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William J.  Powers, M.D. - UNC-Chapel Hill. Chapel Hill, NC, US

William J. Powers, M.D. William J.  Powers, M.D.

Professor and Chairman | UNC-Chapel Hill


Dr. Powers is an expert on cerebral blood flow and metabolism, as well as stroke treatment and prevention.





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Dr. Powers is Chair and Professor in the Department of Neurology. He is an expert on cerebral blood flow and metabolism, as well as stroke treatment and prevention.

Industry Expertise (3)

Research Medical/Dental Practice Education/Learning

Areas of Expertise (4)

Neurology Stroke Prevention Metabolism Stroke Treatment

Accomplishments (1)

The Feinberg Award (professional)

The Feinberg Award is named for Dr. William Feinberg (1952-1997), a prominent stroke clinician-researcher and American Heart Association volunteer who contributed to a fuller understanding of the causes of stroke. The award recognizes a Stroke Council Fellow actively involved in patient-based research who has made significant contributions to clinical stroke research.

Education (5)

University of California, San Francisco: Residency and Chief Residency, Neurology 1980

Duke University Medical Center: Residency, Medicine 1977

Duke University Medical Center: Internship, Medicine 1976

Cornell University: M.D., Medicine 1975

Dartmouth College: Bachelor's Degree, Biology

Media Appearances (5)

Stroke Imaging Breaks the Speed Barrier

Cardiovascular Business  online


“The American Heart Association decided about January to redo the guidelines because they knew there would be new data,” recalls William J. Powers, MD, chair of the neurology department at the University of North Carolina in Chapel Hill and chair of the writing committee that updated stroke guidelines this year. “The original timeline had them to be published in September but because of the importance of this, it was pushed way up to be done in June.”...

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A device deploys, a life is saved: New strategy to treat stroke goes right at the problem

Tampa Bay Times  online


"The previous recommendations were lukewarm," said Dr. William J. Powers, who chairs the Department of Neurology at the University of North Carolina at Chapel Hill and wrote the association's latest update. "We didn't really know if they worked or not."

That changed this year on the heels of several studies published in the New England Journal of Medicine.

"If you compare the people who (had the procedure) to those who didn't, it about doubles your chances of having a good outcome," Powers said...

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Brain stent offers new treatment option for stroke victims

PBS Newshour  online


DR. WILLIAM J. POWERS, University of North Carolina School of Medicine: So, the procedure involves making a puncture in a large artery in the groin and threading a small tube called a catheter up through the chest and up through the neck and into the head, and then pushing that catheter into the blood clot...

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New AHA/ASA Guideline Recommends Endovascular Stroke Therapy

MedScape Multispeciality  online


"We have given the strongest recommendation possible — class 1, level of evidence A — for certain stroke patients to receive endovascular treatment," lead author, William J. Powers, MD, University of North Carolina at Chapel Hill, told Medscape Medical News. "This is the first time such treatment has been strongly recommended in stroke. This is because of the new trials which show very clearly that it is beneficial in certain groups of patients."...

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New Stroke Treatment Option: Clot-Removing Stent

NewsMax Health  online


"It is pretty exciting," and many patients will benefit if they seek help when symptoms first appear, said the head of the guidelines panel, Dr. William J. Powers, neurology chief at the University of North Carolina at Chapel Hill.

Most of the 800,000 strokes in the U.S. each year are caused by a blood clot lodged in the brain.

The usual treatment is a clot-dissolving medicine called tPA, and it remains the first choice.

But the drug must be given within 4 1/2 hours after symptoms start, and most people don't seek help in time. The drug also fails to work in one or two of every four cases, Powers said...

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Articles (7)

National Institute of Neurological Disorders and Stroke–Canadian stroke network vascular cognitive impairment harmonization standards Stroke


BACKGROUND AND PURPOSE: One in 3 individuals will experience a stroke, dementia or both. Moreover, twice as many individuals will have cognitive impairment short of dementia as either stroke or dementia. The commonly used stroke scales do not measure cognition, while dementia criteria focus on the late stages of cognitive impairment, and are heavily biased toward the diagnosis of Alzheimer disease. No commonly agreed standards exist for identifying and describing individuals with cognitive impairment, particularly in the early stages, and especially with cognitive impairment related to vascular factors, or vascular cognitive impairment...

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A default mode of brain function Proceedings of the National Academy of Sciences


A baseline or control state is fundamental to the understanding of most complex systems. Defining a baseline state in the human brain, arguably our most complex system, poses a particular challenge. Many suspect that left unconstrained, its activity will vary unpredictably. Despite this prediction we identify a baseline state of the normal adult human brain in terms of the brain oxygen extraction fraction or OEF. The OEF is defined as the ratio of oxygen used by the brain to oxygen delivered by flowing blood and is remarkably uniform in the awake but resting state (e.g., lying quietly with eyes closed)...

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Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion JAMA


CONTEXT: The relative importance of hemodynamic factors in the pathogenesis and treatment of stroke in patients with carotid artery occlusion remains controversial...

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Cerebral hemodynamics in ischemic cerebrovascular disease Annals of Neurology


ABSTRACT: During the past decade, technological advances have made it possible to measure regional cerebral hemodynamics in individual patients. Studies performed with these techniques have demonstrated that the degree of carotid stenosis correlates poorly with the hemodynamic status of the ipsilateral cerebral circulation. The primary determinant of cerebral perfusion pressure and blood flow under these circumstances is the adequacy of collateral circulatory pathways. Since collateral circulation varies from patient to patient, there is no critical degree of carotid stenosis that consistently produces hemodynamic compromise of the cerebral circulation...

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2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment American Heart Association/American Stroke Association


Purpose—The aim of this guideline is to provide a focused update of the current recommendations for the endovascular treatment of acute ischemic stroke. Where there is overlap, the recommendations made here supersede those of previous guidelines.

Methods—This focused update analyzes results from 8 randomized clinical trials of endovascular treatment and other relevant data published since 2013. It is not intended to be a complete literature review from the date of the previous guideline publication but rather to include pivotal new evidence that justifies changes in current recommendations. Members of the writing committee were appointed by the American Heart Association/American Stroke Association Stroke Council’s Scientific Statement Oversight Committee and the American Heart Association/American Stroke Association Manuscript Oversight Committee (MOC). Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statement Oversight Committee and Stroke Council Leadership Committee.

Results—Evidence-based guidelines are presented for the selection of patients with acute ischemic stroke for endovascular treatment, the endovascular procedure and for systems of care to facilitate endovascular treatment.

Conclusions—Certain endovascular procedures have been demonstrated to provide clinical benefit in selected patients with acute ischemic stroke. Systems of care should be organized to facilitate the delivery of this care.

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Extracranial-Intracranial Bypass Surgery for Stroke Prevention in Hemodynamic Cerebral Ischemia Journal of the American Medical Association


Among participants with recently symptomatic AICAO and hemodynamic cerebral ischemia, EC-IC bypass surgery plus medical therapy compared with medical therapy alone did not reduce the risk of recurrent ipsilateral ischemic stroke at 2 years.

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Metabolic control of resting hemispheric cerebral blood flow is oxidative, not glycolytic. Journal of Cerebral Blood Flow and Metabolism


Although the close regional coupling of resting cerebral blood flow (CBF) with both cerebral metabolic rate of oxygen (CMRO(2)) and cerebral metabolic rate of glucose (CMRglc) within individuals is well documented, there are few data regarding the coupling between whole brain flow and metabolism among different subjects. To investigate the metabolic control of resting whole brain CBF, we performed multivariate analysis of hemispheric CMRO(2), CMRglc, and other covariates as predictors of resting CBF among 23 normal humans. The univariate analysis showed that only CMRO(2) was a significant predictor of CBF. The final multivariate model contained two additional terms in addition to CMRO(2): arterial oxygen content and oxygen extraction fraction. Notably, arterial plasma glucose concentration and CMRglc were not included in the final model. Our data demonstrate that the metabolic factor controlling hemispheric CBF in the normal resting brain is CMRO(2) and that CMRglc does not make a contribution. Our findings provide evidence for compartmentalization of brain metabolism into a basal component in which CBF is coupled to oxygen metabolism and an activation component in which CBF is controlled by another mechanism.

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