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6. Computational Fluid Dynamics of Cerebrospinal Fluid

Author

Fillingham, Patrick, Kurt, Mehmet, Levendovszky, Swati Rane, Levitt, Michael R., Crusio, Wim E., Series Editor, Dong, Haidong, Series Editor, Radeke, Heinfried H., Series Editor, Rezaei, Nima, Series Editor, Steinlein, Ortrud, Series Editor, Xiao, Junjie, Series Editor, Rosenhouse-Dantsker, Avia, Editorial Board Member, Di Ieva, Antonio, editor, Suero Molina, Eric, editor, Liu, Sidong, editor, and Russo, Carlo, editor

Published
2024
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9. Safety and efficacy of early versus delayed acetylsalicylic acid after surgery for spontaneous intracerebral haemorrhage in China (E-start): a prospective, multicentre, open-label, blinded-endpoint, randomised trial

Author

Ren, Jinrui, Jiang, Pengjun, Liu, Qingyuan, Mo, Shaohua, Wu, Jun, Tong, Xianzeng, Wang, Kaiwen, Chen, Xu, Chen, Shanwen, Guo, Shuaiwei, Li, Xiong, Li, Mingde, Peng, Lei, Sun, Xinguo, Wang, Yang, Sun, Jianjun, Pu, Jun, Zheng, Kaige, Zhang, Jiaming, Liu, Yang, Yang, Yi, Wen, Zheng, Nie, Xin, Feng, Yinghe, Lan, Chuanjin, Tang, Haishuang, Wang, Nuochuan, Li, Jiangan, Miao, Zengli, Lu, Xiaojie, Ning, Bo, Zhao, Bing, Kang, Dezhi, Chen, Xiaolin, Zhang, Yanan, Zhang, Yan, Wang, Anxin, Zhu, Chengcheng, Araki, Yoshio, Uda, Kenji, Yoshimura, Shinichi, Uchida, Kazutaka, Morimoto, Takeshi, Yoshioka, Hideyuki, Hasan, David, Du, Rose, Levitt, Michael R, Cao, Yong, Wang, Shuo, and Zhao, Jizong

Published
2024
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13. International controlled study of revascularization and outcomes following COVID‐positive mechanical thrombectomy

Author

Dmytriw, Adam A, Ghozy, Sherief, Sweid, Ahmad, Piotin, Michel, Bekelis, Kimon, Sourour, Nader, Raz, Eytan, Vela‐Duarte, Daniel, Linfante, Italo, Dabus, Guilherme, Kole, Max, Martínez‐Galdámez, Mario, Nimjee, Shahid M, Lopes, Demetrius K, Hassan, Ameer E, Kan, Peter, Ghorbani, Mohammad, Levitt, Michael R, Escalard, Simon, Missios, Symeon, Shapiro, Maksim, Clarençon, Fréderic, Elhorany, Mahmoud, Tahir, Rizwan A, Youssef, Patrick P, Pandey, Aditya S, Starke, Robert M, Naamani, Kareem El, Abbas, Rawad, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, Kuhn, Anna L, Puri, Ajit S, Menon, Bijoy K, Sivakumar, Sanjeev, Mowla, Ashkan, D'Amato, Salvatore, Zha, Alicia M, Cooke, Daniel, Vranic, Justin E, Regenhardt, Robert W, Rabinov, James D, Stapleton, Christopher J, Goyal, Mayank, Wu, Hannah, Cohen, Jake, Turkel‐Parella, David, Xavier, Andrew, Waqas, Muhammad, Tutino, Vincent, Siddiqui, Adnan, Gupta, Gaurav, Nanda, Anil, Khandelwal, Priyank, Tiu, Cristina, Portela, Pere C, de la Ossa, Natalia Perez, Urra, Xabier, Lera, Mercedes, Arenillas, Juan F, Ribo, Marc, Requena, Manuel, Piano, Mariangela, Pero, Guglielmo, Sousa, Keith, Al‐Mufti, Fawaz, Hashim, Zafar, Nayak, Sanjeev, Renieri, Leonardo, Du, Rose, Aziz‐Sultan, Mohamed A, Liebeskind, David, Nogueira, Raul G, Abdalkader, Mohamad, Nguyen, Thanh N, Vigilante, Nicholas, Siegler, James E, Grossberg, Jonathan A, Saad, Hassan, Gooch, Michael R, Herial, Nabeel A, Rosenwasser, Robert H, Tjoumakaris, Stavropoula, Patel, Aman B, Tiwari, Ambooj, Jabbour, Pascal, and Investigators, North American Neurovascular COVID‐19 Consortium Society of Vascular and Interventional Neurology

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Stroke, Clinical Research, Good Health and Well Being, Brain Ischemia, COVID-19, Cross-Sectional Studies, Endovascular Procedures, Humans, Male, Retrospective Studies, Thrombectomy, Treatment Outcome, large vessel occlusion, morbidity, mortality, stroke, North American Neurovascular COVID-19 (NAN-C) Consortium &amp, Society of Vascular and Interventional Neurology (SVIN) Investigators, Neurology & Neurosurgery, Clinical sciences
Abstract

Background and purposePrevious studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors.MethodsA cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted.ResultsIn this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p

Published
2022

15. Earlier Endovascular Thrombectomy and Mortality in Patients with Anterior Circulation Large Vessel Occlusion: A Propensity-Matched Analysis of the Stroke Thrombectomy and Aneurysm Registry

Author

Matsukawa, Hidetoshi, Crosa, Roberto, Cunningham, Conor, Maier, Ilko, Al Kasab, Sami, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Shaban, Amir, Goyal, Nitin, Yoshimura, Shinichi, Cuellar, Hugo, Howard, Brian, Alawieh, Ali, Alaraj, Ali, Ezzeldin, Mohamad, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Siddiqui, Fazeel, Osbun, Joshua, Matouk, Charles, Park, Min S., Levitt, Michael R., Brinjikji, Waleed, Moss, Mark, Williamson, Richard, Navia, Pedro, Kan, Peter, Leacy, Reade De, Chowdhry, Shakeel, and Spiotta, Alejandro M.

Published
2024
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16. Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Author

Jabbour, Pascal, Dmytriw, Adam A, Sweid, Ahmad, Piotin, Michel, Bekelis, Kimon, Sourour, Nader, Raz, Eytan, Linfante, Italo, Dabus, Guilherme, Kole, Max, Martínez-Galdámez, Mario, Nimjee, Shahid M, Lopes, Demetrius K, Hassan, Ameer E, Kan, Peter, Ghorbani, Mohammad, Levitt, Michael R, Escalard, Simon, Missios, Symeon, Shapiro, Maksim, Clarençon, Frédéric, Elhorany, Mahmoud, Vela-Duarte, Daniel, Tahir, Rizwan A, Youssef, Patrick P, Pandey, Aditya S, Starke, Robert M, Naamani, Kareem El, Abbas, Rawad, Hammoud, Bassel, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, Kuhn, Anna L, Puri, Ajit S, Menon, Bijoy K, Sivakumar, Sanjeev, Mowla, Ashkan, D'Amato, Salvatore, Zha, Alicia M, Cooke, Daniel, Goyal, Mayank, Wu, Hannah, Cohen, Jake, Turkel-Parrella, David, Xavier, Andrew, Waqas, Muhammad, Tutino, Vincent M, Siddiqui, Adnan, Gupta, Gaurav, Nanda, Anil, Khandelwal, Priyank, Tiu, Cristina, Portela, Pere C, de la Ossa, Natalia Perez, Urra, Xabier, de Lera, Mercedes, Arenillas, Juan F, Ribo, Marc, Requena, Manuel, Piano, Mariangela, Pero, Guglielmo, De Sousa, Keith, Al-Mufti, Fawaz, Hashim, Zafar, Nayak, Sanjeev, Renieri, Leonardo, Aziz-Sultan, Mohamed A, Nguyen, Thanh N, Feineigle, Patricia, Patel, Aman B, Siegler, James E, Badih, Khodr, Grossberg, Jonathan A, Saad, Hassan, Gooch, M Reid, Herial, Nabeel A, Rosenwasser, Robert H, Tjoumakaris, Stavropoula, and Tiwari, Ambooj

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Clinical Research, Brain Disorders, Stroke, Good Health and Well Being, Brain Ischemia, COVID-19, Cerebral Infarction, Humans, Retrospective Studies, Thrombectomy, Treatment Outcome, SARS-CoV-2, Central nervous system, Cerebrovascular disease, Hypercoagulable, Neurology & Neurosurgery, Clinical sciences, Biological psychology
Abstract

BackgroundThe mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.ObjectiveTo describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.MethodsWe conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.ResultsThe total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002).ConclusionCOVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates.

Published
2022

17. Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions

Author

Matsukawa, Hidetoshi, Uchida, Kazutaka, Cunningham, Conor, Sowlat, Mohammad-Mahdi, Elawady, Sameh Samir, Maier, Ilko, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Shaban, Amir, Arthur, Adam, Cuellar, Hugo, Howard, Brian M., Alawieh, Ali, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Osbun, Joshua, Crosa, Roberto, Matouk, Charles, Park, Min S., Brinjikji, Waleed, Moss, Mark, Williamson, Richard, Navia, Pedro, Kan, Peter, De Leacy, Reade, Chowdhry, Shakeel, Ezzeldin, Mohamad, Spiotta, Alejandro M., Levitt, Michael R., and Yoshimura, Shinichi

Published
2024
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19. Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5

Author

Orscelik, Atakan, Matsukawa, Hidetoshi, Elawady, Sameh Samir, Sowlat, Mohamed Mahdi, Cunningham, Conor, Zandpazandi, Sara, Kasem, Rahim Abo, Maier, Ilko, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M, Psychogios, Marios-Nikos, Shaban, Amir, Goyal, Nitin, Yoshimura, Shinichi, Cuellar, Hugo, Howard, Brian, Alawieh, Ali, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Osbun, Joshua, Crosa, Roberto, Matouk, Charles, Park, Min S., Levitt, Michael R., Brinjikji, Waleed, Moss, Mark, Dumont, Travis, Williamson, Richard, Jr., Navia, Pedro, Kan, Peter, De Leacy, Reade, Chowdhry, Shakeel, Ezzeldin, Mohamad, Spiotta, Alejandro M., and Kasab, Sami Al

Published
2024
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20. A Comparative Analysis of Microsurgical Resection Versus Stereotactic Radiosurgery for Spetzler-Martin Grade III Arteriovenous Malformations: A Multicenter Propensity Score Matched Study

Author

Tos, Salem M, Hajikarimloo, Bardia, Osama, Mahmoud, Mantziaris, Georgios, Adeeb, Nimer, Kandregula, Sandeep, Salim, Hamza Adel, Musmar, Basel, Ogilvy, Christopher, Kondziolka, Douglas, Dmytriw, Adam A., El Naamani, Kareem, Abdelsalam, Ahmed, Kumbhare, Deepak, Gummadi, Sanjeev, Ataoglu, Cagdas, Essibayi, Muhammed Amir, Erginoglu, Ufuk, Keles, Abdullah, Muram, Sandeep, Sconzo, Daniel, Riina, Howard, Rezai, Arwin, Pöppe, Johannes, Sen, Rajeev D., Alwakaa, Omar, Griessenauer, Christoph J., Jabbour, Pascal, Tjoumakaris, Stavropoula I, Burkhardt, Jan-Karl, Starke, Robert M., Baskaya, Mustafa K., Sekhar, Laligam N., Levitt, Michael R., Altschul, David J, Haranhalli, Neil, McAvoy, Malia, Abushehab, Abdallah, Aslan, Assala, Swaid, Christian, Abla, Adib, Stapleton, Christopher, Koch, Matthew, Srinivasan, Visish M., Chen, Peng R., Blackburn, Spiros, Cochran, Joseph, Choudhri, Omar, Pukenas, Bryan, Orbach, Darren, Smith, Edward, Möhlenbruch, Markus, Alaraj, Ali, Aziz-Sultan, Ali, Dlouhy, Kathleen, El Ahmadieh, Tarek, Patel, Aman B., Savardekar, Amey, Cuellar, Hugo H., Lawton, Michael, Guthikonda, Bharat, Morcos, Jacques, and Sheehan, Jason

Published
2024
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26. Outcomes after endovascular mechanical thrombectomy for low compared to high National Institutes of Health Stroke Scale (NIHSS): A multicenter study

Author

Abecassis, Isaac Josh, Almallouhi, Eyad, Chalhoub, Reda, Kasab, Sami Al, Bass, Eric, Ding, Dale, Saini, Vasu, Burks, Joshua D., Maier, Ilko L., Psychogios, Marios-Nikos, Liman, Jan, Alawieh, Ali, Wolfe, Stacey, Arthur, Adam S., Shaban, Amir, Dumont, Travis, Kan, Peter, Kim, Joon-Tae, De Leacy, Reade, Osbun, Joshua, Rai, Ansaar, Jabbour, Pascal, Grossberg, Jonathan A., Park, Min S., Crosa, Roberto, Mascitelli, Justin, Levitt, Michael R., Polifka, Adam, Casagrande, Walter, Yoshimura, Shinichi, Matouk, Charles, Williamson, Richard W., Gory, Benjamin, Mokin, Maxim, Fragata, Isabel, Romano, Daniele G., Chowdhry, Shakeel A., Moss, Mark, Behme, Daniel, Limaye, Kaustubh, Spiotta, Alejandro M., and Starke, Robert M.

Published
2023
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28. Clopidogrel hyper-response increases peripheral hemorrhagic complications without increasing intracranial complications in endovascular aneurysm treatments requiring dual antiplatelet therapy

Author

Young, Christopher C., Bass, David I., Cruz, Michael J., Carroll, Kate, Vanent, Kevin N., Lee, Chungeun, Sen, Rajeev D., Feroze, Abdullah H., Williams, John R., Levy, Samuel, McCray, Denzel, Kelly, Cory M., Barber, Jason, Kim, Louis J., and Levitt, Michael R.

Published
2022
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31. Risk of unruptured aneurysms in subarachnoid hemorrhage patients with multiple intracranial aneurysms: a multicenter, longitudinal, comparative study from China.

Author

Jian Liu, Yiping Zhang, Levitt, Michael R., Mossa-Basha, Mahmud, Chao Wang, Mirzat Turhon, Ying Zhang, Yisen Zhang, Kun Wang, Chengcheng Zhu, and Xinjian Yang

Subjects
INTRACRANIAL aneurysms, ANEURYSMS, RESEARCH funding, SUBARACHNOID hemorrhage, PROBABILITY theory, SEX distribution, RETROSPECTIVE studies, AGE distribution, DESCRIPTIVE statistics, LONGITUDINAL method, ODDS ratio, RESEARCH, COMPARATIVE studies, CONFIDENCE intervals, DISEASE risk factors, DISEASE complications
Abstract

Background In aneurysmal subarachnoid hemorrhage patients with multiple intracranial aneurysms (aSAH-MIA patients), the risk of secondary unruptured intracranial aneurysms is inconsistent. This study aimed to explore the risk of unruptured aneurysms in Chinese aSAH-MIA patients. Methods The medical records and angiographic images of aSAH-MIA patients from eight cerebrovascular centers in China were retrospectively reviewed and analyzed. Patients with a single unruptured intracranial aneurysm (UIA) and no prior aSAH were used as controls. Propensity score matching (PSM) was employed to balance the differences in age, gender, aneurysm size, aneurysm site, and follow-up duration between the two groups. Results The study included 267 unruptured aneurysms from 204 aSAH-MIA patients and 769 single UIA. After PSM, 201 aneurysms were enrolled in the aSAH-MIA group and 201 aneurysms in the control group. The mean follow-up was 2.2 years. Thirty-four aneurysm instability events (28 growth and 6 rupture, 16.9%) occurred during follow-up in the aSAH-MIA group and 16 instability events (13 growth and 3 rupture, 8%) occurred in the control group. Risk factors for aneurysmal instability were aneurysm irregularity (OR 2.53; 95% CI 1.18 to 4.31), higher size ratio (OR 1.23; 95% CI 1.37 to 4.39), and middle cerebral artery location (OR 1.86; 95% CI 1.03 to 3.17). The risk of aneurysmal instability was substantially elevated in the aSAHMIA group (HR 2.07; 95% CI 1.12 to 3.02). Conclusions Unruptured aneurysms in Chinese aSAH-MIA patients exhibited higher risks of growth and rupture than in patients with a single UIA. Middle cerebral artery location, higher size ratio and irregular shape were associated with higher risk of growth or rupture. [ABSTRACT FROM AUTHOR]

Published
2025
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32. Intracranial aneurysm wall displacement depicted by amplified Flow predicts growth.

Author

Pionteck, Aymeric, Abderezaei, Javid, Fillingham, Patrick, Ya-Chen Chuang, Yu Sakai, Belani, Puneet, Rigney, Brian, De Leacy, Reade, Fifi, Johanna T., Aichi Chien, Colby, Geoffrey P., Jahan, Reza, Duckwiler, Gary, Sayre, James, Holdsworth, Samantha J., Mossa-Basha, Mahmud, Levitt, Michael R., Mocco, J., Kurt, Mehmet, and Nael, Kambiz

Subjects
INTRACRANIAL aneurysms, RISK assessment, QUESTIONNAIRES, HEMODYNAMICS, MAGNETIC resonance imaging, RETROSPECTIVE studies, MULTIVARIATE analysis, DESCRIPTIVE statistics, BLOOD flow measurement, MEDICAL records, ACQUISITION of data, STATISTICS, CASE-control method, DATA analysis software, DIGITAL image processing, DISEASE progression, BIOMARKERS, ECHOCARDIOGRAPHY, ALGORITHMS
Abstract

Background Abnormal intracranial aneurysm (IA) wall motion has been associated with IA growth and rupture. Recently, a new image processing algorithm called amplified Flow (aFlow) has been used to successfully track IA wall motion by combining the amplification of cine and four-dimensional (4D) Flow MRI. We sought to apply aFlow to assess wall motion as a potential marker of IA growth in a paired-wise analysis of patients with growing versus stable aneurysms. Methods In this retrospective case--control study, 10 patients with growing IAs and a matched cohort of 10 patients with stable IAs who had baseline 4D Flow MRI were included. The aFlow was used to amplify and extract IA wall displacements from 4D Flow MRI. The associations of aFlow parameters with commonly used risk factors and morphometric features were assessed using paired-wise univariate and multivariate analyses. Results aFlow quantitative results showed significantly (P=0.035) higher wall motion displacement depicted by mean±SD 90th% values of 2.34±0.72 in growing IAs versus 1.39±0.58 in stable IAs with an area under the curve of 0.85. There was also significantly (P<0.05) higher variability of wall deformation across IA geometry in growing versus stable IAs depicted by the dispersion variables including 121-150% larger standard deviation (...) and 128-161% wider interquartile range (...). Conclusions aFlow-derived quantitative assessment of IA wall motion showed greater wall motion and higher variability of wall deformation in growing versus stable IAs. [ABSTRACT FROM AUTHOR]

Published
2025
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33. Smartphone-Based Pupillometry Using Machine Learning for the Diagnosis of Sports-Related Concussion.

Author

Maxin, Anthony J., Whelan, Bridget M., Levitt, Michael R., McGrath, Lynn B., and Harmon, Kimberly G.

Subjects
PUPILLARY reflex, RANDOM forest algorithms, K-nearest neighbor classification, PUPILLOMETRY, MACHINE learning
Abstract

Background: Quantitative pupillometry has been proposed as an objective means to diagnose acute sports-related concussion (SRC). Objective: To assess the diagnostic accuracy of a smartphone-based quantitative pupillometer in the acute diagnosis of SRC. Methods: Division I college football players had baseline pupillometry including pupillary light reflex (PLR) parameters of maximum resting diameter, minimum diameter after light stimulus, percent change in pupil diameter, latency of pupil constriction onset, mean constriction velocity, maximum constriction velocity, and mean dilation velocity using a smartphone-based app. When an SRC occurred, athletes had the smartphone pupillometry repeated as part of their concussion testing. All combinations of the seven PLR parameters were tested in machine learning binary classification models to determine the optimal combination for differentiating between non-concussed and concussed athletes. Results: 93 football athletes underwent baseline pupillometry testing. Among these athletes, 11 suffered future SRC and had pupillometry recordings repeated at the time of diagnosis. In the machine learning pupillometry analysis that used the synthetic minority oversampling technique to account for the significant class imbalance in our dataset, the best-performing model was a random forest algorithm with the combination of latency, maximum diameter, minimum diameter, mean constriction velocity, and maximum constriction velocity PLR parameters as feature inputs. This model produced 91% overall accuracy, 98% sensitivity, 84.2% specificity, area under the curve (AUC) of 0.91, and an F1 score of 91.6% in differentiating between baseline and SRC recordings. In the machine learning analysis prior to oversampling of our imbalanced dataset, the best-performing model was k-nearest neighbors using latency, maximum diameter, maximum constriction velocity, and mean dilation velocity to produce 82% accuracy, 40% sensitivity, 87% specificity, AUC of 0.64, and F1 score of 24%. Conclusions: Smartphone pupillometry in combination with machine learning may provide fast and objective SRC diagnosis in football athletes. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Mechanical Thrombectomy for Distal Occlusions: Efficacy, Functional and Safety Outcomes: Insight from the STAR Collaboration

Author

Anadani, Mohammad, Alawieh, Ali, Chalhoub, Reda, Jabbour, Pascal, Starke, Robert M., Arthur, Adam, Goyal, Nitin, Wolfe, Stacey, Fargen, Kyle M., Grossberg, Jonathan A., Howard, Brian M., De Leacy, Reade, Kellner, Christopher, Kan, Peter, Dumont, Travis, Rai, Ansaar, Osbun, Joshua, Crosa, Roberto, Maier, Ilko, Nascimento, Fábio A., Park, Min S., Levitt, Michael R., Fragata, Isabel, Matouk, Charles, Crowley, R. Webster, Chowdhry, Shakeel A., Ogilvy, Christopher, Mokin, Maxim, Mascitelli, Justin, Yoo, Albert J., Williamson, Richard W., Webb, Sharon, Psychogios, Marios-Nikos, Al kasab, Sami, and Spiotta, Alejandro M.

Published
2021
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37. Comparison between transradial and transfemoral mechanical thrombectomy for ICA and M1 occlusions: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)

Author

Silva, Michael A, Elawady, Sameh Samir, Maier, Ilko, Al Kasab, Sami, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Q, Rai, Ansaar, Psychogios, Marios-Nikos, Samaniego, Edgar A, Goyal, Nitin, Yoshimura, Shinichi, Cuellar, Hugo, Grossberg, Jonathan A, Alawieh, Ali, Alaraj, Ali, Ezzeldin, Mohamad, Romano, Daniele G, Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam J, Siddiqui, Fazeel M, Osbun, Joshua W, Crosa, Roberto Javier, Matouk, Charles, Levitt, Michael R, Brinjikji, Waleed, Moss, Mark, Dumont, Travis M, Williamson, Richard, Navia, Pedro, Kan, Peter, De Leacy, Reade Andrew, Chowdhry, Shakeel A, Spiotta, Alejandro M, Park, Min S, and Starke, Robert M

Abstract

BackgroundThe role for the transradial approach for mechanical thrombectomy is controversial. We sought to compare transradial and transfemoral mechanical thrombectomy in a large multicenter database of acute ischemic stroke.MethodsThe prospectively maintained Stroke Thrombectomy and Aneurysm Registry (STAR) was reviewed for patients who underwent mechanical thrombectomy for an internal carotid artery (ICA) or middle cerebral artery M1 occlusion. Multivariate regression analyses were performed to assess outcomes including reperfusion time, symptomatic intracerebral hemorrhage (ICH), distal embolization, and functional outcomes.ResultsA total of 2258 cases, 1976 via the transfemoral approach and 282 via the transradial approach, were included. Radial access was associated with shorter reperfusion time (34.1 min vs 43.6 min, P=0.001) with similar rates of Thrombolysis in Cerebral Infarction (TICI) 2B or greater reperfusion (87.9% vs 88.1%, P=0.246). Patients treated via a transradial approach were more likely to achieve at least TICI 2C (59.6% vs 54.7%, P=0.001) and TICI 3 reperfusion (50.0% vs 46.2%, P=0.001), and had shorter lengths of stay (mean 9.2 days vs 10.2, P<0.001). Patients treated transradially had a lower rate of symptomatic ICH (8.0% vs 9.4%, P=0.047) but a higher rate of distal embolization (23.0% vs 7.1%, P<0.001). There were no significant differences in functional outcome at 90 days between the two groups.ConclusionsRadial and femoral thrombectomy resulted in similar clinical outcomes. In multivariate analysis, the radial approach had improved revascularization rates, fewer cases of symptomatic ICH, and faster reperfusion times, but higher rates of distal emboli. Further studies on the optimal approach are necessary based on patient and disease characteristics.

Published
2025
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38. Repeat thrombectomy after large vessel re-occlusion: a propensity score matched analysis of technical and clinical outcomes

Author

Zohdy, Youssef M, Saad, Hassan, Howard, Brian M, Cawley, C Michael, Pabaney, Aqueel, Akbik, Feras, Dimisko, Laurie, Maier, Ilko, Spiotta, Alejandro M, Jabbour, Pascal, Wolfe, Stacey Q, Rai, Ansaar, Kim, Joon-tae, Mascitelli, Justin, Starke, Robert M, Shaban, Amir, Yoshimura, Shinichi, De Leacy, Reade, Kan, Peter, Fragata, Isabel, Polifka, Adam J, Arthur, Adam S, Park, Min S, Matouk, Charles, Levitt, Michael R, Tjoumakaris, Stavropoula I, Liman, Jan, Waiters, Vanesha, Pradilla, Gustavo, Fargen, Kyle M, Alawieh, Ali, and Grossberg, Jonathan A

Abstract

BackgroundEndovascular thrombectomy (EVT) remains the standard of care for acute large vessel occlusion (LVO) stroke. However, the safety and efficacy of repeat thrombectomy (rEVT) in recurrent LVO remains unclear. This study uses a large real-world patient cohort to study technical and clinical outcomes after rEVT.MethodsThis is a retrospective cohort study including patients who underwent thrombectomy between January 2013 and December 2022. Data were included from 21 comprehensive stroke centers globally through the Stroke Thrombectomy and Aneurysm Registry (STAR). Patients undergoing single EVT or rEVT within 30 days of LVO stroke were included in the study. Propensity score matching was used to compare patients undergoing single EVT versus rEVT.ResultsOut of a total of 7387 patients who underwent thrombectomy for LVO stroke, 90 (1.2%) patients underwent rEVT for the same vascular territory within 30 days. The median (IQR) time to re-occlusion was 2 (1–7) days. Compared with a matched cohort of patients undergoing a single EVT procedure, patients undergoing rEVT had a comparable rate of good functional outcome and mortality rate, but a higher rate of symptomatic intracranial hemorrhage (sICH). There was a significant reduction in the National Institutes of Health Stroke Scale (NIHSS) score of patients who underwent rEVT at discharge compared with baseline (−4.8±11.4; P=0.006). The rate of successful recanalization was similar in the single thrombectomy and rEVT groups (78% vs 80%, P=0.171) and between index and rEVT performed on the same patient (79% vs 80%; P=0.593).ConclusionShort-interval rEVT is associated with an improvement in the NIHSS score following large vessel re-occlusion. Compared with single thrombectomy, there was a higher rate of sICH with rEVT, but without a significant impact on rates of functional independence or mortality.

Published
2025
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39. Risk of unruptured aneurysms in subarachnoid hemorrhage patients with multiple intracranial aneurysms: a multicenter, longitudinal, comparative study from China

Author

Liu, Jian, Zhang, Yiping, Levitt, Michael R, Mossa-Basha, Mahmud, Wang, Chao, Turhon, Mirzat, Zhang, Ying, Zhang, Yisen, Wang, Kun, Zhu, Chengcheng, and Yang, Xinjian

Abstract

BackgroundIn aneurysmal subarachnoid hemorrhage patients with multiple intracranial aneurysms (aSAH-MIA patients), the risk of secondary unruptured intracranial aneurysms is inconsistent. This study aimed to explore the risk of unruptured aneurysms in Chinese aSAH-MIA patients.MethodsThe medical records and angiographic images of aSAH-MIA patients from eight cerebrovascular centers in China were retrospectively reviewed and analyzed. Patients with a single unruptured intracranial aneurysm (UIA) and no prior aSAH were used as controls. Propensity score matching (PSM) was employed to balance the differences in age, gender, aneurysm size, aneurysm site, and follow-up duration between the two groups.ResultsThe study included 267 unruptured aneurysms from 204 aSAH-MIA patients and 769 single UIA. After PSM, 201 aneurysms were enrolled in the aSAH-MIA group and 201 aneurysms in the control group. The mean follow-up was 2.2 years. Thirty-four aneurysm instability events (28 growth and 6 rupture, 16.9%) occurred during follow-up in the aSAH-MIA group and 16 instability events (13 growth and 3 rupture, 8%) occurred in the control group. Risk factors for aneurysmal instability were aneurysm irregularity (OR 2.53; 95% CI 1.18 to 4.31), higher size ratio (OR 1.23; 95% CI 1.37 to 4.39), and middle cerebral artery location (OR 1.86; 95% CI 1.03 to 3.17). The risk of aneurysmal instability was substantially elevated in the aSAH-MIA group (HR 2.07; 95% CI 1.12 to 3.02).ConclusionsUnruptured aneurysms in Chinese aSAH-MIA patients exhibited higher risks of growth and rupture than in patients with a single UIA. Middle cerebral artery location, higher size ratio and irregular shape were associated with higher risk of growth or rupture.

Published
2025
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43. Early Effects of COVID-19 Pandemic on Neurosurgical Training in the United States: A Case Volume Analysis of 8 Programs

Author

Aljuboori, Zaid S., Young, Christopher C., Srinivasan, Visish M., Kellogg, Ryan T., Quon, Jennifer L., Alshareef, Mohammed A., Chen, Stephanie H., Ivan, Michael, Grant, Gerald A., McEvoy, Sean D., Davanzo, Justin R., Majid, Sonia, Durfy, Sharon, Levitt, Michael R., Sieg, Emily P., Ellenbogen, Richard G., and Nauta, Haring J.

Published
2021
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44. Radiation-Induced Stenosis

Author

Abecassis, Isaac Josh, Young, Christopher C., Sen, Rajeev D., Kelly, Cory M., Levitt, Michael R., Park, Min S., editor, Kalani, M. Yashar S., editor, de Havenon, Adam, editor, and McNally, J. Scott, editor

Published
2020
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45. Impact of Race on Outcomes in the Endovascular and Microsurgical Treatment in Patients With Intracranial Aneurysms.

Author

Hidetoshi Matsukawa, Kazutaka Uchida, Sowlat, Mohammad-Mahdi, Elawady, Sameh Samir, Cunningham, Conor, Alawieh, Ali, Kasab, Sami Al, Jabbour, Pascal, Mascitelli, Justin, Levitt, Michael R., Cuellar, Hugo, Brinjikji, Waleed, Samaniego, Edgar, Burkhardt, Jan-Karl, Kan, Peter, Fox, W. Christopher, Moss, Mark, Ezzeldin, Mohamad, Grandhi, Ramesh, and Altschul, David J.

Published
2024
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50. Impact of Race on Outcomes in the Endovascular and Microsurgical Treatment in Patients With Intracranial Aneurysms

Author

Matsukawa, Hidetoshi, primary, Uchida, Kazutaka, additional, Sowlat, Mohammad-Mahdi, additional, Elawady, Sameh Samir, additional, Cunningham, Conor, additional, Alawieh, Ali, additional, Al Kasab, Sami, additional, Jabbour, Pascal, additional, Mascitelli, Justin, additional, Levitt, Michael R., additional, Cuellar, Hugo, additional, Brinjikji, Waleed, additional, Samaniego, Edgar, additional, Burkhardt, Jan-Karl, additional, Kan, Peter, additional, Fox, W. Christopher, additional, Moss, Mark, additional, Ezzeldin, Mohamad, additional, Grandhi, Ramesh, additional, Altschul, David J., additional, Spiotta, Alejandro M, additional, and Yoshimura, Shinichi, additional

Published
2024
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