Karim Mahawish
A5018029121- Acute Ischemic Stroke Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Stroke Rehabilitation and Recovery
- Cerebrovascular and Carotid Artery Diseases
- Atrial Fibrillation Management and Outcomes
- Neurosurgical Procedures and Complications
- Venous Thromboembolism Diagnosis and Management
- Intracranial Aneurysms: Treatment and Complications
- Neurological and metabolic disorders
- Blood Pressure and Hypertension Studies
- Case Reports on Hematomas
- Spinal Hematomas and Complications
- Botulinum Toxin and Related Neurological Disorders
- Cerebral Venous Sinus Thrombosis
- Traumatic Brain Injury and Neurovascular Disturbances
- Alcoholism and Thiamine Deficiency
- Infectious Encephalopathies and Encephalitis
- Antiplatelet Therapy and Cardiovascular Diseases
- Electrolyte and hormonal disorders
- Cerebrovascular and genetic disorders
- Facial Rejuvenation and Surgery Techniques
- Long-Term Effects of COVID-19
- IgG4-Related and Inflammatory Diseases
- Autoimmune and Inflammatory Disorders
- Moyamoya disease diagnosis and treatment
Auckland University of Technology
2024-2025
Palmerston North Hospital
2020-2025
Middlemore Hospital
2023-2025
Counties Manukau District Health Board
2022-2023
Muhimbili University of Health and Allied Sciences
2021
Catholic University of Health and Allied Sciences
2021
Rotorua Hospital
2017-2019
Warrington Hospital
2012-2015
Warrington and Halton Teaching Hospitals NHS Foundation Trust
2012
Aintree University Hospital
2009-2010
<h3>Objective:</h3> In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non–vitamin K antagonist oral anticoagulation–related ICH (NOAC-ICH) vitamin antagonist–associated (VKA-ICH). <h3>Methods:</h3> We all-cause mortality within 90 days for NOAC-ICH VKA-ICH using a Cox proportional hazards model adjusted age; sex; baseline Glasgow Coma Scale score, location, log...
To compare intracerebral hemorrhage (ICH) volume and clinical outcome of non-vitamin K oral anticoagulants (NOAC)-associated ICH to warfarin-associated ICH.In this multicenter cross-sectional observational study patients with anticoagulant-associated ICH, consecutive NOAC-ICH were compared those warfarin-ICH selected from a population 344 ICH. was measured by an observer blinded details. Outcome measures adjusted for confounding factors.We 11 52 warfarin-ICH. The median 2.4 mL (interquartile...
Background and Purpose: Due to practical advantages, increasing trial safety data, recent Australian Guideline endorsement local population needs we switched tenecteplase for stroke thrombolysis from alteplase. We describe our change process real-world outcome data. Methods: Mixed-methods including stakeholder engagement, preimplementation postimplementation surveys, assessment of patient treatment rates, metrics, clinical outcomes adjusting regression analyses age, sex, National Institutes...
Background: There is limited data on ultra-early hematoma growth dynamics and its clinical relevance in primary intracerebral hemorrhage (ICH). We aimed to estimate the incidence of expansion (HE) within hyperacute period ICH, describe over time, investigate associations between HE outcomes after assess effect tranexamic acid HE. Methods: performed a planned secondary analysis STOP-MSU international multicenter randomized controlled trial. Repeat CT imaging ~1 hour treatment commencement was...
Background and Purpose: The causes of recurrent ischemic stroke despite anticoagulation for atrial fibrillation are uncertain but might include small vessel occlusion. We investigated whether magnetic resonance imaging markers cerebral disease (SVD) associated with risk during follow-up in patients anticoagulated after recent or transient attack. Methods: analyzed data from a prospective multicenter inception cohort study attack (CROMIS-2 [Clinical Relevance Microbleeds Stroke Study]). rated...
Although the association between cerebral amyloid angiopathy (CAA) and cognitive impairment is increasingly recognized, it not clear whether this because of impact recurrent intracerebral hemorrhage (ICH) events, disruptions caused by small vessel damage, or both. We investigated considering before ICH was associated with neuroimaging features CAA on magnetic resonance imaging.We studied 166 patients neuroimaging-confirmed recruited to a prospective multicentre observational study....
The New Zealand (NZ) Central Region Stroke Network, serving 1.17 million catchment population, changed to tenecteplase for stroke thrombolysis in 2020 but was forced revert Alteplase 2021 due a sudden cessation of drug supply. We used this unique opportunity assess potential before and after temporal trend confounding.In NZ all reperfused patients are entered prospectively into national database safety monitoring. assessed patient outcomes treatment metrics over three time periods: alteplase...
Stroke is the second leading cause of death worldwide, with highest mortality rates in low- to middle-income countries, particularly sub-Saharan Africa. We aimed investigate predictors 30-day among patients stroke admitted at a tertiary teaching hospital Northwestern Tanzania.This cohort study recruited World Health Organization's clinical definition stroke. Data were collected on baseline characteristics, degree neurological impairment admission (measured using National Institutes Scale),...
To investigate whether enlarged perivascular spaces (PVS) within the basal ganglia or deep cerebral white matter are risk factors for intracranial hemorrhage in patients taking oral anticoagulants (OACs), independent of established clinical and radiologic factors, we conducted a post hoc analysis Clinical Relevance Microbleeds Stroke (CROMIS-2) (atrial fibrillation [AF]), prospective inception cohort study.Patients with atrial recent TIA ischemic stroke underwent standardized MRI prior to...
Introduction: Hematoma expansion (HE) is strongly associated with mortality and disability in intracerebral hemorrhage (ICH). While it accepted that the majority of this occurs early after onset, there limited data on HE associations outcome ultra-early time window (within 3 hours symptom onset). We aimed to (a) estimate incidence within period ICH, (b) describe hematoma growth dynamics over time, (c) investigate between clinical outcomes ICH. Methods: performed a planned secondary analysis...
Background The most frequent electrolyte derangement in adults with stroke is hyponatremia, which associated increased morbidity, mortality, and prolonged hospital stay. study aimed to investigate the hyponatremia incidence 30-day outcomes among admitted at a large tertiary teaching Northwestern Tanzania. Methods This cohort recruited presenting first-ever (as defined by World Health Organization) between November 2023 May 2024. Data were collected on demographics, degree of neurological...
Background: Atrial fibrillation (AF) increases ischaemic stroke (IS) risk, which can be mitigated using risk prediction models to guide anticoagulation decisions. This resultant widespread use of anticoagulants has reduced IS rates globally. However, commonly used scores were validated in mainly European cohorts. Cardiology society guidelines recommend the local refinement such improve prediction. study aims: 1. To determine trends prevalence AF associated Auckland. 2. perform a validation...
We present the case of a 55-year-old Caucasian man presenting with polyarthritis, weight loss and multiple tender cutaneous nodules. Abnormal liver function tests prompted imaging which demonstrated metastases. Biopsy lesions confirmed diagnosis metastatic pancreatic neuroendocrine carcinoma.
Background It is likely that a proportion of poststroke cognitive impairment sometimes attributable to unidentified prestroke decline; function also clinically relevant because it associated with poor functional outcomes, including death. We investigated the radiological and prognostic associations preexisting in patients ischemic stroke or transient attack atrial fibrillation. Methods Results included 1102 from prospective multicenter observational CROMIS ‐2 (Clinical Relevance Microbleeds...
Rationale Haematoma growth is common early after intracerebral haemorrhage (ICH), and a key determinant of outcome. Tranexamic acid, widely available antifibrinolytic agent with an excellent safety profile, may reduce haematoma growth. Methods design Stopping tranexamic acid for hyperacute onset presentation including mobile stroke units (STOP-MSU) phase II double-blind, randomised, placebo-controlled, multicentre, international investigator-led clinical trial, conducted within the estimand...
Background: Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors identified well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing managing promoting lifestyle changes for patients. Methods: This is a mixed-methods cross-sectional two-phase survey using largely positivist (quantitative qualitative) framework. During Phase 1, prototype of was tested internationally by...
To investigate the efficacy of problem solving therapy for reducing emotional distress experienced by younger stroke survivors.A non-randomized waitlist controlled design was used to compare outcome measures treatment group and a control at baseline post-waitlist/post-therapy. After received an analysis completed on pooled baseline, post-treatment, three-month follow-up.Changes between post-treatment (n = 13) were not significantly different two groups, 13), 16) (between-subject design). The...
Cerebral infarction is a rare but recognised complication of idiopathic thrombocytopenic purpura. With traditional therapies including antiplatelets precluded in such patients and little guidance the literature, optimal treatment strategy unknown. This report describes case ischaemic stroke patient with purpura deteriorating neurology. A successful outcome was made possible using sequential approach initially improving platelet levels steroids intravenous immunoglobulin then commencing...
Background: Stroke is a second leading cause of death globally, with an estimated one in four adults suffering stroke their lifetime. We aimed to describe the clinical characteristics, quality care, and outcomes urban Northwestern Tanzania. Methods: analyzed de-identified data from prospective registry Bugando Medical Centre Mwanza, largest city Tanzania, between March 2020 October 2022. This included all ⩾18 years admitted our hospital who met World Health Organization definition stroke....
We present a case of 74-year-old man who was admitted to our stroke unit with symptoms and signs suggestive left total anterior circulation stroke. Subsequent MRI failed support this diagnosis and, furthermore, correction an incidental finding hyponatraemia due syndrome inappropriate antidiuretic hormone secretion led complete recovery symptoms. Investigation subsequent exclusion other potential differential diagnoses confirmed the mimicking acute
A 58-year-old woman with a history of poorly controlled type 2 diabetes, hypertension and smoking presented left hemiparesis (grade 4/5). Admission glucose was 22.6 mmol/L. MRI the brain demonstrated an area restricted diffusion involving corpus callosum hemisphere (figures 1 2). Investigations into cause her stroke including vasculitic thrombophilic causes, echocardiogram, telemetry carotid Doppler, did not demonstrate any significant pathology. Rather alarmingly, patient's glycated...
We present a case of paraneoplastic limbic encephalitis, describing the presenting features, diagnosis and management plan. Limbic encephalitis is one differential rapidly progressive dementia. describe rational approach to patient with rapid cognitive decline.
Stroke mimics account for up to one-third of acute stroke admissions and are a heterogeneous entity which pose diagnostic challenges. Diagnosing such patients is however crucial avoid delays in treatment potentially harmful medication prescription. We aimed at describing the magnitude, clinical characteristics short-term outcomes clinically diagnosed with stroke.This prospective study enrolled admitted World Health Organization criteria tertiary hospital Tanzania. Baseline data was collected...