A5115600935- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Intracerebral and Subarachnoid Hemorrhage Research
- Venous Thromboembolism Diagnosis and Management
- Peripheral Artery Disease Management
- Cerebral Venous Sinus Thrombosis
- Trauma and Emergency Care Studies
- Neurosurgical Procedures and Complications
- Medical Imaging and Analysis
- Neurological Disorders and Treatments
- Cardiac Imaging and Diagnostics
- Neurological Disease Mechanisms and Treatments
- Climate Change and Health Impacts
- Advanced MRI Techniques and Applications
- Photoacoustic and Ultrasonic Imaging
- Artificial Intelligence in Healthcare and Education
- Musculoskeletal pain and rehabilitation
- Particle physics theoretical and experimental studies
- Ethics in Clinical Research
- Circadian rhythm and melatonin
- Dietary Effects on Health
- MRI in cancer diagnosis
- Intracranial Aneurysms: Treatment and Complications
University of California, Los Angeles
2017-2025
Ronald Reagan UCLA Medical Center
2021-2025
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
SUNY Downstate Health Sciences University
2022
State University of New York
2022
NYU Langone Health
2022
Bellevue Hospital Center
2022
Kings County Hospital Center
2022
UCLA Medical Center
2020-2022
Maimonides Medical Center
2022
Background and Purpose— Prehospital scales have been developed to identify patients with acute cerebral ischemia (ACI) because of large vessel occlusion (LVO) for direct routing Comprehensive Stroke Centers (CSCs), but few validated in the prehospital setting, their impact on intracranial hemorrhage has not delineated. The purpose this study was validate Los Angeles Motor Scale (LAMS) LVO CSC-appropriate (LVO ACI patients) recognition compare LAMS other scales. Methods— performance LAMS,...
Background and Purpose: A survival advantage among individuals with higher body mass index (BMI) has been observed for diverse acute illnesses, including stroke, termed the obesity paradox. However, prior ischemic stroke studies have generally tested only linear rather than nonlinear relations between outcome, few investigated poststroke functional outcomes in addition to mortality. Methods: We analyzed consecutive patients enrolled a 60-center treatment trial, NIH FAST-MAG trial. Outcomes...
ABSTRACT BACKGROUND AND PURPOSE The impact of blood‐brain barrier (BBB) disruption can be detected by intraparenchymal hyperdense lesion on the computed tomography (CT) scan after endovascular stroke therapy. purpose this study was to determine whether early BBB predicts intracranial hemorrhage and poor outcome in patients with acute ischemic treated mechanical thrombectomy. METHODS We analyzed anterior circulation thrombectomy identified noncontrast CT images immediately treatment....
Clot fragmentation and distal embolization during endovascular thrombectomy for acute ischemic stroke may produce emboli downstream of the target occlusion or in previously uninvolved territories. Susceptibility-weighted magnetic resonance imaging can identify both to territories (EDT) new (ENT) as susceptibility vessel signs (SVS). Diffusion-weighted (DWI) infarcts (INT).We studied consecutive patients undergoing before after thrombectomy. Frequency, predictors, outcomes EDT ENT detected on...
Abstract This research paper examines a cosmological model in flat space-time via $f(R,G)$ gravity where $R$ and $G$ are respectively the Ricci scalar Gauss-Bonnet invariant. Our assumes that is an exponential function of combined with linear combination $R$. We scrutinize observational limitations under power law cosmology relies on two parameters - $H_0$, Hubble constant, $q$, deceleration parameter, utilizing 57-point $H(z)$ data, 8-point BAO 1048-point Pantheon joint data + Pantheon,...
Background: A prehospital, paramedic-administered scale to distinguish intracerebral hemorrhage (ICH) from acute cerebral ischemia (ACI) could improve routing appropriate centers, enrich field randomized trials with targeted subtype patients, and potentially guide prehospital clinical treatment such as hyperacute blood pressure (BP) lowering. We aimed create a quickly administered prospectively performed assessments. Methods: Two scales were created NIH Field Administration of Stroke Therapy...
Background: Rapid blood pressure reduction and anticoagulant reversal have been associated with lower mortality improved outcomes in patients acute spontaneous ICH, prompting the establishment of time-based quality measures for ICH care, similar to those ischemic stroke. Multimodal systems care interventions need be developed validated that drive organizational change achieve these targets. Methods: We a multimodal intervention enhance attainment 3 process outcomes: 1) door-to-treatment...
Background: Recent studies have demonstrated time of day variations in ischemic stroke presentation and outcomes with findings that events occurring the evening hours tend to be more severe, progress faster, poorer outcomes. Much less is known about circadian/diurnal influences on intracerebral hemorrhage. Methods: We analyzed patient records a final diagnosis hemorrhage (ICH) from Field Administration Stroke Therapy - Magnesium (FAST-MAG) randomized trial database. Patients were grouped...
Preclinical studies have found marked diurnal/circadian variation in the effect of neuroprotective agents acute ischemic stroke. However, presence diurnal treatment outcomes after therapy has not been analyzed human clinical trials and thrombolytic under-studied. We patients with cerebral ischemia enrolled Field Administration Stroke Therapy - Magnesium (FAST-MAG) randomized trial magnesium sulfate started ambulance within two hours stroke onset (last known well time). Patients times during...
The Heads Up test, initially described in 2017, offers a potential tool for assessing candidacy mechanical thrombectomy (MT) patients with acute large vessel occlusion (LVO) but minimal neurological deficits. This study aims to examine the practical applications and outcomes of test over nine years by analyzing 15 consecutive cases documented testing. By clinical outcomes, interventions, demographic factors influencing decision-making Up-positive cases. Our findings suggest that can provide...
Background and Purpose— The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, predictive validity of LAMS when performed by paramedics in field at multiple sites large diverse geographic region. Methods— analyzed early assessment outcome data prospectively gathered FAST-MAG trial (Field Administration Stroke Therapy–Magnesium phase 3) among patients with acute cerebrovascular disease...
Background and Purpose: We aimed to delineate the determinants of initial speed infarct progression association (SIP) with procedural functional outcomes. Methods: From a prospectively maintained stroke center registry, consecutive anterior circulation ischemic patients large artery occlusion, National Institutes Health Stroke Scale score ≥4, multimodal vessel, core, tissue-at-risk imaging within 24 hours onset were included. Initial SIP was calculated as core volume at first divided by time...
The purpose of this study was to develop and evaluate a scoring system for assessing reperfusion status based on arterial spin labeled (ASL) perfusion MRI in acute ischemic stroke (AIS) patients receiving thrombolysis and/or endovascular treatment. Pseudo-continuous ASL with background suppressed 3D GRASE acquired along DWI 90 within 24 h post-treatment. An automatic (auto-RPS) devised the Alberta Stroke Program Early CT Score (ASPECTS) template, compared manual RPS DWI-ASPECTS. TICI...
The TOAST (Trial of ORG 10172 in Acute Stroke Treatment) is the most commonly used ischemic stroke subtype classification system worldwide and a required field US National Get With Guidelines-Stroke (GWTG-Stroke) registry. However, diagnostics have advanced substantially since was designed 30 years ago, potentially making it difficult to apply reliably.
Novel methods are needed to reduce the disparity of Hispanic enrollment in stroke clinical trials. Prehospital using a dedicated Spanish language line may help overcome this bias.Subjects or legally authorized representatives provided information on race and ethnicity for all cases enrolled FAST-MAG trial (Field Administration Stroke Therapy-Magnesium), prehospital phase 3 randomized study intravenous magnesium neuroprotection. One 2 in-ambulance cell phones (in English Spanish) was used...
Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential and can accelerate processes.From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial adverse effects patients with ischemia large vessel occlusion using (1) automated (algorithmic) (2) expert-guided joint outcome table specification.For the full 7-category...
Abstract Background and Purpose In symptomatic intracranial atherosclerotic stenosis (ICAS), borderzone infarct pattern perfusion mismatch are associated with increased risk of recurrent strokes, which may reflect the shared underlying mechanism hypoperfusion distal to atherosclerosis. Accordingly, we hypothesized a correlation between volumes ICAS patterns based on respective mechanistic subtypes. Methods We conducted retrospective analysis consecutive cases, acute strokes due subocclusive...
Background and Purpose— Paramedic use of fixed-size lumen, gravity-controlled tubing to initiate intravenous infusions in the field may allow rapid start neuroprotective therapy for acute stroke. In a large, multicenter trial, we evaluated its efficacy attaining target serum levels candidate agent magnesium sulfate relation achieved outcome. Methods— The FAST-MAG phase 3 trial (Field Administration Stroke Therapy – Magnesium) randomized 1700 patients within 2 hours onset paramedic-initiated,...
Background and Purpose- The prehospital setting is a promising site for therapeutic intervention in stroke, but current stroke screening tools do not account the evolution of neurological symptoms this early period. We developed validated Paramedic Global Impression Change (PGIC) Scale large, prospective, randomized trial. Methods- In FAST-MAG (Field Administration Stroke Therapy-Magnesium) trial conducted from 2005 to 2013, EMS providers were asked complete PGIC (5-point Likert scale...
To emphasize treatment speed for time-sensitive conditions, emergency medicine has developed not only the concept of golden hour, but also platinum half-hour. Patients with acute stroke treated within first half-hour onset have been previously characterized.In this cohort study, we analyzed patients enrolled in FAST-MAG (Field Administration Stroke Therapy-Magnesium) trial, testing paramedic prehospital start neuroprotective agent ≤2 hours onset. The features all cerebral ischemia, and...