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15 results on '"Moore, Nina Z."'

4. Treatment outcomes for ARUBA-eligible brain arteriovenous malformations: a comparison of real-world data from the NVQI-QOD AVM registry with the ARUBA trial

Author

Alrohimi, Anas, primary, Achey, Rebecca L, additional, Thompson, Nicolas, additional, Abdalla, Ramez N, additional, Patterson, Thomas, additional, Moazeni, Yasaman, additional, Rasmussen, Peter A, additional, Toth, Gabor, additional, Bain, Mark D, additional, Ansari, Sameer A, additional, Hussain, Shazam M, additional, and Moore, Nina Z, additional

Published
2024
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10. Assessment of Cerebral Autoregulation Using Invasive and Noninvasive Methods of Intracranial Pressure Monitoring.

Author

Hassett, Catherine E., Uysal, S. Pinar, Butler, Robert, Moore, Nina Z., Cardim, Danilo, and Gomes, Joao A.

Subjects
CEREBRAL circulation, POSITIVE pressure ventilation, INTRACRANIAL pressure, GLASGOW Coma Scale, BRAIN injuries, BLOOD pressure
Abstract

Background: Pulse amplitude index (PAx), a descriptor of cerebrovascular reactivity, correlates the changes of the pulse amplitude of the intracranial pressure (ICP) waveform (AMP) with changes in mean arterial pressure (MAP). AMP relies on cerebrovascular compliance, which is modulated by the state of the cerebrovascular reactivity. PAx can aid in prognostication after acute brain injuries as a tool for the assessment of cerebral autoregulation and could potentially tailor individual management; however, invasive measurements are required for its calculation. Our aim was to evaluate the relationship between noninvasive PAx (nPAx) derived from a novel noninvasive device for ICP monitoring and PAx derived from gold standard invasive methods. Methods: We retrospectively analyzed invasive ICP (external ventricular drain) and non-invasive ICP (nICP), via mechanical extensometer (Brain4Care Corp.). Invasive and non-invasive ICP waveform morphology data was collected in adult patients with brain injury with arterial blood pressure monitoring. The time series from all signals were first treated to remove movement artifacts. PAx and nPAx were calculated as the moving correlation coefficients of 10-s averages of AMP or non-invasive AMP (nAMP) and MAP. AMP/nAMP was determined by calculating the fundamental frequency amplitude of the ICP/nICP signal over a 10-s window, updated every 10-s. We then evaluated the relationship between invasive PAx and noninvasive nPAx using the methods of repeated-measures analysis to generate an estimate of the correlation coefficient and its 95% confidence interval (CI). The agreement between the two methods was assessed using the Bland–Altman test. Results: Twenty-four patients were identified. The median age was 53.5 years (interquartile range 40–70), and intracranial hemorrhage (84%) was the most common etiology. Twenty-one (87.5%) patients underwent mechanical ventilation, and 60% were sedated with a median Glasgow Coma Scale score of 8 (7–15). Mean PAx was 0.0296 ± 0.331, and nPAx was 0.0171 ± 0.332. The correlation between PAx and nPAx was strong (R = 0.70, p < 0.0005, 95% CI 0.687–0.717). Bland–Altman analysis showed excellent agreement, with a bias of − 0.018 (95% CI − 0.026 to − 0.01) and a localized regression trend line that did not deviate from 0. Conclusions: PAx can be calculated by conventional and noninvasive ICP monitoring in a statistically significant evaluation with strong agreement. Further study of the applications of this clinical tool is warranted, with the goal of early therapeutic intervention to improve neurologic outcomes following acute brain injuries. [ABSTRACT FROM AUTHOR]

Published
2023
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12. List of Contributors

Author

Abtahi, Ali R., Adogwa, Owoicho, Ahmed, A. Karim, Ainechi, Ana, Alan, Nima, Albanese, Jessica, Aleem, Ilyas, Almeida, Joao Paulo, Alshabab, Basel Sheikh, Alvarado, Anthony M., Alvi, Mohammed Ali, Amer, Aboubakr, Ames, Christopher P., Ammanuel, Simon G., Anand, Neel, Anderson, Paul A., Angelov, Lilyana, Arnold, Paul M., Aubin, Carl-Eric, Bae, Junseok, Bain, Mark, Barber, Joshua, Baron, Eli M., Basi, Hersimren Kaur, Bawahab, Asef, Benzel, Edward C., Berven, Sigurd H., Bevan, Adam K., Bice, Miranda, Bilsky, Mark, Bisson, Erica F., Blaskiewicz, Donald, Boody, Barrett S., Bowles, Daniel, Branch, Charles, Brooks, Nathaniel, Buckland, Aaron J., Buell, Thomas J., Burch, Shane, Burke, John F., Butt, Bilal B., Bydon, Mohamad, Camara, Joaquin, Canseco, Jose A., Casper, David S., Cassidy, Matthew, Chao, Samuel T., Chatain, Grégoire P., Chieng, Lee Onn, Cho, Woojin, Choi, Hoon, Christopher, Susan R., Chung, Andrew S., Clark, Aaron J., Coric, Domagoj, Corriveau, Mark D., Cottrill, Ethan, Cychosz, Christopher, Daubs, Gregory, Daubs, Michael D., Davin, Sara, DeMicco, Russell C., de Padua, Ashley, Derman, Peter B., Dhall, Sanjay S., Diab, Mohammad, DiGiorgio, Anthony M., Dimar, John R., II, Dru, Alexander B., Dubousset, Jean, Dunbar, Melissa R., Ebrahim, Zeyd, Ehresman, Jeff, Elder, J. Bradley, Ellenbogen, Richard G., El Naga, Ashraf N., Emans, John B., Engstrom, John W., Errico, Thomas J., Farag, Ehab, Farber, S. Harrison, Fatima, Nida, Fedorak, Graham T., Fehlings, Michael G., Feigenbaum, Frank, Ferrara, Lisa, Fessler, Richard G., Finn, Michael, Fischgrund, Jeffrey S., Fisher, Mark D., Fontes, Ricardo B.V., Fox, Michael A., Freedman, Brett A., Frenkel, Mark, Fridley, Jared, Gabet, Joelle, Garg, Sumeet, German, John W., Ghogawala, Zoher, Gibbs, Christopher M., Gillick, John L., Gilligan, Christopher J., Gillis, Christopher C., Goel, Atul, Gokaslan, Ziya L., Goldstein, Zachary H., Grant, Gerald A., Grasso, Mackenzie, Grossbach, Andrew J., Guan, Jian, Guinn, Jeremy, Gupta, Raghav, Gussous, Yazeed M., Guyer, Richard D., Haddad, Alexander F., Hamilton, Kirsty, Harland, Tessa, Harrop, James S., Hart, David J., Hart, Robert A., Hassan, Waqaas A., Hayes, Amanda W., Heary, Robert F., Hedequist, Daniel, Henderson, Fraser C., Sr., Henzel, M. Kristi, Herring, Eric Z., Higgins, Dominique, Hilibrand, Alan S., Hindoyan, Kevork N., Hines, Kevin, Hitchon, Patrick W., Hoffmann, Jacob C., Hoh, Daniel J., Holt, Joshua, Hsia, Augusto, Hsieh, Jason, Hsu, Wellington K., Hurlbert, John, Hwang, Steven W., Iordanou, Jordan C., Jack, Andrew S., Janich, Karl, Jiang, Bowen, Jiang, Fan, Jimenez, Xavier F., Johnson, J. Patrick, Jones, G. Alexander, Jones, Kristen E., Joseph, Jacob R., Joshi, Rushikesh S., Juthani, Rupa G., Kalfas, Iain H., Kalra, Ricky R., Kang, James D., Kanter, Adam S., Kasliwal, Manish K., Kaushal, Mayank, Kerolus, Mena G., Kesler, Kyle, Kessler, Remi A., Khalaf, Tagreed, Khalil, Jad G., Kim, Terrence T., Kimball, Jon, Kisinde, Stanley, Klineberg, Eric O., Kondylis, Efstathios, Kramer, Dallas E., Krauss, William E., Krishnaney, Ajit A., Krogue, Justin, Kshettry, Varun R., Kumar, Neeraj, Kurpad, Shekar N., Labak, Collin M., Labelle, Hubert, Ladd, Bryan, Lafage, Virginie, Laratta, Joseph L., Lark, Robert, Lau, Darryl, Laufer, Ilya, Lavelle, William F., Le, Hai V., Lee, Andrew, Lee, Nathan J., Lee, Sang-Ho, Lehman, Ronald A., Jr., Lehner, Kurt, Lenke, Lawrence G., Li, Yingda, Lieberman, Isador H., Ling, Marcus Z., Lo, Victor P., Lollis, S. Scott, Lombardi, Joseph M., Long, Donlin, Long, Roger, Lotz, Jeffrey, Lyons, Joseph G., Mac-Thiong, Jean-Marc, Machado, Andre, Mallow, Gary M., Malone, David G., Manjila, Sunil, Maroon, Joseph C., Maslak, Joseph P., Massaad, Elie, Matsumoto, Morio, Martini, Michael L., Mayer, E. Kano, Mayer, Rory, Mazanec, Daniel J., McCormick, Kyle L., McCormick, Paul C., McGrath, Kyle, McNeill, Ian T., Medress, Zachary A., Mendelis, Joseph R., Mendis, Phillip G., Metz, Lionel, Midha, Rajiv, Miele, Vincent J., Mijatovic, Desimir, Mikula, Anthony L., Min, Elliot, Mizuno, Shuichi, Moghaddamjou, Ali, Molenda, Joseph E., Momin, Arbaz, Momin, Eric, Moore, Nina Z., Morris, Dylan, Morrissette, Cole R., Mroz, Thomas E., Mummaneni, Praveen V., Mundis, Gregory M., Munoz, Tess, Naderi, Sait, Nagel, Sean J., Nagoshi, Narihito, Nail, Tara Jayde, Nair, Dileep, NaPier, Zachary, Neifert, Sean N., Nemunaitis, Gregory, Nessim, Adam, Niu, Tianyi, Norwig, John A., Ong, Binnan, Onwuzulike, Kaine C., Oren, Jonathan, Orr, R. Douglas, O’Toole, John E., Ozpinar, Alp, Padua, Fortunato G., Page, Paul, Park, Paul J., Parmar, Vikas, Patel, Arati, Patel, Parthik, Patel, Rakesh, Pelle, Dominic, Peña, Enrique, Pendleton, Courtney, Pennicooke, Brenton, Pennington, Zach, Perez-Cruet, Mick J., Petersen-Fitts, Graysen R., Peterson, Thomas A., Piche, Joshua, Placide, Rick, Platt, Andrew, Polifka, Adam J., Polly, David W., Poree, Lawrence, Rajasekaran, S., Rammo, Richard, Rasouli, Jonathan J., Ratliff, John K., Rawlinson, Jeremy J., Ray, Wilson Z., Recinos, Pablo F., Recinos, Violette M., Reid, Patrick, Renfrow, Jackie, Resnick, Daniel K., Resser, Tina, Rhines, Laurence D., Richardson, Dusty, Riesenburger, Ron, Rispinto, Sarah, Rivera, Joshua, Rosenquist, Richard Wayne, Ross, Lindsey, Rossi, Vincent, Rudisill, Samuel S., Ruggieri, Paul, Ryu, Won Hyung A., Sabourin, Victor, Safaee, Michael M., Safain, Mina, Salaheen, Zaid, Samartzis, Dino, Samdani, Amer F., Samtani, Rahul G., Sasso, Rick, Satin, Alexander M., Savage, Jason W., Sawin, Paul D., Sawires, Andrew N., Sawyer, Aenor, Schmidt, Bradley T., Schmidt, Eric, Schmidt, Meic H., Schwab, Frank J., Sciubba, Daniel M., Sellin, Jonathan N., Shaaya, Elias, Shabani, Saman, Shaffrey, Christopher I., Shankar, Ganesh M., Shao, Jianning, Sharan, Alok D., Shaw, Jeremy D., Shen, Jian, Shenoy, Kartik, Shetty, Ajoy Prasad, Shin, John H., Shook, Steven J., Singh, Harminder, Singh, Rahul, Sissman, Ethan, Siyaji, Zakariah K., Smith, Gabriel A., Smith, John T., Smith, Justin S., Spinner, Robert J., Spurgas, Morgan P., Stefanelli, Anthony J., Steinmetz, Michael P., Sundar, Swetha J., Swarup, Ishaan, Takeoka, Yoshiki, Tatsui, Claudio E., Teferi, Nahom, Telfeian, Albert E., Theodore, Nicholas, Theologis, Alekos A., Thiyagarajah, Nishanth, Thorp, Brian D., Traynelis, Vincent C., Trost, Gregory R., Truong, Huy Q., Tsiang, John T., Tumialán, Luis M., Tymchak, Zane A., Udayasankar, Unni, Umansky, Daniel, Uribe, Juan S., Vaccaro, Alexander R., Vargovich, Alison M., Vaziri, Sasha, Veeravagu, Anand, Venezia, Michael, Verma, Kushagra, Vilarello, Brandon, Viljoen, Stephanus V., Viswanathan, Vibhu Krishnan, Volovetz, Josephine, Vorster, Sarel J., Walker, Corey T., Wallace, Daniel J., Wang, Anthony C., Wang, Jeffrey C., Wang, Marjorie C., Wang, Michael Y., Wang, Xiaoyu, Weinstein, Stuart L., Weisman, Michael H., Weissmann, Karen, Wentworth, Kelly, Whiting, Benjamin, Whitmore, Robert G., Wick, Joseph, Williams, Michelle, Wilson, James R., Wilson, Leslie, Witham, Timothy, Wolfla, Christopher E., Wolinsky, Jean-Paul, Woodard, Eric J., Wu, Hao-Hua, Yang, Michael, Yezdani, Samir G., Yoganandan, Narayan, Yolcu, Yagiz, Young, Robin, Zanation, Adam, Zehri, Aqib, and Zileli, Mehmet

Published
2022
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13. Diagnostic yield of cerebral angiography for intracranial hemorrhage in young patients: A single-center retrospective analysis

Author

El-Abtah, Mohamed E, Kashkoush, Ahmed, Achey, Rebecca, Patterson, Thomas, Moore, Nina Z, and Bain, Mark D

Abstract

Background Intracranial hemorrhage (ICH) secondary to hypertension (HTN) classically occurs in the basal ganglia, cerebellum, or pons. Vascular lesions such as aneurysms or arteriovenous malformations (AVMs) are more common in younger patients. We investigated the utility of diagnostic subtraction angiography (DSA) in young hypertensive patients with non-lobar ICH.Methods A retrospective review (2013–2022) identified young (18–60 years) patients who underwent DSA for ICH. HTN history, ICH location, presence/absence of subarachnoid hemorrhage (SAH), and computed tomography angiography (CTA) findings were collected. The main outcome was DSA-positivity, defined as presence of an AVM, aneurysm, Moyamoya disease, reversible cerebral vasoconstriction syndrome, or dural arteriovenous fistula on DSA.Results Two hundred sixty patients were included, and the DSA-positivity rate was 19%. DSA-positivity was lower in hypertensive patients with ICHs in the cerebellum, pons, or basal ganglia compared to the rest of the patient sample (9% vs 26%, p= 0.0002, Fisher's exact test). We developed the ICH-Angio score (0–5 points) based on CTA findings, ICH location, HTN history, and presence of SAH to predict risk of underlying vascular lesions. DSA-positivity was lower in those with a score of 0 (0/62; 0%) compared to a score of 1 (5/52; 10%), 2 (17/48; 35%), 3 (10/20; 50%), 4 (5/6; 83%), or 5 (3/3; 100%).Conclusion The ICH-Angio score was able to non-invasively rule out an underlying vascular etiology for ICH in up to one-third of patients. HTN, ICH location, CTA findings, and associated SAH can identify patients at low risk for harboring underlying vascular lesions.

Published
2024
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14. A novel endoleak classification for intracranial aneurysm flow diversion: A retrospective case series

Author

Kashkoush, Ahmed, Moore, Nina Z., El-Abtah, Mohamed E., Achey, Rebecca, Toth, Gabor, and Bain, Mark

Abstract

Background Although flow diversion (FD) is safe and effective in the treatment of intracranial aneurysms, a subset tends to continue filling on serial angiography. Risk factors for failed flow diversion include old age, large aneurysm size, and overstenting an adjacent end-arterial vessel. The hemodynamic modes of persistent aneurysm filling, or ‘endoleaks’, after FD are poorly understood. This study aims to characterize the various types of endoleaks following aneurysmal FD.Methods We performed a retrospective review of a prospectively maintained database of all endovascular procedures performed at a single institution between 2017 and 2021. Patients were included if they demonstrated evidence of unique modes of intracranial aneurysm filling after FD. Data regarding treatment, follow-up angiography, as well as clinical course were collected.Results Five patients (mean age 50 years, four females) were included with mean 19-month angiographic follow-up. Five major endoleak types are proposed: Type 1 – due to graft porosity (A – low flow, B – high flow), Type 2 –through an overstented branch vessel, Type 3 – via stent migration no longer covering aneurysmal neck, Type 4 – endoleak due to malapposition of the stent wall, and Type 5 – endoleak via collateralization from adjacent blood vessels. All endoleak types were represented, except for the Type 4 endoleak.Conclusion We propose an endoleak classification scheme to describe the hemodynamic modes of failure following FD of intracranial aneurysms. Future studies are needed to evaluate the natural history of aneurysmal filling following FD and retreatment success according to endoleak type.

Published
2024
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15. Risk assessment of early therapeutic anticoagulation following cranial surgery: an institutional case series.

Author

Davison MA, Patel AA, Lilly DT, Shost MD, Kashkoush AI, Krishnaney AA, Kshettry VR, Moore NZ, Rasmussen PA, and Bain MD

Subjects
Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, Risk Assessment, Adult, Intracranial Hemorrhages chemically induced, Intracranial Hemorrhages etiology, Thrombosis prevention & control, Thrombosis etiology, Anticoagulants adverse effects, Anticoagulants therapeutic use, Neurosurgical Procedures adverse effects, Neurosurgical Procedures methods, Postoperative Complications epidemiology, Postoperative Complications etiology
Abstract

Objective: Postoperative thrombotic complications represent a unique challenge in cranial neurosurgery as primary treatment involves therapeutic anticoagulation. The decision to initiate therapy and its timing is nuanced, as surgeons must balance the risk of catastrophic intracranial hemorrhage (ICH). With limited existing evidence to guide management, current practice patterns are subjective and inconsistent. The authors assessed their experience with early therapeutic anticoagulation (≤ 7 days postoperatively) initiation for thrombotic complications in neurosurgical patients undergoing cranial surgery to better understand the risks of catastrophic ICH., Methods: Adult patients treated with early therapeutic anticoagulation following cranial surgery were considered. Anticoagulation indications were restricted to thrombotic or thromboembolic complications. Records were retrospectively reviewed for demographics, surgical details, and anticoagulation therapy start. The primary outcome was the incidence of catastrophic ICH, defined as ICH resulting in reoperation or death within 30 days of anticoagulation initiation. As a secondary outcome, post-anticoagulation cranial imaging was reviewed for new or worsening acute blood products. Fisher's exact and Wilcoxon rank-sum tests were used to compare cohorts. Cumulative outcome analyses were performed for primary and secondary outcomes according to anticoagulation start time., Results: Seventy-one patients satisfied the inclusion criteria. Anticoagulation commenced on mean postoperative day (POD) 4.3 (SD 2.2). Catastrophic ICH was observed in 7 patients (9.9%) and was associated with earlier anticoagulation initiation (p = 0.02). Of patients with catastrophic ICH, 6 (85.7%) had intra-axial exploration during their index surgery. Patients with intra-axial exploration were more likely to experience a catastrophic ICH postoperatively compared to those with extra-axial exploration alone (OR 8.5, p = 0.04). Of the 58 patients with postoperative imaging, 15 (25.9%) experienced new or worsening blood products. Catastrophic ICH was 9 times more likely with anticoagulation initiation within 48 hours of surgery (OR 8.9, p = 0.01). The cumulative catastrophic ICH risk decreased with delay in initiation of anticoagulation, from 21.1% on POD 2 to 9.9% on POD 7. Concurrent antiplatelet medication was not associated with either outcome measure., Conclusions: The incidence of catastrophic ICH was significantly increased when anticoagulation was initiated within 48 hours of cranial surgery. Patients undergoing intra-axial exploration during their index surgery were at higher risk of a catastrophic ICH.

Published
2024
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