2022
Association 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
2020
Plasma neurofilament light predicts mortality in patients with stroke
Gendron TF, Badi MK, Heckman MG, Jansen-West KR, Vilanilam GK, Johnson PW, Burch AR, Walton RL, Ross OA, Brott TG, Miller TM, Berry JD, Nicholson KA, Wszolek ZK, Oskarsson BE, Sheth KN, Sansing LH, Falcone GJ, Cucchiara BL, Meschia JF, Petrucelli L. Plasma neurofilament light predicts mortality in patients with stroke. Science Translational Medicine 2020, 12 PMID: 33177179, PMCID: PMC9534269, DOI: 10.1126/scitranslmed.aay1913.Peer-Reviewed Original ResearchConceptsBlood neurofilament lightNeurofilament lightStroke typeNeuroaxonal injuryHigher NfL concentrationsMini-Mental State ExaminationStroke brain injuryAcute cerebral infarctionModified Rankin ScaleEarly ischemic injuryNontraumatic intracerebral hemorrhageNIH Stroke ScaleBrain tissue damagePlasma neurofilament lightIntracranial hemorrhage volumeClinical trial efficiencyBlood biomarker studiesStroke therapeuticsCause mortalityStroke ScaleCerebral infarctionRankin ScaleFunctional disabilityIntracerebral hemorrhageIschemic injuryFixed 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 outcomesRace/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage.
Miyares LC, Falcone GJ, Leasure A, Adeoye O, Shi FD, Kittner SJ, Langefeld C, Vagal A, Sheth KN, Woo D. Race/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage. Neurology 2020, 94: e1271-e1280. PMID: 31969467, PMCID: PMC7274930, DOI: 10.1212/wnl.0000000000008930.Peer-Reviewed Original ResearchConceptsSupratentorial intracerebral hemorrhageModified Rankin ScaleIntracerebral hemorrhageRace/ethnicityFunctional outcomeYounger patientsPoor outcomeAdmission Glasgow Coma Scale scoreEthnic/Racial VariationsGlasgow Coma Scale scoreHispanic participantsHispanic race/ethnicityAdmission blood pressureDeep ICH locationIntracerebral Hemorrhage (ERICH) studyProspective multicenter studyGood functional outcomeNon-Hispanic blacksBaseline disabilityRankin ScaleBlood pressureICH locationIntraventricular extensionMulticenter studyICH volume
2019
Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage
Kuramatsu JB, Biffi A, Gerner ST, Sembill JA, Sprügel MI, Leasure A, Sansing L, Matouk C, Falcone GJ, Endres M, Haeusler KG, Sobesky J, Schurig J, Zweynert S, Bauer M, Vajkoczy P, Ringleb PA, Purrucker J, Rizos T, Volkmann J, Müllges W, Kraft P, Schubert AL, Erbguth F, Nueckel M, Schellinger PD, Glahn J, Knappe UJ, Fink GR, Dohmen C, Stetefeld H, Fisse AL, Minnerup J, Hagemann G, Rakers F, Reichmann H, Schneider H, Rahmig J, Ludolph AC, Stösser S, Neugebauer H, Röther J, Michels P, Schwarz M, Reimann G, Bäzner H, Schwert H, Claßen J, Michalski D, Grau A, Palm F, Urbanek C, Wöhrle JC, Alshammari F, Horn M, Bahner D, Witte OW, Günther A, Hamann GF, Hagen M, Roeder SS, Lücking H, Dörfler A, Testai FD, Woo D, Schwab S, Sheth KN, Huttner HB. Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. JAMA 2019, 322: 1392-1403. PMID: 31593272, PMCID: PMC6784768, DOI: 10.1001/jama.2019.13014.Peer-Reviewed Original ResearchConceptsCerebellar intracerebral hemorrhageSurgical hematoma evacuationHematoma evacuationConservative treatmentIntracerebral hemorrhageIndividual participant dataFunctional outcomePrimary outcomeClinical outcomesFunctional disabilityPropensity score-matched groupsFavorable functional outcomeModified Rankin ScaleImproved functional outcomesSecondary outcomesRankin ScaleHematoma volumeICH studiesMAIN OUTCOMEPatientsCutoff valuePropensity scoreParticipant dataMonthsCovariate adjustmentDeviation From Personalized Blood Pressure Targets Is Associated With Worse Outcome After Subarachnoid Hemorrhage
Silverman A, Kodali S, Strander S, Gilmore EJ, Kimmel A, Wang A, Cord B, Falcone G, Hebert R, Matouk C, Sheth KN, Petersen NH. Deviation From Personalized Blood Pressure Targets Is Associated With Worse Outcome After Subarachnoid Hemorrhage. Stroke 2019, 50: 2729-2737. PMID: 31495332, PMCID: PMC6756936, DOI: 10.1161/strokeaha.119.026282.Peer-Reviewed Original ResearchConceptsLimits of autoregulationAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageFunctional outcomeArterial pressureIntracranial pressureBP targetsWorse outcomesPercent timeBlood pressure targetsBlood pressure managementMean arterial pressureModified Rankin ScalePotential neuroprotective strategiesWorse functional outcomePoor functional outcomeCerebral blood flowMultivariate logistic regressionTotal monitoring periodAutoregulatory indexPressure targetsCerebral ischemiaNeuroprotective strategiesRankin ScaleCerebral autoregulationAssociation of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Woo D, Ziai WC, Hanley DF, Salman R, Matouk CC, Sansing LH, Sheth KN, Falcone GJ. Association of Intensive Blood Pressure Reduction With Risk of Hematoma Expansion in Patients With Deep Intracerebral Hemorrhage. JAMA Neurology 2019, 76: 949-955. PMID: 31081862, PMCID: PMC6515816, DOI: 10.1001/jamaneurol.2019.1141.Peer-Reviewed Original ResearchIntensive Blood Pressure ReductionDeep intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageHematoma expansionStandard treatmentIntensive treatmentPressure reductionMAIN OUTCOMEModified Rankin scale score distributionIntensive blood pressure treatmentRankin Scale score distributionBasal ganglia intracerebral hemorrhageThalamic intracerebral hemorrhageBasal ganglia hemorrhageBlood pressure treatmentStandard treatment groupModified Rankin ScaleRankin Scale scorePrimary intracerebral hemorrhageAcute care settingStrong risk factorSpontaneous intracerebral hemorrhageDeep brain nucleiAntihypertensive treatmentEarly Prognostication of 1-Year Outcome After Subarachnoid Hemorrhage: The FRESH Score Validation
Witsch J, Kuohn L, Hebert R, Cord B, Sansing L, Gilmore EJ, Hwang DY, Petersen N, Falcone GJ, Matouk C, Sheth KN. Early Prognostication of 1-Year Outcome After Subarachnoid Hemorrhage: The FRESH Score Validation. Journal Of Stroke And Cerebrovascular Diseases 2019, 28: 104280. PMID: 31326270, DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.038.Peer-Reviewed Original ResearchConceptsSpontaneous subarachnoid hemorrhageModified Rankin ScaleLong-term outcomesSubarachnoid hemorrhageUnfavorable outcomePercent of patientsExclusion of patientsStratification of patientsScore variablesAneurysmal etiologyBleeding sourceRankin ScaleFunctional outcomeMean ageEarly prognosticationPrognostication scoresStudy investigatorsHospital resourcesPatientsDisability partAneurysm coilingOutcomesHigh gradeCharacteristic curveHemorrhageDecreases 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