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1. High prevalence of cognitive impairment after intracerebral hemorrhage.

Author

Mélanie Planton, Laure Saint-Aubert, Nicolas Raposo, Laura Branchu, Aicha Lyoubi, Fabrice Bonneville, Jean-François Albucher, Jean-Marc Olivot, Patrice Péran, and Jérémie Pariente

Subjects
Medicine, Science
Abstract

BACKGROUND:Cognitive impairment seems to be frequent in intracerebral hemorrhage (ICH) survivors, but remains widely understudied. In this study, we investigated the frequency and patterns of vascular cognitive disorders (VCDs) in patients with cerebral amyloid angiopathy (CAA)-related and deep ICH compared to patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD) and healthy controls. METHODS:We prospectively recruited 20 patients with CAA-related lobar ICH, 20 with deep ICH, 20 with MCI-AD and 17 healthy controls. Patients with cognitive decline pre-ICH were excluded from the analysis. Each participant underwent a comprehensive neuropsychological assessment and a structural brain MRI. Cognitive assessment was performed at a median delay of 4 months after the acute phase in ICH patients, and more than 6 months after the first complaint in MCI-AD patients. Cognitive profiles were compared between groups. The prevalence of VCDs in the ICH groups was estimated using the recent VASCOG criteria. RESULTS:"Mild" and "major VCDs" were respectively observed in 87.5% and 2.5% of all ICH patients. Every patient in the CAA group had mild VCDs. No significant difference was observed in cognitive functioning between CAA-related and deep ICH patients. The most impaired process in the CAA group was naming, with a mean (±standard deviation) z-score of -5.2 ±5.5, followed by processing speed (-4.1±3.3), executive functioning (-2.6 ±2.5), memory (-2.4 ±3.5) and attention (-0.9 ±1.3). This cognitive pattern was different from the MCI-AD patients, but the groups were only different in gestural praxis, and by construction, in memory processes. CONCLUSIONS:VCDs are frequent after ICH. Cognitive patterns of patients with deep or CAA-related ICH did not differ, but there was impaired performance in specific domains distinct from the effects of Alzheimer's disease. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01619709.

Published
2017
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2. FIP1L1-PDGFRA-Associated Hypereosinophilic Syndrome as a Treatable Cause of Watershed Infarction

Author

Juliette Tennenbaum, Matthieu Groh, Laura Venditti, France Campos-Gazeau, Emilie Chalayer, Thomas De Broucker, Mohamed Hamidou, Mathilde Hunault, Aicha Lyoubi, Raphaëlle Meunier, Thierry Muron, Damien Sène, Borhane Slama, Céline Guidoux, Guillaume Lefèvre, Jean-Emmanuel Kahn, Christian Denier, and Julien Rohmer

Subjects
Adult, Male, 0301 basic medicine, TOAST Classification, medicine.medical_specialty, Receptor, Platelet-Derived Growth Factor alpha, Oncogene Proteins, Fusion, Hypereosinophilia, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, Hypereosinophilic Syndrome, medicine, Humans, Stroke, Ischemic Stroke, Retrospective Studies, mRNA Cleavage and Polyadenylation Factors, Advanced and Specialized Nursing, First episode, business.industry, Hypereosinophilic syndrome, Coronary Thrombosis, Brain, Retrospective cohort study, Cerebral Infarction, Middle Aged, medicine.disease, Treatment Outcome, 030104 developmental biology, Imatinib mesylate, Imatinib Mesylate, Etiology, Female, Neurology (clinical), medicine.symptom, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Background and Purpose: Ischemic stroke has been reported in various conditions associated with eosinophilia. FIP1L1-PDGFRA fusion ([Fip1-like 1-platelet-derived growth factor receptor alpha]; F/P ) leads to the proliferation of the eosinophilic lineage and thus to a clonal hypereosinophilic syndrome that is highly responsive to imatinib. Methods: We previously reported on a nationwide retrospective study of 151 patients with F/P -associated clonal hypereosinophilic syndrome. Patients from this cohort with a clinical history of ischemic stroke (as well as 2 additional cases) were further analyzed to better define their clinical picture and outcomes. Results: Sixteen male patients (median age, 51 [43–59] years) with low-to-intermediate cardiovascular risk were included. Median National Institutes of Health Stroke Scale was 4 (range, 1–6). Most cerebral imaging disclosed multiple bilateral infarctions of watershed distribution (69%). Despite frequent cardiac involvement (50%), cardiac thrombus was evidenced in a single patient and, according to the TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment), 62.5% of strokes were presumably of undetermined etiology. Among the 15 patients treated with imatinib, and after a median follow-up of 4.5 years, stroke recurred in only 3 patients (consisting of either cardio embolic or hemorrhagic events, unrelated to the first episode). Conclusions: F/P + clonal hypereosinophilic syndrome is a diagnosis to consider in patients with unexplained ischemic stroke and hypereosinophilia (especially in the setting of multiple cortical borderzone distribution) and warrants prompt initiation of imatinib.

Published
2021
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3. SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group

Author

Saeideh Aghayari Sheikh Neshin, Guillaume Turc, Georgios Tsivgoulis, Fahimeh Vahabizad, Stefania Mondello, Oluwaseyi Olulana, Thomas Yasuda, Gelareh Banihashemi, Ali Reza Noorian, Mojdeh Ghabaee, Hany Mohamed Aref, Aristeidis H. Katsanos, Sahar Hojjat-Anasri Komachali, Alaleh Vaghefi Far, Saeed Ansari, Francisco Purroy, Leo H. Bonati, Sakineh Ranji-Burachaloo, Juan F. Arenillas, Afshin Borhani-Haghighi, Peyman Nowrouzi-Sohrabi, Ilaria Gandoglia, Zabihollah Babaeepour, Mohammad Hossein Harirchian, Alia Saberi, Vivek Sharma, Fabricio Buchadid Cardoso, Jusun Moon, Nitin Goyal, Arash Kia, Ronen R. Leker, Mercedeh Sepehrnia, João Sargento-Freitas, Apoorva Dev, Asadollah Mir Ghasemi, Mirna Sabra, Mohammad Ghorbani, Aicha Lyoubi, Bruce C.V. Campbell, Saeideh Salehizadeh, Christos Krogias, Shailesh Male, Mehrdad Roozbeh, Elahe Mohammadi-Vosough, Durgesh Chaudhary, Soheil Naderi, Nasrin Rahimian, Konark Malhotra, Mehmet Hanci, Mehdi Farhoudi, Arefeh Babazadeh, Ali Amini Harandi, Ghasem Farahmand, Massimo Del Sette, Martin Punter, Miljenko Crnjakovic, Faezeh Khodadadi, Gian Marco De Marchis, Ashkan Mowla, Nuno Reis Carreira, Fariborz Khorvash, Annemarei Ranta, Zeinab Mohseni Afshar, Orkhan Alizada, Shima Shahjouei, Ana Paula Aires, Diana Aguiar de Sousa, Christoph J. Griessenauer, Ava Hamidi, Seyed Amir Ebrahimzadeh, Farhad Assarzadegan, Jong Ho Park, Hamidreza Mirkarimi, Mostafa Almasi-Dooghaee, Achille Cernigliaro, Jeffrey C Mai, Lawrence Nolan, Mahmoud Reza Azarpazhooh, Leila Poorsaadat, Yasaman Ahmadzadeh, João Pedro Marto, Humain Baharvahdat, Kristi Tempro, Seyed Aidin Sajedi, Teresa Mesquita, Bruno Gonçalves, Venkatesh Avula, Manuel Requena, Jason J. Chang, Mika Niemelä, Zeynab Sadat Hasheminejad, Branko Malojčić, Elsa Azevedo, Abhi Pandhi, Debdipto Misra, Ramin Zand, Vida Abedi, Marta Rubiera, Thorsten Steiner, Alireza Vafaei Sadr, Sepideh Paybast, Rohan Arora, Behnam Rezai Jahromi, Firas Kobeissy, Jiang Li, Daniel Bock, Behnam Sabayan, Eric Koza, Joan Montaner, Lev Lotman, Mercedes de Lera Alfonso, Carlo W. Cereda, Mahtab Ramezani, Matthew S. Tenser, Duchange, Nathalie, Geisinger Health System [Danville, PA, USA], National and Kapodistrian University of Athens (NKUA), Attikon University Hospital, Tehran University of Medical Sciences (TUMS), Geisinger Commonwealth School of Medicine [Scranton, PA, USA], University of Southern California (USC), Université de Genève = University of Geneva (UNIGE), Icahn School of Medicine at Mount Sinai [New York] (MSSM), University of Messina, Regional Health Authority of Sicily [Palermo], University of Otago [Dunedin, Nouvelle-Zélande], PES University [Bangalore], Lebanese University [Beirut] (LU), Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], University of Melbourne, Universidad de Valladolid [Valladolid] (UVa), Klinikum Frankfurt Höchst, University Hospital Virgen Macarena [Sevilla], Poursina Hospital, Universidade de Lisboa = University of Lisbon (ULISBOA), Centro Hospitalar Universitário de São João [Porto], Universidade do Porto = University of Porto, Cerrahpasa Faculty of Medicine, Istanbul University, University of Tennessee [Chattanooga] (UTC), Valiasr Hospital [Borujen], University Hospital Basel [Basel], Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, MedStar Washington Hospital Center, Clinical Hospital Dubrava [Zagreb, Croatia] (CHD), University of Basel (Unibas), Galliera Hospital [Genova, Italy], Yasrebi Hospital [Kashan, Iran] (YH), Tabriz University of Medical Sciences [Tabriz, Iran] (TUOMS), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), McMaster University [Hamilton, Ontario], Ruhr University Bochum (RUB), Hadassah Hebrew University Medical Center [Jerusalem], Albany Medical College, Georgetown University Medical Center, Vidant Medical Center [Greenville, NC, USA] (VMC), Allegheny Health Network [Pittsburgh, PA, USA] (AHN), University Hospital Centre Zagreb, Partenaires INRAE, University of Zagreb, Hospital De Egas Moniz [Lisbon], University of Ottawa [Ottawa], Ain Shams University (ASU), Kermanshah University of Medical Sciences, Asan Medical Center [Seoul], University of Ulsan, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Hospital, Hanyang University College of Medicine, Universitat de Lleida, Vall d'Hebron University Hospital [Barcelona], Universitat Autònoma de Barcelona (UAB), Golestan University of Medical Sciences, Universidade de Coimbra [Coimbra], National University Health System [Singapore] (NUHS), Heidelberg University Hospital [Heidelberg], Hospital for Special Surgery, Iran University of Medical Sciences, Shahid Beheshti University, Babol University of Medical Sciences, Mashhad University of Medical Sciences, Centro Médico de Campinas [São Paulo], Gheshm Hospital, Gilan University of Medical Sciences [Lahijan], Isfahan University of Medical Sciences [Iran] (MUI), University of Florida [Gainesville] (UF), Modarres Hospital [Kashmar], Southern California Permanente Medical Group, Shiraz University of Medical Sciences [Iran] (SUMS), Qazvin University of Medical Sciences, Arak University of Medical Sciences, Harvard Medical School [Boston] (HMS), Salahadin Ayubi Hospital [Baneh], University of Western Ontario (UWO), Long Island Jewish Forest Hills [New York], Biocomplexity Institute of Virginia Tech [Blacksburg], Virginia Tech [Blacksburg], Department of Neurosciences, HUS Neurocenter, Neurokirurgian yksikkö, Clinicum, University of Geneva [Switzerland], Universidade de Lisboa (ULISBOA), Universidade do Porto, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Hospital De Egas Moniz [Lisbon, Portugal] (Centro Hospitalar Lisboa Ocidental), and University of Helsinki

Subjects
Male, Cerebrovascular disorders, MESH: Geography, Epidemiology, International Cooperation, SUBTYPES, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prospective Studies, Young adult, Cerebral Venous Thrombosis, MESH: Treatment Outcome, Subtypes, neuroimaging, MESH: Middle Aged, MESH: Risk, Geography, STATEMENT, cerebrovascular disorders, intracranial hemorrhages, stroke, venous thrombosis, virus diseases, Countries, 3. Good health, MESH: Young Adult, Cardiology and Cardiovascular Medicine, MESH: Intracranial Hemorrhages, COUNTRIES, medicine.medical_specialty, Registry, MESH: Health Expenditures, 03 medical and health sciences, 1ST-EVER ISCHEMIC-STROKE, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, Aged, Ischemic Stroke, Advanced and Specialized Nursing, MESH: Humans, 3112 Neurosciences, MESH: Adult, medicine.disease, MESH: International Cooperation, nervous system, RISK-FACTORS, Observational study, Neurology (clinical), Statement, Health Expenditures, Young-Adults, MESH: Female, 030217 neurology & neurosurgery, viruses, 030204 cardiovascular system & hematology, Sinus Thrombosis, Intracranial, Venous thrombosis, YOUNG-ADULTS, Risk-Factors, EPIDEMIOLOGY, MESH: COVID-19, Prospective cohort study, Stroke, MESH: Aged, musculoskeletal, neural, and ocular physiology, CEREBRAL VENOUS THROMBOSIS, Middle Aged, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Treatment Outcome, MESH: Sinus Thrombosis, Intracranial, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, medicine.symptom, Interstroke, MESH: Ischemic Stroke, Adult, Risk, Subarachnoid hemorrhage, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Neuroimaging, macromolecular substances, Asymptomatic, Young Adult, INTERSTROKE, Aneurysm, Internal medicine, medicine, cardiovascular diseases, business.industry, COVID-19, Artery occlusions, MESH: Male, MESH: Prospective Studies, Intracranial hemorrhages, REGISTRY, MESH: Venous Thrombosis, 1st-Ever Ischemic-Stroke, business
Abstract

Background and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were P =0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P Conclusions: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.

Published
2021
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4. Focal Macroscopic Cortical Lesions in Cerebral Autosomal-Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Author

Aicha Lyoubi-Idrissi, Hugues Chabriat, Eric Jouvent, and François De Guio

Subjects
Adult, Male, Pathology, medicine.medical_specialty, CADASIL, 030204 cardiovascular system & hematology, Imaging data, Cohort Studies, White matter, Leukoencephalopathy, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Aged, Cerebral Cortex, Advanced and Specialized Nursing, medicine.diagnostic_test, business.industry, Cortical degeneration, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Cerebral cortex, Female, Neurology (clinical), Small vessel, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

Background and Purpose— Cortical microinfarcts and secondary cortical degeneration have been demonstrated in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a severe monogenic cerebral small vessel disease. The aim of this study was to determine whether focal macroscopic cortical lesions can be detected using a specific in vivo magnetic resonance imaging approach. Methods— Three-dimensional T1 magnetic resonance imaging scans were obtained in 28 nondemented nondisabled CADASIL patients and 29 age- and sex-matched controls. The cortical mantle of patients and controls were extracted using Brainvisa by an experienced user and then evaluated during a dedicated reading session by a second reader after removing the white matter to stay blind to the clinical status. Thereafter, confirmed focal macroscopic cortical lesions were characterized using all available imaging data, including 7-T magnetic resonance imaging in some patients. Results— Three focal macroscopic cortical lesions were confirmed in 3 of 28 patients (11%) but none in controls. All lesions were observed in the close vicinity of severe signal changes in the underlying white matter. Conclusions— Focal macroscopic cortical lesions can be detected using specific magnetic resonance imaging approaches in CADASIL patients long before the end stage of the disorder. The underlying mechanisms and precise clinical consequences of these cortical changes still need to be determined.

Published
2017
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