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2. Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19

Author

Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., Michel P., Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., and Michel P.

Abstract

Background and Objectives COVID-19–related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19. Methods This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). Results Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16–2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20–2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23–1.99), 24-hour mortality (OR 2.47; 95% CI 1.58–3.86), and 3-month mortality (OR 1.88; 95% CI 1.52–2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26–1.60). Discussion Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non–COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment r

Published
2023

3. Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase

Author

Munckhof, A. van de, Lindgren, E., Kleinig, T.J., Field, T.S., Cordonnier, C., Krzywicka, K., Poli, S., Sanchez van Kammen, M., Borhani-Haghighi, A., Lemmens, R., Scutelnic, A., Ciccone, A., Gattringer, T., Wittstock, M., Dizonno, V., Devroye, A., Elkady, A., Günther, A., Cervera, A., Mengel, A., Chew, B.L.A., Buck, B., Zanferrari, C., Garcia-Esperon, C., Jacobi, C., Soriano, C., Michalski, D., Zamani, Z., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Vuillier, F., Bode, F.J., Caparros, F., Maier, F., Tsivgoulis, G., Katzberg, H.D., Duan, J., Burrow, J., Pelz, J., Mbroh, J., Oen, J., Schouten, J., Zimmermann, J., Ng, K., Garambois, K., Petruzzellis, M., Dias, M., Ghiasian, M., Romoli, M., Miranda, M., Wronski, M., Skjelland, M., Almasi-Dooghaee, M., Cuisenier, P., Murphy, S., Timsit, S., Coutts, S.B., Schönenberger, S., Nagel, S., Hiltunen, S., Chatterton, S., Cox, T., Bartsch, T., Shaygannejad, V., Mirzaasgari, Z., Middeldorp, S., Levi, M.M., Kremer Hovinga, J.A., Jood, K., Tatlisumak, T., Putaala, J., Heldner, M.R., Arnold, M., Aguiar de Sousa, D., Ferro, J.M., Coutinho, J.M., Munckhof, A. van de, Lindgren, E., Kleinig, T.J., Field, T.S., Cordonnier, C., Krzywicka, K., Poli, S., Sanchez van Kammen, M., Borhani-Haghighi, A., Lemmens, R., Scutelnic, A., Ciccone, A., Gattringer, T., Wittstock, M., Dizonno, V., Devroye, A., Elkady, A., Günther, A., Cervera, A., Mengel, A., Chew, B.L.A., Buck, B., Zanferrari, C., Garcia-Esperon, C., Jacobi, C., Soriano, C., Michalski, D., Zamani, Z., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Vuillier, F., Bode, F.J., Caparros, F., Maier, F., Tsivgoulis, G., Katzberg, H.D., Duan, J., Burrow, J., Pelz, J., Mbroh, J., Oen, J., Schouten, J., Zimmermann, J., Ng, K., Garambois, K., Petruzzellis, M., Dias, M., Ghiasian, M., Romoli, M., Miranda, M., Wronski, M., Skjelland, M., Almasi-Dooghaee, M., Cuisenier, P., Murphy, S., Timsit, S., Coutts, S.B., Schönenberger, S., Nagel, S., Hiltunen, S., Chatterton, S., Cox, T., Bartsch, T., Shaygannejad, V., Mirzaasgari, Z., Middeldorp, S., Levi, M.M., Kremer Hovinga, J.A., Jood, K., Tatlisumak, T., Putaala, J., Heldner, M.R., Arnold, M., Aguiar de Sousa, D., Ferro, J.M., and Coutinho, J.M.

Abstract

Item does not contain fulltext, BACKGROUND: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. METHODS: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). RESULTS: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). CONCLUSIONS: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.

Published
2022

4. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author

Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., Heldner, M.R., Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., and Heldner, M.R.

Abstract

Contains fulltext : 282309.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). CONCLUSIONS: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL

Published
2022

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

Author

Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., Poggio, M., et al. Bandettini di, Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., and Poggio, M., et al. Bandettini di

Abstract

Item does not contain fulltext, IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.

Published
2021

14. Determinants and outcome of multiple and early recurrent cervical artery dissections

Author

Compter, A, Schilling, S, Vaineau, C, Goeggel-Simonetti, B, Metso, T, Southerland, A, Pezzini, A, Kloss, M, Touzé, E, Worrall, B, Thijs, V, Bejot, Y, Reiner, P, Grond-Ginsbach, C, Bersano, A, Brandt, T, Caso, V, Lyrer, P, Traenka, C, Lichy, C, Martin, J, Leys, D, Sarikaya, H, Baumgartner, R, Jung, S, Fischer, U, Engelter, S, Dallongeville, J, Chabriat, H, Tatlisumak, T, Bousser, M, Arnold, M, Debette, S, Abboud, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Metso, A, Werner, I, Santos, M, Dichgans, M, Thomas-Feles, C, Weber, R, De Giuli, V, Caria, F, Poli, L, Padovani, A, Lanfranconi, S, Beretta, S, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Bonati, L, Gensicke, H, Amort, M, Altintas, A, Markus, H, Majersik, J, Cole, J, Kittner, S, Buffon, F, Heldner, M, Mattle, H, Kurmann, R, Gralla, J, Compter, Annette, Schilling, Sabrina, Vaineau, Cloé Juliette, Goeggel-Simonetti, Barbara, Metso, Tiina M., Southerland, Andrew, Pezzini, Alessandro, Kloss, Manja, Touzé, Emmanuel, Worrall, Bradford B., Thijs, Vincent, Bejot, Yannick, Reiner, Peggy, Grond-Ginsbach, Caspar, Bersano, Anna, Brandt, Tobias, Caso, Valeria, Lyrer, Philippe A., Traenka, Christopher, Lichy, Christoph, Martin, Juan José, Leys, Didier, Sarikaya, Hakan, Baumgartner, Ralph W., Jung, Simon, Fischer, Urs, Engelter, Stefan T., Dallongeville, Jean, Chabriat, Hugues, Tatlisumak, Turgut, Bousser, Marie-Germaine, Arnold, Marcel, Debette, Stéphanie, Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Metso AJ, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas-Feles C, Weber R, De Giuli V, Caria F, Poli L, Padovani A, Lanfranconi S, Beretta S, Ferrarese C, Giacolone G, Paolucci S, Fluri F, Hatz F, Gisler D, Bonati L, Gensicke H, Amort M, Altintas A, Markus H, Majersik J, Cole J, Kittner S, Buffon F, Heldner MR, Mattle HP, Kurmann R, Gralla J., Compter, A, Schilling, S, Vaineau, C, Goeggel-Simonetti, B, Metso, T, Southerland, A, Pezzini, A, Kloss, M, Touzé, E, Worrall, B, Thijs, V, Bejot, Y, Reiner, P, Grond-Ginsbach, C, Bersano, A, Brandt, T, Caso, V, Lyrer, P, Traenka, C, Lichy, C, Martin, J, Leys, D, Sarikaya, H, Baumgartner, R, Jung, S, Fischer, U, Engelter, S, Dallongeville, J, Chabriat, H, Tatlisumak, T, Bousser, M, Arnold, M, Debette, S, Abboud, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Metso, A, Werner, I, Santos, M, Dichgans, M, Thomas-Feles, C, Weber, R, De Giuli, V, Caria, F, Poli, L, Padovani, A, Lanfranconi, S, Beretta, S, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Bonati, L, Gensicke, H, Amort, M, Altintas, A, Markus, H, Majersik, J, Cole, J, Kittner, S, Buffon, F, Heldner, M, Mattle, H, Kurmann, R, Gralla, J, Compter, Annette, Schilling, Sabrina, Vaineau, Cloé Juliette, Goeggel-Simonetti, Barbara, Metso, Tiina M., Southerland, Andrew, Pezzini, Alessandro, Kloss, Manja, Touzé, Emmanuel, Worrall, Bradford B., Thijs, Vincent, Bejot, Yannick, Reiner, Peggy, Grond-Ginsbach, Caspar, Bersano, Anna, Brandt, Tobias, Caso, Valeria, Lyrer, Philippe A., Traenka, Christopher, Lichy, Christoph, Martin, Juan José, Leys, Didier, Sarikaya, Hakan, Baumgartner, Ralph W., Jung, Simon, Fischer, Urs, Engelter, Stefan T., Dallongeville, Jean, Chabriat, Hugues, Tatlisumak, Turgut, Bousser, Marie-Germaine, Arnold, Marcel, Debette, Stéphanie, Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Metso AJ, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas-Feles C, Weber R, De Giuli V, Caria F, Poli L, Padovani A, Lanfranconi S, Beretta S, Ferrarese C, Giacolone G, Paolucci S, Fluri F, Hatz F, Gisler D, Bonati L, Gensicke H, Amort M, Altintas A, Markus H, Majersik J, Cole J, Kittner S, Buffon F, Heldner MR, Mattle HP, Kurmann R, and Gralla J.

Abstract

Objective To assess putative risk factors and outcome of multiple and early recurrent cervical artery dissection (CeAD). Methods We combined data from 2 multicenter cohorts and compared patients with multiple CeAD at initial diagnosis, early recurrent CeAD within 3 to 6 months, and single nonrecurrent CeAD. Putative risk factors, clinical characteristics, functional outcome, and risk of recurrent ischemic events were assessed. Results Of 1,958 patients with CeAD (mean ± SD age 44.3 ± 10 years, 43.9% women), 1,588 (81.1%) had single nonrecurrent CeAD, 340 (17.4%) hadmultiple CeAD, and 30 (1.5%) presented with single CeAD at admission and had early recurrent CeAD. Patients with multiple or early recurrent CeAD did not significantly differ with respect to putative risk factors, clinical presentation, and outcome. In multivariable analyses, patients with multiple or early recurrent CeAD more often had recent infection (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.29-2.53), vertebral artery dissection (OR 1.82, 95% CI 1.34-2.46), family history of stroke (OR 1.55, 95% CI 1.06-2.25), cervical pain (OR 1.36, 95% CI 1.01-1.84), and subarachnoid hemorrhage (OR 2.85, 95% CI 1.01-8.04) at initial presentation compared to patients with single nonrecurrent CeAD. Patients withmultiple or early recurrent CeAD also had a higher incidence of cerebral ischemia (hazard ratio 2.77, 95% CI 1.49-5.14) at 3 to 6 months but no difference in functional outcome compared to patients with single nonrecurrent CeAD. Conclusion Patients with multiple and early recurrent CeAD share similar risk factors, clinical characteristics, and functional outcome. Compared to patients with single nonrecurrent CeAD, they are more likely to have recurrent cerebral ischemia at 3 to 6 months, possibly reflecting an underlying transient vasculopathy.

Published
2018

26. Neurology

Author

Compter, Annette, Schilling, Sabrina, Vaineau, Cloé Juliette, Goeggel-Simonetti, Barbara, Metso, Tiina M., Southerland, Andrew, Pezzini, Alessandro, Kloss, Manja, Touzé, Emmanuel, Worrall, Bradford B., Thijs, Vincent, Bejot, Yannick, Reiner, Peggy, Grond-Ginsbach, Caspar, Bersano, Anna, Brandt, Tobias, Caso, Valeria, Lyrer, Philippe A., Traenka, Christopher, Lichy, Christoph, Martin, Juan José, Leys, Didier, Sarikaya, Hakan, Baumgartner, Ralph W., Jung, Simon, Fischer, Urs, Engelter, Stefan T., Dallongeville, Jean, Chabriat, Hugues, Tatlisumak, Turgut, Bousser, Marie-Germaine, Arnold, Marcel, Debette, Stéphanie, in CADIPS-Group, C. Ferrarese Collaborators (51): Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Metso AJ, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas-Feles C, Weber R, De Giuli V, Caria F, Poli L, Padovani A, Lanfranconi S, Beretta S, Ferrarese C, Giacolone G, Paolucci S, Fluri F, Hatz F, Gisler D, Bonati L, Gensicke H, Amort M, Altintas A, Markus H, Majersik J, Cole J, Kittner S, Buffon F, Heldner MR, Mattle HP, Kurmann R, Gralla J., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Compter, A, Schilling, S, Vaineau, C, Goeggel-Simonetti, B, Metso, T, Southerland, A, Pezzini, A, Kloss, M, Touzé, E, Worrall, B, Thijs, V, Bejot, Y, Reiner, P, Grond-Ginsbach, C, Bersano, A, Brandt, T, Caso, V, Lyrer, P, Traenka, C, Lichy, C, Martin, J, Leys, D, Sarikaya, H, Baumgartner, R, Jung, S, Fischer, U, Engelter, S, Dallongeville, J, Chabriat, H, Tatlisumak, T, Bousser, M, Arnold, M, Debette, S, In, C, C., F, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Metso, A, Werner, I, Santos, M, Dichgans, M, Thomas-Feles, C, Weber, R, De Giuli, V, Caria, F, Poli, L, Padovani, A, Lanfranconi, S, Beretta, S, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Bonati, L, Gensicke, H, Amort, M, Altintas, A, Markus, H, Majersik, J, Cole, J, Kittner, S, Buffon, F, Heldner, M, Mattle, H, Kurmann, R, and Gralla, J

Subjects
Adult, Male, medicine.medical_specialty, Subarachnoid hemorrhage, Vertebral artery dissection, International Cooperation, 030204 cardiovascular system & hematology, Ribosomal Protein S6 Kinases, 90-kDa, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Risk Factors, Internal medicine, Outcome Assessment, Health Care, medicine, Humans, Thrombolytic Therapy, Family history, Stroke, Vertebral Artery Dissection, business.industry, Hazard ratio, Odds ratio, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Logistic Models, Treatment Outcome, VINTAGE, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery, Fibrinolytic agent, Cohort study
Abstract

ObjectiveTo assess putative risk factors and outcome of multiple and early recurrent cervical artery dissection (CeAD).MethodsWe combined data from 2 multicenter cohorts and compared patients with multiple CeAD at initial diagnosis, early recurrent CeAD within 3 to 6 months, and single nonrecurrent CeAD. Putative risk factors, clinical characteristics, functional outcome, and risk of recurrent ischemic events were assessed.ResultsOf 1,958 patients with CeAD (mean ± SD age 44.3 ± 10 years, 43.9% women), 1,588 (81.1%) had single nonrecurrent CeAD, 340 (17.4%) had multiple CeAD, and 30 (1.5%) presented with single CeAD at admission and had early recurrent CeAD. Patients with multiple or early recurrent CeAD did not significantly differ with respect to putative risk factors, clinical presentation, and outcome. In multivariable analyses, patients with multiple or early recurrent CeAD more often had recent infection (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.29–2.53), vertebral artery dissection (OR 1.82, 95% CI 1.34–2.46), family history of stroke (OR 1.55, 95% CI 1.06–2.25), cervical pain (OR 1.36, 95% CI 1.01–1.84), and subarachnoid hemorrhage (OR 2.85, 95% CI 1.01–8.04) at initial presentation compared to patients with single nonrecurrent CeAD. Patients with multiple or early recurrent CeAD also had a higher incidence of cerebral ischemia (hazard ratio 2.77, 95% CI 1.49–5.14) at 3 to 6 months but no difference in functional outcome compared to patients with single nonrecurrent CeAD.ConclusionPatients with multiple and early recurrent CeAD share similar risk factors, clinical characteristics, and functional outcome. Compared to patients with single nonrecurrent CeAD, they are more likely to have recurrent cerebral ischemia at 3 to 6 months, possibly reflecting an underlying transient vasculopathy.

Published
2018
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27. Cervical artery dissection in patients ≥60 years Often painless, few mechanical triggers

Author

Traenka, C, Dougoud, D, Simonetti, B, Metso, T, Debette, S, Pezzini, A, Kloss, M, Grond Ginsbach, C, Majersik, J, Worrall, B, Leys, D, Baumgartner, R, Caso, V, Béjot, Y, Compter, A, Reiner, P, Thijs, V, Southerland, A, Bersano, A, Brandt, T, Gensicke, H, Touzé, E, Martin, J, Chabriat, H, Tatlisumak, T, Lyrer, P, Arnold, M, Engelter, S, Abboud, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Wiest, T, Werner, I, Santos, M, Dichgans, M, Thomas Feles, C, Weber, R, Del Zotto, E, Giossi, A, Volonghi, I, Padovani, A, Poli, L, Morotti, A, Lanfranconi, S, Baron, P, Beretta, S, Ferrarese, C, Giacolone, G, Fluri, F, Hatz, F, Gisler, D, Bonati, Amort, M, Markus, H, Meschia, J, Cole, J, Kittner, S, Buffon, F, Mawet, J, Heldner, M, Mattle, H, Gralla, J, Engelter, ST, Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Wiest T, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas Feles C, Weber R, Del Zotto E, Giossi A, Volonghi I, Padovani A, Poli L, Morotti A, Lanfranconi S, Baron P, Beretta S, Giacolone G, Fluri F, Hatz F, Gisler D, Amort M, Markus H, Meschia JF, Cole J, Kittner S, Buffon F, Mawet J, Heldner MR, Mattle HP, Gralla J., FERRARESE, CARLO, Traenka, C, Dougoud, D, Simonetti, B, Metso, T, Debette, S, Pezzini, A, Kloss, M, Grond Ginsbach, C, Majersik, J, Worrall, B, Leys, D, Baumgartner, R, Caso, V, Béjot, Y, Compter, A, Reiner, P, Thijs, V, Southerland, A, Bersano, A, Brandt, T, Gensicke, H, Touzé, E, Martin, J, Chabriat, H, Tatlisumak, T, Lyrer, P, Arnold, M, Engelter, S, Abboud, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Leder, S, Léger, A, Deltour, S, Crozier, S, Méresse, I, Canaple, S, Godefroy, O, Giroud, M, Decavel, P, Medeiros, E, Montiel, P, Moulin, T, Vuillier, F, Amouyel, P, Wiest, T, Werner, I, Santos, M, Dichgans, M, Thomas Feles, C, Weber, R, Del Zotto, E, Giossi, A, Volonghi, I, Padovani, A, Poli, L, Morotti, A, Lanfranconi, S, Baron, P, Beretta, S, Ferrarese, C, Giacolone, G, Fluri, F, Hatz, F, Gisler, D, Bonati, Amort, M, Markus, H, Meschia, J, Cole, J, Kittner, S, Buffon, F, Mawet, J, Heldner, M, Mattle, H, Gralla, J, Engelter, ST, Abboud S, Pandolfo M, Bodenant M, Louillet F, Mas JL, Leder S, Léger A, Deltour S, Crozier S, Méresse I, Canaple S, Godefroy O, Giroud M, Decavel P, Medeiros E, Montiel P, Moulin T, Vuillier F, Amouyel P, Wiest T, Werner I, Arnold ML, Santos MD, Dichgans M, Thomas Feles C, Weber R, Del Zotto E, Giossi A, Volonghi I, Padovani A, Poli L, Morotti A, Lanfranconi S, Baron P, Beretta S, Giacolone G, Fluri F, Hatz F, Gisler D, Amort M, Markus H, Meschia JF, Cole J, Kittner S, Buffon F, Mawet J, Heldner MR, Mattle HP, Gralla J., and FERRARESE, CARLO

Abstract

Objective: In a cohort of patients diagnosed with cervical artery dissection (CeAD), to determine the proportion of patients aged ≥ 60 years and compare the frequency of characteristics (presenting symptoms, risk factors, and outcome) in patients aged ,60 vs ≥ 60 years. Methods: We combined data from 3 large cohorts of consecutive patients diagnosed with CeAD (i.e., Cervical Artery Dissection and Ischemic Stroke Patients-Plus consortium). We dichotomized cases into 2 groups, age ≥ 60 and ,60 years, and compared clinical characteristics, risk factors, vascular features, and 3-month outcome between the groups. First, we performed a combined analysis of pooled individual patient data. Secondary analyses were done within each cohort and across cohorts. Crude and adjusted odds ratios (OR [95% confidence interval]) were calculated. Results: Among 2,391 patients diagnosed with CeAD, we identified 177 patients (7.4%) aged ≥ 60 years. In this age group, cervical pain (ORadjusted 0.47 [0.33-0.66]), headache (ORadjusted 0.58 [0.42-0.79]), mechanical trigger events (ORadjusted 0.53 [0.36-0.77]), and migraine (ORadjusted 0.58 [0.39-0.85]) were less frequent than in younger patients. In turn, hypercholesterolemia (ORadjusted 1.52 [1.1-2.10]) and hypertension (ORadjusted 3.08 [2.25-4.22]) were more frequent in older patients. Key differences between age groups were confirmed in secondary analyses. In multivariable, adjusted analyses, favorable outcome (i.e., modified Rankin Scale score 0-2) was less frequent in the older age group (ORadjusted 0.45 [0.25, 0.83]). Conclusion: In our study population of patients diagnosed with CeAD, 1 in 14 was aged ≥ 60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk of missed CeAD diagnosis in older patients.

Published
2017

35. Anemia in young patients with ischaemic stroke

Author

Kellert, L, Kloss, M, Pezzini, A, Metso, T, Metso, A, Debette, S, Leys, D, Caso, V, Thijs, V, Bersano, A, Touzé, E, Tatlisumak, T, Gensicke, H, Lyrer, P, Bösel, J, Engelter, S, Grond-Ginsbach, C, Pandolfo, M, Bodenant, M, Louillet, F, Mas, JL, Deltour, S, Léger, A, Canaple, S, Godefroy, O, Béjot, Y, Moulin, T, Vuillier, F, Dos Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas-Feles, C, Weber, R, Poli, L, Morotti, A, Padovani, A, Lanfranconi, S, Baron, P, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, Altintas, A, Kellert, L, Kloss, M, Pezzini, A, Metso, T, Metso, A, Debette, S, Leys, D, Caso, V, Thijs, V, Bersano, A, Touzé, E, Tatlisumak, T, Gensicke, H, Lyrer, P, Bösel, J, Engelter, S, Grond-Ginsbach, C, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Deltour, S, Léger, A, Canaple, S, Godefroy, O, Béjot, Y, Moulin, T, Vuillier, F, Dos Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas-Feles, C, Weber, R, Poli, L, Morotti, A, Padovani, A, Lanfranconi, S, Baron, P, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, Altintas, A, Heidelberg University Hospital [Heidelberg], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Università degli Studi di Perugia = University of Perugia (UNIPG), Florey Institute of Neuroscience and Mental Health [Melbourne, Victoria, Australia], Austin Health, Politecnico di Torino = Polytechnic of Turin (Polito), Physiopathologie et imagerie des troubles neurologiques (PhIND), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, and Cervical Artery Dissection Ischaemic Stroke Patients (CADISP) study group

Subjects
Adult, Male, United State, medicine.medical_specialty, Neurology, Adolescent, Anemia, Comorbidity, Cervical artery dissection, Severity of Illness Index, Brain Ischemia, Brain ischemia, Young Adult, Modified Rankin Scale, Risk Factors, Aneurysm, Dissecting, Internal medicine, Severity of illness, medicine, Humans, Young adult, Stroke, Ischaemic stroke, Aged, business.industry, Risk Factor, Middle Aged, medicine.disease, United States, Surgery, Aortic Dissection, Stroke severity, Female, Neurology (clinical), business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Human
Abstract

Background and purpose To investigate the association of anemia on admission with ischaemic stroke (IS), stroke severity and early functional outcome in patients with cervical artery dissection (CeAD) or with IS of other causes (non-CeAD-IS patients). Methods The study sample comprised all patients from the Cervical Artery Dissection and Ischaemic Stroke Patients (CADISP) study without pre-existing disability and with documentation of stroke severity and hemoglobin (Hb) concentration on admission. Anemia was classified as mild (Hb

Published
2015
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36. Stroke in first-degree relatives of patients with cervical artery dissection

Author

Kloss, M, Grond Ginsbach, C, Pezzini, A, Metso, T, Metso, A, Debette, S, Leys, D, Dallongeville, J, Caso, V, Thijs, V, Bersano, A, Touzé, E, Bonati, L, Tatlisumak, T, Arnold, M, Lyrer, P, Engelter, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Deltour, S, Anne Léger, N, Canaple, S, Godefroy, O, Yannick Béjot, N, Moulin, T, Vuillier, F, Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas Feles, C, Weber, R, Giossi, A, Volonghi, I, Padovani, A, Lanfranconi, S, Baron, P, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, Altintas, A., FERRARESE, CARLO, Kloss, M, Grond Ginsbach, C, Pezzini, A, Metso, T, Metso, A, Debette, S, Leys, D, Dallongeville, J, Caso, V, Thijs, V, Bersano, A, Touzé, E, Bonati, L, Tatlisumak, T, Arnold, M, Lyrer, P, Engelter, S, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Deltour, S, Anne Léger, N, Canaple, S, Godefroy, O, Yannick Béjot, N, Moulin, T, Vuillier, F, Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas Feles, C, Weber, R, Giossi, A, Volonghi, I, Padovani, A, Lanfranconi, S, Baron, P, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, and Altintas, A

Subjects
Adult, Male, medicine.medical_specialty, Vertebral artery dissection, Young stroke, Brain Ischemia, Nuclear Family, Family history of stroke (FHS), Risk Factors, Internal medicine, medicine, Humans, First-degree relatives, Family history, Young adult, Stroke, Vertebral Artery Dissection, business.industry, Risk Factor, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Surgery, Neurology, Female, Neurology (clinical), business, Cervical artery dissection (CeAD), Body mass index, Human
Abstract

Background and purpose Patients with ischaemic stroke (IS) caused by a spontaneous cervical artery dissection (CeAD) worry about an increased risk for stroke in their families. The occurrence of stroke in relatives of patients with CeAD and in those with ischaemic stroke attributable to other (non-CeAD) causes were compared. Methods The frequency of stroke in first-degree relatives (family history of stroke, FHS) was studied in IS patients (CeAD patients and age- and sex-matched non-CeAD patients) from the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) database. FHS ≤ 50 and FHS > 50 were defined as having relatives who suffered stroke at the age of ≤50 or >50 years. FHS ≤ 50 and FHS > 50 were studied in CeAD and non-CeAD IS patients and related to age, sex, number of siblings, hypertension, hypercholesterolemia, smoking and body mass index (BMI). Results In all, 1225 patients were analyzed. FHS ≤ 50 was less frequent in CeAD patients (15/598 = 2.5%) than in non-CeAD IS patients (38/627 = 6.1%) (P = 0.003; odds ratio 0.40, 95% confidence interval 0.22–0.73), also after adjustment for age, sex and number of siblings (P = 0.005; odds ratio 0.42, 95% confidence interval 0.23–0.77). The frequency of FHS > 50 was similar in both study groups. Vascular risk factors did not differ between patients with positive or negative FHS ≤ 50. However, patients with FHS > 50 were more likely to have hypertension and higher BMI. Conclusion Relatives of CeAD patients had fewer strokes at a young age than relatives of non-CeAD IS stroke patients.

Published
2014

37. Prognostic significance of pulsatile tinnitus in cervical artery dissection

Author

Kellert, L, Kloss, M, Pezzini, A, Debette, S, Leys, D, Caso, V, Thijs, V, Bersano, A, Touzé, E, Tatlisumak, T, Traenka, C, Lyrer, P, Engelter, S, Metso, T, Grond Ginsbach, C, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Deltour, S, Léger, A, Canaple, S, Godefroy, O, Béjot, Y, Moulin, T, Vuillier, F, Dos Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas Feles, C, Weber, R, Costa, P, Poli, L, Morotti, A, Padovani, A, Lanfranconi, S, Baron, P, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, Altintas, A, Altintas, A., FERRARESE, CARLO, Kellert, L, Kloss, M, Pezzini, A, Debette, S, Leys, D, Caso, V, Thijs, V, Bersano, A, Touzé, E, Tatlisumak, T, Traenka, C, Lyrer, P, Engelter, S, Metso, T, Grond Ginsbach, C, Pandolfo, M, Bodenant, M, Louillet, F, Mas, J, Deltour, S, Léger, A, Canaple, S, Godefroy, O, Béjot, Y, Moulin, T, Vuillier, F, Dos Santos, M, Malik, R, Hausser, I, Brandt, T, Thomas Feles, C, Weber, R, Costa, P, Poli, L, Morotti, A, Padovani, A, Lanfranconi, S, Baron, P, Ferrarese, C, Giacolone, G, Paolucci, S, Fluri, F, Hatz, F, Gisler, D, Amort, M, Bevan, S, Altintas, A, Altintas, A., and FERRARESE, CARLO

Abstract

Background and purpose: Our aim was to investigate whether pulsatile tinnitus (PT) in cervical artery dissection (CeAD) has prognostic significance. Methods: All CeAD patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) study with documentation of PT were analysed. The presence of PT was systematically assessed using a standardized questionnaire. Stroke severity at admission was defined according to the National Institutes of Health Stroke Scale (NIHSS). Excellent outcome after 3 months was defined as a modified Rankin Scale of 0–1. Results: Sixty-three of 778 patients (8.1%) reported PT. PT+ patients presented less often with ischaemic stroke (41.3% vs. 63.9%, P < 0.001), more often with dissection in the internal carotid artery (85.7% vs. 64.2%, P = 0.001), less often with vessel occlusion (19.0% vs. 34.1%, P = 0.017) and more often with excellent outcome at 3 months (92.1% vs. 75.4%, P = 0.002). Logistic regression analysis identified PT as an independent predictor of excellent outcome after 3 months [odds ratio (OR) 3.96, 95% confidence interval (CI) 1.22–12.87] adjusted to significant outcome predictors NIHSS on admission (OR 0.82, 95% CI 0.79–0.86), Horner syndrome (OR 1.95, 95% CI 1.16–3.29) and vessel occlusion (OR 0.62, 95% CI 0.40–0.94) and to non-significant predictors age, sex, pain and location of CeAD. Conclusion: The presence of PT in CeAD is associated with a benign clinical course and predicts a favourable outcome.

Published
2016

39. The LPL/ADAM29 expression ratio is a novel prognosis indicator in chronic lymphocytic leukemia

Author

Oppezzo, P., Vasconcelos, Yuri [UNIFESP], Settegrana, C., Jeannel, D., Vuillier, F., Legarff-Tavernier, M., Kimura, Eliza Yuriko Sugano [UNIFESP], Bechet, S., Dumas, G., Brissard, M., Merle-Beral, H., Yamamoto, Mihoko [UNIFESP], Dighiero, G., Davi, F., French Cooperative Grp CLL, Hop La Pitie Salpetriere, Inst Pasteur, and Universidade Federal de São Paulo (UNIFESP)

Subjects
Male, DNA, Complementary, Microarray, Chronic lymphocytic leukemia, Immunology, Gene Expression, chemical and pharmacologic phenomena, Biology, medicine.disease_cause, Biochemistry, law.invention, law, Gene expression, Biomarkers, Tumor, medicine, Humans, Gene, Polymerase chain reaction, Mutation, ZAP-70 Protein-Tyrosine Kinase, Base Sequence, Genes, Immunoglobulin, Reverse Transcriptase Polymerase Chain Reaction, Metalloendopeptidases, Reproducibility of Results, hemic and immune systems, DNA, Neoplasm, Cell Biology, Hematology, Middle Aged, Protein-Tyrosine Kinases, Prognosis, medicine.disease, Leukemia, Lymphocytic, Chronic, B-Cell, Reverse transcription polymerase chain reaction, ADAM Proteins, Lipoprotein Lipase, Real-time polymerase chain reaction, Case-Control Studies, Cancer research, Female, Immunoglobulin Heavy Chains
Abstract

Although the zeta-associated protein of 70 kDa (ZAP-70) is overexpressed in patients with chronic lymphocytic leukemia (CLL) displaying unmutated IGVH genes and poor prognosis, a previous microarray study from our group identified overexpression of LPL and ADAM29 genes among unmutated and mutated CLL, respectively. To assess the prognostic value of these genes, we quantified their expression by real-time quantitative polymerase chain reaction (PCR) in a cohort of 127 patients with CLL and correlated this with clinical outcome, IGVH mutational status, and ZAP-70 protein expression. IGVH mutational status, ZAP-70, and the LPL and ADAM29 mRNA ratios (L/A ratio) were predictive of event-free survival for the whole cohort and for patients with stage A disease. in patients in stage B and C, the L/A ratio was an independent prognostic factor, whereas ZAP-70 did not predict survival. Simultaneous usage of the L/A ratio and ZAP-70 expression allowed an almost perfect (99%) assessment of the IGVH status in the 80% of patients with concordant results (L/A(+), ZAP-70(+) or L/A(-), ZAP-70(-)). LPL and ADAM29 gene expression could also be determined by a simple competitive multiplex reverse transcription PCR assay. Overall, quantification of LPL and ADAM29 gene expression is a strong prognostic indicator in CLL, providing better prognostic assessment than ZAP-70 in advanced stages of the disease. Hop La Pitie Salpetriere, Serv Hematol Biol, F-75013 Paris, France Inst Pasteur, Unite Immunohematol & Immunopathol, F-75724 Paris, France Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, Brazil Inst Pasteur, Dept Ecosyst & Epidemiol Malad Infect, Paris, France Hop La Pitie Salpetriere, Serv Immunol, Paris, France Inst Pasteur, Ctr Rech Vaccinale & Biomed, Paris, France Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, Brazil Web of Science

Published
2005

41. [Isolated pontine infarction: vascular anatomy helps understand clinical signs]

Author

Vuillier, F., Tatu, L., thierry Moulin, Parratte, B., Rumbach, L., and Monnier, G.

Subjects
Adult, Aged, 80 and over, Brain Infarction, Male, Pons, Humans, Female, Middle Aged, Aged
Abstract

Clinical findings of pontine infarcts are more frequently described as classical crossed-syndrome. The aim of this study was to analyse clinical presentation of isolated pontine infarcts. From the Besancon Stroke Registry, we retrospectively studied 34 patients with isolated pontine infarcts documented on MRI with a strict centro-bicommissural plane as the reference. MRI were analyzed using an arterial territories mapping of brainstem. Among our 34 pts, none developed a classical crossed-syndrome. A thorough knowledge of vascular anatomy of brainstem is necessary to understand clinical findings. Moreover, this knowledge allow to explain the rare occurrence of pontine crossed-syndrome.

Published
2002

42. [Brain CT scan for acute cerebral infarction: early signs of ischemia]

Author

Moulin T, Laurent TATU, Vuillier F, and Cattin F

Subjects
Acute Disease, Brain, Humans, Cerebral Infarction, Prognosis, Tomography, X-Ray Computed, Brain Ischemia, Cerebral Hemorrhage
Abstract

Computed tomography (CT) is widely used for early evaluation of acute strokes. Most importantly, CT excludes acute hemorrhage or other diseases mimicking ischemia. Therefore, CT is the main imaging examination in patients with brain ischemia and when antithrombotic agents are being considered. During the first hours after acute ischemic stroke, the CT does not usually show much in the first 24 hours. However, early abnormal findings on CT scan have been described such as the hyperdense middle cerebral artery sign (HMCAS), and reduced contrast attenuation of the cerebral parenchyma. HMCAS reflects arterial occlusion. Early parenchymal abnormalities, the attenuation of lentiform nucleus (ALN), loss of the insular ribbon (LIR) or hemispheric sulcus effacement (HSE) occur less frequently and they are positive criteria for cerebral in progress. Early parenchymal abnormalities might also predict subsequent infarct extension and hemorrhagic transformation. Therapeutic trials of ischemia in MCA territory involved decision making when the CT may not show obvious ischemic changes. Finally, initial CT findings may also help to predict response to therapy.

Published
1999

43. Peroxynitrite inhibits T lymphocyte activation and proliferation by promoting impairment of tyrosine phosphorylation and peroxynitrite-driven apoptotic death

Author

Brito C, Naviliat M, Ac, Tiscornia, Vuillier F, Gualco G, Dighiero G, Radi R, and Alfonso Cayota

Subjects
Nitrates, Time Factors, CD3 Complex, Metalloporphyrins, Superoxide Dismutase, T-Lymphocytes, Immunology, Dose-Response Relationship, Immunologic, Proteins, Apoptosis, Lymphocyte Activation, Monocytes, Immunology and Allergy, Humans, Tyrosine, Lymph Nodes, Nitric Oxide Synthase, Phosphorylation, Cell Division, Cells, Cultured, Immunosuppressive Agents
Abstract

Peroxynitrite (ONOO−) is a potent oxidizing and nitrating agent produced by the reaction of nitric oxide with superoxide. It readily nitrates phenolic compounds such as tyrosine residues in proteins, and it has been demonstrated that nitration of tyrosine residues in proteins inhibits their phosphorylation. During immune responses, tyrosine phosphorylation of key substrates by protein tyrosine kinases is the earliest of the intracellular signaling pathways following activation through the TCR complex. This work was aimed to evaluate the effects of ONOO− on lymphocyte tyrosine phosphorylation, proliferation, and survival. Additionally, we studied the generation of nitrating species in vivo and in vitro during immune activation. Our results demonstrate that ONOO−, through nitration of tyrosine residues, is able to inhibit activation-induced protein tyrosine phosphorylation in purified lymphocytes and prime them to undergo apoptotic cell death after PHA- or CD3-mediated activation but not upon phorbol ester-mediated stimulation. We also provide evidence indicating that peroxynitrite is produced during in vitro immune activation, mainly by cells of the monocyte/macrophage lineage. Furthermore, immunohistochemical studies demonstrate the in vivo generation of nitrating species in human lymph nodes undergoing mild to strong immune activation. Our results point to a physiological role for ONOO− as a down-modulator of immune responses and also as key mediator in cellular and tissue injury associated with chronic activation of the immune system.

Published
1999

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