Carmelo Graffagnino

Journal article Am J Crit Care · July 2009 Featured Work BACKGROUND: Treatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdot ... Full text Link to item Cite

Impact of ruptured cerebral aneurysm coiling and clipping on the incidence of cerebral vasospasm and clinical outcome.

Journal article J Neuroimaging · April 2009 Featured Work BACKGROUND: This study assessed the impact of treatment modality of aneurysmal subarachnoid hemorrhage (aSAH) on the rate of vasospasm (VSP), mortality, and hospital length of stay (LOS) of patients with aneurysmal subarachnoid hemorrhage (aSAH). METHODS: ... Full text Link to item Cite

A randomized evaluation of bispectral index-augmented sedation assessment in neurological patients.

Journal article Neurocrit Care · 2009 Featured Work OBJECTIVE: To assess whether monitoring sedation status using bispectral index (BIS) as an adjunct to clinical evaluation was associated with a reduction in the total amount of sedative drug used in a 12 h period. DESIGN: Prospective randomized controlled ... Full text Link to item Cite

Relation between aspirin dose, all-cause mortality, and bleeding in patients with recent cerebrovascular or coronary ischemic events (from the BRAVO Trial).

Journal article Am J Cardiol · November 15, 2008 Featured Work Despite aspirin's established role in the treatment of atherosclerotic vascular disease, considerable controversy exists regarding its most effective dosing strategy. In a retrospective observational study, we examined the relation between prescribed aspir ... Full text Link to item Cite

The value of CT angiography and transcranial doppler sonography in triaging suspected cerebral vasospasm in SAH prior to endovascular therapy.

Journal article Neurocrit Care · 2008 Featured Work BACKGROUND: Transcranial Doppler sonography (TCD) is a noninvasive method for detecting arterial cerebral vasospasm (CVS) in aneurysmal subarachnoid hemorrhage (SAH). Computed tomographic angiography (CTA) has been increasingly used for CVS diagnosis. The ... Full text Link to item Cite

Use of high frequency oscillatory ventilation (HFOV) in neurocritical care patients.

Journal article Neurocrit Care · 2007 Featured Work INTRODUCTION: Adult respiratory distress syndrome (ARDS) can be a common problem associated with the treatment of acute brain injury. High frequency oscillatory ventilation (HFOV) is a developing therapy for the treatment of ARDS in adult patients that can ... Full text Link to item Cite

The limited reliability of the Ramsay scale.

Journal article Neurocrit Care · 2007 Featured Work INTRODUCTION: The Ramsay scale which is internationally one of the most frequently cited sedation assessment tools has not had adequate psychometric evaluation. The objective of this study was to test the inter-rater reliability of the Ramsay scale. METHOD ... Full text Link to item Cite

Changes in intracranial pressure associated with chest physiotherapy.

Journal article Neurocrit Care · 2007 Featured Work INTRODUCTION: Management of intracranial hypertension is pivotal in the care of brain-injured patients. SUMMARY OF CASE: We report the case of a patient with both a closed head injury and anoxic encephalopathy, who subsequently experienced episodes of refr ... Full text Link to item Cite

Risk of cerebral vasopasm after subarachnoid hemorrhage reduced by statin therapy: A multivariate analysis of an institutional experience.

Journal article J Neurosurg · November 2006 Featured Work OBJECT: Impairment of endothelial nitric oxide synthase (eNOS), endothelium-dependent relaxation, and cerebrovascular autoregulation all occur in vasospastic cerebral arteries following subarachnoid hemorrhage (SAH). The 3-hydroxy-3-methylglutaryl coenzyme ... Full text Link to item Cite

Toward solving the sedation-assessment conundrum: bi-spectral index monitoring and sedation interruption.

Journal article Crit Care Nurs Clin North Am · September 2005 Featured Work The sedation-assessment conundrum is defined by two diametrically opposed goals: to maintain an appropriate level of sedation, and to obtain a comprehensive neurologic examination that most accurately reflects the patient's neurologic status. A case presen ... Full text Link to item Cite

Simvastatin reduces vasospasm after aneurysmal subarachnoid hemorrhage: results of a pilot randomized clinical trial.

Journal article Stroke · September 2005 Featured Work BACKGROUND AND PURPOSE: Cerebral vasospasm remains a major source of morbidity after aneurysmal subarachnoid hemorrhage (SAH). We demonstrate that simvastatin reduces serum markers of brain injury and attenuates vasospasm after SAH. METHODS: Patients with ... Full text Link to item Cite

Intra-arterial thrombolytic therapy in peri-coronary angiography ischemic stroke.

Journal article Stroke · May 2005 Featured Work BACKGROUND: Intra-arterial thrombolysis (IAT) for peri-coronary angiography (CA) stroke may be safe and efficacious. However, IAT may increase the risk of intracranial hemorrhage (ICH). METHODS: A retrospective study was performed involving 3 university ho ... Full text Link to item Cite

Consciousness, coma, and caring for the brain-injured patient.

Journal article AACN Clin Issues · 2005 Featured Work In this article, a preliminary conceptual framework is presented for exploring nursing interventions and research aimed at improving care of the unconscious brain-injured patient during the early subacute phase of brain injury. The cue-response framework p ... Full text Link to item Cite

Systemic hemostasis with recombinant-activated factor VII followed by local thrombolysis with recombinant tissue plasminogen activator in intraventricular hemorrhage.

Journal article Neurocrit Care · 2005 Featured Work INTRODUCTION: A 51-year-old woman on warfarin thromboprophylaxis for transient ischemic attacks developed sudden onset nausea, vomiting, and decreased mental status, rapidly becoming comatose. Head computed tomography (CT) showed intracerebral hemorrhage, ... Full text Link to item Cite

Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome.

Journal article Am Heart J · September 2004 Featured Work BACKGROUND: Stroke is a rare but serious event that complicates the course of patients with acute coronary syndromes (ACS). The type, outcome, and risk factors of stroke occurring in stabilized patients with ACS have not been previously reported. METHODS: ... Full text Link to item Cite

A prospective, multicenter pilot study to evaluate the feasibility and safety of using the CoolGard System and Icy catheter following cardiac arrest.

Journal article Resuscitation · August 2004 Featured Work BACKGROUND: Cardiac arrest causes devastating neurological morbidity and mortality. Mild/moderate hypothermia is neuroprotective after global cerebral ischemia. More rapid controlled attainment of the target temperature may increase efficacy. METHODS: We a ... Full text Link to item Cite

Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease.

Journal article Circulation · July 29, 2003 Featured Work BACKGROUND: This is the primary report of the large-scale evaluation of lotrafiban, an orally administered IIb/IIIa receptor antagonist, a unique trial with respect to the platelet antagonist, protocol design, and inclusion of cerebrovascular disease in a ... Full text Link to item Cite

Effect of apolipoprotein E genotype on in-hospital mortality following intracerebral haemorrhage.

Journal article Acta Neurol Scand · February 2003 Featured Work OBJECTIVE: To determine the relationship between the apolipoprotein E (APOE) epsilon4 allele and in-hospital mortality from intracerebral haemorrhage (ICH). MATERIAL AND METHODS: Patients admitted to two acute stroke units with ICH were prospectively evalu ... Full text Link to item Cite

Nonocclusion and spontaneous recanalization rates in acute ischemic stroke: a review of cerebral angiography studies.

Journal article Arch Neurol · December 2002 Featured Work BACKGROUND: Spontaneous recanalization is an understudied phenomenon in stroke. It is often overestimated by nonocclusion rates. The heterogeneity of the causes and manifestations of stroke and of the studies assessing vascular patency has created difficul ... Full text Link to item Cite

De novo cerebral arteriovenous malformation: case report.

Journal article Neurosurgery · May 2002 Featured Work OBJECTIVE AND IMPORTANCE: Arteriovenous malformations (AVMs) are generally thought to have a congenital cause. This is the first report of an angiographically proven de novo cerebral AVM in an adult patient without previous vascular abnormality. CLINICAL P ... Full text Link to item Cite

Familial clustering of intracerebral hemorrhage: a prospective study in North Carolina.

Journal article Neuroepidemiology · 2002 Featured Work Few studies have assessed the frequency of familial clustering in intracerebral hemorrhage (ICH). Of 144 patients with ICH prospectively assessed, 14 (9.8%) had a positive family history of ICH (FH+). Four pedigrees had more than two affected family member ... Full text Link to item Cite

Feasibility and safety of moderate hypothermia after massive hemispheric infarction.

Journal article Stroke · September 2001 Featured Work BACKGROUND AND PURPOSE: Moderate hypothermia decreases ischemic damage in experimental stroke models. This multicenter study was performed to evaluate (1) the safety and feasibility of moderate hypothermia and (2) its potential to reduce intracranial hyper ... Full text Link to item Cite

Dose-finding, safety, and tolerability study of an oral platelet glycoprotein IIb/IIIa inhibitor, lotrafiban, in patients with coronary or cerebral atherosclerotic disease.

Journal article Circulation · August 15, 2000 Featured Work BACKGROUND: Antiplatelet therapy is the mainstay of the treatment and secondary prevention of cardiovascular and cerebrovascular ischemic events. We assessed the safety, tolerability, and pharmacodynamics of lotrafiban, an oral platelet glycoprotein IIb/II ... Full text Link to item Cite

Design of the blockade of the glycoprotein IIb/IIIa receptor to avoid vascular occlusion (BRAVO) trial.

Journal article Am Heart J · June 2000 Featured Work BACKGROUND: Platelets play a key role in the pathogenesis of atherosclerosis, thrombosis, and acute coronary and cerebrovascular syndromes. Inhibition of platelet function by acetylsalicylic acid (aspirin) has been shown to reduce the incidence atherothrom ... Full text Link to item Cite

Stroke in patients with acute coronary syndromes: incidence and outcomes in the platelet glycoprotein IIb/IIIa in unstable angina. Receptor suppression using integrilin therapy (PURSUIT) trial. The PURSUIT Investigators.

Journal article Circulation · May 11, 1999 Featured Work BACKGROUND: The incidence of stroke in patients with acute coronary syndromes has not been clearly defined because few trials in this patient population have been large enough to provide stable estimates of stroke rates. METHODS AND RESULTS: We studied the ... Full text Link to item Cite

Tissue plasminogen activator in a vertebral artery dissection.

Journal article Can J Neurol Sci · May 1997 Featured Work BACKGROUND: Spontaneous dissection of the vertebral artery is uncommon. METHOD: Case study. RESULTS: We report a 49-year-old woman who presented with the rapidly progressing basilar artery syndrome who was given an intravenous dose of tissue plasminogen ac ... Full text Link to item Cite

Endoglin gene polymorphism as a risk factor for sporadic intracerebral hemorrhage.

Journal article Ann Neurol · May 1997 Featured Work Intracerebral hemorrhage (ICH) is a common and serious type of stroke. Recent studies have shown that inherited factors that affect the development of the vessel wall can increase the risk of ICH. We studied endoglin as a candidate gene in patients with sp ... Full text Link to item Cite

Lipids and stroke: a paradox resolved.

Journal article Arch Neurol · April 1996 Featured Work BACKGROUND: Although dyslipidemia is a well established risk factor for coronary artery disease, its relationship to ischemic cerebrovascular disease has remained unclear, perhaps because of the heterogeneous nature of strokes. METHODS: In a case-control s ... Full text Link to item Cite

Cystatin C mutation in an elderly man with sporadic amyloid angiopathy and intracerebral hemorrhage.

Journal article Stroke · November 1995 Featured Work BACKGROUND: Cerebral amyloid angiopathy (CAA) with intracerebral hemorrhage (ICH) occurs both sporadically and as a result of mutations in either cystatin C or the amyloid precursor protein. ICH due to cystatin C mutations typically occurs in young people ... Full text Link to item Cite

ApoE genotype and survival from intracerebral haemorrhage.

Journal article Lancet · August 26, 1995 Featured Work Full text Link to item Cite

Risk of intracranial aneurysms in families with subarachnoid hemorrhage.

Journal article Can J Neurol Sci · May 1995 Featured Work BACKGROUND: Genetic factors may be important in the etiology of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) formation. Several studies have reported the familial occurrence of SAH and IA, although in most cases asymptomatic family members ... Full text Link to item Cite

A molecular genetic study of intracerebral hemorrhage.

Journal article Arch Neurol · October 1994 Featured Work BACKGROUND: Two forms of inherited intracerebral hemorrhage (ICH) are associated with an amyloid angiopathy caused by mutations in the genes for the amyloid precursor protein or cystatin C. The purpose of this study was to determine whether patients with s ... Full text Link to item Cite

The importance of family history in cerebrovascular disease.

Journal article Stroke · August 1994 Featured Work BACKGROUND AND PURPOSE: The role of genetics in cerebrovascular disease remains controversial. The purpose of this study was to assess the influence of family history on atherothrombotic infarction or transient ischemic attack. METHODS: Ninety patients wit ... Full text Link to item Cite

Restriction fragment length polymorphism of the apoprotein A-I-C-III gene cluster in control and stroke-prone white and black subjects: racial differences.

Journal article Stroke · June 1993 Featured Work Full text Link to item Cite

Ulcerated plaques in the aortic arch in patients with stroke.

Journal article N Engl J Med · July 9, 1992 Featured Work Full text Link to item Cite