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8 results on '"Neuroradiology Department, Neurological Hospital"'

1. Matrix Metalloproteinase-9 and Monocyte Chemoattractant Protein-1 Are Associated With Collateral Status in Acute Ischemic Stroke With Large Vessel Occlusion

Author

Camille Amaz, Nathan Mewton, Yves Berthezène, Claire Crola Da Silva, Marielle Buisson, Thomas Bochaton, Nathalie Dufay, Elodie Ong, Omer Eker, Alexandre Paccalet, Norbert Nighoghossian, Laurent Derex, Michel Ovize, Tae-Hee Cho, Laura Mechtouff, Stroke Department, Neurological Hospital, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Virologie et pathogenèse virale (VPV), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Neuroradiology Department, Neurological Hospital, Department of Cardiology, and Imagerie Tomographique et Radiothérapie

Subjects
Monocyte Chemoattractant Proteins, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, digital subtraction angiography, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, collateral circulation, Acute ischemic stroke, brain edema, Advanced and Specialized Nursing, medicine.diagnostic_test, business.industry, Matrix metalloproteinase 9, Digital subtraction angiography, Collateral circulation, Inflammatory biomarkers, Cardiology, matrix metalloproteinase 9, Neurology (clinical), monocyte chemoattractant proteins, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Large vessel occlusion, Monocyte chemoattractant protein
Abstract

Background and Purpose: In ischemic stroke, inflammatory status may condition the development of collateral circulation. Here we assessed the relationship between systemic inflammatory biomarkers and collateral status in large vessel occlusion before mechanical thrombectomy. Methods: HIBISCUS-STROKE is a cohort study including acute ischemic stroke patients with large vessel occlusion treated with mechanical thrombectomy following admission magnetic resonance imaging. MMP-9 (matrix metalloproteinase-9) and MCP-1 (monocyte chemoattractant protein-1) were measured on blood sampling collected at admission. Collateral status was assessed on pretreatment Digital subtraction angiography and categorized into poor (Higashida score, 0–2) and good (Higashida score, 3–4). A multiple logistic regression model was performed to detect independent markers of good collateral status. Results: One hundred and twenty-two patients were included, of them 71 patients (58.2%) had a good collateral status. In univariate analysis, low MMP-9 levels ( P =0.01), high MCP-1 levels ( P P =0.046), a high diastolic blood pressure ( P =0.049), the absence of tandem occlusion ( P =0.046), a high Alberta Stroke Program Early CT Score ( P P P =0.02) and high MCP-1 levels ( P Conclusions: Low MMP-9 and high MCP-1 levels were associated with good pretreatment collateral status in patients with acute ischemic stroke with large vessel occlusion. These results might suggest a relationship between collateral status and inflammation.

Published
2020
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2. Impact of Collateral Status on Neuroprotective Effect of Cyclosporine A in Acute Ischemic Stroke

Author

Roxana Ameli, Omer Eker, Norbert Nighoghossian, Lise Prune Berner, Lucie Cornut, Yves Berthezène, Camille Amaz, Nathan Mewton, Michel Ovize, T.-H. Cho, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Neuroradiologie[Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Imagerie Tomographique et Radiothérapie, Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Department of Cardiology, Hospices Civils de Lyon (HCL), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Neuroradiology Department, Neurological Hospital, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL)

Subjects
0301 basic medicine, Male, medicine.medical_specialty, acute ischemic stroke, [SDV]Life Sciences [q-bio], Phases of clinical research, Collateral Circulation, Lesion volume, Neuroprotection, Brain Ischemia, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, collateral flow, Developmental Neuroscience, Internal medicine, medicine, Humans, In patient, cyclosporine, Acute ischemic stroke, Aged, Aged, 80 and over, business.industry, Brain, Middle Aged, Infarct size, Collateral circulation, Magnetic Resonance Imaging, reperfusion, Stroke, 030104 developmental biology, Collateral flow, Neuroprotective Agents, Treatment Outcome, Neurology, Cardiology, Female, neuroprotection, business, 030217 neurology & neurosurgery, Mri
Abstract

Background: Neuroprotection for acute ischemic stroke remains an elusive goal. Intracranial collaterals may favor neuroprotective drugs delivery at the acute stage of ischemic stroke. A recent phase 2 study showed that cyclosporine A (CsA) reduced ischemic damage in patients with a proximal occlusion who experienced effective recanalization. Collateral flow may improve this benefit. Materials & Methods: Collateral supply was assessed using dynamic susceptibility contrast MRI in 47 patients among the 110 patients from the original study and were graded in two groups: good collaterals and poor collaterals. Patients with good collaterals had significantly smaller initial infarct in both CsA group (p = 0.003) and controls (p = 0.016). Similarly, the final lesion volume was significantly lower in patients with good collaterals in both groups. Results: In patients with either good or poor collaterals CsA showed no additional benefit on ischemic lesion progression and final infarct size at day 30. Conclusion: We failed to demonstrate any significant additional benefit of CsA in patients with good collateral circulation.

Published
2019
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3. 18 F-NaF PET-MRI: an innovative tool to assess carotid artery plaque vulnerability

Author

Laura Mechtouff, N. Costes, Norbert Nighoghossian, Philippe Douek, Yves Berthezène, Monica Sigovan, D. Collet‐Benzaquen, Stroke Department, Neurological Hospital, Hospices Civils de Lyon (HCL), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Etude et de Recherche Multimodal Et Pluridisciplinaire en imagerie du vivant (CERMEP - imagerie du vivant), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Department of Radiology, Cardiological Hospital, Hospices Civils de Lyon, Laboratoire Technipath, Neuroradiology Department, Neurological Hospital, and ANR-10-IBHU-0003,CESAME,Institut Cerveau et Santé Mentale(2010)

Subjects
0301 basic medicine, business.industry, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Vulnerability, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, Carotid artery plaque, positron emission tomography computed tomography, Neurology, chemistry, Sodium fluoride, sodium fluoride, Medicine, carotid stenosis, Neurology (clinical), business, Nuclear medicine, ComputingMilieux_MISCELLANEOUS, Positron Emission Tomography-Computed Tomography
Abstract

International audience

Published
2018
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4. Impact of Brain Atrophy on Early Neurological Deterioration and Outcome in Severe Ischemic Stroke Treated by Intravenous Thrombolysis

Author

Salem Hannoun, Norbert Nighoghossian, Adeline Mansuy, Nathan Mewton, Gabriela Moreno Legast, Magali Bischoff, Yves Berthezène, Audrey de Parisot, Laurent Derex, Dominique Sappey-Marinier, Marielle Buisson, Carlos El Khoury, Olivier Tschirret, Leila Chamard, Laura Mechtouff, aucun, Syndicat mixte des bassins hydrauliques de l'Isère, Centre d'Etude et de Recherche Multimodal Et Pluridisciplinaire en imagerie du vivant (CERMEP - imagerie du vivant), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Stroke Department, Neurological Hospital, Hospices Civils de Lyon (HCL), and Neuroradiology Department, Neurological Hospital

Subjects
Male, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, Infarction, 030204 cardiovascular system & hematology, Brain Ischemia, Brain ischemia, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Modified Rankin Scale, Internal medicine, medicine, Humans, Thrombolytic Therapy, Prospective Studies, Prospective cohort study, Stroke, Aged, Aged, 80 and over, Univariate analysis, business.industry, Brain, Thrombolysis, Recovery of Function, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Treatment Outcome, Neurology, Cardiology, Administration, Intravenous, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: Brain atrophy has shown a protective effect on the risk of early neurological deterioration (END) related to malignant edema in patients with hemispheric infarction but could be deleterious on the outcome. Aims: We aimed to assess whether brain atrophy has an impact on the risk of END and on the outcome in severe ischemic strokes after intravenous (IV) thrombolysis. Methods: From a prospective thrombolysis registry, 137 patients who had a National Institutes of Health Stroke Scale (NIHSS) ≥15, MRI at admission, and IV thrombolysis were included. Relative cerebral volume was calculated. END was defined as a ≥2-points deterioration 72-h NIHSS and a good outcome as a modified Rankin Scale (mRS) ≤2 at 3 months. A multiple logistic regression analysis with a stepwise backward procedure was performed. Results: END and a good outcome were observed, respectively, in 20 (14.6%) and 48 (37.5%) patients. In univariate analysis, predictors of END included age (p = 0.049), diabetes (p = 0.041), and parenchymal hemorrhage (p = 0.039). In multivariate analysis, age (p = 0.018) was significantly associated with END. Brain atrophy was not associated with END even in subgroup analysis according to the baseline infarct size. In univariate analysis, age (p = 0.003), prestroke mRS (p = 0.002), hypertension (p = 0.006), baseline NIHSS (p = 0.002), END (p = 0.002), proximal occlusion (p = 0.006), and recanalization at 24 h (p < 0.001) were associated with a good outcome. Only baseline NIHSS (p = 0.006) was associated with a good outcome after adjustment. Conclusions: We did not find any impact of brain atrophy on the risk of END and the outcome at 3 months in severe ischemic strokes after IV thrombolysis.

Published
2017

5. MRI Profile and Collateral Status in Patients with a Transient Ischemic Attack and an Intracranial Artery Occlusion.

Author

Ong E, Eker O, Chamard L, Cho TH, Derex L, Buisson M, Mechtouff L, Berthezene Y, and Nighoghossian N

Subjects
Arterial Occlusive Diseases complications, Arterial Occlusive Diseases drug therapy, Female, Fibrinolytic Agents therapeutic use, Humans, Ischemic Attack, Transient drug therapy, Ischemic Attack, Transient etiology, Magnetic Resonance Imaging methods, Male, Middle Aged, Retrospective Studies, Stroke drug therapy, Stroke etiology, Thrombectomy, Thrombolytic Therapy methods, Tissue Plasminogen Activator therapeutic use, Treatment Outcome, Arterial Occlusive Diseases diagnostic imaging, Ischemic Attack, Transient diagnostic imaging, Stroke diagnostic imaging
Abstract

Background and Purpose: Transient ischemic attack may rarely reveal an intracranial artery occlusion. We analyzed acute magnetic resonance imaging (MRI) patterns and early outcome after reperfusion therapy in these cases., Method: Clinical and imaging data were taken retrospectively from our comprehensive stroke center registry. Two MRI patterns were determined. Pattern A: full mismatch with negative diffusion-weighted imaging (DWI) and perfusion defect. Pattern B: large mismatch with positive DWI and perfusion defect. MRI-derived collateral flow maps were automatically generated from the raw of dynamic susceptibility contrast MRI. Patients were treated either by recombinant tissue plasminogen activator (rtPA) alone or in combination with mechanical thrombectomy., Results: From October 1, 2010 to May 15, 2016, 1,019 patients were admitted and treated by t-PA within 4.5 hours of stroke onset of them; 14 had a transient ischemic attack (TIA) within the 6 hours preceding MRI. Perfusion imaging was performed in 11 patients. An arterial occlusion was found in all of them, 11 patients had a distal anterior circulation occlusion, whereas 3 patients (21%) had a proximal occlusion. According to MRI, 6 patients showed pattern A, whereas 5 patients had pattern B. Good collaterals were observed in 10 patients (6 patients with grade 3 and 4 patients with grade 4), whereas 1 patient had poor collaterals (grade 2). The day 1 National Institutes of Health Stroke Scale median was 0. Modified Rankin Scale median at 3 months was 0., Conclusion: TIAs may reveal acute intracranial artery occlusion. Acute MRI may able to assist in therapeutic decision., (© 2018 by the American Society of Neuroimaging.)

Published
2019
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7. MRI-Guided Thrombolysis for Stroke with Unknown Time of Onset.

Author

Thomalla G, Simonsen CZ, Boutitie F, Andersen G, Berthezene Y, Cheng B, Cheripelli B, Cho TH, Fazekas F, Fiehler J, Ford I, Galinovic I, Gellissen S, Golsari A, Gregori J, Günther M, Guibernau J, Häusler KG, Hennerici M, Kemmling A, Marstrand J, Modrau B, Neeb L, Perez de la Ossa N, Puig J, Ringleb P, Roy P, Scheel E, Schonewille W, Serena J, Sunaert S, Villringer K, Wouters A, Thijs V, Ebinger M, Endres M, Fiebach JB, Lemmens R, Muir KW, Nighoghossian N, Pedraza S, and Gerloff C

Subjects
Acute Disease, Administration, Intravenous, Aged, Brain Ischemia diagnostic imaging, Diffusion Magnetic Resonance Imaging, Female, Fibrinolytic Agents adverse effects, Humans, Intracranial Hemorrhages chemically induced, Male, Middle Aged, Stroke diagnostic imaging, Stroke surgery, Thrombectomy, Time-to-Treatment, Tissue Plasminogen Activator adverse effects, Treatment Outcome, Fibrinolytic Agents therapeutic use, Magnetic Resonance Imaging, Interventional, Stroke drug therapy, Thrombolytic Therapy methods, Tissue Plasminogen Activator therapeutic use
Abstract

Background: Under current guidelines, intravenous thrombolysis is used to treat acute stroke only if it can be ascertained that the time since the onset of symptoms was less than 4.5 hours. We sought to determine whether patients with stroke with an unknown time of onset and features suggesting recent cerebral infarction on magnetic resonance imaging (MRI) would benefit from thrombolysis with the use of intravenous alteplase., Methods: In a multicenter trial, we randomly assigned patients who had an unknown time of onset of stroke to receive either intravenous alteplase or placebo. All the patients had an ischemic lesion that was visible on MRI diffusion-weighted imaging but no parenchymal hyperintensity on fluid-attenuated inversion recovery (FLAIR), which indicated that the stroke had occurred approximately within the previous 4.5 hours. We excluded patients for whom thrombectomy was planned. The primary end point was favorable outcome, as defined by a score of 0 or 1 on the modified Rankin scale of neurologic disability (which ranges from 0 [no symptoms] to 6 [death]) at 90 days. A secondary outcome was the likelihood that alteplase would lead to lower ordinal scores on the modified Rankin scale than would placebo (shift analysis)., Results: The trial was stopped early owing to cessation of funding after the enrollment of 503 of an anticipated 800 patients. Of these patients, 254 were randomly assigned to receive alteplase and 249 to receive placebo. A favorable outcome at 90 days was reported in 131 of 246 patients (53.3%) in the alteplase group and in 102 of 244 patients (41.8%) in the placebo group (adjusted odds ratio, 1.61; 95% confidence interval [CI], 1.09 to 2.36; P=0.02). The median score on the modified Rankin scale at 90 days was 1 in the alteplase group and 2 in the placebo group (adjusted common odds ratio, 1.62; 95% CI, 1.17 to 2.23; P=0.003). There were 10 deaths (4.1%) in the alteplase group and 3 (1.2%) in the placebo group (odds ratio, 3.38; 95% CI, 0.92 to 12.52; P=0.07). The rate of symptomatic intracranial hemorrhage was 2.0% in the alteplase group and 0.4% in the placebo group (odds ratio, 4.95; 95% CI, 0.57 to 42.87; P=0.15)., Conclusions: In patients with acute stroke with an unknown time of onset, intravenous alteplase guided by a mismatch between diffusion-weighted imaging and FLAIR in the region of ischemia resulted in a significantly better functional outcome and numerically more intracranial hemorrhages than placebo at 90 days. (Funded by the European Union Seventh Framework Program; WAKE-UP ClinicalTrials.gov number, NCT01525290; and EudraCT number, 2011-005906-32 .).

Published
2018
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