A5090947757- Cerebrovascular and Carotid Artery Diseases
- Intracranial Aneurysms: Treatment and Complications
- Acute Ischemic Stroke Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Spinal Fractures and Fixation Techniques
- Vascular Malformations Diagnosis and Treatment
- Reconstructive Surgery and Microvascular Techniques
- Traumatic Brain Injury Research
- Moyamoya disease diagnosis and treatment
- Venous Thromboembolism Diagnosis and Management
- Orthopedic Surgery and Rehabilitation
- Advanced Neuroimaging Techniques and Applications
- Atrial Fibrillation Management and Outcomes
- Cardiac Arrest and Resuscitation
- Intracerebral and Subarachnoid Hemorrhage Research
- Vagus Nerve Stimulation Research
- Stroke Rehabilitation and Recovery
- Cardiovascular Health and Disease Prevention
- Meningioma and schwannoma management
- Cerebrospinal fluid and hydrocephalus
- Head and Neck Cancer Studies
- Neurological Complications and Syndromes
- Vitamin C and Antioxidants Research
- Intraoperative Neuromonitoring and Anesthetic Effects
- Cervical and Thoracic Myelopathy
Virginia Commonwealth University
2015-2025
Children's Hospital of Richmond at VCU
2025
Virginia Commonwealth University Medical Center
2015-2021
Neurological Surgery
2005-2020
University Health System
2020
Hellenic Air Force
2019
Emory University
2019
Aristotle University of Thessaloniki
2019
Mayo Clinic
2019
Joint Base San Antonio
2018
Several inflammatory cytokines, most notably tumor necrosis factor (TNF) and IL-1, induce anorexia loss of lean body mass, common manifestations acute chronic conditions. In C57BL/6 female mice, the administration TNF, and, to a lesser extent, leukemia inhibitory (LIF), produced prompt dose-dependent increase in serum leptin levels mRNA expression fat. IL-10, IL-4, ciliary neurotrophic factor, IL-2, cytokines not known or decrease food intake, had no effect on gene levels. After Escherichia...
Background: Since the approval of oral factor Xa inhibitors, there have been concerns regarding ability to neutralize their anticoagulant effects after intracranial hemorrhage (ICH). Multiple guidelines suggest using prothrombin complex concentrates (PCCs) in these patients on basis research that includes a limited number with ICH. Given this, we aimed evaluate safety and efficacy PCCs for inhibitor–related ICH large, multicenter cohort patients. Methods: This was multicenter, retrospective,...
Care for US military personnel with combat-related concussive traumatic brain injury (TBI) has substantially changed in recent years, yet trends clinical outcomes remain largely unknown. Our prospective longitudinal studies of TBI from 2008-2013 at Landstuhl Regional Medical Center Germany and twp sites Afghanistan provided an opportunity to assess changes over time analyze correlates overall disability. We enrolled 321 active-duty who sustained theater 254 controls. prospectively assessed...
OBJECTIVE Inflammation contributes to morbidity following subarachnoid hemorrhage (SAH). The authors of this study evaluate how applying noninvasive transauricular vagus nerve stimulation (taVNS) can target deleterious inflammatory response SAH and reduce the rate radiographic vasospasm. METHODS In prospective, triple-blinded, randomized controlled trial, 27 patients were taVNS or sham stimulation. Serial blood CSF samples collected every 3 days quantify markers. Radiographic cerebral...
Object. The goal of this study was to identify the origins spontaneous fusiform middle cerebral artery (MCA) aneurysms. Methods. One hundred two cases MCA aneurysms were reviewed, including 40 from authors' institutions and 62 identified literature. mean age at symptom onset 38 years, male/female ratio 1.4:1. At presentation, lumen stenosed or occluded in 12 patients, focally dilated 57, appeared “serpentine” 33. Most lesions originated M 1 2 segments, most (80%) presented with...
Stent-assisted coil embolization using the new generation Neuroform Atlas Stent System has shown promising safety and efficacy. The primary study results of anterior circulation aneurysm cohort treatment wide-neck, saccular, intracranial, aneurysms with (ATLAS trial [Safety Effectiveness Treatment Wide Neck, Saccular Intracranial Aneurysms With System]) are presented.ATLAS IDE (Investigational Device Exemption) is a prospective, multicenter, single-arm, open-label wide-neck (neck ≥4 mm or...
Moyamoya disease is a disorder characterized by bilateral progressive steno-occlusion of the terminal internal carotid arteries with associated development fragile network basal collateral vessels. It most commonly presents in children, but also frequently seen adults, especially third or fourth decade life. Adults afflicted this have very different clinical characteristics as compared children. For example, adults more present hemorrhage than cerebral ischemia, while children ischemia...
High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such can be predicted acutely after is unknown. We performed a prospective, observational study personnel with (n = 38) and controls 34) enrolled between March September 2012. Importantly all subjects returned duty did not require evacuation. Subjects were evaluated 0–7 days at two sites Afghanistan again 6–12 months later United...
<h3>Objective:</h3> To evaluate whether diffusion tensor imaging (DTI) will noninvasively reveal white matter changes not present on conventional MRI in acute blast-related mild traumatic brain injury (mTBI) and to determine correlations with clinical measures recovery. <h3>Methods:</h3> Prospective observational study of 95 US military service members mTBI enrolled within 7 days from Afghanistan 101 healthy controls. Assessments included Rivermead Post-Concussion Symptoms Questionnaire...
Most cervical dissections are treated with anticoagulation or antiplatelet agents very good results; however, some patients may benefit from endovascular intervention. High and skull base often more challenging to treat because of the distal location tortuous anatomy. The Pipeline Embolization Device (PED) be a reasonable treatment option for this indication.To report case series PED high dissections, focusing on their presentation, indications treatment, dissection revascularization...
Abstract Background Inflammation contributes to morbidity following subarachnoid hemorrhage (SAH). Transauricular vagus nerve stimulation (taVNS) offers a noninvasive approach target the inflammatory response SAH. Methods In this prospective, triple-blinded, randomized, controlled trial, twenty-seven patients were randomized taVNS or sham stimulation. Blood and cerebrospinal fluid (CSF) collected quantify markers. Cerebral vasospasm severity functional outcomes (modified Rankin Scale, mRS)...
Medulloblastoma is the most common malignant central nervous system neoplasm found in children. A distinct variant designated large cell/anaplastic (LC/A) medulloblastoma characterized by frequent dissemination of cerebrospinal fluid (CSF) at presentation and a more aggressive clinical course. The authors report on their examination clinicopathological genetic features seven such cases encountered institution.Eighty medulloblastomas were reviewed (8.8%) these believed to fit histological...
Funding: The INSIGHT Registry is funded by Penumbra. Introduction: Thrombi have shown to modify and be modified their microenvironment throughout the pathogenesis of ischemic stroke. molecular mechanisms which this occurs how it corresponds symptomatic presentation unknown. Here, we identify a transcriptomic signature in thrombi associated with increased NIHSS severity at presentation, suggesting mechanistic role for immune clearance clinical Methods: registry prospective, multicenter,...
Funding: The INSIGHT Registry is funded by Penumbra. Introduction: Rapid and precise determination of the etiology acute ischemic stroke crucial in long-term management prevention recurrence. Identification etiology-associated molecular biomarkers following thrombectomy may allow for personalized intervention. Here, we examine transcriptomics cardioembolic thrombi as a result atrial fibrillation, identifying distinct transcriptomic signature relative to other causes stroke. Methods: registry...
The anatomy of the lateral arm flap is further elucidated, and surgical techniques involved in raising are described detail. data derived from studies 25 cadavers five clinical cases. relative merits this versatile free discussed. Three cases cited for illustration.
The authors conducted a prospective study to evaluate the clinical and radiological outcomes complications associated with uni- bilateral transforaminal lumbar interbody fusion (TLIF) performed using carbon fiber Brantigan I/F Cages pedicle screw fixation.Forty-two consecutive patients who had undergone or TLIF between February 1999 July 2000 were prospectively evaluated. Clinical outcome was graded modified Prolo Scale, McGill Pain Index follow-up questionnaire, charts. An independent...
Object This study was conducted to determine whether there is a change in intracranial arterial diameters after verapamil infusion for vasospasm and, if it present, the occurs proximal, intermediate, or distal vessels. Methods The authors measured all patients treated with intraarterial at their institutions between August 2003 and September 2004. In all, 18 treatments were examined 15 patients. Measurements made before blinded fashion aid of magnification loupe nine predetermined sites on...
Management of the patient with moderate to severe brain injury in any environment can be time consuming and resource intensive. In austere or hostile environment, challenges deliver care this population are magnified. These guidelines have been developed by acknowledging commonly recognized recommendations for neurosurgical neuro-critical patients augmenting those evaluations interventions based on experience neurosurgeons, trauma surgeons, intensivists who delivered during recent coalition...