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13. Ultra-early neurological deterioration following a brain arteriovenous malformation rupture.

Author

Shotar, Eimad, Chiaroni, Pierre-Marie, Haffaf, Idriss, Cortese, Jonathan, Jacquens, Alice, Garzelli, Lorenzo, Allard, Julien, Elhorany, Mahmoud, Amouyal, Caroline, Mathon, Bertrand, Nouet, Aurélien, Premat, Kévin, Lenck, Stéphanie, Sourour, Nader-Antoine, Degos, Vincent, and Clarençon, Frédéric

Subjects
CEREBRAL arteriovenous malformations, GLASGOW Coma Scale, CLINICAL deterioration, HOSPITAL mortality, INTRAVENTRICULAR hemorrhage
Abstract

Purpose: This study aims to explore the impact of ultra-early neurological deterioration (U-END) on the outcome (mortality and poor neurological status) following a brain arteriovenous malformation (BAVM) rupture and identify determinants of U-END. Methods: Patients with BAVM ruptures admitted to a single tertiary care center were retrospectively reviewed. U-END was defined as a worsening by two or more points on the Glasgow Coma Scale (GCS). U-END was tested as a potential predictor of in-hospital mortality and poor outcomes. Univariate and multivariate analyses were performed to identify determinants of U-END. Patients with U-END were also matched and compared with BAVM rupture controls presenting with a GCS close or equal to either their initial or their lowest GCS. Results: A total of 248 patients with BAVM ruptures met the inclusion criteria, with 39 (15.7%) patients presenting with U-END. U-END was not associated with and was not an independent predictor of in-hospital mortality (12.8 vs. 10.5% in the rest of the study population; p = 0.67) or poor outcomes (39.5 vs. 36.9%; p = 0.77). The only independent determinants of U-END were hydrocephalus (OR 2.6 [95%CI, 1.1-6.4]; p = 0.03) and intraventricular hemorrhage (IVH; OR 3.5 [95%CI, 1.1-11.7]; p = 0.04). When compared to the initial GCS control group, U-END patients more often presented with IVH (89.5 vs. 64.1%; p = 0.009) and hydrocephalus (73 vs. 38.5%; p = 0.003). When compared to the lowest GCS control group, U-END patients had lower early S100B serum levels (0.35 ± 0.37 vs. 0.83 ± 1; p = 0.009) and a lower rate of poor outcome (39.5 vs. 64.9%; p = 0.03). Conclusion: Ultra-early neurological deterioration in ruptured BAVMs did not result in increased mortality or poor outcomes and was most often related to IVH and hydrocephalus. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Insights into acute mesenteric ischaemia: an up-to-date, evidence-based review from a mesenteric stroke centre unit

Author

Garzelli, Lorenzo, primary, Ben Abdallah, Iannis, additional, Nuzzo, Alexandre, additional, Zappa, Magaly, additional, Corcos, Olivier, additional, Dioguardi Burgio, Marco, additional, Cazals-Hatem, Dominique, additional, Rautou, Pierre-Emmanuel, additional, Vilgrain, Valérie, additional, Calame, Paul, additional, and Ronot, Maxime, additional

Published
2023
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17. Hemorrhage Expansion After Pediatric Intracerebral Hemorrhage

Author

Boulouis, Gregoire, Hak, Jean-François, Kerleroux, Basile, Benichi, Sandro, Stricker, Sarah, Gariel, Florent, Alias, Quentin, Bourgeois, Marie, Meyer, Philippe, Kossorotoff, Manoelle, Garzelli, Lorenzo, Garcelon, Nicolas, Boddaert, Nathalie, Morotti, Andrea, Blauwblomme, Thomas, and Naggara, Olivier

Published
2021
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24. MRI for the Detection of Small Bowel Ischemic Injury in Arterial Acute Mesenteric Ischemia: Preclinical Study in a Porcine Model

Author

Garzelli, Lorenzo, primary, Felli, Eric, additional, Al‐Taher, Mahdi, additional, Barberio, Manuel, additional, Agnus, Vincent, additional, Plaforet, Vincent, additional, Bonvalet, Fanny, additional, Baiocchini, Andrea, additional, Nuzzo, Alexandre, additional, Paulatto, Luisa, additional, Vilgrain, Valérie, additional, Gallix, Benoit, additional, Diana, Michele, additional, and Ronot, Maxime, additional

Published
2022
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26. MRI for the Detection of Small Bowel Ischemic Injury in Arterial Acute Mesenteric Ischemia: Preclinical Study in a Porcine Model

Author

Garzelli, Lorenzo, Felli, Eric, Al-Taher, Mahdi, Barberio, Manuel, Agnus, Vincent, Plaforet, Vincent, Bonvalet, Fanny, Baiocchini, Andrea, Nuzzo, Alexandre, Paulatto, Luisa, Vilgrain, Valérie, Gallix, Benoit, Diana, Michele, and Ronot, Maxime

Subjects
610 Medicine & health
Abstract

BACKGROUND MRI is the reference for the diagnosis of arterial cerebral ischemia, but its role in acute mesenteric ischemia (AMI) is poorly known. PURPOSE To assess MRI detection of early ischemic bowel lesions in a porcine model of arterial AMI. STUDY TYPE Prospective/cohort. ANIMAL MODEL Porcine model of arterial AMI obtained by embolization of the superior mesenteric artery (seven pigs). FIELD STRENGTH/SEQUENCE A 5-T. T1 gradient-echo-weighted-imaging (WI), half-Fourier-acquisition-single-shot-turbo-spin-echo, T2 turbo-spin-echo, true-fast-imaging-with-steady-precession (True-FISP), diffusion-weighted-echo-planar (DWI). ASSESSMENT T1-WI, T2-WI, and DWI were performed before and continuously after embolization for 6 hours. The signal intensity (SI) of the ischemic bowel was assessed visually and quantitatively on all sequences. The apparent diffusion coefficient (ADC) was assessed. STATISTICAL TESTS Paired Student's t-test or Mann-Whitney U-test, significance at P

Published
2022
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27. Improving clinical suspicion of acute mesenteric ischemia among patients with acute abdomen: a cross-sectional study from an intestinal stroke center.

Author

Nuzzo, Alexandre, Peoc'h, Katell, Vaittinada Ayar, Prabakar, Tran-Dinh, Alexy, Weiss, Emmanuel, Panis, Yves, Ronot, Maxime, Garzelli, Lorenzo, Eloy, Philippine, Ben Abdallah, Iannis, Castier, Yves, and Corcos, Olivier

Subjects
C-reactive protein, HOSPITAL emergency services, PATIENTS, HOSPITAL admission & discharge, STROKE units, ACUTE abdomen, DESCRIPTIVE statistics, RESEARCH funding, MESENTERIC ischemia, RECEIVER operating characteristic curves, ACUTE diseases, EARLY diagnosis
Abstract

Background: Early diagnosis of acute mesenteric ischemia (AMI) is essential for a favorable outcome. Selection of patients requiring a dedicated multiphasic computed tomography (CT) scan remains a clinical challenge. Methods: In this cross-sectional diagnostic study conducted from 2016 to 2018, we compared the presentation of AMI patients admitted to an intestinal stroke center to patients with acute abdominal pain of another origin admitted to the emergency room (controls). Results: We included 137 patients—52 with AMI and 85 controls. Patients with AMI [median age: 65 years (interquartile range 55–74)] had arterial and venous AMI in 65% and 35% of cases, respectively. Relative to controls, AMI patients were significantly older, more likely to have risk factors or a history of cardiovascular disease, and more likely to present with sudden-onset and morphine-requiring abdominal pain, hematochezia, guarding, organ dysfunction, higher white blood cell and neutrophil counts, and higher plasma C-reactive protein (CRP) and procalcitonin concentrations. On multivariate analysis, two independent factors were associated with the diagnosis of AMI: the sudden-onset (OR = 20, 95%CI 7–60, p < 0.001) and the morphine-requiring nature of the acute abdominal pain (OR = 6, 95%CI 2–16, p = 0.002). Sudden-onset and/or morphine-requiring abdominal pain was present in 88% of AMI patients versus 28% in controls (p < 0.001). The area under the receiver operating characteristic curve for the diagnosis of AMI was 0.84 (95%CI 0.77–0.91), depending on the number of factors. Conclusions: Sudden onset and the need for morphine are suggestive of AMI in patients with acute abdominal pain and should prompt multiphasic CT scan including arterial and venous phase images for confirmation. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Arterial Spin Labeling for the Etiological Workup of Intracerebral Hemorrhage in Children

Author

Hak, Jean François, primary, Boulouis, Grégoire, additional, Kerleroux, Basile, additional, Benichi, Sandro, additional, Stricker, Sarah, additional, Gariel, Florent, additional, Garzelli, Lorenzo, additional, Meyer, Philippe, additional, Kossorotoff, Manoelle, additional, Boddaert, Nathalie, additional, Vidal, Vincent, additional, Girard, Nadine, additional, Dangouloff Ros, Volodia, additional, Brunelle, Francis, additional, Blauwblomme, Thomas, additional, and Naggara, Olivier, additional

Published
2022
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29. MRI for the Detection of Small Bowel Ischemic Injury in Arterial Acute Mesenteric Ischemia: Preclinical Study in a Porcine Model.

Author

Garzelli, Lorenzo, Felli, Eric, Al‐Taher, Mahdi, Barberio, Manuel, Agnus, Vincent, Plaforet, Vincent, Bonvalet, Fanny, Baiocchini, Andrea, Nuzzo, Alexandre, Paulatto, Luisa, Vilgrain, Valérie, Gallix, Benoit, Diana, Michele, and Ronot, Maxime

Subjects
MESENTERIC ischemia, SMALL intestine, ARTERIAL injuries, MESENTERIC artery, MAGNETIC resonance imaging, CEREBRAL ischemia
Abstract

Background: MRI is the reference for the diagnosis of arterial cerebral ischemia, but its role in acute mesenteric ischemia (AMI) is poorly known. Purpose: To assess MRI detection of early ischemic bowel lesions in a porcine model of arterial AMI. Study Type: Prospective/cohort. Animal Model: Porcine model of arterial AMI obtained by embolization of the superior mesenteric artery (seven pigs). Field Strength/Sequence: A 5‐T. T1 gradient‐echo‐weighted‐imaging (WI), half‐Fourier‐acquisition‐single‐shot‐turbo‐spin‐echo, T2 turbo‐spin‐echo, true‐fast‐imaging‐with‐steady‐precession (True‐FISP), diffusion‐weighted‐echo‐planar (DWI). Assessment: T1‐WI, T2‐WI, and DWI were performed before and continuously after embolization for 6 hours. The signal intensity (SI) of the ischemic bowel was assessed visually and quantitatively on all sequences. The apparent diffusion coefficient (ADC) was assessed. Statistical Tests: Paired Student's t‐test or Mann–Whitney U‐test, significance at P < 0.05. Results: One pig died from non‐AMI‐related causes. The remaining pigs underwent a median 5 h53 (range 1 h24–6 h01) of ischemia. Visually, the ischemic bowel showed signal hyperintensity on DWI‐b800 after a median 85 (57–276) minutes compared to the nonischemic bowel. DWI‐b800 SI significantly increased after 2 hours (+19%) and the ADC significant decrease within the first hour (−31%). The ischemic bowel was hyperintense on precontrast T1‐WI after a median 87 (70–171) minutes with no significant quantitative changes over time (P = 0.46–0.93). The ischemic bowel was hyperintense on T2‐WI in three pigs with a significant SI increase on True‐FISP after 1 and 2 hours. Data Conclusion: Changes in SI and ADC can be seen early after the onset of arterial AMI with DWI. The value of T2‐WI appears to be limited. Evidence Level: 1 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Published
2023
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30. Colonic involvement in acute mesenteric ischemia: prevalence, risk factors, and outcomes

Author

Ksouri, Aida, primary, Copin, Pauline, additional, Bonvalet, Fanny, additional, Bozi, Lilian, additional, Cazals-Hatem, Dominique, additional, Garzelli, Lorenzo, additional, Panis, Yves, additional, Weiss, Emmanuel, additional, Castier, Yves, additional, Bouhnik, Yoram, additional, Corcos, Olivier, additional, Vilgrain, Valérie, additional, Ronot, Maxime, additional, and Nuzzo, Alexandre, additional

Published
2021
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31. Pediatric brain arteriovenous malformation recurrence: a cohort study, systematic review and meta-analysis

Author

Hak, Jean-Francois, primary, Boulouis, Gregoire, additional, Kerleroux, Basile, additional, Benichi, Sandro, additional, Stricker, Sarah, additional, Gariel, Florent, additional, Garzelli, Lorenzo, additional, Meyer, Philippe, additional, Kossorotoff, Manoelle, additional, Boddaert, Nathalie, additional, Vidal, Vincent, additional, Girard, Nadine, additional, Dangouloff-Ros, Volodia, additional, Brunelle, Francis, additional, Fullerton, Heather, additional, Hetts, Steven W, additional, Blauwblomme, Thomas, additional, and Naggara, Olivier, additional

Published
2021
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35. Noncontrast Computed Tomography Markers in Brain Arteriovenous Malformation-Related Hematoma Are Not Predictive of Clinical Outcome

Author

Cortese, Jonathan, primary, Haffaf, Idriss, additional, Garzelli, Lorenzo, additional, Boulouis, Grégoire, additional, Mathon, Bertrand, additional, Boch, Anne-Laure, additional, Lenck, Stéphanie, additional, Jacquens, Alice, additional, Amouyal, Caroline, additional, Premat, Kevin, additional, Sourour, Nader-Antoine, additional, Degos, Vincent, additional, Clarençon, Frédéric, additional, and Shotar, Eimad, additional

Published
2021
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36. Mortality and functional outcome after pediatric intracerebral hemorrhage: cohort study and meta-analysis

Author

Boulouis, Grégoire, primary, Stricker, Sarah, additional, Benichi, Sandro, additional, Hak, Jean-François, additional, Gariel, Florent, additional, Kossorotoff, Manoelle, additional, Garcelon, Nicolas, additional, Harroche, Annie, additional, Alias, Quentin, additional, Garzelli, Lorenzo, additional, Bajolle, Fanny, additional, Boddaert, Nathalie, additional, Meyer, Philippe, additional, Blauwblomme, Thomas, additional, and Naggara, Olivier, additional

Published
2021
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38. Acute surgical management of children with ruptured brain arteriovenous malformation

Author

Stricker, Sarah, primary, Boulouis, Grégoire, additional, Benichi, Sandro, additional, Bourgeois, Marie, additional, Gariel, Florent, additional, Garzelli, Lorenzo, additional, Hak, Jean-François, additional, Alias, Quentin, additional, Kerleroux, Basile, additional, Beccaria, Kevin, additional, Chivet, Anaïs, additional, de Saint Denis, Timothée, additional, James, Syril, additional, Paternoster, Giovanna, additional, Zerah, Michel, additional, Kossorotoff, Manoelle, additional, Boddaert, Nathalie, additional, Brunelle, Francis, additional, Meyer, Philippe, additional, Puget, Stéphanie, additional, Naggara, Olivier, additional, and Blauwblomme, Thomas, additional

Published
2021
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41. Etiology of intracerebral hemorrhage in children: cohort study, systematic review, and meta-analysis

Author

Boulouis, Grégoire, primary, Stricker, Sarah, additional, Benichi, Sandro, additional, Hak, Jean-François, additional, Gariel, Florent, additional, Alias, Quentin, additional, de Saint Denis, Timothée, additional, Kossorotoff, Manoelle, additional, Bajolle, Fanny, additional, Garzelli, Lorenzo, additional, Beccaria, Kevin, additional, Paternoster, Giovanna, additional, Bourgeois, Marie, additional, Garcelon, Nicolas, additional, Harroche, Annie, additional, Mancusi, Rossella Letizia, additional, Boddaert, Nathalie, additional, Puget, Stephanie, additional, Brunelle, Francis, additional, Blauwblomme, Thomas, additional, and Naggara, Olivier, additional

Published
2021
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42. Secondary S100B Protein Increase Following Brain Arteriovenous Malformation Rupture is Associated with Cerebral Infarction

Author

Garzelli, Lorenzo, primary, Jacquens, Alice, additional, Amouyal, Caroline, additional, Premat, Kevin, additional, Sourour, Nader, additional, Cortese, Jonathan, additional, Haffaf, Idriss, additional, Mathon, Bertrand, additional, Lenck, Stéphanie, additional, Clarençon, Frédéric, additional, Degos, Vincent, additional, and Shotar, Eimad, additional

Published
2020
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43. Hydrocephalus in children with ruptured cerebral arteriovenous malformation

Author

Stricker, Sarah, primary, Boulouis, Grégoire, additional, Benichi, Sandro, additional, Gariel, Florent, additional, Garzelli, Lorenzo, additional, Beccaria, Kevin, additional, Chivet, Anais, additional, de Saint Denis, Timothee, additional, James, Syril, additional, Paternoster, Giovanna, additional, Zerah, Michel, additional, Bourgeois, Marie, additional, Boddaert, Nathalie, additional, Brunelle, Francis, additional, Meyer, Philippe, additional, Puget, Stephanie, additional, Naggara, Olivier, additional, and Blauwblomme, Thomas, additional

Published
2020
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45. Pediatric brain arteriovenous malformation recurrence: a cohort study, systematic review and meta-analysis.

Author

Hak, Jean-Francois, Boulouis, Gregoire, Kerleroux, Basile, Benichi, Sandro, Stricker, Sarah, Gariel, Florent, Garzelli, Lorenzo, Meyer, Philippe, Kossorotoff, Manoelle, Boddaert, Nathalie, Vidal, Vincent, Girard, Nadine, Dangouloff-Ros, Volodia, Brunelle, Francis, Fullerton, Heather, Hetts, Steven W., Blauwblomme, Thomas, and Naggara, Olivier

Subjects
DISEASE relapse, BRAIN diseases, META-analysis, CONFIDENCE intervals, SYSTEMATIC reviews, RISK assessment, RESEARCH funding, DESCRIPTIVE statistics, ENDOVASCULAR surgery, RADIOSURGERY, ARTERIOVENOUS malformation, CHILDREN
Abstract

Background Recurrence following obliteration of brain arteriovenous malformations (AVMs) is common in children surgically treated, but recurrences following endovascular (EVT) and radiosurgical approaches are scantily reported. Objective To analyze the rates and risk factors for AVM recurrence after obliteration in a single-center cohort of children with ruptured AVMs treated with multimodal approaches, and to carry out a comprehensive review and meta-analysis of current data. Methods Children with ruptured AVMs between 2000 and 2019 enrolled in a prospective registry were retrospectively screened and included after angiographically determined obliteration to differentiate children with/without recurrence. A complementary systematic review and meta-analysis of studies investigating AVM recurrence in children between 2000 and 2020 was aggregated to explore the overall recurrence rates across treatment modalities by analyzing surgery versus other treatments. Results Seventy children with obliterated AVMs were included. AVM recurrences (n=10) were more commonly treated with EVT as final treatment (60% in the recurrence vs 13.3% in the no- recurrence group, p=0.018). Infratentorial locations were associated with earlier and more frequent recurrences (adjusted relative risk=4.62, 95% CI 1.08 to 19.04; p=0.04). In the aggregate analysis, the pooled rate of AVM recurrence was 10.9% (95% CI 8.7% to 13.5%). Younger age at presentation was associated with more frequent recurrences (RR per year increase, 0.97, 95% CI 0.93 to 0.99; p=0.046). Conclusion Location of infratentorial AVMs and younger age at presentation may be associated with earlier and more frequent recurrences. The higher rates of recurrence in patients with AVMs obliterated with EVT questions its role in an intent-to-cure approach and reinforces its position as an adjunct to surgery and/or radiosurgery. [ABSTRACT FROM AUTHOR]

Published
2022
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46. Facteurs de risques en faveur d’une rupture précoce des malformations artério-veineuses cérébrales : une étude de cohorte de patients pédiatriques et adultes

Author

Garzelli, Lorenzo, primary, Shotar, Eimad, additional, Blauwblomme, Thomas, additional, Sourour, Nader, additional, Alias, Quentin, additional, Stricker, Sarah, additional, Mathon, Bertrand, additional, Kossorotoff, Manoëlle, additional, Degos, Vincent, additional, Gariel, Florent, additional, Boddaert, Nathalie, additional, Brunelle, Francis, additional, Meyer, Philippe, additional, Naggara, Olivier, additional, Clarençon, Frédéric, additional, and Boulouis, Grégoire, additional

Published
2020
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47. First Line Onyx Embolization in Ruptured Pediatric Arteriovenous Malformations

Author

Alias, Quentin, primary, Boulouis, Grégoire, additional, Blauwblomme, Thomas, additional, Benichi, Sandro, additional, Beccaria, Kevin, additional, Gariel, Florent, additional, Garzelli, Lorenzo, additional, Meyer, Philippe, additional, Kossorotoff, Manoelle, additional, Boddaert, Nathalie, additional, Brunelle, Francis, additional, and Naggara, Olivier, additional

Published
2019
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49. COURRIER.

Author

Garzelli, Lorenzo

Abstract

The article presents a letter to the editor on the subject of film criticism and the quality of acting in certain films such as "No Country for Old Men." A correction is also presented concerning the role of Thomas Sankara in the Festival Panafricain de Ouagadougou.

Published
2008

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