Heads Down for Acute Stroke: Supine Position for Acute Large Vessel Occlusion in Ischemic Stroke

Authors

• Hassaan A. Khan, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Emmanuel J. Thomas, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Sufyan K. Zackariya, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Kate M. Kelly, George Washington University School of Medicine Washington DC USA.
• Saniya K. Zackariya, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Zenia Qasim, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Manaal Buchh, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Ameera S. Khan, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Hala K. Ansari, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Holly P. Lankford, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Leigh K. Van Ryn, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Caroline C. Howell, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Mahmoud D. Al-Fadhl, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Marie Nour Karam, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Anthony V. Thomas, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Rodolfo Gonzalez, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Faisal S. Shariff, Department of Internal Medicine The University of Toledo Toledo Ohio USA.
• Adeela M. Alizai, Michiana Ophthalmology LLC Mishawaka Indiana USA.
• Donald F. Zimmer, Indiana University School of Medicine - South Bend South Bend Indiana USA.
• Mathew K. Marsee, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.
• Mark M. Walsh, Department of Emergency and Internal Medicine Saint Joseph Regional Medical Center Mishawaka Indiana USA.

Document Type

Journal Article

Publication Date

1-1-2026

Journal

Clinical case reports

Volume

14

Issue

1

DOI

10.1002/ccr3.71477

Keywords

carotid artery thrombosis; collateral circulation; ischemic stroke; ophthalmic artery; stents

Abstract

This case demonstrates that for large vessel occlusion strokes in the acute stage before surgical, pharmacologic, or radiologic intervention, supine positioning may be assumed because of the hemodynamic changes that can prevent and alleviate stroke, supporting the results of the ZerO Degree head positioning In Acute ischemiC stroke (ZODIAC) trial.

APA Citation

Khan, Hassaan A.; Thomas, Emmanuel J.; Zackariya, Sufyan K.; Kelly, Kate M.; Zackariya, Saniya K.; Qasim, Zenia; Buchh, Manaal; Khan, Ameera S.; Ansari, Hala K.; Lankford, Holly P.; Van Ryn, Leigh K.; Howell, Caroline C.; Al-Fadhl, Mahmoud D.; Karam, Marie Nour; Thomas, Anthony V.; Gonzalez, Rodolfo; Shariff, Faisal S.; Alizai, Adeela M.; Zimmer, Donald F.; Marsee, Mathew K.; and Walsh, Mark M., "Heads Down for Acute Stroke: Supine Position for Acute Large Vessel Occlusion in Ischemic Stroke" (2026). GW Authored Works. Paper 8346.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8346

Department

School of Medicine and Health Sciences Student Works