Faculty

Patrick Lyden

Patrick Lyden

Professor of Physiology and Neuroscience and Neurology
Neurology
ZNI 201, 1501 San Pablo Street Health Sciences Campus Los Angeles

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Cedars-Sinai Medical Center: Faculty Teaching Award, 2020

American Heart Association/American Stroke Association: AHA/ASA William M. Feinberg Award for Excellence in Clinical Stroke , 2019

American Heart Association/American Stroke Association: AHA/ASA William M. Feinberg Award for Excellence in Clinical Stroke, 2019

UT Houston: Gladys & George T. Abell Lecturship in Neurology, 2019

UCSD: Department of Neurosciences Award for Outstanding Teaching, 2014

University of Iowa: Adolf L. Sahs, MD Memorial Visiting Lecturer, 2011

American Heart Association, San Diego Affiliate: Heart of Gold Award, 2002

: Best Doctors in America, 2001-now

Disparate trends of atherosclerotic plaque evolution in stroke patients under 18-month follow-up: a 3D whole-brain magnetic resonance vessel wall imaging study Neuroradiol J. 2022 Feb; 35(1):42-52. . View in PubMed

2022 Update From the American Stroke Association and the Stroke Council Stroke. 2022 08; 53(8):e383-e384. . View in PubMed

Therapeutic hypothermia for intracerebral hemorrhage: Systematic review and meta-analysis of the experimental and clinical literature Int J Stroke. 2022 06; 17(5):506-516. . View in PubMed

Bias in Stroke Evaluation: Rethinking the Cookie Theft Picture Stroke. 2022 06; 53(6):2123-2125. . View in PubMed

The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results Stroke. 2022 05; 53(5):1802-1812. . View in PubMed

Temporal Profile of Pneumonia After Stroke Stroke. 2022 01; 53(1):53-60. . View in PubMed

Pro-resolving lipid mediators in traumatic brain injury: emerging concepts and translational approach Am J Transl Res. 2022; 14(3):1482-1494. . View in PubMed

Association of Recent Use of Non-Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase JAMA. 2022 02 22; 327(8):760-771. . View in PubMed

Author Correction: Differential expression of circulating exosomal microRNAs in refractory intracranial atherosclerosis associated with antiangiogenesis Sci Rep. 2021 Jul 21; 11(1):15266. . View in PubMed

Munchausen Syndrome by Tissue Plasminogen Activator: Patients Seeking Thrombolytic Administration Neurol Clin Pract. 2021 Feb; 11(1):64-68. . View in PubMed

Encephaloduroarteriosynangiosis (EDAS) revascularization for symptomatic intracranial atherosclerotic steno-occlusive (ERSIAS) Phase-II objective performance criterion trial Int J Stroke. 2021 08; 16(6):701-709. . View in PubMed

Top Priorities for Cerebroprotective Studies-A Paradigm Shift: Report From STAIR XI Stroke. 2021 08; 52(9):3063-3071. . View in PubMed

Cerebroprotection for Acute Ischemic Stroke: Looking Ahead Stroke. 2021 08; 52(9):3033-3044. . View in PubMed

Diagnosis and Management of Cerebral Venous Sinus Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia Stroke. 2021 07; 52(7):2478-2482. . View in PubMed

Temperature Management in Neurological and Neurosurgical Intensive Care Unit Ther Hypothermia Temp Manag. 2021 03; 11(1):7-9. . View in PubMed

The future of neuroprotection in stroke J Neurol Neurosurg Psychiatry. 2021 02; 92(2):129-135. . View in PubMed

Acute ischemic stroke versus transient ischemic attack: Differential plaque morphological features in symptomatic intracranial atherosclerotic lesions Atherosclerosis. 2021 02; 319:72-78. . View in PubMed

Stroke Treatment With PAR-1 Agents to Decrease Hemorrhagic Transformation Front Neurol. 2021; 12:593582. . View in PubMed

COVID-19 Impact on Acute Ischemic Stroke Treatment at 9 Comprehensive Stroke Centers across Los Angeles Cerebrovasc Dis. 2021; 50(6):707-714. . View in PubMed

Retinal Venular Tortuosity Jointly with Retinal Amyloid Burden Correlates with Verbal Memory Loss: A Pilot Study Cells. 2021 10 28; 10(11). . View in PubMed

Amendment on the article "Missing outcome data management in acute stroke trials testing iv thrombolytics: Is there risk of bias? " Eur Stroke J. 2020 Dec; 5(4):453-454.. View in PubMed

Magnetic Resonance Vessel Wall Imaging in Central Nervous System Vasculitides: A Case Series Neurologist. 2020 Nov; 25(6):174-177. . View in PubMed

Acute ophthalmic artery occlusion in a COVID-19 patient on apixaban J Stroke Cerebrovasc Dis. 2020 Aug; 29(8):104982. . View in PubMed

Hemodynamic latency is associated with reduced intelligence across the lifespan: an fMRI DCM study of aging, cerebrovascular integrity, and cognitive ability Brain Struct Funct. 2020 Jul; 225(6):1705-1717. . View in PubMed

Is there risk of bias? Eur Stroke J. 2020 Jun; 5(2):148-154.. View in PubMed

COVID-19 hypothesis: Activated protein C for therapy of virus-induced pathologic thromboinflammation Res Pract Thromb Haemost. 2020 May; 4(4):506-509. . View in PubMed

Stroke, Research and Science in the Time of COVID Stroke. 2020 09; 51(9):2613-2614. . View in PubMed

3K3A-Activated Protein C Variant Does Not Interfere With the Plasma Clot Lysis Activity of Tenecteplase Stroke. 2020 07; 51(7):2236-2239. . View in PubMed

Selective cerebral cooling for acute ischemic stroke J Cereb Blood Flow Metab. 2020 07; 40(7):1365-1367. . View in PubMed

Temperature Management in Neurological and Neurosurgical Intensive Care Unit Ther Hypothermia Temp Manag. 2020 06; 10(2):86-90. . View in PubMed

Assessing Cerebrovascular Hemodynamics Using Transcranial Doppler in Patients with Mechanical Circulatory Support Devices J Neuroimaging. 2020 05; 30(3):297-302. . View in PubMed

Measuring Outcome After Stroke: More Lessons Learned Again Stroke. 2020 04; 51(4):1053-1054. . View in PubMed

Training and Certifying Users of the National Institutes of Health Stroke Scale Stroke. 2020 03; 51(3):990-993. . View in PubMed

Current Advances in the Use of Therapeutic Hypothermia Ther Hypothermia Temp Manag. 2020 03; 10(1):2-5. . View in PubMed

Neuron-generated thrombin induces a protective astrocyte response via protease activated receptors Glia. 2020 02; 68(2):246-262. . View in PubMed

Sectoral segmentation of retinal amyloid imaging in subjects with cognitive decline Alzheimers Dement (Amst). 2020; 12(1):e12109. . View in PubMed

Therapeutic hypothermia and Type II errors: Do not throw out the baby with the ice water Brain Circ. 2019 Oct-Dec; 5(4):203-210. . View in PubMed

Differential Expression of Vascular Endothelial Growth Factor-A165 Isoforms Between Intracranial Atherosclerosis and Moyamoya Disease J Stroke Cerebrovasc Dis. 2019 Feb; 28(2):360-368. . View in PubMed

Differential effects of hypothermia on neurovascular unit determine protective or toxic results: Toward optimized therapeutic hypothermia J Cereb Blood Flow Metab. 2019 09; 39(9):1693-1709. . View in PubMed

Thrombolytic Therapy for Acute Ischemic Stroke Stroke. 2019 09; 50(9):2597-2603. . View in PubMed

Studies Targeting Stroke and Acute Myocardial Infarction Ther Hypothermia Temp Manag. 2019 03; 9(1):8-12. . View in PubMed

Final Results of the RHAPSODY Trial: A Multi-Center, Phase 2 Trial Using a Continual Reassessment Method to Determine the Safety and Tolerability of 3K3A-APC, A Recombinant Variant of Human Activated Protein C, in Combination with Tissue Plasminogen Activator, Mechanical Thrombectomy or both in Moderate to Severe Acute Ischemic Stroke Ann Neurol. 2019 01; 85(1):125-136. . View in PubMed

Differential expression of circulating exosomal microRNAs in refractory intracranial atherosclerosis associated with antiangiogenesis Sci Rep. 2019 12 19; 9(1):19429. . View in PubMed

Neuroprotection and vasculoprotection using genetically targeted protease-ligands Brain Res. 2019 07 15; 1715:13-20. . View in PubMed

Acute neuropathological consequences of short-term mechanical ventilation in wild-type and Alzheimer's disease mice Crit Care. 2019 02 22; 23(1):63. . View in PubMed

Retinal Microvascular Abnormalities as Surrogate Markers of Cerebrovascular Ischemic Disease: A Meta-Analysis J Stroke Cerebrovasc Dis. 2018 Jul; 27(7):1960-1968. . View in PubMed

Can an anticoagulant reduce brain hemorrhage: Invited comment on "Dabigatran reduces endothelial permeability through inhibition of thrombin-induced cytoskeleton reorganization" Thromb Res. 2018 Jun 12. . View in PubMed

Local to Systemic Use of Hypothermia Ther Hypothermia Temp Manag. 2018 Mar; 8(1):4-8. . View in PubMed

Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data Lancet Neurol. 2018 10; 17(10):885-894. . View in PubMed

Unique Uses of Cooling Strategies Ther Hypothermia Temp Manag. 2018 09; 8(3):126-130. . View in PubMed

Lack of Early Improvement Predicts Poor Outcome Following Acute Intracerebral Hemorrhage Crit Care Med. 2018 04; 46(4):e310-e317. . View in PubMed

Paradoxical cerebrovascular hemodynamic changes with nicardipine J Neurosurg. 2018 04; 128(4):1015-1019. . View in PubMed

When less is more (brain)-comment on "Rivaroxaban plasma levels in acute ischemic stroke and intracerebral hemorrhage" Ann Neurol. 2018 03; 83(3):446-448. . View in PubMed

Effects of alteplase for acute stroke according to criteria defining the European Union and United States marketing authorizations: Individual-patient-data meta-analysis of randomized trials Int J Stroke. 2018 02; 13(2):175-189. . View in PubMed

Cerebral Pulsatility Index Is Elevated in Patients with Elevated Right Atrial Pressure J Neuroimaging. 2018 01; 28(1):95-98. . View in PubMed

Treatment Modality and Quality Benchmarks of Aneurysmal Subarachnoid Hemorrhage at a Comprehensive Stroke Center Front Neurol. 2018; 9:152. . View in PubMed

Hypothermia in acute ischemic stroke therapy Handb Clin Neurol. 2018; 157:823-837. . View in PubMed

Perspectives on Temperature Management Ther Hypothermia Temp Manag. 2017 Dec; 7(4):188-192. . View in PubMed

Cerebral microemboli detection for monitoring structural cardiac disease Neurol Clin Pract. 2017 Oct; 7(5):409-412. . View in PubMed

Meta-Analysis of Pre-Clinical Trials of Therapeutic Hypothermia for Intracerebral Hemorrhage Ther Hypothermia Temp Manag. 2017 Sep; 7(3):141-146. . View in PubMed

Optimizing Outcomes for Mechanically Ventilated Patients in an Era of Endovascular Acute Ischemic Stroke Therapy J Intensive Care Med. 2017 Sep; 32(8):467-472. . View in PubMed

Intracerebral Hemorrhagic Expansion Occurs in Patients Using Non-Vitamin K Antagonist Oral Anticoagulants Comparable with Patients Using Warfarin J Stroke Cerebrovasc Dis. 2017 Aug; 26(8):1874-1882. . View in PubMed

Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study Lancet. 2017 Jun 17; 389(10087):2383-2392. . View in PubMed

Temperature Management in Neurological and Neurosurgical Intensive Care Unit Ther Hypothermia Temp Manag. 2017 Jun; 7(2):70-74. . View in PubMed

In Response J Stroke Cerebrovasc Dis. 2017 Feb; 26(2):454. . View in PubMed

Clinical Studies Targeting Stroke and Ischemic Insults Ther Hypothermia Temp Manag. 2017 Jan 20. . View in PubMed

2018: The Beginning of a New Era J Cereb Blood Flow Metab. 2017 10; 37(10):3273-3275. . View in PubMed

Brain Transforming Growth Factor-ß Resists Hypertension Via Regulating Microglial Activation Stroke. 2017 09; 48(9):2557-2564. . View in PubMed

Translational Stroke Research: Vision and Opportunities Stroke. 2017 09; 48(9):2632-2637. . View in PubMed

Rethinking Training and Distribution of Vascular Neurology Interventionists in the Era of Thrombectomy Stroke. 2017 08; 48(8):2313-2317. . View in PubMed

Clinical Studies Targeting Stroke and Ischemic Insults Ther Hypothermia Temp Manag. 2017 03; 7(1):12-15. . View in PubMed

Using the National Institutes of Health Stroke Scale: A Cautionary Tale Stroke. 2017 02; 48(2):513-519. . View in PubMed

Migraine and the Risk of Carotid Artery Dissection in the IPSYS Registry: Are They Related? JAMA Neurol. 2017 05 01; 74(5):503-504.. View in PubMed

Transcranial Doppler Changes in Patients Treated with Extracorporeal Membrane Oxygenation J Stroke Cerebrovasc Dis. 2016 Dec; 25(12):2882-2885. . View in PubMed

Temperature Management in Neurological and Neurosurgical Intensive Care Unit Ther Hypothermia Temp Manag. 2016 Dec; 6(4):164-168. . View in PubMed

Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis Lancet Neurol. 2016 Aug; 15(9):925-933. . View in PubMed

Activated protein C promotes neuroprotection: mechanisms and translation to the clinic Thromb Res. 2016 May; 141 Suppl 2:S62-4. . View in PubMed

Clinical Studies Targeting Stroke and In-Hospital Cardiac Arrest Ther Hypothermia Temp Manag. 2016 Mar; 6(1):6-8. . View in PubMed

Current Advances in the Use of Therapeutic Hypothermia Ther Hypothermia Temp Manag. 2016 Mar; 6(1):2-5. . View in PubMed

Online Tool to Improve Stratification of Adverse Events in Stroke Clinical Trials Stroke. 2016 Mar; 47(3):882-5. . View in PubMed

Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2) Stroke. 2016 12; 47(12):2888-2895. . View in PubMed

Selecting Patients for Intra-Arterial Therapy in the Context of a Clinical Trial for Neuroprotection Stroke. 2016 12; 47(12):2979-2985. . View in PubMed

Effects of Alteplase for Acute Stroke on the Distribution of Functional Outcomes: A Pooled Analysis of 9 Trials Stroke. 2016 09; 47(9):2373-9. . View in PubMed

Still cooling after all these years: Meta-analysis of pre-clinical trials of therapeutic hypothermia for acute ischemic stroke J Cereb Blood Flow Metab. 2016 07; 36(7):1157-64. . View in PubMed

Novel method for inducing rapid, controllable therapeutic hypothermia in rats using a perivascular implanted closed-loop cooling circuit J Neurosci Methods. 2016 07 15; 267:55-61. . View in PubMed

Seizures and Meperidine: Overstated and Underutilized Ther Hypothermia Temp Manag. 2015 Dec; 5(4):223-7. . View in PubMed

Troubleshooting the NIHSS: question-and-answer session with one of the designers Int J Stroke. 2015 Dec; 10(8):1284-6. . View in PubMed

Letter by Lahiri et al Regarding Article, "Endovascular Thrombectomy for Anterior Circulation Stroke: Systematic Review and Meta-Analysis" Stroke. 2015 Dec; 46(12):e258. . View in PubMed

Arabic cross cultural adaptation and validation of the National Institutes of Health Stroke Scale J Neurol Sci. 2015 Oct 15; 357(1-2):152-6. . View in PubMed

Microglia participate in neurogenic regulation of hypertension Hypertension. 2015 Aug; 66(2):309-16. . View in PubMed

Why don't more patients receive intravenous rt-PA for acute stroke? Expert Rev Neurother. 2015 Jun; 15(6):571-4.. View in PubMed

Type of admission is associated with outcome of spontaneous subarachnoid hemorrhage Int J Stroke. 2015 Jun; 10(4):529-33. . View in PubMed

Teaching neuroImages: short stature, imperforate anus, and polydactyly: When is a hypothalamic mass an incidentaloma? Neurology. 2015 Apr 14; 84(15):e117.. View in PubMed

Thrombolysis in acute stroke--authors' reply Lancet. 2015 Apr 11; 385(9976):1396. . View in PubMed

Aphasia and Dysarthria in Acute Stroke: Recovery and Functional Outcome Int J Stroke. 2015 Apr; 10(3):400-406. . View in PubMed

Robust and fragile aspects of cortical blood flow in relation to the underlying angioarchitecture Microcirculation. 2015 Apr; 22(3):204-218. . View in PubMed

Clinical studies targeting stroke Ther Hypothermia Temp Manag. 2015 Mar; 5(1):4-8. . View in PubMed

Revisiting cerebral postischemic reperfusion injury: new insights in understanding reperfusion failure, hemorrhage, and edema Int J Stroke. 2015 Feb; 10(2):143-52. . View in PubMed

Protease activated receptor-1 mediates cytotoxicity during ischemia using in vivo and in vitro models Neuroscience. 2014 Dec 05; 281:229-40. . View in PubMed

Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials Lancet. 2014 Nov 29; 384(9958):1929-35. . View in PubMed

Challenges of decision making regarding futility in a randomized trial: the Interventional Management of Stroke III experience Stroke. 2014 May; 45(5):1408-14. . View in PubMed

Direct thrombin inhibitor argatroban reduces stroke damage in 2 different models Stroke. 2014 Mar; 45(3):896-9. . View in PubMed

Pooled assessment of computed tomography interpretation by vascular neurologists in the STRokE DOC telestroke network J Stroke Cerebrovasc Dis. 2014 Mar; 23(3):511-5. . View in PubMed

Representation of people with aphasia in randomized controlled trials of acute stroke interventions Int J Stroke. 2014 Feb; 9(2):174-82. . View in PubMed

Clinical use of computed tomographic perfusion for the diagnosis and prediction of lesion growth in acute ischemic stroke J Stroke Cerebrovasc Dis. 2014 Jan; 23(1):114-22. . View in PubMed

Endovascular therapeutic hypothermia for acute ischemic stroke: ICTuS 2/3 protocol Int J Stroke. 2014 Jan; 9(1):117-25. . View in PubMed

Does the cognitive measure Cog-4 show improvement among patients treated with thrombolysis after acute stroke? Int J Stroke. 2013 Dec; 8(8):652-6.. View in PubMed

Optically induced occlusion of single blood vessels in rodent neocortex Cold Spring Harb Protoc. 2013 Dec 01; 2013(12):1153-60. . View in PubMed

Stroke treatment academic industry roundtable: research priorities in the assessment of neurothrombectomy devices Stroke. 2013 Dec; 44(12):3596-601. . View in PubMed

Mild hypothermia reduces tissue plasminogen activator-related hemorrhage and blood brain barrier disruption after experimental stroke: editorial commentary on tang et Al, 2013. Ther Hypothermia Temp Manag. 2013 Dec; 3(4):171-2. . View in PubMed

Activated protein C analog protects from ischemic stroke and extends the therapeutic window of tissue-type plasminogen activator in aged female mice and hypertensive rats Stroke. 2013 Dec; 44(12):3529-36. . View in PubMed

Preclinical and clinical studies targeting stroke Ther Hypothermia Temp Manag. 2013 Sep; 3(3):114-9. . View in PubMed

Acute Stroke Imaging Research Roadmap II Stroke. 2013 Sep; 44(9):2628-39. . View in PubMed

Hemorrhagic transformation during thrombolytic therapy and reperfusion: effects of age, blood pressure, and matrix metalloproteinases J Stroke Cerebrovasc Dis. 2013 May; 22(4):532-8. . View in PubMed

Preclinical and clinical studies targeting therapeutic hypothermia in cerebral ischemia and stroke Ther Hypothermia Temp Manag. 2013 Mar; 3(1):3-6. . View in PubMed

Thrombolysis in stroke despite contraindications or warnings? Stroke. 2013 Mar; 44(3):727-33.. View in PubMed

Determinants of Pneumonia Risk During Endovascular Hypothermia Ther Hypothermia Temp Manag. 2013 Mar; 3(1):24-27. . View in PubMed

Concurrent middle cerebral artery occlusion and intra-arterial drug infusion via ipsilateral common carotid artery catheter in the rat J Neurosci Methods. 2013 Feb 15; 213(1):63-9. . View in PubMed

Relationship between temperature, hematoma growth, and functional outcome after intracerebral hemorrhage Neurocrit Care. 2013 Feb; 18(1):45-53. . View in PubMed

Recovery from poststroke visual impairment: evidence from a clinical trials resource Neurorehabil Neural Repair. 2013 Feb; 27(2):133-41. . View in PubMed

PHLPP1 gene deletion protects the brain from ischemic injury J Cereb Blood Flow Metab. 2013 Feb; 33(2):196-204. . View in PubMed

Correlations among impairment, daily activities and thinking operations after stroke NeuroRehabilitation. 2013; 33(1):153-60. . View in PubMed

The smallest stroke: occlusion of one penetrating vessel leads to infarction and a cognitive deficit Nat Neurosci. 2013 Jan; 16(1):55-63. . View in PubMed

Phase 1 safety, tolerability and pharmacokinetics of 3K3A-APC in healthy adult volunteers Curr Pharm Des. 2013; 19(42):7479-85. . View in PubMed

The effect of transfer and hospital volume in subarachnoid hemorrhage patients Neurocrit Care. 2012 Dec; 17(3):312-23. . View in PubMed

Overview of therapeutic hypothermia Curr Treat Options Neurol. 2012 Dec; 14(6):541-8. . View in PubMed

Sisyphus and translational stroke research Sci Transl Med. 2012 Oct 17; 4(156):156ps20. . View in PubMed

Eagle syndrome revisited: cerebrovascular complicationsAnn Vasc Surg. 2012 Jul; 26(5):729. e1-5. . View in PubMed

ß-adrenergic receptor inhibition affects cerebral glucose metabolism, motor performance, and inflammatory response after traumatic brain injury J Trauma Acute Care Surg. 2012 Jul; 73(1):33-40. . View in PubMed

Ther Hypothermia Temp Manag. 2012 Jun; 2(2):51-2. . View in PubMed

In anticipation of International Stroke Trial-3 (IST-3) Stroke. 2012 Jun; 43(6):1691-4. . View in PubMed

Determinants of effective cooling during endovascular hypothermia Neurocrit Care. 2012 Jun; 16(3):413-20. . View in PubMed

Thrombin activity associated with neuronal damage during acute focal ischemia J Neurosci. 2012 May 30; 32(22):7622-31. . View in PubMed

Stroke: Haemorrhage risk after thrombolysis--the SEDAN score Nat Rev Neurol. 2012 Apr 17; 8(5):246-7. . View in PubMed

The argatroban and tissue-type plasminogen activator stroke study: final results of a pilot safety study Stroke. 2012 Mar; 43(3):770-5. . View in PubMed

Editorial on "A simple, assumption-free, and clinically interpretable approach for analysis of modified Rankin outcomes" Stroke. 2012 Mar; 43(3):621-2. . View in PubMed

Response of blood pressure and blood glucose to treatment with recombinant tissue-type plasminogen activator in acute ischemic stroke: evidence from the virtual international stroke trials archive Stroke. 2012 Feb; 43(2):399-404. . View in PubMed

Tenecteplase for acute ischemic stroke Int J Stroke. 2011 Dec; 6(6):509-10. . View in PubMed

The future of basic science research and stroke: hubris and translational stroke research Int J Stroke. 2011 Oct; 6(5):412-3. . View in PubMed

Low body temperature does not compromise the treatment effect of alteplase Stroke. 2011 Sep; 42(9):2618-21. . View in PubMed

Advanced brain imaging studies should not be performed in patients with suspected stroke presenting within 45 hours of symptom onset. Stroke. 2011 Sep; 42(9):2668-9. . View in PubMed

Commentary: The endovascular procedure-specific neurological examination scheme J Endovasc Ther. 2011 Aug; 18(4):538-9. . View in PubMed

Small intracerebral haemorrhages are associated with less haematoma expansion and better outcomes Int J Stroke. 2011 Jun; 6(3):201-6. . View in PubMed

Anti-adrenergic medications and edema development after intracerebral hemorrhage Neurocrit Care. 2011 Jun; 14(3):395-400. . View in PubMed

Home time is extended in patients with ischemic stroke who receive thrombolytic therapy: a validation study of home time as an outcome measure Stroke. 2011 Apr; 42(4):1046-50. . View in PubMed

Validation assessment of risk scores to predict postthrombolysis intracerebral haemorrhage Int J Stroke. 2011 Apr; 6(2):109-11. . View in PubMed

Frequent early cardiac complications contribute to worse stroke outcome in atrial fibrillation Cerebrovasc Dis. 2011; 32(5):454-60. . View in PubMed

Developing clinical trials in stroke Ther Hypothermia Temp Manag. 2011; 1(4):175-8. . View in PubMed

The correlation of independency in activities of daily living performance with cognitive status and the intensity of neurological impairment in right-handed stroke patients NeuroRehabilitation. 2011; 29(3):311-6. . View in PubMed

Therapeutic hypothermia is associated with a decrease in urine output in acute stroke patients Resuscitation. 2010 Dec; 81(12):1642-7. . View in PubMed

Influence of age on outcome from thrombolysis in acute stroke: a controlled comparison in patients from the Virtual International Stroke Trials Archive (VISTA) Stroke. 2010 Dec; 41(12):2840-8. . View in PubMed

Strokes with minor symptoms: an exploratory analysis of the National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator trials Stroke. 2010 Nov; 41(11):2581-6. . View in PubMed

Thrombolysis is associated with consistent functional improvement across baseline stroke severity: a comparison of outcomes in patients from the Virtual International Stroke Trials Archive (VISTA) Stroke. 2010 Nov; 41(11):2612-7. . View in PubMed

Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results Stroke. 2010 Oct; 41(10):2265-70. . View in PubMed

ACCESS: acute cerebrovascular care in emergency stroke systems Arch Neurol. 2010 Oct; 67(10):1210-8. . View in PubMed

Thrombin mediates severe neurovascular injury during ischemia Stroke. 2010 Oct; 41(10):2348-52. . View in PubMed

Disability status at 1 month is a reliable proxy for final ischemic stroke outcome Neurology. 2010 Aug 24; 75(8):688-92. . View in PubMed

Analysis of the National Institute of Neurological Disorders and Stroke tissue plasminogen activator studies following European Cooperative Acute Stroke Study III patient selection criteria J Stroke Cerebrovasc Dis. 2010 Jul-Aug; 19(4):290-3. . View in PubMed

Production and validation of Putonghua- and Cantonese-Chinese language National Institutes of Health Stroke Scale training and certification videos Int J Stroke. 2010 Apr; 5(2):74-9. . View in PubMed

An ethical hierarchy for decision making during medical emergencies Ann Neurol. 2010 Apr; 67(4):434-40. . View in PubMed

Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial Stroke. 2010 Apr; 41(4):707-11. . View in PubMed

Evolution of the thrombolytic treatment window for acute ischemic stroke Curr Neurol Neurosci Rep. 2010 Jan; 10(1):29-33. . View in PubMed

Time of day, outcome, and response to thrombolytic therapy: the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Trial experience J Stroke Cerebrovasc Dis. 2010 Jan; 19(1):40-8. . View in PubMed

Severe blood-brain barrier disruption and surrounding tissue injury Stroke. 2009 Dec; 40(12):e666-74. . View in PubMed

Extending the time window for thrombolytic therapy--primum non tardare Lancet Neurol. 2009 Dec; 8(12):1074-5. . View in PubMed

Correlations of neuronal and microvascular densities in murine cortex revealed by direct counting and colocalization of nuclei and vessels J Neurosci. 2009 Nov 18; 29(46):14553-70. . View in PubMed

Delayed detection of atrial fibrillation after ischemic stroke J Stroke Cerebrovasc Dis. 2009 Nov-Dec; 18(6):453-7. . View in PubMed

A randomized, double-blind, placebo-controlled trial to evaluate the efficacy, safety, tolerability, and pharmacokinetic/pharmacodynamic effects of a targeted exposure of intravenous repinotan in patients with acute ischemic stroke: modified Randomized Exposure Controlled Trial (mRECT) Stroke. 2009 Nov; 40(11):3518-25. . View in PubMed

Interconversion of the National Institutes of Health Stroke Scale and Scandinavian Stroke Scale in acute stroke J Stroke Cerebrovasc Dis. 2009 Nov-Dec; 18(6):466-8. . View in PubMed

Factors associated with intracerebral hemorrhage after thrombolytic therapy for ischemic stroke: pooled analysis of placebo data from the Stroke-Acute Ischemic NXY Treatment (SAINT) I and SAINT II Trials Stroke. 2009 Sep; 40(9):3067-72. . View in PubMed

The modified National Institutes of Health Stroke Scale: its time has come Int J Stroke. 2009 Aug; 4(4):267-73. . View in PubMed

Development of the Italian version of the National Institutes of Health Stroke Scale: It-NIHSS Stroke. 2009 Jul; 40(7):2557-9. . View in PubMed

Premature closure of the TUCSON trial: Stroke research is not for the faint of heart Ann Neurol. 2009 Jul; 66(1):4-5. . View in PubMed

National Institutes of Health Stroke Scale certification is reliable across multiple venues Stroke. 2009 Jul; 40(7):2507-11. . View in PubMed

Acute vascular disruption and aquaporin 4 loss after stroke Stroke. 2009 Jun; 40(6):2182-90. . View in PubMed

Natural history of complications after intracerebral haemorrhage Eur J Neurol. 2009 May; 16(5):624-30. . View in PubMed

Prior antiplatelet use does not affect hemorrhage growth or outcome after ICH Neurology. 2009 Apr 21; 72(16):1397-402. . View in PubMed

Active dilation of penetrating arterioles restores red blood cell flux to penumbral neocortex after focal stroke J Cereb Blood Flow Metab. 2009 Apr; 29(4):738-51. . View in PubMed

Hypothermia after acute ischemic stroke J Neurotrauma. 2009 Mar; 26(3):387-91. . View in PubMed

Multimodal neuroprotective therapy with induced hypothermia after ischemic stroke Stroke. 2009 Mar; 40(3 Suppl):S126-8. . View in PubMed

Selecting a measurement model for the analysis of the National Institutes of Health Stroke Scale Int J Neurosci. 2009; 119(7):1042-59. . View in PubMed

Assessment of a patient with stroke neurological examination and clinical rating scales Handb Clin Neurol. 2009; 94:971-1009. . View in PubMed

Can comprehensive stroke centers erase the 'weekend effect'? Cerebrovasc Dis. 2009; 27(2):107-13.. View in PubMed

In vitro sonothrombolysis with duplex ultrasound: first results using a simplified model Cerebrovasc Dis. 2009; 28(4):365-70. . View in PubMed

Prophylactic antiepileptic drug use is associated with poor outcome following ICH Neurocrit Care. 2009; 11(1):38-44. . View in PubMed

Is the NIHSS certification process too lenient? Cerebrovasc Dis. 2009; 27(5):426-32.. View in PubMed

Stroke outcome in clinical trial patients deriving from different countries Stroke. 2009 Jan; 40(1):35-40. . View in PubMed

Stroke. 2008 Dec; 39(12):3335-40. . View in PubMed

Hematoma growth in oral anticoagulant related intracerebral hemorrhage Stroke. 2008 Nov; 39(11):2993-6. . View in PubMed

Metabolic downregulation: a key to successful neuroprotection? Stroke. 2008 Oct; 39(10):2910-7.. View in PubMed

Thrombolytic therapy for acute stroke--not a moment to lose N Engl J Med. 2008 Sep 25; 359(13):1393-5. . View in PubMed

Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study Lancet Neurol. 2008 Sep; 7(9):787-95. . View in PubMed

Serum calcium as prognosticator in ischemic stroke Stroke. 2008 Aug; 39(8):2231-6. . View in PubMed

The promise and potential pitfalls of serum biomarkers for ischemic stroke and transient ischemic attack Neurologist. 2008 Jul; 14(4):243-6. . View in PubMed

NXY-059 for the treatment of acute stroke: pooled analysis of the SAINT I and II Trials Stroke. 2008 Jun; 39(6):1751-8. . View in PubMed

Code stroke in the cath lab J Am Coll Cardiol. 2008 Mar 04; 51(9):912. . View in PubMed

Effect of endovascular hypothermia on acute ischemic edema: morphometric analysis of the ICTuS trial Neurocrit Care. 2008; 8(1):42-7. . View in PubMed

Identification of nonischemic stroke mimics among 411 code strokes at the University of California, San Diego, Stroke Center J Stroke Cerebrovasc Dis. 2008 Jan-Feb; 17(1):23-5. . View in PubMed

The STRokE DOC trial technique: 'video clip, drip, and/or ship' Int J Stroke. 2007 Nov; 2(4):281-7. . View in PubMed

NXY-059 for the treatment of acute ischemic stroke N Engl J Med. 2007 Aug 09; 357(6):562-71. . View in PubMed

Safety and tolerability of NXY-059 for acute intracerebral hemorrhage: the CHANT Trial Stroke. 2007 Aug; 38(8):2262-9. . View in PubMed

Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Circulation. 2007 May 22; 115(20):e478-534. . View in PubMed

Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke. 2007 May; 38(5):1655-711. . View in PubMed

Real-time cerebral angiography: sensitivity of a new contrast-specific ultrasound technique AJNR Am J Neuroradiol. 2007 Apr; 28(4):635-9. . View in PubMed

Stroke-evoked angiogenesis results in a transient population of microvessels J Cereb Blood Flow Metab. 2007 Apr; 27(4):755-63. . View in PubMed

Measurement properties of the National Institutes of Health Stroke Scale for people with right- and left-hemisphere lesions: further analysis of the clomethiazole for acute stroke study-ischemic (class-I) trial Arch Phys Med Rehabil. 2007 Mar; 88(3):302-8. . View in PubMed

Induced hypothermia for acute stroke Stroke. 2007 Feb; 38(2 Suppl):794-9. . View in PubMed

Penetrating arterioles are a bottleneck in the perfusion of neocortex Proc Natl Acad Sci U S A. 2007 Jan 02; 104(1):365-70. . View in PubMed

An expedited code stroke protocol is feasible and safe Stroke. 2006 Dec; 37(12):2935-9. . View in PubMed

Additional outcomes and subgroup analyses of NXY-059 for acute ischemic stroke in the SAINT I trial Stroke. 2006 Dec; 37(12):2970-8. . View in PubMed

Alteplase for acute stroke revisited: the first 10 years Lancet Neurol. 2006 Sep; 5(9):722-4. . View in PubMed

A trial of therapeutic hypothermia via endovascular approach in awake patients with acute ischemic stroke: methodology Acad Emerg Med. 2006 Aug; 13(8):820-7. . View in PubMed

Contraindications of VEGF-based therapeutic angiogenesis: effects on macrophage density and histology of normal and ischemic brains Vascul Pharmacol. 2006 May; 44(5):316-25. . View in PubMed

Should all stroke patients receive tissue plasminogen activator therapy, despite mild or improving symptoms? Nat Clin Pract Cardiovasc Med. 2006 Apr; 3(4):184-5.. View in PubMed

NXY-059 for acute ischemic stroke N Engl J Med. 2006 Feb 09; 354(6):588-600. . View in PubMed

Therapeutic hypothermia for acute stroke Int J Stroke. 2006 Feb; 1(1):9-19. . View in PubMed

Two-photon imaging of cortical surface microvessels reveals a robust redistribution in blood flow after vascular occlusion PLoS Biol. 2006 Feb; 4(2):e22. . View in PubMed

Targeted insult to subsurface cortical blood vessels using ultrashort laser pulses: three models of stroke Nat Methods. 2006 Feb; 3(2):99-108. . View in PubMed

Stroke thrombolysis in the elderly: risk or benefit? Neurology. 2005 Dec 13; 65(11):1690-1.. View in PubMed

NIHSS training and certification using a new digital video disk is reliable Stroke. 2005 Nov; 36(11):2446-9. . View in PubMed

Real-time flow dynamics of a giant aneurysm Neurology. 2005 Aug 23; 65(4):E8. . View in PubMed

Transcranial ultrasound angiography (T USA): a new approach for contrast specific imaging of intracranial arteries Ultrasound Med Biol. 2005 Aug; 31(8):1001-6. . View in PubMed

Intravascular Cooling in the Treatment of Stroke (ICTuS): early clinical experience J Stroke Cerebrovasc Dis. 2005 May-Jun; 14(3):107-14. . View in PubMed

Beyond subgroup analysis: improving the clinical interpretation of treatment effects in stroke research J Neurosci Methods. 2005 Apr 30; 143(2):209-16. . View in PubMed

The impact of imbalances in baseline stroke severity on outcome in the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Ann Emerg Med. 2005 Apr; 45(4):377-84. . View in PubMed

Prospective reliability of the STRokE DOC wireless/site independent telemedicine system Neurology. 2005 Mar 22; 64(6):1058-60. . View in PubMed

Asymptomatic hemorrhagic transformation of cerebral infarction does not worsen long-term outcome J Stroke Cerebrovasc Dis. 2005 Mar-Apr; 14(2):50-4. . View in PubMed

A pilot dose-escalation safety study of tenecteplase in acute ischemic stroke Stroke. 2005 Mar; 36(3):607-12. . View in PubMed

Thrombosis of the posterior cerebral artery (PCA) visualized on computed tomography: the dense PCA sign Arch Neurol. 2004 Dec; 61(12):1960-1. . View in PubMed

Factor analysis of the National Institutes of Health Stroke Scale in patients with large strokes Arch Neurol. 2004 Nov; 61(11):1677-80. . View in PubMed

Neuroprotection of ischemic brain by vascular endothelial growth factor is critically dependent on proper dosage and may be compromised by angiogenesis J Cereb Blood Flow Metab. 2004 Jun; 24(6):693-702. . View in PubMed

Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials Lancet. 2004 Mar 06; 363(9411):768-74. . View in PubMed

Early impairment in consciousness predicts mortality after hemispheric ischemic stroke Crit Care Med. 2004 Jan; 32(1):241-5. . View in PubMed

Population pharmacokinetics of clomethiazole and its effect on the natural course of sedation in acute stroke patients Br J Clin Pharmacol. 2003 Aug; 56(2):173-83. . View in PubMed

Lack of hemispheric dominance for consciousness in acute ischaemic stroke J Neurol Neurosurg Psychiatry. 2003 Jul; 74(7):889-92. . View in PubMed

Early major ischemic changes on computed tomography should not preclude use of tissue plasminogen activator Stroke. 2003 Mar; 34(3):821-2. . View in PubMed

Admission glucose level and clinical outcomes in the NINDS rt-PA Stroke Trial Neurology. 2002 Sep 10; 59(5):669-74. . View in PubMed

Inter-relationships between spinal cord blood flow, neuronal death and neurological function in rabbit spinal cord ischemia Brain Res. 2002 Aug 09; 946(1):43-51. . View in PubMed

Modified National Institutes of Health Stroke Scale for use in stroke clinical trials: prospective reliability and validity Stroke. 2002 May; 33(5):1261-6. . View in PubMed

Telephone assessment of functioning and well-being following stroke: is it feasible? J Stroke Cerebrovasc Dis. 2002 Mar-Apr; 11(2):80-7.. View in PubMed

Systematic review of nimodipine Stroke. 2002 Feb; 33(2):639-40. . View in PubMed

Clomethiazole Acute Stroke Study in ischemic stroke (CLASS-I): final results Stroke. 2002 Jan; 33(1):122-8. . View in PubMed

Lack of clinical significance of early ischemic changes on computed tomography in acute stroke JAMA. 2001 Dec 12; 286(22):2830-8. . View in PubMed

Thrombolysis in patients with transient neurologic deficits Neurology. 2001 Dec 11; 57(11):2125-8. . View in PubMed

Further randomized controlled trials of tPA within 3 hours are required-not! Stroke 2001 Nov; 32(11):2709-10. . View in PubMed

The Clomethiazole Acute Stroke Study in tissue-type plasminogen activator-treated stroke (CLASS-T): final results Neurology. 2001 Oct 09; 57(7):1199-205. . View in PubMed

Use of image analysis for estimation of the numerical densities of neurons and synapses in cerebral cortex Brain Res Brain Res Protoc. 2001 Oct; 8(2):150-1. . View in PubMed

Angiogenesis after stroke is correlated with increased numbers of macrophages: the clean-up hypothesis J Cereb Blood Flow Metab. 2001 Oct; 21(10):1223-31. . View in PubMed

A simple stereologic method for analysis of cerebral cortical microvessels using image analysis Brain Res Brain Res Protoc. 2001 Aug; 8(1):45-57. . View in PubMed

A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity Stroke. 2001 Jun; 32(6):1310-7. . View in PubMed

Apolipoprotein E phenotype and the efficacy of intravenous tissue plasminogen activator in acute ischemic stroke Ann Neurol. 2001 Jun; 49(6):736-44. . View in PubMed

Quantitative effects of nefiracetam on spatial learning of rats after cerebral embolism J Stroke Cerebrovasc Dis. 2001 May-Jun; 10(3):99-105. . View in PubMed

Comparison of TNK with wild-type tissue plasminogen activator in a rabbit embolic stroke model Stroke. 2001 Mar; 32(3):748-52. . View in PubMed

Clinical deterioration following improvement in the NINDS rt-PA Stroke Trial Stroke. 2001 Mar; 32(3):661-8. . View in PubMed

Neuroprotectants in the treatment of stroke--an overview J Stroke Cerebrovasc Dis. 2000 Nov; 9(6 Pt 2):32-5. . View in PubMed

Mechanisms of action of neuroprotectants in stroke J Stroke Cerebrovasc Dis. 2000 Nov; 9(6 Pt 2):9-14. . View in PubMed

J Stroke Cerebrovasc Dis. 2000 Nov; 9(6 Pt 2):21-3. . View in PubMed

Finding the most powerful measures of the effectiveness of tissue plasminogen activator in the NINDS tPA stroke trial Stroke. 2000 Oct; 31(10):2335-41. . View in PubMed

Synergistic combinatorial stroke therapy: A quantal bioassay of a GABA agonist and a glutamate antagonist Exp Neurol. 2000 Jun; 163(2):477-89. . View in PubMed

Recent advances in stroke management J Stroke Cerebrovasc Dis. 2000 May-Jun; 9(3):95-105. . View in PubMed

Effect of ganaxolone in a rodent model of cerebral hematoma Stroke. 2000 Jan; 31(1):169-75. . View in PubMed

Criteria for selection of older patients for thrombolytic therapy Clin Geriatr Med. 1999 Nov; 15(4):721-39. . View in PubMed

Stroke. 1999 Nov; 30(11):2355-9. . View in PubMed

Thrombolysis for acute stroke Prog Cardiovasc Dis. 1999 Nov-Dec; 42(3):175-83. . View in PubMed

Underlying structure of the National Institutes of Health Stroke Scale: results of a factor analysisNINDS tPA Stroke Trial Investigators. Stroke. 1999 Nov; 30(11):2347-54. . View in PubMed

Agreement and variability in the interpretation of early CT changes in stroke patients qualifying for intravenous rtPA therapy Stroke. 1999 Aug; 30(8):1528-33. . View in PubMed

Spatial attention deficits in patients with acquired or developmental cerebellar abnormality J Neurosci. 1999 Jul 01; 19(13):5632-43. . View in PubMed

Acute medical therapy J Stroke Cerebrovasc Dis. 1999 May-Jun; 8(3):139-45. . View in PubMed

Editorial commentary J Stroke Cerebrovasc Dis. 1998 Nov-Dec; 7(6):i-ii. . View in PubMed

The clomethiazole acute stroke study in ischemic, hemorrhagic, and t-PA treated stroke: Design of a phase III trial in the united states and canada J Stroke Cerebrovasc Dis. 1998 Nov-Dec; 7(6):435-41. . View in PubMed

The diagnostic accuracy of bedside and laboratory coagulation: procedures used to monitor the anticoagulation status of patients treated with heparin Am J Clin Pathol. 1998 Apr; 109(4):371-8. . View in PubMed

Acute hypertension promotes hemorrhagic transformation in a rabbit embolic stroke model: effect of labetalol Exp Neurol. 1998 Mar; 150(1):153-8. . View in PubMed

Assessment scales for the evaluation of stroke patients J Stroke Cerebrovasc Dis. 1998 Mar-Apr; 7(2):113-27. . View in PubMed

Medical and neurological complications of ischemic stroke: experience from the RANTTAS trialRANTTAS Investigators. Stroke. 1998 Feb; 29(2):447-53. . View in PubMed

Effects of hyperbaric oxygen on neurologic outcome for cerebral ischemia in rats Acad Emerg Med. 1998 Jan; 5(1):18-24. . View in PubMed

Total quality improvement method for reduction of delays between emergency department admission and treatment of acute ischemic strokeThe National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Arch Neurol. 1997 Dec; 54(12):1466-74. . View in PubMed

High dose baclofen is neuroprotective but also causes intracerebral hemorrhage: a quantal bioassay study using the intraluminal suture occlusion method Exp Neurol. 1997 Oct; 147(2):346-52. . View in PubMed

Effect of ischemic cerebral volume changes on behavior Behav Brain Res. 1997 Aug; 87(1):59-67. . View in PubMed

Intravenous thrombolysis for acute stroke Neurology. 1997 Jul; 49(1):14-20. . View in PubMed

Neuroprotection: before and after thrombolysis J Stroke Cerebrovasc Dis. 1997 Apr-May; 6(4):198-9. . View in PubMed

Thrombolysis: findings and lessons of the clinical trials J Stroke Cerebrovasc Dis. 1997 Apr-May; 6(4):195-7. . View in PubMed

Medical therapy for intracerebral hematoma with the gamma-aminobutyric acid-A agonist muscimol Stroke. 1997 Feb; 28(2):387-91. . View in PubMed

Thrombolytic therapy in acute ischemic stroke N Engl J Med. 1997 Jan 02; 336(1):65-6; author reply 66-7. . View in PubMed

GABA and neuroprotection Int Rev Neurobiol. 1997; 40:233-58. . View in PubMed

Visualization of the cerebral circulation using three-dimensional transcranial power Doppler ultrasound imaging J Neuroimaging. 1997 Jan; 7(1):35-9. . View in PubMed

Use of a global test for multiple outcomes in stroke trials with application to the National Institute of Neurological Disorders and Stroke t-PA Stroke Trial Stroke. 1996 Nov; 27(11):2136-42. . View in PubMed

Guidelines for thrombolytic therapy for acute stroke: a supplement to the guidelines for the management of patients with acute ischemic strokeA statement for healthcare professionals from a Special Writing Group of the Stroke Council, American Heart Association. Circulation. 1996 Sep 01; 94(5):1167-74. . View in PubMed

Randomized trial of Cervene, a kappa receptor-selective opioid antagonist, in acute ischemic stroke J Stroke Cerebrovasc Dis. 1996 Sep-Oct; 6(1):3-4. . View in PubMed

Guidelines for Thrombolytic Therapy for Acute Stroke: a Supplement to the Guidelines for the Management of Patients with Acute Ischemic StrokeA statement for healthcare professionals from a Special Writing Group of the Stroke Council, American Heart Association. Stroke. 1996 Sep; 27(9):1711-8. . View in PubMed

Demographic and clinical characteristics of patients with episodic migraine versus chronic daily headache Cephalalgia. 1996 Feb; 16(1):44-9; discussion 4. . View in PubMed

Spontaneous early improvement following ischemic stroke Stroke. 1995 Aug; 26(8):1358-60. . View in PubMed

Combination chemotherapy extends the therapeutic window to 60 minutes after stroke J Neurotrauma. 1995 Apr; 12(2):223-30. . View in PubMed

Gait parameters following stroke: a practical assessment J Rehabil Res Dev. 1995 Feb; 32(1):25-31. . View in PubMed

Impact of race and ethnicity on ischemic strokeThe University of California at San Diego Stroke Data Bank. Stroke. 1995 Feb; 26(2):245-8. . View in PubMed

A rapid, reliable, and valid method for measuring infarct and brain compartment volumes from computed tomographic scans Stroke. 1994 Dec; 25(12):2421-8. . View in PubMed

Improved reliability of the NIH Stroke Scale using video trainingNINDS TPA Stroke Study Group. Stroke. 1994 Nov; 25(11):2220-6. . View in PubMed

Combination therapy protects ischemic brain in ratsA glutamate antagonist plus a gamma-aminobutyric acid agonist. Stroke. 1994 Jan; 25(1):189-96. . View in PubMed

Ultra-rapid identification, triage, and enrollment of stroke patients into clinical trials J Stroke Cerebrovasc Dis. 1994; 4(2):106-13. . View in PubMed

Migraine and migrainous stroke: risk factors and prognosis Neurology. 1993 Dec; 43(12):2473-6. . View in PubMed

An analysis of ischemic stroke in an urban southern California populationThe University of California, San Diego, Stroke Data Bank. Arch Intern Med. 1993 Mar 08; 153(5):619-24. . View in PubMed

Hemorrhagic transformation after cerebral ischemia: mechanisms and incidence Cerebrovasc Brain Metab Rev. 1993; 5(1):1-16. . View in PubMed

Protective effect of synaptic inhibition during cerebral ischemia in rats and rabbits Stroke. 1992 Oct; 23(10):1463-9; discussion 1469-70. . View in PubMed

Quantitative effects of cerebral infarction on spatial learning in rats Exp Neurol. 1992 May; 116(2):122-32. . View in PubMed

A critical appraisal of stroke evaluation and rating scales Stroke. 1991 Nov; 22(11):1345-52. . View in PubMed

Cerebral hemorrhagic risk of aspirin or heparin therapy with thrombolytic treatment in rabbits Stroke. 1991 Jul; 22(7):872-6. . View in PubMed

MR imaging of vertebrobasilar vascular disease J Comput Assist Tomogr. 1990 Nov-Dec; 14(6):895-904. . View in PubMed

Incidence of cerebral hemorrhage after treatment with tissue plasminogen activator or streptokinase following embolic stroke in rabbits [corrected] Stroke. 1990 Nov; 21(11):1589-93. . View in PubMed

Duplex carotid sonographyPeak systolic velocity in quantifying internal carotid artery stenosis. J Ultrasound Med. 1990 Jun; 9(6):345-9. . View in PubMed

The ferret as an animal model in cerebrovascular research Stroke. 1989 Aug; 20(8):1085-8. . View in PubMed

Carotid endarterectomy in a teaching hospital Stroke. 1989 Jul; 20(7):968-9. . View in PubMed

Acute anticoagulation following cardioembolic stroke Stroke. 1989 Jun; 20(6):730-4. . View in PubMed

Tissue plasminogen activator-mediated thrombolysis of cerebral emboli and its effect on hemorrhagic infarction in rabbits Neurology. 1989 May; 39(5):703-8. . View in PubMed

Thrombolytic therapy for acute stroke West J Med. 1989 May; 150(5):577. . View in PubMed

Delayed emergence of striatal dopaminergic hyperactivity after anterolateral ischemic cortical lesions in humans; evidence from turning behavior Biol Psychiatry. 1989 Feb 01; 25(3):265-74. . View in PubMed

Migrainous stroke Stroke. 1988 Oct; 19(10):1306. . View in PubMed

Effects of calcium channel blockers on neurologic outcome after focal ischemia in rabbits Stroke. 1988 Aug; 19(8):1020-6. . View in PubMed

Ischemic stroke associated with methamphetamine inhalation Neurology. 1988 Apr; 38(4):589-92. . View in PubMed

Tissue plasminogen activatorReduction of neurologic damage after experimental embolic stroke. Arch Neurol. 1988 Apr; 45(4):387-91. . View in PubMed

Prostaglandin concentrations in cerebrospinal fluid of rabbits under normal and ischemic conditions Stroke. 1988 Mar; 19(3):349-51. . View in PubMed

Glutamate antagonist therapy reduces neurologic deficits produced by focal central nervous system ischemia Arch Neurol. 1988 Feb; 45(2):148-53. . View in PubMed

'Crescendo' transient ischemic attacks: clinical and angiographic correlations Neurology. 1988 Feb; 38(2):198-201. . View in PubMed

Hemodilution with low-molecular-weight hydroxyethyl starch after experimental focal cerebral ischemia in rabbits Stroke. 1988 Feb; 19(2):223-7. . View in PubMed

Migrainous stroke Arch Neurol. 1988 Jan; 45(1):63-7. . View in PubMed

A model for quantitative evaluation of embolic stroke therapy Brain Res. 1987 Dec 01; 435(1-2):305-9. . View in PubMed

A new approach to stroke management Am Fam Physician. 1987 Oct; 36(4):189-97. . View in PubMed

Intracerebral hemorrhage after experimental embolic infarctionAnticoagulation. Arch Neurol. 1987 Aug; 44(8):848-50. . View in PubMed

Brain magnetic resonance imaging in the evaluation of lacunar stroke Stroke. 1987 Jul-Aug; 18(4):781-6. . View in PubMed

Asymmetric cavernous sinus not necessarily pathologic Neurology. 1987 Jan; 37(1):175. . View in PubMed

I am a neurologist with specialty board certification in Vascular Neurology. I have run large, multi-center clinical trials for industry and NIH. I have a laboratory effort that has been funded for over 30 years by NIH, VA and AHA focused on translational pre-clinical stroke modeling, pharmacology, and vascular biology. Our lab has recently focused on the role of thrombin mediating cytotoxicity and cytoprotection in the brain. Also, we have a long-standing interest in pre-clinical models of therapeutic hypothermia, motivated by my role as PI of the largest clinical trial of therapeutic hypothermia for stroke, the ICTuS program. We have considerable experience with a variety of experimental models; behavioral testing; histology; and cell biology. My team and I were recently selected by NINDS to develop the Stroke Preclinical Assessment Network (SPAN) as the Coordinating Center. The SPAN will test 6 novel stroke treatments in a state-of-the-art, rigorous network of expert pre-clinical stroke testing centers. We have considerable experience with a variety of experimental stroke models; behavioral testing; histology; and cell biology. Details follow:

I joined the Justin Zivin lab as a post-doctoral Fellow at the time he published his seminal demonstration that rt-PA powerfully protected neurological function after cerebral embolism (Zivin et al, 1985; Science 230:1289). During a 5-year R29 (NS267883) under Zivin, I created a model of post-embolic hemorrhage and contributed to the development of rt-PA as a clinical therapeutic. I was honored to be selected as the San Diego site PI of the NINDS for rt-PA Acute Stroke Trial (N01-N292332 and N01-NS02377), during which I helped draft the protocol and main results for that landmark trial. I wrote, produced and directed the NIH Stroke Scale training and certification video that has now been viewed by over 2M individuals around the world—I oversaw the clinimetric validation of these video tools. The rt-PA for stroke trial, published in the New England Journal of Medicine in 1995, is one of the most influential trials in the history of modern neurology.

My earliest research focused on agonists of the GABA-A receptor as neuroprotectants, which I demonstrated were at least as powerful in vivo as glutamate channel antagonists. The combination of both classes of drug exhibited powerful synergism. These studies led to several clinical trials for which I was the San Diego site PI. Then, I was chosen to serve as the global principal investigator of the GABA-A agonist clomethiazole trial known as CLASS, the global PI of the CHANT trial, and the North American coordinating investigator for SAINT 1 and SAINT 2.

In later studies, my lab studied angiogeneis, and the potential for angiogenic growth factors to serve as neuroprotectants. We noted a blood-brain barrier effect of VEGF, used in these studies, which led to several studies of angiogenesis (R01 NS43300) as we explored the role of putative neuroprotective growth factors. We eventually discovered that ischemic brain produces angiogenic growth factors to open capillaries and to promote entry of phagocytic macrophages, a phenomenon we labeled “the Clean-up hypothesis”. We showed convincingly that the angiogenesis documented around infarcts serves ONLY the clean-up of necrosis and is not a protective or neo-restorative effect.

During the vascular leakage studies in the lab, we became aware of work showing that thrombin powerfully opens the BBB by a direct effect on endothelial cells and kills neurons and astrocytes. Given our interest in leakage, we began working with thrombin. We also were aware of the seemingly contradictory effect of very-low-dose thrombin to protect brain (pre-conditioning). One of my PhD students noted that neurons expressed prothrombin message, an effect we dismissed at first as lab error. After confirming his results and finding traces of a similar finding in the literature, we began to ask what the purpose could be of neuronal-expressed thrombin. We showed (R01 NS075930) that thrombin powerfully kills cells in a dose-dependent manner via the PAR-1 receptor. Thrombin activity is associated with direct neuron killing during stroke. Thrombin antagonists, such as argatroban, are powerful neuroprotectants, and a clinical trial studied PAR-1 agent 3K3A-APC for which I served as the national PI (U01 NS088312). Argatroban itself is under study as stroke therapy, and I served as the Los Angeles site PI (P50 NS044227, Grotta).

Although these translational results were gratifying, we were left with the question, why does brain make the serum clotting factor prothrombin? We have used oxygen-glucose deprivation (OGD) in cell culture to model cellular responses to stroke or cardiac arrest. In a series of elegant in vitro experiments, my colleague Padmesh Rajput and I have demonstrated the OGD stressed neurons secrete thrombin into the culture media; OGD neuronal conditioned-media causes astrocyte activation; such astrocyte activation can be reproduced with low doses of thrombin; and is blocked by thrombin inhibitors or by knocking down or knocking out PAR-1 from the astrocytes. We then created an inducible, neuron-targeted prothrombin knock out experimental. After inducing the neuronal prothrombin knock out, the region of induced infarction in these experimentals is significantly enlarged and there is greatly reduced evidence of astrocyte activation in the ischemic bed. Taken together, these results suggest the novel hypothesis that neurons produce prothrombin as a distress signal to adjacent astrocytes, which respond with the newly described astrocyte protective response. We are actively engaged in multiple studies to support/refute this hypothesis; extend it to other elements in the NVU; and identify the active agent(s) comprising the astrocyte protective response.

Another area of interest in our laboratory is brain cooling, or therapeutic hypothermia, the most powerful neuroprotectant ever documented in stroke models. Therapeutic hypothermia is of proven benefit for victims of cardiac arrest or neonatal hypoxic-ischemic injury. For over a decade I worked on the ICTuS program (P50 NS044148) to deliver therapeutic hypothermia to patients. In the first trial, ICTuS, we showed that therapeutic hypothermia could be safely delivered with an endovascular cooling catheter. In the ICTuS-L program, we safely combined endovascular cooling with rt-PA. In the ICTuS 2/3 trial we attempted to document efficacy of therapeutic hypothermia and thrombolysis. The trial was stopped early, however, after several other trials of intra-arterial neurothrombectomy were overwhelmingly positive. We revised the ICTuS 3 protocol to accommodate neurothrombectomy, but during analysis of the small ICTuS 2 dataset we noted a troubling trend (not statistically significant) toward pneumonia risk during cooling. Also, other trials were published showing lack of efficacy for therapeutic hypothermia in head trauma, and no discernible difference between 33ºC vs 36ºC target temperatures for hypothermia after cardiac arrest. We asked if we were using therapeutic hypothermia correctly in treating these illnesses. Based on our observations of astrocyte protection of neurons, we asked whether cooling could disrupt the astrocyte mediated protection of neurons. In fact, we showed that hypothermia interferes with the astrocytes, in a graded, temperature-dependent manner. We recently showed that ultra-fast cooling to 33ºC for a short time was more powerful in the MCAo model than longer cooling periods. These exciting and novel data, if confirmed, suggest a reason for the failures of therapeutic hypothermia in some clinical trials. Moreover, our data suggests testable hypotheses about the effects of temperature in modulating NVU protection during ischemia.
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