2024
Association 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 data
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 levelsOne-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 III
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 treatmentThe coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume
Haider SP, Qureshi AI, Jain A, Tharmaseelan H, Berson ER, Majidi S, Filippi CG, Mak A, Werring DJ, Acosta JN, Malhotra A, Kim JA, Sansing LH, Falcone G, Sheth K, Payabvash S. The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume. International Journal Of Stroke 2021, 17: 777-784. PMID: 34569877, PMCID: PMC9005571, DOI: 10.1177/17474930211050749.Peer-Reviewed Original ResearchAdmission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH‐2 trial intracerebral hemorrhage population
Haider SP, Qureshi AI, Jain A, Tharmaseelan H, Berson ER, Zeevi T, Majidi S, Filippi CG, Iseke S, Gross M, Acosta JN, Malhotra A, Kim JA, Sansing LH, Falcone GJ, Sheth KN, Payabvash S. Admission computed tomography radiomic signatures outperform hematoma volume in predicting baseline clinical severity and functional outcome in the ATACH‐2 trial intracerebral hemorrhage population. European Journal Of Neurology 2021, 28: 2989-3000. PMID: 34189814, PMCID: PMC8818333, DOI: 10.1111/ene.15000.Peer-Reviewed Original ResearchConceptsAdmission Glasgow Coma ScaleGlasgow Coma ScaleRadiomics signatureMRS scoreHematoma volumeICH volumeClinical severityNoncontrast head CT scansAdmission National InstitutesHealth Stroke ScaleRankin Scale scoreStrong associationBaseline clinical severityMedium-term outcomesIndependent validation cohortHead CT scanATACH-2 trialStroke ScaleAdmission NIHSSIndependent predictorsClinical presentationComa ScaleBaseline CTICH patientsValidation cohort
2020
Ultra‐Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage
Li Q, Warren AD, Qureshi AI, Morotti A, Falcone GJ, Sheth KN, Shoamanesh A, Dowlatshahi D, Viswanathan A, Goldstein JN. Ultra‐Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage. Annals Of Neurology 2020, 88: 388-395. PMID: 32453453, PMCID: PMC8697414, DOI: 10.1002/ana.25793.Peer-Reviewed Original ResearchConceptsBlood pressure reductionBlood pressure treatmentOnset of symptomsIntensive Blood Pressure ReductionIntensive blood pressure treatmentHematoma growthNicardipine treatmentPressure reductionBetter outcomesModified Rankin scale score distributionRankin Scale score distributionStandard blood pressure treatmentElevated blood pressureStandard treatment groupSubgroup of patientsIntracerebral hemorrhage patientsPost-hoc exploratory analysisAnn NeurolAntihypertensive treatmentIntravenous nicardipineScale score distributionBlood pressureIntracerebral hemorrhageMultivariable analysisDecreased risk
2019
Deep Learning for Automated Measurement of Hemorrhage and Perihematomal Edema in Supratentorial Intracerebral Hemorrhage
Dhar R, Falcone GJ, Chen Y, Hamzehloo A, Kirsch EP, Noche RB, Roth K, Acosta J, Ruiz A, Phuah CL, Woo D, Gill TM, Sheth KN, Lee JM. Deep Learning for Automated Measurement of Hemorrhage and Perihematomal Edema in Supratentorial Intracerebral Hemorrhage. Stroke 2019, 51: 648-651. PMID: 31805845, PMCID: PMC6993878, DOI: 10.1161/strokeaha.119.027657.Peer-Reviewed Original ResearchConceptsSupratentorial intracerebral hemorrhagePerihematomal edemaIntracerebral hemorrhagePHE volumeResults Two hundred twentyIntracerebral Hemorrhage (ERICH) studyMechanism of injuryIntracerebral hemorrhage patientsSpontaneous intracerebral hemorrhageLarge cohort studyComputed tomography scanSecondary outcomesCohort studyPrimary outcomeHemorrhage patientsSecondary injuryTomography scanHundred twentyMedian volumeLarge cohortHemorrhagePatientsQuantification of hemorrhageFirst cohortDisease biologyPerihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy
Gusdon AM, Nyquist PA, Torres-Lopez VM, Leasure AC, Falcone GJ, Sheth KN, Sansing LH, Hanley DF, Malani R. Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy. Stroke 2019, 51: 129-136. PMID: 31744426, PMCID: PMC7048624, DOI: 10.1161/strokeaha.119.027085.Peer-Reviewed Original ResearchConceptsBlood product transfusionThirty-day mortalityIntracerebral hemorrhagePerihematomal edemaActive malignancyProduct transfusionPHE volumeICH volumeActive cancerPHE growthPlatelet transfusionsCentral nervous system involvementRecurrence of malignancyNervous system involvementNontraumatic intracerebral hemorrhageCancer-specific dataPHE expansionRecent chemotherapyChart reviewConclusions PatientsControl patientsMost patientsHematoma volumeInstitutional databaseSystem involvementAssociation 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 adjustmentIdentification and Validation of Hematoma Volume Cutoffs in Spontaneous, Supratentorial Deep Intracerebral Hemorrhage
Leasure AC, Sheth KN, Comeau M, Aldridge C, Worrall BB, Vashkevich A, Rosand J, Langefeld C, Moomaw CJ, Woo D, Falcone GJ. Identification and Validation of Hematoma Volume Cutoffs in Spontaneous, Supratentorial Deep Intracerebral Hemorrhage. Stroke 2019, 50: 2044-2049. PMID: 31238829, PMCID: PMC6646054, DOI: 10.1161/strokeaha.118.023851.Peer-Reviewed Original ResearchConceptsDeep intracerebral hemorrhageBasal ganglia intracerebral hemorrhageIntracerebral hemorrhagePoor outcomeValidation cohortC-statisticVolume cutoffDeep ICH patientsMultivariable outcome modelsThalamic intracerebral hemorrhageSpontaneous intracerebral hemorrhageATACH-2 trialClinical trial designCharacteristic curve analysisDeep brain nucleiEffects of interventionsATACH-2Complete neuroimagingICH variesICH patientsICH volumeBasal gangliaCandidate therapiesInclusion criteriaOutcome data
2018
17p12 Influences Hematoma Volume and Outcome in Spontaneous Intracerebral Hemorrhage
Marini S, Devan WJ, Radmanesh F, Miyares L, Poterba T, Hansen BM, Norrving B, Jimenez-Conde J, Giralt-Steinhauer E, Elosua R, Cuadrado-Godia E, Soriano C, Roquer J, Kourkoulis CE, Ayres AM, Schwab K, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Kidwell CS, Montaner J, Fernandez-Cadenas I, Delgado P, Greenberg SM, Lindgren A, Matouk C, Sheth KN, Woo D, Anderson CD, Rosand J, Falcone GJ. 17p12 Influences Hematoma Volume and Outcome in Spontaneous Intracerebral Hemorrhage. Stroke 2018, 49: 1618-1625. PMID: 29915124, PMCID: PMC6085089, DOI: 10.1161/strokeaha.117.020091.Peer-Reviewed Original ResearchConceptsAssociation studiesGenome-wide association studiesNumerous copy number variantsSusceptibility risk lociWide association studyNovel biological pathwaysGenomic regionsIntergenic regionCopy number variantsRisk lociBiological pathwaysSusceptibility lociAssociation testingGenetic variantsNumber variantsEuropean ancestryLociReplicationDiscovery phaseVariantsAncestryImportant determinantPathwayTranslational studiesQuality control
2016
CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage
Morotti A, Jessel MJ, Brouwers HB, Falcone GJ, Schwab K, Ayres AM, Vashkevich A, Anderson CD, Viswanathan A, Greenberg SM, Gurol ME, Romero JM, Rosand J, Goldstein JN. CT Angiography Spot Sign, Hematoma Expansion, and Outcome in Primary Pontine Intracerebral Hemorrhage. Neurocritical Care 2016, 25: 79-85. PMID: 26759226, PMCID: PMC4940347, DOI: 10.1007/s12028-016-0241-2.Peer-Reviewed Original ResearchConceptsPrimary pontine hemorrhagePositive predictive valueSupratentorial intracerebral hemorrhageIntracerebral hemorrhageHematoma expansionHospital mortalitySpot signNegative predictive valuePredictive valueNon-contrast CT scanCT angiography spot signAbsolute hematoma growthBrainstem ICHTomography angiography spot signConsecutive ICH patientsComputer-assisted volumetric analysisSpot sign presenceNegative likelihood ratioCTA spot signCollected cohortICH patientsPontine hemorrhagePPH casesHematoma growthHematoma volume
2015
Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage
Brouwers HB, Battey TW, Musial HH, Ciura VA, Falcone GJ, Ayres AM, Vashkevich A, Schwab K, Viswanathan A, Anderson CD, Greenberg SM, Pomerantz SR, Ortiz CJ, Goldstein JN, Gonzalez RG, Rosand J, Romero JM. Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage. Stroke 2015, 46: 2498-2503. PMID: 26243220, PMCID: PMC4550492, DOI: 10.1161/strokeaha.115.009659.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageHematoma expansionContrast extravasationIntracerebral hemorrhageSpot signExtravasation rateTomographic angiographyConsecutive intracerebral hemorrhage patientsML/minContrast extravasation rateAcute intracerebral hemorrhageIntracerebral hemorrhage patientsMultivariable logistic regressionRate of bleedingIntracerebral hemorrhage volumeSpot sign presenceHospital mortalityMultivariable analysisHemorrhage patientsPostcontrast CTHemorrhage volumeSemiautomated softwareMortalityLogistic regressionHemorrhage
2013
Predictors of Hematoma Volume in Deep and Lobar Supratentorial Intracerebral Hemorrhage
Falcone GJ, Biffi A, Brouwers HB, Anderson CD, Battey TW, Ayres AM, Vashkevich A, Schwab K, Rost NS, Goldstein JN, Viswanathan A, Greenberg SM, Rosand J. Predictors of Hematoma Volume in Deep and Lobar Supratentorial Intracerebral Hemorrhage. JAMA Neurology 2013, 70: 988-994. PMID: 23733000, PMCID: PMC3808840, DOI: 10.1001/jamaneurol.2013.98.Peer-Reviewed Original ResearchConceptsLobar intracerebral hemorrhageIntensity of anticoagulationIntracerebral hemorrhageICH volumeHematoma volumeIndependent predictorsLobar supratentorial intracerebral haemorrhageProspective cohort studyCoronary artery diseaseSupratentorial intracerebral hemorrhageMedian ICH volumePrimary ICH patientsComputed tomography scanMultivariable linear regressionAcademic medical centerIntracerebral hemorrhage volumeLobar hemorrhageAntiplatelet treatmentRadiological outcomesArtery diseaseCohort studyDeep hemorrhagesICH locationICH patientsMale sexWarfarin and Statins are Associated with Hematoma Volume in Primary Infratentorial Intracerebral Hemorrhage
Falcone GJ, Brouwers HB, Biffi A, Anderson CD, Battey TW, Ayres AM, Vashkevich A, Schwab KM, Rost NS, Goldstein JN, Viswanathan A, Greenberg SM, Rosand J. Warfarin and Statins are Associated with Hematoma Volume in Primary Infratentorial Intracerebral Hemorrhage. Neurocritical Care 2013, 21: 192-199. PMID: 23839705, PMCID: PMC4107188, DOI: 10.1007/s12028-013-9839-9.Peer-Reviewed Original ResearchConceptsInfratentorial intracerebral hemorrhageIntracerebral hemorrhageICH volumeSurgical evacuationHematoma volumeBrainstem ICHSingle-center studySupratentorial intracerebral hemorrhageWarfarin treatmentStatin treatmentEmergency departmentICH casesRetrospective analysisCT scanLogistic regressionWarfarinICH subjectsLimited dataHemorrhageStatinsFurther studiesComputer-assisted methodTreatmentInverse relationLinear regressionHeritability Estimates Identify a Substantial Genetic Contribution to Risk and Outcome of Intracerebral Hemorrhage
Devan WJ, Falcone GJ, Anderson CD, Jagiella JM, Schmidt H, Hansen BM, Jimenez-Conde J, Giralt-Steinhauer E, Cuadrado-Godia E, Soriano C, Ayres AM, Schwab K, Kassis SB, Valant V, Pera J, Urbanik A, Viswanathan A, Rost NS, Goldstein JN, Freudenberger P, Stögerer EM, Norrving B, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Kidwell CS, Montaner J, Fernandez-Cadenas I, Delgado P, Greenberg SM, Roquer J, Lindgren A, Slowik A, Schmidt R, Woo D, Rosand J, Biffi A. Heritability Estimates Identify a Substantial Genetic Contribution to Risk and Outcome of Intracerebral Hemorrhage. Stroke 2013, 44: 1578-1583. PMID: 23559261, PMCID: PMC3684199, DOI: 10.1161/strokeaha.111.000089.Peer-Reviewed Original ResearchConceptsGenetic variationGenome-wide genotype dataGenome-wide dataGenetic contributionHeritability estimatesPedigree-based studiesSubstantial genetic contributionFamily-based dataAdditional lociGenotype dataRisk variantsGenetic variantsHeritabilityGenetic influencesHeritability estimationProportion of variationNovel analytic toolGenetic risk factorsPhenotypeSubstantial roleUnrelated subjectsGenomeGenesLociVariants