2024
Endovascular thrombectomy versus medical management for patients with large vessel stroke and infective endocarditis
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Endovascular thrombectomy versus medical management for patients with large vessel stroke and infective endocarditis. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022374. PMID: 39317440, DOI: 10.1136/jnis-2024-022374.Peer-Reviewed Original ResearchEfficacy of endovascular thrombectomyLarge vessel occlusionInfective endocarditisPropensity score matchingIntracerebral hemorrhageSubarachnoid hemorrhageMedical managementMultivariable adjustmentOdds of intracerebral hemorrhageEndovascular thrombectomyHome dischargeRate of intracerebral hemorrhageFavorable hospital outcomesRate of in-hospital deathAssociated with significantly higher oddsLarge vessel occlusion strokeIn-hospital mortalityRoutine home dischargeIn-hospital deathRate of subarachnoid hemorrhageRate of home dischargeSignificantly higher oddsRate of routine dischargePrimary outcomeSecondary outcomesPost-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators. Diagnostics 2024, 14: 1856. PMID: 39272641, PMCID: PMC11394096, DOI: 10.3390/diagnostics14171856.Peer-Reviewed Original ResearchSubarachnoid hemorrhageIntraparenchymal hemorrhageAssociated with higher oddsEndovascular thrombectomyFemale sexAssociated with increased odds of in-hospital mortalityHospital outcomesHigher oddsNon-SAH groupSite of vascular occlusionOdds of in-hospital mortalityMultivariate logistic regression modelEndovascular thrombectomy patientsIn-hospital mortalityAssociated with increased oddsOdds of routine dischargeClinical detrimentRegression modelsLogistic regression modelsVascular occlusionSelf-careVessel occlusionPatientsSignificant predictorsHemorrhage
2020
Posterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage
Elsamadicy AA, Koo AB, Reeves BC, Sujijantarat N, David WB, Malhotra A, Gilmore EJ, Matouk CC, Hebert R. Posterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage. World Neurosurgery 2020, 143: e309-e323. PMID: 32721559, DOI: 10.1016/j.wneu.2020.07.135.Peer-Reviewed Original ResearchConceptsPosterior reversible encephalopathy syndromeSystolic blood pressure goalBlood pressure goalsReversible encephalopathy syndromeAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageEncephalopathy syndromeCerebral vasospasmClinical statusFluid-attenuated inversion recovery hyperintensityMiddle cerebral artery syndromeAcute-onset headachePossible ischemic eventsClinical examination findingsInversion recovery hyperintensityPatient's clinical statusTransient clinical improvementArtery aneurysm ruptureMiddle cerebral arteryLevel of arousalMagnetic resonance imagingDigital subtraction angiographyInduced hypertensionClinical improvementIschemic events
2019
Cost-Effectiveness of Computed Tomography Angiography in Management of Tiny Unruptured Intracranial Aneurysms in the United States
Wu X, Matouk CC, Mangla R, Forman HP, Gandhi D, Sanelli P, Malhotra A. Cost-Effectiveness of Computed Tomography Angiography in Management of Tiny Unruptured Intracranial Aneurysms in the United States. Stroke 2019, 50: 2396-2403. PMID: 31340732, DOI: 10.1161/strokeaha.119.025600.Peer-Reviewed Original ResearchConceptsComputed tomography angiographyUnruptured intracranial aneurysmsIntracranial aneurysmsTomography angiographyCancer riskCTA surveillanceCost-effective strategyRadiation-induced brain tumorsRadiation-induced cancer riskSubsequent magnetic resonanceBrain cancer riskBetter health outcomesAnnual rupture riskProbabilistic sensitivity analysesRupture riskLower healthcare spendingAggressive managementPatients 30Subarachnoid hemorrhageIncidental detectionPrior historyHigh riskBrain tumorsAneurysmsHealth outcomesMeta-analysis of recent literature on utility of follow-up imaging in isolated perimesencephalic hemorrhage
Geng B, Wu X, Brackett A, Malhotra A. Meta-analysis of recent literature on utility of follow-up imaging in isolated perimesencephalic hemorrhage. Clinical Neurology And Neurosurgery 2019, 180: 111-116. PMID: 30974309, DOI: 10.1016/j.clineuro.2019.03.006.Peer-Reviewed Original ResearchConceptsPerimesencephalic subarachnoid hemorrhageSubarachnoid hemorrhageTomographic angiogramInitial angiographic studyRetrospective institutional analysisUtility of repeatSubarachnoid hemorrhage patientsVascular causesBenign prognosisVascular etiologyAngiographic studiesClinical pictureHemorrhage patientsHemorrhage patternAneurysmal ruptureAdditional imagingHemorrhageUse of repeatPatientsInstitutional reviewAngiogramsDistinct subtypesPerimesencephalic hemorrhageLimited benefitEtiology
2018
The Patient with Thunderclap Headache
Malhotra A, Wu X, Gandhi D, Sanelli P. The Patient with Thunderclap Headache. Neuroimaging Clinics Of North America 2018, 28: 335-351. PMID: 30007749, DOI: 10.1016/j.nic.2018.03.002.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhageThunderclap headacheCT angiographyConvexity subarachnoid hemorrhageHours of onsetPerimesencephalic subarachnoid hemorrhageNegative CT angiographyPattern of bloodCommon presentationEmergency departmentEarly diagnosisPatientsMR imagingMultiple causesHeadacheAngiographyHemorrhageBloodDiagnosisCTManagement of Tiny Unruptured Intracranial Aneurysms: A Comparative Effectiveness Analysis
Malhotra A, Wu X, Forman HP, Matouk CC, Gandhi D, Sanelli P. Management of Tiny Unruptured Intracranial Aneurysms: A Comparative Effectiveness Analysis. JAMA Neurology 2018, 75: 27-34. PMID: 29159405, PMCID: PMC5833486, DOI: 10.1001/jamaneurol.2017.3232.Peer-Reviewed Original ResearchConceptsUnruptured intracranial aneurysmsComparative effectiveness analysisPreventive treatmentAdult patientsAnnual riskIntracranial aneurysmsHealth benefitsFollow-up imagingCurrent clinical practiceBetter health outcomesRisk of ruptureImaging surveillanceTiny aneurysmsMean ageSubarachnoid hemorrhageRoutine treatmentIncidental detectionEffectiveness analysisClinical studiesMAIN OUTCOMEHigh riskGeneral populationPatientsPubMed searchClinical practice
2016
Cerebral Microhemorrhages and Meningeal Siderosis in Infective Endocarditis
Malhotra A, Schindler J, 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 T2HypertensionSiderosisEndocarditisShould Patients Be Counseled About Possible Recurrence of Perimesencephalic Subarachnoid Hemorrhage?
Malhotra A, Wu X, Borse R, Matouk CC, Bulsara K. Should Patients Be Counseled About Possible Recurrence of Perimesencephalic Subarachnoid Hemorrhage? World Neurosurgery 2016, 94: 580.e17-580.e22. PMID: 27521726, DOI: 10.1016/j.wneu.2016.07.112.Peer-Reviewed Original ResearchConceptsPerimesencephalic subarachnoid hemorrhageAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageTomography angiographyBetter outcomesBenign natural courseNew neurologic signsComputed tomography angiographyHistory of traumaPossibility of recurrenceDigital subtraction angiographyRecurrent hemorrhageSevere headacheVascular anomaliesNeurologic signsCase reportNatural courseInitial episodeSixth decadeSubarachnoid bleedSudden onsetPossible recurrenceLower riskPatientsPrevious episodesRegarding “Cerebral Angiography for Evaluation of Patients with CT Angiogram-Negative Subarachnoid Hemorrhage: An 11-Year Experience”
Wu X, Kalra VB, Forman HP, Matouk CC, Mongelluzzo G, Liu R, Malhotra A. Regarding “Cerebral Angiography for Evaluation of Patients with CT Angiogram-Negative Subarachnoid Hemorrhage: An 11-Year Experience”. American Journal Of Neuroradiology 2016, 37: e52-e53. PMID: 27056430, PMCID: PMC7963535, DOI: 10.3174/ajnr.a4794.Peer-Reviewed Original Research
2014
Use of Follow-Up Imaging in Isolated Perimesencephalic Subarachnoid Hemorrhage
Kalra VB, Wu X, Matouk CC, Malhotra A. Use of Follow-Up Imaging in Isolated Perimesencephalic Subarachnoid Hemorrhage. Stroke 2014, 46: 401-406. PMID: 25523050, DOI: 10.1161/strokeaha.114.007370.Peer-Reviewed Original ResearchConceptsPerimesencephalic subarachnoid hemorrhageInitial digital subtraction angiographyDigital subtraction angiographySubtraction angiographySubarachnoid hemorrhageNegative CTARetrospective institutional analysisFollow-up imagingInitial diagnosisTomographic angiogramInitial CTANoncontrast CTPatientsInstitutional reviewAneurysmsAngiographyImaging studiesExperienced neuroradiologistsIntracranial aneurysmsMultiple followMultiple studiesCTAHemorrhageCareful reviewAdditional use
2013
Vessel Wall Magnetic Resonance Imaging Identifies the Site of Rupture in Patients With Multiple Intracranial AneurysmsProof of Principle
Matouk CC, Mandell DM, Günel M, Bulsara KR, Malhotra A, Hebert R, Johnson MH, Mikulis DJ, Minja FJ. Vessel Wall Magnetic Resonance Imaging Identifies the Site of Rupture in Patients With Multiple Intracranial AneurysmsProof of Principle. Neurosurgery 2013, 72: 492-496. PMID: 23151622, DOI: 10.1227/neu.0b013e31827d1012.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageSite of ruptureSubarachnoid hemorrhageMultiple intracranial aneurysmsMR-VWIHigh-resolution magnetic resonance vessel wall imagingIntracranial aneurysmsSteno-occlusive cerebrovascular diseaseVessel wall magnetic resonance imagingMR imaging findingsVessel wall enhancementMagnetic resonance vessel wall imagingMagnetic resonance imagingVessel wall imagingDefinitive treatmentCerebrovascular diseaseImaging findingsMedical recordsRuptured aneurysmsUnruptured aneurysmsPatientsAneurysmsWall enhancementResonance imagingRupture