A5021195319- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Radiomics and Machine Learning in Medical Imaging
- Advanced MRI Techniques and Applications
- Cardiac Arrest and Resuscitation
- Intracerebral and Subarachnoid Hemorrhage Research
- S100 Proteins and Annexins
- Facial Trauma and Fracture Management
- Thermal Regulation in Medicine
- Cardiac, Anesthesia and Surgical Outcomes
- Lipoproteins and Cardiovascular Health
- Congenital Heart Disease Studies
- Peripheral Artery Disease Management
- Cerebral Venous Sinus Thrombosis
- Blood properties and coagulation
- Intraoperative Neuromonitoring and Anesthetic Effects
- Brain Tumor Detection and Classification
- Emergency and Acute Care Studies
- Ophthalmology and Eye Disorders
- Neurosurgical Procedures and Complications
- Medical Imaging and Analysis
- Advanced Proteomics Techniques and Applications
University of Manitoba
2017-2025
Health and Education Research Management and Epidemiologic Services (United States)
2023
Island Health
2017-2018
University of Calgary
2015-2017
Chosun University
2017
Vall d'Hebron Hospital Universitari
2017
Western University
2017
Dalhousie University
2017
Lawson Health Research Institute
2017
King Abdulaziz University
2017
<h3>Importance</h3> Recanalization of intracranial thrombus is associated with improved clinical outcome in patients acute ischemic stroke. The association intravenous alteplase treatment and characteristics recanalization over time important for stroke triage future trial design. <h3>Objective</h3> To examine across a range occlusion sites imaging treated or not alteplase. <h3>Design, Setting, Participants</h3> Multicenter prospective cohort study 575 from 12 centers (in Canada, Spain,...
<h3>BACKGROUND AND PURPOSE:</h3> Carotid webs may cause recurrent ischemic stroke. We describe the prevalence, demographics, clinical presentation, imaging features, histopathology, and stroke risk associated with this under-recognized lesion. <h3>MATERIALS METHODS:</h3> A carotid web was defined on CTA as a thin intraluminal filling defect along posterior wall of bulb just beyond bifurcation oblique sagittal section that seen septum axial CTA. Using prospective case series from April 2013...
BackgroundWhether the large effect size of endovascular thrombectomy (EVT) for stroke due to large-vessel occlusion applies medium-vessel is unclear.MethodsIn a multicenter, prospective, randomized, open-label trial with blinded outcome evaluation, we assigned patients acute ischemic who presented within 12 hours from time that they were last known be well and had favorable baseline noninvasive brain imaging receive EVT plus usual care or alone. The primary was modified Rankin scale score...
<h3>BACKGROUND AND PURPOSE:</h3> An ability to predict early reperfusion with IV tPA in patients acute ischemic stroke and intracranial clots can help clinicians decide if additional intra-arterial therapy is needed or not. We explored the association between novel clot characteristics on baseline CTA by using classification regression tree analysis. <h3>MATERIALS METHODS:</h3> Data are from proximal anterior circulation occlusions Calgary data base (2003–2012) Keimyung Stroke Registry...
Within different brain regions, we determine the comparative value of multiphase computed tomographic angiography (mCTA) and perfusion (CTP) in predicting follow-up infarction.Patients with M1-middle cerebral artery occlusions were prospectively included this multicenter study. Regional analysis was performed for each patient within Alberta Stroke Program Early CT Score regions M2 to M6. pial vessel filling assessed on mCTA 3 ways: (1) Washout contrast vessels; (2) Extent maximal enhancement...
To derive a plasma biomarker protein panel from list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke non-cerebrovascular (mimic) conditions in emergency department (ED) settings.Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 h following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS).Totally 545 participants suspected TIA enrolled the EDs two urban...
In the SPOTLIGHT trial (Spot Sign Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy), patients with a computed tomography (CT) angiography spot-sign positive acute intracerebral hemorrhage were randomized rFVIIa (recombinant activated factor VIIa; 80 μg/kg) or placebo within 6 hours onset, aiming limit hematoma expansion. Administration did not significantly reduce this prespecified analysis, we aimed investigate impact delays from baseline imaging study drug administration...
A diagnostic blood test for stroke is desirable but will likely require multiple proteins rather than a single "troponin." Validating large protein panels requires patient numbers. Mass spectrometry (MS) cost-effective tool this task. We compared differences in the abundance of 147 markers to distinguish 20 acute cerebrovascular syndrome (ACVS) patients who presented Emergency Department one urban hospital within < 24 h from onset) and control were enrolled via an outpatient neurology...
OBJECTIVE: To validate our previously developed 16 plasma-protein biomarker panel to differentiate between transient ischaemic attack (TIA) and non-cerebrovascular emergency department (ED) patients.METHOD: Two consecutive cohorts of ED patients prospectively enrolled at two urban medical centers into the second phase SpecTRA study (training, cohort 2A, n = 575; test, 2B, 528). Plasma samples were analyzed using liquid chromatography/multiple reaction monitoring-mass spectrometry. Logistic...
Introduction Severe traumatic brain injury (TBI) is a catastrophic neurological condition with significant economic burden. Early in-hospital mortality (<48 hours) severe TBI estimated at 50%. Several clinical examinations exist to determine death; however, most are difficult elicit in the acute setting patients TBI. Having definitive assessment tool would help predict early this population. CT perfusion (CTP) has shown promise diagnosing and other populations. The purpose of study...
ABSTRACT: Purpose: Endovascular thrombectomy (EVT) significantly improves outcomes for acute ischemic stroke patients with large vessel occlusion (LVO) who present in a time sensitive manner. Prolonged EVT access times may reduce benefits eligible patients. We evaluated the efficiency of services including rates, onset-to-CTA and onset-to-groin puncture our province. Materials methods: Three areas were defined: zone I- urban region, II-areas within 1 h drive distance from Comprehensive...
The effectiveness and safety of endovascular thrombectomy (EVT) for medium vessel occlusions (MeVO) in the anterior intracranial circulation patients with acute ischemic stroke (AIS) has yet to be definitively established. We compared outcomes undergoing EVT large occlusion (LVO) versus those MeVO.This retrospective cohort study, using an intention treat design, 90-day modified Rankin Scale (mRS) score between 43 MeVO 199 LVO circulation. Secondary outcome measures included recanalization...
Background In ischaemic stroke, minor deficits (National Institutes of Health Stroke Scale (NIHSS) ≤5) at presentation are common but often progress, leaving patients with significant disability. We compared the efficacy and safety intravenous thrombolysis tenecteplase versus alteplase in who had a stroke enrolled Alteplase Compared to Tenecteplase Patients With Acute Ischemic (AcT) trial. Methods The AcT trial included individuals aged >18 years, were eligible for standard-of-care...
Background Orbital infarction syndrome (OIS) is a rare entity defined as acute ischemia of intraorbital structures. Its occurrence requires interruption the rich collateral supply to orbit from both ophthalmic artery (OA) and branches external carotid artery. Three case reports have recently been published OIS occurring after endovascular thrombectomy (EVT). The goal this study was determine true incidence post‐EVT identify associated imaging findings on computed tomography angiography...
Abstract Purpose: We measured anterior cerebral artery (ACA)-middle (MCA) and posterior (PCA)-MCA pial filling on single-phase computed tomography angiograms (sCTAs) in acute ischemic stroke correlate with the CTA-based Massachusetts General Hospital (MGH) digital subtraction angiography (DSA)-based American Society of Interventional Therapeutic Neuroradiology (ASITN) score. Methods: Patients M1 MCA±intracranial internal carotid occlusion baseline CTA were included. Baseline sCTA was...
Background The relationship between duration of transient neurological events and presence diffusion-weighted lesions by symptom type is unclear. Methods Results This was a substudy SpecTRA (Spectrometry for Transient Ischemic Attack Rapid Assessment), multicenter prospective cohort patients with minor ischemic cerebrovascular or stroke mimics at academic emergency departments in Canada. For this study we included resolved symptoms determined the imaging (DWI) lesion on magnetic resonance...
ABSTRACT: Endovascular thrombectomy (EVT) has revolutionized the care of patients with acute ischemic stroke. The efficacy EVT is dependent on optimal setup a stroke system. Extrapolating results clinical trials to any individual center should be done caution. This more important for centers suboptimal systems care. Canadian registry helped highlight outcome post in Manitoba. could potentially optimized addition an unit near future. Our study will serve as baseline future improvement
Introduction: Decisions to transport patients from primary comprehensive stroke centre would be influenced by info on likelihood/timing of spontaneous or IV tPA recanalization (recan). We examined recan rates time for a wide range occlusion sites in the INTERRSeCT multicenter prospective cohort study. Methods: Acute consented/enrolled at 12 centers/5 countries if intracranial present baseline CTA; eGFR≥60 ml/min. CTA was repeated 2-6 hrs later unless patient taken EVT (first run angio used...
Background: Orbital infarction syndrome (OIS) is a rare entity defined as acute ischemia of intraorbital structures. Three case reports OIS post-endovascular thrombectomy (EVT) have recently been published, two demonstrating absent choroid blush (CB) on digital subtraction angiogram (DSA). Our goals are to determine the true incidence post-EVT and identify imaging findings (e.g. CB) that may alert neurologists potential cases. Methods: A retrospective cohort study including all EVT patients...
Restless leg syndrome (RLS) is a common neurological disorder which can affect individuals of all age groups and incidence increasing with age. It cause severe sleep disruption negatively impact quality life an individual. Its diagnosis clinical, based on essential criteria International RLS Study Group. be idiopathic or associated various medical other disorders. Idiopathic sporadic may have familial inheritance, several genetic loci been reported till date. has strong association periodic...
To evaluate the performance of a novel triage system for Transient Ischemic Attack (TIA) units built upon an existent clinical prediction rule (CPR) to reduce time unit arrival, relative symptom onset, true TIA and minor stroke patients. Differentiating between false TIA/minor cases (mimics) is necessary effective as medical intervention time-sensitive spots are finite resource. Prospective cohort study design utilizing patient referral data arrival times from regional fast-track on...
Background: Leptomeningeal collaterals preserve ischemic brain beyond an occluded artery until reperfusion is achieved. This systematic review and meta-analysis seeks to update current state of knowledge on the use collateral imaging as a prognostic patient selection tool in patients with acute stroke. Methods: We searched all published studies measuring status stroke its association clinical outcome using MEDLINE, EMBASE Cochrane Systematic Review database between Jan 1951- May 2014....
<h3>Background</h3> Patients with proximal arterial M2-segment of the Middle Cerebral Artery (M2-MCA) occlusions were largely excluded from endovascular stroke trials. Current American Stroke guidelines are conservative in recommending thrombectomy for such patients. We sought to assess natural history medically- treated M2-MCA occlusion <h3>Methods</h3> This is a prospective multi-central international cohort study all acute ischemic patients intracranial on baseline imaging. identified CT...
Background: Cerebral ischemia causes cellular injury, involving not only neurons, but also cells of the neurovascular unit. DWI provides sensitive detection cytotoxic injury during early stages stroke onset; however, measurement free-water with quantitative T2 (qT2) is generally overlooked, and may provide important additional information about tissue properties appreciated ADC alone. Therefore, better characterization ischemic required, particularly in context future clinical trials....