A5064330307- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Cerebrovascular and Carotid Artery Diseases
- Acute Ischemic Stroke Management
- Vascular Malformations Diagnosis and Treatment
- Intracerebral and Subarachnoid Hemorrhage Research
- Atrial Fibrillation Management and Outcomes
- Neurosurgical Procedures and Complications
- Stroke Rehabilitation and Recovery
- Cardiac, Anesthesia and Surgical Outcomes
- Takotsubo Cardiomyopathy and Associated Phenomena
- Cardiac Imaging and Diagnostics
- Moyamoya disease diagnosis and treatment
- Venous Thromboembolism Diagnosis and Management
- Cerebrospinal fluid and hydrocephalus
- Cardiac electrophysiology and arrhythmias
- Health Systems, Economic Evaluations, Quality of Life
- Neurological Disorders and Treatments
- Cerebral Venous Sinus Thrombosis
- Aortic aneurysm repair treatments
- Hemodynamic Monitoring and Therapy
- Innovations in Medical Education
- Advanced Neuroimaging Techniques and Applications
- Cardiovascular Health and Disease Prevention
- Intensive Care Unit Cognitive Disorders
TESLA (Czechia)
2024
University of Nebraska Medical Center
2017-2023
Nebraska Medical Center
2023
Newcastle University
2019
Stanford University
2019
University of Cincinnati
2019
University of Cincinnati Medical Center
2019
Johns Hopkins University
1985-2019
University of Kansas
2019
The University of Texas at San Antonio
2019
Nonrheumatic atrial fibrillation increases the risk of stroke, presumably from thromboemboli. There is uncertainty about efficacy and risks long-term warfarin therapy to prevent stroke.
Abstract An open angiography‐based, dose rate escalation study on the effect of intravenous infusion recombinant tissue plasminogen activator(rt‐PA) cerebral arterial recanalization in patients with acute focal ischemia was performed at 16 centers. Arterial occlusions consistent carotid or vertebrobasilar territory absence detectable intracerebal hemorrhage were prerequisites for treatment. After 60‐minute rt‐PA infusion, perfusion assesed by repeat angiography and computed tomography scans...
The objective of this study was to describe the recent epidemiology mortality from subarachnoid hemorrhage in United States.Subarachnoid is distinct other forms stroke its risk factors, demographics, and treatment. However, it often clustered with subtypes, obscuring unique epidemiology.We analyzed data National Center for Health Statistics States years 1979 1994 compared subtypes.Age-adjusted rates were 62% greater females than males 57% blacks whites. median age death 59 73 intracerebral...
IMPORTANCE Intracranial stenosis is one of the most common etiologies stroke.To our knowledge, no randomized clinical trials have compared balloon-expandable stent treatment with medical therapy in symptomatic intracranial arterial stenosis.OBJECTIVE To evaluate efficacy and safety plus vs alone patients (Ն70%). DESIGN, SETTING, AND PATIENTS VISSIT (the Vitesse Stent Study for IschemicStroke Therapy) trial an international, multicenter, 1:1 randomized, parallel group that enrolled from 27...
The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after have not been clearly established, and the need completely occlude aneurysms debated.The Cerebral Aneurysm Rerupture After Treatment (CARAT) study an ambidirectional cohort all patients with ruptured treated coil embolization or surgical clipping at 9 high-volume centers in United States from 1996 1998. All subjects were followed through 2005, potential reruptures adjudicated by a...
Subarachnoid hemorrhage (SAH) frequently results in myocardial necrosis with release of cardiac enzymes. Historically, this has been attributed to coronary artery disease, vasospasm, or oxygen supply-demand mismatch. Experimental evidence, however, indicates that excessive norepinephrine from the sympathetic nerves is most likely cause. We hypothesized after SAH a neurally mediated process dependent on severity neurological injury.Consecutive patients admitted were enrolled prospectively....
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered have substantial areas salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6–24 from (TLSW) better outcomes at three months compared treated with standard medical therapy alone. Age-adjusted is defined by age...
Unruptured cerebral aneurysms are commonly treated by surgical clipping, but endovascular coil embolization is increasingly employed as an alternative. In a blinded review of unruptured at our institution since 1990, we identified patients whose were judged to be treatable both neurosurgeons and neurointerventional radiologists. A change in Rankin Scale score 2 or more from hospital admission discharge, indicating new moderate disability worse, was predefined the primary outcome measure....
To compare complications of surgical clipping and coil embolization in the treatment unruptured aneurysms.Surgical has been preferred for cerebral aneurysms but endovascular is an increasingly employed alternative. No direct comparisons techniques are available to guide clinical decision making.We performed a cohort study patients treated at 60 university hospitals from January 1994 through June 1997 using University HealthSystem Consortium database. The database was validated by chart...
Background and Purpose —The impact of endovascular therapy on treatment outcomes unruptured cerebral aneurysms has not been studied in a defined geographic area. Methods —All primary diagnoses were retrieved from statewide database hospital discharges California January 1990 through December 1998. Admissions for initial all follow-up care combined to reflect the entire course therapy. An adverse outcome was as an in-hospital death or discharge nursing home rehabilitation at any point during...
“If you wish to converse with me,” said Voltaire, “define your terms.” How many a debate would have been deflated into paragraph if the disputants had dared define their terms! Will Durant: The Story of Philosophy
Background and Purpose — Studies of several complex medical conditions have shown that outcomes are better at hospitals treat more cases. We tested the hypothesis patients with subarachnoid hemorrhage treated high-volume outcomes. Methods Using a database all admissions to nonfederal in California from 1990 1999, we obtained discharge abstracts for primary diagnosis who were admitted through emergency department. Hospital volume, defined as average number cases each year, was divided into...
Subarachnoid hemorrhage (SAH) has been associated with cardiac injury and left ventricular (LV) dysfunction. The incidence natural history of neurocardiogenic after SAH remains poorly understood. objective this study was to describe the incidence, time course, recovery rate, segmental patterns LV dysfunction SAH.Echocardiography performed three times over a 7-day period in 173 patients SAH. global (ejection fraction [EF] < 50%) (any regional wall-motion abnormality [RWMA]) measured. course...
Background and Purpose— The formation certification of Primary Stroke Centers has progressed rapidly since the Brain Attack Coalition's original recommendations in 2000. purpose this article is to revise update our for reflect latest data experience. Methods— We conducted a literature review using MEDLINE PubMed from March 2000 January 2011. focused on studies that were relevant acute stroke diagnosis, treatment, care. Original references as well meta-analyses other care guidelines also...
Abstract BACKGROUND Minimally invasive surgery procedures, including stereotactic catheter aspiration and clearance of intracerebral hemorrhage (ICH) with recombinant tissue plasminogen activator hold a promise to improve outcome supratentorial brain hemorrhage, morbid disabling type stroke. A recently completed Phase III randomized trial showed improved mortality but was neutral on the primary (modified Rankin scale score 0 3 at 1 yr). OBJECTIVE To assess surgical performance its impact...
Background Mechanical thrombectomy has been shown to be effective in patients with acute ischemic stroke secondary large‐vessel occlusion and small moderate infarct volume. However, there are no randomized clinical trials for large‐core volume comparing mechanical medical therapy the population selected based solely on noncontrast computed tomography brain scan. The TESLA (Thrombectomy Emergent Salvage of Large Anterior Circulation Ischemic Stroke) trial is designed address this question....
Background and Purpose— Current guidelines recommend the use of head CT in evaluation patients with transient ischemic attack (TIA), but data supporting its value are sparse. Methods— Patients who presented to 1 16 emergency departments a large Northern California health maintenance organization received diagnosis TIA from November 1997 through February 1998 were enrolled followed up for 90 days. Clinical, demographic, outcome obtained computerized databases medical records. Physicians...
Background and Purpose —Vertebrobasilar territory ischemia (VBI) leads to disabling neurological symptoms poses a risk for stroke by an embolic or flow-related mechanism. We present our clinical experience in the endovascular treatment of patients with symptomatic VBI from severe atherosclerosis dissection vertebral subclavian arteries that was unresponsive medical therapy. Methods —Twenty-one (9 female, 12 male) mean age 65.7 years (range 47 81 years) underwent percutaneous balloon...
Many patients with an acute stroke live in areas without ready access to a Primary or Comprehensive Stroke Center. The formation of care facilities that meet the needs these might improve their and outcomes guide them emergency responders such centers within system care.The Brain Attack Coalition conducted electronic search English medical literature from January 2000 December 2012 identify elements processes shown be beneficial for care. We used evidence grading consensus paradigms...
Objective: To determine which unruptured cerebral aneurysms should be treated considering the risks, benefits, and costs. Background: Asymptomatic are commonly by surgical clipping or endovascular coil embolization to prevent subarachnoid hemorrhage (SAH). Methods: We performed a cost–utility analysis comparing with no treatment for aneurysms. Eight clinical scenarios were defined based on aneurysm size, symptoms, history of SAH from different aneurysm. Health outcomes hypothetical cohort...