About

Karen L. Furie is the Samuel I. Kennison, M.D., and Bertha S. Kennison Professor of Clinical Neuroscience, Professor of Neurology, and Chair of Neurology at Brown University. She received her undergraduate degree in English and American Literature from Brown University in 1987, earned her MD from Brown University School of Medicine in 1990, and completed a Masters in Public Health at Harvard University in 1996. Her medical training includes an internship at Miriam Hospital, a Neurology Residency, and a Fellowship in Cerebrovascular Disease at Rhode Island Hospital. Dr. Furie's career has been dedicated to clinical and translational stroke research, with a focus on stroke prevention, cerebrovascular disease, and neurology. She has developed collaborative multispecialty initiatives and has been supported continuously by NIH and foundation grants. Her research has defined optimal antithrombotic therapy for stroke prevention, clarified the role of high-dose vitamins in hyperhomocysteinemia treatment, and provided insights into the pathophysiology of ischemic stroke. She has led multiple significant research projects, including the NINDS P50 Partners SPOTRIAS and the Harvard Bugher Center for Stroke Prevention and Genetics Research. Her current research focuses on the interaction between oxidative stress and matrix metalloproteinases to better understand injury mechanisms in acute stroke and identify potential intervention targets. She is also involved in examining dietary factors affecting antioxidant capacity, exploring the effects of inflammation on oxidative stress, and developing methods for analyzing white matter disease. Dr. Furie is committed to mentoring patient-oriented research involving medical students, residents, and fellows, contributing significantly to the advancement of stroke and cerebrovascular disease understanding and treatment.

Research topics

• Medicine
• Internal medicine
• Cardiology
• Surgery
• Family medicine
• Radiology
• Intensive care medicine
• Medical emergency

Selected publications

• Association of External Ventricular Drain Duration and Cerebral Infarct in Aneurysmal Subarachnoid Hemorrhage (P4-13.017)

  Neurology · 2025-04-07

  article

  To determine the association of EVD duration with outcomes, including cerebral infarct.

  PublisherDOI

• Abstract TMP9: What Drives Early Recurrence in Intracranial Atherosclerosis: A Multicenter Study

  Stroke · 2025-01-30

  articleSenior author

  Background: Intracranial Atherosclerosis carries a high recurrence rate. Single center studies have shown that impaired distal perfusion is a driver of early recurrence. In this study, we aim to identify predictors of 30-day ischemic stroke recurrence in a multicenter cohort. Methods: This is a pooled analysis of individual patient data from four comprehensive stroke centers of hospitalized patients with symptomatic intracranial arterial stenosis (50-99%) of the intracranial ICA and proximal middle cerebral artery (M1 or proximal M2). The study outcome was recurrent ischemic stroke by day 30. We compared baseline demographics (age, sex, race, ethnicity), vascular risk factors (hypertension, hyperlipidemia, diabetes, atrial fibrillation), NIHSS score, last known well to arrival, home medications (aspirin, anticoagulation), imaging variables (prior infarct in territory, degree of stenosis, perfusion delay volume, borderzone infarct pattern), and in-hospital treatments (thrombolysis, dual antiplatelet therapy, statin, permissive hypertension). Variables with p<0.1 on univariate analyses were included in a Cox regression model to identify important outcome predictors. Missing data was imputed as absent for categorical variables and at the median for continuous variables. Results: We identified 274 patients hospitalized with symptomatic intracranial stenosis who met the inclusion criteria; 70 patients (25.5%) had a recurrent ischemic stroke within 30 days. In unadjusted Cox regression models, predictors of early recurrence were mismatch volume of 25 ml or greater at T max of 6 seconds (HR 2.19 95% CI 1.37-3.51, p = 0.001), 70-99% (vs. 50-69%) stenosis (HR 3.34 95% CI 1.05-10.60, p = 0.041), diabetes (HR 1.60 95% CI 1.0-2.57, p = 0.048), home aspirin (HR 1.77, 95% CI 1.06-2.95, p = 0.029), and home statin (HR 1.73 95% CI 1.04-2.89, p = 0.039). In adjusted Cox regression, the only predictors of 30-day recurrence were T max 6 mismatch volume 25 mL or more (adjusted HR 2.14 95% CI 1.27-3.61, p = 0.004), and 70-99% (vs. 50-69%) stenosis (adjusted HR 3.37 95% CI 1.05-10.84, p = 0.041). Conclusions: One in four medically treated patients with proximal anterior circulation symptomatic ICAS have a recurrent stroke within 30 days with impaired distal perfusion being an important driver of recurrence. Studies are needed to validate these findings and test reperfusion strategies in those with impaired perfusion.

  PublisherDOI

• Abstract WP15: Intravenous Thrombolysis in Cervical Artery Dissection-Related Stroke: A Nationwide Study

  Stroke · 2025-01-30

  article

  Introduction: The safety and efficacy of intravenous thrombolysis (IVT) in cervical artery dissection-related acute ischemic stroke (CeAD-AIS) remains unclear. We performed a retrospective study of data from the National Inpatient Sample investigating outcomes in CeAD-AIS patients treated with and without IVT. Methods: We included adult patients with CeAD-AIS hospitalized between 2016 to 2019. CeAD-AIS was defined by concurrent CeAD and AIS diagnoses, identified with ICD-10 codes. The primary outcome was home discharge. The safety outcomes were inpatient death and intracerebral hemorrhage (ICH). We used survey-weighted multivariable adjusted logistic regressions comparing the groups (IVT versus no IVT), followed by interaction analyses to examine for effect modifications based on age, medical history, stroke severity, and endovascular treatment. Results: Between 2016-2019, 1,360 (12.1%) of 11,285 CeAD-AIS patients received IVT. Patients treated with IVT- had higher NIH Stroke Scale (NIHSS) scores (median 8 [4-17] versus 3 [1-11]; p < 0.001). In adjusted analyses, treatment with IVT was associated with a greater odds of home discharge (adjusted odds ratio [aOR] 1.49; 95% confidence interval [CI] 1.09-2.05, p = 0.014), but not ICH (aOR 0.90, 95% CI 0.43-1.86, p = 0.773) or inpatient death (aOR 1.22, 95% CI 0.72-2.06, p = 0.454). In interaction analyses, stroke severity significantly interacted with IVT ( p for interaction = 0.001), where IVT was significantly associated with increased likelihood of home discharge in patients with moderate to severe strokes (NIHSS > 4) (aOR 2.28, 95% CI 1.59-3.26, p < 0.001) but not in those with mild stroke (NIHSS 0-4) (aOR 1.03 95% CI 0.62-1.70, p = 0.922). Conclusion: IVT improved the likelihood of home discharge in patients with CeAD-AIS without increasing the risk of inpatient death or ICH.

  PublisherDOI

• Abstract WP10: Safety and Efficacy of Intravenous Cangrelor for Acute Rescue Cervical and Intracranial Stenting in Ischemic Stroke

  Stroke · 2025-01-30

  article

  Background: Increased immediate and delayed re-occlusion rates, up to 33%, are reported in patients undergoing acute stenting for tandem lesions, with symptomatic hemorrhage rates around 10-15%. Intraprocedural intravenous (IV) cangrelor is emerging as a bridging therapy for antiplatelet inhibition during acute stenting in ischemic stroke. We report our single-center experience with IV cangrelor in patients undergoing rescue stenting. Methods: We conducted a retrospective analysis from a single-center large vessel occlusion registry from July 2015 to October 2023. Patients who underwent emergent stenting and received IV cangrelor (30 mcg/kg bolus, then 4 mcg/kg/min), followed by dual antiplatelet therapy upon achieving enteric access, were included. The primary outcome was re-occlusion of cervical or intracranial arteries, assessed immediately, early (within 24 hours), and at follow-up. Secondary outcomes included symptomatic hemorrhage or death (based on ECAS-III criteria) and early neurologic deterioration (defined as a change in NIHSS score of ≥4 within 24 hours). Continuous variables were summarized with means and standard deviations; categorical variables were presented as frequencies and percentages. T-tests compared continuous variables, while chi-square or Fisher’s exact tests analyzed categorical variables. Results: Among 220 patients, 201 (91%) underwent cervical stenting, and 19 (9%) received intracranial stenting. The mean age was 68 years (SD ± 11.50), with a male predominance of 63%; 85% did not experience immediate, early, or delayed re-occlusion, a rate lower than previously reported. The symptomatic hemorrhage rate was 10.76%, consistent with prior literature. No significant differences in symptomatic hemorrhage were found between cervical and intracranial stenting groups (10% vs. 1%, p = 0.3) or between those with and without IV thrombolytics (11% vs. 10%, p = 0.80). Early neurologic deterioration occurred more frequently in the intracranial stenting group (33% vs. 17%, p = 0.23), though not statistically significant. At 90 days, favorable outcomes (mRS 0-2) were similar between the intracranial and cervical stenting groups (42% vs. 49%, p = 0.55). Conclusion: IV cangrelor can be considered as a bridging therapy for antiplatelet inhibition during acute rescue stenting. Larger studies are needed to validate these findings.

  PublisherDOI

• Correction: Risk Factors for Opioid Utilization in Patients with Intracerebral Hemorrhage

  Neurocritical Care · 2025-12-05

  articleOpen access
  PublisherOA PDFDOI

• Predictors of Post-Discharge Seizures in Aneurysmal Subarachnoid Hemorrhage Using EEG Data (S30.007)

  Neurology · 2025-04-07

  article

  To identify predictors of post-discharge seizures in survivors of aneurysmal subarachnoid hemorrhage (aSAH) using electroencephalogram (EEG) data.

  PublisherDOI

• Corrigendum to “Level of consciousness at discharge and associations with outcome after ischemic stroke” [Journal of the Neurological Sciences, Volume 390 (2018): 102–107]

  Journal of the Neurological Sciences · 2025-11-20

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Intravenous Thrombolysis in Cervical Artery Dissection–Related Stroke: A Nationwide Study

  Journal of the American Heart Association · 2025-02-19 · 5 citations

  articleOpen access

  Background Although intravenous thrombolysis (IVT) is safe and effective in populations with general stroke, its impact on cervical artery dissection–related acute ischemic stroke (CeAD‐AIS) remains unclear. This retrospective study used the National Inpatient Sample to compare outcomes in patients with CeAD‐AIS treated with and without IVT. Methods We included adult patients with concurrent CeAD and AIS diagnoses ( International Classification of Diseases, Tenth Revision [ ICD‐10 ], codes) hospitalized from 2016 to 2019. The primary outcome was home discharge; safety outcomes included inpatient death and intracerebral hemorrhage. We performed survey‐weighted multivariable logistic regressions comparing IVT versus no IVT, followed by interaction analyses to examine effect modifications based on age, medical history, stroke severity, carotid artery involvement, and endovascular treatment. Results Between 2016 and 2019, 1360 (12.1%) of 11 285 patients with CeAD‐AIS received IVT. IVT‐treated patients had higher median National Institutes of Health Stroke Scale scores (median [interquartile range], 8 [4–17] versus 3 [1–11]; P <0.001). Adjusted analyses showed IVT was associated with higher odds of home discharge (adjusted odds ratio [OR], 1.40 [95% CI, 1.01–1.92]; P =0.042), but not with inpatient death (adjusted OR, 1.29 [95% CI, 0.76–2.20]; P =0.347) or intracerebral hemorrhage (adjusted OR, 0.69 [95% CI, 0.32–1.48]; P =0.341). Stroke severity ( P for interaction=0.001) and carotid artery involvement ( P for interaction=0.021) significantly modified IVT's effect on home discharge, with IVT being associated with an increased likelihood of home discharge in patients with moderate to severe strokes (National Institutes of Health Stroke Scale score >4) and carotid artery involvement. Conclusions IVT improves the likelihood of home discharge in patients with CeAD‐AIS without increasing the risk of inpatient death or intracerebral hemorrhage.

  PublisherDOI

• Carotid Revascularization Versus Medical Management for Ischemic Stroke with Ipsilateral Carotid Web: A Systematic Review and Meta‐Analysis

  Annals of Neurology · 2025-06-12 · 11 citations

  review

  Objectives Carotid artery web is an underrecognized cause of ischemic stroke and is associated with a high risk of recurrent events. It is uncertain whether medical management or carotid revascularization is beneficial for patients with ischemic stroke and ipsilateral carotid web. In the absence of large randomized clinical trials and observational studies, we performed a systematic review and meta‐analysis comparing medical management and carotid revascularization in this population. Methods The systematic review was registered in PROSPERO (CRD42024485069). We searched five databases: Embase, Scopus, MEDLINE, Web of Science, and CINAHL. We included observational studies that studied the association between recurrent stroke in patients with ipsilateral carotid web receiving medical management (antiplatelet and anticoagulation) and carotid revascularization. Random effects modeling was performed, and risk ratio with 95% confidence intervals were reported. Results We included 17 studies (16 published and 1 institutional study). In the medical management group, 32% (90/281) of patients experienced recurrent ischemic stroke ipsilateral to the carotid web. The meta‐analysis revealed a significantly lower risk of recurrent ischemic stroke with carotid revascularization (relative risk 0.11, 95% confidence interval 0.06–0.28, p < 0.001, I 2 = 14.5%). Both carotid endarterectomy and carotid artery stenting were equally effective in reducing recurrent stroke risk (relative risk 0.44, 95% confidence interval 0.11–1.76, p = 0.99). Interpretation Carotid revascularization is associated with reduced recurrence rates, with no difference between revascularization subtypes (carotid endarterectomy vs carotid artery stenting). However, given the small, heterogeneous cohorts and the uncertain natural history of carotid artery web under medical management, these findings should be interpreted with caution until prospective, controlled comparative effectiveness studies are performed. ANN NEUROL 2025;98:625–633

  PublisherDOI

• Association of Demographics and Socioeconomic Factors on Anxiety and Depression in Survivors of Aneurysmal Subarachnoid Hemorrhage (P12-14.003)

  Neurology · 2025-04-07

  article

  To determine the association of socioeconomic status (SES) with anxiety and depression in survivors of aneurysmal subarachnoid hemorrhage (aSAH).

  PublisherDOI

Recent grants

• NIH Grant K23NS042720

  NIH · $852k · 2006

• NIH Grant R01HS011392

  NIH · $2.0M · 2008

• NIH Grant P50NS051343

  NIH · $19.8M · 2017

• NIH Grant M01RR001066

  NIH · $3.7M · 2008

• NIH Grant R01NS064905

  NIH · $1.3M · 2018

Frequent coauthors

• Shadi Yaghi

  Providence College

  752 shared

• Walter J. Koroshetz

  660 shared

• Michael H. Lev

  479 shared

• Michael Reznik

  University of Pittsburgh Medical Center

  456 shared

• Brian Mac Grory

  Duke University

  454 shared

• Natalia S. Rost

  Massachusetts General Hospital

  425 shared

• Jonathan Rosand

  Massachusetts General Hospital

  424 shared

• Mahesh Jayaraman

  Brown University

  406 shared

Education

• B.A., English and American Literature

  Brown University

  1987

• M.D.

  Brown University School of Medicine

  1990

• M.S., Public Health

  Harvard University School of Public Health

  1996