Firas Kaddouh

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Journals/Publications

• Espinosa, J., Rehman, U., & Kaddouh, F. (2023). A case of intravenous iron administration resulting in cerebral edema expansion. BMC neurology, 23(1), 209.
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  Iron plays an important role in the development of perihematomal edema (PHE) in the setting of intracerebral hemorrhage (ICH). Cerebral iron is increased via direct hemoglobin release in ICH, and several studies have investigated the use of iron-chelating agents to mitigate its toxicity. However, the effect of systemic iron administration, corroborating the reverse concept, has never been investigated or reported clinically. We report the first case of systemic iron administration in the setting of hemorrhagic traumatic brain injury (TBI).
• Margo, T. E., McMullin, P. R., & Kaddouh, F. (2023). An interval of clinically silent gastrointestinal bleed in dysautonomic spinal cord injury: a case report. BMC neurology, 23(1), 70.
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  Gastrointestinal bleed (GIB) has high incidence in traumatic spinal cord injured (tSCI) patients and can frequently be life-threatening, especially early post-injury. Several risk factors often compound bleeding risk, some are unique to this patient population. Normally, clinical suspicion for GIB arises from symptoms like coffee-ground emesis, hematemesis, melena or even hematochezia. A hemoglobin drop may be a late sign. Due to tSCI, however, patients often experience neurogenic bowels and dysautonomia, which may delay symptom presentation and complicate timely diagnosis of GIB. We report a case of an almost clinically silent GI bleed in the context of acute cervical tSCI.
• Shojaei, F., Chi, G., Memar Montazerin, S., Najafi, H., Lee, J. J., Marszalek, J., Kaddouh, F., & Seifi, A. (2022). Clinical outcomes of pharmacological thromboprophylaxis among patients with intracerebral hemorrhage: Systematic review and meta-analysis. Clinical neurology and neurosurgery, 212, 107066.
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  Efficacy and safety of pharmacologic thromboprophylaxis after an episode of intracerebral hemorrhage remains unclear. This meta-analysis aimed at comparing the clinical outcomes of intracerebral hemorrhage patients with or without pharmacologic thromboprophylaxis.
• Ammar, A. A., Ammar, M. A., Owusu, K. A., Brown, S. C., Kaddouh, F., Elsamadicy, A. A., Acosta, J. N., & Falcone, G. J. (2021). Andexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage. Neurocritical care, 35(1), 255-261.
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  There are limited data on the risks and benefits of using andexanet alfa (AA) in comparison with four-factor prothrombin complex concentrate (4F-PCC) to reverse factor Xa inhibitors (FXi) associated intracranial hemorrhage (ICH). We sought to describe our experience with AA or 4F-PCC in patients with oral FXi-related traumatic and spontaneous ICH.
• Brown, S. C., Cormier, J., Tuan, J., Lier, A. J., McGuone, D., Armstrong, P. M., Kaddouh, F., Parikh, S., Landry, M. L., & Gobeske, K. T. (2021). Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019. Emerging infectious diseases, 27(8), 2042-51.
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  During 3 weeks in 2019, 4 human cases of Eastern equine encephalitis (EEE) were diagnosed at a single hospital in Connecticut, USA. The cases coincided with notable shifts in vector–host infection patterns in the northeastern United States and signified a striking change in EEE incidence. All 4 cases were geographically clustered, rapidly progressive, and neurologically devastating. Diagnostic tests conducted by a national commercial reference laboratory revealed initial granulocytic cerebrospinal fluid pleocytosis and false-negative antibody results. EEE virus infection was diagnosed only after patient samples were retested by the arbovirus laboratory of the Centers for Disease Control and Prevention in Fort Collins, Colorado, USA. The crucial diagnostic challenges, clinical findings, and epidemiologic patterns revealed in this outbreak can inform future public health and clinical practice.
• Radcliffe, C., Lier, A., Doilicho, N., Parikh, S., & Kaddouh, F. (2020). Bordetella bronchiseptica: a rare cause of meningitis. BMC infectious diseases, 20(1), 922.
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  Bordetella bronchiseptica is a gram-negative, obligate aerobic coccobacillus known to cause disease in domesticated animals and pets. In humans, B. bronchiseptica commonly leads to respiratory infections like pneumonia or bronchitis, and animal contact usually precedes the onset of symptoms.
• Sheth, K. N., Mazurek, M. H., Yuen, M. M., Cahn, B. A., Shah, J. T., Ward, A., Kim, J. A., Gilmore, E. J., Falcone, G. J., Petersen, N., Gobeske, K. T., Kaddouh, F., Hwang, D. Y., Schindler, J., Sansing, L., Matouk, C., Rothberg, J., Sze, G., Siner, J., , Rosen, M. S., et al. (2020). Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients. JAMA neurology, 78(1), 41-7.
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  Neuroimaging is a key step in the clinical evaluation of brain injury. Conventional magnetic resonance imaging (MRI) systems operate at high-strength magnetic fields (1.5-3 T) that require strict, access-controlled environments. Limited access to timely neuroimaging remains a key structural barrier to effectively monitor the occurrence and progression of neurological injury in intensive care settings. Recent advances in low-field MRI technology have allowed for the acquisition of clinically meaningful imaging outside of radiology suites and in the presence of ferromagnetic materials at the bedside.
• Ghasemi, M., Kaddouh, F., Deb, A., & Owegi, M. A. (2018). Delayed-onset MRI findings in acute chorea related to anoxic brain injury. Clinical imaging, 48, 22-25.
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  Anoxic brain injury can manifest with various abnormal movements. We describe acute chorea in a young patient with anoxic brain injury due to chlordiazepoxide toxicity who had delayed radiographic lesions in bilateral globus pallidus. Although brain MRI 8days after the anoxic event was unremarkable, repeat brain MRI 15days after the event showed T2 hyperintensities and enhancement within the bilateral globus pallidi. It is possible that MRI brain findings of bilateral basal ganglia lesions may appear later than onset of chorea in anoxic brain injury. However, given the normal brain MRI in between, other etiologies cannot be excluded entirely.