2024
Neighborhood Deprivation and Functional Outcomes Following Ischemic Stroke (P2-4.007)
Kleinberg L, Clocchiatti-Tuozzo S, Rivier C, Torres-Lopez V, Kim J, Kitlen E, Kampp M, Jasak S, Schindler J, Sansing L, Sheth K, Falcone G. Neighborhood Deprivation and Functional Outcomes Following Ischemic Stroke (P2-4.007). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205095.Peer-Reviewed Original Research
2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatients
2022
Poor Collaterals and Rapid Early Infarct Progression Are Associated With Increased Vulnerability to Blood Pressure Reductions (S21.002)
Begunova Y, Bartolome D, Kobsa J, Soto A, Prasad A, Galecio M, Vivanco-Suarez J, Quispe-Orozco D, Farooqui M, Sansing L, Schindler J, De Havenon A, Matouk C, Sheth K, Ortega-Gutierrez S, Petersen N. Poor Collaterals and Rapid Early Infarct Progression Are Associated With Increased Vulnerability to Blood Pressure Reductions (S21.002). Neurology 2022, 98 DOI: 10.1212/wnl.98.18_supplement.3104.Peer-Reviewed Original ResearchPortable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke
Yuen MM, Prabhat AM, Mazurek MH, Chavva IR, Crawford A, Cahn BA, Beekman R, Kim JA, Gobeske KT, Petersen NH, Falcone GJ, Gilmore EJ, Hwang DY, Jasne AS, Amin H, Sharma R, Matouk C, Ward A, Schindler J, Sansing L, de Havenon A, Aydin A, Wira C, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke. Science Advances 2022, 8: eabm3952. PMID: 35442729, PMCID: PMC9020661, DOI: 10.1126/sciadv.abm3952.Peer-Reviewed Original ResearchIschemic strokeMagnetic resonance imagingResonance imagingFluid-attenuated inversion recoveryDiffusion-weighted imaging sequencesStroke volume measurementsStroke pathwayStroke severityFunctional outcomeLow-field magnetic resonance imagingBedside evaluationClinical managementStroke volumeMRI studiesStrokePatientsBrain imagingCerebellar structuresHigh-field MRI studiesHyperintense regionsInversion recoveryInfarctsUseful imagingVolume measurementsAcute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns
Baker AD, Schwamm LH, Sanborn DY, Furie K, Stretz C, Mac Grory B, Yaghi S, Kleindorfer D, Sucharew H, Mackey J, Walsh K, Flaherty M, Kissela B, Alwell K, Khoury J, Khatri P, Adeoye O, Ferioli S, Woo D, Martini S, La Rosa F, Demel SL, Madsen T, Star M, Coleman E, Slavin S, Jasne A, Mistry EA, Haverbusch M, Merkler AE, Kamel H, Schindler J, Sansing LH, Faridi KF, Sugeng L, Sheth KN, Sharma R. Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns. Stroke 2022, 53: 1883-1891. PMID: 35086361, PMCID: PMC10214981, DOI: 10.1161/strokeaha.121.036706.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionAcute ischemic strokeDepressed left ventricular ejection fractionVentricular ejection fractionSinus rhythmIschemic strokeEjection fractionPooled prevalenceHealth Stroke Severity ScaleSecondary stroke prevention strategiesMultivariable logistic regression modelAntithrombotic treatment regimensHospital-based cohortRetrospective cohort studySecondary stroke preventionStroke prevention strategiesMulti-center cohortStroke Severity ScaleLogistic regression modelsEchocardiographic characteristicsHospitalization dischargeAntiplatelet therapyStroke preventionCardiac thrombusCohort studyBedside 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
Prior Stroke and Age Predict Acute Ischemic Stroke Among Hospitalized COVID-19 Patients: A Derivation and Validation Study
Peng TJ, Jasne AS, Simonov M, Abdelhakim S, Kone G, Cheng YK, Rethana M, Tarasaria K, Herman AL, Baker AD, Yaghi S, Frontera JA, Sansing LH, Falcone GJ, Spudich S, Schindler J, Sheth KN, Sharma R. Prior Stroke and Age Predict Acute Ischemic Stroke Among Hospitalized COVID-19 Patients: A Derivation and Validation Study. Frontiers In Neurology 2021, 12: 741044. PMID: 34675873, PMCID: PMC8524436, DOI: 10.3389/fneur.2021.741044.Peer-Reviewed Original ResearchAcute ischemic strokeHospitalized COVID-19 patientsCOVID-19 patientsCOVID-19 cohortNeurologic symptomsPrior strokeIschemic strokeAIS patientsDerivation cohortControl cohortRisk of AISMultivariable logistic regression modelIschemic stroke riskCOVID-19 severityYale New Haven HealthLogistic regression modelsHospital presentationIndependent predictorsStroke riskMajor health systemsHigh riskPatientsYounger ageCohortStrokePortable, 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 resonanceCardiovascular 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 ResearchExpedited 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 costsIschemic 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 ResearchIschemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients (2402)
McAlpine L, Zubair A, Maran I, Chojecka P, Lleva P, Jasne A, Navaratnam D, Matouk C, Schindler J, Chun H, Lee A, Spudich S, Sharma R, Sansing L. Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients (2402). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.2402.Peer-Reviewed Original ResearchPrehospital Blood Pressure Reductions Are Associated with Neurologic Worsening in Patients With Large-vessel Occlusion Stroke (2844)
Kobsa J, Prasad A, Soto A, Kodali S, Nguyen C, Peshwe K, Orozco D, Farooqui M, Zevallos C, Sansing L, Schindler J, Matouk C, Sheth K, Ortega-Gutierrez S, Petersen N. Prehospital Blood Pressure Reductions Are Associated with Neurologic Worsening in Patients With Large-vessel Occlusion Stroke (2844). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.2844.Peer-Reviewed Original Research
2020
Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients
Sheth KN, Mazurek MH, Yuen MM, Cahn BA, Shah JT, Ward A, Kim JA, Gilmore EJ, Falcone GJ, Petersen N, Gobeske KT, Kaddouh F, Hwang DY, Schindler J, Sansing L, Matouk C, Rothberg J, Sze G, Siner J, Rosen MS, Spudich S, Kimberly WT. Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients. JAMA Neurology 2020, 78: 41-47. PMID: 32897296, PMCID: PMC7489395, DOI: 10.1001/jamaneurol.2020.3263.Peer-Reviewed Original ResearchIntensive care unit roomsIntensive care settingBrain injuryCare settingsIll patientsNeurological injuryT2 fluid-attenuated inversion recoveryCOVID-19Intensive care unit admissionSingle-center cohort studyIntensive care unit settingUnit roomsYale-New Haven HospitalNasopharyngeal swab resultsCare unit admissionSingle-center seriesBrain imaging findingsIntensive care unitFluid-attenuated inversion recoveryDiffusion-weighted imaging sequencesTraumatic brain injuryClinical care settingsNew Haven HospitalMagnetic resonance imagingConventional magnetic resonance imaging (MRI) systemDirect carotid puncture for mechanical thrombectomy in acute ischemic stroke patients with prohibitive vascular access.
Cord BJ, Kodali S, Strander S, Silverman A, Wang A, Chouairi F, Koo AB, Nguyen CK, Peshwe K, Kimmel A, Porto CM, Hebert RM, Falcone GJ, Sheth KN, Sansing LH, Schindler JL, Matouk CC, Petersen NH. Direct carotid puncture for mechanical thrombectomy in acute ischemic stroke patients with prohibitive vascular access. Journal Of Neurosurgery 2020, 135: 53-63. PMID: 32796146, PMCID: PMC9491727, DOI: 10.3171/2020.5.jns192737.Peer-Reviewed Original ResearchDirect carotid punctureSmaller infarct volumesMechanical thrombectomyVascular accessFunctional outcomeAIS-LVONIHSS scoreDCP groupInfarct volumeTransfemoral accessNeck hematomaStroke patientsCarotid punctureABMT groupAnterior circulation acute ischemic strokeCommon carotid artery dissectionAcute ischemic stroke patientsDirect carotid accessEmergency mechanical thrombectomyAcute ischemic strokeAdmission NIHSS scoreCarotid artery dissectionIschemic stroke patientsGood functional outcomeLarge vessel occlusionEffects 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 hospitalsBlood Pressure Decreases Occur Throughout Endovascular Thrombectomy and Are Associated with Poor Functional Outcome (4872)
Kimmel A, Silverman A, Kodali S, Strander S, Nguyen C, Peshwe K, Wang A, Cardenas G, Holcombe A, Zevallos C, Dandapat S, Sansing L, Schindler J, Falcone G, Matouk C, Sheth K, Ortega-Gutierrez S, Petersen N. Blood Pressure Decreases Occur Throughout Endovascular Thrombectomy and Are Associated with Poor Functional Outcome (4872). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.4872.Peer-Reviewed Original ResearchRisk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457)
Nguyen C, Silverman A, Wang A, Kodali S, Strander S, Kimmel A, Peshwe K, de Havenon A, Gilmore E, Sansing L, Schindler J, Matouk C, Sheth K, Petersen N. Risk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.4457.Peer-Reviewed Original ResearchDeployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272)
Cahn B, Shah J, Dyvorne H, O’Halloran R, Poole M, Yuen M, Mazurek M, Ward A, Payabvash S, Beekman R, Brown S, Falcone G, Gobeske K, Petersen N, Jasne A, Sharma R, Schindler J, Sansing L, Gilmore E, Wira C, Matouk C, Sze G, Rosen M, Kimberly W, Sheth K. Deployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.272.Peer-Reviewed Original Research