A5041498506- Acute Ischemic Stroke Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Neurosurgical Procedures and Complications
- Atrial Fibrillation Management and Outcomes
- Advanced Neuroimaging Techniques and Applications
- Advanced MRI Techniques and Applications
- Antiplatelet Therapy and Cardiovascular Diseases
- Bone and Joint Diseases
- MRI in cancer diagnosis
- Cerebral Venous Sinus Thrombosis
- COVID-19 and healthcare impacts
- Vascular Malformations Diagnosis and Treatment
- Aortic Disease and Treatment Approaches
- Neurological Disorders and Treatments
- NMR spectroscopy and applications
- Trauma and Emergency Care Studies
- Intracranial Aneurysms: Treatment and Complications
- Neurological and metabolic disorders
- Cardiac, Anesthesia and Surgical Outcomes
- Retinal and Optic Conditions
- Aortic aneurysm repair treatments
Centre Hospitalier de l’Université de Montréal
2012-2025
Université de Montréal
2016-2024
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
Health and Education Research Management and Epidemiologic Services (United States)
2023
University of British Columbia
2014-2023
University of Calgary
2014-2020
University of Alberta
2014-2020
Hôpital Notre-Dame
2012-2020
Women's College Hospital
2020
University Health Network
2020
The 2017 update of Canadian Stroke Best Practice Recommendations for the Secondary Prevention is a collection current evidence-based recommendations intended use by clinicians across wide range settings. goal to provide guidance prevention ischemic stroke recurrence through identification and management modifiable vascular risk factors. include those related diagnostic testing, diet lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet anticoagulant therapies, carotid...
Spontaneous intracerebral hemorrhage is a particularly devastating type of stroke with greater morbidity and mortality compared ischemic can account for half or more all deaths from stroke. The seventh update the Canadian Stroke Best Practice Recommendations includes new stand-alone module on hemorrhage, focus elements care that are unique affect persons disproportionately relative to Prior this edition, was included in Acute Management limited its management during first 12 h. With growing...
Diffusion-weighted imaging (DWI) of tissue water is a sensitive and specific indicator acute brain ischemia, where reductions the diffusion are observed acutely in stroke lesion core. Although these changes have been long attributed to cell swelling, precise nature biophysical mechanisms remains uncertain.The potential cause after was investigated using an advanced DWI technique, oscillating gradient spin-echo DWI, that enables much shorter times can improve specificity for alterations...
Early anticoagulation after cardioembolic stroke remains controversial because of the potential for hemorrhagic transformation (HT). We tested safety and feasibility initiating rivaroxaban ≤14 days stroke/transient ischemic attack.A prospective, open-label study patients with atrial fibrillation treated transient attack or (National Institute Health Stroke Scale <9). All underwent magnetic resonance imaging <24 hours initiation day 7. The primary end point was symptomatic HT at 7.Sixty...
Purpose To investigate gradient‐echo phase errors caused by intracranial hemorrhage (ICH) of low signal magnitude, and propose methods to reduce artifacts from in quantitative susceptibility mapping (QSM) ICH. Methods Two QSM are proposed: (1) mask‐inversion that masks the magnitude regions, (2) ICH magnetic dipole field isolation followed superposition using multiple boundaries for background removal. The reconstruction were tested eight subjects with standard single‐echo...
Purpose To follow the evolution of intracranial hemorrhage (ICH) by using quantitative susceptibility mapping (QSM). Materials and Methods Thirty-six patients with ICH confirmed at CT were enrolled to on day 2, 7, 30 after symptom onset between August 2013 April 2017. QSM was reconstructed from MRI gradient-echo phase images acquired 1.5 T or 3.0 T. regions manually drawn two-dimensional sections co-registered MR independently two raters. The areas mean values compared Bland-Altman plots...
Diffusion-weighted imaging (DWI) lesions have been identified both inside and outside the perihematoma region. We tested hypotheses that larger hematoma volumes blood pressure reduction are associated with DWI lesions.Hematoma edema were measured using planimetric techniques in 117 intracerebral hemorrhage (ICH) patients who underwent DWI. Perihematoma remote lesion apparent diffusion coefficient thresholds for moderate (<730×10(-6) mm/s) severe (<550×10(-6) ischemia. Acute change over first...
Background and Purpose- In patients with acute stroke caused by tandem occlusion, the benefit of immediate revascularization (stenting) cervical internal carotid artery lesion during endovascular thrombectomy is uncertain. We sought to determine current practice patterns whether consensus existed among physicians expertise. Methods- distributed an online survey experts affiliated Canadian Stroke Consortium, Interventional Neuro Group, Society Vascular Neurology, international ESCAPE trial...
<h3>Objective:</h3> To assess the natural history of prehospital blood pressure (BP) during emergency medical services (EMS) transport suspected stroke and determine whether BP differs among types patients with (ischemic stroke, TIA, intracerebral hemorrhage [ICH], or mimic). <h3>Methods:</h3> A retrospective, cross-sectional, observational analysis a centralized EMS database containing electronic records transported by to department (ED) an 18-month period was conducted. Hospital charts...
Introduction: Glial fibrillary acidic protein (GFAP), highly brain-specific, is emerging as an attractive blood biomarker in acute stroke. GFAP can discriminate stroke type (ischemic (IS), intracerebral hemorrhage (ICH), mimics (SM) the first hours after onset. Rapid levels using novel point-of-care technology (results <15 minutes) may also offer insights IS, particularly among those with unknown In this study, we aim to evaluate potential of rapid distinguish types undifferentiated...
Importance Diffusion-weighted imaging (DWI) lesions have been demonstrated in patients with subacute intracerebral hemorrhage (ICH), suggesting ischemic injury, which may be related to blood pressure (BP) reduction. Objective To test the hypothesis that acute intensive BP lowering is associated DWI after ICH. Design, Setting, and Participants The Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial 2 (ICHADAPT-2) was a multicenter, randomized, open-label, blinded–end point...
The pathogenesis of perihematoma edema in intracerebral hemorrhage (ICH) is unknown but has been hypothesized to be ischemic. In the ICH Acutely Decreasing Arterial Pressure Trial (ICH ADAPT), cerebral blood flow (CBF) was reduced unaffected by pressure (BP) reduction. Using ADAPT data, we tested hypotheses that growth associated with CBF and lower systolic BP.Noncontrast computed tomographic scans patients were obtained at baseline, 2 hours, 24 hours after randomization target BPs <150 or...
ABSTRACT: This is an observational cohort study comparing 156 patients evaluated for acute stroke between March 30 and May 31, 2020 at a comprehensive center with 138 during the corresponding time period in 2019. During pandemic, proportion of COVID-19 positive was low (3%), from symptom onset to hospital presentation significantly longer, smaller underwent reperfusion therapy. Among directly our institution, door-to-needle door-to-recanalization metrics were longer. Our findings support...
To determine the association between silent ischemic lesions (SILs) on baseline brain MRI and recurrent stroke in young adults with first-ever stroke.This was a single-center retrospective study of adult patients aged 18-50 years investigated by 2002 2009. Silent infarcts (SBIs) were defined as focal T2 hyperintensities ≥ 3 mm without corresponding symptoms, leukoaraiosis focal, multifocal, or confluent T2-weighted sequences. The primary outcome stroke. A forward stepwise Cox regression...
The Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial (ICH ADAPT) demonstrated blood pressure (BP) reduction does not affect mean perihematoma or hemispheric cerebral flow. Nonetheless, portions of the and borderzones may reach ischemic thresholds after BP reduction. We tested hypothesis that intracerebral hemorrhage results in increased critically hypoperfused tissue volumes.Patients with were randomized to a target systolic (SBP) <150 <180 mm Hg imaged computed...
Thrombolysis >4.5 hours after ischemic stroke onset is unproven. We assessed the feasibility of tenecteplase (TNK) treatment in patients with evidence an penumbra 4.5 to 24 onset.Acute underwent perfusion computed tomography (CT)/magnetic resonance imaging. Patients cerebral blood volume (CBV) or diffusion weighted imaging Alberta Stroke Program Early CT Scores (ASPECTS) >6 and mismatch score >2 (defined as ASPECTS regions delay on mean transit time maps normal CBV) were eligible for TNK...
Aggressively lowering blood pressure (BP) in acute intracerebral hemorrhage (ICH) may improve outcome. Although there is no evidence that BP reduction changes cerebral flow, retrospective magnetic resonance imaging (MRI) studies have demonstrated sub-acute ischemic lesions ICH patients. The primary aim of this study to assess lesion development patients randomized two different treatment strategies. We hypothesize aggressive not associated with injury after ICH. Intracerebral Hemorrhage...
KEY POINTS In 2016, 270 204 people in Canada (excluding Quebec) were admitted to hospital for heart conditions, stroke and vascular cognitive impairment, including 107 391 women 162 813 men, of whom 91 524 died.[1][1] This equates 1 out every 3 deaths outpaces other diseases