A5021952496- Intracranial Aneurysms: Treatment and Complications
- Acute Ischemic Stroke Management
- Vascular Malformations Diagnosis and Treatment
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Stroke Rehabilitation and Recovery
- Neurosurgical Procedures and Complications
- Peripheral Artery Disease Management
- Meningioma and schwannoma management
- Cardiac, Anesthesia and Surgical Outcomes
- Moyamoya disease diagnosis and treatment
- Venous Thromboembolism Diagnosis and Management
- Radiation Dose and Imaging
- Cardiovascular Health and Disease Prevention
- Radiology practices and education
- Trigeminal Neuralgia and Treatments
- Intraoperative Neuromonitoring and Anesthetic Effects
- Neuroinflammation and Neurodegeneration Mechanisms
- Healthcare Quality and Management
- Aortic Disease and Treatment Approaches
- Cerebrospinal fluid and hydrocephalus
- COVID-19 and healthcare impacts
- Atrial Fibrillation Management and Outcomes
- Vascular Anomalies and Treatments
Penn State Milton S. Hershey Medical Center
2015-2024
Pennsylvania State University
2004-2024
Faculty of Public Health
2023
University Radiology
2023
Neurological Surgery
2005-2023
American Association of Neurological Surgeons
2012-2017
University of Illinois Chicago
2014-2017
Mount Sinai Hospital
2017
Mount Sinai Hospital
2017
Mount Sinai Hospital
2017
The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management patients with unruptured intracranial aneurysms.Writing group members used systematic literature reviews from January 1977 up June 2014. They also reviewed contemporary published guidelines, personal files, expert opinion summarize existing evidence, indicate gaps in current knowledge, when appropriate, formulated using standard American Heart Association criteria. guideline...
To use baseline computed tomographic (CT) angiography to analyze imaging and clinical end points in an Interventional Management of Stroke III cohort identify patients who would benefit from endovascular stroke therapy.The primary point was 90-day dichotomized modified Rankin Scale (mRS) score. Secondary were mRS score distribution 24-hour recanalization. Prespecified subgroup proximal occlusions (internal carotid, M1, or basilar arteries). Exploratory analyses subsets with any occlusion...
Background and Purpose— General anesthesia (GA) for endovascular therapy (EVT) of acute ischemic stroke may be associated with worse outcomes. Methods— The Interventional Management Stroke III trial randomized patients within 3 hours onset to intravenous tissue-type plasminogen activator±EVT. GA use 7 was recorded per protocol. Good outcome defined as 90-day modified Rankin Scale ≤2. A multivariable analysis adjusting dichotomized National Institutes Health (NIHSS; 8–19 versus ≥20), age,...
Two contrasting roles, one beneficial and the injurious, have been proposed for tumor necrosis factor (TNF) in pathogenesis of cerebral ischemia. Reported here are results obtained a standard model permanent focal cortical ischemia rats, which volume infarction is measured after occlusion middle artery. Administration neutralizing anti-rat TNF antibodies (PI14) into brain cortex significantly reduced ischemic damage (85% infarct as compared with preimmune-treated controls). Similar were...
Cerebral infarction (stroke) is a potentially disastrous complication of diabetes mellitus, principally because the extent cortical loss greater in diabetic patients than nondiabetic patients. The etiology this enhanced neurotoxicity poorly understood. We hypothesized that advanced glycation endproducts (AGEs), which have previously been implicated development other complications, might contribute to and brain damage during ischemic stroke. Using rat model focal cerebral ischemia, we show...
Ischemic stroke is a leading cause of death and disability worldwide. Much the long-term occurs in patients with Emergent Large Vessel Occlusion (ELVO). In fact, these patients, occlusion major intracerebral artery results large area brain injury often resulting
<h3>Objective:</h3> To investigate the temporal pattern and relevant associations of CSF inflammatory measures after intraventricular hemorrhage (IVH). <h3>Methods:</h3> We analyzed prospectively collected cell counts protein glucose levels from participants in Clot Lysis Evaluation Accelerated Resolution IVH phase III (CLEAR III) trial. Corrected leukocyte count index were calculated to adjust for leukocytes attributable circulating blood. Data chronologically plotted. (daily, mean, median,...
INTRODUCTION: Intracranial aneurysm location influences the risks of both rupture and treatment. Aneurysms at anterior (ACOM) posterior (PCOM) communicating arteries, as well in circulation have been associated with a higher risk rupture, while aneurysms treatment risks. METHODS: Data from NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD) intracranial registry were analyzed compared for 4,056 consecutive ruptured unruptured treatments 16 different centers, comparing...
Background and Purpose During a cerebral infarction, complex cascade of cytotoxic events ultimately determines the volume brain cell loss. The studies presented here demonstrate that aminoguanidine, an experimental therapeutic currently in clinical trials to prevent diabetic complications, is cerebroprotective focal infarction. Methods Adult Lewis rats (n=6 12 per group) were anesthetized with ketamine subjected infarction by tandem permanent occlusion right middle artery ipsilateral common...
Abstract OBJECTIVE: To compare endovascular versus surface methods for the induction and reversal of hypothermia during neurosurgery in a multicenter, prospective, randomized study. METHODS: Patients undergoing elective open craniotomy repair an unruptured cerebral aneurysm (n = 153) were randomly assigned (2:1) to undergo whole-body 33°C, either with cooling device placed inferior vena cava via femoral vein 92) or convective air blanket 61). Active rewarming was accomplished using same...
The purpose of this study is to analyze anterior communicating artery (AComA) aneurysm morphology and its relationship the limitations feasibility endovascular coil embolization.One hundred twenty-three patients were treated with embolization for AComA aneurysms. Aneurysm was classified into six categories according projection (anterior, posterior/superior, or inferior) neck size (< 4 mm >or= mm). following used: Class A1, less than mm; A2, more; B1, posterior (superior) B2, C1, inferior C2,...
Repeat stereotactic radiosurgery (SRS) for persistent cerebral arteriovenous malformation (AVM) has generally favorable patient outcomes. However, reporting studies are limited by small numbers and single-institution biases. The purpose of this study was to provide the combined experience multiple centers, in an effort fully define role repeat SRS patients with malformation.This multicenter, retrospective cohort included treated repeat, single-fraction between 1987 2022. Follow-up began at...
Although fever and infection have been implicated in the causation of delayed neurological deficits (DND) poor outcome after aneurysmal subarachnoid hemorrhage (SAH), relationship between these two often related events has not extensively studied. We reviewed through our retrospective database patients with SAH. Multivariate logistic regression was used to determine independent predictors DND outcome. A total 186 were analyzed. noted 76 (45%). Fever recorded 102 (55%); 87 (47%). patient one...
Introduction Management of unruptured brain arteriovenous malformations (AVMs) is controversial, and conducting clinical trials in this area has been a challenge. We sought to determine which, if any, patient/AVM characteristics were most likely influence clinicians’ decisions regarding management trial enrollment. Methods performed an online survey (Survey Monkey) members the American Association Neurological Surgeons (AANS) (n=4836) Society NeuroInterventional (SNIS) (n=512). Physicians...