2024
Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT)
Dierksen F, Sommer J, Tran A, Lin H, Haider S, Maier I, Aneja S, Sanelli P, Malhotra A, Qureshi A, Claassen J, Park S, Murthy S, Falcone G, Sheth K, Payabvash S. Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT). Diagnostics 2024, 14: 2827. PMID: 39767188, PMCID: PMC11674633, DOI: 10.3390/diagnostics14242827.Peer-Reviewed Original ResearchIntegrated discrimination indexNet reclassification indexPerihematomal edemaHead computed tomographyIntracerebral hemorrhageComputed tomographyClinical variablesClinical predictors of poor outcomeOutcome predictionAcute supratentorial intracerebral hemorrhageAdmission head computed tomographyRadiomic featuresNon-contrast head computed tomographyPredictors of poor outcomeModified Rankin Scale scoreIntracerebral hemorrhage scoreSupratentorial intracerebral hemorrhageIntracerebral hemorrhage patientsClinical risk factorsRankin Scale scoreReceiver operating characteristic areaOperating characteristics areaSecondary brain injuryHematoma evacuationPatient selectionA Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence
Tran A, Desser D, Zeevi T, Abou Karam G, Dierksen F, Dell'Orco A, Kniep H, Hanning U, Fiehler J, Zietz J, Sanelli P, Malhotra A, Duncan J, Aneja S, Falcone G, Qureshi A, Sheth K, Nawabi J, Payabvash S. A Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence. Bioengineering 2024, 11: 1274. PMID: 39768092, PMCID: PMC11672977, DOI: 10.3390/bioengineering11121274.Peer-Reviewed Original ResearchNon-contrast head computed tomographyPerihematomal edemaHead computed tomographyIntracerebral hemorrhageComputed tomographyVolume similarityUniversity Medical Center Hamburg-EppendorfSecondary brain injuryYale cohortInfratentorial locationMulticentre trialCT scanTreatment planningNon-contrastHamburg-EppendorfImaging markersHemorrhagic strokeHemorrhageEdemaCohortBrain injuryDice coefficientAssociation of early dexmedetomidine exposure with brain injury biomarker levels following moderate – Severe traumatic brain injury: A TRACK-TBI study
Wongsripuemtet P, Ohnuma T, Temkin N, Barber J, Komisarow J, Manley G, Hatfield J, Treggiari M, Colton K, Sasannejad C, Chaikittisilpa N, Ivins-O’Keefe K, Grandhi R, Laskowitz D, Mathew J, Hernandez A, James M, Raghunathan K, Miller J, Vavilala M, Krishnamoorthy V, investigators T. Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate – Severe traumatic brain injury: A TRACK-TBI study. Journal Of Clinical Neuroscience 2024, 126: 338-347. PMID: 39029302, DOI: 10.1016/j.jocn.2024.07.003.Peer-Reviewed Original ResearchConceptsC-reactive proteinNeuron-specific enolaseGlial fibrillary acidic proteinBiomarker levelsUbiquitin C-terminal hydrolase-L1Traumatic brain injuryDexmedetomidine exposureInjury biomarkersSevere traumatic brain injuryTRACK-TBIS100 calcium-binding protein BInflammatory biomarkers C-reactive proteinCalcium-binding protein BHs-CRP levelsLevel 1 trauma centerRetrospective cohort studyCritically ill TBI patientsAlpha-2 agonistsBrain injuryBrain injury biomarkersBiomarkers C-reactive proteinModulate autonomic functionGlasgow Coma Scale score 3No significant associationSecondary brain injuryPeri-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
Backpack-mediated anti-inflammatory macrophage cell therapy for the treatment of traumatic brain injury
Kapate N, Liao R, Sodemann R, Stinson T, Prakash S, Kumbhojkar N, Suja V, Wang L, Flanz M, Rajeev R, Villafuerte D, Shaha S, Janes M, Park K, Dunne M, Golemb B, Hone A, Adebowale K, Clegg J, Slate A, McGuone D, Costine-Bartell B, Mitragotri S. Backpack-mediated anti-inflammatory macrophage cell therapy for the treatment of traumatic brain injury. PNAS Nexus 2023, 3: pgad434. PMID: 38187808, PMCID: PMC10768983, DOI: 10.1093/pnasnexus/pgad434.Peer-Reviewed Original ResearchTraumatic brain injuryBrain injuryAnti-inflammatory interleukin-4Cortical impact (CCI) TBI modelCell therapyAcute clinical managementDysregulated inflammatory responseSecondary brain injuryAnti-inflammatory phenotypeBrain lesion siteImmune cell therapyRole of macrophagesLarge animal modelUnique therapeutic potentialWound-healing phenotypeRampant inflammationProinflammatory biomarkersTBI modelImmunomodulatory effectsInflammation modulationCurrent therapiesMacrophage-based therapiesNeuroprotection mechanismsProinflammatory activationSerum concentrationsClinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study
Abou Karam G, Tharmaseelan H, Aboian M, Malhotra A, Gilmore E, Falcone G, de Havenon A, Sheth K, Payabvash S. Clinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107375. PMID: 37738914, PMCID: PMC10591892, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107375.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSecondary brain injuryIntracerebral hemorrhagePerihematomal edemaSubacute intracerebral hemorrhageIntravoxel incoherent motion imagingAdmission NIHSSBrain injuryMedian baseline National InstitutesPilot studyBaseline National InstitutesHealth Stroke ScalePerfusion fractionSupratentorial intracerebral hemorrhageIVIM metricsIncoherent motion imagingStroke ScaleNeuroprotective therapiesParenchymal injuryRankin ScaleRisk patientsConsecutive patientsUnivariable analysisPoor outcomeICH volume
2022
Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage
Bevers M, Booraem C, Li K, Sreekrishnan A, Sastre C, Falcone G, Sheth K, Sansing L, Kimberly W. Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage. Neurology 2022, 100: e1329-e1338. PMID: 36549913, PMCID: PMC10065211, DOI: 10.1212/wnl.0000000000206764.Peer-Reviewed Original ResearchConceptsSoluble ST2Deep intraparenchymal hemorrhageIntraparenchymal hemorrhagePerihematomal edemaImmune responseHematoma volumePoor outcomeFunctional outcomeMedian admission Glasgow Coma Scale scoreScale scoreAdmission Glasgow Coma Scale scorePeripheral innate immune responseModified Rankin Scale scoreGlasgow Coma Scale scoreHours of ictusPeripheral immune responseSecondary brain injuryRankin Scale scoreInnate immune cellsImmune cell populationsIntracerebral Hemorrhage ScoreSerial CT scansInnate immune responseHuman brain tissueSST2 levelsElectroencephalogram in the intensive care unit: a focused look at acute brain injury
Alkhachroum A, Appavu B, Egawa S, Foreman B, Gaspard N, Gilmore EJ, Hirsch LJ, Kurtz P, Lambrecq V, Kromm J, Vespa P, Zafar SF, Rohaut B, Claassen J. Electroencephalogram in the intensive care unit: a focused look at acute brain injury. Intensive Care Medicine 2022, 48: 1443-1462. PMID: 35997792, PMCID: PMC10008537, DOI: 10.1007/s00134-022-06854-3.Peer-Reviewed Original ResearchConceptsAcute brain injuryNonconvulsive status epilepticusBrain injuryStatus epilepticusEEG monitoringIntensive care unit settingRefractory status epilepticusSecondary brain injuryIntensive care unitPossible clinical relevanceAssessment of consciousnessResource-limited settingsICU EEG monitoringFrequent seizuresAcute illnessCommon indicationCare unitWorse outcomesUnit settingClinical relevancePathophysiological eventsSeizure criteriaIschemia monitoringInjuryApplication of electroencephalography
2021
A model of metabolic supply-demand mismatch leading to secondary brain injury
Song JL, Kim JA, Struck AF, Zhang R, Westover MB. A model of metabolic supply-demand mismatch leading to secondary brain injury. Journal Of Neurophysiology 2021, 126: 653-667. PMID: 34232754, PMCID: PMC8815783, DOI: 10.1152/jn.00674.2020.Peer-Reviewed Original ResearchConceptsPrimary brain injurySecondary brain injuryAcute brain injuryBrain injuryExtracellular potassiumAdditional brain injuryAssociation of seizuresIschemic strokeNeurologic insultPreventable complicationsSeizure activityCommon sequalaeTissue hypoxiaMetabolic crisisSeizuresInjuryExcitotoxicityPatientsCommon associationAssociationCurrent practiceExcitotoxityComplicationsHemorrhageIschemiaNeuromonitoring After Cardiac Arrest Can Twenty-First Century Medicine Personalize Post Cardiac Arrest Care?
Beekman R, Maciel CB, Balu R, Greer DM, Gilmore EJ. Neuromonitoring After Cardiac Arrest Can Twenty-First Century Medicine Personalize Post Cardiac Arrest Care? Neurologic Clinics 2021, 39: 273-292. PMID: 33896519, DOI: 10.1016/j.ncl.2021.01.002.Peer-Reviewed Original ResearchConceptsSecondary brain injuryCardiac arrest careBrain injuryArrest carePost-cardiac arrest syndromeHypoxic-ischemic brain injuryPost-cardiac arrest careEtiology of arrestSecondary neurologic injuryCardiac arrest survivorsNeurologic comorbiditiesNeuromonitoring toolsNeurologic injuryArrest survivorsCardiac arrestNeuromonitoring techniquesCerebral physiologyPhysiologic variablesIndividualized approachRisk profileInjuryHeterogeneous populationCareArrestComorbidities
2020
Genetic underpinnings of cerebral edema in acute brain injury: an opportunity for pathway discovery
Kirsch E, Szejko N, Falcone GJ. Genetic underpinnings of cerebral edema in acute brain injury: an opportunity for pathway discovery. Neuroscience Letters 2020, 730: 135046. PMID: 32464484, PMCID: PMC7372633, DOI: 10.1016/j.neulet.2020.135046.Peer-Reviewed Original ResearchConceptsAcute brain injuryCerebral edemaBrain injuryEdema formationIntracerebral hemorrhageWorse outcomesBlood-brain barrier disruptionSecondary brain injuryBrain edema formationTraumatic brain injuryApolipoprotein E geneSecondary injuryBarrier disruptionVasogenic edemaCytotoxic edemaInflammatory processUseful intermediate phenotypeEdemaTherapeutic targetAquaporin-4Haptoglobin geneInjuryHp 2Novel susceptibility genesNon-white populationsSoluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage
Lissak IA, Zafar SF, Westover MB, Schleicher RL, Kim JA, Leslie-Mazwi T, Stapleton CJ, Patel AB, Kimberly WT, Rosenthal ES. Soluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage. Stroke 2020, 51: 1128-1134. PMID: 32156203, PMCID: PMC7123848, DOI: 10.1161/strokeaha.119.028515.Peer-Reviewed Original ResearchConceptsPlasma sST2 levelsSoluble ST2Epileptiform abnormalitiesNontraumatic subarachnoid hemorrhageSubarachnoid hemorrhageSST2 levelsNeurophysiologic changesCerebral ischemiaIL-6Continuous electroencephalographyMeasures mixed-effects modelsInnate immune response pathwaysAdmission risk factorsPlasma soluble ST2Secondary brain injurySubgroup of patientsSubarachnoid hemorrhage patientsSerial plasma samplesAssociation of biomarkersInnate immune responseWilcoxon rank sum testImmune response pathwaysMixed-effects modelingRank sum testInflammatory biomarkers
2019
Intensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Walsh KB, Woo D, Shi FD, Huttner HB, Ziai WC, Hanley DF, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Intensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage. Stroke 2019, 50: 2016-2022. PMID: 31272326, PMCID: PMC6646091, DOI: 10.1161/strokeaha.119.024838.Peer-Reviewed Original ResearchConceptsDeep intracerebral hemorrhageIntensive BP reductionBasal ganglia intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageBP reductionPoor outcomeATACH-2Intensive Blood Pressure ReductionPressure reductionPerihematomal edema expansionSecondary brain injurySupratentorial intracerebral hemorrhagePerihematomal edema volumeSpontaneous intracerebral hemorrhageRelevant end pointsDeep locationBaseline characteristicsEdema volumeBasal gangliaBrain injuryClinical trialsTomography scanEdema expansionTreatment groups
2018
A qualitative study exploring nurses’ attitudes, confidence, and perceived barriers to implementing a traumatic brain injury nursing chart in Uganda
Wynveen L, Gamble M, Nabulime J, Luggya T, Kalanzi JK, Mowafi H. A qualitative study exploring nurses’ attitudes, confidence, and perceived barriers to implementing a traumatic brain injury nursing chart in Uganda. African Journal Of Emergency Medicine 2018, 8: 64-68. PMID: 30456150, PMCID: PMC6223585, DOI: 10.1016/j.afjem.2018.01.002.Peer-Reviewed Original ResearchTraumatic brain injury careNursing chartsInjury careBrain injuryEducation sessionsEmergency centerTertiary care trauma hospitalInadequate staffingSecondary brain injuryHospital emergency centreTraumatic brain injuryBrain injury preventionRoad traffic injuriesNeurological statusNurses' confidenceBlood sugarTrauma hospitalTraumatic brainNeurosurgical interventionNurses' attitudesInjury preventionPulse oximetryPatientsTraffic injuriesVital signs
2017
Ictal-Interictal Continuum: When to Worry About the Continuous Electroencephalography Pattern
Cormier J, Maciel CB, Gilmore EJ. Ictal-Interictal Continuum: When to Worry About the Continuous Electroencephalography Pattern. Seminars In Respiratory And Critical Care Medicine 2017, 38: 793-806. PMID: 29262437, DOI: 10.1055/s-0037-1607987.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusIctal-interictal continuumNonconvulsive seizuresEEG patternsSecondary brain injuryContinuous electroencephalography monitoringCritical care physiciansClear clinical significanceIIC patternsIll patientsStatus epilepticusCare physiciansCEEG monitoringElectroencephalography monitoringSeizure riskBrain injuryGuideline statementsClinical dilemmaClinical significanceNeuronal stressClinical approachDefinitive guidelinesElectroencephalography patternsPotential associationEarly detection
2016
Critical Care Management of Intracerebral Hemorrhage
Morawo AO, Gilmore EJ. Critical Care Management of Intracerebral Hemorrhage. Seminars In Neurology 2016, 36: 225-232. PMID: 27214697, DOI: 10.1055/s-0036-1581991.Peer-Reviewed Original ResearchConceptsManagement of ICHIntracerebral hemorrhageMedical complicationsCare managementNeurocritical care managementSecondary brain injuryCritical care managementForm of strokeRole of imagingCritical care settingSpontaneous intracerebral hemorrhageLife-sustaining therapyMajor healthcare concernRisk factorsBrain injuryClinical trialsIntracranial pressureCare settingsEarly withdrawalHemorrhageHealthcare concernComplicationsPrognosisMajor targetIntensive monitoring
2013
Nonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes
Claassen J, Perotte A, Albers D, Kleinberg S, Schmidt JM, Tu B, Badjatia N, Lantigua H, Hirsch LJ, Mayer SA, Connolly ES, Hripcsak G. Nonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes. Annals Of Neurology 2013, 74: 53-64. PMID: 23813945, PMCID: PMC3775941, DOI: 10.1002/ana.23859.Peer-Reviewed Original ResearchConceptsRegional cerebral blood flowAcute brain injuryBrain injuryCerebral physiologic effectsCerebral perfusion pressureSecondary brain injuryBrain tissue oxygenationSubarachnoid hemorrhage patientsCerebral blood flowGlobal brain metabolismElevated heart rateComplex physiologic processBlood pressureNonconvulsive seizuresHemorrhage patientsPerfusion pressureSubarachnoid hemorrhageBrain metabolismFunctional outcomeIntracranial pressureSeizure onsetPhysiologic effectsHeart rateOnly seizuresBlood flow
2012
Traditional systolic blood pressure targets underestimate hypotension-induced secondary brain injury
Brenner M, Stein D, Hu P, Aarabi B, Sheth K, Scalea T. Traditional systolic blood pressure targets underestimate hypotension-induced secondary brain injury. Journal Of Trauma And Acute Care Surgery 2012, 72: 1456-1457. DOI: 10.1097/01.ta.0000414833.80358.72.Peer-Reviewed Original ResearchSystolic blood pressure targetBlood pressure targetsSecondary brain injuryPressure targetsBrain injuryInjury
2010
Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J. Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices. Neurocritical Care 2010, 12: 188-198. PMID: 20107926, DOI: 10.1007/s12028-010-9330-9.Peer-Reviewed Original ResearchConceptsAcute brain injuryBrain injurySevere acute brain injuryNeurological intensive care unitInsertion techniqueSecondary brain injuryDay of admissionMethodsSixty-one patientsRate of hematomaSingle-institution reviewIntensive care unitBrain tissue oxygenCerebral blood flowFocal brain injuryMultimodality brain monitoringPatient-specific selectionInvasive monitoring devicesHospital lengthFrequent complicationNICU lengthPatient demographicsCare unitMultimodality monitoringConsecutive seriesInstitution review
2001
Management of Brain Edema Complicating Stroke
Rosand J, Schwamm L. Management of Brain Edema Complicating Stroke. Journal Of Intensive Care Medicine 2001, 16: 128-141. DOI: 10.1046/j.1525-1489.2001.00128.x.Peer-Reviewed Original ResearchCerebral blood flowSecondary brain injuryBrain edemaMagnetic resonance imagingBrain parenchymaVasogenic edemaBrain injuryBlood-brain barrier integrityGlobal cerebral blood flowIschemic brain swellingLocal tissue dysfunctionSerial Neurologic AssessmentIschemic brain edemaOnset of symptomsIntracranial blood volumeIschemic cell injuryResult of injurySpecific MRI sequencesAccumulation of fluidDiffusion-weighted imagingRheologic agentsNeurologic deteriorationBrain swellingDecompressive surgeryIschemic stroke
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