Publications by authors named "Santosh B Murthy"
: Intracerebral hemorrhages (ICH) and perihematomal edema (PHE) are respective imaging markers of primary and secondary brain injury in hemorrhagic stroke. In this study, we explored the potential added value of PHE radiomic features for prognostication in ICH patients. : Using a multicentric trial cohort of acute supratentorial ICH ( = 852) patients, we extracted radiomic features from ICH and PHE lesions on admission non-contrast head CTs.
View Article and Find Full Text PDFBackground: Secondary stroke prevention in patients with atrial fibrillation (AF) is one of the fastest growing areas in the field of cerebrovascular diseases. This Scientific statement from the World Stroke Organization Brain & Heart Task Force provides a critical analysis of the strength of current evidence this topic, highlights areas of current controversy, identifies knowledge gaps, and proposes priorities for future research.
Methods: We select topics with the highest clinical relevance and perform a systematic search to answer specific practical questions.
Article Synopsis
- The study investigates the link between traditional vascular risk factors and cervical artery dissection, particularly focusing on older patients.
- Using data from Medicare beneficiaries, the research identifies several risk factors, including hypertension, alcohol use, and coronary artery disease, that are associated with an increased likelihood of developing cervical artery dissection.
- The findings suggest that older individuals with certain vascular conditions are at a higher risk, indicating the need for further research on these associations.
Background: Cirrhosis is associated with an increased risk of hemorrhagic stroke. Liver fibrosis, typically a silent condition, is antecedent to cirrhosis. The objective of this study was to test the hypothesis that elevated Fibrosis-4 (FIB-4) index, indicating a high probability of liver fibrosis, is associated with an increased risk of hemorrhagic stroke.
View Article and Find Full Text PDFObjective: Nontraumatic intracerebral hemorrhage (ICH) is a potentially devastating cerebrovascular disorder. Several randomized trials have assessed interventions to improve ICH outcomes. This article summarizes some of the recent developments in the emergent medical and surgical management of acute ICH.
View Article and Find Full Text PDFBackground: Nontraumatic intracerebral hemorrhage (ICH) is independently associated with a long-term increased risk of major arterial ischemic events. While the relationship between ICH location and ischemic risk has been studied, whether hematoma volume influences this risk is poorly understood.
Methods: We pooled individual patient data from the MISTIE III (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation Phase 3) and the ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage-2) trials.
Importance: Cerebral amyloid angiopathy (CAA) is a common cause of spontaneous intracerebral hemorrhage in older patients. Although other types of intracranial hemorrhage can occur in conjunction with CAA-related intracerebral hemorrhage, the association between CAA and other subtypes of intracranial hemorrhage, particularly in the absence of intracerebral hemorrhage, remains poorly understood.
Objective: To determine whether CAA is an independent risk factor for isolated nontraumatic subdural hemorrhage (SDH).
Background: Ischemic lesions on diffusion weighted imaging (DWI) are common after acute spontaneous intracerebral hemorrhage (ICH) but are poorly understood for large ICH volumes (> 30 mL). We hypothesized that large blood pressure drops and effect modification by cerebral small vessel disease markers on magnetic resonance imaging (MRI) are associated with DWI lesions.
Methods: This was an exploratory analysis of participants in the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation phase 3 trial with protocolized brain MRI scans within 7 days from ICH.
Article Synopsis
- - The study investigates the effectiveness of minimally invasive surgery (MIS) for treating spontaneous supratentorial intracerebral hemorrhage (ICH), considering how MRI findings related to cerebral small vessel disease (CSVD) might influence long-term outcomes.
- - Analysis of data from the MISTIE trial showed no significant differences in outcomes between MIS and standard care when looking at specific CSVD features, but certain CSVD conditions were linked to better results in patients with reduced hematoma volumes after MIS.
- - Findings suggest that patients with fewer CSVD-related issues, such as lower amyloid angiopathy scores and no severe white matter hyperintensities, experience better functional outcomes after MIS, indicating these features could aid in patient selection for MIS
Article Synopsis
- Survivors of intracerebral hemorrhage (ICH) have an elevated risk of future ischemic cardiovascular events, but current guidelines do not clearly recommend the use of antithrombotic or statin therapies post-ICH.
- A study analyzed data from the Get With The Guidelines-Stroke registry (2011-2021) to examine patterns of medication prescription at discharge and factors influencing the use of these therapies after ICH.
- Results showed that a small percentage of patients were prescribed antithrombotic medications (10.4%), statins (35.1%), and anticoagulants (5.4%), with higher prescription rates linked to younger age, male sex, and prior medication use for conditions like ischemic vascular
Background: The efficacy of antiplatelet therapy (APT) after aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. We performed a systematic review and meta-analysis to summarize the associations of APT use after aSAH with outcomes.
Methods: We searched published medical literature to identify cohort studies involving adults with aSAH.
Background And Objectives: Factors associated with external ventricular catheter tract hemorrhage (CTH) are well studied; whether CTH adversely influence outcomes after intracerebral hemorrhage (sICH), however, is poorly understood. We therefore sought to evaluate the association between CTH and sICH outcomes.
Methods: We performed a post hoc analysis of the Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage trial.
Objective: Patients with spontaneous intracerebral hemorrhage (ICH) at the highest risk of hematoma growth are those with the most potential to benefit from anti-expansion treatment. Large clinical trials have not definitively shown a clear benefit of blood pressure (BP) reduction. We aim to determine whether intensive blood pressure reduction could benefit patients with fast bleeding ICH.
View Article and Find Full Text PDFBackground: Intracerebral hemorrhage (ICH) is associated with an increased risk of ischemic stroke. Whether there are racial and ethnic disparities in the risk of ischemic stroke after ICH is poorly understood. We therefore aimed to test the hypothesis that non-Hispanic Black and Hispanic ICH patients have a higher risk of ischemic stroke compared with non-Hispanic White ICH patients.
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- Chronic liver disease (CLD) is common and often goes unnoticed, with many individuals having subclinical symptoms that can still be significant.
- CLD affects various bodily functions, impacting factors like blood platelets and clotting, which are relevant to stroke risk and outcomes.
- This review aims to summarize how CLD and stroke are interconnected, providing updated insights for neurologists and treatment recommendations for patients experiencing both conditions.
Background: Serum neutrophil-lymphocyte ratio (NLR) is a surrogate marker for the inflammatory response after intracerebral hemorrhage (ICH) and is associated with perihematomal edema and long-term functional outcomes. Whether NLR is associated with short-term ICH complications is poorly understood. We hypothesized that NLR is associated with 30-day infection and thrombotic events after ICH.
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- The study investigated the relationship between serum levels of sICAM-1 and outcomes in patients with intracerebral hemorrhage (ICH), highlighting that higher levels of sICAM-1 are linked to worse outcomes, including increased mortality and poor recovery.
- Data were taken from the FAST trial, focusing on 507 patients, where results showed a significant association between elevated sICAM-1 levels and complications like hematoma expansion.
- The findings suggest that measuring sICAM-1 at admission could be a potential predictor of outcomes after ICH, especially in patients treated with recombinant activated factor-VII.
Intracranial hypertension is a feared complication of acute brain injury that can cause ischemic stroke, herniation, and death. Identifying those at risk is difficult, and the physical examination is often confounded. Given the widespread availability and use of computed tomography (CT) in patients with acute brain injury, prior work has attempted to use optic nerve diameter measurements to identify those at risk of intracranial hypertension.
View Article and Find Full Text PDFObjective: Patients with posterior reversible encephalopathy syndrome (PRES) can develop seizures during the acute phase. We sought to determine the long-term risk of seizure after PRES.
Methods: We performed a retrospective cohort study using statewide all-payer claims data from 2016-2018 from nonfederal hospitals in 11 US states.
Importance: The evidence linking chronic kidney disease (CKD) to spontaneous intracerebral hemorrhage (ICH) is inconclusive owing to possible confounding by comorbidities that frequently coexist in patients with these 2 diseases.
Objective: To determine whether there is an association between CKD and ICH risk.
Design, Setting, And Participants: A 3-stage study that combined observational and genetic analyses was conducted.
Background: Posterior reversible encephalopathy syndrome (PRES) can cause short-term cerebrovascular complications, such as brain infarction and hemorrhage. We hypothesized that PRES is also associated with an increased long-term risk of stroke.
Methods: We performed a retrospective cohort study in the United States using statewide all-payer claims data from 2016 to 2018 on all admissions to nonfederal hospitals in 11 states.