Journal articleJ Telemed Telecare · February 2026
BackgroundEvolving stroke care demands careful screening of stroke patients to ensure the right care is administered to the right patients in a timely manner. Telestroke has been increasingly utilized to improve access to stroke specialists to make these a ...
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Journal articleJ Stroke Cerebrovasc Dis · December 2024
BACKGROUND: Oral anticoagulation (OAC) is a risk factor for intracerebral hemorrhage (ICH) which is an important source of disability and mortality. OAC-associated ICH (OAC-ICH) patients have worse outcomes as compared to ICH patients not on OAC, likely be ...
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Journal articleAm Heart J · March 2024
BACKGROUND: Despite guidelines and strong evidence supporting intravenous thrombolysis and endovascular thrombectomy for acute stroke, access to these interventions remains a challenge. The objective of the IMPROVE stroke care program was to accelerate acu ...
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Journal articleBMJ Neurol Open · 2022
BACKGROUND/PURPOSE: Cardiac arrest is a common cause of death and neurological injury; therapeutic cooling for neuroprotection is standard of care. Despite numerous and ongoing trials targeting a specified cooling temperature for a target duration, the con ...
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Journal articleNeurohospitalist · October 2021
BACKGROUND AND PURPOSE: Rates of emergency medical services (EMS) utilization for acute stroke remain low nationwide, despite the time-sensitive nature of the disease. Prior research suggests several demographic and social factors are associated with EMS u ...
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Journal articleExp Neurol · June 2020
BACKGROUND: S-Nitrosoglutathione (GSNO) is a nitric oxide donor that has been investigated for neuroprotective and neuro-recovery effect. We aimed to conduct a systematic review on the published literatures using GSNO in both pre-clinical and clinical stro ...
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Journal articleAm Heart J · April 2020
The AHA Guidelines recommend developing multi-tiered systems for the care of patients with acute stroke.1 An ideal stroke system of care should ensure that all patients receive the most efficient and timely care, regardless of how they first enter or acces ...
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Journal articleStroke · April 2020
Background and Purpose- EG-1962 is a sustained release formulation of nimodipine administered via external ventricular drain in patients with aneurysmal subarachnoid hemorrhage. A randomized, open-label, phase 1/2a, dose-escalation study provided impetus f ...
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Journal articleNeurocrit Care · February 2020
INTRODUCTION: Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists a ...
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Journal articleAnesthesiology · June 2019
BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ...
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Journal articleCirculation · January 8, 2019
BACKGROUND: Ischemic stroke has no approved treatments to enhance recovery. ALD-401 is an enriched population of aldehyde dehydrogenase-bright stem cells, capable of reducing neurological deficits in animal models. The primary objective of this trial was t ...
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Journal articleJ Clin Neurosci · August 2017
There is no published literature regarding sub-Saharan health-care providers' understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimiz ...
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Journal articleCrit Care Nurs Clin North Am · June 2016
The sedation-assessment conundrum is the struggle to balance the need for sedation against the need to awaken the patient and perform a neurologic examination. This article discusses the nuances of the sedation-assessment conundrum as well as approaches to ...
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Journal articleAust Crit Care · August 2014
BACKGROUND: Pharmacological sedation is a necessary tool in the management of critically ill, mechanically ventilated patients. The intensive care unit (ICU) sedation strategy is to use the least amount of medication to meet safety and comfort goals. Titra ...
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Journal articleLancet Neurol · May 2014
As increasing numbers of elderly people undergo cardiac surgery, neurologists are frequently called upon to assess patients with neurological complications from the procedure. Some complications mandate acute intervention, whereas others need longer term o ...
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Journal articleStroke · March 2014
BACKGROUND AND PURPOSE: Hemicraniectomy and Durotomy Upon Deterioration From Infarction-Related Swelling Trial (HeADDFIRST) was a randomized pilot study to obtain information necessary to design a Phase III trial to evaluate the benefit of surgical decompr ...
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Journal articleMed Princ Pract · 2014
OBJECTIVE: To report a case of a hyperdense posterior cerebral artery (PCA) sign in the setting of spontaneous vertebral artery dissection. CLINICAL PRESENTATION AND INTERVENTION: A 28-year-old, previously healthy female presented with rapidly progressive ...
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Journal articleMedical Principles and Practice · December 1, 2013
Objective: To report a case of a hyperdense posterior cerebral artery (PCA) sign in the setting of spontaneous vertebral artery dissection. Clinical Presentation and Intervention: A 28-year-old, previously healthy female presented with rapidly progressive ...
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Journal articleJ Neurosurg · October 2013
OBJECT: Cerebral artery vasospasm is a major cause of death and disability in patients recovering from subarachnoid hemorrhage (SAH). Although the exact cause of vasospasm is unknown, one body of research suggests that clearing blood products by CSF draina ...
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Journal articleCerebrovasc Dis · 2013
BACKGROUND: Intracerebral hemorrhage (ICH) causes 10-15% of primary strokes, with mortality related to hematoma volume. Blood pressure (BP) reduction may attenuate hematoma expansion. ACCELERATE (the Evaluation of Patients with Acute Hypertension and Intra ...
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Journal articleAnaesth Intensive Care · November 2012
Sedation for the mechanically-ventilated, brain-injured patient remains challenging. The purpose of this pilot study was to compare the cerebral physiologic effects of sedation with propofol versus dexmedetomidine in mechanically-ventilated, brain-injured ...
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Journal articleAnn Intern Med · September 18, 2012
BACKGROUND: Transitional care is a time-limited service to prevent discontinuous care and adverse outcomes, including rehospitalization. PURPOSE: To describe transitional care interventions and evidence of benefit or harm in patients hospitalized for acute ...
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Journal articleEvid Rep Technol Assess (Full Rep) · October 2011
OBJECTIVES: To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarcti ...
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Journal articleAnn Thorac Surg · June 2011
BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ...
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Journal articleNeurocrit Care · February 2011
BACKGROUND: We examine two accepted methods of managing cerebrospinal fluid (CSF) drainage in patients following subarachnoid hemorrhage (SAH). The first is intermittent CSF drainage when intracranial pressure (ICP) reaches a pre-defined threshold (monitor ...
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Journal articleNurs Crit Care · 2011
BACKGROUND: A primary focus of hospital treatment following admission for subarachnoid haemorrhage (SAH) is a prevention of cerebral artery vasospasm, which may result in ischaemic stroke. Intraventricular catheter (IVC) insertion to facilitate cerebral sp ...
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Journal articleNeurocrit Care · December 2010
BACKGROUND: Studies devoted to intensive glucose control suggested that the intensive insulin therapy (IIT) approach could effectively reduce complications associated with critical illness. A program of IIT with the goal of achieving a blood glucose of 80- ...
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Journal articleJ Stroke Cerebrovasc Dis · March 2010
A better prediction of the time course of symptomatic vasospasm (SVSP) might have a significant impact on the management and prevention of delayed neurologic ischemic deficit (DIND). We studied the influence of the treatment for ruptured aneurysm on SVSP t ...
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Journal articleJ Cardiopulm Rehabil Prev · 2010
PURPOSE: Obesity increases the risk of developing physical disability and pain. Persons with a body mass index (BMI) of 30 kg/m or more have an increased risk for osteoarthritis compared with those with a BMI between 25 and 29 kg/m. The purpose of this stu ...
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Journal articleAm J Crit Care · July 2009
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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 ...
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Journal articleJ Neuroimaging · April 2009
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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: ...
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Journal articleNeurocrit Care · 2009
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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 ...
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Journal articleAm J Cardiol · November 15, 2008
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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 ...
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Journal articleNeurocrit Care · 2008
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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 ...
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Journal articleNeurocrit Care · 2007
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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 ...
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Journal articleNeurocrit Care · 2007
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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 ...
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Journal articleNeurocrit Care · 2007
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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 ...
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Journal articleJ Neurosurg · November 2006
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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 ...
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Journal articleStroke · June 2006
BACKGROUND AND PURPOSE: Although statins reduce the risk of stroke in patients with coronary heart disease, possible differing effects of statins on stroke outcomes based on sex remain uncertain. We investigated the relationships between statin use and sex ...
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Journal articleObesity (Silver Spring) · February 2006
OBJECTIVE: The purpose of our retrospective database analysis was to describe and evaluate the outcomes of a weight loss intervention in a community medical wellness center. RESEARCH METHODS AND PROCEDURES: Four hundred eighteen overweight and obese adults ...
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Journal articleCrit Care Nurs Clin North Am · September 2005
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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 ...
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Journal articleStroke · September 2005
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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 ...
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Journal articleStroke · May 2005
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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 ...
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Journal articleAACN Clin Issues · 2005
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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 ...
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Journal articleNeurocrit Care · 2005
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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, ...
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Journal articleAm Heart J · September 2004
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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: ...
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Journal articleResuscitation · August 2004
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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 ...
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Journal articleCirculation · July 29, 2003
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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 ...
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Journal articleActa Neurol Scand · February 2003
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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 ...
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Journal articleArch Neurol · December 2002
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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 ...
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Journal articleNeurosurgery · May 2002
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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 ...
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Journal articleNeuroepidemiology · 2002
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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 ...
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Journal articleStroke · September 2001
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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 ...
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Journal articleCirculation · August 15, 2000
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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 ...
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Journal articleAm Heart J · June 2000
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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 ...
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Journal articleStroke · March 2000
BACKGROUND AND PURPOSE: Abciximab is a potent parenterally administered platelet glycoprotein IIb/IIIa antagonist. Because this agent has been shown to improve outcomes in coronary artery disease, there is interest to evaluate whether it could improve cere ...
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Journal articleCirculation · May 11, 1999
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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 ...
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Journal articleCan J Neurol Sci · May 1997
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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 ...
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Journal articleAnn Neurol · May 1997
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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 ...
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Journal articleArch Neurol · April 1996
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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 ...
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Journal articleStroke · November 1995
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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 ...
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Journal articleCan J Neurol Sci · May 1995
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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 ...
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Journal articleArch Neurol · October 1994
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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 ...
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Journal articleStroke · August 1994
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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 ...
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