75 results on '"Solène, Moulin"'
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2. Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study
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Candice Sabben, Frédérique Charbonneau, François Delvoye, Davide Strambo, Mirjam R. Heldner, Elodie Ong, Adrien Ter Schiphorst, Hilde Henon, Wagih Ben Hassen, Thomas Agasse-Lafont, Loïc Legris, Igor Sibon, Valérie Wolff, Denis Sablot, Mahmoud Elhorany, Cécile Preterre, Nour Nehme, Sébastien Soize, David Weisenburger-Lile, Aude Triquenot-Bagan, Gioia Mione, Andreea Aignatoaie, Jérémie Papassin, Roxana Poll, Yannick Béjot, Emmanuel Carrera, Pierre Garnier, Patrik Michel, Guillaume Saliou, Pasquale Mordasini, Yves Berthezene, Vincent Costalat, Nicolas Bricout, Gregory W. Albers, Mikael Mazighi, Guillaume Turc, Pierre Seners, Kateryna Antonenko, Caroline Arquizan, Lynda Benammar, Claire Boutet, Frédéric Clarençon, Pierre-Olivier Comby, Hubert Desal, Olivier Detante, François Eugene, Emmanuel Gerardin, Benjamin Gory, Stéphane Kremer, Sylvain Ledure, Mathieu Krug, Bertrand Lapergue, Philippe Niclot, Christophe Magni, Michael Obadia, Canan Ozsancak, Fernando Pico, Sara Pilgram-Pastor, Raoul Pop, Sébastien Richard, Charlotte Rosso, Julien Savatovsky, Solène Moulin, Clément Tracol, and Martin Zbinden
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: Whether endovascular therapy (EVT) added on best medical management (BMM), as compared to BMM alone, is beneficial in acute ischemic stroke with isolated posterior cerebral artery occlusion is unknown. Methods: We conducted a multicenter international observational study of consecutive stroke patients admitted within 6 hours from symptoms onset in 26 stroke centers with isolated occlusion of the first (P1) or second (P2) segment of the posterior cerebral artery and treated either with BMM+EVT or BMM alone. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month good functional outcome (modified Rankin Scale [mRS] score 0–2 or return to baseline modified Rankin Scale). Secondary outcomes were 3-month excellent recovery (modified Rankin Scale score 0–1), symptomatic intracranial hemorrhage, and early neurological deterioration. Results: Overall, 752 patients were included (167 and 585 patients in the BMM+EVT and BMM alone groups, respectively). Median age was 74 (interquartile range, 63–82) years, 329 (44%) patients were female, median National Institutes of Health Stroke Scale was 6 (interquartile range 4–10), and occlusion site was P1 in 188 (25%) and P2 in 564 (75%) patients. Baseline clinical and radiological data were similar between the 2 groups following propensity score weighting. EVT was associated with a trend towards lower odds of good functional outcome (odds ratio, 0.81 [95% CI, 0.66–1.01]; P =0.06) and was not associated with excellent functional outcome (odds ratio, 1.17 [95% CI, 0.95–1.43]; P =0.15). EVT was associated with a higher risk of symptomatic intracranial hemorrhage (odds ratio, 2.51 [95% CI, 1.35–4.67]; P =0.004) and early neurological deterioration (odds ratio, 2.51 [95% CI, 1.64–3.84]; P Conclusions: In this observational study of patients with proximal posterior cerebral artery occlusion, EVT was not associated with good or excellent functional outcome as compared to BMM alone. However, EVT was associated with higher rates of symptomatic intracranial hemorrhage and early neurological deterioration. EVT should not be routinely recommended in this population, but randomization into a clinical trial is highly warranted.
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- 2023
3. Neurologists should not blame emergency physicians for stroke mimics, but train them to identify chameleons
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Didier LEYS, Solène MOULIN, and Patrick GOLDSTEIN
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Published
- 2020
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4. Long-term anxiety in spontaneous intracerebral hemorrhage survivors
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Giuseppe Scopelliti, Barbara Casolla, Grégoire Boulouis, Grégory Kuchcinski, Solène Moulin, Didier Leys, Hilde Hénon, Charlotte Cordonnier, and Marco Pasi
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Stroke ,Cerebral Amyloid Angiopathy ,Neurology ,Humans ,Prospective Studies ,Survivors ,Cerebral Hemorrhage - Abstract
Background: Although anxiety is common in several neurological conditions, it has been poorly investigated after spontaneous intracerebral hemorrhage (ICH). Aims: In consecutive ICH survivors, we assessed the long-term prevalence of anxiety and its clinical and radiological determinants. Methods: Using the Hospital Anxiety and Depression Scale (HADS), we evaluated ICH survivors enrolled in the prospective, single-center Prognosis of Intracerebral Hemorrhage (PITCH) study. The prevalence of anxiety (defined as a HADS-anxiety subscale score >7) was evaluated at three time points (1–2, 3–5, and 6–8 years after ICH), along with neurological symptoms severity, functional disability, and cognitive impairment scores. Clinical and radiological characteristics associated with anxiety were evaluated in univariate and multivariable models. Results: Of 560 patients with spontaneous ICH, 255 were alive 1 year later, 179 of whom completed the HADS questionnaire and were included in the study. Thirty-one patients (17%; 95% confidence interval (CI) = 12–23) had anxiety 1–2 years, 38 (27%; 95% CI = 19–34) 3–5 years, and 18 (21%; 95% CI = 12–30) 6–8 years after ICH. In patients with anxiety, the prevalence of associated depressive symptoms was 48% 1–2 years, 61% 3–5 years, and 56% 6–8 years after ICH. Among clinical and radiological baseline characteristics, only lobar ICH location was significantly associated with anxiety 1–2 years after ICH (odds ratio = 2.8; 95% CI = 1.2–6.5). Anxiety was not associated with concomitant neurological symptoms severity, functional disability, or cognitive impairment. Conclusion: Anxiety is frequent in ICH survivors, often in association with depressive symptoms, even many years after the index event.
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- 2022
5. Thrombolyse intraveineuse dans l’ischémie cérébrale de phase aiguë : sur quoi reposent les recommandations ?
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Alexandre Doucet, Vi Tuan Hua, and Solène Moulin
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Neurology (clinical) - Published
- 2022
6. Get connected to the fungal network for improved transfer of nitrogen: the role of ZmAMT3;1 in ammonium transport in maize-arbuscular mycorrhizal symbiosis
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Solène Moulin
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Nitrogen ,Mycorrhizae ,Ammonium Compounds ,Cell Biology ,Plant Science ,Symbiosis ,Plant Roots ,Zea mays - Published
- 2022
7. Influence of prior intravenous thrombolysis in patients treated with mechanical thrombectomy for M2 occlusions: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) registry
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Agathe, Le Floch, Frédéric, Clarençon, Aymeric, Rouchaud, Maeva, Kyheng, Julien, Labreuche, Igor, Sibon, Gregoire, Boulouis, Benjamin, Gory, Sébastien, Richard, Jildaz, Caroff, Raphaël, Blanc, Pierre, Seners, Omer F, Eker, Tae-Hee, Cho, Arturo, Consoli, Romain, Bourcier, Benoit, Guillon, Cyril, Dargazanli, Caroline, Arquizan, Christian, Denier, Francois, Eugene, Stephane, Vannier, Jean-Christophe, Gentric, Maxime, Gauberti, Olivier, Naggara, Charlotte, Rosso, Guillaume, Turc, Ozlem, Ozkul-Wermester, Christophe, Cognard, Jean François, Albucher, Serge, Timsit, Frederic, Bourdain, Anthony, Le Bras, Sebastian, Richter, Solène, Moulin, Raoul, Pop, Olivier, Heck, Ricardo, Moreno, Vincent, L'Allinec, Bertrand, Lapergue, Gaultier, Marnat, and Alessandra, Biondi
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundIntravenous thrombolysis (IVT) for patients treated with mechanical thrombectomy (MT) for proximal occlusions has recently been questioned through randomized trials. However, few patients with M2 occlusions were included. We investigated the influence of prior IVT for patients presenting M2 occlusions treated with MT in comparison with MT alone.MethodsWe conducted a retrospective analysis of the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a multicenter observational study. Data from consecutive patients treated with MT for M2 occlusions between January 2015 and January 2022 at 26 comprehensive stroke centers were analyzed. The primary endpoint was 90-day modified Rankin Scale score of 0–2. Outcomes were compared using propensity score approaches. We also performed sensitivity analysis in relevant subgroups of patients.ResultsAmong 1132 patients with M2 occlusions treated with MT, 570 received prior IVT. The two groups were comparable after propensity analysis. The rate of favorable functional outcome was significantly higher in the IVT+MT group compared with the MT alone group (59.8% vs 44.7%; adjusted OR 1.38, 95% CI 1.10 to 1.75, P=0.008). Hemorrhagic and procedural complications were similar in both groups. In sensitivity analysis excluding patients with anticoagulation treatment, favorable recanalization was more frequent in the IVT+MT group (OR 1.37, 95% CI 1.11 to 1.70, P=0.004).ConclusionsIn cases of M2 occlusions, prior IVT combined with MT resulted in better functional outcome than MT alone, without increasing the rate of hemorrhagic or procedural complications. These results suggest the benefit of IVT in patients undergoing MT for M2 occlusions.
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- 2022
8. Aspirin versus aggressive antiplatelet therapy for acute carotid stenting plus thrombectomy in tandem occlusions: ETIS Registry results
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Gaultier Marnat, Stefanos Finistis, Ricardo Moreno, Igor Sibon, Raoul Pop, Mikaël Mazighi, Frédéric Clarençon, Charlotte Rosso, Cyril Dargazanli, Jean Darcourt, Jean-Marc Olivot, Gregoire Boulouis, Kevin Janot, Solène Moulin, Romain Bourcier, Arturo Consoli, Sébastien Richard, Caroline Arquizan, Stephane Vannier, Sebastian Richter, Jean-Christophe Gentric, Chrisanthi Papagiannaki, Olivier Naggara, Omer F Eker, Bertrand Lapergue, Jildaz Caroff, and Benjamin Gory
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundPatients treated with acute carotid stenting (CAS) may have higher odds of a favorable outcome than those treated without CAS during thrombectomy in tandem occlusions. Antiplatelet therapy is associated with CAS to avoid stent thrombosis, which occurs in around 20% of patients and negatively impacts outcomes. In this study we compared two antiplatelet strategies in tandem occlusion strokes treated with CAS and intracranial thrombectomy in clinical practice.MethodsThe Endovascular Treatment in Ischemic Stroke Registry is an ongoing prospective observational study involving 21 comprehensive stroke centers performing thrombectomy in France. We analyzed patients with atherosclerotic tandem occlusions treated with acute CAS and intracranial thrombectomy who received at least one antiplatelet agent. Aggressive antiplatelet therapy included oral or intravenous glycoprotein (GP) IIb/IIIa or P2Y12 inhibitors. The primary outcome was cervical carotid artery patency at day 1 imaging follow-up.ResultsAmong the 187 included patients, 124 (66.3%) received aspirin alone and 63 (33.7%) received aggressive antiplatelet therapy. There was no significant difference regarding safety outcomes, especially in symptomatic intracerebral hemorrhage, parenchymal hematoma, and procedural complications. There was a significantly higher rate of carotid stent patency at day 1 in the aggressive antiplatelet therapy group (81.7% vs 97.1%, aOR 17.49, 95% CI 1.10 to 277.2, p=0.042). Odds of favorable functional outcome (90-day modified Rankin Scale score 0–2) were similar between the groups (OR 3.04, 95% CI 0.64 to 14.25, p=0.158).ConclusionsIn tandem occlusions treated with CAS plus thrombectomy, an aggressive antiplatelet regimen was associated with an increased rate of carotid stent patency at day 1 without safety concerns. Randomized trials are warranted to confirm these findings.
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- 2022
9. Intracranial Hemorrhage in the TST Trial
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Pierre Amarenco, Jong S. Kim, Julien Labreuche, Hugo Charles, Maurice Giroud, Philippa C. Lavallée, Byung-Chul Lee, Marie-Hélène Mahagne, Elena Meseguer, Norbert Nighoghossian, Philippe Gabriel Steg, Éric Vicaut, Eric Bruckert, Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul- Wermester, Frédéric Philippeau, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, null Hamon, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal- Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, null Emilie, Mathieu Zuber, Marie Bruandet, Claire Join- Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, null Alnajar-Carpentier, Michèle Levasseur, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, null Stantescu, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Keun Seo, Jongwon Chung, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul, South Korea] (AMC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Equipe Avenir. University of Burgundy, Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Hôpital Pasteur [Nice] (CHU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Université Sorbonne Paris Cité (USPC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Treat Stroke to Target Investigators*: Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Pierre-Jean Touboul, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Hamon, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Stantescu, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Keun Seo, Jongwon Chung, and CarMeN, laboratoire
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Adult ,Male ,[SDV]Life Sciences [q-bio] ,Coronary Artery Disease ,LDL ,Young Adult ,Predictive Value of Tests ,Risk Factors ,Secondary Prevention ,Humans ,cardiovascular diseases ,Aged ,Ischemic Stroke ,Advanced and Specialized Nursing ,Aged, 80 and over ,Anticholesteremic Agents ,Incidence ,cholesterol ,Anticoagulants ,Cholesterol, LDL ,Middle Aged ,Ezetimibe ,Intracranial Arteriosclerosis ,[SDV] Life Sciences [q-bio] ,Ischemic Attack, Transient ,Hypertension ,Female ,Neurology (clinical) ,atherosclerosis ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,Intracranial Hemorrhages - Abstract
Background and Purpose: Although statins are effective in secondary prevention of ischemic stroke, they are also associated with an increase risk of intracranial hemorrhage (ICH) in certain conditions. In the TST trial (Treat Stroke to Target), we prespecified an exploration of the predictors of incident ICH. Methods: Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned in a 1:1 ratio to a target LDL (low-density lipoprotein) cholesterol of Results: Among 2860 patients enrolled, 31 incident ICH occurred over a median follow-up of 3 years (18 and 13 in the lower and higher target group, 3.21/1000 patient-years [95% CI, 2.38–4.04] and 2.32/1000 patient-years [95% CI, 1.61–3.03], respectively). While there were no baseline predictors of ICH, uncontrolled hypertension (HR, 2.51 [95% CI, 1.01–6.31], P =0.041) and being on anticoagulant (HR, 2.36 [95% CI, 1.00–5.62], P =0.047)] during the trial were significant predictors. On-treatment low LDL cholesterol was not a predictor of ICH. Conclusions: Targeting an LDL cholesterol of Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875; EUDRACT identifier: 2009-A01280-57.
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- 2021
10. Crop plants move up a gear: Switching for a faster Rubisco in tobacco
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Solène Moulin
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Cell Biology ,Plant Science - Published
- 2022
11. From the archives: Oxidative stress tolerance in Chlamydomonas and herbicide resistance in the weedy speciesEleusine indica
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Solène Moulin
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Cell Biology ,Plant Science - Published
- 2022
12. Neurologic manifestations associated with COVID-19: a multicentre registry
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Elodie Meppiel, Nathan Peiffer-Smadja, Alexandra Maury, Imen Bekri, Cécile Delorme, Virginie Desestret, Lucas Gorza, Geoffroy Hautecloque-Raysz, Sophie Landre, Annie Lannuzel, Solène Moulin, Peggy Perrin, Paul Petitgas, François SellaI, Adrien Wang, Pierre Tattevin, Thomas de Broucker, Sophie Abgrall, Fanny Alby-Laurent, Thibault Allou, Joséphine Amevigbe, Hanifa Amarguellay, Nabil Alloussi, Guillaume Baille, Mathilde Barbaz, Lamia Bencherif, Samia Bensaadi, Guillaume Beraud, Alexandra Bizot, Laure Bottin, Fabrice Bruneel, Jean-Philippe Camdessanche, Jeanne Chauffier, Jean-Philippe Csajaghy, Chloé De Broucker, Thomas De Broucker, Luc Defebvre, Elodie Dembloque, Nathalie Derache, Olivier Dereeper, Céline Derollez, Cécile Descotes-Genon, Mathilde Devaux, Lydie Dubuc, Gilles Edan, Andréa Fickl, Thibault Fraisse, Michel Gugenheim, Karolina Hankiewicz, Yves Hansmann, Carole Henry, Stéphanie Jobard, Fanny Jouan, Arnaud Kwiatkowski, Thibault Lalu, Johan Leguilloux, Camille Lejeune, Clémence Liegeois, Sophie Mahy, Jonathan Marey, Laure Michel, Rita Mitri, Chloé Moulin, Asma Omarjee, Canan Ozsancak, Fernando Pico, Marie Poupard, Valérie Rabier, Camille Rizzato, Caroline Roos, Julien Saison, Naomi Sayre, Nicolas Sedillot, François Sellal, Jérôme Servan, Caroline Storey, Laurent Suchet, Paul Tarteret, Mathilde Thiebaut, Claudia Vaduva, David Varlan, Virginie Zarrouk, Centre Hospitalier de Saint-Denis [Ile-de-France], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Centre Hospitalier de Versailles André Mignot (CHV), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hospices Civils de Lyon (HCL), Hôpital Foch [Suresnes], Hôpitaux Civils de Colmar, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre Hospitalier Universitaire de Reims (CHU Reims), Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Pontchaillou [Rennes], Service de Neurologie [Hôpitaux Civils de Colmar], Hôpitaux Civils Colmar, Jonchère, Laurent, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
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Male ,0301 basic medicine ,Microbiology (medical) ,Registry ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,030106 microbiology ,Encephalopathy ,Nervous System ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Pleocytosis ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,Mortality rate ,Brain ,COVID-19 ,Retrospective cohort study ,Magnetic resonance imaging ,General Medicine ,Neurologic manifestations ,Middle Aged ,medicine.disease ,Thrombosis ,3. Good health ,[SDV] Life Sciences [q-bio] ,Infectious Diseases ,Neurological manifestations ,Female ,Original Article ,France ,Nervous System Diseases ,business ,Encephalitis - Abstract
International audience; OBJECTIVES: To provide an overview of the spectrum, characteristics and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We conducted a single-centre retrospective study during the French coronavirus disease 2019 (COVID-19) epidemic in March-April 2020. All COVID-19 patients with de novo neurologic manifestations were eligible. RESULTS: We included 222 COVID-19 patients with neurologic manifestations from 46 centres in France. Median (interquartile range, IQR) age was 65 (53-72) years and 136 patients (61.3%) were male. COVID-19 was severe or critical in 102 patients (45.2%). The most common neurologic diseases were COVID-19-associated encephalopathy (67/222, 30.2%), acute ischaemic cerebrovascular syndrome (57/222, 25.7%), encephalitis (21/222, 9.5%) and Guillain-Barré syndrome (15/222, 6.8%). Neurologic manifestations appeared after the first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19-associated encephalopathy, 7 (5-10) days in encephalitis, 12 (7-18) days in acute ischaemic cerebrovascular syndrome and 18 (15-28) days in Guillain-Barré syndrome. Brain imaging was performed in 192 patients (86.5%), including 157 magnetic resonance imaging (70.7%). Among patients with acute ischaemic cerebrovascular syndrome, 13 (22.8%) of 57 had multiterritory ischaemic strokes, with large vessel thrombosis in 16 (28.1%) of 57. Brain magnetic resonance imaging of encephalitis patients showed heterogeneous acute nonvascular lesions in 14 (66.7%) of 21. Cerebrospinal fluid of 97 patients (43.7%) was analysed, with pleocytosis found in 18 patients (18.6%) and a positive SARS-CoV-2 PCR result in two patients with encephalitis. The median (IQR) follow-up was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). CONCLUSIONS: Clinical spectrum and outcomes of neurologic manifestations associated with SARS-CoV-2 infection were broad and heterogeneous, suggesting different underlying pathogenic processes.
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- 2021
13. La présence du Brush Sign est associée à un meilleur pronostic fonctionnel à 3 mois des patients atteints d’AVC ischémique ayant bénéficié d’une thrombectomie mécanique
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Sami Benhammida, Vi Tuan Hua, Thi Ngoc Phuong Nguyen, Sébastien Soize, and Solène Moulin
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Neurology ,Neurology (clinical) - Published
- 2023
14. Use of MRI to predict symptomatic haemorrhagic transformation after thrombolysis for cerebral ischaemia
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Barbara Casolla, Jean-Pierre Pruvo, Solène Moulin, François Caparros, Didier Leys, Charlotte Cordonnier, Agathe Drelon, Grégory Kuchcinski, Nelly Dequatre-Ponchelle, and Hilde Hénon
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Aged ,Cerebral Hemorrhage ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Area under the curve ,Brain ,Magnetic resonance imaging ,Retrospective cohort study ,Thrombolysis ,Middle Aged ,Magnetic Resonance Imaging ,Hyperintensity ,Stroke ,Psychiatry and Mental health ,Tissue Plasminogen Activator ,Predictive value of tests ,Cohort ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background and objectivePredictors of symptomatic haemorrhagic transformation (s-HT) of cerebral ischaemia after intravenous recombinant tissue-plasminogen activator (rt-PA) were identified in studies using CT scans. We evaluated whether MRI can identify other predictors.MethodWe analysed predictors of s-HT in a cohort of consecutive patients who received intravenous rt-PA for cerebral ischaemia after MRI at baseline. We used receiver operating characteristic curves considering an area under the curve (AUC) of 0.70 or higher as indicating acceptable discrimination.ResultsOf 944 patients, 49 patients (5.2%) developed s-HT. Clinical factors independently associated with s-HT were age (adjusted OR (adjOR) 1.03 for 1 year increase; 95% CI 1.01 to 1.05), excessive alcohol consumption (adjOR 3.13; 95% CI 1.32 to 7.42), recent transient ischaemic attack (adjOR 2.88; 95% CI 1.04 to 7.95) and baseline national institutes of health stroke scale score (adjOR 1.06 for 1 point increase; 95% CI 1.02 to 1.10). MRI predictors were vascular hyperintensities (adjOR 3.89; 95% CI 1.50 to 10.08), old infarcts (adjOR 2.01; 95% CI 1.11 to 3.66) and volume of diffusion-weighted imaging (DWI) abnormality (adjOR 1.02 for 1 cm3 increase; 95% CI 1.01 to 1.03). The only variable with an acceptable discrimination was volume of DWI abnormality (AUC 0.72; 95% CI 0.64 to 0.79), a value of 4 cm3 predicting s-HT with a 78% sensitivity and 58% specificity. Variables that can be assessed only with MRI did not predict s-HT.ConclusionAlthough the volume of DWI abnormality predicts s-HT, other imaging characteristics that can only be assessed with MRI were not significantly associated with s-HT.Trial registration numberNCT01614080
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- 2020
15. Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial
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Urs Fischer, Johannes Kaesmacher, Daniel Strbian, Omer Eker, Christoph Cognard, Patricia S Plattner, Lukas Bütikofer, Pasquale Mordasini, Sandro Deppeler, Vitor M Pereira, Jean François Albucher, Jean Darcourt, Romain Bourcier, Guillon Benoit, Chrysanthi Papagiannaki, Ozlem Ozkul-Wermester, Gerli Sibolt, Marjaana Tiainen, Benjamin Gory, Sébastien Richard, Jan Liman, Marielle Sophie Ernst, Marion Boulanger, Charlotte Barbier, Laura Mechtouff, Liqun Zhang, Gaultier Marnat, Igor Sibon, Omid Nikoubashman, Arno Reich, Arturo Consoli, Bertrand Lapergue, Marc Ribo, Alejandro Tomasello, Suzana Saleme, Francisco Macian, Solène Moulin, Paolo Pagano, Guillaume Saliou, Emmanuel Carrera, Kevin Janot, María Hernández-Pérez, Raoul Pop, Lucie Della Schiava, Andreas R Luft, Michel Piotin, Jean Christophe Gentric, Aleksandra Pikula, Waltraud Pfeilschifter, Marcel Arnold, Adnan H Siddiqui, Michael T Froehler, Anthony J Furlan, René Chapot, Martin Wiesmann, Paolo Machi, Hans-Christoph Diener, Zsolt Kulcsar, Leo H Bonati, Claudio L Bassetti, Mikael Mazighi, David S Liebeskind, Jeffrey L Saver, Jan Gralla, Angelika Alonso, Caroline Arquizan, Xavier Barreau, Rémy Beaujeux, Daniel Behme, Tobias Boeckh-Behrens, Christian Boehme, Martí Boix, Grégoire Boulouis, Nicolas Bricout, Nicolas Broc, Carlo W. Cereda, Emmanuel Chabert, Tae-Hee Cho, Alessandro Cianfoni, Vincent Costalat, Christian Denier, Frederico Di Maria, Richard du Mesnil de Rochemont, Patricia Fearon, Anna Ferrier, Sebastian Fischer, Maxime Gauberti, Marie Gaudron, Laetitia Gimenez, Christoph Globas, Michael Görtler, Mayank Goyal, Ruediger Hilker-Roggendorf, Michael D. Hill, Vi Tuan Hua, Lisa Humbertjean, Olav Jansen, Simon Jung, Georg Kägi, Michael E. Kelly, Ilka Kleffner, Michael Knoflach, Krassen Nedeltchev, Lars Udo Krause, Kimmo Lappalainen, Margaux Lefebvre, Joe Leyon, Liang Liao, Jean-Sebastien Liegey, Christian Loehr, Patrik Michel, Stefania Nannoni, Patrick Nicholson, Lorena Nico, Michael Obadia, Julien Ognard, Ayokunle Ogungbemi, Jean-Marc Olivot, Simon Escalard, Marco Pasi, Lissa Peeling, Jane Perez, Martina Petersen, Eike Piechowiak, Roberto Raposo, Silja Räty, Sarah C. Reitz, Sebastià Remollo, Luca Remonda, Ian Rennie, Manuel Requena, Alexander Riabikin, Roberto Riva, Aymeric Rouchaud, Andrea Rosi, Marta Rubiera, Laurent Spelle, Marlena Schnieder, Joanna D. Schaafsma, Tilman Schubert, Jörg B. Schulz, Mohammed Siddiqui, Sébastien Soize, Michael Sonnberger, Emmanuel Touze, Aude Triquenot, Guillaume Turc, Lucy Vieira, Wagih Ben Hassen, Judith N. Wagner, Katrin Wasser, Johannes Weber, Holger Wenz, David Weisenburger-Lile, Fritz Wodarg, Valérie Wolff, Silke Wunderlich, University of Bern, Bern University Hospital [Berne] (Inselspital), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Service de neuroradiologie [Lyon], Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Toulouse [Toulouse], Département de Neuro-Radiologie [Bordeaux] (DNR - Bordeaux), CHU Bordeaux [Bordeaux], University of Toronto, Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Radiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service de neurologie [Rouen], Helsinki University Hospital [Finland] (HUS), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de neurologie [CHRU Nancy], University Medical Center Göttingen (UMG), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Interférométrie, In situ et Instrumentation pour la Microscopie Electronique (CEMES-I3EM), Centre d'élaboration de matériaux et d'études structurales (CEMES), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Universitätsklinikum RWTH Aachen - University Hospital Aachen [Aachen, Germany] (UKA), Rheinisch-Westfälische Technische Hochschule Aachen University (RWTH), Hôpital Foch [Suresnes], Institut de Ciencies del Cosmos (ICCUB), Universitat de Barcelona (UB), Observatoire océanologique de Banyuls (OOB), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Limoges, Environnement, Bioénergie, Microalgues et Plantes (EBMP), Institut de Biosciences et Biotechnologies d'Aix-Marseille (ex-IBEB) (BIAM), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Hôpitaux Universitaires de Genève (HUG), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Germans Trias i Pujol University Hospital [Badalona, Barcelona, Spain] (GTPUH), Département de Neuroradiologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Lille, University hospital of Zurich [Zurich], Fondation Ophtalmologique Adolphe de Rothschild [Paris], Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Toronto Western Hospital, Frankfurt University Hospital, University at Buffalo [SUNY] (SUNY Buffalo), State University of New York (SUNY), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Case Western Reserve University [Cleveland], Alfried Krupp Krankenhaus [Essen], Geneva University Hospitals and Geneva University, Institute of Medical Informatics, Biometrics and Epidemiology [ Essen, Germany] (IMIBE), University Hospital Basel [Basel], University of Basel (Unibas), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), FHU NeuroVasc [Site Sainte-Anne, Paris] (GHU-PPN), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), David Geffen School of Medicine [Los Angeles], University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), University of California (UC), SWIFT DIRECT Collaborators: Angelika Alonso, Caroline Arquizan, Xavier Barreau, Rémy Beaujeux, Daniel Behme, Tobias Boeckh-Behrens, Christian Boehme, Martí Boix, Grégoire Boulouis, Nicolas Bricout, Nicolas Broc, Carlo W Cereda, Emmanuel Chabert, Tae-Hee Cho, Alessandro Cianfoni, Vincent Costalat, Christian Denier, Frederico Di Maria, Richard du Mesnil de Rochemont, Patricia Fearon, Anna Ferrier, Sebastian Fischer, Maxime Gauberti, Marie Gaudron, Laetitia Gimenez, Christoph Globas, Michael Görtler, Mayank Goyal, Ruediger Hilker-Roggendorf, Michael D Hill, Vi Tuan Hua, Lisa Humbertjean, Olav Jansen, Simon Jung, Georg Kägi, Michael E Kelly, Ilka Kleffner, Michael Knoflach, Krassen Nedeltchev, Lars Udo Krause, Kimmo Lappalainen, Margaux Lefebvre, Joe Leyon, Liang Liao, Jean-Sebastien Liegey, Christian Loehr, Patrik Michel, Stefania Nannoni, Patrick Nicholson, Lorena Nico, Michael Obadia, Julien Ognard, Ayokunle Ogungbemi, Jean-Marc Olivot, Simon Escalard, Marco Pasi, Lissa Peeling, Jane Perez, Martina Petersen, Eike Piechowiak, Roberto Raposo, Silja Räty, Sarah C Reitz, Sebastià Remollo, Luca Remonda, Ian Rennie, Manuel Requena, Alexander Riabikin, Roberto Riva, Aymeric Rouchaud, Andrea Rosi, Marta Rubiera, Laurent Spelle, Marlena Schnieder, Joanna D Schaafsma, Tilman Schubert, Jörg B Schulz, Mohammed Siddiqui, Sébastien Soize, Michael Sonnberger, Emmanuel Touze, Aude Triquenot, Guillaume Turc, Lucy Vieira, Wagih Ben Hassen, Judith N Wagner, Katrin Wasser, Johannes Weber, Holger Wenz, David Weisenburger-Lile, Fritz Wodarg, Valérie Wolff, Silke Wunderlich., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), St George’s University Hospitals, Vall d'Hebron University Hospital [Barcelona], and CarMeN, laboratoire
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[SDV] Life Sciences [q-bio] ,[SDV]Life Sciences [q-bio] ,General Medicine ,610 Medicine & health - Abstract
Background Whether thrombectomy alone is equally as effective as intravenous alteplase plus thrombectomy remains controversial. We aimed to determine whether thrombectomy alone would be non-inferior to intravenous alteplase plus thrombectomy in patients presenting with acute ischaemic stroke. Methods In this multicentre, randomised, open-label, blinded-outcome trial in Europe and Canada, we recruited patients with stroke due to large vessel occlusion confirmed with CT or magnetic resonance angiography admitted to endovascular centres. Patients were randomly assigned (1:1) via a centralised web server using a deterministic minimisation method to receive stent-retriever thrombectomy alone or intravenous alteplase plus stent-retriever thrombectomy. In both groups, thrombectomy was initiated as fast as possible with any commercially available Solitaire stent-retriever revascularisation device (Medtronic, Irvine, CA, USA). In the combined treatment group, intravenous alteplase (0.9 mg/kg bodyweight, maximum dose 90 mg per patient) was administered as early as possible after randomisation for 60 min with 10% of the calculated dose given as an initial bolus. Personnel assessing the primary outcome were masked to group allocation; patients and treating physicians were not. The primary binary outcome was a score of 2 or less on the modified Rankin scale at 90 days. We assessed the non-inferiority of thrombectomy alone versus intravenous alteplase plus thrombectomy in all randomly assigned and consenting patients using the one-sided lower 95% confidence limit of the Mantel-Haenszel risk difference, with a prespecified non-inferiority margin of 12%. The main safety endpoint was symptomatic intracranial haemorrhage assessed in all randomly assigned and consenting participants. This trial is registered with ClinicalTrials.gov, NCT03192332, and is closed to new participants. Findings Between Nov 29, 2017, and May 7, 2021, 5215 patients were screened and 423 were randomly assigned, of whom 408 (201 thrombectomy alone, 207 intravenous alteplase plus thrombectomy) were included in the primary efficacy analysis. A modified Rankin scale score of 0-2 at 90 days was reached by 114 (57%) of 201 patients assigned to thrombectomy alone and 135 (65%) of 207 patients assigned to intravenous alteplase plus thrombectomy (adjusted risk difference -7 .3%, 95% CI -16.6 to 2.1, lower limit of one-sided 95% CI -15.1%, crossing the non-inferiority margin of - 12%). Symptomatic intracranial haemorrhage occurred in five (2%) of 201 patients undergoing thrombectomy alone and seven (3%) of 202 patients receiving intravenous alteplase plus thrombectomy ( risk difference -1.0%, 95% CI -4.8 to 2 .7). Successful reperfusion was less common in patients assigned to thrombectomy alone (182 [ 91%] of 201 vs 199 [96%] of 207, risk difference -5.1%, 95% CI -10.2 to 0. 0, p=0.047). Interpretation Thrombectomy alone was not shown to be non-inferior to intravenous alteplase plus thrombectomy and resulted in decreased reperfusion rates. These results do not support omitting intravenous alteplase before thrombectomy in eligible patients. Copyright (C) 2022 Elsevier Ltd. All rights reserved.
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- 2022
16. Remote brain hemorrhage after IV thrombolysis
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Agathe Drelon, Didier Leys, Nelly Dequatre-Ponchelle, Charlotte Cordonnier, Solène Moulin, Jean-Pierre Pruvo, Régis Bordet, Grégory Kuchcinski, and François Caparros
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Prodromal Symptoms ,Neuroimaging ,Asymptomatic ,Brain Ischemia ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Modified Rankin Scale ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Prospective Studies ,cardiovascular diseases ,Prospective cohort study ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Age Factors ,Brain ,Magnetic resonance imaging ,Thrombolysis ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,nervous system diseases ,Blood pressure ,Cardiology ,Female ,France ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo test the hypothesis that remote intracerebral hemorrhages (r-ICHs) after IV thrombolysis occur in preexisting brain lesions.MethodWe prospectively collected baseline data from consecutive patients treated with IV thrombolysis for cerebral ischemia and reviewed their baseline MRI scans to identify preexisting lesions in those who developed r-ICH. We evaluated outcomes with the modified Rankin Scale (mRS) and defined good outcomes as scores of 0 to 2 or similar to the preexisting mRS score.ResultsOf 944 patients, 24 (2.5%) had r-ICH: lobar in 14, deep in 7, and both in 3. Sixteen of them (1.7% of all patients, 66.7% of those with r-ICH) were asymptomatic. Of the 41 r-ICHs found in these patients, 17 (41%) occurred within a lesion present before thrombolysis: 6 cerebral microbleeds (CMBs), 6 old and 1 recent infarct, and 4 areas of white matter hyperintensity. Patients with r-ICH were more likely to have strictly lobar CMBs (p = 0.049). They were 10 years older (p = 0.007), had a 16–mm Hg higher systolic blood pressure (p = 0.035) at baseline, and had more CMBs (p = 0.007). r-ICHs were better predicted by clinical (age, baseline systolic blood pressure) than imaging (purely lobar CMBs and having >5 CMBs) variables. r-ICHs tended to be associated with worse outcomes.ConclusionWe identified preexisting brain lesions in nearly half of the patients with r-ICH. All were of vascular origin, supporting the hypothesis that r-ICHs occur in preexisting brain lesions. Higher-field machines could help identifying preexisting lesions in those who developed r-ICH in an apparently normal area.
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- 2019
17. Early-onset delirium after spontaneous intracerebral hemorrhage
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Barbara Casolla, Charlotte Cordonnier, Didier Leys, Marina Diomedi, Marco Pasi, Hilde Hénon, Federico Marrama, Solène Moulin, Matthieu P. Rutgers, and Maeva Kyheng
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Male ,business.industry ,Delirium ,Settore MED/26 ,mortality ,Stroke ,Neurology ,Risk Factors ,Anesthesia ,medicine ,Humans ,Female ,Dementia ,Neurology (clinical) ,Spontaneous intracerebral hemorrhage ,Prospective Studies ,Intracerebral hemorrhage ,medicine.symptom ,business ,long-term outcomes ,Early onset ,Aged ,Cerebral Hemorrhage - Abstract
Objective This study aimed at identifying the incidence, predictors, and impact on long-term mortality and dementia of early-onset delirium in a cohort of patients with spontaneous intracerebral hemorrhage. Methods We prospectively recruited consecutive patients in the Prognosis of InTra-Cerebral Hemorrhage (PITCH) cohort and analyzed incidence rate of early-onset delirium (i.e. during the first seven days after intracerebral hemorrhage onset) with a competing risk model. We used a multivariable Fine-Gray model to identify baseline predictors, a Cox regression model to study its impact on the long-term mortality risk, and a Fine-Gray model adjusted for pre-specified confounders to analyze its impact on new-onset dementia. Results The study population consisted of 248 patients (mean age 70 years, 54% males). Early-onset delirium incidence rate was 29.8% (95% confidence interval (CI) 24.3–35.6). Multivariate analysis showed that pre-existing dementia (subhazard ratio (SHR) 2.08, 95%CI 1.32–3.32, p = 0.002), heavy alcohol intake (SHR 1.79, 95%CI 1.13–2.82, p = 0.013), and intracerebral hemorrhage lobar location (SHR 1.56, 95%CI 1.01–2.42, p = 0.049) independently predicted early-onset delirium. Median follow-up was 9.5 years. Early-onset delirium was associated with higher mortality rates during the first five years of follow-up (HR 1.52, 95%CI 1.00–2.31, p = 0.049), but did not predict new-onset dementia (SHR 1.31, 95%CI 0.60–2.87). Conclusion Early-onset delirium is a frequent complication after intracerebral hemorrhage; it is associated with markers of pre-existing brain vulnerability and with higher mortality risk, but not with higher dementia rates during long-term follow-up.
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- 2021
18. The big guy keeps the gate: The largest chloroplast-encoded protein, Orf2971, serves for translocation and quality control of chloroplast-imported proteins
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Solène Moulin
- Subjects
Quality Control ,Chloroplast Proteins ,Protein Transport ,Chloroplasts ,Proteins ,Cell Biology ,Plant Science ,Plant Proteins - Published
- 2022
19. Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol \textless70 mg/dL During 5 Years After Ischemic Stroke
- Author
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Pierre Amarenco, Jong S. Kim, Julien Labreuche, Hugo Charles, Maurice Giroud, Byung-Chul Lee, Marie-Hélène Mahagne, Norbert Nighoghossian, Philippe Gabriel Steg, Éric Vicaut, Eric Bruckert, Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Philippa Lavallée, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, Yun Jeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-Bègue Marsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Eric Alnajar-Carpentier, Michèle Levasseur, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, null Stantescu, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Fibrose Inflammation Remodelage [Hôpitaux Universitaires Paris Nord Val de Seine] (DHU FIRE ), Hôpitaux Universitaires Paris Nord Val de Seine, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul], University of Ulsan, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Hôpital Pasteur [Nice] (CHU), Hospices Civils de Lyon (HCL), Université de Lyon, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Royal Brompton Hospital, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Treat Stroke to Target Investigators: Pierre-Jean Touboul, Didier Leys, Yannick Béjot, Philippa Lavallée, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Pierre-Jean Touboul, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, Yun Jeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-Bègue Marsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani Emilie, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Eric Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Stantescu, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung, and UPJV, BU Santé
- Subjects
Male ,medicine.medical_specialty ,Statin ,Time Factors ,medicine.drug_class ,[SDV]Life Sciences [q-bio] ,Brain Ischemia ,LDL ,chemistry.chemical_compound ,Drug Delivery Systems ,Ezetimibe ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,angiography ,Myocardial infarction ,Stroke ,Aged ,Advanced and Specialized Nursing ,Cerebral infarction ,Cholesterol ,business.industry ,Anticholesteremic Agents ,informed consent ,cholesterol ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,stroke ,[SDV] Life Sciences [q-bio] ,aorta ,chemistry ,Number needed to treat ,Cardiology ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background and Purpose— The TST trial (Treat Stroke to Target) evaluated the benefit of targeting a LDL (low-density lipoprotein) cholesterol of 4 mm, in a French and Korean population. The follow-up lasted a median of 5.3 years in French patients (similar to the median follow-up time in the SPARCL trial [Stroke Prevention by Aggressive Reduction in Cholesterol Level]) and 2.0 years in Korean patients. Exposure duration to statin is a well-known driver for cardiovascular risk reduction. We report here the TST results in the French cohort. Methods— One thousand seventy-three French patients were assigned to Results— After a median follow-up of 5.3 years, the achieved LDL cholesterol was 66 (1.69 mmol/L) and 96 mg/dL (2.46 mmol/L) on average, respectively. The primary end point occurred in 9.6% and 12.9% of patients, respectively (HR, 0.74 [95% CI, 0.57–0.94]; P =0.019). Cerebral infarction or urgent carotid revascularization following transient ischemic attack was reduced by 27% ( P =0.046). Cerebral infarction or intracranial hemorrhage was reduced by 28% ( P =0.023). The primary outcome or intracranial hemorrhage was reduced by 25% ( P =0.021). Intracranial hemorrhages occurred in 13 and 11 patients, respectively (HR, 1.17 [95% CI, 0.53–2.62]; P =0.70). Conclusions— After an ischemic stroke of documented atherosclerotic origin, targeting a LDL cholesterol of Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.
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- 2020
20. Long-term neuropsychiatric symptoms in spontaneous intracerebral haemorrhage survivors
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Didier Leys, Solène Moulin, Charlotte Cordonnier, Gregoire Boulouis, Giuseppe Scopelliti, Hilde Hénon, Grégory Kuchcinski, Marco Pasi, and Barbara Casolla
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Male ,Pediatrics ,medicine.medical_specialty ,Apathy ,medicine ,Prevalence ,Dementia ,Cognitive status ,Humans ,In patient ,Cognitive Dysfunction ,Affective Symptoms ,Cognitive decline ,Stroke ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,Surgery ,Female ,Neurology (clinical) ,Cerebral amyloid angiopathy ,medicine.symptom ,business ,Neuropsychiatric Inventory Questionnaire - Abstract
ObjectiveNeuropsychiatric (NP) symptoms are prominent features of cognitive decline, but they have been understudied in patients with spontaneous intracerebral haemorrhage (ICH). In ICH survivors, we aimed at assessing NP symptoms prevalence and profiles, and their influence on long-term outcomes.MethodsWe analysed data from consecutive 6-month ICH survivors enrolled in the Prognosis of Intracerebral Haemorrhage study. We performed NP evaluation using the Neuropsychiatric Inventory Questionnaire. Patients underwent long-term clinical follow-up after ICH (median follow-up time 7.2 years, IQR 4.8–8.2).ResultsOut of 560 patients with ICH, 265 survived at 6 months. NP evaluation 6 months after ICH was feasible in 202 patients. NP symptoms were present in 112 patients (55%), and in 36 out of 48 patients (75%) with post-ICH dementia. Affective symptoms were present in 77 patients (38%), followed by vegetative symptoms (52 patients, 26%) and hyperactivity (47 patients, 23%). Apathy and hyperactivity were associated with post-ICH dementia and cerebral amyloid angiopathy MRI profile (all pConclusionNP symptoms were present in more than half of 6-month ICH survivors, with higher prevalence and severity in patients with post-ICH dementia. Distinctive NP profile might be associated to cognitive status and inform on long-term dementia risk.
- Published
- 2021
21. With a little help from my friends: mitochondria maintain redox balance for the endoplasmic reticulum
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Solène Moulin
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Cell Biology ,Plant Science - Published
- 2022
22. Access to mechanical thrombectomy for cerebral ischaemia: A population-based study in the North-of-France
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F. Mounier-Vehier, Caroline Moreau, Solène Moulin, Isabelle Girard-Buttaz, Charlotte Cordonnier, Didier Leys, Marc Ferrigno, Romain Tortuyaux, Maxime Chochoi, Nelly Dequatre-Ponchelle, J.-P. Pruvo, Hilde Hénon, Barbara Casolla, Patrick Goldstein, Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
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Male ,medicine.medical_specialty ,Mechanical Thrombolysis ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Population ,Health Services Accessibility ,Brain Ischemia ,Hospitals, Private ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Modified Rankin Scale ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,education ,Stroke ,Aged ,Thrombectomy ,Aged, 80 and over ,education.field_of_study ,Hospitals, Public ,business.industry ,Cerebral Infarction ,Thrombolysis ,Middle Aged ,medicine.disease ,Confidence interval ,3. Good health ,Mechanical thrombectomy ,Population based study ,Treatment Outcome ,Neurology ,Female ,Cerebral ischaemia ,France ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background and purpose Hospitals admitting acute strokes should offer access to mechanical thrombectomy (MT), but local organisations are still based on facilities available before MT was proven effective. MT rates and outcomes at population levels are needed to adapt organisations. We evaluated rates of MT and outcomes in inhabitants from the North-of-France (NoF) area. Method We prospectively evaluated rates of MT and outcomes of patients at 3 months, good outcomes being defined as a modified Rankin scale (mRS) 0 to 2 or like the pre-stroke mRS. Results During the study period (2016–2017), 666 patients underwent MT (454, 68.1% associated with intravenous thrombolysis [IVT]). Besides, 1595 other patients received IVT alone. The rate of MT was 81 (95% confidence interval [CI] 72–90) per million inhabitants-year, ranging from 36 to 108 between districts. The rate of IVT was 249 (95% CI 234–264) per million inhabitants-year, ranging from 155 to 268. After 3 months, 279 (41.9%) patients who underwent MT had good outcomes, and 167 (25.1%) had died. Patients living outside the district of Lille where the only MT centre is, were less likely to have good outcomes at 3 months, after adjustment on age, sex, baseline severity, and delay. Conclusion The rate of MT is one of the highest reported up to now, even in low-rate districts, but outcomes were significantly worse in patients living outside the district of Lille, and this is not only explained by the delay.
- Published
- 2019
23. Stroke mimics and chameleons
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Didier Leys and Solène Moulin
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0301 basic medicine ,medicine.medical_specialty ,Neuroimaging ,Brain Ischemia ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Humans ,Medicine ,cardiovascular diseases ,Stroke ,medicine.diagnostic_test ,business.industry ,Stroke mimics ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,030104 developmental biology ,Neurology ,Neurology (clinical) ,business ,Intracranial Hemorrhages ,030217 neurology & neurosurgery - Abstract
A stroke mimic is a situation in which a diagnosis of stroke at admission is not confirmed, and a stroke chameleon is a situation in which a stroke is revealed by clinical symptoms that are not usual in stroke. The objective of this review is to identify the most frequent clinical situations in which stroke mimics and chameleons are encountered and consequences for the patient.The safety profile of intravenous thrombolysis (IVT) in patients who have stroke mimics is excellent, and intracranial hemorrhages are rare. Modern neuroimaging techniques help identifying most mimics. For stroke chameleons the role of imaging may be less important, especially when the clinical presentation is not suggestive of a brain disorder that request immediate neuroimaging. Education of health providers to identify such situations is crucial.Stroke mimics account for up to 25% of admissions for probable strokes. The proportion of patients with stroke mimics decreases with use of MRI at baseline. Mimics cannot always be ruled out in emergency. The problem with mimics is that stroke facilities are not properly used, and patients may receive IVT. However, thrombolysis is usually well tolerated in mimics and we should not spend much time in all patients to improve diagnostic accuracy, knowing that the time lost is harmful in all patients, and will only prevent treating one mimic out of 100 patients. The problem with chameleons is more serious, because patients are not identified, and are not properly treated.
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- 2019
24. Stroke
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Didier Leys, Solène Moulin, and Valeria Caso
- Abstract
Many strokes are treatable in the acute stage, provided patients are admitted soon enough. There is evidence that stroke unit care improves outcomes, and that the benefit does not depend on age, severity, and stroke subtype. In ischaemic strokes, specific therapies include intravenous recombinant tissue plasminogen activator, given as soon as possible and mechanical thrombectomy in case of proximal arterial occlusion, on top of thrombolysis in the absence of contraindication or alone otherwise, aspirin 300 mg, immediately or after 24 hours in case of thrombolysis, and, in a few patients, decompressive surgery. The time window for thrombolysis or thrombectomy can be extended beyond the usual 4.5h and 6h in a few patients who are likely to have significant penumbra. In intracerebral haemorrhages, blood pressure lowering and haemostatic therapy, when needed, are the two targets, while surgery does not seem effective to reduce death and disability.
- Published
- 2021
25. Troubles du sommeil, mouvements anormaux, cognition, verticalité : anti-IgLON5 ?
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Clément Prévost, Anne Doé de Maindreville, Maximilien Moulin, Thierry Dubard, Claire Launois, Jérôme Honnorat, and Solène Moulin
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Neurology ,Neurology (clinical) - Published
- 2022
26. [News in the management of spontaneous cerebral hemorrhages (non-traumatic, non-malformative)]
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Solène, Moulin and François, Proust
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Humans ,Cerebral Hemorrhage - Published
- 2020
27. Long-term mortality in survivors of spontaneous intracerebral hemorrhage
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Maeva Kyheng, Barbara Casolla, Didier Leys, Gregoire Boulouis, Marco Pasi, Charlotte Cordonnier, Julien Labreuche, Solène Moulin, Hilde Hénon, and Grégory Kuchcinski
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Cerebral atrophy ,Intracerebral hemorrhage ,Male ,medicine.medical_specialty ,business.industry ,medicine.disease ,Stroke ,Neurology ,Risk Factors ,Internal medicine ,Cardiology ,Medicine ,Humans ,Long term mortality ,Spontaneous intracerebral hemorrhage ,Prospective Studies ,Survivors ,business ,Cerebral Hemorrhage - Abstract
Background Factors associated with long-term mortality after spontaneous intracerebral hemorrhage (ICH) have been poorly investigated. Aim Our objective was to identify variables associated with long-term mortality in a prospective cohort of 30-day ICH survivors. Methods We prospectively included consecutive 30-day spontaneous ICH survivors. We evaluated baseline and follow-up clinical characteristics and magnetic resonance imaging (MRI) markers of chronic brain injury as variables associated with long-term mortality using univariate and multivariable Cox proportional hazard regression models. Results Of 560 patients with spontaneous ICH, 304 (54.2%) survived more than 30 days and consented for follow-up. During a median follow-up of 10 years (interquartile range: 8.0–10.5), 176 patients died. The cumulative survival rate at 10 years was 38%. In multivariable analysis, variables independently associated with long-term mortality were age (hazard ratio (HR) per 10-year increase: 1.68, 95% confidence interval (CI): 1.45–1.95), male gender (HR: 1.41, CI: 1.02–1.95), prestroke dependency (HR: 1.66, CI: 1.15–2.39), National Institutes of Health Stroke Scale score (HR per 1-point increase: 1.03, CI: 1.01–1.04), occurrence of any stroke (HR: 2.24, CI: 1.39–3.60), and dementia (HR: 1.51, CI: 1.06–2.16) during follow-up. Among MRI markers, only cerebral atrophy (HR per 1-point increase: 1.50, CI: 1.13–2.00) was independently associated with long-term mortality. Conclusions Preexisting comorbidities, clinical severity at presentation, and significant clinical event during follow-up are associated with long-term mortality. Among MRI markers of chronic brain injury, only cerebral atrophy is associated with long-term mortality.
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- 2020
28. Long-term functional decline of spontaneous intracerebral haemorrhage survivors
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Marco Pasi, Charlotte Cordonnier, Maeva Kyheng, Solène Moulin, Grégory Kuchcinski, Didier Leys, Julien Labreuche, Gregoire Boulouis, Hilde Hénon, and Barbara Casolla
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Dementia ,Humans ,In patient ,Prospective Studies ,Functional decline ,Stroke ,Aged ,Cerebral Hemorrhage ,Clinical events ,business.industry ,Age Factors ,Recovery of Function ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Psychiatry and Mental health ,Baseline characteristics ,Surgery ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
ObjectiveTo identify in patients who survived 6 months after a spontaneous intracerebral haemorrhage (ICH) baseline characteristics and new clinical events associated with functional decline.MethodsIn a single-centre study, we prospectively included 6-month survivors with a modified Rankin Scale (mRS) score 0–3. We defined functional decline by a transition to mRS 4–5. We evaluated associations of baseline characteristics and new clinical events with functional decline, using univariate and multivariable models.ResultsOf 560 patients, 174 (31%) had an mRS score 0–3 at 6 months. During a median follow-up of 9 years (IQR 8.1–9.5), 40 (23%) converted to mRS 4–5. Age, diabetes mellitus, ICH volume and higher mRS scores at 6 months were independently associated with functional decline. Among baseline MRI markers, presence of strictly lobar cerebral microbleeds (CMBs), and mixed lobar and deep CMBs were independently associated with functional decline. When new clinical events occurring during follow-up were added in multivariable models, age (cause-specific HR (CSHR): 1.07; 95% CI: 1.03 to 1.11), ICH volume (CSHR: 1.03; 95% CI: 1.01 to 1.06), mRS score at 6 months (CSHR per 1 point increase 1.61, 95% CI 1.07 to 2.43), occurrence of dementia (CSHR: 3.81, 95% CI: 1.78 to 8.16) and occurrence of any stroke (CSHR: 4.29, 95% CI: 1.80 to 10.22) remained independently associated with transition to mRS 4–5.InterpretationAlmost one-fourth of patients with spontaneous ICH developed a functional decline over time. Age, ICH volume, higher mRS score at 6 months and new clinical events after ICH are the major determinants.
- Published
- 2020
29. MRI for in vivo diagnosis of cerebral amyloid angiopathy: Tailoring artifacts to image hemorrhagic biomarkers
- Author
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Olivier Naggara, Catherine Oppenheim, Charlotte Cordonnier, Gregoire Boulouis, Solène Moulin, W. Ben Hassen, and M Edjlali-Goujon
- Subjects
Pathology ,medicine.medical_specialty ,Context (language use) ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,In vivo ,mental disorders ,medicine ,Humans ,cardiovascular diseases ,Cerebral Hemorrhage ,medicine.diagnostic_test ,business.industry ,nutritional and metabolic diseases ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,Superficial siderosis ,Clinical Practice ,Cerebral Amyloid Angiopathy ,Neurology ,Research studies ,Neurology (clinical) ,Cerebral amyloid angiopathy ,Small vessel ,Artifacts ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Cerebral amyloid angiopathy (CAA) is a frequent age-related small vessel disease (SVD) with cardinal magnetic resonance imaging (MRI) signatures that are hemorrhagic in nature, and include the presence of strictly lobar (superficial) cerebral microbleeds and intracerebral hemorrhages as well as cortical superficial siderosis. When investigating a patient with suspected CAA in the context of intracranial hemorrhage (parenchymal or subarachnoid) or cognitive dysfunction, various MRI parameters influence the optimal detection and characterization (and prognostication) of this frequent SVD. The present report describes the influence of imaging techniques on the detection of the key hemorrhagic CAA imaging signatures in clinical practice, in research studies, and the imaging parameters that must be understood when encountering a CAA patient, as well as reviewing CAA literature.
- Published
- 2017
30. Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Stroke Thrombolysis
- Author
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Wataru Kakuda, Kazumi Kimura, H. Rolf Jäger, Jeffrey L. Saver, Gregory W. Albers, Vincent Thijs, Chelsea S. Kidwell, Christian H. Nolte, Marwan El-Koussy, Duncan Wilson, Wakoh Takahashi, David J. Werring, Guillaume Turc, Jean-Claude Baron, Ashkan Shoamanesh, Hebun Erdur, Andreas Charidimou, Simon Jung, Gareth Ambler, Shunya Takizawa, Jan F. Scheitz, Zoe Fox, Min Lou, Heinrich Mattle, Oscar R. Benavente, Solène Moulin, Junya Aoki, Myriam Edjlali-Goujon, Charlotte Cordonnier, Yusuke Moriya, Asma Sallem, Catherine Oppenheim, Shenqiang Yan, and Pascal P. Klinger-Gratz
- Subjects
Advanced and Specialized Nursing ,Intracerebral hemorrhage ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Retrospective cohort study ,Thrombolysis ,Odds ratio ,030204 cardiovascular system & hematology ,medicine.disease ,Tissue plasminogen activator ,Confidence interval ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Cardiology ,Neurology (clinical) ,Cerebral amyloid angiopathy ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background and Purpose— We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. Methods— We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator. Using multilevel mixed-effects logistic regression, we investigated associations of pre-treatment CMB presence, burden (1, 2–4, ≥5, and >10), and presumed pathogenesis (cerebral amyloid angiopathy defined as strictly lobar CMBs and noncerebral amyloid angiopathy) with symptomatic ICH, parenchymal hematoma (within [parenchymal hemorrhage, PH] and remote from the ischemic area [remote parenchymal hemorrhage, PHr]), and poor 3- to 6-month functional outcome (modified Rankin score >2). Results— In 1973 patients from 8 centers, the crude prevalence of CMBs was 526 of 1973 (26.7%). A total of 77 of 1973 (3.9%) patients experienced symptomatic ICH, 210 of 1806 (11.6%) experienced PH, and 56 of 1720 (3.3%) experienced PHr. In adjusted analyses, patients with CMBs (compared with those without CMBs) had increased risk of PH (odds ratio: 1.50; 95% confidence interval: 1.09–2.07; P =0.013) and PHr (odds ratio: 3.04; 95% confidence interval: 1.73–5.35; P P =0.014), PH ( P =0.013), and PHr ( P 10 CMBs independently predicted poor 3- to 6-month outcome (odds ratio: 1.85; 95% confidence interval: 1.10–3.12; P =0.020; and odds ratio: 3.99; 95% confidence interval: 1.55–10.22; P =0.004, respectively). Conclusions— Increasing CMB burden is associated with increased risk of ICH (including PHr) and poor 3- to 6-month functional outcome after intravenous thrombolysis for acute ischemic stroke.
- Published
- 2017
31. Brain hemorrhage recurrence, small vessel disease type, and cerebral microbleeds
- Author
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Barbara Casolla, Alexandro Biffi, Jong Seung Kim, André Peeters, Steven M. Greenberg, David J. Werring, Patrice Laloux, Toshio Imaizumi, Charlotte Cordonnier, Hans Rolf Jäger, Dong-Wha Kang, Solène Moulin, Andreas Charidimou, Eric E. Smith, Anand Viswanathan, Jean-Claude Baron, Neshika Samarasekera, Hiromitsu Naka, Mar Hernández-Guillamon, Simone M. Gregoire, Yusuke Yakushiji, Joan Montaner, Yves Vandermeeren, Rustam Al-Shahi Salman, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - SSS/IONS - Institute of NeuroScience, UCL - (MGD) Service de neurologie, and UCL - (SLuc) Service de neurologie
- Subjects
Risk ,medicine.medical_specialty ,Disease ,030204 cardiovascular system & hematology ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,Odds ratio ,medicine.disease ,Magnetic Resonance Imaging ,Confidence interval ,nervous system diseases ,3. Good health ,Meta-analysis ,Etiology ,Neurology (clinical) ,Cerebral amyloid angiopathy ,business ,030217 neurology & neurosurgery - Abstract
Objective:We evaluated recurrent intracerebral hemorrhage (ICH) risk in ICH survivors, stratified by the presence, distribution, and number of cerebral microbleeds (CMBs) on MRI (i.e., the presumed causal underlying small vessel disease and its severity).Methods:This was a meta-analysis of prospective cohorts following ICH, with blood-sensitive brain MRI soon after ICH. We estimated annualized recurrent symptomatic ICH rates for each study and compared pooled odds ratios (ORs) of recurrent ICH by CMB presence/absence and presumed etiology based on CMB distribution (strictly lobar CMBs related to probable or possible cerebral amyloid angiopathy [CAA] vs non-CAA) and burden (1, 2–4, 5–10, and >10 CMBs), using random effects models.Results:We pooled data from 10 studies including 1,306 patients: 325 with CAA-related and 981 CAA-unrelated ICH. The annual recurrent ICH risk was higher in CAA-related ICH vs CAA-unrelated ICH (7.4%, 95% confidence interval [CI] 3.2–12.6 vs 1.1%, 95% CI 0.5–1.7 per year, respectively; p = 0.01). In CAA-related ICH, multiple baseline CMBs (versus none) were associated with ICH recurrence during follow-up (range 1–3 years): OR 3.1 (95% CI 1.4–6.8; p = 0.006), 4.3 (95% CI 1.8–10.3; p = 0.001), and 3.4 (95% CI 1.4–8.3; p = 0.007) for 2–4, 5–10, and >10 CMBs, respectively. In CAA-unrelated ICH, only >10 CMBs (versus none) were associated with recurrent ICH (OR 5.6, 95% CI 2.1–15; p = 0.001). The presence of 1 CMB (versus none) was not associated with recurrent ICH in CAA-related or CAA-unrelated cohorts.Conclusions:CMB burden and distribution on MRI identify subgroups of ICH survivors with higher ICH recurrence risk, which may help to predict ICH prognosis with relevance for clinical practice and treatment trials.
- Published
- 2017
32. In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy
- Author
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Anais Hochart, Didier Leys, Hilde Hénon, Marie Bodenant, A. Decourcelle, Nelly Dequatre, Marc Ferrigno, Charlotte Cordonnier, Solène Moulin, and François Caparros
- Subjects
Male ,medicine.medical_specialty ,Vitamin K ,Mechanical Thrombolysis ,medicine.drug_class ,medicine.medical_treatment ,Brain Ischemia ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Modified Rankin Scale ,Humans ,Medicine ,Thrombolytic Therapy ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Stroke ,Aged ,Aged, 80 and over ,business.industry ,Odds ratio ,Thrombolysis ,Middle Aged ,Vitamin K antagonist ,medicine.disease ,Confidence interval ,Surgery ,Hospitalization ,Treatment Outcome ,Neurology ,Anesthesia ,Administration, Intravenous ,Female ,Neurology (clinical) ,business ,Intracranial Hemorrhages ,030217 neurology & neurosurgery ,Fibrinolytic agent ,Follow-Up Studies - Abstract
Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition). Of 1209 patients, 64 (5.3%) had IHS, with an increasing proportion over time (p = 0.001). Their median onset-to-needle time was 128 min vs. 145 in COS (p
- Published
- 2017
33. Are the results of intravenous thrombolysis trials reproduced in clinical practice? Comparison of observed and expected outcomes with the stroke-thrombolytic predictive instrument (STPI)
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Eric Wiel, Hilde Hénon, Didier Leys, Charlotte Cordonnier, Marie Girot, Patrick Goldstein, Marie Bodenant, Solène Moulin, Nelly Dequatre-Ponchelle, J. P. Pruvo, Régis Bordet, A. Decourcelle, and Costanza Rossi
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Brain Ischemia ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Randomized controlled trial ,Modified Rankin Scale ,law ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Practice Patterns, Physicians' ,Stroke ,Aged ,Cerebral Hemorrhage ,Randomized Controlled Trials as Topic ,Retrospective Studies ,Intracerebral hemorrhage ,Stroke scale ,business.industry ,Cerebral Infarction ,Thrombolysis ,Middle Aged ,Prognosis ,medicine.disease ,University hospital ,Surgery ,Clinical Practice ,Treatment Outcome ,Neurology ,Administration, Intravenous ,Female ,Neurology (clinical) ,Intracranial Thrombosis ,business ,030217 neurology & neurosurgery - Abstract
Aim In patients with cerebral ischemia, intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) increases survival without handicap or dependency despite an increased risk of bleeding. This study evaluated whether the results of randomized controlled trials are reproduced in clinical practice. Method Data from a registry of consecutive patients treated by rt-PA at Lille University Hospital were retrospectively analyzed for outcomes, using modified Rankin Scale (mRS) scores, at 3 months. The observed outcomes were then compared with the probability of good (mRS 0–1) and of catastrophic (mRS 5–6) outcomes, as predicted by the stroke-thrombolytic predictive instrument (STPI). Results Of the 1000 consecutive patients (469 male, median age 74 years, median baseline National Institutes of Health Stroke Scale 11, median onset-to-needle time 143 min), 438 (43.8%) had a good outcome, 565 (56.5%) had an mRS score 0–2 or similar to their pre-stroke mRS, 155 (15.5%) died within 3 months and 74 (7.4%) developed symptomatic intracerebral hemorrhage according to ECASS-II (Second European–Australasian Acute Stroke Study) criteria. Of the 613 patients (61.3%) eligible for evaluation by the s-TPI, the observed rate of good outcomes was 41.3% (95% CI: 37.5–45.3%), while expected rates with and without rt-PA were 48.8% (95% CI: 44.8–52.7%) and 32.5% (95% CI: 28.8–36.2%), respectively; the observed rate of catastrophic outcomes was 17.0% (95% CI: 14.0–19.9%), while the expected rate was 19.2% (95% CI: 16.1–22.4%) with or without rt-PA. Conclusion In clinical practice, the rate of good outcomes is slightly lower than expected, according to the s-TPI, except for the most severe cases, whereas the rate of catastrophic outcomes is roughly similar. However, the rate of good outcomes is higher than predicted without treatment. This finding suggests that rt-PA is effective for improving outcomes in clinical practice.
- Published
- 2017
34. Stroke occurring in patients with cognitive impairment or dementia
- Author
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Didier Leys and Solène Moulin
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medicine.medical_specialty ,infarto cerebral ,030204 cardiovascular system & hematology ,lcsh:RC321-571 ,03 medical and health sciences ,mild cognitive impairment ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Dementia ,In patient ,Cognitive impairment ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Stroke ,Gynecology ,cerebral hemorrhage ,comprometimento cognitivo leve ,business.industry ,hemorragia cerebral ,demência ,acidente vascular cerebral ,Prognosis ,cerebral infarction ,medicine.disease ,stroke ,Neurology ,Neurology (clinical) ,Cognition Disorders ,business ,030217 neurology & neurosurgery ,dementia - Abstract
One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others. RESUMO Um em cada seis pacientes internados em decorrência de acidente vascular cerebral (AVC) apresenta diagnóstico prévio de demência. Estes indivíduos têm menor acesso à assistência recomendada para pacientes com AVC, mas pouco ainda se sabe em relação aos cuidados médicos ideais que devem receber. Objetivo Determinar como o comprometimento cognitivo prévio ao AVC pode ser detectado, qual o mecanismo etiológico subjacente, e as consequências para o prognóstico e para o acompanhamento clínico. Método Pesquisa bibliográfica. Resultados (i) O rastreamento sistemático com o Informant Questionnaire of Cognitive Decline in the Elderly é recomendado; (ii) O comprometimento cognitivo preexistente pode ser devido a lesões cerebrais de origem vascular, degenerativa ou mista; (iii) Pacientes com demência prévia ao AVC têm pior prognóstico, maior frequência de crises epilépticas, de delirium e depressão, além de taxas de mortalidade mais altas; eles frequentemente são institucionalizados após o AVC; (iv) Embora a tolerabilidade às medicações não seja tão boa quanto a de pacientes com AVC sem comprometimento cognitivo, a relação risco/benefício é a favor de tratamento similar àquele oferecido aos demais pacientes. Conclusão Pacientes com comprometimento cognitivo que apresentam AVC têm pior prognóstico, porém eles devem ser tratados de modo semelhante aos demais casos.
- Published
- 2017
35. Role of Cerebral Microbleeds for Intracerebral Haemorrhage and Dementia
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Charlotte Cordonnier and Solène Moulin
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0301 basic medicine ,Male ,medicine.medical_specialty ,Neurology ,Neuroimaging biomarkers ,Disease ,law.invention ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Ischaemic stroke ,medicine ,Dementia ,Humans ,Clinical significance ,Prospective Studies ,Intensive care medicine ,Stroke ,Aged ,Cerebral Hemorrhage ,business.industry ,General Neuroscience ,medicine.disease ,Magnetic Resonance Imaging ,030104 developmental biology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Cerebral microbleeds (CMB)—small round or ovoid lesions detected in hyposignal on blood-sensitive MRI sequences—are promising radiological biomarkers of cerebral small vessel disease. Their relations with ischaemic or haemorragic stroke and their potential contribution to dementia have been extensively addressed. This article reviews recent research on the clinical significance of CMB that remains to be determined. The presence, burden and location of CMB allow to obtain a more accurate estimate of intracerebral haemorrhage and ischaemic stroke risk. Most studies evaluating the association between CMB and dementia are hampered by methodological limitations and show conflicting results. CMB mainly reflect the severity of the underlying small vessel disease and should not be interpreted independently of the others neuroimaging biomarkers or the clinical setting. Future large prospective longitudinal studies and randomized controlled trials in various settings are required to determine whether specific therapies are beneficial in case of incidental findings.
- Published
- 2019
36. Five-year risk of major ischemic and hemorrhagic events after intracerebral hemorrhage
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Didier Leys, Barbara Casolla, Maeva Kyheng, Solène Moulin, Hilde Hénon, Christophe Bauters, Charlotte Cordonnier, Julien Labreuche, Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Université de Lille, LillOA
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,[SDV]Life Sciences [q-bio] ,Subgroup analysis ,030204 cardiovascular system & hematology ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,cohort studies ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,Prospective Studies ,Hemorrhagic risk ,cardiovascular diseases ,vascular events ,Antihypertensive Agents ,Aged ,Aged, 80 and over ,Advanced and Specialized Nursing ,Intracerebral hemorrhage ,Secondary prevention ,cerebral hemorrhage ,business.industry ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,nervous system diseases ,[SDV] Life Sciences [q-bio] ,Cohort ,Female ,Neurology (clinical) ,prognosis ,France ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Cohort study - Abstract
Background and Purpose— We aimed to determine incidences and predictors of major vascular events in intracerebral hemorrhage (ICH) survivors. Methods— We did a prospective observational cohort study in patients with spontaneous ICH from the Prognosis of Intracerebral Hemorrhage cohort in Lille, France. We studied incidences and predictors of long-term vascular events (cerebral and extracerebral, ischemic and hemorrhagic) in patients alive at 30 days with a prespecified subgroup analysis according to ICH location. We performed multivariable analyses (competing risk analyses, with death during follow-up as a competing event). Results— From the 560 patients with spontaneous ICH enrolled between November 2004 and March 2009, we included 310 patients (median age, 70 years). Eighty-two patients presented at least 1 major vascular event leading to an incidence rate of 20.0% (95% CI, 15.7–24.7) at 5 years after ICH. In the overall cohort, ischemic events were more frequent than hemorrhagic events. However, the incidence strikingly differed according to ICH location: deep ICH was associated with future ischemic events (subhazard ratio, 1.85; 95% CI, 1.01–3.40), whereas lobar ICH with hemorrhagic events (subhazard ratio, 2.38; 95% CI, 1.17–4.86). In deep ICH, the incidence of ischemic events at 5 years was 6× higher than the incidence of hemorrhagic events. Conclusions— ICH survivors are at high risk of both cerebral and extracerebral vascular events. The ischemic or hemorrhagic risk profile varies according to the index ICH location with a stronger ischemic risk in deep ICH. Secondary prevention, tailored on ICH location, should target not only cerebral recurrences but also extracerebral vascular events.
- Published
- 2019
37. [The high incidence of post-stroke cognitive decline]
- Author
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Solène, Moulin and Didier, Leys
- Subjects
Stroke ,Incidence ,Humans ,Cognitive Dysfunction - Published
- 2018
38. Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study
- Author
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Didier Leys, Alain Duhamel, Solène Moulin, Gregoire Boulouis, Stéphanie Bombois, Hilde Hénon, Charlotte Cordonnier, Julien Labreuche, and Costanza Rossi
- Subjects
medicine.medical_specialty ,Pediatrics ,business.industry ,Incidence (epidemiology) ,030204 cardiovascular system & hematology ,medicine.disease ,Superficial siderosis ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Cohort ,medicine ,Dementia ,Neurology (clinical) ,Cerebral amyloid angiopathy ,Prospective cohort study ,business ,Stroke ,030217 neurology & neurosurgery ,Cohort study - Abstract
Summary Background Dementia occurs in at least 10% of patients within 1 year after stroke. However, the risk of dementia after spontaneous intracerebral haemorrhage that accounts for about 15% of all strokes has not been investigated in prospective studies. We aimed to determine the incidence of dementia and risk factors after an intracerebral haemorrhage. Methods We did a prospective observational cohort study in patients with spontaneous intracerebral haemorrhage from the Prognosis of Intracerebral Haemorrhage (PITCH) cohort who were admitted to Lille University Hospital, Lille, France. We included patients aged 18 years and older with parenchymal haemorrhage on the first CT scan. Exclusion criteria were pure intraventricular haemorrhage; intracerebral haemorrhage resulting from intracranial vascular malformation, intracranial venous thrombosis, head trauma, or tumour; haemorrhagic transformation within an infarct; and referral from other hospitals. Median follow-up was 6 years. We studied risk factors (clinical and neuroradiological [MRI] biomarkers) of new-onset dementia as per a prespecified subgroup analysis, according to intracerebral haemorrhage location. Dementia diagnosis was based on the National Institute on Aging-Alzheimer's Association criteria for all-cause dementia. We did multivariable analyses using competing risk analyses, with death during follow-up as a competing event. Findings From the 560 patients with spontaneous intracerebral haemorrhage enrolled in the PITCH cohort between Nov 3, 2004 and March 29, 2009, we included 218 patients (median age 67·5 years) without pre-existing dementia who were alive at 6 months follow-up. 63 patients developed new-onset dementia leading to an incidence rate of 14·2% (95% CI 10·0–19·3) at 1 year after intracerebral haemorrhage, and incidence reached 28·3% (22·4–34·5) at 4 years. The incidence of new-onset dementia was more than two times higher in patients with lobar intracerebral haemorrhage (incidence at 1 year 23·4%, 14·6–33·3) than for patients with non-lobar intracerebral haemorrhage (incidence at 1 year 9·2%, 5·1–14·7). Disseminated superficial siderosis (subhazard ratio [SHR] 7·45, 95% CI 4·27–12·99), cortical atrophy score (SHR per 1-point increase 2·61, 1·70–4·01), a higher number of cerebral microbleeds (SHR for >5 cerebral microbleeds 2·33, 1·38–3·94), and older age (SHR per 10-year increase 1·34, 1·00–1·79) were risk factors of new-onset dementia. Interpretation There is a substantial risk of incident dementia in dementia-free survivors of spontaneous intracerebral haemorrhage; our results suggest that underlying cerebral amyloid angiopathy is a contributing factor to the occurrence of new-onset dementia. Future clinical trials including patients with intracerebral haemorrhage should assess cognitive endpoints. Funding French Ministry of Education, Research, and Technology, Adrinord, Inserm U1171.
- Published
- 2016
39. Orolingual Angioedema During or After Thrombolysis for Cerebral Ischemia
- Author
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Didier Leys, Patrick Girardie, Régis Bordet, François Caparros, Charlotte Cordonnier, Solène Moulin, Fjorda Myslimi, Sophie Gautier, and Nelly Dequatre-Ponchelle
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Angiotensin-Converting Enzyme Inhibitors ,030204 cardiovascular system & hematology ,Brain Ischemia ,Tongue Diseases ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Modified Rankin Scale ,medicine ,Humans ,Thrombolytic Therapy ,Prospective Studies ,Angioedema ,Propensity Score ,Prospective cohort study ,Aged ,Aged, 80 and over ,Cerebral Cortex ,Advanced and Specialized Nursing ,business.industry ,Cerebral infarction ,Lip Diseases ,Cerebral Infarction ,Thrombolysis ,Middle Aged ,medicine.disease ,Recombinant Proteins ,Surgery ,Airway Obstruction ,Tissue Plasminogen Activator ,Anesthesia ,Female ,Neurology (clinical) ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Complication ,030217 neurology & neurosurgery ,Fibrinolytic agent - Abstract
Background and Purpose— Orolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE. Methods— We prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE. Results— Of 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6–9.7; P =0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5–16.5; P =0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6–11.9; P =0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3–8.1; P =0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3–2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1–1.8), and death (adjOR, 1.1; 95% CI, 0.3–3.8). Conclusions— OLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.
- Published
- 2016
40. Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke
- Author
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Christian H. Nolte, Thomas P. Zonneveld, Yannick Béjot, Christian Hametner, Stefan T. Engelter, Didier Leys, Andrea Zini, Laura Vandelli, Jukka Putaala, Olivier Bill, Leo H. Bonati, Yvo B. Roos, Patrik Michel, Georg Kägi, Henrik Gensicke, Alessandro Pezzini, Nils Peters, Peter Arthur Ringleb, Turgut Tatlisumak, Jan F. Scheitz, Daniel Strbian, Peter M. Koch, Christopher Traenka, David J. Seiffge, Paul J. Nederkoorn, Charlotte Cordonnier, Sami Curtze, Visnja Padjen, Hebun Erdur, Sanne M. Zinkstok, Gerli Sibolt, Solène Moulin, Philippe A. Lyrer, Sydney Corbiere, Département de neurologie - Department of neurology [Hôpital de Bâle], Hôpital Universitaire de Bâle, Hirnschlagzentrum - Stroke center [Hôpital de Bâle], Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry, UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Felix Splatter Hospital [Bâle], Stroke-[Hirnschlag]-Fund Basel, Swiss National Foundation (Grant number : 33CM30-124119 et 33CM30-140340/1 ), University of Basel, Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Neurology, ANS - Neurovascular Disorders, Graduate School, and ACS - Amsterdam Cardiovascular Sciences
- Subjects
Male ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,law.invention ,Cohort Studies ,0302 clinical medicine ,Randomized controlled trial ,law ,Modified Rankin Scale ,Activities of Daily Living ,80 and over ,Thrombolytic Therapy ,Registries ,Stroke ,risk ,Aged, 80 and over ,preexisting disability ,Medicine (all) ,survivors ,Thrombolysis ,Middle Aged ,3. Good health ,Treatment Outcome ,Infusions, intravenous ,Intracranial hemorrhages ,Outcome assessment (health care) ,Survivors ,Administration, Intravenous ,Aged ,Female ,Humans ,Logistic Models ,Independent Living ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Advanced and Specialized Nursing ,controlled-trial ,Administration ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,acute ischemic-stroke ,hemorrhage ,Cohort study ,medicine.medical_specialty ,intracranial hemorrhages ,statins ,scale ,03 medical and health sciences ,Internal medicine ,medicine ,Dementia ,outcome assessment (health care) ,reliability ,business.industry ,Odds ratio ,medicine.disease ,Confidence interval ,infusions ,Surgery ,[ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,intravenous ,iv thrombolysis ,business ,030217 neurology & neurosurgery - Abstract
Background and Purpose— We compared outcome and complications in patients with stroke treated with intravenous thrombolysis (IVT) who could not live alone without help of another person before stroke (dependent patients) versus independent ones. Methods— In a multicenter IVT-register–based cohort study, we compared previously dependent (prestroke modified Rankin Scale score, 3–5) versus independent (prestroke modified Rankin Scale score, 0–2) patients. Outcome measures were poor 3-month outcome (not reaching at least prestroke modified Rankin Scale [dependent patients]; modified Rankin Scale score of 3–6 [independent patients]), death, and symptomatic intracranial hemorrhage. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (OR [95% confidence interval]) were calculated. Results— Among 7430 IVT-treated patients, 489 (6.6%) were dependent and 6941 (93.4%) were independent. Previous stroke, dementia, heart, and bone diseases were the most common causes of preexisting dependency. Dependent patients were more likely to die (OR unadjusted , 4.55 [3.74–5.53]; OR adjusted , 2.19 [1.70–2.84]). Symptomatic intracranial hemorrhage occurred equally frequent (4.8% versus 4.5%). Poor outcome was more frequent in dependent (60.5%) than in independent (39.6%) patients, but the adjusted ORs were similar (OR adjusted , 0.95 [0.75–1.21]). Among survivors, the proportion of patients with poor outcome did not differ (35.7% versus 31.3%). After adjustment for age and stroke severity, the odds of poor outcome were lower in dependent patients (OR adjusted , 0.64 [0.49–0.84]). Conclusions— IVT-treated stroke patients who were dependent on the daily help of others before stroke carry a higher mortality risk than previously independent patients. The risk of symptomatic intracranial hemorrhage and the likelihood of poor outcome were not independently influenced by previous dependency. Among survivors, poor outcome was avoided at least as effectively in previously dependent patients. Thus, withholding IVT in previously dependent patients might not be justified.
- Published
- 2016
41. Outcomes of Nonagenarians with Acute Ischemic Stroke Treated with Intravenous Thrombolytics
- Author
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Réza Behrouz, Solène Moulin, Mickael Zedet, Charlotte Cordonnier, Maaike Dirks, Lizz Paley, Jaime Masjuan-Vallejo, Daniel Agustin Godoy, Joshua Z. Willey, Rocio Vera, Karin Kanselaar, Christine Roffe, Mahmoud Reza Azarpazhooh, Muhib Khan, Catharina J.M. Klijn, Benjamin Bray, Mario Di Napoli, Brian Silver, and Craig J. Smith
- Subjects
Male ,Time Factors ,medicine.medical_treatment ,Logistic regression ,Brain Ischemia ,Disability Evaluation ,0302 clinical medicine ,Elderly ,Risk Factors ,Odds Ratio ,Acute stroke ,Thrombolytic Therapy ,030212 general & internal medicine ,Hospital Mortality ,Registries ,Acute stroke treatment ,Nonagenarian ,Infusions, Intravenous ,Acute ischemic stroke ,Aged, 80 and over ,Mortality rate ,Rehabilitation ,Age Factors ,Thrombolysis ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Europe ,Stroke ,Treatment Outcome ,Tissue Plasminogen Activator ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Clinical Decision-Making ,Argentina ,Clinical Neurology ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Fibrinolytic Agents ,Internal medicine ,medicine ,Humans ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Chi-Square Distribution ,business.industry ,Patient Selection ,Odds ratio ,medicine.disease ,Confidence interval ,Surgery ,Logistic Models ,Multivariate Analysis ,North America ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Nonagenarians are under-represented in thrombolytic trials for acute ischemic stroke (AIS). The effectiveness of intravenous thrombolytics in nonagenarians in terms of safety and outcome is not well established. Materials and Methods We used a multinational registry to identify patients aged 90 years or older with good baseline functional status who presented with AIS. Differences in outcomes—disability level at 90 days, frequency of symptomatic intracerebral hemorrhage (sICH), and mortality—between patients who did and did not receive thrombolytics were assessed using multivariable logistic regression, adjusted for prespecified prognostic factors. Coarsened exact matching (CEM) was utilized before evaluating outcome by balancing both groups in the sensitivity analysis. Results We identified 227 previously independent nonagenarians with AIS; 122 received intravenous thrombolytics and 105 did not. In the unmatched cohort, ordinal analysis showed a significant treatment effect (adjusted common odds ratio [OR]: .61, 95% confidence interval [CI]: .39-.96). There was an absolute difference of 8.1% in the rate of excellent outcome in favor of thrombolysis (17.4% versus 9.3%; adjusted ratio: .30, 95% CI: .12-.77). Rates of sICH and in-hospital mortality were not different. Similarly, in the matched cohort, CEM analysis showed a shift in the primary outcome distribution in favor of thrombolysis (adjusted common OR: .45, 95% CI: .26-.76). Conclusions Nonagenarians treated with thrombolytics showed lower stroke-related disability at 90 days than those not treated, without significant difference in sICH and in-hospital mortality rates. These observations cannot exclude a residual confounding effect, but provide evidence that thrombolytics should not be withheld from nonagenarians because of age alone.
- Published
- 2018
42. Intravenous thrombolysis and platelet count
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David J. Seiffge, Didier Leys, Dejana R. Jovanović, Turgut Tatlisumak, Charlotte Cordonnier, Abdulaziz S Al Sultan, Daniel Strbian, Patrik Michel, Christoph Gumbinger, Stefan T. Engelter, Yvo B.W.E.M. Roos, Romina Lachenmeier, Sami Curtze, Thomas P. Zonneveld, Christopher Traenka, Gerli Sibolt, Alessandro Pezzini, Christian Hametner, Sanne M. Zinkstok, Visnja Padjen, Hemasse Amiri, Solène Moulin, Alexandros A Polymeris, Laura Vandelli, Peter A. Ringleb, Nils Peters, Philippe Lyrer, Georg Kägi, Silja Räty, Andrea Zini, Olivier Bill, Paul J. Nederkoorn, Henrik Gensicke, Neurology, ANS - Neurovascular Disorders, Graduate School, ACS - Amsterdam Cardiovascular Sciences, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hemorrhage ,030204 cardiovascular system & hematology ,Logistic regression ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Risk Factors ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Platelet ,Prospective Studies ,Registries ,030212 general & internal medicine ,Prospective cohort study ,Survival analysis ,Aged ,Aged, 80 and over ,Thrombocytosis ,Platelet Count ,business.industry ,Odds ratio ,Thrombolysis ,Middle Aged ,medicine.disease ,Survival Analysis ,Thrombocytopenia ,Confidence interval ,3. Good health ,Stroke ,Administration, Intravesical ,Cardiology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo study the effect of platelet count (PC) on bleeding risk and outcome in stroke patients treated with IV thrombolysis (IVT) and to explore whether withholding IVT in PC < 100 × 109/L is supported.MethodsIn this prospective multicenter, IVT register–based study, we compared PC with symptomatic intracranial hemorrhage (sICH; Second European-Australasian Acute Stroke Study [ECASS II] criteria), poor outcome (modified Rankin Scale score 3–6), and mortality at 3 months. PC was used as a continuous and categorical variable distinguishing thrombocytopenia (9/L), thrombocytosis (>450 × 109/L), and normal PC (150–450 × 109/L [reference group]). Moreover, PC < 100 × 109/L was compared to PC ≥ 100 × 109/L. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) from the logistic regression models were calculated.ResultsAmong 7,533 IVT-treated stroke patients, 6,830 (90.7%) had normal PC, 595 (7.9%) had thrombocytopenia, and 108 (1.4%) had thrombocytosis. Decreasing PC (every 10 × 109/L) was associated with increasing risk of sICH (ORadjusted 1.03, 95% CI 1.02–1.05) but decreasing risk of poor outcome (ORadjusted 0.99, 95% CI 0.98–0.99) and mortality (ORadjusted 0.98, 95% CI 0.98–0.99). The risk of sICH was higher in patients with thrombocytopenic than in patients with normal PC (ORadjusted 1.73, 95% CI 1.24–2.43). However, the risk of poor outcome (ORadjusted 0.89, 95% CI 0.39–1.97) and mortality (ORadjusted 1.09, 95% CI 0.83–1.44) did not differ significantly. Thrombocytosis was associated with mortality (ORadjusted 2.02, 95% CI 1.21–3.37). Forty-four (0.3%) patients had PC < 100 × 109/L. Their risks of sICH (ORunadjusted 1.56, 95% CI 0.48–5.07), poor outcome (ORadjusted 1.63, 95% CI 0.82–3.24), and mortality (ORadjusted 1.38, 95% CI 0.64–2.98) did not differ significantly from those of patients with PC ≥ 100 × 109/L.ConclusionLower PC was associated with increased risk of sICH, while higher PC indicated increased mortality. Our data suggest that PC modifies outcome and complications in individual patients, while withholding IVT in all patients with PC < 100 × 109/L is challenged.
- Published
- 2018
43. Cortical superficial siderosis: A prospective observational cohort study
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Gregoire Boulouis, Hilde Hénon, Charlotte Cordonnier, Costanza Rossi, Barbara Casolla, Didier Leys, Solène Moulin, and Grégory Kuchcinski
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Male ,medicine.medical_specialty ,Siderosis ,Neuroimaging ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Recurrence ,Risk Factors ,Internal medicine ,Prevalence ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Aged, 80 and over ,business.industry ,Hazard ratio ,Case-control study ,Age Factors ,Odds ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Case-Control Studies ,Cohort ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
ObjectiveTo determine the prevalence of cortical superficial siderosis (cSS), its clinical and neuroimaging associated markers, and its influence on the risk of recurrent intracerebral hemorrhage (ICH) in a prospective observational ICH cohort.MethodsWe investigated clinical and radiologic markers associated with cSS using multivariable analysis. In survival analyses, we used Cox models to identify predictors of recurrent ICH after adjusting for potential confounders.ResultsOf the 258 patients included in the study, 49 (19%; 95% confidence interval [CI] 14%–24%) had cSS at baseline. Clinical factors independently associated with the presence of cSS were increasing age (odds ratio [OR] 1.03 per 1-year increase, 95% CI 1.001–1.06, p = 0.044), preexisting dementia (OR 2.62, 95% CI 1.05–6.51, p = 0.039), and history of ICH (OR 4.02, 95% CI 1.24–12.95, p = 0.02). Among radiologic biomarkers, factors independently associated with the presence of cSS were ICH lobar location (OR 24.841, 95% CI 3.2–14.47, p < 0.001), severe white matter hyperintensities score (OR 5.51, 95% CI 1.17–5.78, p = 0.019), and absence of lacune (OR 4.46, 95% CI 1.06–5.22, p = 0.035). During a median follow-up of 6.4 (interquartile range 2.9–8.4) years, recurrent ICH occurred in 19 patients. Only disseminated cSS (hazard ratio 4.69, 95% CI 1.49–14.71, p = 0.008), not the presence or absence of cSS or focal cSS on baseline MRI, was associated with recurrent symptomatic ICH.ConclusionIn a prospective observational cohort of spontaneous ICH, clinical and radiologic markers associated with cSS suggest the implication of underlying cerebral amyloid angiopathy. Disseminated cSS may become a key prognostic neuroimaging marker of recurrent ICH that could be monitored in future clinical trials dedicated to patients with ICH.
- Published
- 2017
44. Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes
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Susanna Melkas, Régis Bordet, Sophie Gautier, Elena Haapaniemi, Solène Moulin, Charlotte Cordonnier, Didier Leys, Tiina Sairanen, Daniel Strbian, Gerli Sibolt, Ilaria Maestrini, Turgut Tatlisumak, and Nelly Dequatre-Ponchelle
- Subjects
Male ,medicine.medical_specialty ,Neutrophils ,medicine.medical_treatment ,Gastroenterology ,Brain Ischemia ,Cohort Studies ,Predictive Value of Tests ,Risk Factors ,Modified Rankin Scale ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Thrombolytic Therapy ,Prospective Studies ,Registries ,Neutrophil to lymphocyte ratio ,Prospective cohort study ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,business.industry ,Thrombolysis ,Odds ratio ,Middle Aged ,Surgery ,Treatment Outcome ,Tissue Plasminogen Activator ,Predictive value of tests ,Absolute neutrophil count ,Female ,Neurology (clinical) ,business - Abstract
Objective: To determine whether higher neutrophil counts before IV recombinant tissue plasminogen activator (rtPA) administration in ischemic stroke (IS) patients are associated with symptomatic intracerebral hemorrhages (sICH) and worse outcomes at 3 months. Methods: Blood samples for leukocyte, neutrophil, and lymphocyte counts were drawn before IV rtPA administration in IS patients included in the cohorts of Lille and Helsinki. The primary endpoint was sICH (European Cooperative Acute Stroke–II definition). Secondary endpoints were death and excellent (modified Rankin Scale [mRS] score 0–1 or equal to prestroke mRS) and good (mRS score 0–2 or equal to prestroke mRS) outcomes at 3 months. Results: We included 846 patients (median age 71 years; 50.8% men). The neutrophil count and neutrophil to lymphocyte ratio (NLR) were independently associated with the 4 endpoints: sICH (adjusted odds ratio [ adj OR] for an increase of 1,000 neutrophils = 1.21 and adj OR 1.11, respectively), death ( adj OR 1.16 and adj OR 1.08), and excellent ( adj OR 0.87 and adj OR 0.85) and good ( adj OR 0.86 and adj OR 0.91) outcomes. The total leukocyte count was not associated with any of the 4 endpoints. The best discriminating factor for sICH was NLR ≥4.80 (sensitivity 66.7%, specificity 71.3%, likelihood ratio 2.32). Patients with NLR ≥4.80 had a 3.71-fold increased risk for sICH (95% confidence interval adj OR: 1.97–6.98) compared to patients with NLR Conclusions: Higher neutrophil counts and NLR are independently associated with sICH and worse outcome at 3 months. The identification of mediators of this effect could provide new targets for neuroprotection in patients treated by rtPA.
- Published
- 2015
45. Influence of neurologists’ experience on the outcome of patients treated by intravenous thrombolysis for cerebral ischaemia
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Frédéric Dumont, Stéphanie Debette, Didier Leys, Hilde Hénon, Nelly Dequatre-Ponchelle, Marie Bodenant, Catherine Lefebvre, Charlotte Cordonnier, Solène Moulin, and Amélie Tuffal
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Neurology ,medicine.medical_treatment ,Severity of Illness Index ,Statistics, Nonparametric ,Brain Ischemia ,Fibrinolytic Agents ,Modified Rankin Scale ,Physicians ,Internal medicine ,mental disorders ,Odds Ratio ,medicine ,Humans ,Stroke ,Aged ,Retrospective Studies ,Neuroradiology ,Aged, 80 and over ,business.industry ,Odds ratio ,Thrombolysis ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Confidence interval ,nervous system diseases ,Logistic Models ,Treatment Outcome ,Quartile ,Tissue Plasminogen Activator ,Physical therapy ,Administration, Intravenous ,Female ,Neurology (clinical) ,business - Abstract
Intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) should be available on a 24/7 basis in hospitals admitting patients with stroke. We aimed at evaluating the influence of the number of patients previously treated with i.v. rt-PA by neurologists on patients' outcome. For each patient consecutively treated with i.v. rt-PA for cerebral ischaemia at the Lille University Hospital, we determined the number of previous treatments with rt-PA administered by the neurologist. We performed logistic regression analyses to determine the influence of the experience on the outcome evaluated by the modified Rankin scale (mRS) after 3 months, 0-1 meaning independence, and 0-2 meaning absence of handicap. We compared outcomes of patients treated by the 25% less experienced neurologists with those of trials. Forty-four neurologists treated 800 patients. The experience of the treating neurologist was independently associated with independence (adjusted odds ratio [(adj)OR] 1.062 for 10 patients more; 95% confidence interval [CI] 1.008-1.120), and absence of handicap ((adj)OR 1.076 for 10 patients more; 95%CI 1.016-1.140) at 3 months, but not with symptomatic intracerebral haemorrhage and death. The proportions of patients from the 1st quartile who were independent and without handicap at 3 months were 37.9 and 51.1%. Patients treated by less experienced neurologists, have similar outcomes than expected from trials, suggesting they benefit from thrombolysis. However, the outcome of patients treated by more experienced neurologists was slightly better. Less experienced neurologists should not be excluded from rt-PA programmes, but their practices should be evaluated and educational programmes organised.
- Published
- 2015
46. Identification of a specific functional network altered in poststroke cognitive impairment
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Charlotte Cordonnier, Anne-Marie Mendyk, Xavier Leclerc, Stéphanie Bombois, Solène Moulin, Régis Bordet, Renaud Lopes, Christine Delmaire, Hilde Hénon, Clément Bournonville, and Thibaut Dondaine
- Subjects
Male ,computer.software_genre ,Brain mapping ,050105 experimental psychology ,Brain Ischemia ,Functional networks ,03 medical and health sciences ,0302 clinical medicine ,Voxel ,Neural Pathways ,medicine ,Humans ,0501 psychology and cognitive sciences ,Cognitive Dysfunction ,Cognitive impairment ,Cognitive deficit ,Aged ,Brain Mapping ,medicine.diagnostic_test ,business.industry ,05 social sciences ,Brain ,Magnetic resonance imaging ,Cognition ,Middle Aged ,Magnetic Resonance Imaging ,White Matter ,Hyperintensity ,Stroke ,Female ,Neurology (clinical) ,medicine.symptom ,business ,computer ,Neuroscience ,030217 neurology & neurosurgery - Abstract
ObjectiveTo study the association between poststroke cognitive impairment and defining a specific resting functional marker.MethodsThe resting-state functional connectivity 6 months after an ischemic stroke in 56 patients was investigated. Twenty-nine of the patients who had an impairment of one or several cognitive domains were compared to 27 without any cognitive deficit. We studied the whole-brain connectivity using 2 complementary approaches: graph theory to study the functional network organization and network-based statistics to explore connectivity between brain regions. We assessed the potential cortical atrophy using voxel-based morphometry analysis.ResultsThe overall topological organization of the functional network was not altered in cognitively impaired stroke patients, who had the same mean node degree, average clustering coefficient, and global efficiency as cognitively healthy stroke patients. Network-based statistics analysis showed that poststroke cognitive impairment was associated with dysfunction of a whole-brain network composed of 167 regions and 178 connections, and functional disconnections between superior, middle, and inferior frontal gyri and the superior and inferior temporal gyri. These regions had connections that were specifically and positively correlated with cognitive domain scores. No intergroup differences in overall gray matter thickness and ischemic infarct topography were observed. To assess the effect of prestroke white matter hyperintensities on connectivity, we included the initial Fazekas scale in the regression model for a second network-based analysis. The resulting network was associated with the same key alterations but had fewer connections.ConclusionsThe observed functional network alterations suggest that the appearance of a cognitive impairment following stroke may be associated with a particular functional alteration, shared specifically between cognitive domains.
- Published
- 2017
47. Abstract 212: Cortical Superficial Siderosis and Risk of Recurrent Intracerebral Haemorrhage in Cerebral Amyloid Angiopathy: A Meta-analysis
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Steven M. Greenberg, Jean-Marc Olivot, Frank A. Wollenweber, Solène Moulin, Jonathan Rosand, Andreas Charidimou, Gregoire Boulouis, Alison M. Ayres, Mar Hernández-Guillamon, Anand Viswanathan, Mahmut Edip Gurol, Kristin Schwab, Charlotte Cordonnier, Nicolas Raposo, Jennifer Linn, and Duangnapa Roongpiboonsopit
- Subjects
Advanced and Specialized Nursing ,Intracerebral hemorrhage ,Pathology ,medicine.medical_specialty ,Subarachnoid hemorrhage ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Superficial siderosis ,nervous system diseases ,Meta-analysis ,medicine ,cardiovascular diseases ,Neurology (clinical) ,Cerebral amyloid angiopathy ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Cerebral amyloid angiopathy (CAA) is a major cause of spontaneous lobar intracerebral hemorrhage (ICH) in the elderly. CAA-related ICH survivors are at substantial risk for recurrent ICH, accounting for the significant morbidity of the disease. Identifying predictors of recurrence is therefore crucial. Recent data have implicated cortical superficial siderosis (cSS) as a key hemorrhagic MRI signature of CAA, and a possible marker of increased risk for CAA-ICH recurrence. However, data remain limited. We obtained precise estimates on cSS as an independent predictor of ICH recurrence risk in CAA cohorts from a systematic review of published studies pooled with data from our centre. Methods: We included cohort studies of consecutive CAA-related ICH patients based on the original Boston criteria, with available blood-sensitive MRI sequences at baseline for cSS assessment, and adequate follow-up for recurrent symptomatic ICH. The strength of the association between cSS and recurrent ICH was quantified using random effects models. Covariate-adjusted hazard rations (adj-HR) as provided from pre-specified Cox proportional hazard models were used for a two-stage meta-analysis. Results: Three cohorts including 443 CAA-ICH patients were eligible for analysis. The pooled prevalence of cSS presence and disseminated cSS (>3 affected sulci) was 32% (95%CI: 32%-41%) and 21% (95%CI: 18%-25%) respectively. During a mean follow-up of 2.5 years (range: 2-3 years) 92 patients experienced recurrent ICH, a pooled risk ratio of 6.9% per year (I 2 : 63%, p=0.07). In adjusted pooled analysis, any cSS and disseminated cSS were both independently associated with increased lobar ICH recurrence risk (adj-HR: 2.4; 95%CI: 1.5-3.8; p2 : 0% and adj-HR: 4.1; 95%CI: 2.6-6.6; p2 : 47%), after adjusting for multiple strictly lobar microbleeds presence and increasing age. Conclusions: Our findings in a large population of CAA patients with ICH and a large number of recurrence events, indicate that cSS, particularly if disseminated, is the single most important prognostic risk factor on MRI for future recurrent lobar ICH. The provided estimates may help stratify future bleeding risk in CAA, with clinical implications for prognosis and treatment.
- Published
- 2017
48. Thrombolytic therapy for stroke in patients with preexisting cognitive impairment
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Yannick Béjot, Tetsuro Ago, Olivier Godefroy, Solène Moulin, Kei Murao, Agnès Jacquin, Maurice Giroud, Takanari Kitazono, Florence Pasquier, Igor Sibon, Charlotte Cordonnier, Yasushi Okada, Jean-Louis Mas, Kazumi Kimura, Stéphanie Bombois, Yoshinobu Wakisaka, Régis Bordet, Hilde Hénon, and Didier Leys
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Ischemia ,Brain Ischemia ,Fibrinolytic Agents ,Informant Questionnaire on Cognitive Decline in the Elderly ,Modified Rankin Scale ,Clinical endpoint ,medicine ,Humans ,Thrombolytic Therapy ,Prospective Studies ,Prospective cohort study ,Stroke ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,Intracerebral hemorrhage ,business.industry ,Middle Aged ,medicine.disease ,Treatment Outcome ,Tissue Plasminogen Activator ,Female ,Observational study ,Neurology (clinical) ,Cognition Disorders ,business - Abstract
We aimed to evaluate the influence of prestroke cognitive impairment (PSCI) on outcomes in stroke patients treated with IV recombinant tissue plasminogen activator (rtPA).OPHELIE-COG was a prospective observational multicenter study conducted in French and Japanese patients treated with IV rtPA for cerebral ischemia. The preexisting cognitive status was evaluated by the short version of the Informant Questionnaire on Cognitive Decline in the Elderly. PSCI was defined as a mean score3. The primary endpoint was a favorable outcome (modified Rankin Scale [mRS] score 0-1) after 3 months. Secondary endpoints were symptomatic intracerebral hemorrhage (sICH), mRS scores 0-2, and mortality at 3 months. We performed a pooled analysis with Biostroke and Strokdem.Of 205 patients, 62 (30.2%) met criteria for PSCI. They were 11 years older (p0.001). Although they had more sICH and were less frequently independent after 3 months, they did not differ for any endpoint after adjustment for age, baseline NIH Stroke Scale score, and onset-to-needle time: sICH (odds ratio [OR] 2.78; 95% confidence interval [CI] 0.65-11.86), mRS 0-1 (OR 0.82; 95% CI 0.41-1.65), mRS 0-2 (OR 0.62; 95% CI 0.28-1.37), death (OR 0.40; 95% CI 0.08-2.03). The pooled analysis found no association of PSCI with any endpoint.Ischemic stroke patients with PSCI should receive rtPA if they are eligible. This conclusion cannot be extended to severe cognitive impairment or severe strokes.This study provides Class IV evidence that in patients with PSCI presenting with acute ischemic stroke, IV rtPA improves outcomes.
- Published
- 2014
49. Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke
- Author
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Didier, Leys, Yannick, Hommet, Clémence, Jacquet, Solène, Moulin, Igor, Sibon, Jean-Louis, Mas, Thierry, Moulin, Maurice, Giroud, Sharmila, Sagnier, Charlotte, Cordonnier, Elisabeth, Medeiros de Bustos, Guillaume, Turc, Thomas, Ronzière, Yannick, Bejot, Olivier, Detante, Thavarak, Ouk, Anne-Marie, Mendyk, Pascal, Favrole, Mathieu, Zuber, Aude, Triquenot-Bagan, Ozlem, Ozkul-Wermester, Francisco Macian, Montoro, Chantal, Lamy, Anthony, Faivre, Laurent, Lebouvier, Camille, Potey, Mathilde, Poli, Hilde, Hénon, Pauline, Renou, Nelly, Dequatre-Ponchelle, Marie, Bodenant, Sabrina, Debruxelles, Costanza, Rossi, Régis, Bordet, Denis, Vivien, Marina, Rubio, Troubles cognitifs dégénératifs et vasculaires ( DN2M ), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ) -INSERM, Sérine protéases et physiopathologie de l'unité neurovasculaire, Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry, Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de Neurologie [Rennes], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
- Subjects
Male ,medicine.medical_specialty ,Ischemia ,Single chain ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Gastroenterology ,Brain Ischemia ,Time-to-Treatment ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Seizures ,Modified Rankin Scale ,Internal medicine ,Post-hoc analysis ,Severity of illness ,medicine ,Humans ,Thrombolytic Therapy ,Stroke ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,Recombinant Proteins ,Confidence interval ,Surgery ,Treatment Outcome ,Tissue Plasminogen Activator ,[ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Female ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Objective:To determine whether the ratio single chain (sc)/(sc + 2 chain [tc]) recombinant tissue plasminogen activator (rtPA) influences outcomes in patients with cerebral ischemia.Methods:We prospectively included consecutive patients treated with IV rtPA for cerebral ischemia in 13 stroke centers and determined the sc/(sc + tc) ratio in the treatment administered to each patient. We evaluated the outcome with the modified Rankin Scale (mRS) at 3 months (prespecified analysis) and occurrence of epileptic seizures (post hoc analysis). We registered Outcome of Patients Treated by IV Rt-PA for Cerebral Ischaemia According to the Ratio Sc-tPA/Tc-tPA (OPHELIE) under ClinicalTrials.gov identifier no. NCT01614080.Results:We recruited 1,004 patients (515 men, median age 75 years, median onset-to-needle time 170 minutes, median NIH Stroke Scale score 10). We found no statistical association between sc/(sc + tc) ratios and handicap (mRS > 1), dependency (mRS > 2), or death at 3 months. Patients with symptomatic intracerebral hemorrhages had lower ratios (median 69% vs 72%, adjusted p = 0.003). The sc/(sc + tc) rtPA ratio did not differ between patients with and without seizures, but patients with early seizures were more likely to have received a sc/(sc + tc) rtPA ratio >80.5% (odds ratio 3.61; 95% confidence interval 1.26–10.34).Conclusions:The sc/(sc + tc) rtPA ratio does not influence outcomes in patients with cerebral ischemia. The capacity of rtPA to modulate NMDA receptor signaling might be associated with early seizures, but we observed this effect only in patients with a ratio of sc/(sc + tc) rtPA >80.5% in a post hoc analysis.
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- 2016
50. Management of acute cerebral ischaemia
- Author
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Solène Moulin and Didier Leys
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Occlusion ,medicine ,Humans ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Stroke ,Aspirin ,business.industry ,Incidence (epidemiology) ,Public health ,General Medicine ,Thrombolysis ,medicine.disease ,Surgery ,Emergency medicine ,Acute Disease ,Cerebral ischaemia ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Stroke is a major public health issue. Many are treatable in the acute stage, provided patients are admitted soon enough. The overall incidence of stroke in Western countries is approximately 2400 per year per million inhabitants, and 80% are due to cerebral ischaemia. The prevalence is approximately 12,000 per million inhabitants. Stroke is associated with increased long-term mortality, handicap, cognitive and behavioural impairments, recurrence, and an increased risk of other types of vascular events. There is strong evidence that stroke patients should be treated in dedicated stroke units; each time 24 patients are treated in a stroke unit, instead of a conventional ward, one death and one dependence are prevented. This effect does not depend on age, severity, and the stroke subtype. For this reason, stroke unit care is the cornerstone of the treatment of stroke, aiming at the detection and management of life-threatening emergencies, stabilization of most physiological parameters, and prevention of early complications. In cerebral ischaemia, besides this general management, specific therapies include intravenous recombinant tissue plasminogen activator, given as soon as possible and before 4.5hours, mechanical thrombectomy on top of rt-PA or alone in case of contra-indication to rt-PA, in patients with proximal large-vessel occlusion, aspirin 300mg, immediately or after 24hours in case of thrombolysis, and, in a few patients, decompressive surgery.
- Published
- 2016
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