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1. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study

Author: Buture A, Boland JW, Ahmed F, and Dikomitis L
Subjects: drawings, migraine, screening tool, diagnosis, visual, images, Medicine (General), R5-920
Abstract: Alina Buture,1 Jason W Boland,2 Fayyaz Ahmed,1,3 Lisa Dikomitis4,51Hull York Medical School, University of Hull, Hull, UK; 2Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK; 3Department of Neurology, Hull Royal Infirmary, Hull, UK; 4School of Medicine, Keele University, Newcastle-under-Lyme, UK; 5School of Primary, Community and Social Care, Keele University, Newcastle-under-Lyme, UKCorrespondence: Alina ButureHull York Medical School, University of Hull, Cottingham Road, Hull HU6 7RX, UKTel +44 745 987 2950Email hyab20@hyms.ac.ukIntroduction and objective: The diagnosis of primary headaches is based on the International Classification of Headache Disorders (ICHD-3). Cluster headache (CH), a debilitating primary headache, is often misdiagnosed as migraine. In the absence of biological markers, a new visual screening tool with images depicting pain could aid the correct diagnosis of CH. The objective of the study is to test the tool on healthy participants and participants with CH and migraine.Methods: In phase 1, 6 images portraying people with pain were tested on 150 healthy participants. The healthy participants were asked to rate the images as mild, moderate, severe or excruciating pain. In phase 2, the images were further tested on 116 participants with headache (16 participants with CH, 100 participants with migraine). The participants were recruited prospectively from a tertiary headache center between February and May 2017. The participants were asked to choose which image best illustrated their headache attacks.Results: Phase 1 results showed that the images represent a range of headache pain severities from mild to excruciating as rated by healthy participants. They rated two images as excruciating, one image as severe, one image as moderate/severe, one image as moderate and one image as mild. Phase 2 results showed that two-thirds of participants with CH (69%) and half of the participants with migraine (52%) chose an image described as excruciating by the healthy participants.Conclusion: We developed a screening tool with six drawings depicting headache pain severities from mild to excruciating as rated by the healthy participants. Although the images did not differentiate between CH and migraine, the study indicated the potential of using visual aids to assess headache severity.Keywords: drawings, migraine, screening tool, diagnosis, visual, pictures, excruciating
Published: 2019

2. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies

Author: Buture A, Boland JW, Dikomitis L, and Ahmed F
Subjects: voxel-based morphometry, single-photon emission computer tomography, positron emission tomography, functional magnetic resonance imaging, calcitonin gene related peptide, pituitary adenylate cyclase activating peptide, Medicine (General), R5-920
Abstract: Alina Buture,1,2 Jason W Boland,2 Lisa Dikomitis,3 Fayyaz Ahmed1,2 1Department of Neurology, Hull Royal Infirmary, Hull, UK; 2Hull York Medical School, University of Hull, Hull, UK; 3School of Medicine and Institute of Primary Care and Health Sciences, Keele University, Newcastle, UK Objective: Cluster headache (CH) is the most severe primary headache condition. Its pathophysiology is multifaceted and incompletely understood. This review brings together the latest neuroimaging and neuropeptide evidence on the pathophysiology of CH.Methods: A review of the literature was conducted by searching PubMed and Web of Science. The search was conducted using the following keywords: imaging studies, voxel-based morphometry, diffusion-tensor imaging, diffusion magnetic resonance imaging, tractography, connectivity, cerebral networks, neuromodulation, central modulation, deep brain stimulation, orexin-A, orexin-B, tract-based spatial statistics, single-photon emission computer tomography studies, positron-emission tomography, functional magnetic resonance imaging, magnetic resonance spectroscopy, trigeminovascular system, neuropeptides, calcitonin gene-related peptide, neurokinin A, substance P, nitric oxide synthase, pituitary adenylate cyclase-activating peptide, vasoactive intestinal peptide, neuropeptide Y, acetylcholine, noradrenaline, and ATP. “Cluster headache” was combined with each keyword for more relevant results. All irrelevant and duplicated records were excluded. Search dates were from October 1976 to May 2018.Results: Neuroimaging studies support the role of the hypothalamus in CH, as well as other brain areas involved in the pain matrix. Activation of the trigeminovascular system and the release of neuropeptides play an important role in CH pathophysiology. Among neuropeptides, calcitonin gene-related peptide, vasoactive intestinal peptide, and pituitary adenylate cyclase-activating peptide have been reported to be reliable biomarkers for CH attacks, though not specific for CH. Several other neuropeptides are involved in trigeminovascular activation, but the current evidence does not qualify them as reliable biomarkers in CH.Conclusion: CH has a complex pathophysiology and the pain mechanism is not completely understood. Recent neuroimaging studies have provided insight into the functional and structural network bases of CH pathophysiology. Although there has been important progress in neuropeptide studies, a specific biomarker for CH is yet to be found. Keywords: voxel-based morphometry, single-photon emission computer tomography, positron-emission tomography, functional magnetic resonance imaging, calcitonin gene-related peptide, pituitary adenylate cyclase-activating peptide
Published: 2019

3. Iatrogenic visual aura: a case report and a brief review of the literature

Author: Buture A, Khalil M, and Ahmed F
Subjects: migraine aura, iatrogenic, trans-septal catheterisation, Therapeutics. Pharmacology, RM1-950
Abstract: Alina Buture, Modar Khalil, Fayyaz Ahmed Neurology Department, Hull Royal Infirmary, Hull, UK Abstract: Iatrogenic migraine aura following transseptal catheterization has only rarely been reported in the literature. We report the case of a 60-year-old female who presented with new onset of migraine with visual aura 1 day after transseptal cryoballoon catheter ablation for atrial fibrillation. The patient had a 5-year history of typical migraine without aura and had never experienced visual aura before the cardiac intervention. The neurological examination, fundoscopy, and blood tests were normal. The magnetic resonance imaging of the brain showed small vessel ischemia without evidence of vessel ischemic changes in the occipital lobes and large blood vessel disease. A change in the characteristics of existing migraine could occur following an iatrogenic episode, which in this case was catheter ablation for atrial fibrillation. A new onset of aura is considered an indication for a brain scan as it may signify underlying new pathology. Keywords: migraine aura, iatrogenic, transseptal catheterization
Published: 2017

4. Evidence-based treatments for cluster headache

Author: Gooriah R, Buture A, and Ahmed F
Subjects: Therapeutics. Pharmacology, RM1-950
Abstract: Rubesh Gooriah, Alina Buture, Fayyaz Ahmed Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK Abstract: Cluster headache (CH), one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition. Keywords: cluster headache, pathogenesis, vasoactive intestinal peptide, suprachiasmatic nucleus
Published: 2015

5. Medium-term real-world data for erenumab in 177 treatment resistant or difficult to treat chronic migraine patients: persistence and patient reported outcome measures after 17–30 months

Author: Troy, Emma, Shrukalla, Arif A., Buture, Alina, Conaty, Katie, Macken, Esther, Lonergan, Roisin, Melling, Jane, Long, Niamh, Shaikh, Eamonn, Birrane, Kieran, Tomkins, Esther M., Goadsby, Peter J., and Ruttledge, Martin H.
Published: 2023
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6. Exploring the diagnosis of cluster headache : a multi-method study

Author: Buture, Alina, Dikomitis, Lisa, and Boland, Jason W.
Subjects: Medical sciences
Abstract: Background: Cluster headache (CH) is a severe primary headache affecting 1/1000 people of the general population. The diagnostic delay, misdiagnosis and mismanagement of CH are well evidenced in the literature. The aim of this doctoral research is to understand the under- recognition by exploring the diagnosis of CH. Methods: Multi-method study comprised of four main parts: (1) A systematic literature review on the delays in diagnosis and misdiagnosis of CH; (2) A literature review on the pathophysiology of CH; (3) A prospective observational study of a novel screening tool with images depicting headache pain that could differentiate between CH and migraine. Images depicting headache pain were assessed on healthy participants to test if they depict a range of pain severities. The screening tool was tested and refined in a pilot study and subsequently assessed in a larger-scale study. The total screening tool score (which ranged between 3-32) was used as predictor of CH. (4) A qualitative study with semi-structured interviews that explored the perceptions on the CH diagnosis among three key stakeholder groups: participants with CH, GPs and neurologists. Results: (1) The systematic literature review brought together the existing evidence on diagnostic delays, numerous misdiagnosis, consultation of multiple clinicians and mismanagement of CH. (2) The literature review on the pathophysiology of CH summarised the research on the biomedical aspects of CH and informed on the imaging, peptide and genetic studies in CH. (3) Six images depicting headache pain tested on 150 healthy participants showed a range of severities from mild to excruciating. The screening tool was piloted on 100 patients with migraine and 16 patients with CH. The refined screening tool was assessed on 81 patients with CH and 215 patients with migraine. Patients with CH had a higher mean test score compared to patients with migraine (28.4 versus 19.5). At a cut-off score of >25 out of 32, the screening tool for CH had a sensitivity of 86.4% and a specificity of 92.0%. (4) The qualitative data set that included 26 patients with CH, eight GPs and eight neurologists identified prolonged diagnostic journey of CH with significant impact on social life and mental health. Both patient and clinician's factors are involved in the diagnostic delay. Conclusions: This multi-method study identified challenges around the timely diagnosis of CH and multiple factors involved in the under-recognition of CH. The screening tool could be a useful instrument to aid the diagnosis of CH. Validation in other medical settings including primary care is required.
Published: 2020

7. Medium-term real-world data for erenumab in 177 treatment resistant or difficult to treat chronic migraine patients: persistence and patient reported outcome measures after 17–30 months

Author: Emma Troy, Arif A. Shrukalla, Alina Buture, Katie Conaty, Esther Macken, Roisin Lonergan, Jane Melling, Niamh Long, Eamonn Shaikh, Kieran Birrane, Esther M. Tomkins, Peter J. Goadsby, and Martin H. Ruttledge
Subjects: Resistant chronic migraine, Erenumab, Patient related outcome measures (PROM), Headache impact Test-6 (HIT-6), Migraine associated disability assessment (MIDAS) test, Migraine-specific quality-of-life questionnaire (MSQ), Medicine
Abstract: Abstract Background Many migraine patients do not respond adequately to conventional preventive treatments and are therefore described as treatment/medically resistant or difficult to treat cases. Calcitonin gene-related peptide monoclonal antibodies are a relatively novel molecular treatment for episodic and chronic migraine that have been shown to be effective in short duration clinical trials in approximately 40–50% of all chronic migraine patients. Patient Related Outcome Measures (PROM) or Quality of Life (QoL) questionnaires are used to help measure response to treatment in migraine. Although some open label extension studies have become available for erenumab, there is a lack of real-world data pertaining to quality of life in the medium to long-term for chronic and treatment resistant migraine patients. Methods A total of 177 treatment resistant CM patients were started on erenumab (70 mg or 140 mg subcutaneous injection every 4 weeks) in our three specialist Headache Clinics. Of these, 174 had their first injection between December 2018 and October 2019. All patients were evaluated with the following PROM: the Headache Impact Test− 6, Migraine Associated Disability Assessment test and Migraine-Specific QoL Questionnaire, before starting treatment with erenumab and at intervals of 3–12 months after starting treatment. The decision to continue treatment was based on subjective clinical improvement of at least 30% (as reported by the patient), supported with diaries and QoL questionnaires. We present here the QoL measurements for this group of 177 patients. Prior preventive migraine treatments included conventional oral prophylactic medications (such as topiramate, candesartan, propranolol, or amitriptyline), at least two cycles of PREEMPT protocol onabotulinumtoxin A or (in a small number of cases) neuromodulation with single pulse Transcranial Magnetic Stimulation. Results Of the 177 patients who started treatment with erenumab, 68/177 (38.4%) stopped during the first year, either due to lack of efficacy (no significant benefit or only minimal improvement) and/or possible side effects. 109/177 (61.6%) patients reported clinically significant improvement after 6–12 months and wished to stay on treatment. Twelve of these 109 patients subsequently stopped treatment in the period between 1 year and up to June 2021 (mainly due to a worsening of their migraine). Therefore, a total of 97/177 patients (54.8%) remained on treatment as of June 2021 (duration of treatment 17–30 months, median of 25 months). Conclusion Approximately 55% of treatment resistant or difficult to treat CM patients who trialled erenumab in our clinics reported a subjective benefit and were still on treatment after 17–30 months.
Published: 2023
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8. Ischemic stroke with extensive vasculopathy in a patient with neurofibromatosis type 1

Author: Fiona J. Desmond, MB BCh, BAO, Alina Buture, MD, PhD, Eoin C. Kavanagh, FFR, RCSI, and Sean Murphy, MD, FRCPI
Subjects: Neurofibromatosis type 1 (NF1), Stroke, Vasculopathy, Dolichoectasia, Pseudoaneurysm, Dissection, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract: Neurofibromatosis type 1 is an autosomal dominant genetic disorder with multisystem manifestations including vascular abnormalities. The condition is also associated with an increased risk of both ischemic and hemorrhagic stroke. Here we report a case of a 60-year-old male with known neurofibromatosis who presented with right sided hemiparesis. Neuroimaging work-up revealed left internal carotid artery dissection and tandem occlusion of the left internal carotid artery and left middle cerebral artery. There was associated territorial ischemic infarction. The patient was found to have extensive intra and extra cranial vasculopathy including gross basilar dolichoectasia and a right-sided cervical internal carotid artery pseudoaneurysm. This case highlights the clinical significance of neurofibromatosis associated vasculopathy which can result in stroke.
Published: 2022
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9. Abstract TP180: Characteristics and Outcomes of Cerebral Venous Sinus Thrombosis Associated With COVID-19

Author: Scutelnic, Adrian, primary, van de Munckhof, Anita, additional, Miaclin, Angel, additional, AARON, SANJITH, additional, Hameed, Sajid, additional, Wasay, Muhammad, additional, Grosu, Oxana, additional, Krzywicka, Katarzyna, additional, Sanchez van Kammen, Mayte, additional, Lindgren, Erik, additional, Hom Moreira, Tiago, additional, Acampora, Roberto, additional, Alberto, Negro, additional, KARAPANAYIOTIDES, Theodoros, additional, Marialuisa, Zedde, additional, Yaghi, Shadi, additional, Ana, Barbera, additional, Cuadrado Godia, Elisa, additional, La Spina, Paolo, additional, Francesco, Grillo, additional, GIamello, Fabrizio, additional, Nguyen, Thanh, additional, Abdalkader, Mohamad, additional, Alina, Buture, additional, raposo, Nicolas, additional, Tsivogoulis, Georgios, additional, Candelaresi, Paolo, additional, Kristoffersen, Espen Saxhaug, additional, Ciacciarelli, Antonio, additional, Mbroh, Joshua, additional, Katheryna, Antonenko, additional, Kremer Hovinga, Johanna A., additional, Batenkova, Tatjana, additional, Scoppettuolo, Pasquale, additional, Jood, Katarina, additional, Aguiar De Sousa, Diana, additional, Poli, Sven, additional, Tatlisumak, Turgut, additional, Putaala, Jukka, additional, Coutinho, Jonathan M, additional, Ferro, Jose, additional, Arnold, Marcel, additional, and Heldner, Mirjam, additional
Published: 2024
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10. Raynaud's phenomenon secondary to erenumab in a patient with chronic migraine

Author: Agaath Hedina Manickam, Alina Buture, Esther Tomkins, and Martin Ruttledge
Subjects: CGRP monoclonal antibodies, chronic migraine, erenumab, Raynaud's phenomenon, Medicine, Medicine (General), R5-920
Abstract: Abstract Raynaud's phenomenon is a rare side effect of CGRP monoclonal antibodies. These molecular treatments are a relatively new class of drugs for the prevention of migraine. It is likely that we will see this side effect more often in the future. Patients with a background of Raynaud's phenomenon may experience worsening of their symptoms if started on these treatments.
Published: 2021
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11. Long term outcome for onabotulinumtoxinA (Botox) therapy in chronic migraine: A 2-year prospective follow-up audit of patients attending the Hull (UK) migraine clinic

Author: Fayyaz Ahmed, Alina Buture, Taukir Tanvir, and Modar Khalil
Subjects: Therapeutics. Pharmacology, RM1-950, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract: Objective: The objective of this prospective audit was to determine the long term outcome of patients diagnosed with chronic migraine who were treated with onabotulinumtoxinA for the prevention of chronic migraine. Background: While long term and real-world studies have confirmed the safety and efficacy of onabotulinumtoxinA in CM, there remains limited information from large patient numbers on the number of cycles and duration of onabotulinumtoxinA needed to successfully convert chronic migraine to episodic migraine, development of resistance to treatment and sustainability of response after stopping treatment. Methods: A total of 655 adult patients diagnosed with chronic migraine who received onabotulinumtoxinA at the Hull Migraine Clinic were followed up prospectively for a minimum of 2 years. OnabotulinumtoxinA was delivered as per the PREEMPT study protocol and patients were asked to keep a headache diary for at least 30 days prior to and continuously after receiving onabotulinumtoxinA. The primary outcome assessed in this prospective real-world audit was either the number of patients who achieved a ≥50% reduction in headache days or migraine days or an increment in crystal clear days twice that of baseline in a 30-day period. Patients were also assessed for analgesic medication overuse. Results: Treatment data were available for 655 patients who commenced treatment between July 2010 and October 2016 and followed for at least 2 years (24–70 months), with the last follow-up taking place in September 2018. Of the 655 patients, 380 patients responded to treatment after two cycles and went on to receive the third cycle. Of these, 152 patients were still on active treatment at 2 years. A further 61 patients had relapsed and were on treatment at 2 years. Of the 228 patients who stopped treatment, 112 were successfully converted to episodic migraine and showed a sustained response, 28 reverted to chronic migraine after the initial response despite continuing treatment (developed resistance), 14 were lost to follow up and 61 patients after achieving remission relapsed after a mean of 9 months (range 4–24 months) and recommenced treatment with onabotulinumtoxinA. Conclusion: After a minimum of 2 years, 29.4% of patients with chronic migraine who initially responded to treatment were successfully converted to episodic migraine and maintained a sustained response. Forty percent of the initial cohort of responders continued therapy with onabotulinumtoxinA to manage their chronic migraine.
Published: 2021
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12. Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache

Author: Buture, Alina, Ahmed, Fayyaz, Dikomitis, Lisa, and Boland, Jason W.
Published: 2019
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13. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Author: Scutelnic, Adrian, primary, van de Munckhof, Anita, additional, Krzywicka, Katarzyna, additional, van Kammen, Mayte Sánchez, additional, Lindgren, Erik, additional, Cordonnier, Charlotte, additional, Kleinig, Timothy J, additional, Field, Thalia S, additional, Poli, Sven, additional, Lemmens, Robin, additional, Middeldorp, Saskia, additional, Aaron, Sanjith, additional, Borhani-Haghighi, Afshin, additional, Arauz, Antonio, additional, Kremer Hovinga, Johanna A, additional, Günther, Albrecht, additional, Putaala, Jukka, additional, Wasay, Mohammad, additional, Conforto, Adriana Bastos, additional, de Sousa, Diana Aguiar, additional, Jood, Katarina, additional, Tatlisumak, Turgut, additional, Ferro, José M, additional, Coutinho, Jonathan M, additional, Arnold, Marcel, additional, Heldner, Mirjam R, additional, Antonenko, Kateryna, additional, Mbroh, Joshua, additional, Brodard, Justine, additional, Hooshmandi, Etrat, additional, Dizonno, Vanessa, additional, Devroye, Annemie, additional, Ciccone, Alfonso, additional, Wittstock, Matthias, additional, Zimmermann, Julian, additional, Bode, Felix J., additional, Skjelland, Mona, additional, Duan, Jiangang, additional, Hiltunen, Sini, additional, Zuurbier, Susanna M., additional, Petruzzellis, Marco, additional, Sharma, Aarti R., additional, Ghoreishi, Abdoreza, additional, Elkady, Ahmed, additional, Negro, Alberto, additional, Gutschalk, Alexander, additional, Schoenenberger, Silvia, additional, Nagel, Simon, additional, Buture, Alina, additional, Cervera, Alvaro, additional, Paiva Nunes, Ana, additional, Romina Montané Baños, Ana, additional, Tiede, Andreas, additional, Puthuppallil, Anemon, additional, Tuladhar, Anil M., additional, Mengel, Annerose, additional, Medina, Antonio, additional, Hellström Vogel, Åslög, additional, Tawa, Audrey, additional, Aujayeb, Avinash, additional, Ramasamy, Balakrishnan, additional, Casolla, Barbara, additional, Lim Alvin Chew, Beng, additional, Ziaadini, Bentalhoda, additional, Varkey Maramattom, Boby, additional, Buck, Brian, additional, Zanferrari, Carla, additional, Garcia-Esperon, Carlos, additional, Vayne, Caroline, additional, Legault, Catherine, additional, Jacobi, Christian, additional, Pfrepper, Christian, additional, Pelz, Johann, additional, Wahl, Christoph, additional, Kern, Rolf, additional, Tracol, Clement, additional, Soriano, Cristina, additional, Guisado-Alonso, Daniel, additional, Bougon, David, additional, Bal, Deepti, additional, Sergio Zimatore, Domenico, additional, Michalski, Dominik, additional, Blacquiere, Dylan, additional, Johansson, Elias, additional, Cuadrado-Godia, Elisa, additional, Sadeghi-Hokmabadi, Elyar, additional, Carrera, Emmanuel, additional, De Maistre, Emmanuel, additional, Saxhaug Kristoffersen, Espen, additional, Bonneville, Fabrice, additional, Geeraerts, Thomas, additional, Vuillier, Fabrice, additional, Giammello, Fabrizio, additional, D’Onofrio, Florindo, additional, Grillo, Francesco, additional, Caparros, François, additional, Susen, Sophie, additional, Maier, Frank, additional, Tsivgoulis, Georgios, additional, Gulli, Giosue, additional, Frisullo, Giovanni, additional, Franchineau, Guillaume, additional, Cangür, Hakan, additional, Katzberg, Hans, additional, Mozhdehipanah, Hossein, additional, Sibon, Igor, additional, Baharoglu, M. Irem, additional, Masjuan, Jaime, additional, Brar, Jaskiran, additional, Payen, Jean-Francois, additional, Burrow, Jim, additional, Fernandes, João, additional, Octavio López Esparza, Jorge, additional, Oen, Joyce, additional, Schouten, Judith, additional, Ng, Karl, additional, Chatterton, Sophie, additional, Wronski, Miriam, additional, Althaus, Katharina, additional, Garambois, Katia, additional, Derex, Laurent, additional, Puy, Laurent, additional, Poorsaadat, Leila, additional, Valler, Lenise, additional, Januzi de Almeida Rocha, Letícia, additional, Humbertjean, Lisa, additional, Lebrato Hernandez, Lucia, additional, Murillo-Bonilla, Luis, additional, Kellermair, Lukas, additional, Morin Martin, Mar, additional, Sofia Cotelli, Maria, additional, Hernandez Perez, Maria, additional, Zedde, Marialuisa, additional, Carvalho Dias, Mariana, additional, Dubois, Marie-Cecile, additional, Carvalho, Marta, additional, Ghiasian, Masoud, additional, Umaiorubahan, Meenakshisundaram, additional, Kumar Karunakaran, Ravi, additional, Roozbeh, Mehrdad, additional, Romoli, Michele, additional, Miranda, Miguel, additional, Saadatnia, Mohammad, additional, Bandettini di Poggio, Monica, additional, Scholz, Moritz J., additional, Kahnis, Robert, additional, Almasi-Dooghaee, Mostafa, additional, Hoseininejad Mir, Nahid, additional, Ichaporia, Nasli R., additional, Kumar Paramasivan, Naveen, additional, Erat Sreedharan, Sapna, additional, Sylaja, PN, additional, Raposo, Nicolas, additional, Fadakar, Nima, additional, Kruyt, Nyika, additional, Detante, Olivier, additional, Cuisenier, Pauline, additional, Huet, Olivier, additional, Sharma, Pankaj, additional, Candelaresi, Paolo, additional, Scoppettuolo, Pasquale, additional, Reiner, Peggy, additional, Nemati, Reza, additional, Vieira, Ricardo, additional, Goh, Rudy, additional, Murphy, Seán, additional, Timsit, Serge, additional, Coutts, Shelagh, additional, Sharma, Shyam S., additional, Bal, Simerpreet, additional, Kaul, Subhash, additional, Karapanayiotides, Theodoros, additional, Cox, Thomas, additional, Gattringer, Thomas, additional, Mathew, Thomas, additional, Bartsch, Thorsten, additional, Shaygannejad, Vahid, additional, Garcia-Talavera, Veronica, additional, Palma, Vincenzo, additional, Arslan, Yıldız, additional, Mirzaasgari, Zahra, additional, Yavari, Zeinab, additional, Zamani, Zohreh, additional, Bakchoul, Tamam, additional, Levi, Marcel, additional, and van Gorp, Eric C.M., additional
Published: 2023
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14. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Author: van de Munckhof, Anita, primary, Borhani-Haghighi, Afshin, additional, Aaron, Sanjith, additional, Krzywicka, Katarzyna, additional, van Kammen, Mayte Sánchez, additional, Cordonnier, Charlotte, additional, Kleinig, Timothy J, additional, Field, Thalia S, additional, Poli, Sven, additional, Lemmens, Robin, additional, Scutelnic, Adrian, additional, Lindgren, Erik, additional, Duan, Jiangang, additional, Arslan, Yıldız, additional, van Gorp, Eric CM, additional, Kremer Hovinga, Johanna A, additional, Günther, Albrecht, additional, Jood, Katarina, additional, Tatlisumak, Turgut, additional, Putaala, Jukka, additional, Heldner, Mirjam R, additional, Arnold, Marcel, additional, de Sousa, Diana Aguiar, additional, Wasay, Mohammad, additional, Arauz, Antonio, additional, Conforto, Adriana Bastos, additional, Ferro, José M, additional, Coutinho, Jonathan M, additional, Mbroh, Joshua, additional, Ciccone, Alfonso, additional, Wittstock, Matthias, additional, Zimmermann, Julian, additional, Bode, Felix J, additional, Skjelland, Mona, additional, Dizonno, Vanessa, additional, Devroye, Annemie, additional, Hiltunen, Sini, additional, Petruzzellis, Marco, additional, Bakchoul, Tamam, additional, Levi, Marcel, additional, Middeldorp, Saskia, additional, Sharma, Aarti R, additional, Ghoreishi, Abdoreza, additional, Elkady, Ahmed, additional, Negro, Alberto, additional, Gutschalk, Alexander, additional, Buture, Alina, additional, Cervera, Alvaro, additional, Paiva Nunes, Ana, additional, Romina Montané Baños, Ana, additional, Tiede, Andreas, additional, Tuladhar, Anil M, additional, Mengel, Annerose, additional, Medina, Antonio, additional, Aujayeb, Avinash, additional, Ramasamy, Balakrishnan, additional, Casolla, Barbara, additional, Spratt, Neil, additional, Ziaadini, Bentolhoda, additional, Varkey Maramattom, Boby, additional, Buck, Brian, additional, Garcia-Esperon, Carlos, additional, Vayne, Caroline, additional, Jacobi, Christian, additional, Pfrepper, Christian, additional, Bal, Deepti, additional, Sergio Zimatore, Domenico, additional, Michalski, Dominik, additional, Blacquiere, Dylan, additional, Johansson, Elias, additional, Cuadrado-Godia, Elisa, additional, Sadeghi-Hokmabadi, Elyar, additional, Carrera, Emmanuel, additional, Maistre, Emmanuel De, additional, Saxhaug Kristoffersen, Espen, additional, Hooshmandi, Etrat, additional, Bonneville, Fabrice, additional, Vuillier, Fabrice, additional, Giammello, Fabrizio, additional, D’Onofrio, Florindo, additional, Tsivgoulis, Georgios, additional, Gulli, Giosue, additional, Katzberg, Hans, additional, Sibon, Igor, additional, Baharoglu, Irem, additional, Masjuan, Jaime, additional, Fernandes, João, additional, Pelz, Johann, additional, Octavio López Esparza, Jorge, additional, Schouten, Judith, additional, Ng, Karl, additional, Derex, Laurent, additional, Puy, Laurent, additional, Poorsaadat, Leila, additional, Valler, Lenise, additional, Januzi de Almeida Rocha, Letícia, additional, Murillo-Bonilla, Luis, additional, Kellermair, Lukas, additional, Morin Martin, Mar, additional, Sofia Cotelli, Maria, additional, Hernandez Perez, Maria, additional, Zedde, Marialuisa, additional, Carvalho Dias, Mariana, additional, Carvalho, Marta, additional, Ghiasian, Masoud, additional, Umaiorubahan, Meenakshisundaram, additional, Roozbeh, Mehrdad, additional, Romoli, Michele, additional, Miranda, Miguel, additional, Wronski, Miriam, additional, Saadatnia, Mohammad, additional, Bandettini di Poggio, Monica, additional, Almasi-Dooghaee, Mostafa, additional, Hoseininejad Mir, Nahid, additional, Ichaporia, Nasli R, additional, Kumar Paramasivan, Naveen, additional, Raposo, Nicolas, additional, Fadakar, Nima, additional, Kruyt, Nyika, additional, Detante, Olivier, additional, Sharma, Pankaj, additional, Candelaresi, Paolo, additional, Scoppettuolo, Pasquale, additional, Reiner, Peggy, additional, Sylaja, PN, additional, Kumar Karunakaran, Ravi, additional, Vieira, Ricardo, additional, Kern, Rolf, additional, Goh, Rudy, additional, Erat Sreedharan, Sapna, additional, Murphy, Seán, additional, Timsit, Serge, additional, Coutts, Shelagh, additional, Sharma, Shyam S, additional, Schoenenberger, Silvia, additional, Nagel, Simon, additional, Kaul, Subhash, additional, Karapanayiotides, Theodoros, additional, Gattringer, Thomas, additional, Mathew, Thomas, additional, Bartsch, Thorsten, additional, Palma, Vincenzo, additional, Mirzaasgari, Zahra, additional, Zamani, Zohreh, additional, Mirahmadizadeh, Alireza, additional, Gutierrez-Romero, Alonso, additional, Iván Valdes-Ferrer, Ivan, additional, Elizabeth Ceballos-Liceaga, Santa, additional, and Maria Santibañez-Copado, Ana, additional
Published: 2023
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15. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Adrian Scutelnic, Katarzyna Krzywicka, Joshua Mbroh, Anita van de Munckhof, Mayte Sánchez van Kammen, Diana Aguiar de Sousa, Erik Lindgren, Katarina Jood, Albrecht Günther, Sini Hiltunen, Jukka Putaala, Andreas Tiede, Frank Maier, Rolf Kern, Thorsten Bartsch, Katharina Althaus, Alfonso Ciccone, Markus Wiedmann, Mona Skjelland, Antonio Medina, Elisa Cuadrado‐Godia, Thomas Cox, Avinash Aujayeb, Nicolas Raposo, Katia Garambois, Jean‐Francois Payen, Fabrice Vuillier, Guillaume Franchineau, Serge Timsit, David Bougon, Marie‐Cécile Dubois, Audrey Tawa, Clement Tracol, Emmanuel De Maistre, Fabrice Bonneville, Caroline Vayne, Annerose Mengel, Dominik Michalski, Johann Pelz, Matthias Wittstock, Felix Bode, Julian Zimmermann, Judith Schouten, Alina Buture, Sean Murphy, Vincenzo Palma, Alberto Negro, Alexander Gutschalk, Simon Nagel, Silvia Schoenenberger, Giovanni Frisullo, Carla Zanferrari, Francesco Grillo, Fabrizio Giammello, Mar Morin Martin, Alvaro Cervera, Jim Burrow, Carlos Garcia Esperon, Beng Lim Alvin Chew, Timothy J. Kleinig, Cristina Soriano, Domenico S. Zimatore, Marco Petruzzellis, Ahmed Elkady, Miguel S. Miranda, João Fernandes, Åslög Hellström Vogel, Elias Johansson, Anemon Puthuppallil Philip, Shelagh B. Coutts, Simerpreet Bal, Brian Buck, Catherine Legault, Dylan Blacquiere, Hans D. Katzberg, Thalia S. Field, Vanessa Dizonno, Thomas Gattringer, Christian Jacobi, Annemie Devroye, Robin Lemmens, Espen Saxhaug Kristoffersen, Monica Bandettini di Poggio, Masoud Ghiasian, Theodoros Karapanayiotides, Sophie Chatterton, Miriam Wronski, Karl Ng, Robert Kahnis, Thomas Geeraerts, Peggy Reiner, Charlotte Cordonnier, Saskia Middeldorp, Marcel Levi, Eric C. M. van Gorp, Diederik van de Beek, Justine Brodard, Johanna A. Kremer Hovinga, Marieke J. H. A. Kruip, Turgut Tatlisumak, José M. Ferro, Jonathan M. Coutinho, Marcel Arnold, Sven Poli, Mirjam R. Heldner, Virology, Hematology, HUS Neurocenter, Department of Neurosciences, University of Helsinki, Neurologian yksikkö, Clinicum, Neurology, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, ARD - Amsterdam Reproduction and Development, ANS - Neuroinfection & -inflammation, AII - Infectious diseases, and Repositório da Universidade de Lisboa
Subjects: SINUS THROMBOSIS, Venous Thrombosis, COVID-19 Vaccines, SARS-CoV-2, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Vaccination, 3112 Neurosciences, Embòlia i trombosi cerebral, Anticoagulants, COVID-19, Immunoglobulins, Intravenous, 610 Medicine & health, Hematology, Vacunes, COVID-19 (Malaltia), 3124 Neurology and psychiatry, Adenoviridae, Neurology, SDG 3 - Good Health and Well-being, Humans, Hematologi, Neurology (clinical), Intracranial Thrombosis
Abstract: © 2022 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.562 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made., Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL 2022;92:562-573., This research was funded by The Netherlands Organisation for Health Research and Development (ZonMw, grant number 10430072110005) and the Dr. C. J. Vaillant Foundation.
Published: 2022

16. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Author: Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, van Gorp, Eric C.M., Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, and van Gorp, Eric C.M.
Abstract: Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
Published: 2023

17. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Author: van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, Maria Santibañez-Copado, Ana, van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, and Maria Santibañez-Copado, Ana
Abstract: Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
Published: 2023

18. sj-pdf-1-cep-10.1177_03331024231182126 - Supplemental material for Two-year, real-world erenumab persistence and quality of life data in 82 pooled patients with abrupt onset, unremitting, treatment refractory headache and a migraine phenotype: New daily persistent headache or persistent post-traumatic headache in the majority of cases

Author: Buture, Alina, Tomkins, Esther M., Shukralla, Arif, Troy, Emma, Conaty, Katie, Macken, Esther, Lonergan, Roisin, Melling, Jane, Long, Niamh, Birrane, Kieran, Shaikh, Eamonn, Goadsby, Peter J., and Ruttledge, Martin H.
Subjects: FOS: Psychology, FOS: Clinical medicine, 170199 Psychology not elsewhere classified, 110319 Psychiatry (incl. Psychotherapy), 110306 Endocrinology, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract: Supplemental material, sj-pdf-1-cep-10.1177_03331024231182126 for Two-year, real-world erenumab persistence and quality of life data in 82 pooled patients with abrupt onset, unremitting, treatment refractory headache and a migraine phenotype: New daily persistent headache or persistent post-traumatic headache in the majority of cases by Alina Buture, Esther M. Tomkins, Arif Shukralla, Emma Troy, Katie Conaty, Esther Macken, Roisin Lonergan, Jane Melling, Niamh Long, Kieran Birrane, Eamonn Shaikh, Peter J. Goadsby and Martin H. Ruttledge in Cephalalgia
Published: 2023
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19. Ischemic stroke with extensive vasculopathy in a patient with neurofibromatosis type 1

Author: Desmond, Fiona J., primary, Buture, Alina, additional, Kavanagh, Eoin C., additional, and Murphy, Sean, additional
Published: 2022
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20. Two-year, real-world erenumab persistence and quality of life data in 82 pooled patients with abrupt onset, unremitting, treatment refractory headache and a migraine phenotype: New daily persistent headache or persistent post-traumatic headache in the majority of cases

Author: Buture, Alina, Tomkins, Esther M., Shukralla, Arif, Troy, Emma, Conaty, Katie, Macken, Esther, Lonergan, Roisin, Melling, Jane, Long, Niamh, Birrane, Kieran, Shaikh, Eamonn, Goadsby, Peter J., and Ruttledge, Martin H.
Subjects: *PRIMARY headache disorders, *ERENUMAB, *MIGRAINE, *HEADACHE, *QUALITY of life, *DATA quality
Abstract: Background: Patients diagnosed with New Daily Persistent Headache and Persistent Post-Traumatic Headache belong to a heterogeneous group of primary and secondary headache disorders, with the common clinical feature that these conditions start abruptly, continue unabated, and are refractory to conventional migraine preventive treatments. Objective: This is a real-world, medium-term audit to explore whether erenumab improves quality of life in a pooled group of 82 abrupt-onset, unremitting and treatment refractory patients, where the diagnosis is new daily persistent headache and persistent post-traumatic headache in the majority of cases. Methods: Eighty-two patients were treated with erenumab every 28 days over a two to three-year period, beginning in December 2018. These patients were "longstanding chronic" and refractory with a median of eight (IQR 4–12) prior failed migraine preventive treatments and median duration of disease of seven (IQR 3–11) years. The starting dose of erenumab was 70 mg in 79% of cases and 140 mg in the remaining patients (individuals with a BMI of more than 30). All patients were asked to complete three migraine specific Quality of Life questionnaires or Patient Reported Outcome Measures before starting treatment and typically at 3–12 intervals until the end of June 2021 or cessation of treatment. The Patient Reported Outcome Measures included: Headache Impact Test-6, Migraine Associated Disability Assessment test and Migraine-Specific Quality-of-Life Questionnaire. Patients generally only stayed on treatment after 6–12 months if there was deemed to be an improvement of at least 30% and there were no significant side effects. The longest treated cases have quality of life data for 30 months after starting erenumab. Results: Of the 82 patients, 29 (35%) had improvement in Quality of Life scores, with no significant side effects, and wished to stay on treatment. Fifty-three patients (65%) stopped treatment during the first 6–25 months due to lack of efficacy and/or patient reported side effects (n = 33 and n = 17, respectively) or a combination of both, pregnancy planning (n = 2), and lost to follow up (n = 1). Conclusion: Significant improvements in Quality of Life scores were recorded by one-third of patients over a period of 11–30 months, with a 35% persistence after a median of 26 months of treatment. This contrasts with our recently published, treatment resistant, chronic migraine cohort where the persistence with erenumab treatment was almost 55% after a median time of 25 months. [ABSTRACT FROM AUTHOR]
Published: 2023
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21. Caracterização e análise de uma unidade fabril de batata

Author: Ediléia Camila Fernandes Buture, Juliana Vitória Messias Bittencourt, Mariana Machado Fidelis do Nascimento, and UTFPR
Subjects: Engenharia de Produção, Gerência de Produção, Garantia de Controle de Qualidade, Controle estatístico do processo, batata frita, ferramenta de qualidade, Earth-Surface Processes
Abstract: O presente artigo tem como objetivo caracterizar uma indústria de batatas fritas e realizar estudos estatísticos durante o acompanhamento do processo produtivo da própria, tendo como objetivo desenvolver um controle estatístico da produtividade da organização. Durante o acompanhamento da produção na unidade fabril, dados foram coletados, e de igual forma, dados retrospectivos desse processo também foram obtidos para uma análise estatística; tabelas e gráficos foram gerados possibilitando o desenvolvimento de um controle estatístico da produtividade da instituição. Através das análises, foi possível avaliar a quantidade de perdas diárias de batatas fritas e embalagens, e a frequência com que elas ocorrem, bem como o rendimento do óleo utilizado. Os resultados mostram a porcentagem de perdas diárias de batatas já frita, e de igual forma as perdas diárias de embalagens, mostrando a necessidade da realização de um acompanhamento sistemático, visto que, algumas falhas são percebidas no processo; e que, se inspecionadas e controladas, poderia ocorrer uma melhora significativa na lucratividade da instituição como também atuaria numa possível redução de custos.
Published: 2022
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22. Does analgesic overuse matter? Response to OnabotulinumtoxinA in patients with chronic migraine with or without medication overuse

Author: Ahmed, Fayyaz, Zafar, Hassan W., Buture, Alina, and Khalil, Modar
Published: 2015
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23. Caracterização e análise de uma unidade fabril de batata

Author: Buture, Ediléia Camila Fernandes, primary, Bittencourt, Juliana Vitória Messias, additional, and Nascimento, Mariana Machado Fidelis do, additional
Published: 2022
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24. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID‐19 Vaccination

Author: Scutelnic, Adrian, primary, Krzywicka, Katarzyna, additional, Mbroh, Joshua, additional, van de Munckhof, Anita, additional, van Kammen, Mayte Sánchez, additional, de Sousa, Diana Aguiar, additional, Lindgren, Erik, additional, Jood, Katarina, additional, Günther, Albrecht, additional, Hiltunen, Sini, additional, Putaala, Jukka, additional, Tiede, Andreas, additional, Maier, Frank, additional, Kern, Rolf, additional, Bartsch, Thorsten, additional, Althaus, Katharina, additional, Ciccone, Alfonso, additional, Wiedmann, Markus, additional, Skjelland, Mona, additional, Medina, Antonio, additional, Cuadrado‐Godia, Elisa, additional, Cox, Thomas, additional, Aujayeb, Avinash, additional, Raposo, Nicolas, additional, Garambois, Katia, additional, Payen, Jean‐Francois, additional, Vuillier, Fabrice, additional, Franchineau, Guillaume, additional, Timsit, Serge, additional, Bougon, David, additional, Dubois, Marie‐Cécile, additional, Tawa, Audrey, additional, Tracol, Clement, additional, De Maistre, Emmanuel, additional, Bonneville, Fabrice, additional, Vayne, Caroline, additional, Mengel, Annerose, additional, Michalski, Dominik, additional, Pelz, Johann, additional, Wittstock, Matthias, additional, Bode, Felix, additional, Zimmermann, Julian, additional, Schouten, Judith, additional, Buture, Alina, additional, Murphy, Sean, additional, Palma, Vincenzo, additional, Negro, Alberto, additional, Gutschalk, Alexander, additional, Nagel, Simon, additional, Schoenenberger, Silvia, additional, Frisullo, Giovanni, additional, Zanferrari, Carla, additional, Grillo, Francesco, additional, Giammello, Fabrizio, additional, Martin, Mar Morin, additional, Cervera, Alvaro, additional, Burrow, Jim, additional, Esperon, Carlos Garcia, additional, Chew, Beng Lim Alvin, additional, Kleinig, Timothy J., additional, Soriano, Cristina, additional, Zimatore, Domenico S., additional, Petruzzellis, Marco, additional, Elkady, Ahmed, additional, Miranda, Miguel S., additional, Fernandes, João, additional, Vogel, Åslög Hellström, additional, Johansson, Elias, additional, Philip, Anemon Puthuppallil, additional, Coutts, Shelagh B., additional, Bal, Simerpreet, additional, Buck, Brian, additional, Legault, Catherine, additional, Blacquiere, Dylan, additional, Katzberg, Hans D., additional, Field, Thalia S., additional, Dizonno, Vanessa, additional, Gattringer, Thomas, additional, Jacobi, Christian, additional, Devroye, Annemie, additional, Lemmens, Robin, additional, Kristoffersen, Espen Saxhaug, additional, di Poggio, Monica Bandettini, additional, Ghiasian, Masoud, additional, Karapanayiotides, Theodoros, additional, Chatterton, Sophie, additional, Wronski, Miriam, additional, Ng, Karl, additional, Kahnis, Robert, additional, Geeraerts, Thomas, additional, Reiner, Peggy, additional, Cordonnier, Charlotte, additional, Middeldorp, Saskia, additional, Levi, Marcel, additional, van Gorp, Eric C. M., additional, van de Beek, Diederik, additional, Brodard, Justine, additional, Kremer Hovinga, Johanna A., additional, Kruip, Marieke J. H. A., additional, Tatlisumak, Turgut, additional, Ferro, José M., additional, Coutinho, Jonathan M., additional, Arnold, Marcel, additional, Poli, Sven, additional, and Heldner, Mirjam R., additional
Published: 2022
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25. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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26. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., Heldner, M.R., Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., and Heldner, M.R.
Abstract: Contains fulltext : 282309.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). CONCLUSIONS: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL
Published: 2022

27. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study

Author: Jason W Boland, Lisa Dikomitis, Alina Buture, and Fayyaz Ahmed
Subjects: medicine.medical_specialty, business.industry, 030503 health policy & services, Cluster headache, Excruciating pain, General Medicine, medicine.disease, Excruciating, 03 medical and health sciences, 0302 clinical medicine, Primary headache, Migraine, medicine, Physical therapy, International Classification of Headache Disorders, Screening tool, 030212 general & internal medicine, 0305 other medical science, business, General Nursing, Headache pain
Abstract: Introduction and objective The diagnosis of primary headaches is based on the International Classification of Headache Disorders (ICHD-3). Cluster headache (CH), a debilitating primary headache, is often misdiagnosed as migraine. In the absence of biological markers, a new visual screening tool with images depicting pain could aid the correct diagnosis of CH. The objective of the study is to test the tool on healthy participants and participants with CH and migraine. Methods In phase 1, 6 images portraying people with pain were tested on 150 healthy participants. The healthy participants were asked to rate the images as mild, moderate, severe or excruciating pain. In phase 2, the images were further tested on 116 participants with headache (16 participants with CH, 100 participants with migraine). The participants were recruited prospectively from a tertiary headache center between February and May 2017. The participants were asked to choose which image best illustrated their headache attacks. Results Phase 1 results showed that the images represent a range of headache pain severities from mild to excruciating as rated by healthy participants. They rated two images as excruciating, one image as severe, one image as moderate/severe, one image as moderate and one image as mild. Phase 2 results showed that two-thirds of participants with CH (69%) and half of the participants with migraine (52%) chose an image described as excruciating by the healthy participants. Conclusion We developed a screening tool with six drawings depicting headache pain severities from mild to excruciating as rated by the healthy participants. Although the images did not differentiate between CH and migraine, the study indicated the potential of using visual aids to assess headache severity.
Published: 2019

28. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies

Author: Jason W Boland, Lisa Dikomitis, Fayyaz Ahmed, and Alina Buture
Subjects: positron emission tomography, Vasoactive intestinal peptide, Neuropeptide, Review, Calcitonin gene-related peptide, calcitonin gene-related peptide, pituitary adenylate cyclase activating peptide, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, 030202 anesthesiology, voxel-based morphometry, Medicine, single-photon emission computer tomography, lcsh:R5-920, business.industry, Trigeminovascular system, Neuropeptide Y receptor, R1, functional magnetic resonance imaging, Neuromodulation (medicine), Pituitary adenylate cyclase-activating peptide, Anesthesiology and Pain Medicine, pituitary adenylate cyclase-activating peptide, calcitonin gene related peptide, positron-emission tomography, lcsh:Medicine (General), business, Neuroscience, 030217 neurology & neurosurgery
Abstract: Alina Buture,1,2 Jason W Boland,2 Lisa Dikomitis,3 Fayyaz Ahmed1,2 1Department of Neurology, Hull Royal Infirmary, Hull, UK; 2Hull York Medical School, University of Hull, Hull, UK; 3School of Medicine and Institute of Primary Care and Health Sciences, Keele University, Newcastle, UK Objective: Cluster headache (CH) is the most severe primary headache condition. Its pathophysiology is multifaceted and incompletely understood. This review brings together the latest neuroimaging and neuropeptide evidence on the pathophysiology of CH.Methods: A review of the literature was conducted by searching PubMed and Web of Science. The search was conducted using the following keywords: imaging studies, voxel-based morphometry, diffusion-tensor imaging, diffusion magnetic resonance imaging, tractography, connectivity, cerebral networks, neuromodulation, central modulation, deep brain stimulation, orexin-A, orexin-B, tract-based spatial statistics, single-photon emission computer tomography studies, positron-emission tomography, functional magnetic resonance imaging, magnetic resonance spectroscopy, trigeminovascular system, neuropeptides, calcitonin gene-related peptide, neurokinin A, substance P, nitric oxide synthase, pituitary adenylate cyclase-activating peptide, vasoactive intestinal peptide, neuropeptide Y, acetylcholine, noradrenaline, and ATP. “Cluster headache” was combined with each keyword for more relevant results. All irrelevant and duplicated records were excluded. Search dates were from October 1976 to May 2018.Results: Neuroimaging studies support the role of the hypothalamus in CH, as well as other brain areas involved in the pain matrix. Activation of the trigeminovascular system and the release of neuropeptides play an important role in CH pathophysiology. Among neuropeptides, calcitonin gene-related peptide, vasoactive intestinal peptide, and pituitary adenylate cyclase-activating peptide have been reported to be reliable biomarkers for CH attacks, though not specific for CH. Several other neuropeptides are involved in trigeminovascular activation, but the current evidence does not qualify them as reliable biomarkers in CH.Conclusion: CH has a complex pathophysiology and the pain mechanism is not completely understood. Recent neuroimaging studies have provided insight into the functional and structural network bases of CH pathophysiology. Although there has been important progress in neuropeptide studies, a specific biomarker for CH is yet to be found. Keywords: voxel-based morphometry, single-photon emission computer tomography, positron-emission tomography, functional magnetic resonance imaging, calcitonin gene-related peptide, pituitary adenylate cyclase-activating peptide&nbsp
Published: 2019

29. Raynaud's phenomenon secondary to erenumab in a patient with chronic migraine

Author: Manickam, Agaath Hedina, primary, Buture, Alina, additional, Tomkins, Esther, additional, and Ruttledge, Martin, additional
Published: 2021
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30. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Gregory Polkinghorne, Jean-François Payen, Fabrice Vuillier, Katarina Jood, Simon Nagel, Suzanne Silvis, Hans D. Katzberg, Aarti Sharma, Anemon Puthuppallil Philip, Caroline Vayne, Pankaj Sharma, Marcel Levi, Sini Hiltunen, Mayte Sánchez van Kammen, Monica Bandettini di Poggio, Erik Lindgren, Moritz J Scholz, Roberto Acampora, Felix J. Bode, Shyam S Sharma, Jim Burrow, Miguel Miranda, Alfonso Ciccone, Guillaume Franchineau, Ana Paiva Nunes, Yildiz Arslan, Christian Pfrepper, Vanessa Dizonno, Frank Maier, Emmanuel De Maistre, Domenico S Zimatore, Ahmed Elkady, Giovanni Frisullo, Fabrizio Giammello, Laurent Puy, Albrecht Günther, Dominik Michalski, Clement Tracol, Marta Carvalho, Irem Baharoglu, Jukka Putaala, José M. Ferro, Olivier Huet, Matthias Wittstock, Florindo d'Onofrio, Sophie Susen, Ronen R. Leker, Brian Buck, Jaskiran Brar, Katia Garambois, Barbara Casolla, Lukas Kellermair, Robert Kahnis, Avinash Aujayeb, Lucia Lebrato Hernandez, Catherine Legault, Simerpreet Bal, Mar Morin Martin, David Bougon, Anita van de Munckhof, Ricardo Vieira, Julian Zimmerman, Turgut Tatlisumak, Audrey Tawa, Hakan Cangür, Cristina Soriano, Georgios Tsivgoulis, Alberto Negro, Annerose Mengel, Jonathan M. Coutinho, Saskia Middeldorp, Dylan Blacquiere, Emmanuel Carrera, Antonio Arauz, Sean Murphy, Elias Johansson, Silvia Schönenberger, Judith Schouten, Thomas Gattringer, Sven Poli, François Cotton, Miguel A Barboza, Thomas Geeraerts, Nicolas Raposo, Nyika D. Kruyt, Mirjam Rachel Heldner, Shelagh B. Coutts, Timothy Kleinig, Elisa Cuadrado-Godia, Katarzyna Krzywicka, Mona Skjelland, Daniel Guisado-Alonso, Charlotte Cordonnier, Andreas Tiede, Marie-Cécile Dubois, Maria Cotelli, Diana Aguiar de Sousa, Maryam Mansour, Katharina Althaus, Peggy Reiner, Carlos Garcia-Esperon, Marcel Arnold, Thomas Cox, Laurent Derex, Thalia S. Field, Thijs F. van Haaps, Carla Zanferrari, Paolo Candelaresi, François Caparros, Åslög Hellström Vogel, Lisa Humbertjean, Francesco Grillo, A. Medina, Giosue Gulli, Marco Petruzzellis, Rolf Kern, Igor Sibon, João Fernandes, Fabrice Bonneville, Johanna A. Kremer Hovinga, Alexander Gutschalk, Alina Buture, Thorsten Bartsch, Graduate School, Neurology, Amsterdam Neuroscience - Neurovascular Disorders, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, Amsterdam Reproduction & Development, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, and ARD - Amsterdam Reproduction and Development
Subjects: Male, Pediatrics, Outcome Assessment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], 030204 cardiovascular system & hematology, Sinus Thrombosis, Sinus Thrombosis, Intracranial/blood, Cohort Studies, Sinus Thrombosis, Intracranial, Venous Thromboembolism/blood, 0302 clinical medicine, Outcome Assessment, Health Care, Hospital Mortality, Registries, Original Investigation, Mortality rate, Syndrome, Venous Thromboembolism, Heparin, Middle Aged, Thrombosis, 3. Good health, Vaccination, Female, Thrombocytopenia/blood, Cohort study, medicine.drug, Adult, medicine.medical_specialty, COVID-19 Vaccines, Drug-Related Side Effects and Adverse Reactions, Young Adult, 03 medical and health sciences, Sex Factors, ChAdOx1 nCoV-19, medicine, Intracranial/blood, Humans, Thrombus, Cerebral venous sinus thrombosis, BNT162 Vaccine, Aged, Ad26COVS1, business.industry, medicine.disease, Intracranial, Thrombocytopenia, Health Care, Drug-Related Side Effects and Adverse Reactions/mortality, Concomitant, Neurology (clinical), business, 030217 neurology & neurosurgery, COVID-19 Vaccines/adverse effects
Abstract: Contains fulltext : 245661.pdf (Publisher’s version ) (Closed access) IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. CONCLUSIONS AND RELEVANCE: In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
Published: 2021

31. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., Poggio, M., et al. Bandettini di, Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., and Poggio, M., et al. Bandettini di
Abstract: Item does not contain fulltext, IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.
Published: 2021

32. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, Arslan, Yildiz, Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, and Arslan, Yildiz
Abstract: Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI
Published: 2021
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33. Long Term Outcome for OnabotulinumtoxinA (Botox) Therapy in Chronic Migraine: A 2-Year Follow up of Patients Attending the Hull (UK) Migraine Clinic

Author: Modar Khalil, Fayyaz Ahmed, Taukir Tanvir, and Alina Buture
Subjects: Pediatrics, medicine.medical_specialty, Chronic Migraine, Migraine, business.industry, Medicine, business, medicine.disease, Outcome (game theory), Term (time)
Abstract: ObjectiveThe objective of this prospective analysis was to determine the long-term outcome of patients diagnosed with chronic migraine who were treated with OnabotulinumtoxinA for the prevention of chronic migraine.BackgroundThe long-term outcomes of patients treated with OnabotulinumtoxinA remains uncertain, including information on the number of cycles and duration of OnabotulinumtoxinA needed to successfully convert chronic migraine to episodic migraine, development of resistance to treatment and sustainability of response after stopping treatment.MethodsA total of 655 adult patients diagnosed with chronic migraine who received OnabotulinumtoxinA at the Hull Migraine Clinic were followed up prospectively for a minimum of 2 years. OnabotulinumtoxinA was delivered as per the PREEMPT study protocol and patients were asked to keep a headache diary for at least 30 days prior to and continuously after receiving OnabotulinumtoxinA. The primary outcome was either the number of patients who achieved a ≥50% reduction in headache days or migraine days or an increment in crystal clear days twice that of baseline in a 30-day period. Patients were also assessed for analgesic medication overuse.ResultsTreatment data were available for 655 patients who commenced treatment between July 2010 and October 2016 and followed for at least 2 years (24–70 months). Of the 655 patients, 380 patients responded to treatment after two cycles and went on to receive the third cycle. Of these, 152 patients were still on active treatment at 2 years. Of the 228 patients who stopped treatment, 112 were successfully converted to episodic migraine and showed a sustained response, 28 reverted to chronic migraine after the initial response inspite of continuing treatment (developed resistance), 14 were lost to follow up and 61 patients after achieving remission relapsed after a mean of 9 months (range 4–24 months) and recommenced treatment with OnabotulinumtoxinA. ConclusionAfter a minimum of 2 years, 29.4% of patients with chronic migraine who initially responded to treatment were successfully converted to episodic migraine and maintained a sustained response. Forty percent of the initial cohort of responders continued therapy with OnabotulinumtoxinA to manage their chronic migraine.
Published: 2020

34. Startups : os instrumentos jurídicos e o incentivo aos novos negócios

Author: Carneiro, Wagner Buture, 1988, Cunha, Cleverson Renan da, 1971, Universidade Federal do Paraná. Setor de Ciências Sociais Aplicadas. Programa de Pós-Graduação em Propriedade Intelectual e Transferência de Tecnologia para Inovação, and Conrado, Marcelo Miguel, 1976
Subjects: Empresas novas - Planejamento, Aplicativos móveis
Abstract: Orientador: Prof. Dr. Marcelo Miguel Conrado Coorientador: Prof. Dr. Cleverson Renan Cunha Dissertação (mestrado profissional) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Programa de Pós-Graduação em Propriedade Intelectual e Transferência de Tecnologia para Inovação - PROFNIT. Defesa : Curitiba, 20/08/2020 Inclui referências: p.78-88 Resumo: Pesquisas recentes revelam que a ausência de reflexão sobre as implicações legais do negócio e de gestão dos aspectos jurídicos estão entre as causas frequentes de descontinuidade precoce das startups. A linguagem excessivamente técnica utilizada pelos advogados e a associação à entraves burocráticos fazem com que os empreendedores releguem o Direito a um segundo plano. Apesar de existir um cenário propício, poucos estudos foram dedicados a aproximar o Direito da prática cotidiana das startups. Este trabalho tem o objetivo geral de desenvolver um material didático e instrucional e um projeto de aplicativo móvel, que possam ser utilizados por empreendedores de startups e suas equipes, advogados, professores e acadêmicos dos cursos de Direito, demonstrando que tão importante quanto a determinação de objetivos e planos de ação para a execução da ideia, é enxergar o Direito e os instrumentos jurídicos como ferramentas estratégicas. Em relação aos procedimentos metodológicos para alcançar esse objetivo, utilizou-se um estudo qualitativo, iniciado por um levantamento bibliográfico, contextualizando, no referencial teórico, a problemática sobre startups, planejamento estratégico, modelos de negócio, quadro de modelo de negócios ou Canvas, Direito e gestão jurídica. Na sequência, foram apuradas as principais áreas e ramos do Direito que afetam diretamente a tomada de decisões em uma startup, concebendo dez seções de livre preenchimento, em que o usuário direcionado por questionamentos poderá apontar desafios, riscos e planos de ação. O trabalho ainda consistiu na criação do layout do material didático e no desenvolvimento de projeto de aplicativo móvel, de modo a proporcionar maior interatividade aos usuários e despertar o interesse, pensando na acessibilidade do conteúdo exposto e em formatos que estimulem a usabilidade. Ao final, apresenta-se as considerações finais, contribuições teóricas e práticas do trabalho, bem como sugestões para pesquisas futuras. Palavras-chaves: Startups. Planejamento jurídico. Estratégia. Aplicativo. Abstract: Recent researches shows that the lack of concerning on the legal implications of the business is among the most frequent causes of early mortality of startups. The overly technical language used by lawyers and the association between law and bureaucratic obstacles, make entrepreneurs relegate legal issues to a secondary level. Although there is a favorable scenario, few studies have been dedicated to bringing Law closer to the daily practice of startups. This work has the general objective of developing a didactic and instructional material and a mobile application project, which can be used by entrepreneurs of startups and their teams, lawyers, teachers and academics from Law courses, demonstrating that as important as the determination of objectives and action plans for the execution of the business idea, is to see law and legal instruments as strategic tools. In relation to the methodological procedures to achieve this objective, a qualitative study was used, initiated by a bibliographic survey, contextualizing, in the theoretical framework, the problem about startups, strategic planning, business models, business model framework (or Canvas), Law and legal management. In sequence, the study presents the main areas and branches of law that directly affect decision-making in a startup, conceiving ten free-to-fill tables, in which the user guided by questions can point out challenges, risks and action plans. The work has also created a layout of a didactic material and a mobile application project, in order to provide greater interactivity to users, also generating greater interest, thinking about the accessibility of the content exposed and in formats that encourage usability. Finally, the work brings it's last considerations, it's theoretical and practical contributions, as well as suggestions for future research. Keywords: Startups. Legal planning. Strategy. App
Published: 2020

35. Long term outcome for onabotulinumtoxinA (Botox) therapy in chronic migraine: A 2-year prospective follow-up audit of patients attending the Hull (UK) migraine clinic

Author: Ahmed, Fayyaz, primary, Buture, Alina, additional, Tanvir, Taukir, additional, and Khalil, Modar, additional
Published: 2021
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36. Long Term Outcome for OnabotulinumtoxinA (Botox) Therapy in Chronic Migraine: A 2-Year Follow up of Patients Attending the Hull (UK) Migraine Clinic

Author: Ahmed, Fayyaz, primary, Buture, Alina, additional, Tanvir, Taukir, additional, and Khalil, Modar, additional
Published: 2020
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37. Perceptions, experiences, and understandings of cluster headache among GPs and neurologists: a qualitative study

Author: Buture, Alina, primary, Ahmed, Fayyaz, additional, Mehta, Yachna, additional, Paemeleire, Koen, additional, Goadsby, Peter J, additional, and Dikomitis, Lisa, additional
Published: 2020
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38. Development and Evaluation of a Screening Tool to Aid the Diagnosis of Cluster Headache

Author: Buture, Alina, primary, Boland, Jason W, additional, Dikomitis, Lisa, additional, Huang, Chao, additional, and Ahmed, Fayyaz, additional
Published: 2020
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39. Iatrogenic visual aura: a case report and a brief review of the literature

Author: Modar Khalil, Fayyaz Ahmed, and Alina Buture
Subjects: medicine.medical_specialty, Aura, medicine.medical_treatment, Ischemia, Neurological examination, Catheter ablation, Case Report, 030204 cardiovascular system & hematology, transseptal catheterization, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, Internal medicine, Magnetic resonance imaging of the brain, medicine, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Chemical Health and Safety, medicine.diagnostic_test, business.industry, iatrogenic, Atrial fibrillation, General Medicine, migraine aura, medicine.disease, Migraine, Cardiology, business, Safety Research, 030217 neurology & neurosurgery
Abstract: Iatrogenic migraine aura following transseptal catheterization has only rarely been reported in the literature. We report the case of a 60-year-old female who presented with new onset of migraine with visual aura 1 day after transseptal cryoballoon catheter ablation for atrial fibrillation. The patient had a 5-year history of typical migraine without aura and had never experienced visual aura before the cardiac intervention. The neurological examination, fundoscopy, and blood tests were normal. The magnetic resonance imaging of the brain showed small vessel ischemia without evidence of vessel ischemic changes in the occipital lobes and large blood vessel disease. A change in the characteristics of existing migraine could occur following an iatrogenic episode, which in this case was catheter ablation for atrial fibrillation. A new onset of aura is considered an indication for a brain scan as it may signify underlying new pathology.
Published: 2017

40. Perceptions, experiences, and understandings of cluster headache among GPs and neurologists: a qualitative study

Author: Peter J. Goadsby, Koen Paemeleire, Alina Buture, Lisa Dikomitis, Yachna Mehta, and Fayyaz Ahmed
Subjects: medicine.medical_specialty, Neurology, Referral, Cluster Headache, Q1, 03 medical and health sciences, 0302 clinical medicine, Health care, medicine, Humans, 030212 general & internal medicine, Neurologists, Qualitative Research, business.industry, Cluster headache, Research, medicine.disease, Mental health, R1, England, Family medicine, Anxiety, Perception, medicine.symptom, Thematic analysis, Family Practice, business, 030217 neurology & neurosurgery, Qualitative research
Abstract: BackgroundCluster headache is a severe primary headache with a similar prevalence to that of multiple sclerosis. Cluster headache is characterised by unilateral trigeminal distribution of pain, ipsilateral cranial autonomic features, and a tendency to circadian and circannual periodicity.AimTo explore the perceptions, experiences, and understandings of cluster headache among GPs and neurologists.Design and settingQualitative interview study in primary care surgeries and neurology departments in the north of England.MethodSemi-structured interviews were conducted with GPs and neurologists, recorded, and transcribed. A thematic analysis was applied to the dataset.ResultsSixteen clinicians participated in this study: eight GPs and eight neurologists. Four main themes were identified following thematic analysis: challenges with the cluster headache diagnosis; impact of cluster headache; challenges with treatment; and appropriateness of referrals to secondary care. Clinicians recognised the delays in the diagnosis of cluster headache, misdiagnosis, and mismanagement, and were aware of the potential impact cluster headache can have on patients’ mental health and ability to remain in employment. Findings highlighted tensions between primary and secondary care around the cost of medication and the remit of prescribing treatment regimens. Patients’ anxiety, their need for reassurance, and their insistence about seeing a specialist are some of the reasons for referrals.ConclusionClinicians acknowledged delays in diagnosis, misdiagnosis, and mismanagement of cluster headache. The responsibility of prescribing causes ongoing tensions between primary and secondary care. Clear referral and management pathways for primary headaches are required to improve patient outcomes and healthcare costs.
Published: 2019

41. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study

Author: Buture,Alina, Boland,Jason W, Ahmed,Fayyaz, Dikomitis,Lisa, Buture,Alina, Boland,Jason W, Ahmed,Fayyaz, and Dikomitis,Lisa
Abstract: Alina Buture,1 Jason W Boland,2 Fayyaz Ahmed,1,3 Lisa Dikomitis4,51Hull York Medical School, University of Hull, Hull, UK; 2Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK; 3Department of Neurology, Hull Royal Infirmary, Hull, UK; 4School of Medicine, Keele University, Newcastle-under-Lyme, UK; 5School of Primary, Community and Social Care, Keele University, Newcastle-under-Lyme, UKCorrespondence: Alina ButureHull York Medical School, University of Hull, Cottingham Road, Hull HU6 7RX, UKTel +44 745 987 2950Email hyab20@hyms.ac.ukIntroduction and objective: The diagnosis of primary headaches is based on the International Classification of Headache Disorders (ICHD-3). Cluster headache (CH), a debilitating primary headache, is often misdiagnosed as migraine. In the absence of biological markers, a new visual screening tool with images depicting pain could aid the correct diagnosis of CH. The objective of the study is to test the tool on healthy participants and participants with CH and migraine.Methods: In phase 1, 6 images portraying people with pain were tested on 150 healthy participants. The healthy participants were asked to rate the images as mild, moderate, severe or excruciating pain. In phase 2, the images were further tested on 116 participants with headache (16 participants with CH, 100 participants with migraine). The participants were recruited prospectively from a tertiary headache center between February and May 2017. The participants were asked to choose which image best illustrated their headache attacks.Results: Phase 1 results showed that the images represent a range of headache pain severities from mild to excruciating as rated by healthy participants. They rated two images as excruciating, one image as severe, one image as moderate/severe, one image as moderate and one image as mild. Phase 2 results showed that two-thirds of participants with CH (69%) and half of the participants with migraine (52%) c
Published: 2019

42. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies

Author: Buture,Alina, Boland,Jason W, Dikomitis,Lisa, Ahmed,Fayyaz, Buture,Alina, Boland,Jason W, Dikomitis,Lisa, and Ahmed,Fayyaz
Abstract: Alina Buture,1,2 Jason W Boland,2 Lisa Dikomitis,3 Fayyaz Ahmed1,2 1Department of Neurology, Hull Royal Infirmary, Hull, UK; 2Hull York Medical School, University of Hull, Hull, UK; 3School of Medicine and Institute of Primary Care and Health Sciences, Keele University, Newcastle, UK Objective: Cluster headache (CH) is the most severe primary headache condition. Its pathophysiology is multifaceted and incompletely understood. This review brings together the latest neuroimaging and neuropeptide evidence on the pathophysiology of CH.Methods: A review of the literature was conducted by searching PubMed and Web of Science. The search was conducted using the following keywords: imaging studies, voxel-based morphometry, diffusion-tensor imaging, diffusion magnetic resonance imaging, tractography, connectivity, cerebral networks, neuromodulation, central modulation, deep brain stimulation, orexin-A, orexin-B, tract-based spatial statistics, single-photon emission computer tomography studies, positron-emission tomography, functional magnetic resonance imaging, magnetic resonance spectroscopy, trigeminovascular system, neuropeptides, calcitonin gene-related peptide, neurokinin A, substance P, nitric oxide synthase, pituitary adenylate cyclase-activating peptide, vasoactive intestinal peptide, neuropeptide Y, acetylcholine, noradrenaline, and ATP. “Cluster headache” was combined with each keyword for more relevant results. All irrelevant and duplicated records were excluded. Search dates were from October 1976 to May 2018.Results: Neuroimaging studies support the role of the hypothalamus in CH, as well as other brain areas involved in the pain matrix. Activation of the trigeminovascular system and the release of neuropeptides play an important role in CH pathophysiology. Among neuropeptides, calcitonin gene-related peptide, vasoactive intestinal peptide, and pituitary adenylate cyclase-activating peptide have been reported to be reliable biomarkers for CH
Published: 2019

43. Poster session 5The imaging examinationP1097Correlation between visual and quantitative assessment of left ventricle: intra- and inter-observer agreementP1099Incremental prognostic value of late gadolinium-enhanced by cardiac magnetic resonance in patients with heart failureAnatomy and physiology of the heart and great vesselsP1100Left ventricular geometry and diastolic performance in erectile dysfunction patients; a topic of differential arterial stiffness influenceAssessment of diameters, volumes and massP1101Impact of the percutaneous closure of atrial septal defect on the right heart 'remodeling'P1102Left Ventricular Mass Indexation in Infants, Children and Adolescents: a Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical PracticeP1103Impact of trabecules while quantifying cardiac magnetic resonance exams in patients with systemic right ventricleP1104Detection of subclinical atherosclerosis by carotid intima-media thickness: correlation with leukocytes telomere shorteningAssessments of haemodynamicsP1105Flow redirection towards the left ventricular outflow tract: vortex formation is not affected by variations in atrio-ventricular delayAssessment of systolic functionP1106Reproducibility and feasibility of cardiac MRI feature tracking in Fabry diseaseP1107Normal left ventricular strain values by two-dimensional strain echocardiography; result of normal (normal echocardiographic dimensions and functions in korean people) studyP1108Test-retest repeatability of global strain following st-elevation myocardial infarction - a comparison of tagging and feature trackingP1109Cardiotoxicity induced by tyrosine kinase inhibitors in patients with gastrointestinal stromal tumors (GIST)P1110Finite strain ellipses for the analysis of left ventricular principal strain directions using 3d speckle tracking echocardiographyP1111Antihypertensive therapy reduces time to peak longitudinal strainP1112Right ventricular systolic function as a marker of prognosis after inferior myocardial infarction - 5-year follow-upP1113Is artery pulmonary dilatation related with right but also early left ventricle dysfunction in pulmonary artery hypertension?P1114Right ventricular mechanics changes according to pressure overload increasing, a 2D-speckle tracking echocardiographic evaluationAssessment of diastolic functionP1115Paired comparison of left atrial strain from P-wave to P-wave and R-wave to R-waveP1116Diagnostic role of Tissue Doppler Imaging echocardiographic criteria in obese heart failure with preserved ejection fraction patientsP1117Evaluation of diastolic function of right ventricle in idiopathic pulmonary arterial hypertensionP1118Severity and predictors of diastolic dysfunction in a non-hypertensive non-ischemic cohort of Egyptian patients with documented systemic autoimmune disease; pilot reportP1119correlation between ST segment shift and cardiac diastolic function in patients with acute myocardial infarctionIschemic heart diseaseP1120Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)P1121Utility of transmural myocardial mechanic for early infarct size prediction after primary percutaneous coronary intervention in STEMI patientsP1122Progressive Improvements of the echocardiographic deformation parameters in ST Elevation Myocardial Infarction after five years follow-upP1123Long-term prognostic value of left ventricular dyssynchrony as assessed by cardiac magnetic resonance feature-tracking imaging after a first st-segment elevation myocardial infarctionP1124Differences in mitral annulus remodeling in acute anterior ST elevation and acute inferior ST elevation myocardial infarctionP1125Reduction of microvascular injury using a novel theragnostic ultrasound strategy: a first in men feasibility and safety studyP1126Impact of focused echocardiography in clinical decision of patient presented with st elevation myocardial infarction underwent primary angioplastyHeart valve DiseasesP1127Aortic valve area calculation in aortic stenosis: a comparison among conventional and 3D-transesophageal echocardiography and computed tomographyP1128Myocardial fibrosis and microRNA-21 expression in patients with severe aortic valve stenosis and preserved ejection fraction: a 2D speckle tracking echocardiography, tissutal and plasmatic studyP1129Quantification of calcium amount in a new experimental model: a comparison between calibrated integrated backscatter of ultrasound and computed tomographyP1130Altered diffusion capacity in aortic stenosis: role of the right heartP1131Osteoprotegerin predicts all-cause mortality in calcific aortic stenosis patients with preserved left ventricle ejection fraction in long term observationP1132Mitral regurgitation as a risk factor for pulmonary hypertension in patients with aortic stenosisP1133The relationship between the level of plasma B-type natriuretic peptide and mitral stenosisP1134Aortic regurgitation, left ventricle mechanics and vascular load: a single centre 2d derived-speckle tracking studyP1135Feasibility and reproducibility issues limit the usefulness of quantitative colour Doppler parameters in the assessment of chronic aortic and mitral regurgitation severityP1136Predictors of postoperative outcome in degenerative mitral regurgitationP1137Left ventricular mechanical dyssynchrony in patients with severe mitral regurgitation of rheumatic etiology; three dimensional echocardiography studyP1138Functional mitral regurgitation and left atrial dysfunction concur in determining pulmonary hypertension and functional status in subjects with left ventricular systolic dysfunctionP11393D echocardiography allows more effective quantitative assessment of the severity of functional tricuspid regurgitation than conventional 2D/Doppler echocardiographyP1140Prosthetic valve thrombosis: still a severe disease? 10-years experience in a university hospitalP1141Validity of echocardiography in the hospital course of patients with feverP1142Do baseline 3DTEE characteristics of mitral valve apparatus predict long term result in patients undergoing percutaneous valve repair for degenerative regurgitation?P1143Influence of baseline aortic regurgitation on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP1144Prevalence of echocardiography detected significant valvular regurge in subclinical rheumatic carditis in assiut childrenCardiomyopathiesP1145Can we early detect left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy using global longitudinal strain assessment?P1146Prevalence of isolated papillary muscle hypertrophy in young competitive athletesP1147Troponin release after exercise in patients with hypertrophic cardiomyopathy: associations with clinical and mr imaging characteristicsP1148Atrial fibrillation in hypertrophic cardiomyopathy: can we score the risk?P1149Impact of hypertrophy on multiple layer longitudinal deformation in hypertrophy cardiomyopathy and cardiac amyloidosis compared to controlsP1150Functional evaluation in hypertrophic cardiomyopathy combining cardiopulmonary exercise testing combined with exercise-echocardiographyP1151Refinement of the old diagnostic criteria of left ventricular noncompaction cardiomyopathy (LVNC) based on cardiac magnetic resonance (CMR)P1152Differences of clinical characteristics and outcomes between acute myocarditis with preserved and reduced left ventricular systolic functionP1153Value of longitudinal strain for distinguishing left ventricular non-compaction from idiopathic dilated cardiomyopathyP1154Speed of recovery of left ventricular function is not related to the prognosis of Takotsubo cardiomyopathy. A Portuguese multicentre studyP1155Predictors of in-hospital left ventricular systolic function recovery after admission with takotsubo cardiomyopathy. Portuguese multicentre studyP1156Mid-ventricular takotsubo detected by initial echocardiogram associates with recurrence of takotsubo cardiomyopathy - a portuguese multicentre studySystemic diseases and other conditionsP1157Relations between left ventricle remodelling and expression of angiotensin 2 AT2R1 geneP1158Impact of renal denervation on long-term blood pressure variability and surrogate markers of target organ damage in individuals with drug-resistant arterial hypertensionP1159Greater improvement of coronary artery function, left ventricular deformation and twisting by IL12/23 compared to TNF-a inhibition in psoriasisP1160Advanced glycation end products play a role in adverse LV remodeling following MIP1161Incidence of subclinical myocardial dysfunction in patients with systemic sclerosis and normal left ventricular systolic and diastolic functionP1162Left atrial remodeling and dysfunction occur early in patients with systemic sclerosis and normal left ventricular functionP1163Intrinsic vortex formation : a unique performance indicatorP1164P-wave morphology is unaffected by training-induced biatrial dilatation: a prospective, longitudinal study in healthy athletesP1165Usefulness of transthoracic echocardiography in diagnosis of young patients with ischemic strokeP1166Primary cardiac lymphoma: role of echocardiography in the clinical managementP1167Abnormal echocardiographic findings in cancer patients before chemotherapyMasses, tumors and sources of embolismP1168Three-dimensional transesophageal echocardiography of the left atrial appendage reduces rate of postpone electrical cardioversionP1169Detection of ventricular thrombus by cmr after reperfused st-segment elevation myocardial infarction correlated with echocardiographyP1170Clinical and transthoracic echocardiographic predictors of left atrial appendage thrombus in patients with atrial fibrillationStress echocardiographyP1171Pharmacological stress echocardiography complications: a 4-year single center experienceP1172Myocardial functional and perfusion reserve in type I diabetesP1173Feasibility of incorporating 3D Dobutamine stress echocardiography into routine clinical practiceP1174Right ventricular isovolumic acceleration at rest and during exercise in children after heart transplantP1175Right ventricular systolic and diastolic response to exercise in children after heart transplant -a bicycle exercise studyP1176Determinants of functional capacity in heart failure patients with reduced ejection fractionP1177Handgrip stress echocardiography with emotional component compared to conventional isometric exercise in coronary artery disease diagnosisP1178The relationship between resting transthoracic echocardiography and exercise capacity in patients with paroxysmal atrial fibrillationP1179Correlation between NT-proBNP and selected echocardiography parameters at rest and after exercise in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatmentReal-time three-dimensional TEEP1180Vena contracta area for severity grading in functional and degenerative mitral regurgitation: A study based on transesophageal 3D colour Doppler in 419 patientsP1181Proximal flow convergence by 3D echocardiography in the evaluation of mitral valve area in rheumatic mitral stenosisP1182Quantification of valve dimensions by transesophageal 3D echocardiography in patients with functional and degenerative mitral regurgitationTissue Doppler and speckle trackingP1183Automatic calculation of left ventricular volume changes over a cardiac cycle from echocardiography images by nonlinear dimensionality reductionP1184Effect of the mitral valve repairs on the left ventricular blood flow formationP1185Quantification of left atrial strain using cardiovascular magnetic resonance. a comparison between hypertrophic cardiomyopathy and healthy controlsP1186The role of early systolic lengthening in patients with non-ST elevation acute coronary syndrome and its relation to syntax scoreP1187Different standard two dimensional strain methods to quantity left ventricular mechanicsP1188Atrial function and electrocardiography caracteristics in sportsmen with or without paroxysmal atrial fibrillationP1189Right ventricular outflow premature contractions induce regional left ventricular dysfunctionP1190Ultrasound guided venous access for pacemaker and defibrillators. Randomized TrialP1191Atrial function analysis correlates with symptoms and quality of life of heart failure patientsP1192The use of tissue doppler echocardiography in myocardial iron overload in patients with thalassaemia majorP1193Independent association between pulse pressure and left ventricular global longitudinal strainP1194Global and regional longitudinal strain identifies the presence of coronary artery disease in patients with suspected reduction of coronary flow reserve and absence of wall motion abnormalitiesP1195Prognostic value of invasive and noninvasive parameters of right ventricular function in patients with pulmonary arterial hypertension receiving specific vasodilator therapyP1196Myocardial deformation analysis to improve arrhythmic risk stratificationP1197Quantitative assessment of regional systolic and diastolic function parameters for detecting prior transient ischemia in normokinetic segmentsP1198Left atrial function in patients with corrected tetralogy of Fallot - a three-dimensional speckle-tracking echocardiographic studyP1199Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiographyP1200Acute angulation of the aortic arch late after the arterial switch operation for transposition of the great arteries: impact on cardiac mechanicsP1201Circumferential deformation of the ascending thoracic aorta in hypertensive patients by three-dimensional speckle tracking echocardiographyCardiac Magnetic ResonanceP1202The incremental value of cardiac magnetic resonance on diagnosis myocardial infarction and non-obstructed coronary arteriesP1204Reference ranges of global and regional myocardial T1 values derived from MOLLI and shMOLLI at 3TComputed Tomography & Nuclear CardiologyP1205Deformation of the left atrial appendage after percutaneous closure with the Amplatzer cardiac plugP1206Prognostic impact of non-obstructive coronary artery disease on coronary computed tomographic angiography: A single-center study

Author: B Jug, X Iriart, A M Maceira Gonzalez, P Caravaca, L Capotosto, G Di Salvo, A Nemes, K Wdowiak-Okrojek, G Novo, R Enache, C Goffredo, M Lembo, E Ako, M Cameli, M Liccardo, OA Enescu, A Hubert, S Ranjbar, T Unkun, G Alonso Salinas, M Karvandi, B Goebel, R Ladeiras-Lopes, J Kochanowski, JJ Van Zalen, VA Kuznetsov, F Bandera, B Cifra, R Aghamohammadzadeh, B Shivalkar, J F Carvalho, K Kupczynska, E Cambronero Cortinas, O Tereshina, O Gonzalez Fernandez, P Sormani, C Ferrera Duran, F D'ascenzi, GJ King, D Peluso, V Ferferieva, I Ikonomidis, J Mesquita, MV Krestjyaninov, K Domingues, L Reis, B F Lourenco Marmelo, F Tarando, J Y Cho, M Kubik, M Mielczarek, A R Godinho, D H F Gommans, C De Gregorio, M Marchel, D M Raafat, F Ancona, G Tamborini, D Fasano, O De Diego Soler, P Aruta, G Palmiero, AAM Farrag, R Zilberszac, S A Gao, M Santos, T E Chalbia, YJ Lim, A Borowiec, K Gillis, I Fabiani, C Marini, M S Qasem, S T Roos, A Sirtautas, G Nucifora, R Acar, G Krljanac, G Pontone, A Azoz, M Mandour Ali, R Sattarzadeh Badkoubeh, A De La Rosa Riestra, E Wellnhofer, V Illatopa, K Smarz, M Cikes, S F De Marchi, A Shetye, JH Park, A B Reid, D Rodriguez Munoz, M G Andreassi, A Toth, M Chinali, P G Dinis, A Angelis, C Gonzalez Matos, S Colunga Blanco, A Garcia Campos, E Capin Sampedro, C Corros Vicente, M Martin Fernandez, V Leon Arguero, A Fidalgo Arguelles, E Velasco Alonso, F Lopez Iglesias, JM De La Hera Galarza, M Chaparro-Munoz, A Recio-Mayoral, C Vlachopoulos, N Ioakeimidis, I Felekos, M Abdelrasoul, K Aznaouridis, C Chrysohoou, G Rousakis, K Aggeli, D Tousoulis, AC Faustino, L Paiva, A Fernandes, M Costa, MC Cachulo, L Goncalves, F Emma, G Rinelli, C Esposito, A Franceschini, A Doyon, F Raimondi, F Schaefer, G Pongiglione, MC Mateucci, H Vago, C Juhasz, C Janosa, V Oprea, OH Balint, A Temesvari, T Simor, K Kadar, B Merkely, R M Bruno, A Borghini, F Stea, L Gargani, A Mercuri, R Sicari, E Picano, C Lozano Granero, A Carbonell San Roman, JL Moya Mur, C Fernandez-Golfin, J Moreno Planas, S Fernandez Santos, E Casas Rojo, A Hernandez-Madrid, JL Zamorano Gomez, K Pearce, W Gamlin, C Miller, M Schmitt, IW Seong, KH Kim, MJ Kim, HO Jung, IS Sohn, SM Park, GY Cho, JO Choi, SW Park, SA Nazir, JN Khan, A Singh, P Kanagala, I Squire, GP Mccann, D Di Lisi, MC Meschisi, V Brunco, G Badalamenti, E Bronte, A Russo, S Novo, M Von Tscharner, S Urheim, S Aakhus, C Seiler, S Schmalholz, T Biering-Sorensen, S Cheng, S Oparil, J Izzo, B Pitt, SD Solomon, B Zaborska, T Jaxa-Chamiec, M Tysarowski, A Budaj, F Cordova, O Aguirre, S Sanabria, J Ortega, G Romeo, M Perazzolo Marra, F Tona, G Famoso, E Pigatto, F Cozzi, S Iliceto, LP Badano, C Kriatselis, JH Gerds-Li, M Kropf, B Pieske, M Graefe, P Martinez Santos, E Batlle Lopez, I Vilacosta, B Sanchez Sauce, E Espana Barrio, J Jimenez Valtierra, R Campuzano Ruiz, J Alonso Bello, MD Martin Rios, M Farrashi, H Abtahi, H Sadeghi, P Sadeghipour, A Tavoosi, TA Abdel Rahman, LA Mohamed, HM Maghraby, IM Kora, FR Abdel Hameed, MN Ali, A Al Shehri, A Youssef, A Gad, M Alsharqi, L Alsaikhan, D Andreini, C Rota, M Guglielmo, S Mushtaq, A Baggiano, V Beltrama, A Solbiati, AI Guaricci, M Pepi, D Trifunovic, D Sobic Saranovic, L Savic, I Grozdic Milojevic, M Asanin, M Srdic, M Petrovic, N Zlaic, I Mrdovic, C Dogan, S Izci, C Gecmen, M Cap, E Erdogan, C Onal, F Yilmaz, N Ozdemir, D Muser, C Tioni, D Zanuttini, G Morocutti, L Spedicato, G Bernardi, A Proclemer, R Pranevicius, N Zapustas, K Briedis, Z Valuckiene, R Jurkevicius, LJM Juffermans, V Enait, N Van Royen, AC Van Rossum, O Kamp, HASSEN Khalaf, SAKER Hitham, AS Osama, RAMI Abazid, RAHIM Guall, SHAFAT Durdan, ZYAD Mohammed, S Stella, I Rosa, M Spartera, L Italia, A Latib, A Colombo, A Margonato, E Agricola, C Scatena, C Mazzanti, L Conte, N Pugliese, V Barletta, U Bortolotti, AG Naccarato, V Di Bello, G Bala, B Roosens, S Hernot, I Remory, S Droogmans, B Cosyns, G Generati, V Labate, V Donghi, M Pellegrino, F Carbone, E Alfonzetti, M Guazzi, R Dabrowski, I Kowalik, B Firek, T Chwyczko, H Szwed, A Kawamura, S Kawano, A Zaroui, R Ben Said, M Ben Halima, N Kheder, A Farhati, S Mourali, R Mechmech, L Leite, R Martins, R Baptista, A Barbosa, N Ribeiro, A Oliveira, G Castro, M Pego, C L Polte, K Lagerstrand, Å A Johnsson, M Janulewicz, O Bech-Hanssen, H Gabriel, W Wisser, G Maurer, R Rosenhek, W El Aroussy, M Abdel Ghany, K Al Adeeb, L Ascione, G Carlomagno, C Sordelli, A Ferro, R Ascione, S Severino, P Caso, D Muraru, C Janei, M Haertel Miglioranza, G Cavalli, U Cucchini, L Badano, X Armario Bel, C Garcia-Garcia, E Ferrer Sistach, F Rueda Sobella, T Oliveras Vila, C Labata Salvador, J Serra Flores, J Lopez-Ayerbe, A Bayes-Genis, E Conte, A Gonella, L Morena, D Civelli, L Losardo, F Margaria, L Riva, M Tanga, C Carminati, M Muratori, P Gripari, S Ghulam Ali, L Fusini, C Vignati, AL Bartorelli, F Alamanni, M Montorfano, A Ismaiel, N Ali, S Amry, A Serafin, KJ Filipiak, G Opolski, G Speranza, G Ando', L Magaudda, GE Cramer, J Bakker, M Michels, HJ Dieker, MA Fouraux, CLM Marcelis, J Timmermans, MA Brouwer, MJM Kofflard, M Vasconcelos, V Araujo, P Almeida, C Sousa, F Macedo, JS Cardoso, MJ Maciel, D Voilliot, O Huttin, C Venner, A Olivier, T Villemin, R Deballon, V Manenti, Y Juilliere, C Selton-Suty, A Dabrowska-Kugacka, K Dorniak, E Lewicka, D Szalewska, M Kutniewska-Kubik, G Raczak, K H Kim, H J Yoon, H J Park, Y Ahn, M H Jeong, J G Cho, J C Park, J H Kim, E Galli, G Habib, F Schnell, M Lederlin, JC Daubert, P Mabo, E Donal, R Faria, P Magalhaes, N Marques, C Lourenco, AR Almeida, L Teles, B Picarra, O Azevedo, M Oliveira, B Marmelo, A Almeida, D Bento, I Cruz, RH Gimaev, MA Melnikova, NV Olezov, VI Ruzov, P Goncalves, M S Almeida, P Branco, M S Carvalho, H Dores, M A Gaspar, H Sousa, M J Andrade, M Mendes, G Makavos, M Varoudi, E Papadavid, I Andreadou, K Gravanis, N Liarakos, G Pavlidis, D Rigopoulos, J Lekakis, D Deluyker, V Bito, L Punzi, T Neilan, K Coen, S Gannon, K Bennet, JG Clarke, M Solari, M Focardi, D Corrado, M Bonifazi, M Henein, S Mondillo, C Gomez-Escalonilla, A De Agustin, J Egido, F Islas, P Simal, JJ Gomez De Diego, M Luaces, C Macaya, L Perez De Isla, M Zancanella, C Rusconi, F Musca, G Santambrogio, B De Chiara, P Vallerio, R Cairoli, G Giannattasio, A Moreo, C Alvarez Ortega, R Mori Junco, J Caro Codon, P Meras Colunga, I Ponz De Antonio, T Lopez Fernandez, S Valbuena Lopez, M Moreno Yanguela, JL Lopez-Sendon, E Surkova, C Bonanad-Lozano, MP Lopez-Lereu, JV Monmeneu-Menadas, J Gavara, E De Dios, A Paya-Chaume, D Escribano-Alarcon, FJ Chorro-Gasco, V Bodi-Peris, BW Michalski, D Miskowiec, JD Kasprzak, P Lipiec, G Morgado, D Caldeira, I Joao, A R Almeida, L Lopes, P Fazendas, C Cotrim, H Pereira, C De Block, D Buys, R Salgado, C Vrints, L Van Gaal, C Mctear, RB Irwin, A Dragulescu, M Friedberg, L Mertens, DV Krinochkin, EI Yaroslavskaya, EH Zaharova, GS Pushkarev, C Sugihara, NR Patel, AN Sulke, GW Lloyd, R Piatkowski, P Scislo, M Grabowski, H Roland, A Hamadanchi, S Otto, C Jung, A Lauten, HC Figulla, TC Poerner, F Sampaio, P Fonseca, R Fontes-Carvalho, M Pinho, AS Campos, P Castro, C Fonseca, J Ribeiro, V Gama, R Heck, A Hamdanchi, HR Figulla, M Ghaffaripour Jahromi, R Hinojar, C Fernandez Golfin, A Esteban, M Pascual-Izco, A Garcia-Martin, JJ Jimenez-Nacher, JL Zamorano, RB Bakal, C Kaymaz, V Galand, D Matelot, C Leclercq, F Carre, BC Suran, AD Margulescu, RC Rimbas, C Siliste, D Vinereanu, P Nocerino, AC Urso, A Borrino, C Carbone, P Follero, C Ciardiello, L Prato, G Salzano, F Marino, A Ruspetti, S Sparla, C Di Tommaso, F Loiacono, J Porter, M Walker, F Lo Iudice, R Esposito, C Santoro, S Cocozza, R Izzo, N De Luca, G De Simone, B Trimarco, M Galderisi, F Gervasi, G Patti, S Mega, M Bono, G Di Sciascio, A Buture, R Badea, P Platon, I Ghiorghiu, R Jurcut, IM Coman, BA Popescu, C Ginghina, M Lunetta, MS Spoto, AM Lo Vi, G Pensabene, P Carita, G Coppola, P Assennato, A Shim, P Wejner-Mik, K Havasi, P Domsik, A Kalapos, T Forster, GA Piros, C Lengyel, A Orosz, Z Bulbul, Z Issa, A Al Sehly, V Pergola, S Oufi, Y Conde, E Cimino, E Rinaldi, R Ashurov, S Ricci, M Pergolini, A Vitarelli, JE Lujan Valencia, M Chaparro, A Garcia-Guerrero, MJ Cristo Ropero, A Izquierdo Bajo, L Madrona, JV Monmeneu, B Igual, P Lopez Lereu, MP Garcia, W Selmi, Z Jalal, JB Thambo, D Kosuta, and Z Fras
Subjects: medicine.medical_specialty, business.industry, General Medicine, medicine.disease, medicine.anatomical_structure, St elevation myocardial infarction, Internal medicine, Mitral valve, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Mitral annulus, Cardiology and Cardiovascular Medicine, Ventricular remodeling, business
Published: 2015

44. Development and Evaluation of a Screening Tool to Aid the Diagnosis of Cluster Headache

Author: Fayyaz Ahmed, Lisa Dikomitis, Alina Buture, Jason W Boland, and Chao Huang
Subjects: Pediatrics, medicine.medical_specialty, specificity, Article, lcsh:RC321-571, intervention development, 03 medical and health sciences, 0302 clinical medicine, Primary headache, Chronic Migraine, Episodic migraine, Medicine, migraine, survey, Screening tool, 030212 general & internal medicine, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Headache pain, business.industry, questionnaire, General Neuroscience, Cluster headache, RC346, sensitivity, medicine.disease, Visual analogue pain scale, drawings, images, Migraine, business, 030217 neurology & neurosurgery
Abstract: Cluster headache (CH), a severe primary headache, is often misdiagnosed and mismanaged. The aim of this study was to develop and evaluate a screening tool to aid the diagnosis of CH. We developed a novel 12-item screening tool. This was comprised of four components: (1) images depicting headache pain, (2) pain descriptors, (3) key questions that could differentiate between CH and migraine, and (4) a visual analogue pain scale. The total possible questionnaire score ranged from 3-32. Patients with CH and migraines (control group) were recruited prospectively from a headache centre in the North of England, UK. Two-hundred and ninety-six patients were included in the study: 81 CH patients, 36 of which suffer with episodic CH and 45 with chronic CH, 215 migraine patients, 92 of which suffer with episodic migraine and 123 with chronic migraine. The mean questionnaire score was higher in CH patients versus migraine patients (28.4 versus 19.5). At a cut-off score of &gt, 25 out of 32, the screening tool had a sensitivity of 86.4% and a specificity of 92.0% in differentiating between CH and migraine. The screening tool could be a useful instrument to aid the diagnosis of a CH. The images depicting headache pain do not clearly discriminate between CH and migraine.
Published: 2020

45. Evidence-based treatments for cluster headache

Author: Fayyaz Ahmed, Alina Buture, and Rubesh Gooriah
Subjects: medicine.medical_specialty, Deep brain stimulation, Evidence-based practice, medicine.medical_treatment, Review, Refractory, medicine, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Intensive care medicine, Psychiatry, vasoactive intestinal peptide, Chemical Health and Safety, business.industry, Cluster headache, pathogenesis, suprachiasmatic nucleus, cluster headache, Treatment options, General Medicine, Surgical procedures, medicine.disease, Sumatriptan, Verapamil, business, Safety Research, medicine.drug
Abstract: Cluster headache (CH), one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition.
Published: 2015

46. Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache

Author: Buture, Alina, primary, Ahmed, Fayyaz, additional, Dikomitis, Lisa, additional, and Boland, Jason W., additional
Published: 2018
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47. Iatrogenic visual aura: a case report and a brief review of the literature

Author: Buture,Alina, Khalil,Modar, Ahmed,Fayyaz, Buture,Alina, Khalil,Modar, and Ahmed,Fayyaz
Abstract: Alina Buture, Modar Khalil, Fayyaz Ahmed Neurology Department, Hull Royal Infirmary, Hull, UK Abstract: Iatrogenic migraine aura following transseptal catheterization has only rarely been reported in the literature. We report the case of a 60-year-old female who presented with new onset of migraine with visual aura 1 day after transseptal cryoballoon catheter ablation for atrial fibrillation. The patient had a 5-year history of typical migraine without aura and had never experienced visual aura before the cardiac intervention. The neurological examination, fundoscopy, and blood tests were normal. The magnetic resonance imaging of the brain showed small vessel ischemia without evidence of vessel ischemic changes in the occipital lobes and large blood vessel disease. A change in the characteristics of existing migraine could occur following an iatrogenic episode, which in this case was catheter ablation for atrial fibrillation. A new onset of aura is considered an indication for a brain scan as it may signify underlying new pathology. Keywords: migraine aura, iatrogenic, transseptal catheterization
Published: 2017

48. Current Understanding on Pain Mechanism in Migraine and Cluster Headache

Author: Randa Nimeri, Fayyaz Ahmed, Alina Buture, and Rubesh Gooriah
Subjects: 0301 basic medicine, medicine.medical_specialty, business.industry, Mechanism (biology), Cluster headache, Pain, Context (language use), Cluster Headache, Review Article, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Anesthesiology and Pain Medicine, Migraine, Medicine, business, Intensive care medicine, Psychiatry, 030217 neurology & neurosurgery, Primary Headache Disorders
Abstract: Context Migraine and cluster headache are undoubtedly painful conditions. The respective pathogenesis of these two conditions is incompletely understood. In both cases, the treatments used have largely been empirical and have relied to a much lesser extent on our understanding of the mechanisms causing pain. We hereby review the pain mechanisms in migraine and cluster headache, two of the commonest primary headache disorders. Evidence Acquisition A review of the English literature was conducted by searching PubMed for studies on pain mechanism in migraine and cluster headache. We entered [migraine] and [pain mechanism] in Pubmed and 488 articles were obtained. Articles were then included according to their relevance to the topic. Similarly, [cluster headache] and [pain mechanism] revealed 79 search results. Results There is evidence that the trigeminovascular system and neurogenic inflammation play important roles, together with certain areas of the brain, leading to these conditions being termed ‘neurovascular headaches’. Functional imaging findings suggest a possible role of the dorsolateral pons in generating migraine attacks while the role of the hypothalamus in cluster headache is more firmly established. Conclusions Migraine and cluster headache have complex pathophysiologies. The exact mechanism causing pain in both conditions is incompletely understood and more research needs to be undertaken in this area.
Published: 2016

49. Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19

Author: Scutelnic, Adrian, van de Munckhof, Anita, Miraclin, Angel T., Aaron, Sanjith, Hameed, Sajid, Wasay, Mohammad, Grosu, Oxana, Krzywicka, Katarzyna, Sánchez van Kammen, Mayte, Lindgren, Erik, Moreira, Tiago, Acampora, Roberto, Negro, Alberto, Karapanayiotides, Theodoros, Yaghi, Shadi, Revert, Anna, Cuadrado Godia, Elisa, Garcia-Madrona, Sebastian, La Spina, Paolino, Grillo, Francesco, Giammello, Fabrizio, Nguyen, Thanh N., Abdalkader, Mohamad, Buture, Alina, Sofia Cotelli, Maria, Raposo, Nicolas, Tsivgoulis, Georgios, Candelaresi, Paolo, Ciacciarelli, Antonio, Mbroh, Joshua, Batenkova, Tatiana, Scoppettuolo, Pasquale, Zedde, Marialuisa, Pascarella, Rosario, Antonenko, Kateryna, Kristoffersen, Espen S., Kremer Hovinga, Johanna A., Jood, Katarina, Aguiar de Sousa, Diana, Poli, Sven, Tatlisumak, Turgut, Putaala, Jukka, Coutinho, Jonathan M., Ferro, José M., Arnold, Marcel, and Heldner, Mirjam R.
Abstract: Introduction: Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT.Patients and methods: This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023. Data collected by the International Cerebral Venous Thrombosis Consortium from patients with CVT diagnosed between 2017 and 2018 served as a comparison. Outcome analyses were adjusted for age and sex.Results: We included 70 patients with COVID-CVT from 23 hospitals in 15 countries and 206 controls from 14 hospitals in 13 countries. The proportion of women was smaller in the COVID-CVT group (50% vs 68%, p< 0.01). A higher proportion of COVID-CVT patients presented with altered mental state (44% vs 25%, p< 0.01), the median thrombus load was higher in COVID-CVT patients (3 [IQR 2–4] vs 2 [1–3], p< 0.01) and the length of hospital stay was longer compared to controls (11 days [IQR 7–20] vs 8 [4–15], p= 0.02). In-hospital mortality did not differ (5/67 [7%, 95% CI 3–16] vs 7/206 [3%, 2–7], aOR 2.6 [95% CI 0.7–9]), nor did the frequency of functional independence after 6 months (modified Rankin Scale 0–2; 45/58 [78%, 95% CI 65–86] vs 161/185 [87%, 81–91], aOR 0.5 [95% CI 0.2–1.02]).Conclusion: In contrast to previous studies, the in-hospital mortality rate and functional outcomes during follow-up did not differ between COVID-CVT patients and the pre-COVID-19 controls.
Published: 2024
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50. Levels of lead and cadmium in mineral supplements for cattle commercialized in Londrina/ Níveis de chumbo e cádmio em suplementos minerais para bovinos comercializados em Londrina

Author: Rodrigo de Andrade e Silva, Maíra Salomão Fortes, Marcos Coelho de Carvalho, Iara de Oliveira Buture, and Wilmar Sachetin Marçal
Subjects: Metais pesados, Cádmio, lcsh:Agriculture (General), Bovinos, lcsh:S1-972, Suplementos minerais, Chumbo
Abstract: We measured lead and cadmium concentrations in samples of mineral mixtures commercialized in Londrina city. Lead and cadmium content were determined by inductively coupled plasma atomic emission spectrometry. Considering maximum concentrations recommended by National Research Council (1996) and Association of American Feed Control Officials Incorporated (2001), of the 10 analyzed samples, 06 had values greater than 30 ppm of lead and all of them had values greater than 0.5 ppm of cadmium. These findings show the necessity for careful industrial monitoring because some mineral mixtures contain sufficient lead and cadmium to cause bovine toxicity.Para se proceder a uma investigação em misturas minerais, foi realizada uma pesquisa quantificando os elementos chumbo e cádmio em diferentes formulações, comercializadas na cidade de Londrina. Os metais pesados foram determinados pela técnica de espectrofotometria de absorção atômica por plasma de indução acoplada. Considerando como parâmetro de comparação às referências do National Research Council (1996) e a Association of American Feed Control Officials Incorporated (2001), em 10 diferentes marcas analisadas, seis apresentaram níveis de chumbo inorgânico superiores ao limite máximo aceitável que é de 30 ppm. Contudo, em todas as amostras o nível de cádmio encontrado superou o limite de 0,5 ppm, que é o valor máximo aceitável. Os resultados demonstram a urgente necessidade de monitoramento junto aos fabricantes e/ou revendedores, pois algumas misturas minerais podem ser eminentemente perigosas, possibilitando efeitos cumulativos tóxicos de chumbo e cádmio inorgânico aos bovinos.
Published: 2004

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