A5077445734- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Peripheral Artery Disease Management
- Medical Imaging and Analysis
- Blind Source Separation Techniques
- Cardiac Imaging and Diagnostics
- Intracerebral and Subarachnoid Hemorrhage Research
- Intracranial Aneurysms: Treatment and Complications
- Clinical practice guidelines implementation
- Neurological Disease Mechanisms and Treatments
- Brain Tumor Detection and Classification
- Ethics in Clinical Research
- Multiple Sclerosis Research Studies
- Cerebral Venous Sinus Thrombosis
- Neurological and metabolic disorders
- Dermatological and COVID-19 studies
- Urban Arborization and Environmental Studies
- Biomedical Ethics and Regulation
- Neurological Disorders and Treatments
- Pharmacological Effects and Toxicity Studies
- Electrical and Bioimpedance Tomography
- Agricultural and Food Sciences
Universidade Federal de Santa Catarina
2015-2024
Brazilian Society of Computational and Applied Mathematics
2024
Emory University
2018-2023
Grady Memorial Hospital
2019-2023
Governador Celso Ramos Hospital
2022
Universidade Federal de Minas Gerais
2020
Emory and Henry College
2019
Hospital Moinhos de Vento
2018
Universidade São Judas Tadeu
2015
Hospital de Santa Maria
1996-1998
Background and Purpose- It is unclear which factors predict acute neurological deterioration in patients with large vessel occlusion mild symptoms. We aim to evaluate the frequency, timing, potential predictors of ≥4 National Institutes Health Stroke Scale (NIHSS) points medically managed presentation. Methods- Single-center retrospective study consecutive minor stroke (defined as NIHSS score ≤5 on presentation) from January 2014 December 2017. Primary outcome was during hospitalization....
We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients to study association between histological and etiology METHODS: Consecutive enrolled in Stroke Thromboembolism Registry Imaging Pathology (STRIP) were included this study. All underwent mechanical thrombectomy sent a central core lab for processing. Histological analysis was performed using martius scarlet blue (MSB) staining, quantification red blood cells (RBCs), white (WBCs), fibrin platelets...
Background and Purpose Interobserver reliability of the diagnosis transient ischemic attack (TIA) is low, TIA made by nonneurologists often erroneous. We sought to validate general practitioners (GPs) hospital emergency service physicians (emergency MDs). Methods A list 20 neurological symptoms was distributed GPs 22 neurologists who graded compatibility each symptom with diagnosis. At least two validated diagnoses for patients under their care or MDs. Results Compared neurologists,...
Introduction Technical improvements to enhance distal occlusion thrombectomy are desirable. We describe the blind catheter exchange technique and report pinning with small devices (‘mini-pinning’) for occlusions. Methods A retrospective review of a prospective database from January 2015 August 2018 was performed cases in which ‘blind exchange/mini-pinning’ (BEMP) techniques were used. The involves deployment 3 mm Trevo retriever followed by microcatheter removal advancement 3MAX aspiration...
Although aspiration and stent retriever thrombectomy perform similarly in proximal occlusions, no comparative series are available distal occlusions. We aimed to compare the 3 mm Trevo Retriever against 3MAX thromboaspiration catheter arterial occlusions.A single-center retrospective review of a prospectively maintained databank for patients treated with or as upfront approach occlusions (middle cerebral artery mid/distal M2/M3, anterior A1/A2/A3 posterior P1/P2) from January 2014 July 2018...
Background and Purpose- We aimed to determine the safety mortality after mechanical thrombectomy in patients taking vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). Methods- In a multicenter observational cohort study, we used multiple logistic regression analysis evaluate associations of symptomatic intracranial hemorrhage (sICH) with VKA DOAC prescription before as compared no anticoagulation. The primary outcomes were rate sICH all-cause at 90 days, incorporating...
Background and Purpose: The e-Stroke Suite software (Brainomix, Oxford, United Kingdom) is a tool designed for the automated quantification of Alberta Stroke Program Early CT Score ischemic core volumes on noncontrast computed tomography (NCCT). We sought to compare prediction postreperfusion infarct clinical outcomes across NCCT versus RAPID (IschemaView, Menlo Park, CA) perfusion measurements. Methods: All consecutive patients with anterior circulation large vessel occlusion stroke...
Background: Rapidly progressive dementia (RPD) is linked to several disorders. Reference centers for Creutzfeldt–Jakob disease have reported prion diseases as the most frequent cause of RPD. Alternatively, tertiary found high frequencies nonprion causing RPD, including a significant number potentially treatable This study aimed at describing etiologies RPD among inpatients from four in Florianópolis, Brazil. Methods: We reviewed medical records patients hospitalized 2001 2020 under codes...
Background and Purpose —The first medical contact of an acute stroke victim is often a nonneurologist. Validation diagnosis made by these doctors poorly known. The present study seeks to validate the diagnoses general practitioners (GPs) hospital emergency service physicians (ESPs). Methods —Validation through direct interview examination neurologist was performed for GPs in patients under their care working at departments 3 hospitals. Results GP confirmed 44 cases (85%); (6%) had transient...
Expediting notification of lesions in acute ischemic stroke (AIS) is critical. Limited availability experts to assess such and delays large vessel occlusion (LVO) recognition can negatively affect outcomes. Artificial intelligence (AI) may aid LVO treatment. This study aims evaluate the performance an AI-based algorithm for detection AIS.Retrospective analysis a database AIS patients admitted single center between 2014 2019. Vascular neurologists graded computed tomography angiographies...
Several animal studies have demonstrated that mechanical thrombectomy (MT) for acute ischemic stroke (AIS) may cause vessel wall injury (VWI). However, the histological changes in human cerebral arteries following MT are difficult to determine.To investigate occurrence of VWI during by and immunohistochemical evaluation AIS clots.As part multicenter STRIP registry, 277 clots from 237 patients were analyzed using Martius Scarlett Blue stain immunohistochemistry CD34 (endothelial cells) smooth...
Computed tomography perfusion (CTP) has played an important role in patient selection for mechanical thrombectomy (MT) acute ischemic stroke. We aimed to investigate the agreement between parametric maps of 3 software packages - RAPID (RapidAI-IschemaView), Viz CTP(Viz.ai), and e-CTP(Brainomix) estimating baseline core volumes near completely/completely reperfused patients.We retrospectively reviewed a prospectively maintained MT database identify patients with anterior circulation large...
Patients with large vessel occlusion stroke (LVOS) and a low Alberta Stroke Program Early CT Score (ASPECTS) are often not offered endovascular therapy (ET) as they thought to have poor prognosis.To compare the outcomes of patients high ASPECTS undergoing ET based on baseline infarct volumes.Review prospectively collected database at tertiary care center between September 2010 March 2020. All anterior circulation LVOS interpretable perfusion (CTP) were included. Subjects divided into groups...
Background Compositional and structural features of retrieved clots by thrombectomy can provide insight into improving the endovascular treatment ischemic stroke. Currently, histological analysis is limited to quantification compositions qualitative description clot structure. We hypothesized that heterogeneous would be prone poorer recanalization rates performed a quantitative test this hypothesis. Methods collected did histology on mechanical from 157 stroke cases (107 achieved first-pass...
Abstract Background Patients with epilepsy (PWE) frequently have comorbid psychiatric disorders, the most common of which are depression and anxiety. Attention deficit disorder hyperactivity (ADHD) is also more frequent among PWE, though that condition has been scarcely studied adult PWE population. Objective This study aimed to compare presence ADHD symptoms between general Methods was an observational case-control study. Ninety-five from a tertiary center in southern Brazil were compared...
Background Computed tomography perfusion (CTP) has been increasingly used for patient selection in mechanical thrombectomy stroke. However, previous studies suggested that CTP might overestimate the infarct size. The term ghost core (GIC) to describe an overestimation of final volumes by pre-treatment >10 ml. Aim We sought study frequency and predictors GIC. Methods A prospectively collected database at a comprehensive stroke center between September 2010 August 2020 was reviewed....
Background and purpose The optimal selection methodology for stroke thrombectomy beyond 6 hours remains to be established. Methods Review of a prospectively collected database patients with anterior circulation strokes, adequate CT perfusion (CTP) maps, National Institute Health Stroke Scale (NIHSS)≥10 presenting from January 2014 October 2018. Patients were categorised according five paradigms: DAWN clinical-core mismatch (DAWN-CCM): between age-adjusted NIHSS CTP core, DEFUSE 3 imaging...
Proper identification of infarct extent is crucial for thrombectomy and prognostication. We sought to study the frequency topographic aspects those cases in which CT perfusion (CTP) misses a core lesion that present on initial non-contrast (NCCT).A review was carried out prospectively collected database endovascular patients with anterior circulation large vessel occlusion strokes from January 2014 November 2018. Patients an e-ASPECTS <10 adequate CTP maps were included. Total missed...
Age, neurologic deficits, core volume (CV), and clinical or radiographic mismatch are considered in selection for endovascular therapy (ET) anterior circulation emergent large vessel occlusion (aELVO). Semiquantitative CV estimation by Alberta Stroke Programme Early CT Score (CT ASPECTS) quantitative perfusion (CTP) both used paradigms.To compare the prognostic value of CTP with ASPECTS aELVO.Patients an institutional registry who had aELVO, pre-ET National Institutes Health Scale (NIHSS)...
Age and infarct volume are among the most powerful predictors of outcome after large vessel occlusion acute strokes (LVOS).To study impact age-adjusted final (FIV) on functional outcomes.Review a prospectively collected thrombectomy database at tertiary care center between September 2010 February 2018. Consecutive patients with anterior circulation LVOS who achieved full reperfusion (modified Thrombolysis in Cerebral Infarction 3) were categorized into four age groups: (G1) <60 years, (G2)...
The pilot use of a smartphone platform for electronic informed consent (e-Consent) in large vessel occlusion acute stroke (LVOS) trials has recently been reported. degree satisfaction from Legal Authorized Representatives (LARs) with regard to this process remains be established.A single-center study evaluating the experience LARs e-Consent LVOS randomized trial an investigational drug administered within 12 hours last known normal was carried out. A structured survey used evaluate...
Mechanical thrombectomy (MT) for large vessel occlusion often requires multiple passes to retrieve the entire thrombus load. In this multi-institutional study we sought examine composition of fragments retrieved with each pass during MT.Patients who required were included. Histopathological evaluation from was performed using Martius Scarlet Blue staining and component including RBC, fibrin platelet determined image analysis software.154 patients underwent MT 868 which resulted in 263...
Intra-procedural characterization of stroke thromboemboli might guide mechanical thrombectomy (MT) device choice to improve recanalization rates. Electrochemical impedance spectroscopy (EIS) has been used characterize various biological tissues in real time but not thrombus. To perform a feasibility study EIS analysis thrombi retrieved by MT evaluate: (1) the ability and machine learning predict red blood cell (RBC) percentage content (2) classify as "RBC-rich" or "RBC-poor" based on range...
Background Pupils' abnormalities are associated to bad prognosis in traumatic brain injury. We investigated the association between side of pupil mydriasis and long‐term cognitive performance patients with severe injury ( TBI ). Methods analyzed admitted at intensive care unit isochoric pupils IP , n = 28), left LM 10), right RM 9) evaluated mean 2.5 years after controls 26) matched for age, sex education level. Results Patients had similar scores four WAIS ‐ III subtests. In comparison...