A5080688035- Acute Ischemic Stroke Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Stroke Rehabilitation and Recovery
- Healthcare Systems and Practices
- Diversity and Career in Medicine
- Cerebrovascular and Carotid Artery Diseases
- Infective Endocarditis Diagnosis and Management
- Cardiac electrophysiology and arrhythmias
- Aortic Thrombus and Embolism
- Infectious Encephalopathies and Encephalitis
- Medical Education and Admissions
- Gastroesophageal reflux and treatments
- Cerebral Venous Sinus Thrombosis
- Dental Education, Practice, Research
- Prion Diseases and Protein Misfolding
- Cervical and Thoracic Myelopathy
- Vascular Malformations Diagnosis and Treatment
- Neurosurgical Procedures and Complications
- Emergency and Acute Care Studies
- Long-Term Effects of COVID-19
- Vascular Procedures and Complications
- Bacterial Infections and Vaccines
- Neurological Disease Mechanisms and Treatments
- Atrial Fibrillation Management and Outcomes
Yale University
2019-2025
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
Arcadia
2024
Yale Cancer Center
2023
Yale New Haven Hospital
2018
Columbia University
2009-2012
Neurological Surgery
2009-2012
Background: Anecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in code calls and treatments at 3 Connecticut local emergence of COVID-19 examine patient characteristics process measures a Comprehensive Stroke Center (CSC) before Methods: activity was analyzed from January 1 April 28, 2020, corresponding dates 2019. Piecewise linear regression spline models identified when codes...
Acute kidney injury occurs in 1% to 25% of critically ill patients with small increases creatinine adversely affecting outcome. We sought determine the burden acute aneurysmal subarachnoid hemorrhage and whether this dysfunction affects outcome.Between 1996 2008, 787 consecutive were enrolled our prospective database. Demographics, serum levels, discharge modified Rankin scores recorded, changes clearance calculated. A multiple logistic regression was performed using known predictors for...
Delivery of acute ischemic stroke (AIS) therapies is contingent on the duration from last known well (LKW) to emergency department arrival time (EDAT). One reason for treatment ineligibility delay in presentation hospital. We evaluate patient and neighborhood characteristics associated with LKW EDAT.
Introduction: Education, a key modifiable social determinant of health, plays significant role in shaping outcomes related to ischemic stroke. Higher educational attainment has been linked improved management risk factors and greater adherence medical treatments. However, the impact education on patients suffering from intracerebral hemorrhage (ICH) remains underexplored. Methods: We conducted post-hoc analysis Ethnic/Racial Variations Intracerebral Hemorrhage (ERICH) study examine good...
Introduction: Insurance status may serve as an indicator of social and financial barriers that impede access to quality care. Disparities in outcomes patients with ischemic stroke have been associated insurance coverage. However, there are few studies investigating the impact on intracerebral hemorrhage (ICH). Methods: We performed a post-hoc analysis Ethnic/Racial Variations Intracerebral Hemorrhage (ERICH) study investigate good functional outcome (modified Rankin Scale score 0-3 at 90...
Intraventricular hemorrhage (IVH) is associated with a poor outcome. External ventricular drainage together clot lysis through intrathecal tissue plasminogen activator (IT-tPA) has been proposed as promising therapy. However, recent experimental work implicated (tPA) in the pathogenesis of cerebral edema.We reviewed records all patients IVH caused by primary supratentorial intracerebral who underwent external without surgical evacuation between January 2001 and June 2008. Of these 30...
Object Cystathionine β-synthase (CBS) is an enzyme that metabolizes homocysteine to form H 2 S in the brain. Hydrogen sulfide functions as a vasodilator well regulator of neuronal ion channels and multiple intracellular signaling pathways. Given myriad effects S, authors hypothesized patients possessing gain-of-function polymorphisms CBS gene will experience decreased incidence delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). Methods Patients were enrolled...
A 54-year-old man presented to the emergency department with a 3-week history of cognitive decline. Imaging and cerebrospinal fluid markers were consistent Creutzfeldt–Jakob disease.
A 59-year-old man with hypertension, hyperlipidemia, and type 2 diabetes presented sudden-onset, bilateral ptosis, ataxia, confusion. Examination showed ophthalmoparesis sparing minimal adduction abduction, poorly reactive dilated pupils, global ataxia (video). The oculocephalic reflex revealed normal abduction. Bell phenomenon convergence were absent. MRI brain paramedian mesencephalic ischemic stroke (figure). Here in a variant, clinical presentation imaging closely follow the description...
Background: Antiphospholipid syndrome (APLS) is an acquired thrombophilia that a known cause of ischemic stroke (IS). However, there paucity population-based studies the prevalence and effects APLS diagnosis on patients hospitalized with IS. Here we use National Inpatient Sample (NIS) to evaluate characteristics admitted hospital for IS APLS. Methods: Adult in NIS from 2016-20 non-elective admissions primary discharge (ICD-10 I63*) were included. The study exposure was APLS, defined ICD-10...
Objective: This study is a post-hoc analysis of the Interventional Management Stroke (IMS) III trial investigating burden white matter hyperintensities (WMH), using van Swieten Scale (VSS), on functional outcomes for acute ischemic stroke (AIS) patients treated with either intravenous thrombolysis (IVT) or IVT mechanical thrombectomy (MT). Background: WMH are well-established marker underlying cerebral microvascular disease. VSS quantifies disease from zero to four higher numbers signifying...
A 57-year-old man presented with sudden neck pain radiating down his arms. This progressed to bilateral upper and subsequently lower extremity weakness numbness. His vitals were notable for systolic blood pressures than baseline (down 90 mm Hg). The patient’s neurological examination as well magnetic resonance imaging of the cervical thoracic spine localized a lesion in anterior spinal cord. differential diagnosis such an acute presentation included stroke, demyelination, intramedullary...
<h3>Objective:</h3> To determine the effect of changing criteria from faculty vote to a blinded clinical case report on reducing bias in neurology resident award. <h3>Background:</h3> Women are under-represented field Neurology, especially at leadership level. Awards can play an important role career advancement. In absence well-designed process for identifying award winners, there is risk that demographics awardees will reflect those voters. We hypothesized merit-based approach junior could...
Background: Delivery of acute ischemic stroke therapies is contingent on the duration from last known normal (LKN) to emergency department arrival time (EDAT). Methods: We studied patients presenting Yale-New Haven Hospital 2010-2020 who met these criteria 1) stroke, 2) age ≥ 18, 3) not transferred another hospital, and 4) symptom onset prior hospital presentation. The outcome was LKN EDAT dichotomized at 4.5 hours. Temporal trends were assessed by linear regression. Covariates analyzed for...
Introduction: Video telestroke consultations are increasingly utilized to provide acute stroke care virtually, yet it remains uncertain whether patients satisfied with this medium of care. We aimed evaluate patient perception their during video in a HUB and SPOKE network. Methods: Patients from Yale New Haven Health System affiliate hospitals evaluated by were screened for enrollment contacted between 7-14 days encounter administer telephone survey. excluded if the suspicion cerebrovascular...