A5044695100- Traumatic Brain Injury and Neurovascular Disturbances
- Acute Ischemic Stroke Management
- Intracranial Aneurysms: Treatment and Complications
- Neurosurgical Procedures and Complications
- Cerebrospinal fluid and hydrocephalus
- Cardiac Arrest and Resuscitation
- Cerebrovascular and Carotid Artery Diseases
- Hemodynamic Monitoring and Therapy
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Tracheal and airway disorders
- Optical Imaging and Spectroscopy Techniques
- Intensive Care Unit Cognitive Disorders
- Venous Thromboembolism Diagnosis and Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Ultrasound in Clinical Applications
- Organ Donation and Transplantation
- Cerebral Venous Sinus Thrombosis
- Neurological Complications and Syndromes
- Cardiac, Anesthesia and Surgical Outcomes
- Peripheral Neuropathies and Disorders
- Liver Disease and Transplantation
- Long-Term Effects of COVID-19
- Sepsis Diagnosis and Treatment
- Hereditary Neurological Disorders
Baylor College of Medicine
2025
University of Michigan
2015-2024
A. Alfred Taubman Health Care Center
2011-2024
Ann Arbor VA Medical Center
2022
Michigan Medicine
2011-2021
Neurological Surgery
2020
Oxford University Press (United Kingdom)
2020
University of Ottawa
2019
University of Maryland, Baltimore
2016
The University of Texas Health Science Center at Houston
2016
Information regarding the histological structure of thromboemboli that cause acute stroke provides insight into pathogenesis and clinical management.This report describes analysis retrieved by endovascular mechanical extraction from middle cerebral artery (MCA) intracranial carotid (ICA) 25 patients with ischemic stroke.The large majority (75%) shared architectural features random fibrin:platelet deposits interspersed linear collections nucleated cells (monocytes neutrophils) confined...
Many patients with severe stroke have impaired airway protective reflexes, resulting in prolonged invasive mechanical ventilation.To test whether early vs standard tracheostomy improved functional outcome among receiving ventilation.In this randomized clinical trial, 382 acute ischemic or hemorrhagic ventilation were randomly assigned (1:1) to (≤5 days of intubation) ongoing ventilator weaning if needed from day 10. Patients between July 28, 2015, and January 24, 2020, at 26 US German...
To determine the frequency of early neurologic deterioration with infarct expansion (ENDIE) and poor outcomes among ischemic stroke patients not treated reperfusion therapies because rapidly improving or mild symptoms (RIMS) to study predictive value hyperacute MRI in these patients.We identified consecutive acute undergoing multimodal within 6 hours onset without evidence hemorrhage on imaging. Medical records were reviewed for 48 hours. All deteriorating had repeat ascertain causes...
Background and Purpose— The Stroke PROTECT (Preventing Recurrence Of Thromboembolic Events through Coordinated Treatment) program systematically implements, at the time of acute transient ischemic attack (TIA) or stroke admission, 8 medication/behavioral secondary prevention measures known to improve outcome in patients with cerebrovascular disease. objective this study was determine if high utilization rates previously demonstrated hospital discharge were maintained 90 days after discharge....
Abstract Introduction Ultrasound (US) performed prior to percutaneous tracheostomy (PT) may be useful in avoiding injury pretracheal vascular structures and high placement of the tube. Bedside real-time US guidance with visualization needle path is routinely utilized for other procedures such as central venous catheterization, enhance safety accuracy PT without causing airway occlusion or hypercarbia. Our objective was demonstrate that under during tracheal puncture feasible, including...
In a previous study, 0.3 and 0.45 mg/kg of intravenous recombinant tissue plasminogen activator (rt-PA) were safe when combined with eptifibatide 75 mcg/kg bolus 2-hour infusion (0.75 per minute). The Combined Approach to Lysis Utilizing Eptifibatide rt-PA in Acute Ischemic Stroke-Enhanced Regimen (CLEAR-ER) trial sought determine the safety higher-dose regimen establish evidence for phase III trial.CLEAR-ER was multicenter, double-blind, randomized study. stroke patients 0.6 plus (135 at...
Abstract Introduction Optic nerve sheath diameter (ONSD) measurement with bedside ultrasound has been shown in many studies to accurately detect high intracranial pressure (ICP). The accuracy of point-in-time ONSD the presence ongoing fluctuation ICP between and normal is not known. Recent laboratory investigation suggests that reversal optic distension may be impaired following bouts hypertension. Our objective was compare setting fluctuating versus stable ICP. Methods This a retrospective...
There is an urgent unmet need for a reliable noninvasive tool to detect elevations in intracranial pressure (ICP) above guideline-recommended thresholds treatment. Gold standard invasive ICP monitoring unavailable many settings, including resource-limited environments, and situations such as liver failure which coagulopathy increases the risk of monitoring. Although large number techniques have been evaluated, this article reviews potential clinical role, if any, that undergone most...
The purpose of the optic nerve sheath diameter (ONSD) research group project is to establish an individual patient-level database from high quality studies ONSD ultrasonography for detection raised intracranial pressure (ICP), and perform a systematic review patient data meta-analysis (IPDMA), which will provide cutoff value help physicians making decisions encourage further research. Previous meta-analyses were able assess diagnostic accuracy in detecting ICP but failed determine precise...
Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) have a role ALF management, these patients are typically coagulopathic and at risk for hemorrhage (ICH). Contemporary techniques coagulopathy reversal strategies be associated with lower of hemorrhage. Our objective was to evaluate the safety, feasibility, impact on clinical management outcomes protocol-directed use IICPM ALF.Adult admitted between June 2011 October 2016,...
A variety of neurological manifestations have been attributed to COVID-19, but there is currently limited evidence regarding risk factors and outcomes for delirium in critically ill patients with COVID-19. The purpose this study was identify a large cohort ICU associated features clinical at the time hospital discharge.This an observational 213 consecutive admitted COVID-19 respiratory illness. Delirium diagnosed by trained abstractors using CHART-DEL instrument. associations between key...
<b>Objective: </b> To evaluate the independent effect of premorbid antiplatelet use on incident ischemic stroke severity and outcome at discharge. <b>Methods: The authors studied consecutive patients presenting within 24 hours over a 1-year period. National Institutes Health Stroke Scale (NIHSS) score presentation was used as index modified Rankin scale 0 to1 discharge good functional outcome. Patients were categorized according to their antiplatelet-inclusive (AI) no (NA). Demographic data,...
Although a recent clinical trial (BEST TRIP) demonstrated no improvement in outcomes with invasive intracranial pressure (ICP) monitoring (ICPM) following severe traumatic brain injury (TBI), its generalizability has been called into question. In several global settings ICPM is not the standard of care and used at discretion attending neurosurgeon. Our objective was to determine impact on mortality 6-month functional TBI. The setting referral trauma center 36 intensive unit (ICU) beds...
Recent studies have demonstrated the feasibility of real-time ultrasound guidance during percutaneous dilatational tracheostomy, including in patients with risk factors such as coagulopathy, cervical spine immobilization and morbid obesity. Use has been shown to improve technical accuracy tracheostomy; however, it is unclear if there an associated reduction complications. Our objective was determine whether peri-procedural use a complications tracheostomy using propensity score analysis.This...