A5027243816- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Intracerebral and Subarachnoid Hemorrhage Research
- Health Systems, Economic Evaluations, Quality of Life
- Cerebral Venous Sinus Thrombosis
- Intracranial Aneurysms: Treatment and Complications
- Ultrasound and Hyperthermia Applications
- S100 Proteins and Annexins
- Dysphagia Assessment and Management
- Blood Coagulation and Thrombosis Mechanisms
- Ethics in Clinical Research
- Atrial Fibrillation Management and Outcomes
- Vascular Malformations Diagnosis and Treatment
- Biomedical Ethics and Regulation
- Peripheral Artery Disease Management
- Neurological Disorders and Treatments
- Neurosurgical Procedures and Complications
- Astronomy and Astrophysical Research
- Cardiovascular and Diving-Related Complications
- History and Developments in Astronomy
- Esophageal and GI Pathology
- Cardiac, Anesthesia and Surgical Outcomes
The University of Texas Health Science Center at Houston
2016-2025
Centers for Disease Control and Prevention
2024
National Center for Emerging and Zoonotic Infectious Diseases
2024
University of Cincinnati Medical Center
2024
University of Virginia
2024
University of Tennessee Health Science Center
2018-2021
National and Kapodistrian University of Athens
2020-2021
University of Houston
2007-2021
Stanford University
2021
OhioHealth
2021
Patients with acute neurologic symptoms may have other causes simulating ischemic stroke, called stroke mimics (SM), but they also averted strokes that do not appear as infarcts on neuroimaging, which we call neuroimaging-negative cerebral ischemia (NNCI). We determined the safety and outcome of IV thrombolysis within 3 hours symptom onset in patients SM NNCI.Patients treated tissue plasminogen activator (tPA) were identified from our registry June 2004 to October 2008. collected admission...
The efficacy and safety of endovascular thrombectomy (EVT) in patients with large ischemic cores remains unknown, to our knowledge.To compare outcomes treated EVT medical management vs alone.This prespecified analysis the Optimizing Patient's Selection for Endovascular Treatment Acute Ischemic Stroke (SELECT) trial, a prospective cohort study imaging selection that was conducted 9 US comprehensive stroke centers, enrolled between January 2016 February 2018, followed them up 90 days. Patients...
Microspheres (microS) reach intracranial occlusions and transmit energy momentum from an ultrasound wave to residual flow promote recanalization. We report a randomized multicenter phase II trial of microS dose escalation with systemic thrombolysis.Stroke patients receiving 0.9mg/kg tissue plasminogen activator (tPA) pretreatment proximal on transcranial Doppler (TCD) were (2:1 ratio) (MRX-801) infusion over 90 minutes (Cohort 1, 1.4ml; Cohort 2, 2.8ml) continuous TCD insonation, whereas...
<b>Background: </b> Spontaneous intracerebral hemorrhage (ICH) is frequently associated with intraventricular (IVH), which an independent predictor of poor outcome. The purpose this study was to examine the relationship between ICH volume and anatomic location IVH, determine if decompression into ventricle truly beneficial. <b>Methods: We retrospectively analyzed CT scans charts all patients admitted our stroke center over a 3-year period. Outcome data were collected using prospective...
Ultrasound transiently expands perflutren-lipid microspheres (muS), transmitting energy momentum to surrounding fluids. We report a pilot safety/feasibility study of ultrasound-activated muS with systemic tissue plasminogen activator (tPA).Stroke subjects treated within 3 hours had abnormal Thrombolysis in Brain Ischemia (TIBI) residual flow grades 0 before tPA on transcranial Doppler (TCD). Randomization included Controls (tPA+TCD) or Target (tPA+TCD+2.8 mL microS). The primary safety end...
Intraventricular extension of intracerebral hemorrhage (IVH) is an independent predictor poor outcome. IVH volume may be important in outcome prediction and management; however, it difficult to measure routinely.We reviewed the charts computed tomographies a cohort consecutive patients with IVH. The was divided into two groups: index validation by random sampling. (ICH) were measured manually all patients. also graded using simple classification system termed score (IVHS). Clinical...
Current selection criteria for intra-arterial therapies in the anterior circulation use time windows of 8 hours. Modern neuroimaging techniques have identified individuals with salvageable penumbra who present beyond this timeframe. We sought to assess safety, procedural, and clinical outcomes MRI or CT perfusion imaging-based endovascular therapy patients stroke treated hours from last seen well.We conducted a multicenter retrospective review consecutive meeting following criteria: (1)...
Approximately 25% of ischemic stroke patients awaken with their deficits. The last-seen-normal time is defined as the patient went to sleep, which places these outside window for thrombolysis. purpose this study was describe our center's experience off-label, compassionate thrombolysis wake-up (WUS) patients.A retrospective review database identified 3 groups patients: (1) WUS treated thrombolysis; (2) nontreated WUS; and (3) 0- 3-hour intravenous tissue plasminogen activator-treated...
The Stroke Imaging Research (STIR) group, the Working Group of StrokeNet, American Society Neuroradiology, and Foundation Neuroradiology sponsored an imaging session workshop during Treatment Academy Industry Roundtable (STAIR) IX on October 5 to 6, 2015 in Washington, DC. purpose this roadmap was focus role future research clinical trials.This forum brought together stroke neurologists, neuroradiologists, neuroimaging scientists, members National Institute Neurological Disorders (NINDS),...
We conducted a randomized exploratory study to assess safety and the probability of favorable outcome with adjunctive argatroban, direct thrombin-inhibitor, administered recombinant tissue-type plasminogen activator (r-tPA)-treated ischemic stroke patients.Patients treated standard-dose r-tPA, not receiving endovascular therapy, were receive no argatroban or (100 μg/kg bolus) followed by infusion either 1 (low dose) 3 per minute (high for 48 hours. Safety was incidence symptomatic...
The benefit of endovascular stroke therapy (EVT) in large vessel occlusion (LVO) ischemic is highly time dependent. Process improvements to accelerate in-hospital workflows are critical.
SummaryA multinational outbreak of nosocomial fusarium meningitis occurred among immunocompetent patients who had undergone surgery with epidural anesthesia in Mexico. The pathogen involved a high predilection for the brain stem and vertebrobasilar arterial system was associated mortality from vessel injury. Effective treatment options remain limited; vitro susceptibility testing organism suggested that it is resistant to all currently approved antifungal medications United States. To...
Intravenous thrombolysis is a standard treatment of acute ischemic stroke. The efficacy and safety combining intravenous with argatroban (an anticoagulant agent) or eptifibatide antiplatelet are unclear.
Patients with large ischemic core stroke have poor clinical outcomes and are frequently not considered for interfacility transfer endovascular thrombectomy (EVT).
Intra-arterial recanalization therapy (IAT) is increasingly used for acute stroke. Despite high rates of recanalization, the outcome variable. We attempted to identify predictors that will enable better patient selection IAT.All patients who underwent IAT at University Texas Houston Stroke Center were reviewed. Poor was defined as modified Rankin Scale score 4 6 on hospital discharge. Findings validated in an independent data set 175 from California Los Angeles Center.One hundred ninety...
Background and Purpose— Cocaine is a cause of intracerebral hemorrhage (ICH), but there are no large studies that have characterized the location, pathology, outcome patients with cocaine-associated ICH. Methods— We performed retrospective analysis all admitted to our stroke service from 2004 2007 who had nontraumatic ICH urine drug screens positive for cocaine compared them similar negative cocaine. Results— identified 45 105 cocaine-negative There were significant differences in age or...
Argatroban is a direct thrombin inhibitor that safely augments recanalization achieved by tissue-type plasminogen activator (tPA) in animal stroke models. The tPA Stroke Study was an open-label, pilot safety study of plus patients with ischemic due to proximal intracranial occlusion.
Background and Purpose— Intra-arterial therapy (IAT) promotes recanalization of large artery occlusions in acute ischemic stroke. Despite high rates, poor clinical outcomes are common. We attempted to optimize a score that combines imaging variables more accurately predict outcome after IAT anterior circulation occlusions. Methods— Patients with stroke undergoing at University Texas (UT) Houston for (middle cerebral or internal carotid artery) were reviewed. Independent predictors (modified...
The 'spot sign' is a bright spot on computerized tomography angiography (CTA) source images predictive of hematoma growth. Contrast extravasation (CE) seen routine head CT following CTA as pooling contrast within the hematoma. Our aim was to re-evaluate value both sign and CE measure reliability scoring them.Consecutive cases spontaneous intracerebral hemorrhage (ICH) presenting 4 h. presence 'spot' CE, ICH intraventricular volume at baseline follow-up scans were assessed. Clinical outcome...
Background In animal models, the spleen contracts after acute ischemic stroke, followed by release of inflammatory cells leading to secondary brain injury. Aims We aim characterize splenic responses in patients with stroke. Methods this prospective observational study, we measured daily sizes abdominal ultrasound 30 suspected Splenic ultrasounds were also performed 20 healthy individuals. Results A generalized estimating equation, longitudinal regression model for adjusted measurements...
RATIONALE : Preclinical work demonstrates that the transcription factor peroxisome proliferator-activated receptor gamma plays an important role in augmenting phagocytosis while modulating oxidative stress and inflammation. We propose targeted stimulation of to promote efficient removal hematoma without harming surrounding brain cells may be a therapeutic option for intracerebral hemorrhage. AIMS The primary objective is assess safety agonist, pioglitazone, increasing doses three-days...
Animal models provide evidence of spleen mediated post-stroke activation the peripheral immune system. Translation these findings to stroke patients requires estimation pre-stroke volume along with quantification its day-to-day variation. We enrolled a cohort 158 healthy volunteers and measured their over course five consecutive days. also concurrent patients, initial within 24 h symptom onset followed by daily assessments. Blood samples for cytokine analysis were collected from subset...