About

Pooja Khatri, MD, MSc, is the Albert E. Kent Professor of Neurology and Chair of the Department of Neurology at Yale School of Medicine. She also serves as the chief of Neurology at Yale New Haven Hospital and the Yale New Haven Health System. Recognized internationally as an expert in stroke care and research, Dr. Khatri has a distinguished background that includes her previous role as vice chair of research within the Department of Neurology and Rehabilitation Medicine at the University of Cincinnati College of Medicine, where she also directed the Vascular Neurology Division and the multidisciplinary UC Stroke team serving a tristate area. Her research spans acute stroke therapy, prevention of early stroke recurrence, development of radiological biomarkers, and clinical trial design. She has demonstrated the time-dependence of endovascular therapy for stroke, contributing to its development as an effective treatment, and has influenced clinical guidelines regarding IV thrombolysis for mild strokes. Dr. Khatri has led numerous NIH-funded projects, including the first platform trial in stroke and studies on stroke biomarkers and population-level radiological brain health. With over 300 publications and recognition as a top 1% Highly Cited Researcher globally, her expertise encompasses drug and device development, translational science, and clinical trial methodology. She is actively involved in training and mentorship, holding leadership roles in major stroke organizations and serving as an editor for prominent journals.

Research topics

• Medicine
• Internal medicine
• Surgery
• Radiology
• Computer Science
• Machine Learning
• Pediatrics
• Cardiology
• Artificial Intelligence
• Physical medicine and rehabilitation
• Engineering
• Emergency medicine
• Medical physics
• Pathology
• Demography
• Environmental health
• Biology

Selected publications

• High-Dose, High-Intensity Stroke Rehabilitation: Why Aren’t We Giving It?

  Stroke · 2025-04-28 · 16 citations

  articleOpen access
  PublisherOA PDFDOI

• Abstract 54: Stroke Incidence by Race in a Large, Biracial Population Over Time: 2020 Update

  Stroke · 2025-01-30

  article

  Background: Understanding the trends of stroke incidence and how those strokes are distributed across race is a critical step to implement trials and programs to decrease the burden caused by stroke nationally. In 2015, we reported that stroke incidence is decreasing in both Black and White adults. We investigated the continued trends in stroke incidence by race in 2020. Methods: In this population-based stroke surveillance study, all cases of stroke within a 5-county population surrounding Cincinnati in adults aged ≥20 years were ascertained during a full year every 5 years from 1993 to 2020. Cases were abstracted by study nurses and adjudicated by trained study physicians. Temporal trends were evaluated by age, race (Black or White), and subtype (ischemic stroke (IS), intracranial hemorrhage (ICH), or subarachnoid hemorrhage (SAH)). Stroke incidence rates per 100,000 individuals from 1993 to 2020 were calculated using US Census data and age-, race-, and sex-standardized as appropriate. Trends were evaluated using linear regression. Disparities were evaluated using risk ratios and reported with 95% CIs. Results: In 2020, we identified 2280 first-ever strokes. Of these, 23% (N=524) were Black adults and 52% (N=1,177) were female. The overall annual incidence of stroke in 2020 was 203/100,000. Table 1 reports the temporal trends of stroke incidence by subtype for both Black and White race from 1993 to 2020. For all races, any stroke increased between 2015 and 2020 (p=0.003, driven largely by an increase in stroke in White adults), while the overall trend since 1993 is no longer declining. Ischemic stroke also increased between 2015 and 2020 (pairwise comparison, p=0.011) in all races. Figure 1 shows the stroke incidence rate of overall stroke (any subtype) over time. The overall risk ratio of any incident stroke between Black and White adults was RR 1.84 (1.66, 2.02; p-value 0.022). Conclusions: Compared to our analysis after our 2015 study, overall stroke incidence over time is no longer decreasing. Between 2015 and 2020, we observed an increasing rate of stroke in our population. For the first time in a 27-year period we report a significant increase in stroke incidence, mostly driven by an increase in ischemic stroke incidence in whites. ICH/SAH rates are stably higher in blacks compared to whites. More work needs to be done to investigate any possible association to COVID or other traditional risk factors to address racial disparities in stroke burden.

  PublisherDOI

• Considering Thrombolysis for Mild Stroke—Pitfalls of Subgroup Analyses

  JAMA Neurology · 2025-10-27

  article1st authorCorresponding
  PublisherDOI

• Safety and efficacy of low-intensity versus standard monitoring following intravenous thrombolytic treatment in patients with acute ischaemic stroke (OPTIMISTmain): an international, pragmatic, stepped-wedge, cluster-randomised, controlled non-inferiority trial

  The Lancet · 2025-05-01 · 12 citations

  article
  PublisherDOI

• SATURN MRI: study protocol for the statin use in intracerebral hemorrhage patients MRI ancillary study

  Trials · 2025-08-30

  articleOpen access

  BACKGROUND: The benefit-risk of statins in patients with lobar intracerebral hemorrhage (ICH) is under investigation in the StATins Use in intRacerebral hemorrhage patieNts (SATURN) trial. The relationship between statin use in ICH survivors, MRI markers of cerebral small vessel disease (CSVD), and outcomes such as recurrent ICH or major adverse cardiovascular or cerebrovascular events (MACCE) is unclear. The ancillary study, SATURN-MRI, intends to evaluate the interrelationship between statin use, the progression of MRI markers of CSVD, and cognitive and functional outcomes. Additionally, SATURN-MRI aims to assess whether baseline MRI markers of CSVD interact with statin continuation for the outcomes of recurrent ICH or MACCE in patients with lobar ICH. METHODS: A target of 894 SATURN participants will undergo a baseline MRI within 7 days of randomization and a repeat MRI at the end of the 24-month follow-up period. Any SATURN subject without contraindication to MRI has the option to participate in SATURN MRI. MRIs will be reviewed by blinded central raters to assess for the presence and burden of markers of CSVD and their progression. The primary outcome is new cerebral microbleeds and/or sulci with cortical superficial siderosis identified on T2*-weighted (GRE, SWI or SWAN) images between baseline and end-study MRI. Additional outcomes include the progression of white matter hyperintensity and incidence of covert infarcts. DISCUSSION: The results will provide insights about the interrelationship between the effects of statins, progression of MRI markers of CSVD, and functional and cognitive outcomes. They might lead to the validation of MRI markers as tools to assist with individualized decision-making regarding the effects of statins continuation/discontinuation in patients with lobar ICH. TRIAL REGISTRATION: ClinicalTrials.gov NCT03936361. SATURN Trial was originally registered on May 1, 2019 and modified on February 28, 2022.

  PublisherOA PDFDOI

• Projecting US Population Eligibility for Minimally Invasive Surgical Evacuation of Intracerebral Hemorrhage

  Stroke · 2025-09-17

  articleOpen accessSenior author

  BACKGROUND: Minimally invasive surgical evacuation improved outcomes for patients with acute, spontaneous, lobar intracerebral hemorrhage (ICH) in the ENRICH trial (Early Minimally Invasive Removal of ICH). We determined the percentage of patients with ICH in a US population-based study eligible for minimally invasive surgical evacuation and projected the annual number of patients with ICH in the United States in 2020 eligible for this therapy. METHODS: codes, clinical data abstracted, and physician adjudicated. Location and volume of ICH were centrally adjudicated by neuroradiologists. We applied ENRICH trial criteria to calculate conservative and liberal estimates of the percentage of patients with (1) all ICH at any location and (2) lobar ICH eligible for minimally invasive surgical evacuation. We extrapolated our estimates to the 2020 US adult population using 2020 US census data. RESULTS: We identified 196 patients in Greater Cincinnati/Northern Kentucky in 2015 with acute, spontaneous ICH. After applying all criteria, 2.0% (n=5) of all patients with acute ICH (5.1%; n=5 lobar ICH) were eligible for minimally invasive surgical evacuation. The most common exclusion criteria were ICH volume <30 mL (60%) and prestroke modified Rankin Scale score >1 (52%). In liberal estimates, 2.6% to 3.6% (n=4-7) of all patients with acute ICH (4.1%-7.1% of lobar ICH) were eligible. We projected 1066 to 1848 patients of an estimated 72 283 adult patients with ICH in the United States in 2020 met eligibility criteria. CONCLUSIONS: Approximately 2% to 4% of patients with ICH in our population were eligible for minimally invasive surgical evacuation based on ENRICH criteria, which extrapolates to 1066 to 1848 patients with ICH in the United States annually. Future research is needed to determine whether indications for effective surgical therapy for ICH can be expanded.

  PublisherOA PDFDOI

• Optimizing Reperfusion Trials: A Consensus Research Roadmap From the STAIR XIII Conference

  Stroke · 2025-11-14 · 1 citations

  article

  The STAIR (Stroke Treatment Academic Industry Roundtable) sponsored a workshop during the STAIR XIII conference in Washington, DC on March 27 to 28, 2025, to develop consensus recommendations, particularly regarding research priorities and design elements for trials of reperfusion therapies. This forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke, and industry representatives to discuss future developments in reperfusion therapies. The reperfusion trials session summarized and compared recent acute stroke trials. The workshop developed consensus recommendations for research priorities and trial design challenges. Given that the majority of patients eligible for reperfusion therapies present initially to primary stroke centers, developing research networks that allow trials to be conducted in the transfer setting and overcome the logistical challenges in such centers was identified as a key priority. A particular focus was the definition and investigation of microvascular reperfusion and the no-reflow phenomenon. Potential trial paradigms to advance the field were discussed. Recent acute stroke clinical trials have extended the scope of intravenous thrombolytics and endovascular thrombectomy. Recruitment for future trials at both primary and comprehensive stroke centers, in addition to standard of care, poses challenges, particularly for novel thrombolytics. Recommendations for enhancing stroke imaging research and the definition of macrovascular versus microvascular reperfusion are provided.

  PublisherDOI

• Microstructural and microvascular features of white matter hyperintensities and their association with small vessel disease markers

  Scientific Reports · 2025-05-27 · 1 citations

  articleOpen access

  White matter hyperintensities (WMH) are the most prominent imaging feature of small vessel disease (SVD). WMH and other imaging features of SVD are likely the result of ongoing insults associated with cognitive decline and cerebrovascular events. Emerging evidence suggests degradation of the neurovascular unit may underlie the pathogenesis of SVD. This prospective pilot study employed MRI in 19 subjects (68.2 ± 11.5 years of age) for diffusion-weighted imaging, applied to intravoxel incoherent motion (IVIM) modeling, to characterize microstructural and microvascular properties throughout the brain and arterial spin labeling, using multiple labeling and delay times, to measure dynamic perfusion properties including blood-brain barrier permeability (PS) in gray matter (GM). IVIM revealed WMH to have significantly greater blood volume fraction and lower pseudodiffusion and bulk diffusion than normal-appearing white matter (NAWM). IVIM parameters and PS, in canonical GM network regions, correlated with WMH volume with at least moderate effect size. Findings suggest the potential for neovascularization and evidence of restricted diffusion in WMH compared to surrounding NAWM. Regional changes in GM pertaining to the NVU scale in proportion to WMH load. Observed GM changes precede visible MR imaging abnormalities. Their early detection could elucidate SVD mechanisms of brain injury and inform future preventative measures.

  PublisherDOI

• Electronic Informed Consent in the Multi-Arm Optimization of Stroke Thrombolysis Trial

  Stroke · 2025-04-16 · 2 citations

  article

  BACKGROUND: Obtaining timely informed consent is a key barrier in acute ischemic stroke clinical trial recruitment. Electronic consent (eConsent) allows electronic delivery and documentation of the informed consent process, which may optimize recruitment. eConsent in acute ischemic stroke clinical trials, however, is limited and understudied. We conducted a post hoc analysis of eConsent adoption in MOST (Multi-Arm Optimization of Stroke Thrombolysis Trial), a phase III acute ischemic stroke clinical trial, and studied the impact on recruitment. METHODS: From October 10, 2019, to July 5, 2023, MOST enrolled 514 participants at 57 sites in the United States. Study databases were reviewed to determine informed consent modality for each participant: paper—in person, paper—remote, eConsent—in person, and eConsent—remote. Study sites could use paper consent or eConsent for each enrollment. eConsent adoption trends and participant demographic diversity were reported using descriptive statistics. We utilized χ 2 and Kruskal-Wallis tests to compare individual site enrollment, remote consent utilization, baseline neuroimaging-to-randomization times, data clarification requests, and reportable consent-related unanticipated events. RESULTS: eConsent was utilized for 173 (33.7%) of 514 participants. Of 57 sites, 32 (56.1%) utilized eConsent at least once: those sites had higher median enrollment over the course of the entire trial than non-eConsent sites (7.5 [interquartile range, 5–17] versus 3 [interquartile range, 2–4]; P &lt;0.001). eConsent was completed remotely more frequently than paper consent (46.2% versus 1.2%; P &lt;0.001). Participant demographic diversity and baseline neuroimaging-to-randomization times were similar between eConsent—in person and paper—in person (median, 58.5 [interquartile range, 46.5–72.5] versus 55 [interquartile range, 39–70] minutes). Consent documentation adherence was superior with eConsent—in person compared with paper—in person including decreased data clarification requests (44 versus 81 per 100 participants) and reportable unanticipated events (6 versus 25 per 100 participants). CONCLUSIONS: eConsent in MOST was associated with higher individual site enrollment, higher remote consent rates, and improved consent documentation adherence over paper consent. Our study outlines the potential advantages of eConsent adoption in future acute ischemic stroke clinical trials and stroke research networks.

  PublisherDOI

• Abstract DP24: Trends in Stroke Incidence Over Time by Sex in the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS)

  Stroke · 2025-01-30

  article

  Background: Ongoing surveillance of stroke incidence over time by demographic groups is critical to understand trends in disease burden and effective interventions. Our objective was to examine changes in stroke incidence by sex and age over 27 years. Methods: In a population-based stroke surveillance study covering a 5-county region of southern Ohio and northern Kentucky, hospital cases of stroke were ascertained and adjudicated by trained study physicians during six 1-year periods (07/1993–06/1994, 1999, 2005, 2010, 2015, 2020). Temporal trends in stroke incidence were evaluated by sex, age, and subtype (ischemic (IS), hemorrhagic (ICH), subarachnoid hemorrhage (SAH)). Stroke incidence rates per 100,000 people were calculated using U.S. Census data and age-, race-, and sex-standardized as appropriate. Trends in incidence over time were evaluated using linear regression, weighted with the inverse of the standard error of the estimated incidence rate. Female:male risk ratios (RRs) were reported in each of the study periods for the overall population stratified by age, and the trend over time was evaluated using linear regression using inverse weighting of the standard error. Results: 11,813 stroke events occurred in total, 56% in females and 20% in Black patients (Table 1). The trend over time for any stroke (IS, ICH, SAH or unknown) was not significant in females (208 [95%CI 195-221] in 1993/4 to 187 [95%CI 176-198] in 2020, per 100,000, p=0.06) or males (251 [95%CI 233-269] in 1993/4 to 220 [95%CI 207-234] in 2020, per 100,000, p=0.13). The decreasing trend in IS was significant in females (p=0.03) but not males (p=0.07). Trend in ICH was not significant in females (p=0.75) or males (p=0.06), and trend in SAH was not significant in either sex (all trend data in Figure 1). For female: male RRs for any stroke, overall (combined age groups) RRs ranged from 0.83 (95%CI 0.75-0.91) in 1993/4 to 0.97 (95%CI 0.88-1.06) in 2010; trend over time was not significant (p=0.82). RRs varied with age (2020 data in Figure 2) with a U-shaped relationship. Discussion: Over 27 years in a population-based stroke surveillance study, trends over time in any, IS, ICH, and SAH appear to be stabilizing with the only significant decrease seen in females with IS. Though findings suggest that previously reported decreasing incidence rates in stroke appear to be trending upward in 2020, future work is needed to understand the effect of COVID on 2020 rates and to continue surveillance.

  PublisherDOI

Recent grants

• NIH StrokeNet National Clinical Coordinating Center (NCC)

  NIH · $32.3M · 2013–2028

• Ohio Valley Regional Coordinating Center for NINDS Stroke Trial Network

  NIH · $2.9M · 2023–2028

• NIH Grant K23NS059843

  NIH · $778k · 2012

• Cincinnati Neuroscience Clinical Trials Research Center (CinciNEXT)

  NIH · $2.1M · 2011–2018

• Cincinnati Regional Coordinating Stroke Center (Cincinnati RCC)

  NIH · $1.9M · 2013–2018

Frequent coauthors

• Joseph P. Broderick

  1270 shared

• Dawn Kleindorfer

  Michigan Medicine

  881 shared

• Daniel Woo

  University of Cincinnati

  786 shared

• Opeolu Adeoye

  Washington University in St. Louis

  747 shared

• Simona Ferioli

  University of Cincinnati

  671 shared

• Jane Khoury

  University of Cincinnati

  660 shared

• Brett Kissela

  645 shared

• Kathleen Alwell

  644 shared

Labs

• Pooja Khatri LabPI

Education

• M.D., Neurology

  Yale School of Medicine

• M.S.

  Not specified in the provided HTML