2024
Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan.
Chen Y, Rivier C, Mora S, Torres Lopez V, Payabvash S, Sheth K, Harloff A, Falcone G, Rosand J, Mayerhofer E, Anderson C. Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan. European Stroke Journal 2024, 23969873241260154. PMID: 38880882, DOI: 10.1177/23969873241260154.Peer-Reviewed Original ResearchIntracerebral hemorrhage scoreNon-contrast CT scanIntracerebral hemorrhageCT scanFUNC scoreIntracerebral hemorrhage patientsNon-contrast CTFunctional impairmentSevere disabilityDependent living statusLong-term functional impairmentC-indexPrognostic toolFunctional outcomesTreatment decisionsAcute settingClinical implementationRehabilitation strategiesDependent livingPatientsPredicting functional impairmentLong-term care needsPlanning of patient careDeep learning modelsHemorrhageRadiomic 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-ICHOral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis (S34.001)
Rivier C, Clocchiatti-Tuozzo S, Huo S, Renedo D, Hawkes M, Sunmonu N, Sheth K, Falcone G. Oral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis (S34.001). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204999.Peer-Reviewed Original ResearchChronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004)
Vanent K, Rivier C, Matouk C, Levitt M, Leslie-Mazwi T, Gill T, Sheth K, Falcone G. Chronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205783.Peer-Reviewed Original ResearchFactors Associated with Delayed Clinical Evaluation for Patients with Intracerebral Hemorrhage in the ERICH Study (S41.010)
Lalwani D, Zabinska J, Peasley E, De Havenon A, Falcone G, Goldstein J, Woo D, Sheth K. Factors Associated with Delayed Clinical Evaluation for Patients with Intracerebral Hemorrhage in the ERICH Study (S41.010). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204689.Peer-Reviewed Original ResearchDisparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020)
Zabinska J, Taylor C, Peasley E, Lalwani D, Schwartz A, Falcone G, Sansing L, Arora R, Mena-Hurtado C, De Havenon A, Okpala M, Bushnell C, Mullen M, Cohen J, Cohen D, Messe S, Forman R, Sheth K. Disparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206241.Peer-Reviewed Original ResearchBurden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019
Renedo D, Acosta J, Leasure A, Sharma R, Krumholz H, de Havenon A, Alahdab F, Aravkin A, Aryan Z, Bärnighausen T, Basu S, Burkart K, Coberly K, Criqui M, Dai X, Desai R, Dharmaratne S, Doshi R, Elgendy I, Feigin V, Filip I, Gad M, Ghozy S, Hafezi-Nejad N, Kalani R, Karaye I, Kisa A, Krishnamoorthy V, Lo W, Mestrovic T, Miller T, Misganaw A, Mokdad A, Murray C, Natto Z, Radfar A, Ram P, Roth G, Seylani A, Shah N, Sharma P, Sheikh A, Singh J, Song S, Sotoudeh H, Vervoort D, Wang C, Xiao H, Xu S, Zand R, Falcone G, Sheth K. Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019. JAMA Neurology 2024, 81: 394-404. PMID: 38436973, PMCID: PMC10913004, DOI: 10.1001/jamaneurol.2024.0190.Peer-Reviewed Original ResearchBurden of strokeHemorrhagic strokeBurden trendsGlobal burdenGlobal Burden of Disease StudyBurden of Disease StudyAge-standardized ratesAge-standardized estimatesPublic health policiesStroke-related outcomesIschemic strokeCross-sectional studyPublic health challengeCross-sectional analysisStroke mortalityStroke burdenHealth policyOlder adultsMain OutcomesStroke incidenceStroke casesIntracerebral hemorrhageEscalating burdenHealth challengesSignificant disparitiesUncertainty-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 riskPatientsAPOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation
Renedo D, Rivier C, Koo A, Sujijantarat N, Clocchiatti-Tuozzo S, Wu K, Torres-Lopez V, Huo S, Gunel M, de Havenon A, Sheth K, Matouk C, Falcone G. APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation. JAMA Network Open 2024, 7: e2355368. PMID: 38363572, PMCID: PMC10873768, DOI: 10.1001/jamanetworkopen.2023.55368.Peer-Reviewed Original ResearchConceptsApolipoprotein E e4Participants of European ancestryRisk of intracerebral hemorrhageHigh risk of intracerebral hemorrhageCross-sectional studyUK BiobankEuropean ancestryHigh riskUs Research ProgramUK Biobank participantsInternational Classification of DiseasesAssociated with higher risk of ICHCross-sectional study of patientsAPOE e4 statusClassification of DiseasesApolipoprotein ENinth Revision and Tenth RevisionAssociated with higher riskIndividual-level dataMultivariate logistic regressionIntracerebral hemorrhage riskBrain arteriovenous malformationsIntracerebral hemorrhageBiobank participantsTenth RevisionAssociation Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient dataCerebral Amyloid Angiopathy and Risk of Isolated Nontraumatic Subdural Hemorrhage
Rivier C, Kamel H, Sheth K, Iadecola C, Gupta A, de Leon M, Ross E, Falcone G, Murthy S. Cerebral Amyloid Angiopathy and Risk of Isolated Nontraumatic Subdural Hemorrhage. JAMA Neurology 2024, 81: 163-169. PMID: 38147345, PMCID: PMC10751656, DOI: 10.1001/jamaneurol.2023.4918.Peer-Reviewed Original ResearchCerebral amyloid angiopathyMultivariable logistic regression analysisSubdural hemorrhageLogistic regression analysisIntracerebral hemorrhageIntracranial hemorrhageUK Biobank cohortAmyloid angiopathyMean ageUS cohortRisk factorsHigher oddsDiagnosis of CAAPopulation-based cohort studyBiobank cohortClinical Modification diagnosis codesCAA-related intracerebral hemorrhageCox proportional hazards modelRegression analysisAntithrombotic medication useIndependent risk factorCox regression analysisMultivariable logistic regressionNovel risk factorsSpontaneous intracerebral hemorrhageCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatientsTime-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 factorsHematomaPeri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage
Dierksen F, Tran A, Zeevi T, Maier I, Qureshi A, Sanelli P, Werring D, Malhotra A, Falcone G, Sheth K, Payabvash S. Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage. European Stroke Journal 2024, 9: 383-390. PMID: 38179883, PMCID: PMC11318427, DOI: 10.1177/23969873231223814.Peer-Reviewed Original ResearchNIH Stroke ScaleGlasgow Coma ScaleAssociation of baselineIntracerebral hemorrhagePerihematomal edemaHematoma volumeAcute supratentorial intracerebral hemorrhageNon-traumatic intracerebral hemorrhageSecondary brain injuryAcute ICH patientsIndependent prognostic factorSupratentorial intracerebral hemorrhageAdmission NIH Stroke ScalePotential treatment targetRankin scoreStroke ScaleIndependent predictorsPatient agePrognostic factorsComa ScaleMultivariable analysisICH patientsPrognostic valueBrain injuryFavorable outcome
2023
A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage
Myserlis E, Georgakis M, Demel S, Sekar P, Chung J, Malik R, Hyacinth H, Comeau M, Falcone G, Langefeld C, Rosand J, Woo D, Anderson C. A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage. Stroke 2023, 54: 973-982. PMID: 36799223, PMCID: PMC10050100, DOI: 10.1161/strokeaha.122.041701.Peer-Reviewed Original ResearchConceptsClinical risk factorsIncident intracerebral hemorrhageIntracerebral hemorrhageHigh-risk populationRisk factorsGenomic risk scoresRisk scoreHigher oddsHigh riskRisk factor-adjusted modelsStandard clinical risk factorsVascular risk factorsLobar intracerebral hemorrhageLow-risk populationNonlobar intracerebral hemorrhageUse of anticoagulantsPopulation-based UK Biobank cohortUK Biobank cohortEuropean ancestryAntithrombotic treatmentClinical predictorsSD incrementMedication usersLifetime riskMetaGRSEmergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patients
2022
One-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability
Shah VA, Thompson RE, Yenokyan G, Acosta JN, Avadhani R, Dlugash R, McBee N, Li Y, Hansen BM, Ullman N, Falcone G, Awad IA, Hanley DF, Ziai WC. One-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability. JAMA Neurology 2022, 79: 856-868. PMID: 35877105, PMCID: PMC9316056, DOI: 10.1001/jamaneurol.2022.1991.Peer-Reviewed Original ResearchConceptsSevere intracerebral hemorrhagePhase 3 trialIntracerebral hemorrhageIntraventricular hemorrhagePoor functional outcomeHospital eventsBetter outcomesDay 30Functional recoveryPoor outcomeFunctional outcomeLong-term functional recoverySevere disabilityMultivariable logistic regression modelHealth Stroke ScaleAcute ischemic strokeCerebral perfusion pressureRankin Scale scoreStandard medical careIndividual patient dataOverall mean ageIntracranial pressure monitoringLogistic regression modelsIntraventricular alteplaseMISTIE IIIAssociation of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage
Vanent KN, Leasure AC, Acosta JN, Kuohn LR, Woo D, Murthy SB, Kamel H, Messé SR, Mullen MT, Cohen JB, Cohen DL, Townsend RR, Petersen NH, Sansing LH, Gill TM, Sheth KN, Falcone GJ. Association of Chronic Kidney Disease With Risk of Intracerebral Hemorrhage. JAMA Neurology 2022, 79: 911-918. PMID: 35969388, PMCID: PMC9379821, DOI: 10.1001/jamaneurol.2022.2299.Peer-Reviewed Original ResearchAssociation of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis
Kuramatsu JB, Gerner ST, Ziai W, Bardutzky J, Sembill JA, Sprügel MI, Mrochen A, Kölbl K, Ram M, Avadhani R, Falcone GJ, Selim MH, Lioutas VA, Endres M, Zweynert S, Vajkoczy P, Ringleb PA, Purrucker JC, Volkmann J, Neugebauer H, Erbguth F, Schellinger PD, Knappe UJ, Fink GR, Dohmen C, Minnerup J, Reichmann H, Schneider H, Röther J, Reimann G, Schwarz M, Bäzner H, Claßen J, Michalski D, Witte OW, Günther A, Hamann GF, Lücking H, Dörfler A, Ishfaq MF, Chang JJ, Testai FD, Woo D, Alexandrov AV, Staykov D, Goyal N, Tsivgoulis G, Sheth KN, Awad IA, Schwab S, Hanley DF, Huttner HB, Sansing L, Matouk C, Leasure A, Sobesky J, Bauer M, Schurig J, Rizos T, Haeusler K, Müllges W, Kraft P, Schubert A, Stösser S, Ludolph A, Nueckel M, Glahn J, Stetefeld H, Rahmig J, Fisse A, Michels P, Schwert H, Hagemann G, Rakers F, Wöhrle J, Alshammari F, Horn M, Bahner D, Urbanek C, Palm F, Grau A. Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis. Stroke 2022, 53: 2876-2886. PMID: 35521958, PMCID: PMC9398945, DOI: 10.1161/strokeaha.121.038455.Peer-Reviewed Original ResearchConceptsAbsolute treatment effectStandard of careIntraventricular fibrinolysisIntracerebral hemorrhageIntraventricular hemorrhagePrimary outcomeAcute hydrocephalusAdverse eventsFunctional disabilityIVF treatmentFunctional outcomeOdds ratioOrdinal shift analysisIndividual Participant Data Meta-AnalysisModified Rankin ScaleExternal ventricular drainageImproved functional outcomesData Meta-AnalysisPromising therapeutic targetTreatment effectsIndividual participant dataCause mortalityRankin ScaleSecondary outcomesSymptom onset
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 treatment