Helena Lau

Boston University | BU · Department of Neurology

Sleep disordered breathing (SDB) is highly prevalent, but frequently unrecognized among stroke patients. Polysomnography (PSG) is difficult to perform soon after a stroke. We evaluated the use of screening questionnaires and portable sleep testing (PST) for patients with acute stroke, subarachnoid hemorrhage, or transient ischemic attack to expedit...

Background and purpose: Enlarged perivascular spaces (EPVS) are considered subclinical markers of small vessel disease, associated with increased risk of stroke and dementia. Increasing evidence links chronic kidney disease (CKD) to small vessel disease. We explored the relationship between CKD and EPVS burden and the influence of racial group in...

Perihematomal edema (PHE) surrounding intracerebral hemorrhage (ICH) may contribute to disease-associated morbidity. Before quantifying PHE's effects on morbidity, a fast, accurate, and reproducible method for measuring PHE volume is needed. The aim of this study is to demonstrate the use of a semiautomated dual clustering segmentation algorithm to...

Background: Cerebral microbleeds (CMB) signal cerebral small vessel disease and are associated with ischemic stroke (IS) incidence, recurrence, and complications. While illicit drug use (IDU) is associated with cerebral small vessel disease, the association between CMB and IDU is understudied. We sought to delineate differences in vascular risk fac...

Background: Cerebral microbleeds (CMB) are associated with dementia and stroke. CMB are attributed to cerebral amyloid angiopathy (lobar CMB), and hypertensive angiopathy (deep CMB). Racial minorities (RM) have a higher prevalence and poorer control of vascular risk factors, thus CMB may differ in prevalence and distribution in RM. We determined th...

Background: Cortical Superficial Siderosis (cSS) detected on brain MRI affects 0.7% of the general population. In studies of predominantly White individuals, cSS is considered a sensitive marker of cerebral amyloid angiopathy (CAA) associated with increased risk of intracerebral hemorrhage. However, its prevalence and predictors in ischemic stroke...

Purpose: Racial minorities have a higher prevalence of vascular risk factors (VRF), as well as higher incidence and greater severity of stroke. Enlarged perivascular spaces (EPVS) are considered a marker of small vessel disease reflecting the long term effect of VRF. We aim to determine the prevalence and burden of EPVS in racial minorities, and ex...

Purpose: Enlarged perivascular spaces (EPVS) are brain MRI markers of subclinical small vessel disease (SVD). Recent studies suggest that basal ganglia (BG) EPVS represent hypertensive vasculopathy, while centrum semiovale (CSO) EPVS represent cerebral amyloid angiopathy. Increasing evidence links chronic kidney disease (CKD) to SVD, but the relati...

Background: Data on cerebral microbleeds (CMBs) in younger populations are lacking, particularly in young stroke patients. We sought to characterize CMBs in an inner city cohort of young adults with stroke. Methods: CMB presence, count, and topography were assessed on magnetic resonance imaging (MRI) scans of 104 young stroke patients (≤49 years...

Background: Basilar artery stroke causes substantial morbidity and mortality. Although its unusual clinical presentation potentially contributes to a delay in diagnosis, this problem has not been systematically studied. We compared intervals between symptom onset, initial presentation, and diagnosis in stroke due to basilar artery (BA) versus left...

We used a prospective clinical trial to examine the risks conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent strokes in the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. The SPS3 trial enrolled 3,020 patients with lacunar strokes. Participants were stratified into groups of METS only, DM only, bo...

Objectives To determine safety and tolerability of lowering blood pressure in older adults with lacunar stroke.DesignCohort study.SettingThe Secondary Prevention of Small Subcortical Strokes (SPS3) Trial, which compared the efficacy of two systolic blood pressure (SBP) targets (<130 mmHg and 130–149 mmHg) for secondary stroke prevention.Participant...

Background: Smoking, alcohol use, and physical inactivity represent health behaviors that, if modified, may significantly reduce the burden of stroke. Purpose: To evaluate the impact of trial participation on health behavior modification. Methods: The Secondary Stroke Prevention Study (SPS3) study enrolled 3020 subjects followed for an average of...

Methods: We included 1061 consecutive patients with ischemic stroke (2005-2008) in our local Get-With-The-Guidelines (GWTG) database. Multivariate logistic regression analysis was used to evaluate the relation of race and insurance status to risk factors, intravenous thrombolytic therapy (IV-tPA) use, stroke severity (National Institute of Health S...

Background and purpose: In contrast to middle cerebral artery territory strokes, anterior cerebral artery strokes (ACAS) occur rarely. The low frequency of ACAS, in relation to middle cerebral artery territory strokes, may be explained by differences in ACA and middle cerebral artery anatomy influencing their respective flow-directed embolism rate...

Background: Anterior cerebral artery strokes (ACAS) account for only 1-2% of cerebral infarctions, and typically result from embolism in western populations. The cause of the low frequency of ACAS in relation to MCA strokes (MCAS) is uncertain, but differences in arterial anatomy may affect flow-directed embolism rates. We aimed to determine whethe...

Background: White-matter hyperintensities (WMH) and cerebral microbleeds (CMBs) are considered radiographic markers of small vessel disease (SVD). Literature on CMB and WMH prevalence and associated risk factors in young patients presenting with stroke is limited. We have reported high prevalence of both WMH and CMBs in our cohort of young stroke p...

We sought to describe the course and predictors of quality of life (QOL) after lacunar stroke. We hypothesized that there is a decline in QOL after recovery from lacunar stroke. The Secondary Prevention of Small Subcortical Strokes is a clinical trial in lacunar stroke patients with annual assessments of QOL with the stroke-specific QOL score. The...

Background: Introduction of neurocritical care services to dedicated neuro-ICUs is associated with improved quality of care. The impact of a neurocritical care service without a dedicated neuro-ICU has not been studied. Methods: We retrospectively identified all patients admitted to our institution with intracerebral hemorrhage (ICH) in two 12-m...

Objective: To assess for unplanned effects of trial participation as measured by changes in smoking, alcohol use, and exercise. Background: Trial effect is a non-specific element of trial participation that has been difficult to quantify. Recent trials are beginning to measure this with promising results. The SPS3 study tests the effects of antipla...

Background: Smoking, alcohol use, and physical inactivity represent health behaviors that, if modified, may significantly reduce the burden of stroke. Purpose: To evaluate the impact of trial participation on health behavior modification. Methods: The Secondary Stroke Prevention Study (SPS3) study enrolled 3020 subjects followed for an average of...