A5025115314- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Atrial Fibrillation Management and Outcomes
- Clinical practice guidelines implementation
- Advanced MRI Techniques and Applications
- Cerebral Venous Sinus Thrombosis
- Healthcare Systems and Practices
- Blood Coagulation and Thrombosis Mechanisms
- Cardiovascular Health and Disease Prevention
- Dysphagia Assessment and Management
- Cardiac Arrhythmias and Treatments
- Dementia and Cognitive Impairment Research
- Antiplatelet Therapy and Cardiovascular Diseases
- Spinal Fractures and Fixation Techniques
- Peripheral Artery Disease Management
- Migration, Health and Trauma
- Neurological Complications and Syndromes
- Advanced Neuroimaging Techniques and Applications
- Neurological Disorders and Treatments
- MRI in cancer diagnosis
University of Toronto
2016-2025
Toronto Western Hospital
2011-2025
University Health Network
2016-2025
University of Calgary
2004-2024
McMaster University
2018-2024
Hamilton Health Sciences
2018-2024
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
Krembil Research Institute
2024
Krembil Foundation
2024
Population Health Research Institute
2018-2024
Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment addition standard care acute ischemic small infarct core, intracranial arterial occlusion, and moderate-to-good collateral circulation.We randomly assigned participants receive (control group) plus use available thrombectomy devices (intervention group)....
The effect of endovascular thrombectomy that is performed more than 6 hours after the onset ischemic stroke uncertain. Patients with a clinical deficit disproportionately severe relative to infarct volume may benefit from late thrombectomy.
ContextIntravenous tissue-type plasminogen activator can be beneficial to some patients when given within 3 hours of stroke onset, but many present later after onset and alternative treatments are needed.ObjectiveTo determine the clinical efficacy safety intra-arterial (IA) recombinant prourokinase (r-proUK) in with acute less than 6 hours' duration caused by middle cerebral artery (MCA) occlusion.DesignPROACT II (Prolyse Acute Cerebral Thromboembolism II), a randomized, controlled,...
Carotid-artery stenting and carotid endarterectomy are both options for treating carotid-artery stenosis, an important cause of stroke.
Endovascular therapy is increasingly used after the administration of intravenous tissue plasminogen activator (t-PA) for patients with moderate-to-severe acute ischemic stroke, but whether a combined approach more effective than t-PA alone uncertain.
Analysis of early deaths after stroke is important, since some may be preventable. Previous studies have relied on retrospective and often incomplete clinical data, for comparison with pathological findings. The present study based 1073 consecutive patients admitted to an intensive care unit from a well-defined population. There were 212 within the first 30 days, yielding mortality rate 20%. Clinical, radiological, laboratory data collected prospectively according standardized protocol....
Government legislators and research ethics boards in some jurisdictions require all patients to give written informed consent before enrollment clinical registries. However, the effect of such a requirement on use registries extent which registry data can be generalized remain uncertain.We examined effectiveness comprehensive attempt obtain between June 2001 December 2002 overall participation rate characteristics participating Registry Canadian Stroke Network, prospective based at 20 major...
Warfarin is the most effective stroke prevention medication for high-risk individuals with atrial fibrillation, yet it often underused. This study examined magnitude of this problem in a large contemporary, prospective registry.We analyzed data from Registry Canadian Stroke Network, database consecutive patients admitted to 12 designated centers Ontario (2003 2007). We included an acute ischemic who (1) had known history fibrillation; (2) were classified as high risk systemic emboli...
Background: Conventional arterial imaging focuses on the vessel lumen but lacks specificity because different pathologies produce similar luminal defects. Wall can characterize extracranial pathology, intracranial walls has been limited by resolution and signal constraints. Higher-field scanners may improve visualization of these smaller vessels.
Background— Stroke is an important cause of death and disability in women as well men. However, little known about sex differences stroke care outcomes. Methods— The Registry the Canadian Network (RCSN) captured data on patients with seen at acute hospitals across Canada. We used from phase 1 (July 2001 to February 2002) 2 (June December RCSN compare presentation, management, 6-month outcomes men using multivariable regression techniques adjust for age other factors. Results— study sample...
Background and Purpose— Dysphagia occurs in 55% of all acute stroke patients. Early identification dysphagia from screening can lead to earlier treatments thereby reduce complications. We designed validated a new bedside tool—the Toronto Bedside Swallowing Screening Test (TOR-BSST) for survivors rehabilitative settings. Methods— The TOR-BSST initially contained 5 items with proven high predictive ability dysphagia. Trained screeners administer score the less than 10 minutes. nurses 2...
Background and Purpose— The safety of carotid artery stenting (CAS) endarterectomy (CEA) has varied by symptomatic status in previous trials. Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) data were analyzed to determine asymptomatic patients. Methods— CREST is a randomized trial comparing efficacy CAS versus CEA patients with high-grade stenoses. Patients defined as if they had relevant symptoms within 180 days randomization. primary end point was stroke, myocardial...
Background— The Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial used innovative imaging aggressive target time metrics to demonstrate the benefit of endovascular treatment in patients with acute ischemic stroke. We analyze impact on clinical outcome effect patient, hospital, health system characteristics workflow within trial. Methods Results— Relationship between (modified Rankin Scale) interval times was modeled by using logistic regression....
Background and Purpose— Value-based health care aims to bring together patients systems maximize the ratio of quality over cost. To enable assessment healthcare value in stroke management, an international standard set patient-centered outcome measures was defined for use a variety settings. Methods— A modified Delphi process implemented with expert panel representing patients, advocates, clinical specialists outcomes, registers, global health, epidemiology, rehabilitation reach consensus on...
We sought to characterize the subtypes of stroke associated with pregnancy and puerperium, emphasis on timing, etiology, risk factors, outcome.We conducted a retrospective analysis patients admitted Toronto Hospital between January 1, 1980, June 30, 1997, diagnosis during or within 6 weeks postpartum. Strokes were classified as ischemic (arterial venous) hemorrhagic (subarachnoid intracerebral). All investigated at least CT scan head, most had MRI and/or cerebral angiography.Of approximately...
Population-based, case-control and case-crossover study.To investigate associations between chiropractic visits vertebrobasilar artery (VBA) stroke to contrast this with primary care physician (PCP) VBA stroke.Chiropractic is popular for neck pain headache, but may increase the risk dissection stroke. Neck headache are common symptoms of dissection, which commonly precedes stroke.Cases included eligible incident strokes admitted Ontario hospitals from April 1, 1993 March 31, 2002. Four...
For the clinician, diagnosis of arterial ischemic stroke (AIS) in children is a challenge. Prompt pediatric AIS within 6 hours enables stroke-specific thrombolytic and neuroprotective strategies.We conducted retrospective study prospectively enrolled consecutive cohort with AIS, admitted to The Hospital for Sick Children, Toronto, from January 1992 December 2004. data on clinical presentation, symptom onset, emergency department arrival, neuroimaging were recorded. putative predictors...
Prospective differentiation between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis can be challenging. We hypothesized that high-resolution vessel wall MRI would demonstrate arterial enhancement in but not syndrome.We identified all patients with multifocal segmental narrowing of large intracranial arteries who had follow-up angiography at our institute over a 4-year period performed detailed chart review.Three lacked enhancement, these reversal within 3...