factorEnzyme-linked immunosorbentCSF cytokinesRelative PHELigand CCL2Obstructive hydrocephalusVentricular drainageEdema volumeCytokine expressionICH volumeExpedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly
Garg A, Maran I, Amin H, Vlieks K, Neuschatz K, Coppola A, Poskus K, Johnson J, Davis M, Minja F, Schindler J, Sansing LH, Malhotra A, Jasne AS, Sharma R. Expedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106016. PMID: 34325273, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical ProtocolsCost SavingsCost-Benefit AnalysisDecision Support TechniquesDelivery of Health Care, IntegratedEmergency Service, HospitalFeasibility StudiesFemaleHospital CostsHumansIschemic Attack, TransientLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeTriageConceptsLow-risk TIA patientsTransient ischemic attackTIA patientsEmergency roomAcademic comprehensive stroke centerSingle-center cohort studyPre-pathway groupComprehensive stroke centerClinical practice recommendationsLength of stayOutcomes of interestImpending strokeIschemic attackOutpatient echocardiogramRapid outpatientTIA admissionsEchocardiogram findingsEchocardiographic findingsStroke clinicCohort studyStroke centersNeurovascular eventsEmergency departmentFinal diagnosisHospital costsIntracerebral Hemorrhage in Patients With COVID-19
Leasure AC, Khan YM, Iyer R, Elkind MSV, Sansing LH, Falcone GJ, Sheth KN. Intracerebral Hemorrhage in Patients With COVID-19. Stroke 2021, 52: e321-e323. PMID: 34082576, PMCID: PMC8238884, DOI: 10.1161/strokeaha.121.034215.Peer-Reviewed Original ResearchAdolescentAdultAge FactorsAgedAnticoagulantsCerebral HemorrhageCOVID-19C-Reactive ProteinExtracorporeal Membrane OxygenationFemaleHeart Disease Risk FactorsHospital MortalityHospitalizationHumansIntensive Care UnitsInterleukin-6MaleMiddle AgedRegistriesRespiration, ArtificialRisk FactorsSARS-CoV-2Sex FactorsUnited StatesYoung AdultIschemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients
McAlpine LS, Zubair AS, Maran I, Chojecka P, Lleva P, Jasne AS, Navaratnam D, Matouk C, Schindler J, Sheth KN, Chun H, Lee AI, Spudich S, Sharma R, Sansing LH. Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients. Stroke 2021, 52: e233-e238. PMID: 33966492, PMCID: PMC8140646, DOI: 10.1161/strokeaha.120.031971.Peer-Reviewed Original ResearchObstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Geer JH, Falcone GJ, Vanent KN, Leasure AC, Woo D, Molano JR, Sansing LH, Langefeld CD, Pisani MA, Yaggi HK, Sheth KN. Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage. Stroke 2021, 52: 1835-1838. PMID: 33827242, PMCID: PMC8085039, DOI: 10.1161/strokeaha.120.033342.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaRisk factorsBerlin questionnaireIntracerebral hemorrhageSleep apneaEthnic/Racial VariationsHigher body mass indexMultivariable logistic regression modelBody mass indexIntracerebral hemorrhage riskCase-control studyExposure of patientsLogistic regression analysisLogistic regression modelsOSA statusHemorrhage riskMass indexHeart diseaseNontraumatic ICHRacial variationApneaHemorrhageRegression analysisICHRegression modelsLeukocyte dynamics after intracerebral hemorrhage in a living patient reveal rapid adaptations to tissue milieu
Goods BA, Askenase MH, Markarian E, Beatty HE, Drake RS, Fleming I, DeLong JH, Philip NH, Matouk CC, Awad IA, Zuccarello M, Hanley DF, Love JC, Shalek AK, Sansing LH, Investigators T. Leukocyte dynamics after intracerebral hemorrhage in a living patient reveal rapid adaptations to tissue milieu. JCI Insight 2021, 6: e145857. PMID: 33749664, PMCID: PMC8026179, DOI: 10.1172/jci.insight.145857.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageAcute brain injurySystemic immune responsesBrain tissue injuryHigh mortality rateLocal cellular responseAcute injuryTreatment optionsIntracerebral eventsBrain injuryCerebral hematomaLeukocyte responseTissue injuryT cellsImmune responseCT scanMortality rateDevastating formImmune dynamicsTherapeutic interventionsLeukocyte dynamicsBrain tissuePatientsInvasive surgeryInjuryAssociation of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Leasure AC, Kuohn LR, Vanent KN, Bevers MB, Kimberly WT, Steiner T, Mayer SA, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Stroke 2021, 52: 1733-1740. PMID: 33682454, PMCID: PMC8085132, DOI: 10.1161/strokeaha.120.032888.Peer-Reviewed Original ResearchConceptsIL-6 levelsPerihematomal edema volumeIntracerebral hemorrhageIL-6Edema volumeFunctional outcomeICH locationICH volumeTreatment groupsSerum IL-6 levelsBaseline ICHAcute brain injuryLarge intracerebral hemorrhageSerum IL-6Predictors of outcomeSpontaneous intracerebral hemorrhageRankin ScalePoor outcomeProinflammatory cytokinesTrial populationBrain injurySecondary analysisStrong associationFast trialsOutcomesAdmission 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 outcomesLongitudinal transcriptomics define the stages of myeloid activation in the living human brain after intracerebral hemorrhage
Askenase MH, Goods BA, Beatty HE, Steinschneider AF, Velazquez SE, Osherov A, Landreneau MJ, Carroll SL, Tran TB, Avram VS, Drake RS, Gatter GJ, Massey JA, Karuppagounder SS, Ratan RR, Matouk CC, Sheth KN, Ziai WC, Parry-Jones AR, Awad IA, Zuccarello M, Thompson RE, Dawson J, Hanley DF, Love JC, Shalek AK, Sansing LH, Barrer S, MacKenzie L, Jonczak K, Bussinger P, Nakaji P, Wright S, Honea N, Zomorodi A, James M, Yeh E, Galicich W, Bergman T, France K, Leiphart J, Ramesh S, Brennan T, Huang J, Ziai W, White M, Camarata P, Abraham M, Gorup J, Reimer R, Freeman W, Williams C, Edwards E, Pollack A, Terry J, Shoen A, Jahromi B, Maas M, Yip B, Amidei C, Muñoz L, Lopez G, Holtz R, Gupta G, Rybinnik I, Moccio M, Lovick D, Brion B, Titus K, Jallo J, Rincon F, Pigott K, Boyden L, Dougherty J, Harrigan M, Miller D, Nelson L, Thompson G, Rajajee V, Pandey A, Ball R, Carlson A, Tran H, Alchbli A, James R, Jerde A, Taussky P, Ansari S, Neate C, Martinez J, Letsinger J, Fagatele L, Eaquinto C, Matouk C, Sheth K, Sansing L, Ryall L, Kunze K, Mampre D, Jasak S, Abdul-Rahim A, Abou-Hamden A, Abraham M, Ahmed A, Alba C, Aldrich E, Ali H, Altschul D, Amin-Hanjani S, Anderson C, Anderson D, Ansari S, Antezana D, Ardelt A, Arikan F, Awad R, Baguena M, Baker A, Barrer S, Barzo P, Becker K, Bergman T, Betz J, Bistran-Hall A, Boström A, Braun J, Brindley P, Broaddus W, Brown R, Buki A, Bulters D, Camarata P, Cao B, Cao Y, Carhuapoma J, Carlson A, Caron J, Carrion-Penagos J, Chalela J, Chang T, Chicoine M, Chorro I, Chowdhry S, Cobb C, Corral L, Csiba L, Davies J, Dawson J, Díaz A, Derdeyn C, Diringer M, Dlugash R, Dodd R, Ecker R, Economas T, Enriquez P, Ezer E, Fan Y, Feng H, Franz D, Freeman W, Fusco M, Galicich W, Gandhi D, Gelea M, Goldstein J, Gonzalez A, Grabarits C, Greenberg S, Gregson B, Gress D, Gu E, Gupta G, Hall C, Hanley D, Hao Y, Harnof S, Harrigan M, Hernandez F, Hoesch R, Hoh B, Houser J, Hu R, Huang J, Huang Y, Hussain M, Insinga S, Jadhav A, Jaffe J, Jahromi B, Jallo J, James M, James R, Janis S, Jankowitz B, Jeon E, Jichici D, Jonczak K, Jonker B, Karlen N, Kase C, Keric N, Kerz T, Kitagawa R, Knopman J, Koenig C, Krishnamurthy S, Kumar A, Kureshi I, Laidlaw J, Lakhanpal A, Lane K, Latorre J, LeDoux D, Lees K, Leifer D, Leiphart J, Lenington S, Li Y, Lopez G, Lovick D, Lumenta C, Luo J, Maas M, MacDonald J, MacKenzie L, Madan V, Majkowski R, Major O, Malhorta R, Malkoff M, Mangat H, Maswadeh A, Matouk C, Mayo S, McArthur K, McBee N, McCaul S, Medow J, Mendelow A, Mezey G, Mighty J, Miller D, Mitchell P, Mohan K, Money P, Mould W, Muir K, Muñoz L, Nakaji P, Nee A, Nekoovaght-Tak S, Nyquist P, O’Kane R, Okasha M, O'Kelly C, Ostapkovich N, Pandey A, Parry-Jones A, Patel H, Perla K, Pollack A, Polster S, Pouratian N, Quinn T, Rajajee V, Reddy K, Rehman M, Reimer R, Rincon F, Rosenblum M, Rybinnik I, Sanchez B, Sansing L, Sarabia R, Schneck M, Schuerer L, Schul D, Schweitzer J, Seder D, Seyfried D, Sheth K, Spiotta A, Stadnik A, Stechison M, Sugar E, Szabo K, Tamayo G, Tanczos K, Taussky P, Teitelbaum J, Terry J, Testai F, Thomas K, Thompson C, Thompson G, Thompson R, Torner J, Tran H, Tucker K, Ullman N, Ungar L, Unterberg A, Varelas P, Vargas N, Vatter H, Venkatasubramanian C, Vermillion K, Vespa P, Vollmer D, Wang W, Wang Y, Wang Y, Wen J, Whitworth L, Willis B, Wilson A, Wolfe S, Wrencher M, Wright S, Xu Y, Yanase L, Yenokyan G, Yi X, Yu Z, Ziai W, Zomorodi A, Zuccarello M. Longitudinal transcriptomics define the stages of myeloid activation in the living human brain after intracerebral hemorrhage. Science Immunology 2021, 6 PMID: 33891558, PMCID: PMC8252865, DOI: 10.1126/sciimmunol.abd6279.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageHypoxia-inducible factorMyeloid activationBrain injuryImmune responseAnti-inflammatory circuitsSubtypes of strokeAnti-inflammatory factorsInflammatory gene expressionPositive patient outcomesMonocytes/macrophagesDynamics of inflammationAcute sterile injuryLongitudinal transcriptional profilingHuman brainNeurological recoveryMyeloid responseProinflammatory profileImmune resolutionPatient cohortImmune factorsClinical trialsPatient outcomesSterile injuryProstaglandin E
2020
Cause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study.
Kuohn LR, Leasure AC, Acosta JN, Vanent K, Murthy SB, Kamel H, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Cause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study. Neurology 2020, 95: e2736-e2745. PMID: 32917797, PMCID: PMC7734723, DOI: 10.1212/wnl.0000000000010736.Peer-Reviewed Original ResearchConceptsCause of deathRecurrent intracranial hemorrhageIntracerebral hemorrhage survivorsAtrial fibrillationICH survivorsIschemic strokeIntracranial hemorrhageSpontaneous intracerebral hemorrhage survivorsMultivariable Cox proportional hazardsCox proportional hazardsLong-term survivalMedian followRespiratory failureHospital readmissionPrimary outcomePrimary diagnosisSpontaneous ICHCardiac diseaseClaims dataMultinomial logistic regressionNontraumatic ICHProportional hazardsAdult survivorsLogistic regressionPatientsEffects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke
Al-Dasuqi K, Payabvash S, Torres-Flores GA, Strander SM, Nguyen CK, Peshwe KU, Kodali S, Silverman A, Malhotra A, Johnson MH, Matouk CC, Schindler JL, Sansing LH, Falcone GJ, Sheth KN, Petersen NH. Effects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke. Stroke 2020, 51: e193-e202. PMID: 32781941, PMCID: PMC7484023, DOI: 10.1161/strokeaha.120.029892.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArterial Occlusive DiseasesCerebral InfarctionCohort StudiesCollateral CirculationComputed Tomography AngiographyEndovascular ProceduresFemaleHumansInfarction, Middle Cerebral ArteryLinear ModelsMagnetic Resonance AngiographyMaleMiddle AgedReperfusionRetrospective StudiesStrokeThrombectomyTreatment OutcomeWhite MatterConceptsLarge vessel occlusion strokeFinal infarct volumeCollateral statusPoor collateral statusFavorable outcomeInfarct distributionInfarct volumeReperfusion successIndependent predictorsOcclusion strokeInternal capsuleAnterior circulation large vessel occlusion ischemic strokeLarge vessel occlusion ischemic strokeDeep white matter tractsBaseline collateral statusBorder-zone infarctionEarly favorable outcomeEarly functional outcomesRankin Scale scoreCohort of patientsDegree of reperfusionLarge vessel occlusionComputed tomography angiographyDeep white matterMagnetic resonance imagingStroke 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 hospitalsGenetically Elevated LDL Associates with Lower Risk of Intracerebral Hemorrhage
Falcone GJ, Kirsch E, Acosta JN, Noche RB, Leasure A, Marini S, Chung J, Selim M, Meschia JF, Brown DL, Worrall BB, Tirschwell DL, Jagiella JM, Schmidt H, Jimenez‐Conde J, Fernandez‐Cadenas I, Lindgren A, Slowik A, Gill D, Holmes M, Phuah C, Petersen NH, Matouk CN, Gunel M, Sansing L, Bennett D, Chen Z, Sun LL, Clarke R, Walters RG, Gill TM, Biffi A, Kathiresan S, Langefeld CD, Woo D, Rosand J, Sheth KN, Anderson CD, Consortium F. Genetically Elevated LDL Associates with Lower Risk of Intracerebral Hemorrhage. Annals Of Neurology 2020, 88: 56-66. PMID: 32277781, PMCID: PMC7523882, DOI: 10.1002/ana.25740.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhagePolygenic risk scoresLDL cholesterolLower riskTotal cholesterolICH riskLow-density lipoprotein cholesterol levelsRisk of ICHLipoprotein cholesterol levelsPotential causal roleMendelian randomization analysisAnn NeurolLDL levelsCholesterol levelsICH casesObservational studySD increaseSignificant single nucleotide polymorphismsRisk scoreSignificant associationCholesterolMR analysisInverse correlationRandomization analysisSingle nucleotide polymorphisms