A5046286943- Blood Coagulation and Thrombosis Mechanisms
- Moyamoya disease diagnosis and treatment
- Acute Ischemic Stroke Management
- Vasculitis and related conditions
- Cerebrovascular and Carotid Artery Diseases
- Psychosomatic Disorders and Their Treatments
- Intracranial Aneurysms: Treatment and Complications
- Cerebral Venous Sinus Thrombosis
- Neurological Complications and Syndromes
- Renal and Vascular Pathologies
- Traumatic Brain Injury and Neurovascular Disturbances
- Otitis Media and Relapsing Polychondritis
- Atherosclerosis and Cardiovascular Diseases
- Venous Thromboembolism Diagnosis and Management
- Cardiovascular Issues in Pregnancy
- Coronary Artery Anomalies
- Stress Responses and Cortisol
- Infectious Encephalopathies and Encephalitis
- Neonatal and fetal brain pathology
- Congenital Heart Disease Studies
- Infant Development and Preterm Care
- Pregnancy and preeclampsia studies
- Herpesvirus Infections and Treatments
- Virology and Viral Diseases
- Inflammasome and immune disorders
HeartMath Institute
2020-2024
Vanderbilt University Medical Center
2020
Stanford University
2015-2019
Lucile Packard Children's Hospital
2014-2018
Toronto Western Hospital
2018
Stanford Medicine
2017
Hospital for Sick Children
2008-2016
University of California, San Francisco
2015-2016
Palo Alto University
2016
Stanford Health Care
2014-2016
The purpose of this study was to review the experience with herpes simplex encephalitis at Hospital for Sick Children over past 12 years.All patients who were admitted our institution acute between January 1994 and December 2005 enrolled prospectively in an registry. from registry included study; we detailed clinical presentations, laboratory findings, electroencephalographic diagnostic imaging treatments, outcomes all cases.Of 322 cases encephalitis, 5% caused by virus. Initially negative...
Background and Purpose— Published cohorts of children with arterial ischemic stroke (AIS) in the 1990s to early 2000s reported 5-year cumulative recurrence rates approaching 20%. Since then, utilization antithrombotic agents for secondary prevention has increased. We sought determine predictors recurrent current era. Methods— The Vascular Effects Infection Pediatric Stroke (VIPS) study enrolled 355 AIS at 37 international centers from 2009 2014 followed them prospectively stroke. Index...
Background and Purpose— Although arteriopathies are the most common cause of childhood arterial ischemic stroke, strongest predictor recurrent they difficult to diagnose. We studied role clinical data follow-up imaging in diagnosing cerebral cervical arteriopathy children with stroke. Methods— Vascular effects infection pediatric an international prospective study, enrolled 355 cases stroke (age, 29 days 18 years) at 39 centers. A neuroradiologist neurologist independently reviewed vascular...
Background and Purpose— In adult stroke, the advent of thrombolytic therapy led to development primary stroke centers capable diagnose treat patients with acute rapidly. We describe pediatric through preparation participating in Thrombolysis Pediatric Stroke (TIPS) trial. Methods— collected data from 17 enrolling TIPS regarding process becoming an center capability diagnose, evaluate, rapidly, including use therapy. Results— Before 2004, <25% sites had continuous 24-hour availability...
Minor infection can trigger adult arterial ischemic stroke (AIS) and is common in childhood. We tested the hypotheses that transiently increases risk of AIS children, regardless subtype, while vaccination against protective.The Vascular Effects Infection Pediatric Stroke study an international case-control prospectively enrolled 355 centrally confirmed cases (29 days-18 years old) 354 stroke-free controls. To determine prior exposure to infections vaccines, we conducted parental interviews...
This study aimed to describe children with moyamoya disease from an international multicenter stroke database, and explore risk factors for recurrence. We reviewed data of >28-days old enrolled in the International Pediatric Stroke Study January 2003 March 2013. A total 174 32 sites 14 countries had disease; median age 7.4 years, 49% male. Of these, 90% presented ischemic stroke, 7.5% transient attack, 2.5% hemorrhagic stroke. One-third patients syndrome. recurrence was 20% over follow-up...
Abstract Objective:: Primary angiitis of the central nervous system in childhood (cPACNS) is an immune‐mediated inflammatory process directed toward blood vessels system. It has been associated with variable clinical and radiological presentations, devastating consequences without treatment. Brain biopsy required for definitive diagnosis. The objective this study was to characterize histopathological features brain biopsies small‐vessel cPACNS (SVcPACNS). Methods:: A single‐center...
Neonatal stroke is increasingly recognized, and risk factors have been identified. The placenta has implicated as a potential contributor to neonatal stroke; however, pathology not previously described. This case series systematically evaluates prenatal, maternal, describes placental in 12 cases of stroke.We reviewed the Canadian Pediatric Ischemic Stroke Registry from 1992 2006, which consists 186 patients. Twelve patients with symptomatic cerebral arterial ischemic or sinovenous thrombosis...
This population-based study assesses the long-term impact of childhood stroke on function and independence in young adults. We undertook a cross-sectional outcome patients with arterial ischemic cerebral sinovenous thrombosis, beyond 18 years age. studied 26 patients; 21 stroke, 5 16 females. Mean age at assessment was 21.5 years, mean follow-up time 10.8 years. According to modified Rankin Scale, final outcomes were 37% normal, 42% mild, 8% moderate, 15% severe deficits. Risk factors for...
Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers toxic physiology; biological, behavioral, or cognitive treatments specifically focused on normalizing processes; and agreed-upon guidelines for treating the clinic evaluating efficacy interventions that seek to reduce improve human functioning. We address these critical issues by (a) systematically describing systems...
Background and Purpose— Among children with arterial ischemic stroke (AIS), those arteriopathy have the highest recurrence risk. We hypothesized that progression is an inflammatory process biomarkers would predict recurrent AIS. Methods— In international study of childhood AIS, we selected cases classified into 1 3 most common AIS causes: definite arteriopathic (n=103), cardioembolic (n=55), or idiopathic (n=78). measured serum concentrations high-sensitivity C-reactive protein, amyloid A,...
Arteriopathy is common in childhood arterial ischemic stroke (AIS) and predicts recurrence. Currently available vascular imaging techniques mainly image the lumen rather than vessel wall have a limited ability to differentiate among arteriopathies. We aimed investigate value of magnetic resonance imaging-based technique, namely noninvasive (AWI), for distinguishing arteriopathy subtypes consecutive cohort children presenting with AIS.Children confirmed AIS angiography underwent 3-Tesla AWI...
Background and Purpose: To assess whether initial imaging characteristics independently predict 1-year neurological outcomes in childhood arterial ischemic stroke patients. Methods: We used prospectively collected demographic clinical data, from the VIPS study (Vascular Effects of Infection Pediatric Stroke). In 288 patients with first-time stroke, we measured infarct volume location on acute magnetic resonance studies hemorrhagic transformation brain during presentation. Neurological...
Background and Purpose— Arteriopathy is the leading cause of childhood arterial ischemic stroke. Mechanisms are poorly understood but may include inherent abnormalities structure. Extracranial dissection associated with connective tissue disorders in adult Focal cerebral arteriopathy a common syndrome where pathophysiology unknown intracranial or transient arteriopathy. We aimed to quantify tortuosity stroke, hypothesizing increased dissection. Methods— Children (1 month 18 years) stroke...
The ability to alter one's emotional responses is central overall well-being and effectively meeting the demands of life. In this article, we discuss perspective that self-regulate quality feeling emotion moment-to-moment experience influences our physiology reciprocal interactions between physiological, cognitive, systems. We outline bi-directional communication pathways heart brain, how neural activity in these affect processes cognitive function self-regulatory capacity. self-induced...
A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment PCA. The made excellent recovery no significant residual neurologic deficit.
To determine whether lower socioeconomic status (SES) is associated with worse 1-year neurologic outcomes and reduced access to rehabilitation services in children arterial ischemic stroke (AIS).From 2010 2014, the Vascular effects of Infection Pediatric Stroke (VIPS) observational study prospectively enrolled confirmed 355 (age 29 days-18 years) AIS at 37 international centers. SES markers measured via parental interview included annual household income (US dollars) time enrollment,...
We report the prevalence of children with multiple medical symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore association adverse childhood experiences (ACEs).We retrospectively reviewed 100 consecutive patients from an outpatient clinic. Patients were included if they ≥5 years old reported ≥4 that unexplained for ≥3-months. Symptom profiles across six functional domains recorded: (1) executive dysfunction, (2) sleep disturbances, (3) autonomic...