2022
Bedside 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
Portable, 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 Research
2020
Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion
Khunte M, Wu X, Payabvash S, Zhu C, Matouk C, Schindler J, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion. Journal Of NeuroInterventional Surgery 2020, 13: 784-789. PMID: 33077578, DOI: 10.1136/neurintsurg-2020-016765.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyMedical managementProbabilistic sensitivity analysesM2 occlusionsAcute strokeBranch occlusionEVT-treated patientsAcute ischemic strokeQuality-adjusted life yearsLifetime quality-adjusted life yearsDecision analytic modelDecision analytic studyIschemic strokeReperfusion techniquesLifetime horizonBetter outcomesPatientsLife yearsAge groupsPerfect healthSocietal perspectiveCost-effective strategyStrokeHealth benefitsOcclusionEffects 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 hospitalsCarotid-Cavernous Fistula Presenting With Bilateral Abducens Palsy
Peng TJ, Stretz C, Mageid R, Mac Grory B, Yaghi S, Matouk C, Schindler J. Carotid-Cavernous Fistula Presenting With Bilateral Abducens Palsy. Stroke 2020, 51: e107-e110. PMID: 32295511, DOI: 10.1161/strokeaha.120.029306.Peer-Reviewed Case Reports and Technical NotesEfficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial
Hill MD, Goyal M, Menon BK, Nogueira RG, McTaggart RA, Demchuk AM, Poppe AY, Buck BH, Field TS, Dowlatshahi D, van Adel BA, Swartz RH, Shah RA, Sauvageau E, Zerna C, Ospel JM, Joshi M, Almekhlafi MA, Ryckborst KJ, Lowerison MW, Heard K, Garman D, Haussen D, Cutting SM, Coutts SB, Roy D, Rempel JL, Rohr AC, Iancu D, Sahlas DJ, Yu AYX, Devlin TG, Hanel RA, Puetz V, Silver FL, Campbell BCV, Chapot R, Teitelbaum J, Mandzia JL, Kleinig TJ, Turkel-Parrella D, Heck D, Kelly ME, Bharatha A, Bang OY, Jadhav A, Gupta R, Frei DF, Tarpley JW, McDougall CG, Holmin S, Rha JH, Puri AS, Camden MC, Thomalla G, Choe H, Phillips SJ, Schindler JL, Thornton J, Nagel S, Heo JH, Sohn SI, Psychogios MN, Budzik RF, Starkman S, Martin CO, Burns PA, Murphy S, Lopez GA, English J, Tymianski M, Demchuk A, Barber P, Smith E, Bal S, Subramaniam S, Peters S, Couillard P, Klein G, Stys P, Menon B, Coutts S, Almekhlafi M, Hill M, Goyal M, Wong J, Mitha A, Eesa M, Morrish W, Alqatani S, Kashani N, Joshi M, Zerna C, Ospel J, Venkatesan P, Teleg E, Sitaram A, Graham B, Van Gaal S, Moussaddy A, Chakraborty D, Maraj N, Loockey A, Chen S, Singh R, Alsultan A, Asuncion 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, Zhang O, Doram C, Lowerison M, Hanley A, Campbell L, Ure A, Taylor F, Hul D, Wiebe S, Saluzzi M, Blenkin N, Frayne R, Buck B, Butcher K, Shuaib A, Jeerakathil T, Jickling G, Emery D, Rempel J, Owen 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, Poppe A, Roy D, Daneault 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, Moussaddy A, Legault C, Durcan L, Moore A, Cole E, Magnussen C, Salmon K, Khalil S, Desloges I, Waxman L, Abdon W, Lai S, Dowlatshahi D, Iancu 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, Del 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-Farina C, Diestro J, Camden M, Verreault S, Mackey A, Audet M, Milot G, Lavoie P, Gariépy J, Collard K, Haché A, Van Adel B, Sahlas D, Alshanbari A, Baldwin J, Catanese L, Chen B, Boasquevisque D, Deshmukh A, Knapman J, Lamers S, Larrazabal R, MacMillan S, Mai L, Mattia A, Nayar S, Ng K, Oczkowski W, Perera K, Shawawrah M, Shoamanesh A, Sobhi G, Syed N, Taher N, Vandervelde C, Pharm 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, 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, Devlin T, 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, Gilchrist V, Feineigle P, 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, 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, McTaggart R, Jayaraman M, Cutting S, Smith W, Foley S, Paolucci G, Has R, Quinn K, Fuller L, Brierley R, Watkins C, Demir N, Lopez G, Vargas A, Osteraas N, Holtz B, Sauvageau E, Hanel R, Aghaebrahim A, Chmayssani M, Naval N, Day J, Dellorso S, Ludwig B, Schemmel D, Ebreo N, Bell K, Lewis L, Delucia M, Nogueira R, Haussen D, Frankel M, Bhatt N, Bianchi N, Anderson A, Belagaje S, Liberato B, Rangaraju S, Al-Bayati A, Grossberg J, Craft L, Schindler K, Schaad E, Schultz M, Southerly L, Doppelheuer S, Charlton J, Faggard J, Barbret Z, 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, 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, Kuohn L, Orgass H, Leary M, Nye J, Halbert K, Nystrom K, Neuschatz K, Petrucci D, Coppola A, Tarpley J, 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, Gupta R, Bain M, 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, 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, Shah 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, Nurs 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, Holmin S, 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, Thomalla G, Golsari A, Hoppe J, Deb-Chatterji M, Cheng B, Barrow 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, Puetz V, 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, Velktamp R, Nagel S, Ringleb P, Heyse M, Amiri H, Mundiyanapurath S, Chen M, Bevrle E, Beck P, Möhlenbruch M, Tymianski M, Potvin A, Harris C, Wang C, Adams C, Mayor D, Garman D, Chau D, Wu J, Lunn J, Heard K, Bermanis L, Teyes L, Constant M, Galsim M, Helbin M, Leroux M, Felix N, Bendre N, Cuthbert S, Brokx S, Zhang Y, Lingham T, Kohli Y, Salter M, Liebeschuetz J, Hofmann F, Constant J, Soeder T, Snoke K, Bologa M, Stahl K, Graziewicz M. Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. The Lancet 2020, 395: 878-887. PMID: 32087818, DOI: 10.1016/s0140-6736(20)30258-0.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic strokeIschemic strokeEndovascular thrombectomySecondary outcomesScale scoreHealth Stroke Scale scoreModified Rankin Scale scorePost-synaptic density protein 95H treatment windowIntravenous alteplase treatmentBaseline National InstitutesPlacebo-controlled studySerious adverse eventsStroke Scale scoreExcellent functional outcomeProportion of patientsTime of randomisationLarge vessel occlusionPreclinical stroke modelsRankin Scale scoreBetter clinical outcomesMultiphase CT angiographyAcute care hospitalsGood collateral fillingFixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke
Petersen NH, Silverman A, Strander SM, Kodali S, Wang A, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Jasne AS, Cord B, Hebert RM, Johnson M, Matouk CC, Sheth KN. Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke. Stroke 2020, 51: 914-921. PMID: 32078493, PMCID: PMC7050651, DOI: 10.1161/strokeaha.119.026596.Peer-Reviewed Original ResearchConceptsSystolic BP thresholdMean arterial pressureArterial pressureEndovascular thrombectomyIschemic strokeSystolic BPFunctional outcomePercent timeFurther brain injuryModified Rankin ScaleBlood pressure changesPoor functional outcomeBP thresholdAutoregulatory indexHemorrhagic transformationMechanical thrombectomyRankin ScaleBlood pressureBP targetsHemodynamic managementAcute phaseBP managementStroke patientsCerebral autoregulationWorse outcomesCT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis.
Wu X, Hughes DR, Gandhi D, Matouk CC, Sheth K, Schindler J, Wira C, Wintermark M, Sanelli P, Malhotra A. CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis. Radiology 2020, 294: 580-588. PMID: 31934828, DOI: 10.1148/radiol.2019191238.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionAcute minor strokeBest medical managementMinor strokeCT angiographyMedical managementProbabilistic sensitivity analysesLower health benefitsImmediate thrombectomyHealth benefitsHealth outcomesVascular imagingAcute ischemic strokeMarkov decision-analytic modelWorse health outcomesImproved health outcomesDecision analytic modelNet monetary benefitIntravenous thrombolysisIschemic strokeYounger patientsThrombectomy strategyPatientsAngiographyStroke
2019
Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic stroke
2017
Functional Improvement Among Intracerebral Hemorrhage (ICH) Survivors up to 12 Months Post-injury
Sreekrishnan A, Leasure AC, Shi FD, Hwang DY, Schindler JL, Petersen NH, Gilmore EJ, Kamel H, Sansing LH, Greer DM, Sheth KN. Functional Improvement Among Intracerebral Hemorrhage (ICH) Survivors up to 12 Months Post-injury. Neurocritical Care 2017, 27: 326-333. PMID: 28685394, PMCID: PMC5700855, DOI: 10.1007/s12028-017-0425-4.Peer-Reviewed Original Research
2016
Cerebral Microhemorrhages and Meningeal Siderosis in Infective Endocarditis
Malhotra A, Schindler J, Mac Grory B, Chu SY, Youn TS, Matouk C, Greer DM, Schrag M. Cerebral Microhemorrhages and Meningeal Siderosis in Infective Endocarditis. Cerebrovascular Diseases 2016, 43: 59-67. PMID: 27871078, DOI: 10.1159/000452718.Peer-Reviewed Original ResearchConceptsCerebral amyloid angiopathyInfective endocarditisSusceptibility-weighted imaging (SWI) sequencesSmall subarachnoid hemorrhageGradient-echo T2Sensitive diagnostic techniquesSWI MRIMycotic aneurysmSevere hypertensionGroups of subjectsAmyloid angiopathyCerebral insultCerebral microhemorrhagesNeurological involvementWorse prognosisSubarachnoid hemorrhageSWI findingsAcademic hospitalSignificant predilectionMicrohemorrhagesPatientsGRE T2HypertensionSiderosisEndocarditisValidation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis. Clinical Neurology And Neurosurgery 2016, 146: 71-75. PMID: 27152469, DOI: 10.1016/j.clineuro.2016.04.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsNew Haven HospitalTwo-sample t-testStroke patientsCharacteristic curveThrombolysisHemorrhageSignificant differencesPatientsT-testScoresExternal datasetSimple predictorInternal datasetHospitalMissed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services
Arch AE, Weisman DC, Coca S, Nystrom KV, Wira CR, Schindler JL. Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services. Stroke 2016, 47: 668-673. PMID: 26846858, DOI: 10.1161/strokeaha.115.010613.Peer-Reviewed Original ResearchConceptsEmergency departmentLarge community hospitalCommunity hospitalIschemic strokeStroke diagnosisAcademic hospitalNausea/vomitingSecondary prevention therapiesAcute ischemic strokeRetrospective chart reviewIschemic stroke diagnosisAcademic teaching hospitalEndovascular considerationsChart reviewPrompt treatmentSymptom onsetPosterior circulationPrevention therapyNeurology serviceAcute interventionAnterior strokeAtypical symptomsStroke historyPosterior strokeTeaching hospital
2015
On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis. Journal Of Stroke And Cerebrovascular Diseases 2015, 25: 447-451. PMID: 26654664, DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhagePrimary stroke centerClinical outcomesStroke centersStroke severitySymptom onsetStroke careStroke patientsPatient cohortIntravenous recombinant tissue plasminogen activator (rt-PA) therapyTreatment durationRecombinant tissue plasminogen activator therapyHealth Stroke Scale scoreTissue plasminogen activator therapyConsistent quality careBaseline National InstitutesStroke Scale scoreAcute stroke careIschemic stroke patientsPlasminogen activator therapyMann-Whitney testSICH rateAcute strokeIschemic strokeConsecutive patientsIntravenous Fibrinolytic Therapy in Central Retinal Artery Occlusion: A Patient-Level Meta-analysis
Schrag M, Youn T, Schindler J, Kirshner H, Greer D. Intravenous Fibrinolytic Therapy in Central Retinal Artery Occlusion: A Patient-Level Meta-analysis. JAMA Neurology 2015, 72: 1148-1154. PMID: 26258861, DOI: 10.1001/jamaneurol.2015.1578.Peer-Reviewed Original ResearchConceptsCentral retinal artery occlusionRetinal artery occlusionSystemic fibrinolytic therapyVisual acuity outcomesPatient-level dataNatural history groupConservative treatmentFibrinolytic therapyArtery occlusionAcuity outcomesPatient-Level Meta-AnalysisIntravenous fibrinolytic therapyAnterior chamber paracentesisAbsolute risk reductionOutcome of treatmentNatural history studiesTissue plasminogen activatorRandom-effects modelRelevant review articlesWeb of ScienceFibrinolysis treatmentConservative therapyRetinal ischemiaVisual outcomeConservative modalitiesTURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis
Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN. TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocritical Care 2015, 23: 166-171. PMID: 25869481, DOI: 10.1007/s12028-015-0131-z.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageBaseline NIHSS scorePrestroke mRS scoreNIHSS scoreMRS scoreIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsIschemic stroke treatmentIndependent predictorsStroke treatmentStroke patientsClinical parametersPlatelet countHyperacute strokeDerivation datasetThrombolysisLogistic regressionSubstantial riskNew scoreCharacteristic curveHemorrhage