A5019948345- Traumatic Brain Injury and Neurovascular Disturbances
- Traumatic Brain Injury Research
- Cardiac Arrest and Resuscitation
- Acute Ischemic Stroke Management
- Intracranial Aneurysms: Treatment and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Epilepsy research and treatment
- Cerebrospinal fluid and hydrocephalus
- Neurosurgical Procedures and Complications
- Optical Imaging and Spectroscopy Techniques
- Cerebrovascular and Carotid Artery Diseases
- Heart Rate Variability and Autonomic Control
- EEG and Brain-Computer Interfaces
- Neuroscience and Neuropharmacology Research
- Thermal Regulation in Medicine
- Psychosomatic Disorders and Their Treatments
- Long-Term Effects of COVID-19
- Palliative Care and End-of-Life Issues
- Cardiovascular Syncope and Autonomic Disorders
- Intensive Care Unit Cognitive Disorders
- Pharmacological Effects and Toxicity Studies
- Vascular Malformations Diagnosis and Treatment
- Artificial Intelligence in Healthcare and Education
- Sepsis Diagnosis and Treatment
- Neuroscience, Education and Cognitive Function
Columbia University
2015-2025
New York Hospital Queens
2021-2025
NewYork–Presbyterian Hospital
2015-2025
Neurology, Inc
2025
Columbia University Irving Medical Center
2017-2024
Athinoula A. Martinos Center for Biomedical Imaging
2024
Harvard University
2024
Spaulding Rehabilitation Hospital
2024
Massachusetts General Hospital
2024
Presbyterian Hospital
2023
Brain activation in response to spoken motor commands can be detected by electroencephalography (EEG) clinically unresponsive patients. The prevalence and prognostic importance of a dissociation between commanded behavior brain the first few days after injury are not well understood.
Traumatic brain injury (TBI) results in persistent disruption of metabolism that has yet to be mechanistically defined. Early post-traumatic seizures are one potential mechanism for metabolic crisis and hence could a therapeutic target. We hypothesized pseudoperiodic discharges (PDs) may linked as measured by cerebral microdialysis.A prospective multicenter study surface intracortical depth electroencephalography (EEG) was performed conjunction with microdialysis cohort severe TBI patients...
Patients with brain injury who are unresponsive to commands may perform cognitive tasks that detected on functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). This phenomenon, known as motor dissociation, has not been systematically studied in a large cohort of persons disorders consciousness.
<h3>Importance</h3> Periodic discharges (PDs) that do not meet seizure criteria, also termed the<i>ictal interictal continuum</i>, are pervasive on electroencephalographic (EEG) recordings after acute brain injury. However, their association with homeostasis and the need for clinical intervention remain unknown. <h3>Objective</h3> To determine whether distinct PD patterns can be identified that, similar to electrographic seizures, cause tissue hypoxia, a measure of ongoing <h3>Design,...
Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. acute ischemic stroke safe feasible in pilot trials. We designed study protocol to provide safer, faster therapeutic patients.Safety procedures 4°C saline infusions cooling were added the ICTuS trial (Intravascular Cooling Treatment of Stroke) protocol. A femoral venous intravascular catheter intravenous recombinant tissue-type plasminogen activator...
Objective To create a multidimensional tool to prognosticate long‐term functional, cognitive, and quality of life outcomes after spontaneous subarachnoid hemorrhage (SAH) using data up 48 hours admission. Methods Data were prospectively collected for 1,619 consecutive patients enrolled in the SAH outcome project July 1996 March 2014. Linear models (LMs) applied identify factors associated with 1,526 complete data. Twelve‐month measured modified Rankin scale (mRS), Telephone Interview...
Objective Accurate behavioral assessments of consciousness carry tremendous significance in guiding management, but are extremely challenging acutely brain‐injured patients. We evaluated whether electroencephalography (EEG) and multimodality monitoring parameters may facilitate assessment patients with subarachnoid hemorrhage. Methods A retrospective analysis was performed 83 consecutively treated adults All were initially comatose had invasive brain placed. Behavioral during daily...
To test ketamine infusion efficacy in the treatment of super-refractory status epilepticus (SRSE), we studied patients with SRSE who were treated retrospectively. We also effect high doses on brain physiology as reflected by invasive multimodality monitoring (MMM).We a consecutive series 68 admitted between 2009 and 2018, ketamine, monitored scalp EEG. Eleven these underwent MMM at time administration. compared had seizure cessation after initiation to those did not.Mean age was 53 ± 18...
Recognition of potential for neurological recovery in patients who remain comatose after cardiac arrest is challenging and strains clinical decision making. Here, we utilize an approach that based on physiological principles underlying consciousness show correlation with acute anoxic brain injury.A cohort study 54 admitted to Intensive Care Unit underwent standardized bedside behavioral testing (Coma Recovery Scale - Revised [CRS-R]) during EEG monitoring. Blinded all variables,...
To evaluate whether delayed appearance of intraventricular hemorrhage (dIVH) represents an independent entity from (IVH) present on admission CT or is primarily related to the time interval between symptom onset and CT.A total 282 spontaneous intracerebral (ICH) patients, admitted February 2009-March 2014 neurological intensive care unit a tertiary university hospital, were prospectively enrolled in ICH Outcomes Project. Multivariate logistic regression was used determine associations with...
Background: Targeting a cerebral perfusion pressure optimal for autoregulation (CPPopt) has been gaining more attention to prevent secondary damage after acute neurological injury. Brain tissue oxygenation (PbtO 2 ) can identify insufficient blood flow and brain Defining the relationship between CPPopt PbtO aneurysmal subarachnoid hemorrhage may result in (1) mechanistic insights into whether how CPPopt-based strategies might be beneficial (2) establishing support use of as an adjunctive...
Abstract In unconscious appearing patients with acute brain injury, wilful activation to motor commands without behavioural signs of command following, known as cognitive dissociation (CMD), is associated functional recovery. CMD can be detected by applying machine learning EEG recorded during presentation in behaviourally unresponsive patients. Identifying carries clinical implications for patient interactions, communication families, and guidance therapeutic decisions but underlying...
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage negatively impacts long-term recovery but is often detected too late to prevent damage. We aim develop hourly risk scores using routinely collected clinical data detect DCI.A DCI classification model was trained vital sign measurements (heart rate, blood pressure, respiratory and oxygen saturation) demographics for care. Twenty-two time-varying physiological measures were computed including mean, SD, cross-correlation...
Objective The purpose of this study was to estimate the time recovery command‐following and associations between hypoxemia with command‐following. Methods In multicenter, retrospective, cohort during initial surge United Statesʼ pandemic (March–July 2020) we from intubation command‐following, using Kaplan Meier cumulative‐incidence curves Cox proportional hazard models. Patients were included if they admitted 1 3 hospitals because severe coronavirus disease 2019 (COVID‐19), required...
Background and Purpose— Symptomatic vasospasm is a common cause of morbidity mortality after subarachnoid hemorrhage. We sought to identify predictors the long-term impact treatment failure with hypertensive therapy for symptomatic vasospasm. Methods— performed retrospective analysis 1520 hemorrhage patients prospectively enrolled in Columbia University SAH Outcomes Project between August 1996 2012. One hundred ninety-eight were treated vasopressors raise arterial blood pressure, without...
OBJECTIVES: Low hemoglobin concentration impairs clinical hemostasis across several diseases. It is unclear whether impacts laboratory functional coagulation assessments. We evaluated the relationship of on viscoelastic hemostatic assays in intracerebral hemorrhage (ICH) and perioperative patients admitted to an ICU. DESIGN: Observational cohort study separate vitro study. SETTING: Multicenter tertiary referral ICUs. PATIENTS: Two acute ICH cohorts receiving distinct testing modalities:...