Article
Clinical Neurology
M. Goyal, J. Kromm, A. Ganesh, C. Wira, A. Southerland, K. N. Sheth, H. Khosravani, P. Panagos, N. McNair, J. M. Ospel
Summary: Handling a health care crisis like the COVID-19 pandemic requires quick allocation of hospital staff and resources. Key strategies for integrating new team members during such emergencies include transferring essential knowledge, promoting open communication, strategic task assignment, and graded learning and responsibility. These strategies are crucial in ensuring smooth integration of new team members in challenging working environments.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2021)
Article
Clinical Neurology
Abdel Douiri, Walter Muruet, Ajay Bhalla, Martin James, Lizz Paley, Kaili Stanley, Anthony G. Rudd, Charles D. A. Wolfe, Benjamin D. Bray
Summary: The initial wave of the COVID-19 pandemic in the UK led to a decrease in admissions for acute stroke patients, with older patients and those with less severe strokes being more affected. While quality of stroke care was maintained and even improved in some aspects, there was an increase in inpatient case fatality, especially among patients with confirmed or suspected COVID-19 infections. These findings suggest that hospital avoidance during the pandemic may have resulted in untreated stroke patients with poorer outcomes, highlighting the need for resilient healthcare systems.
Article
Clinical Neurology
Richa Sharma, Lindsey R. Kuohn, Daniel M. Weinberger, Joshua L. Warren, Lauren H. Sansing, Adam Jasne, Guido Falcone, Amar Dhand, Kevin N. Sheth
Summary: Excess cerebrovascular deaths occurred during the COVID-19 pandemic in the United States, with decreased stroke-related EMS calls and increased time spent at home being associated factors. Public health measures are necessary to address the decrease in seeking medical care for acute stroke during the pandemic.
Article
Clinical Neurology
Alejandro Vargas, Nicholas D. Osteraas, Rima M. Dafer, Laurel J. Cherian, Sarah Y. Song, James J. Conners
Summary: The study examined the impact of COVID-19 on telestroke evaluations and the characteristics of patients assessed remotely for acute ischemic stroke (AIS). The results showed a significant decrease in telestroke evaluation requests in 2020 compared to 2019, along with a lower average age and higher NIHSS scores among AIS/TIA suspected patients.
NEUROLOGICAL SCIENCES
(2022)
Article
Clinical Neurology
Anne-Sophie Mariet, Maurice Giroud, Eric Benzenine, Jonathan Cottenet, Adrien Roussot, Ludwig Serge Aho-Glele, Pascale Tubert-Bitter, Yannick Bejot, Catherine Quantin
Summary: During the COVID-19 pandemic in France, there was a significant decrease in hospitalization rates for stroke/TIA in the most affected region, with a fast rebound after the lockdown ended. In contrast, the least affected region saw a slower recovery with a nonsignificant drop in hospitalization rates for stroke/TIA.
Article
Clinical Neurology
Shiyuan Gu, Zhengze Dai, Huachao Shen, Yongjie Bai, Xiaohao Zhang, Xinfeng Liu, Gelin Xu
Summary: The COVID-19 pandemic has significantly prolonged both pre- and posthospital delays in the management of acute ischemic stroke, leading to a decreased proportion of patients receiving intravenous thrombolysis within the recommended time window. Factors such as lower educational level, rural residency, mild symptoms, small artery occlusion, and transportation by means other than ambulance were associated with delayed treatment. Efforts are needed to reduce these delays and improve stroke outcomes as COVID-19 measures become routine in medical practice.
CEREBROVASCULAR DISEASES
(2021)
Article
Psychology, Multidisciplinary
David M. Markowitz, Brittany Shoots-Reinhard, Ellen Peters, Michael C. Silverstein, Raleigh Goodwin, Par Bjalkebring
Summary: During the COVID-19 pandemic, many Americans dehumanize Asians and Asian Americans, perceiving the virus as less severe and being more prone to believing in conspiracy theories about the virus.
FRONTIERS IN PSYCHOLOGY
(2021)
Article
Clinical Neurology
Valerian L. Altersberger, Lotte J. Stolze, Mirjam R. Heldner, Hilde Henon, Nicolas Martinez-Majander, Christian Hametner, Annika Nordanstig, Andrea Zini, Stefania Nannoni, Bruno Goncalves, Christian H. Nolte, Philipp Baumgartner, Andreas Kastrup, Panagiotis Papanagiotou, Georg Kagi, Ronen R. Leker, Marialuisa Zedde, Alessandro Padovani, Alessandro Pezzini, Visnja Padjen, Carlo W. Cereda, Georges Ntaios, Leo H. Bonati, Leon A. Rinkel, Urs Fischer, Jan F. Scheitz, Susanne Wegener, Guillaume Turc, Patrik Michel, Mauro Gentile, Alexandros Rentzos, Peter A. Ringleb, Sami Curtze, Charlotte Cordonnier, Marcel Arnold, Paul J. Nederkoorn, Stefan T. Engelter, Henrik Gensicke
Summary: During the COVID-19 pandemic lockdown, there was a slight decline in the number of stroke patients receiving acute reperfusion therapies. However, the key quality performance measures remained stable, indicating the resilience of acute stroke care service during the lockdown, especially in well-established European stroke centers.
Article
Oncology
Chris Labaki, Solange Peters, Toni K. Choueiri
Summary: Cancer patients have been significantly impacted by the COVID-19 pandemic, leading to changes in treatment decisions and disruptions in care. It is crucial for oncologists to make appropriate therapeutic choices based on clear recommendations to prevent a surge in cancer-related deaths in the coming months.
Article
Clinical Neurology
Marina Padroni, Michele Laudisi, Cristiano Azzini, Alesandro De Vito, Ilaria Casetta
Summary: The study analyzed the impact of the COVID-19 pandemic on stroke care in the province of Ferrara. It found a reduction in admission and thrombolysis rates for ischemic stroke during the first wave of the pandemic. While admission rates did not significantly differ in subsequent phases, thrombolysis rates remained lower. This suggests a shift in patient attitudes during the pandemic and highlights the success of health system and public health campaigns in reassuring patients about the safety of seeking emergency care.
NEUROLOGICAL SCIENCES
(2022)
Article
Clinical Neurology
Jung Jae Lee, Wing Nga Tsang, Sook Ching Yang, Jojo Yan Yan Kwok, Vivian W. Q. Lou, Kui Kai Lau
Summary: This study explored the caregiving experiences of Hong Kong stroke caregivers during the COVID-19 pandemic, revealing that caregivers experienced worsened physical and psychological well-being due to increased care burden and reduced support, leading to threatened relationships between caregivers and stroke survivors.
Article
Clinical Neurology
Hebun Erdur, Bob Siegerink, Christoph Leithner, Christiana Franke, Irina Lorenz-Meyer, Sarah Theen, Anselm Angermaier, Stephan Kinze, Joachim E. Weber, Jessica L. Rohmann, Jan F. Scheitz, Christian H. Nolte, Matthias Endres, Heinrich J. Audebert
Summary: During the early phase of the COVID-19 pandemic, both urban and rural regions in Northeastern Germany experienced a decrease in stroke admissions compared to previous years, primarily driven by avoidance of admissions of mildly affected stroke patients.
FRONTIERS IN NEUROLOGY
(2021)
Article
Rehabilitation
Suzanne Perea Burns, Talya K. Fleming, Sam S. Webb, Alice Sau Han Kam, Jaimee D. P. Fielder, Grace J. Kim, Xiaolei Hu, Mary Thelander Hill, Emily A. Kringle
Summary: Health care delivery for stroke patients has been negatively impacted during the COVID-19 pandemic, leading to delays in seeking care and changes in treatment patterns. The American Congress of Rehabilitation Medicine has convened a task force to discuss international experiences and propose interdisciplinary approaches to address these challenges.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2022)
Article
Multidisciplinary Sciences
Frederik Jorgensen, Alexander Bor, Magnus Storm Rasmussen, Marie Fly Lindholt, Michael Bang Petersen
Summary: Pandemic fatigue, as a psychological consequence of the COVID-19 pandemic, may lead to non-compliance with health-related policies and fuel political discontent. The study shows that pandemic fatigue significantly increases over time and is positively associated with the severity of interventions, but negatively associated with COVID-19 deaths. Fatigue elicits a broad range of discontent, including protest support and conspiratorial thinking.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2022)
Article
Medicine, General & Internal
Adam de Havenon, John P. Ney, Brian Callaghan, Samuel Hohmann, Ernie Shippey, Shadi Yaghi, Mohammad Anadani, Jennifer J. Majersik
Summary: After the outbreak of COVID-19, hospitalizations of patients with ischemic stroke decreased but returned to pre-pandemic levels by July 2020 in the United States. Comorbid COVID-19 was relatively common among patients with IS between April and December 2020, particularly among Black and Hispanic populations, with high morbidity rates.
Article
Neuroimaging
Johanna Maria Ospel, Rosalie McDonough, Wolfgang G. Kunz, Mayank Goyal
Summary: The study compared the long-term costs and cost-effectiveness of LVO stroke patients receiving EVT with concurrent IV alteplase versus EVT only. The results showed that EVT without concurrent alteplase is the preferred strategy from a health economic standpoint.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Clinical Neurology
F. Bala, N. Singh, F. Moreau, T. S. Field, M. Goyal, M. D. Hill, S. B. Coutts, M. Almekhlafi
Summary: This study investigated the prevalence and risk factors of intracranial atherosclerotic disease in patients with low-risk transient or persistent neurologic events. The results showed that intracranial atherosclerotic disease is not rare in these patients and is associated with MR imaging-proved ischemia. Therefore, evaluation of the intracranial arteries is crucial in determining the etiology of such low-risk events.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2022)
Article
Clinical Neurology
J. M. Ospel, F. Bala, R. V. McDonough, O. Volny, N. Kashani, W. Qiu, B. K. Menon, M. Goyal
Summary: This study evaluated the accuracy and interrater agreement of detecting medium-vessel occlusions using single-phase and multiphase CTA, finding that multiphase CTA had higher agreement and greater accuracy compared to single-phase CTA.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2022)
Review
Neuroimaging
Mayank Goyal, Joachim Fladt, J. M. Coutinho, Rosalie McDonough, Johanna Ospel
Summary: This review discusses the major obstacles in identifying cerebral venous thrombosis (CVT) patients who may benefit from endovascular treatment (EVT), and proposes a roadmap for overcoming these challenges in the near future.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Neuroimaging
Romain Bourcier, Mayank Goyal, Keith W. Muir, Hubert Desal, Diederik W. J. Dippel, Charles B. L. M. Majoie, Wim H. van Zwam, Tudor G. Jovin, Peter J. Mitchell, Andrew M. Demchuk, Robert J. van Oostenbrugge, Scott B. Brown, Bruce Campbell, Philip White, Michael D. Hill, Jeffrey L. Saver, Christian Weimar, Reza Jahan, Francis Guillemin, Serge Bracard, Olivier Naggara
Summary: This study analyzed the risk factors of UnEND in patients with anterior circulation acute ischemic stroke receiving EVT and MM treatment. The study found that the incidence of UnEND was similar in both treatment groups, with lower baseline NIHSS, higher baseline glucose, and lower collateral grade being independent risk factors in the EVT population. Higher baseline glucose was the only independent predictor in the MM population. UnEND was associated with unfavorable outcome in both treatment arms.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Clinical Neurology
Johanna Maria Ospel, Rosalie McDonough, Aravind Ganesh, Arshia Sehgal, Manon Kappelhof, Nima Kashani, Karin Klijn, Michael Hill, Jeffrey Saver, Mayank Goyal
Summary: The lack of funding in neurovascular research is a major problem, with high competitiveness, time-consuming funding processes, and excessive administrative requirements being the key obstacles to obtaining funding. Traditional funding agencies are perceived to be the most capable of closing the funding gap.
INTERVENTIONAL NEURORADIOLOGY
(2023)
Review
Neuroimaging
Johanna M. Ospel, Adam A. Dmytriw, Robert W. Regenhardt, Aman B. Patel, Joshua A. Hirsch, Martin Kurz, Mayank Goyal, Aravind Ganesh
Summary: Triage is an important process of resource allocation based on their best utilization, need, and potential success. In time-critical conditions like acute ischemic stroke, triage aims to minimize delays and consider factors like resource availability, workflows, and geography. Teamwork is the key factor in optimizing EVT triage, involving various healthcare professionals and requiring continuous efforts and hands-on training.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Review
Clinical Neurology
Johanna Ospel, Nishita Singh, Aravind Ganesh, Mayank Goyal
Summary: There are controversies regarding the role of sex and gender in acute stroke, as assessing their individual roles is difficult due to their intertwined nature. Furthermore, differences in baseline function between women and men contribute to disparities in post-stroke outcomes. Understanding these sex and gender differences is crucial to provide optimal care for acute stroke patients. Ignoring these factors may lead to erroneous conclusions and suboptimal care.
Article
Clinical Neurology
K. Zhu, F. Bala, J. Zhang, F. Benali, P. Cimflova, B. J. Kim, R. McDonough, N. Singh, M. D. Hill, M. Goyal, A. Demchuk, B. K. Menon, W. Qiu
Summary: This article aims to develop an automated approach to quantify thrombus on NCCT and CTA in patients with stroke. The deep learning model obtained reliable results in both internal and external datasets.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Article
Clinical Neurology
F. Bala, B. J. Kim, M. Najm, J. Thornton, E. Fainardi, P. Michel, K. Alpay, D. Herlihy, M. Goyal, I. Casetta, S. Nannoni, P. Ylikotila, S. Power, V. Saia, A. Hegarty, G. Pracucci, R. Rautio, A. Ademola, A. Demchuk, S. Mangiafico, K. Boyle, M. D. Hill, D. Toni, S. Murphy, B. K. Menon, M. A. Almekhlafi
Summary: This study demonstrated that in the late time window, patients with M2 occlusions treated with endovascular thrombectomy achieved better clinical outcomes, similar reperfusion, and lower symptomatic intracranial hemorrhage rates compared with patients with M1 occlusion.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Review
Neuroimaging
Johanna Maria Ospel, Manon Kappelhof, Aravind Ganesh, David F. Kallmes, Waleed Brinjikji, Mayank Goyal
Summary: Symptomatic non-stenotic carotid plaques (SyNC) are an under-researched and under-recognized source of stroke. It is necessary to conduct additional prospective studies to confirm the causal relationships between imaging markers of non-stenotic carotid plaques associated with stroke risk. Currently, there is a lack of standardized definition and imaging protocols for SyNC, and many neuroradiologists are unaware of the condition. Endovascular SyNC treatment shows promise, but there is a need for a device specifically designed for SyNC.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Review
Clinical Neurology
Johanna Ospel, Nathaniel Rex, Sandeep Kandregula, Mayank Goyal
Summary: In clinical practice, achieving recanalization of occluded blood vessels is an important goal for treating acute ischemic stroke patients. However, successful recanalization does not guarantee successful reperfusion of ischemic tissue, and various post-recanalization tissue damage mechanisms can impair patient outcomes. Understanding the prevalence and importance of these mechanisms is crucial for identifying promising cerebroprotectants and designing effective clinical trials. Serial human MRI studies combined with animal studies could provide valuable insights and help accelerate the translation of cerebroprotective agents from bench to bedside.
Article
Clinical Neurology
Tanaporn Jaroenngarmsamer, Faysal Benali, Joachim Fladt, Nishita Singh, Fouzi Bala, Michael Tymianski, Michael D. Hill, Mayank Goyal, Aravind Ganesh
Summary: This study compared the ability of NCCT and MR imaging to assess brain atrophy in patients with acute ischemic stroke. The results showed that NCCT had a weaker ability to assess cortical atrophy and a stronger ability to assess subcortical atrophy.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Review
Clinical Neurology
Joachim Fladt, Johanna M. Ospel, Nishita Singh, Jeffrey L. Saver, Marc Fisher, Mayank Goyal
Summary: In recent decades, with continuous technological advances and the availability of novel therapies, there has been a growing interest in shifting advanced acute care from hospitals to the prehospital setting. However, there are challenges related to conducting clinical trials, ambulance design and costs. Utilizing new technologies and customized software applications can help overcome these challenges and establish efficient, targeted care strategies in the prehospital setting.
Article
Clinical Neurology
Johanna M. Ospel, Corey Adams, Michael Tymianski, Mayank Goyal, Michael Hill
Summary: This study assessed the health economic impact of intravenous Nerinetide as an adjunctive treatment in endovascular treatment patients who do not receive concurrent intravenous alteplase. The results showed that adding Nerinetide to endovascular treatment resulted in higher net monetary benefits from both a healthcare and societal perspective.
INTERVENTIONAL NEURORADIOLOGY
(2023)
