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Current guidelines suggest that perfusion imaging should only be performed > 6 h after symptom onset. Pathophysiologically, brain perfusion should matter whatever the elapsed time. We aimed to compare relative contribution of recanalization time and stroke core volume in predicting functional outcome in patients treated by endovascular thrombectomy within 6-h of stroke-onset., SCOPUS: ar.j, info:eu-repo/semantics/published

Introduction: We report a case of a Kernohan notch phenomenon caused by an acute life-threatening intracranial subdural hematoma due to a cerebrospinal fluid (CSF) leak following lumbar surgery. Case report: A 71-year-old patient underwent decompressive lumbar surgery for refractory neurogenic claudication. Intraoperatively, a dural tear was noted and repaired. Two days later, the patient presented a sudden loss of consciousness following a CSF outflow in the subfascial lumbar drain. A head CT revealed an acute intracranial subdural hematoma with mass effect. A craniotomy was performed to evacuate the hematoma. The lumbar operative site was inspected and revealed a CSF leakage due to a dural defect which was subsequently repaired. The patient subsequently developed a Kernohan's notch phenomenon which partially recovered after two months of rehabilitation. Conclusion: We report a rare and dramatic case of Kernohan notch phenomenon due to an acute intracranial subdural hematoma occurring in the setting of a CSF leak following lumbar spine surgery. This case demonstrates the need to be aware of this potentially fatal complication after spine surgery and the importance of early diagnosis and appropriate treatment., SCOPUS: ar.j, info:eu-repo/semantics/published

Background and Purpose: Previous studies have noted the angiographic appearance of early venous filling (EVF) following recanalisation in acute ischemic stroke. However, the prognostic implications of EVF as a novel imaging biomarker remain unclear. We aimed to evaluate the correlation between EVF with (i) the risk of subsequent reperfusion hemorrhage (RPH) and (ii) the association of EVF on both the NIHSS score at 24 h and functional outcome as assessed with the Modified Rankin Scale (mRS) score at 90 days. Methods: We conducted a retrospective cohort study of patients presenting with an acute ischemic stroke due to a proximal large-vessel occlusion of the anterior circulation treated by thrombectomy. Post-reperfusion digital subtraction angiography was reviewed to look for EVF as evidenced by the contrast opacification of any cerebral vein before the late arterial phase. Results: EVF occurred in 22.4% of the 147 cases included. The presence of EVF significantly increased the risk of RPH (p = 0.0048), including the risk of symptomatic hemorrhage (p = 0.0052). The presence of EVF (p = 0.0016) and the absence of RPH (p = 0.0021) were independently associated with a better outcome as defined by the NIHSS difference at 24 h, most significantly in the EVF+RPH- group. No significant relationship was however found between either EVF or RPH and a mRS score ≤ 2 at 90 days. Conclusion: Early venous filling on angiographic imaging is a potential predictor of reperfusion hemorrhage. The absence of subsequent RPH in this sub-group is associated with better outcomes at 24 h post-thrombectomy than in those with RPH., SCOPUS: ar.j, info:eu-repo/semantics/published

The number of demented patients has increased significantly in recent years. The many challenges that dementia causes increase the stress of their caregivers and lead to shortening the time to institutionalization compared to the general population. A psychoeducational program for these accompanying persons was set up in Brussels. This type of program resulted in a 557-day delay in institutionalization in New York City. The objective of our study was to check whether our program also has such an impact, but also to see its potential effect on the psychobehavioral disorders of patients and the burden of caregivers., SCOPUS: ar.j, info:eu-repo/semantics/published