BRUNSER RABOVICH, ALEJANDRO MICHEL
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BRUNSER RABOVICH, ALEJANDRO MICHEL
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Email
abrunser@alemana.cl
ORCID
Scopus Author ID
26644722200

Research Output

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Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

2017 , Craig S. Anderson , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Laurent Billot , Maree L. Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , BRUNSER RABOVICH, ALEJANDRO MICHEL , Bin Peng , Liying Cui , Lily Song , Kris Rogers , Sandy Middleton , Joyce Y. Lim , Denise Forshaw , C. Elizabeth Lightbody , Mark Woodward , Octavio Pontes-Neto , H. Asita De Silva , Ruey-Tay Lin , Tsong-Hai Lee , Jeyaraj D. Pandian , Gillian E. Mead , Thompson Robinson , Caroline Watkins

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Telestroke in Chile: 1 year experience at 7 hospitals

2019 , Eloy Mansilla , Enrico Mazzon , Daniel Cárcamo , Felipe Jurado , Lorena Lara , Mirya Arévalo , Diego Rojas , Gloria Stephens , Arnold Hoppe , BRUNSER, ALEJANDRO

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Cervical Artery Dissection in Postpartum Women after Cesarean and Vaginal Delivery

2022 , Francisca Urrutia , MAZZON AGURTO, ENRICO , BRUNSER, ALEJANDRO , DIAZ TAPIA, VIOLETA DEL CARMEN , CALDERON GIADROSIC, JUAN FRANCISCO , STECHER GUZMAN, XIMENA PATRICIA , Tomas Bernstein , Paulo Zuñiga , SCHILLING REDLICH, ANDREA INGRID , MUÑOZ VENTURELLI, PAULA

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Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort

2020 , MAZZON AGURTO, ENRICO , D. Rocha , BRUNSER, ALEJANDRO , C. De la Barra , X. Stecher , T. Bernstein , P. Zúñiga , DIAZ TAPIA, VIOLETA DEL CARMEN , G. Martínez , MUÑOZ VENTURELLI, PAULA ANDREA

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Association between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography

2023 , Kevin Cheng , Andrew Lin , STECHER GUZMAN, XIMENA PATRICIA , Tomas Bernstein , Paulo Zuñiga , Gonzalo Martinez , BRUNSER, ALEJANDRO , DIAZ TAPIA, VIOLETA DEL CARMEN , MAZZON AGURTO, ENRICO , William Cameron , Stephen J Nicholls , Sanjay Patel , Damini Dey , Dennis TL Wong , MUÑOZ VENTURELLI, PAULA ANDREA

Background: Spontaneous cervical artery dissection (sCAD) is a leading cause of ischemic stroke in young patients. Studies using high-resolution magnetic resonance imaging and positron emission tomography have suggested vessel wall inflammation to be a pathogenic factor in sCAD. Computed tomography (CT) attenuation of perivascular adipose tissue (PVAT) is an established non-invasive imaging biomarker of inflammation in coronary arteries, with higher attenuation values reflecting a greater degree of vascular inflammation. Objectives: We evaluate the CT attenuation of PVAT surrounding the internal carotid artery (PVATcarotid) with and without spontaneous dissection. Methods: Single-center prospective observational study of 56 consecutive patients with CT-verified spontaneous dissection of the internal carotid artery (ICA). Of these patients, six underwent follow-up computed tomography angiography (CTA). Twenty-two patients who underwent CTA for acute neurological symptoms but did not have dissection formed the control group. Using semi-automated research software, PVATcarotid was measured as the mean Hounsfield unit (HU) attenuation of adipose tissue within a defined volume of interest surrounding the ICA. Results: PVATcarotid was significantly higher around dissected ICA compared with non-dissected contralateral ICA in the same patients (−58.7 ± 10.2 vs −68.9 ± 8.1 HU, p < 0.0001) and ICA of patients without dissection (−58.7 ± 10.2 vs −69.3 ± 9.3 HU, p < 0.0001). After a median follow-up of 89 days, there was a significant reduction in PVATcarotid around dissected ICA (−57.5 ± 13.4 to −74.3 ± 10.5 HU, p < 0.05), while no change was observed around non-dissected contralateral ICA (−71.0 ± 4.4 to −74.1 ± 4.1 HU, p = 0.19). ICA dissection was an independent predictor of PVATcarotid following multivariable adjustment for age and the presence of ICA occlusion. Conclusion: PVATcarotid is elevated in the presence of sCAD and may decrease following the acute event.

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Stroke symptoms, risk factors awareness and personal decision making in Chile. A national survey

2022 , NAVIA GONZALEZ, VICTOR HUGO , MAZZON AGURTO, ENRICO , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , ALMEIDA TORO, JUAN MANUEL , BRUNSER, ALEJANDRO , LAVADOS GERMAIN, PABLO MANUEL , HOFFMEISTER ARCE, LORENA , MUÑOZ VENTURELLI, PAULA ANDREA

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Seasonal trend of cervical artery dissection in a Chilean cohort

2019 , RECULE GONZALEZ, FRANCISCA , MAZZON AGURTO, ENRICO , DIAZ TAPIA, VIOLETA DEL CARMEN , Rocha, Diego , BRUNSER RABOVICH, ALEJANDRO MICHEL , De La Barra, Camila , Zuniga, Paulo , Dominga Garcia, Maria , Gabriel Cavada , MUÑOZ VENTURELLI, PAULA ANDREA , Zeballos, Shirley , Charaf, Yusef

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Who is in the emergency room matters when we talk about door-to-needle time: a single-center experience

2023 , BRUNSER RABOVICH, ALEJANDRO MICHEL , Juan-Cristobal Nuñez , Eloy Mansilla , Gabriel Cavada , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , MUÑOZ VENTURELLI, PAULA ANDREA , LAVADOS GERMAIN, PABLO MANUEL

Abstract Background The efficacy of intravenous thrombolysis (IVT) is time-dependent. Objective To compare the door-to-needle (DTN) time of stroke neurologists (SNs) versus non-stroke neurologists (NSNs) and emergency room physicians (EPs). Additionally, we aimed to determine elements associated with DTN ≤ 20 minutes. Methods Prospective study of patients with IVT treated at Clínica Alemana between June 2016 and September 2021. Results A total of 301 patients underwent treatment for IVT. The mean DTN time was 43.3 ± 23.6 minutes. One hundred seventy-three (57.4%) patients were evaluated by SNs, 122 (40.5%) by NSNs, and 6 (2.1%) by EPs. The mean DTN times were 40.8 ± 23, 46 ± 24.7, and 58 ± 22.5 minutes, respectively. Door-to-needle time ≤ 20 minutes occurred more frequently when patients were treated by SNs compared to NSNs and EPs: 15%, 4%, and 0%, respectively (odds ratio [OR]: 4.3, 95% confidence interval [95%CI]: 1.66–11.5, p = 0.004). In univariate analysis DTN time ≤ 20 minutes was associated with treatment by a SN (p = 0.002), coronavirus disease 2019 pandemic period (p = 0.21), time to emergency room (ER) (p = 0.21), presence of diabetes (p = 0.142), hypercholesterolemia (p = 0.007), atrial fibrillation (p < 0.09), score on the National Institutes of Health Stroke Scale (NIHSS) (p = 0.001), lower systolic (p = 0.143) and diastolic (p = 0.21) blood pressures, the Alberta Stroke Program Early CT Score (ASPECTS; p = 0.09), vessel occlusion (p = 0.05), use of tenecteplase (p = 0.18), thrombectomy (p = 0.13), and years of experience of the physician (p < 0.001). After multivariate analysis, being treated by a SN (OR: 3.95; 95%CI: 1.44–10.8; p = 0.007), NIHSS (OR: 1.07; 95%CI: 1.02–1.12; p < 0.002) and lower systolic blood pressure (OR: 0.98; 95%CI: 0.96–0.99; p < 0.003) remained significant. Conclusion Treatment by a SN resulted in a higher probability of treating the patient in a DTN time within 20 minutes.

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The Role of TCD in the Evaluation of Acute Stroke

2016 , BRUNSER, ALEJANDRO , Eloy Mansilla , Arnold Hoppe , Verónica Olavarría , Emi Sujima , Pablo M. Lavados

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Low blood pressure and adverse outcomes in acute stroke: HeadPoST study explanations

2020 , Menglu Ouyang , MUÑOZ VENTURELLI, PAULA ANDREA , Laurent Billot , Xia Wang , Lili Song , Hisatomi Arima , LAVADOS GERMAIN, PABLO MANUEL , Maree L. Hackett , OLAVARRIA IANISZEWSKY, VERONICA VIVIANA , BRUNSER, ALEJANDRO , Sandy Middleton , Octavio M. Pontes-Neto , Tsong-Hai Lee , Caroline L. Watkins , Thompson Robinson , Craig S. Anderson

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