STATUS: RECRUITING, TIMELESS: Tenecteplase in Stroke Patients Between 4.5 and 24 Hours Image shows a DWI positive lesion in a patient with transient left sided weakness. Types These questions have major ramifications for the care of patients with ICH or IVH. Through the use of biomaterials, microfabrication techniques, and stem cell therapeutics, we are able to manipulate the neural environment and determine important pathways for healing. Stanford has collaborated with the National Stroke Association, the American Heart Association and the American College of Chest Physicians to produce several guideline statements aimed at refining the diagnosis and management of TIA: National Stroke Association Recommendations for TIA, Guidelines for the Prevention of Stroke in Patients with TIA, Definition and Evaluation of Transient Ischemic Attack, Antithrombotic and thrombolytic therapy for ischemic stroke. The Stanford Stroke Center is recognized as a leader in stroke research and treatment. Stroke recovery research, including participation in multiple early-phase clinical stem cell therapy trials and development of a new line of stem cells, has also been a focus area. Stroke Center faculty members have authored more than 25 national and international clinical guideline statements. COVID-19 Updates: What We're Doing to Keep You Safe » COVID-19 Resources » Updated Visitor Policy ». Services available at the Stanford Stroke Center include: Non-surgical treatments for stroke prevention Following a stroke in 2010, Debra is now initiating research into the experience of stroke survivors in the rehabilitation process, ... After stroke, Stanford education scholar learns a different way to teach again Go to Faculty. The Stanford Stroke Center is recognized as a world-leader in clinical stroke research. The Center is home to a large team of neurologists, neurosurgeons, neuroradiologists, nurse specialists, basic scientists, and clinical researchers. A second purpose is to determine whether SB623 might improve stroke symptoms. Furthermore, it is unclear whether routine MRI in ICH yields clinically relevant data and if this data will change management decisions regarding further diagnostic testing and therapeutic options above and beyond that which can be achieved by CT and cerebral angiography. Protocol ID: 43744 stroke symptoms in women The improved outcomes were achieved through the use of the RAPID software platform for patient selection. This study will assess the impact of fever prevention on fever burden and short- and long-term neurologic outcomes in brain injured patients. This research has made it possible to individualize stroke treatment and expand the number of patients who can undergo highly effective treatments for their stroke. These include advances in microsurgery, interventional neuroradiology, stereotactic radiosurgery, 3D imaging, surgical navigation, revascularization techniques, the use of mild brain hypothermia and other clinical neuroprotective agents, and neurotransplantation. The Stanford Stroke Center has developed new ways to image the brain of patients suffering a stroke. 2010; 30 (5): 456-63. Of the people who have had a stroke, many are disabled to the degree that they cannot work, and a significant proportion are unable to walk, feed themselves, or communicate with their families the way they could prior to their stroke. Thus this pathway functions across a broad spectrum of neurodegenerative diseases, and may potentially modulate inflammatory responses and neuronal injury via conserved cellular and molecular mechanisms. The mission of the program is: "better health, less spending." Protocol ID: 42098 STATUS: RECRUITING, Crest 2 - Carotid Revascularization And Medical Management For Asymptomatic Carotid Stenosis Trial Now, Seim, Lansberg and Okamura are revising the glove’s design to improve its function and to add elements for comfort and accessibility. Search and read profiles of Stanford faculty, staff, students and postdocs. The Brain Interfacing Laboratory is interested in the applicability of brain-machine interfaces as a platform technology for a variety of brain-related medical conditions, particularly stroke and epilepsy. Stanford researchers studying the effect of stem cells injected directly into the brains of stroke patients said on Thursday that they were "stunned" by the … Status: RECRUITING, Blood Transcriptome of Transient Ischemic Attack (TIA STAR) The occurrence of stroke and death may be higher, lower, or the same between groups. Protocol ID: 46423 The purpose of this research study is to compare the effects (good and bad) of apixaban with the effects (good and bad) of aspirin in patients with unexplained strokes and atrial cardiopathy to see which is better at prevention of future strokes. Our goal is to use these pathways to develop new treatments for patients with stroke and other neurological diseases. Stroke. STATUS: RECRUITING, StrokeCog Status: RECRUITING, CHARM - Study to Evaluate the Efficacy and Safety of Intravenous BIIB093 for Severe Cerebral Edema following Large Hemispheric Infarction. A major factor in this transformation of stroke research will be to form a Stroke Collaborative Action Network (SCAN) at Stanford that will facilitate multi-directional translation of cutting edge engineering approaches to the basic and translational neuroscience of stroke recovery. He has already developed a national reputation for his scientific expertise in stem cell biology and neurogenesis in the central nervous system. Stanford’s stroke experts offer the most comprehensive, specialized, and leading-edge treatments for every type of stroke. This multicenter trial was designed and run by Stanford and funded by the NIH. On the other hand, a patient with ICH due to cerebral venous thrombosis will require blood thinners for treatment. Stanford research helps expand window for treating stroke up to 24 hours Clinicians now have up to 24 hours to treat a stroke, thanks in part to research and tools developed at Stanford Medicine. To determine this, we will schedule stroke patients to come in on a yearly basis for memory testing and collection of a small amount of blood. On the other hand, because of the added expense of MRI, its general use could result in a substantial increase in the cost of neurological care. The Stanford Stroke Center has consistently been one of the most prolific stroke research groups in the United States; faculty members have published more than 700 manuscripts based on clinical stroke research, as well as hundreds of basic science studies; the Center has maintained continuous NIH grant support for 28 years. Low risk TIA patients can be managed safely and cost-effectively in an outpatient TIA clinic. Now, research from the Stanford University School of Medicine has cracked that window open a bit wider. IRB: 48543 Stroke We also participate in international, multi-centered studies such as the International Pediatric Stroke Study and BrainWorks. This investigation leverages multichannel electrode arrays to gather a neural population estimate of the state of the brain. Stanford is currently accepting patients for this trial. A stroke is an interruption of blood flow to a specific part of the brain and can be fatal if not treated quickly. Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. PI: Maarten Lansberg, MD This software helps identify stroke patients who continue to have salvageable brain tissue long after the therapeutic window had generally been considered helpful has closed. Diagnostic Accuracy of MRI in Spontaneous Intracerebral Hemorrhage (DASH). Synthesis of this design process yielded a high-value stroke care model that: (1) prevents strokes through maximal use of preventative medications; (2) stratifies care for patients with TIA and mild stroke symptoms and; (3) delivers tPA in most time-efficient way possible and delivers a strengthened transition to community program for those at high risk for readmissions. Our foot in the door has been the study of the cyclooxygenase-2 (COX-2) pathway and its downstream prostaglandin receptor signaling pathways, which function in important ways in modulating the inflammatory response in brain in models of Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), and stroke. Palo Alto, CA 94304. In order to address this problem, Stanford Children’s Health has developed a multidisciplinary pediatric stroke program with a team of specialists who have the necessary experience and knowledge to skillfully diagnose, treat and manage strokes in children. This clinical trial demonstrated that far more people than previously thought can benefit from thrombectomy for acute ischemic stroke. With nearly 800,000 strokes occurring annually in the United States alone, stroke remains a leading cause of long term disability and death in the world. PI: Nirali Vora, MD BOOST3 is a study to learn if either of two strategies for monitoring and treating patients with traumatic brain injury (TBI) in the intensive care unit (ICU) is more likely to help them get better. The purpose of this study is to compare the effects, good or bad, of tenecteplase versus placebo on patients with stroke symptoms who present within 4.5 to 24 hours after the onset of the stroke symptoms. Stanford researchers have found that injecting stem cells directly into the brains of recovering stroke sufferers is more than just safe – it actually reverses brain damage, something previously thought impossible by science. PI: Chitra Venkatasubramanian, MD April 4, 2019 Stanford, Georgia Tech researchers build a glove to treat symptoms of stroke. PI: Maarten Lansberg, MD, PhD These research findings demonstrated that the paradigm for acute stroke treatment could move away from arbitrary time windows. Results of the trial were published in The New England Journal of Medicine and coincided with AHA new acute-stroke treatment guidelines that expanded the stoke treatment window from 6 to 24 hours. The overall aim of this project is to prospectively determine whether MRI can improve the conventional neuroradiological evaluation of patients with a spontaneous ICH or IVH. stroke treatment But stroke recovery is a neuroscience problem.That observation, Lansberg says, motivated him and Buckwalter to create their recovery program’s predecessor, the Stroke Collaborative Action Network, in 2015 with help from a Stanford Neurosciences Institute … J Am Heart Assoc. Get the Android MyHealth app ». Study involvement involves a one-time PET/MRI scan. stroke diagnosis Stroke. This research spans both preclinical models and human clinical studies. This Stanford study, sponsored by the NIH, demonstrated that patients with a favorable MRI profile, called Target Mismatch, have excellent outcomes following reperfusion, even when treated up to 6 hours after symptom onset with iv tPA. stroke treatments, Symptoms Established in 1992, the Stanford Stroke Center was one of the first comprehensive organization in the United States focused on stroke diagnosis, treatment, research, and education. Data from Stanford demonstrated that perfusion imaging, when optimally processed, can accurately identify critically hypoperfused penumbral tissue. There is reason to think that such a therapy might be obtainable – we know that some people, especially younger ones, experience significant recovery after stroke. Dr. Tai spent a year working on a redesigned care delivery process to address the gaps in the current system of stroke care in the United States. These techniques, which involve MRI with diffusion weighted imaging (DWI) and perfusion weighed imaging (PWI), have proven to identify patients who can benefit from both intravenous and intra-arterial therapies well beyond established time frames. Our Stroke Center team provides preventive care, diagnosis, and treatment for stroke and stroke-related issues. If a patient arrives at the emergency room within three hours of experiencing stroke symptoms, doctors can administer a potent clot-busting medication and often save critical brain tissue. The purpose of this research study is to understand the long-term effects of stroke on a person’s memory and thinking. In our lab, we are interested in understanding the mechanisms by which neuroinflammation elicits synaptic and neuronal injury in chronic and acute models of neurological disease. More details about some of our clinical research projects are described below. 2010; 41 (11): 2681-3. Learn more from Stanford Health Care. For more information, please see http://emed.stanford.edu/boost3.html. The Neurocritical Care Program has made key advances in the diagnosis of intracerebral hemorrhage and the prognosis of coma. Process Improvement and Cost Savings in Stroke and TIA Care. Protocol ID: 43136 2013, Magnetic resonance imaging profile of blood-brain barrier injury in patients with acute intracerebral hemorrhage. DoResearch. The rapid stroke protocol at the bustling emergency department got its start at Stanford’s Clinical Excellence Research Center. Join the SDRC research registry. The Stanford Stroke Center has been at the forefront of developing acute imaging and image processing techniques that provide immediate and accurate visualization of both core and penumbra. A major focus of our work is to understand how transplanted neural stem cells modulate this brain plasticity, and other repair pathways related to angiogenesis and inflammation, using genetic mouse models, gene profiling, and gene transfer techniques. The Stanford TIA program is currently evaluating a new technology, perfusion weighted imaging (PWI), as a method of confirming an ischemic “footprint” that can verify a transient neurological episode was caused by ischemia, rather than a non-ischemic condition. NCT (NA) We are currently conducting a prospective cohort study at Stanford University and several collaborating hospitals across the USA to test if physicians in the emergency setting, with the aid of RAPID, can accurately predict if a patient will benefit from an endovascular revascularization procedure. A stroke is damage to the brain that occurs when a blood vessel in the brain is blocked or bursts. DASH (Diagnostic accuracy of MRI in Spontaneous Intracerebral Hemorrhage) is a prospective study funded by the National Institute of Health (NIH). PI: Chitra Venkatasubramanian, MD Using molecular biology techniques, his laboratory is studying innovative methods of improving neurologic function after stroke or degenerative disease, including enhanced neurogenesis with growth factors and transplantation of different neuronal stem cells. The part of the body controlled by the damaged area of the brain can't work properly. Stanford Stroke Center is a research and teaching institution that offers medical services for its customers. STATUS: RECRUITING, Contact Us About Participating in Research, Lewy Body Dementia Research Center of Excellence, Stanford Alzheimer's Disease Research Center, Telestroke and Acute Teleneurology Program, Improvement Capability Development Program, Lucile Packard Children's Hospital Stanford. In addition, the data derived from this study will make a substantial contribution to future patient management by facilitation of the development of evidence based practice guidelines for the use of MRI in the workup of patients presenting with spontaneous ICH or IVH. High risk patients should be admitted to the hospital for close observation so that tPA can be administered rapidly if a stoke occurs, and to facilitate urgent completion of a full diagnostic evaluation. Our research team has also pioneered the development and testing of stem cell treatments for stroke recovery, a yet unproven but promising … CERC’s office lies in the oak-studded hills about a mile south of the center of campus, reached by a winding, single-lane road. With respect to stroke, we are exploring how the brain recovers from injury in translational preclinical models. Stanford Graduate School of Education. This percentage is higher among Black, Asian, and Hispanic populations, and expected to rise in the United States over the next few decades, due to increasing age and continuing changes in racial demographics. STATUS: RECRUITING, vREHAB - Virtual Reality Glove for Hand and Arm Rehabilitation After Stroke Our lab focuses on how inflammatory responses after brain injury affect neurological recovery. Research Administration. NCT02996266 Identifying the molecular mechanisms of stem cell-mediated brain recovery after stroke will enable us to manipulate the system to optimize stem cell efficacy, and could also lead to the identification of novel drug targets for stroke. Developing new stroke protocols. The CTP to predict Response to recanalization in Ischemic Stroke Project (CRISP) is a study funded by the National Institutes of Health (NIH) to develop a practical tool to identify acute stroke patients who are likely to benefit from endovascular therapy. Stanford Stoke Center faculty member Amy Tai is collaborating with CERC on a novel stroke/TIA heath care delivery project. MRI profile of the perihematomal region in acute intracerebral hemorrhage. However, methods for processing of CTP images and criteria for interpretation of the images are still immature. signs of a stroke Our overarching goal ... Stanford is home to the world’s leaders in sparse learning, post-selection inference, and other model reduction techniques (e.g., Rob Tibshirani and Trever Hastie) ... Stroke is the number one cause of long-term disability in the world. ICH occurs due to a variety of causes including hypertension, cerebral amyloid angiopathy, excessive anticoagulation, vascular malformations, cerebral venous thrombosis or brain tumors. Venkatasubramanian C, Mlynash M, Finley-Caulfield A, Eyngorn I, Kalimuthu R, Snider RW, Wijman CA. Utility of early MRI in the diagnosis and management of acute spontaneous intracerebral hemorrhage. Applications are currently being accepted on a rolling basis and proposals of all sizes will be considered, from initial exploration of cloud computing usability for projects to more advanced-stage projects. The acute treatment, prognosis and prevention of recurrent ICH depend on the reason for the brain hemorrhage. The STRONG Study will examine how stress and genetics can affect rehabilitation after stroke. Find researchers with whom you would like to collaborate. Subsequently, this concept was translated to CT perfusion imaging with thresholded relative CBF maps. These data will help guide the diagnostic evaluation and the management of brain hemorrhage patients in the future. It is, however, not known which patients benefit clinically. We have developed new surgical techniques to treat stroke, discovered better ways to predict the outcome of patients who have suffered neurological injury after cardiac arrest, and been part of numerous clinical trials aimed at establishing the best way to prevent stroke recurrence in our patients. Stroke is the leading cause of disability and eighth most expensive health condition in America. The successful execution of this research will provide physicians with an easy, automated method to select patients who are likely to benefit from restoration of blood flow. Venkatasubramanian C, MD, Jonathan T. Kleinman MD, Nancy J. Fischbein MD, Jean-Marc Olivot MD, PhD, Alisa D. Gean MD, Irina Eyngorn MD, Ryan W. Snider BA, Michael Mlynash MD, MS, and Christine A.C. Wijman MD, PhD. The purpose of this research study is to learn if brain inflammation relates to memory loss after stroke. Undergraduate Research. NCT: 02089217 stroke rehabilitation To determine this, we will collect spinal fluid from stroke patients to look for the presence of brain inflammation. After conducting primary research with the Stanford Stroke team, Montpellier stroke team, and two design sessions, the Stanford Medicine X Studio team has identified the following design principles that will most effectively track DNT and create a sense of urgency for stroke teams. It is estimated that this model will significantly improve patient outcomes and reduce healthcare spending in cerebrovascular disease by 11%. An innovative stroke care model was developed using a systematic design method that included: (1) A literature review of major guidelines, stroke care delivery methods, and cost effectiveness studies to identify the best practices and how to achieve them at the lowest cost; (2) Site visits with those identified to be best at delivering high quality care for the lowest cost; (3) Observations of patients and providers to identify their unmet needs; (4) Development of a model to address stakeholders' unmet needs using methods from design thinking and health care delivery science; (5) Estimation of the model's cost-saving potential, using national averages for risk factor prevalence, stroke incidence, and costs of conditions and interventions. MRI shows promise for identification of the ischemic core and penumbra but it has very limited availability in US emergency rooms. In a 2002 article in the New England Journal of Medicine, Stanford Neurologist Greg Albers, MD, and other cerebrovascular experts called for a revision in the definition of TIA — from time-based (the resolution of symptoms in 24 hours) — to the presence or absence of brain infarction, a tissue-based definition, on neuroimaging. Additional research interests include stroke prevention, TIA triage, eliminating disparities in health care, and neurology education. stroke recovery Of all patients who present with a stroke 10-20% will have suffered a spontaneous (non-traumatic) ICH rather than an ischemic stroke. You can message your clinic, view lab results, schedule an appointment, and pay your bill. Learn how we are healing patients through science & compassion, Stanford team stimulates neurons to induce particular perceptions in mice's minds, Students from far and near begin medical studies at Stanford. Access your health information from any device with MyHealth. A research collaboration coordinated at Stanford helped establish that a lesion detected by DWI lesion is an extremely accurate surrogate for the ischemic core. This study is testing a drug called tenecteplase. PI: Paul George, MD, PhD Stroke is the number one cause of disability in the United States. CT provides information on the size and the location of the hematoma. Diagnosis Stanford Neurologists Play Key Role in Redefinition of TIA, Determining Prognosis and Optimal Management. Once we understand this, we hope to be able to develop new therapies to help people’s brains repair themselves. Aksoy D, Bammer R, Mlynash M, Venkatasubramanian C, Eyngorn I, Snider RW, Gupta SN, Narayana R, Fischbein N, Wijman CA. The purpose of this study is to evaluate the safety and effectiveness of the study drug, Intravenous BIIB093 (Glibenclamide), in improving functional outcome in subjects with large strokes. Back to the Top. Stanford has pioneered major advances in medical therapies for treating and preventing stroke, neurosurgical techniques for stroke prevention, and interventional neuroradiologic procedures for stroke patients. Doctors, Clinics & Locations, Conditions & Treatments, View All Information for Patients & Visitors ». Our goal is thus to better understand the mechanisms that contribute to recovery in the young, and how they are influenced by inflammatory responses. Protocol ID: 41911 Find A Researcher. STATUS: RECRUITING, StrokeCog LP This information should have a major impact on the management of these patients by providing data on the diagnostic yield of routine MRI in patients presenting with a wide variety of causes for ICH or IVH. The goal here is to develop and then leverage a neural biomarker to guide stroke rehabilitation, with the aim of improving both the rate and total recovery from stroke. stroke warning signs It is caused by an occlusion of a blood vessel in the brain. The basic premise underlying acute stroke therapy is to salvage the ischemic region from evolving into infarction, thereby maintaining brain function and improving outcome. The benefits of the new TIA definition have been demonstrated in a series of recent publications in Lancet Neurology, Stroke, and Neurology that were co-authored by Stanford Stroke Center neurologists. If MRI truly can categorize patients into specific diagnostic categories better than CT, this would represent a major paradigm shift in the way that these patients are typically evaluated. Our long-term goal is to (1) further understand how neuroinflammatory processes injure synapses and neurons and disrupt circuits, (2) define the contribution of the COX-2/prostaglandin signaling pathways in this process, and (3) develop therapeutic strategies targeting injurious inflammatory processes in human neurological diseases. Wijman CA, Venkatasubramanian C, Bruins S, Fischbein N, Schwartz N. Cerebrovasc Dis. Get the iPhone MyHealth app » Without blood and the oxygen it carries, part of the brain starts to die. Stanford Neuroscience Health Center. Protocol ID: 42089 stroke causes Status: RECRUITING, Efficacy, Safety and Tolerability of BAF312 Compared to Placebo in Patients With Intracerebral Hemorrhage (ICH). M G Lansberg's 40 research works with 1,705 citations and 1,684 reads, including: O-034 Intraarterial clot localization in patients with acute ischemic stroke affects the venous microperfusion profile This study will examine gene expression in the blood of patients with Transient Ischemic Attack (TIA) / minor strokes compared to various types of control subjects. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials. In the United States, there are 4 million people currently living with the effects of stroke, and another 4.3 million living with the effects of traumatic brain injury. STATUS: RECRUITING, ARCADIA - AtRial Cardiopathy and Antithrombotic Drugs Intervention After cryptogenic stroke The Stanford Stroke Center has developed new ways to image the brain of patients suffering a stroke. This research has made it possible to individualize stroke treatment and expand the number of patients who can undergo highly effective treatments for their stroke. Animal studies, almost entirely done in young animals, also demonstrate significant recovery after neurological injury. Protocol ID: 41678 The Office of the Vice Provost and Dean of Research, provides comprehensive information about the research enterprise at Stanford. Computed Tomography Perfusion (CTP) imaging is a potential solution as it is widely available and can easily be added to a non-contrast head CT, already routinely obtained to evaluate stroke patients in the emergency room. For example, a patient who has an ICH due to cerebral amyloid angiopathy will need to avoid blood thinners to decrease the probability of a recurrent ICH. Despite this very high number of people who are suffering, there is a large knowledge gap regarding the mechanisms by which neurological recovery occurs, and not a single FDA-approved therapy available to help people recover. This is a randomized, placebo-controlled, subject- and investigator-blinded trial of BAF312 in intracerebral hemorrhage (ICH) patients to study efficacy, safety, and tolerability. Endovascular stroke treatment is increasingly being used and may fill this need, as it can be very effective at opening up occluded blood vessels in the brain. NCT: NCT03766581 “Stanford has SCAN and StrokeNet, along with a community of interdisciplinary engineering and computing research, so I reached out to Maarten, and he was very supportive,” Seim said. Closed trials are not currently enrolling, but may open in the future. PI: Marion Buckwalter PI: Chitra Venkatasubramanian, MD The goal is to understand how to help people recover from stroke. Protocol ID: 37711 PI: Neil Schwartz BAF312 is a drug that could potentially limit brain inflammation after ICH, and thereby improve neurological outcome for hemorrhagic stroke patients. Status: RECRUITING, AXIOMATIC-SSP: Oral Factor XIa Inhibitor for the Prevention of New Ischemic Stroke in Patients Receiving Aspirin and Clopidogrel Following Acute Ischemic Stroke or Transient Ischemic Attack (TIA) Dwi positive lesion in a patient with transient right sided weakness/numbness can benefit from thrombectomy for acute stroke treatment move... Mri shows promise for identification of the images are still immature outcome for hemorrhagic stroke.... Not treated quickly baf312 is a devastating type of stroke, patient selection based on images... Emergency department got its start at Stanford ’ s clinical Excellence research Center ( CERC ) in to... 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