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Article ; Online: Commentary on "Hospital Discharge Disposition of Stroke Patients in the State of Tennessee".

Abraham, Michael G

2017 Volume 110, Issue 9, Page(s) 601–602

MeSH term(s)	Humans ; Patient Discharge ; Stroke ; Tennessee
Language	English
Publishing date	2017-09-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000000695
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Article ; Online: Dual-Stent retriever thrombectomy for extensive dural sinus thrombosis.

Byer, Stefano H / Madarang, E John / Abraham, Michael G

The International journal of neuroscience

2022 Volume 133, Issue 12, Page(s) 1374–1379

Abstract: Introduction: First line treatment for cerebral venous thrombosis (CVT) is systemic anticoagulation. In cases with symptoms of elevated ICP, endovascular thrombectomy (EVT) is pursued. We describe two cases in which dual stent-retrievers were used for ... ...

Abstract	Introduction: First line treatment for cerebral venous thrombosis (CVT) is systemic anticoagulation. In cases with symptoms of elevated ICP, endovascular thrombectomy (EVT) is pursued. We describe two cases in which dual stent-retrievers were used for EVT. Objectives: The use of dual stent-retrievers has been described in arterial stroke when clot is present in the M1 artery and both M2 branches as a rescue therapy after 1 stent-retriever failed to remove the clot. We applied this same thinking to our EVT patients. Methods: A 17-year-old female with imaging demonstrating occlusion of the superior sagittal sinus (SSS), dominant right transverse sinus (TS), right sigmoid sinus (SS), and upper right internal jugular vein (IJV). A 20-year-old female with a magnetic resonance venography (MRV) noting CVT in the dominant lateral left TS, SS, and upper left IJV. Results: Both were taken for EVT due to severity of symptoms. Two 6 × 40 mm stent-retrievers were deployed into the CVT and then remove with continuous aspiration with significant recanalization. Conclusions: The average diameter of the dural sinuses is 8 mm compared to the average size of the middle cerebral artery 3-4 mm. The largest available SR in the United States is 6 mm, and the largest outer diameter of available aspiration catheters is 2-3 mm. Due to the larger size of the dural sinuses, using two SRs can result in more efficient recanalization and less radiation.
MeSH term(s)	Female ; Humans ; Adolescent ; Young Adult ; Adult ; Thrombectomy/methods ; Sinus Thrombosis, Intracranial/diagnostic imaging ; Sinus Thrombosis, Intracranial/surgery ; Cranial Sinuses/diagnostic imaging ; Cranial Sinuses/surgery ; Thrombosis ; Stents ; Treatment Outcome
Language	English
Publishing date	2022-06-13
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2022.2080675
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Article ; Online: Takotsubo cardiomyopathy in the setting of a myasthenic crisis.

Ranellone, Adam / Abraham, Michael G

The International journal of neuroscience

2020 Volume 132, Issue 1, Page(s) 89–94

Abstract: Background: Myasthenic crisis is characterized by severe weakness in bulbar and respiratory muscles leading to respiratory failure and can be a natural result of myasthenia gravis or precipitate due to infections, surgeries, and pregnancy. It has been ... ...

Abstract	Background: Myasthenic crisis is characterized by severe weakness in bulbar and respiratory muscles leading to respiratory failure and can be a natural result of myasthenia gravis or precipitate due to infections, surgeries, and pregnancy. It has been shown that stressful emotional events can lead to stress, or takotsubo cardiomyopathy. Takotsubo cardiomyopathy is characterized by transient reversible left ventricular dysfunction in the absence of obstructive artery disease with hypo- or akinesis of the apex with hypercontractility of the base. Methods: Case report and review of literature. Results: We report a 77-year old man with myasthenia gravis that was admitted to the neurological intensive care unit due to a myasthenic crisis. During the course of his treatment with plasma exchange, he developed hypotension with a reduced cardiac ejection fraction found on transthoracic electrocardiography. Repeat echocardiography 2 and 8 days later showed a normal ejection fraction and resolved cardiac function. Conclusion: While takotsubo cardiomyopathy rarely presents concurrently with a myasthenic crisis, its consideration is warranted in the face of cardiovascular decompensation. Given that several cardiac complications are known to be associated with myasthenic crisis, cardiac monitoring is advised. Nine reports describe takotsubo cardiomyopathy occurring concurrently with a myasthenic crisis; however, only one report demonstrates this association in the absence of concomitant comorbidities or significant emotional distress.
MeSH term(s)	Aged ; Humans ; Male ; Myasthenia Gravis/complications ; Takotsubo Cardiomyopathy/physiopathology
Language	English
Publishing date	2020-07-23
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2020.1797720
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Article ; Online: Commentary on "Intravenous Thrombolysis Attenuates Neurologic Deterioration After Ischemic Stroke".

Abraham, Michael G

Southern medical journal

2016 Volume 109, Issue 10, Page(s) 668–669

Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000000540
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Article ; Online: A Systematic Review and Meta-Analysis of Drug Eluting Stents for Safety and Efficacy in Intracranial Atherosclerotic Disease.

Dharia, Anand A / Byer, Stefano H / Le, Kevin / Chen, Xi / Abraham, Nihil / Hunt, Suzanne / Abraham, Michael G

The International journal of neuroscience

2024 , Page(s) 1–11

Abstract: Background: Advancements in arterial stenting technology have challenged prior notions favoring medical management for intracranial atherosclerotic disease (ICAD). Where previous conclusions were drawn from bare metal stent (BMS) technology, recent ... ...

Abstract	Background: Advancements in arterial stenting technology have challenged prior notions favoring medical management for intracranial atherosclerotic disease (ICAD). Where previous conclusions were drawn from bare metal stent (BMS) technology, recent studies suggest drug-eluting stents (DES) are favorable due to their anti-proliferative effect, which reduces vascular remodeling. Methods: We conducted a systematic review and meta-analysis of the literature prior to August 2023 reviewing all reports of ICAD treated with DES. Our target outcomes were incidence of any stroke, transient ischemic attack (TIA), or death within 30 days (postprocedural complications), ischemic stroke in the territory of the qualifying artery beyond 30 days (long-term complications), radiographically detected in-stent restenosis rate (ISR), and symptomatic ISR during follow-up. A subgroup analysis further stratified preprocedural mean stenosis above and below 70% into severe and moderate cohorts, respectively. Results: PubMed, Web of Science, Cochrane and EMBASE query identified 527 candidate articles, from which 14 studies met inclusion criteria for a total of 607 patients and 640 ICAD lesions. Incidence of postprocedural complications was 7.3% (95% CI 3.9-11.7%) with subgroup analysis demonstrating significantly higher incidence in the severely stenotic group [9.0% (95% CI 4.7-14.5%)] than the moderately stenotic group [3.0% (95% CI 0.7-6.8%)]. Long-term complications were 1.2% (95% CI 0.4-2.3%). Radiographic ISR was 3.5% (95% CI 1.4-6.3%) and symptomatic ISR was 0.3% (95% CI 0.0-1.5%). Conclusions: Our systematic review and meta-analysis suggest that DES can effectively reduce the risk of ISR and may be a viable treatment modality to reduce long-term complications in refractory ICAD patients.
Language	English
Publishing date	2024-02-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2024.2313013
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Article ; Online: Stent-assisted coiling of dural sinus diverticula: a case series.

Keshary, Sanjeev Raj / Everett, Travis / Alvarado, Anthony Michael / Abraham, Michael G

Journal of neurointerventional surgery

2021 Volume 14, Issue 9, Page(s) 920–924

Abstract: Background: Dural sinus diverticula are a rare vascular etiology of pulsatile tinnitus. Patients typically present with disabling symptoms and undergo an extensive workup for common causes of pulsatile tinnitus. Endovascular treatment has been shown to ... ...

Abstract	Background: Dural sinus diverticula are a rare vascular etiology of pulsatile tinnitus. Patients typically present with disabling symptoms and undergo an extensive workup for common causes of pulsatile tinnitus. Endovascular treatment has been shown to be effective in several case reports. We present the largest case series of eight patients treated with endovascular therapy using stent-assisted coiling and describe the unique details of intervention. Methods: A retrospective chart review was performed on all patients who underwent endovascular dural sinus stenting. Results: One-hundred-twenty patients underwent dural sinus stetnting from August 2012 to February 2020. Eight of these had symptomatic pulsatile tinnitus secondary to a dural sinus diverticulum and were successfully treated with stent-assisted coil embolization. No complications occurred. Conclusion: Our case series demonstrates that endovascular dural sinus stent-assisted coil embolization for symptomatic dural sinus diverticula is a safe and effective treatment.
MeSH term(s)	Cranial Sinuses/diagnostic imaging ; Cranial Sinuses/surgery ; Diverticulum/complications ; Diverticulum/diagnostic imaging ; Diverticulum/surgery ; Embolization, Therapeutic/adverse effects ; Humans ; Retrospective Studies ; Stents/adverse effects ; Tinnitus/etiology
Language	English
Publishing date	2021-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2020-016937
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Article: Secondary Analysis of Walking Activities during the Acute Stroke Hospital Stay and Cerebrovascular Health.

Whitaker, Alicen A / Henry, Madison L / Morton, Allegra / Ward, Jaimie L / Eickmeyer, Sarah M / Abraham, Michael G / Billinger, Sandra A

Cardiopulmonary physical therapy journal

2022 Volume 33, Issue 3, Page(s) 130–137

Abstract: Purpose: Physical activity within the hospital post-stroke is recommended for cardiovascular and musculoskeletal health, but no studies have examined cerebrovascular health. We hypothesized individuals who walked farther distances (FARhigh) during the ... ...

Abstract	Purpose: Physical activity within the hospital post-stroke is recommended for cardiovascular and musculoskeletal health, but no studies have examined cerebrovascular health. We hypothesized individuals who walked farther distances (FARhigh) during the acute phase of stroke recovery in a hospital setting would have a higher resting middle cerebral artery blood velocity (MCAv) and a greater cerebrovascular response (CVR) to moderate-intensity exercise at 3-months post-stroke, compared to individuals who walked shorter distances (FARlow). Methods: At 3-month post-stroke, we recorded 90-seconds of resting baseline (BL) MCAv followed by 6-minutes of moderate-intensity exercise. We calculated CVR as the change in MCAv from BL to steady-state exercise. We Results: Twenty participants completed the study, age 63 (15) years. BL MCAv was not different between groups (p = 0.07). In comparison to FARlow, we report a higher CVR in FARhigh's ipsilesional ( Conclusions: Physical activity during the hospital stay post-stroke may support cerebrovascular health after discharge. Prospective studies are needed to support this finding.
Language	English
Publishing date	2022-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2561970-6
ISSN	2374-8907 ; 1541-7891
ISSN (online)	2374-8907
ISSN	1541-7891
DOI	10.1097/CPT.0000000000000196
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Article ; Online: Unique variant of idiopathic intracranial hypertension dural sinus stenting.

Alvarado, Anthony M / Nalluri, Praneeta / Alvarado, Andrew M / Reeves, Alan / Abraham, Michael G

The International journal of neuroscience

2020 Volume 131, Issue 2, Page(s) 196–198

Abstract: Purpose/aim of the study: To report on the successful treatment of idiopathic intracranial hypertension (IIH) in a patient with venous sinus stenosis secondary to a persistent occipital-marginal sinus (POMS) utilizing venous sinus stenting.: Materials/ ...

Abstract	Purpose/aim of the study: To report on the successful treatment of idiopathic intracranial hypertension (IIH) in a patient with venous sinus stenosis secondary to a persistent occipital-marginal sinus (POMS) utilizing venous sinus stenting. Materials/methods: A 55-year-old female presented with headaches and blurry vision. Ophthalmologic examination demonstrated papilledema. Two lumbar punctures demonstrated opening pressures of 31 and 38 cmH2O and provided temporary symptom relief. Cerebral venography demonstrated hypoplastic bilateral transverse-sigmoid sinuses with dominant drainage through a persistent occipital-marginal sinus (POMS). Multiple enlarged arachnoid granulations resulted in stenosis in the marginal sinus with an 18 mmHg mean pressure gradient across the stenosis. Results: The decision was made for venous sinus stenting of the POMS. Immediate post-stenting venography demonstrated resolution of the POMS stenosis with flow only into the POMS and a mean pressure gradient across the stenosis normalized to 2 mmHg. Six-month follow-up venography demonstrated continued stent patency and clinical symptoms remained resolved. She has remained symptom free at 18 months. Conclusion: This writing summarizes the utility of endovascular dural sinus stenting and the importance of recognizing the dominant dural sinus drainage route in the treatment of IIH.
MeSH term(s)	Cranial Sinuses/surgery ; Endoscopy/methods ; Female ; Humans ; Middle Aged ; Pseudotumor Cerebri/surgery ; Stents ; Treatment Outcome
Language	English
Publishing date	2020-03-06
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2020.1734597
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Article ; Online: Push and Fluff technique for optimization of clot integration with stent-retriever: An in vitro model.

Pinheiro, Agostinho C / Nogueira, Raul G / Grandfield, Ryan M / Lin, Shao-Pow / Majjhoo, Aniel Q / Aghaebrahim, Amin Nima / Abraham, Michael G / Mazaris, Paul / Singer, Justin A / Al-Bayati, Alhamza R / Verhey, Leonard H / Lin, Eugene / Haussen, Diogo C

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

2023 , Page(s) 15910199231175348

Abstract: Background: For stent-retriever (SR) thrombectomy, technical developments such as the Push and Fluff technique (PFT) appear to have a significant impact on procedural success. This study aimed to (1) quantify the enhancement in clot traction when using ... ...

Abstract	Background: For stent-retriever (SR) thrombectomy, technical developments such as the Push and Fluff technique (PFT) appear to have a significant impact on procedural success. This study aimed to (1) quantify the enhancement in clot traction when using PFT as compared to the standard unsheathing technique (SUT) and (2) to evaluate the performance of PFT in new versus established users of the technique. Methods: Operators were divided between established PFT and SUT users. Each experiment was labeled according to the SR size, utilized technique, and operator experience. A three-dimensional-printed chamber with a clot simulant was used. After each retriever deployment, the SR wire was connected to a force gauge. Tension was applied by pulling the gauge until clot disengagement. The maximal force was recorded. Results: A total of 167 experiments were performed. The median overall force to disengage the clot was 1.11 pounds for PFT and 0.70 pounds for SUT (an overall 59.1% increment with PFT; p < 0.001). The PFT effect was consistent across different retriever sizes (69% enhancement with the 3 × 32mm device, 52% with the 4 × 28mm, 65% with the 4 × 41mm, 47% with the 6 × 37mm). The ratio of tension required for clot disengagement with PFT versus SUT was comparable between physicians who were PFT versus SUT operators (1.595 [0.844] vs. 1.448 [1.021]; p: 0.424). The PFT/SUT traction ratio remained consistent from passes 1 to 4 of each technique in SUT users. Conclusion: PFT led to reproduceable improvement in clot engagement with an average ∼60% increase in clot traction in this model and was found not to have a significant learning curve.
Language	English
Publishing date	2023-05-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1354913-3
ISSN	2385-2011 ; 1591-0199 ; 1123-9344
ISSN (online)	2385-2011
ISSN	1591-0199 ; 1123-9344
DOI	10.1177/15910199231175348
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Article ; Online: Pilot Study to Characterize Middle Cerebral Artery Dynamic Response to an Acute Bout of Moderate Intensity Exercise at 3- and 6-Months Poststroke.

Billinger, Sandra A / Whitaker, Alicen A / Morton, Allegra / Kaufman, Carolyn S / Perdomo, Sophy J / Ward, Jaimie L / Eickmeyer, Sarah M / Bai, Stephen X / Ledbetter, Luke / Abraham, Michael G

Journal of the American Heart Association

2021 Volume 10, Issue 3, Page(s) e017821

Abstract: Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3- and 6-months poststroke. As a secondary objective, we grouped individuals ... ...

Abstract	Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3- and 6-months poststroke. As a secondary objective, we grouped individuals according to the MCAv dynamic response to the exercise bout as responder or nonresponder. We tested whether physical activity, aerobic fitness, and exercise mean arterial blood pressure differed between groups. Methods and Results Transcranial Doppler ultrasound measured MCAv during a 90-second baseline followed by a 6-minute moderate intensity exercise bout. Heart rate, mean arterial blood pressure, and end-tidal CO
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Blood Flow Velocity/physiology ; Blood Pressure/physiology ; Cerebrovascular Circulation/physiology ; Exercise/physiology ; Exercise Therapy/methods ; Female ; Follow-Up Studies ; Heart Rate/physiology ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/diagnostic imaging ; Middle Cerebral Artery/physiopathology ; Pilot Projects ; Prognosis ; Stroke/diagnosis ; Stroke/physiopathology ; Stroke Rehabilitation/methods ; Time Factors ; Ultrasonography, Doppler, Transcranial/methods
Language	English
Publishing date	2021-01-26
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.120.017821
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