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Schneckenburger R, Boulanger M, Nehme A, Watrin M, Le Du G, Guettier S, Guittet L, Touzé E. Epidemiology of transient ischemic attack in the normandy stroke population-based study. Eur Stroke J 2024:23969873241251722. [PMID: 38711259 DOI: 10.1177/23969873241251722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Transient ischemic attack (TIA) is a frequent neurological emergency which management and definition have changed radically over the last 15 years. However, recent epidemiological studies of TIA are scarce. We report here on the impact of the shift from a time-based to a tissue-based definition of TIA on its incidence and risk of recurrence in a new population-based cohort with a high rate of patients investigated by MRI. MATERIALS AND METHODS We prospectively included all TIAs that occurred between May 2017 and May 2021 from the Normandy Stroke Study, a population-based registry using multiple overlapping sources for exhaustive case identification in Caen la Mer area. TIAs were classified as either time-based (symptoms <24 h) or tissue-based (<24 h and no lesion on brain imaging). Attack and incidence rates were calculated, as was the 90-day ischemic stroke rate. RESULTS Five hundred and sixty-seven TIAs (549 single patients) were included, with 80.6% having a brain MRI. Four hundred and ten (72.3%) met the definition of tissue-based TIA. The age standardized attack (to the 2013 European population) rate was 39.5 (95% CI 35.7-43.5) and the age-standardized incidence rate (first ever cerebrovascular event) was 29.7 (95% CI 27.3-34.2). The overall recurrent stroke rate at 90 days was 2.7%, with no difference between patients with or without ischemic lesions on MRI. CONCLUSION We found that the use of the tissue-based definition of TIA resulted in a 27.5% reduction in incidence as compared to the time-based definition, but had no impact on the 90-day stroke rate. The burden of TIA remains high, and is likely to increase as the population ages.
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Affiliation(s)
- Romain Schneckenburger
- Université Caen Normandie, Caen, France
- Department of Neurology, CHU de Caen Normandie, Caen, France
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
| | - Marion Boulanger
- Université Caen Normandie, Caen, France
- Department of Neurology, CHU de Caen Normandie, Caen, France
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
| | - Ahmad Nehme
- Université Caen Normandie, Caen, France
- Department of Neurology, CHU de Caen Normandie, Caen, France
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
| | - Marguerite Watrin
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
- Department of Clinical Research, CHU de Caen Normandie, Caen, France
| | - Gwendoline Le Du
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
- Department of Clinical Research, CHU de Caen Normandie, Caen, France
| | - Sophie Guettier
- Department of Neurology, CHU de Caen Normandie, Caen, France
| | - Lydia Guittet
- Université Caen Normandie, Caen, France
- Department of Clinical Research, CHU de Caen Normandie, Caen, France
| | - Emmanuel Touzé
- Université Caen Normandie, Caen, France
- Department of Neurology, CHU de Caen Normandie, Caen, France
- INSERM UMR-S U1237 PhIND/BB@C, Caen, France
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Olivot J, Finitsis S, Lapergue B, Marnat G, Sibon I, Richard S, Viguier A, Cognard C, Mazighi M, Gory B, Piotin M, Blanc R, Redjem H, Escalard S, Desilles J, Delvoye F, Smajda S, Maïer B, Hebert S, Mazighi M, Obadia M, Sabben C, Seners P, Raynouard I, Corabianu O, de Broucker T, Manchon E, Taylor G, Maacha MB, Thion L, Lecler A, Savatovsjy J, Wang A, Evrard S, Tchikviladze M, Ajili N, Lapergue B, Weisenburger‐Lile D, Gorza L, Buard G, Coskun O, Consoli A, Di Maria F, Rodesh G, Zimatore S, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Marinier S, Nighoghossian N, Riva R, Eker O, Turjman F, Derex L, Cho T, Mechtouff L, Lukaszewicz A, Philippeau F, Cakmak S, Blanc‐Lasserre K, Vallet A, Marnat G, Gariel F, Barreau X, Berge J, Menegon P, Sibon I, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Rouanet F, Tourdias T, Liegey J, Briau P, Pangon N, Bourcier R, Detraz L, Daumas‐Duport B, Alexandre P, Roy M, Lenoble C, Desal H, Guillon B, de Gaalon S, Preterre C, Gory B, Bracard S, Anxionnat R, Braun M, Derelle A, Liao L, Zhu F, Schmitt E, Planel S, Richard S, Humbertjean L, Mione G, Lacour J, Douarinou M, Audibert G, Voicu M, Alb I, Reitter M, Brezeanu M, Masson A, Tabarna A, Podar I, Bourst P, Beaumont M, Chen (Mitchelle) B, Guy S, Georges V, Bechiri F, Macian‐Montoro F, Saleme S, Mounayer C, Rouchaud A, Gimenez L, Cosnard A, Costalat V, Arquizan C, Dargazanli C, Gascou G, Lefèvre P, Derraz I, Riquelme C, Gaillard N, Mourand I, Corti L, Cagnazzo F, ter Schiphorst A, Alias Q, Boustia F, Ferre J, Raoult H, Gauvrit J, Vannier S, Guillen M, Ronziere T, Lassalle V, Tracol C, Malrain C, Boinet S, Clarençon F, Shotar E, Sourour N, Lenck S, Premat K, Samson Y, Léger A, Crozier S, Baronnet F, Alamowitch S, Bottin L, Yger M, Degos V, Spelle L, Denier C, Chassin O, Chalumeau V, Caroff J, Chassin O, Venditti L, Sarov M, Legris N, Naggara O, Hassen WB, Boulouis G, Rodriguez‐Régent C, Trystram D, Kerleroux B, Turc G, Domigo V, Lamy C, Birchenall J, Isabel C, Lun F, Viguier A, Cognard C, Januel A, Olivot J, Raposo N, Bonneville F, Albucher J, Calviere L, Darcourt J, Bellanger G, Tall P, Touze E, Barbier C, Schneckenburger R, Boulanger M, Cogez J, Guettier S, Gauberti M, Timsit S, Gentric J, Ognard J, Merrien FM, Wermester OO, Massardier E, Papagiannaki C, Triquenot A, Lefebvre M, Bourdain F, Bernady P, Lagoarde‐Segot L, Cailliez H, Veunac L, Higue D, Wolff V, Quenardelle V, Lauer V, Gheoca R, Pierre‐Paul I, Pop R, Beaujeux R, Mihoc D, Manisor M, Pottecher J, Meyer A, Chamaraux‐Tran T, Le Bras A, Evain S, Le Guen A, Richter S, Hubrecht R, Demasles S, Barroso B, Sablot D, Farouil G, Tardieu M, Smadja P, Aptel S, Seiler I. Parenchymal hemorrhage rate is associated with time to reperfusion and outcome. Ann Neurol 2022; 92:882-887. [DOI: 10.1002/ana.26478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Bertrand Lapergue
- Department of Neurology Foch Hospital Versailles Saint‐Quentin en Yvelines University Suresnes France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology University Hospital of Bordeaux France
| | - Igor Sibon
- Department of Neurology, Stroke Center University Hospital of Bordeaux France
| | - Sebastien Richard
- Université de Lorraine, CHRU‐Nancy, Department of Neurology, Stroke Unit F‐54000 Nancy France
- CIC‐P 1433 , INSERM U1116, CHRU‐Nancy, F‐54000 Nancy France
| | - Alain Viguier
- Acute Stroke Unit‐ CIC 1436‐UMR 1214, CHU Toulouse France
| | - Christophe Cognard
- Department of Interventional and Diagnostic Neuroradiolology CHU Toulouse France
| | - Mikael Mazighi
- Department of Interventional Neuroradiology FHU Neurovasc, INSERM 1148, Université de Paris Cité Rothschild Foundation, Paris France
- Diagnostic and Therapeutic Neuroradiology, F‐54000 Nancy France
| | - Benjamin Gory
- Université de Lorraine, IADI, INSERM U1254 F‐54000 Nancy France
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Schneckenburger R, Boulanger M, Watrin M, Le Du G, Morello R, Touzé E. Incidence and outcomes of acute cerebrovascular events: methodology of the population-based Normandy Stroke Study. Neuroepidemiology 2022; 57:112-120. [PMID: 35820376 DOI: 10.1159/000525408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The number of strokes has been steadily increasing due to the ageing of the population and its management has changed dramatically in recent years. Nevertheless, there are few unbiased epidemiological studies to investigate the incidence of strokes and their long-term prognosis. METHODS The Normandy Stroke Study (NSS) is a prospective population-based study of all strokes and transient ischemic attacks in a large urban, suburban, and rural area in the Northwest of France. It is designed to meet the current gold standard in stroke epidemiological study by using multiple overlapping sources for case identification. It also aims to assess the impact of socio-economic disparities and long-term prognosis of stroke through an additional follow-up up to three years after the event to better understand the functional and cognitive prognostic of stroke as well as the quality of life in patients after stroke. CONCLUSION NSS will provide important data on epidemiology and long-term consequences of stroke at the population level and will help care providers to adapt resource allocation.
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Coste T, Hervé D, Neau JP, Jouvent E, Ba F, Bergametti F, Lamy M, Cogez J, Derache N, Schneckenburger R, Grelet M, Gollion C, Lanotte L, Lauer V, Layet V, Urbanczyk C, Didic M, Raynouard I, Delaval L, Dassa J, Florea A, Badiu C, Nguyen K, Tournier-Lasserve E. Heterozygous HTRA1 nonsense or frameshift mutations are pathogenic. Brain 2021; 144:2616-2624. [PMID: 34270682 DOI: 10.1093/brain/awab271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/12/2022] Open
Abstract
Heterozygous missense HTRA1 mutations have been associated with an autosomal dominant cerebral small vessel disease (CSVD) whereas the pathogenicity of heterozygous HTRA1 stop codon variants is unclear. We performed a targeted high throughput sequencing of all known CSVD genes, including HTRA1, in 3853 unrelated consecutive CSVD patients referred for molecular diagnosis. The frequency of heterozygous HTRA1 mutations leading to a premature stop codon in this patient cohort was compared with their frequency in large control databases. An analysis of HTRA1 mRNA was performed in several stop codon carrier patients. Clinical and neuroimaging features were characterized in all probands. Twenty unrelated patients carrying a heterozygous HTRA1 variant leading to a premature stop codon were identified. A highly significant difference was observed when comparing our patient cohort with control databases: gnomAD v3.1.1 [P = 3.12 × 10-17, odds ratio (OR) = 21.9], TOPMed freeze 5 (P = 7.6 × 10-18, OR = 27.1) and 1000 Genomes (P = 1.5 × 10-5). Messenger RNA analysis performed in eight patients showed a degradation of the mutated allele strongly suggesting a haploinsufficiency. Clinical and neuroimaging features are similar to those previously reported in heterozygous missense mutation carriers, except for penetrance, which seems lower. Altogether, our findings strongly suggest that heterozygous HTRA1 stop codons are pathogenic through a haploinsufficiency mechanism. Future work will help to estimate their penetrance, an important information for genetic counselling.
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Affiliation(s)
- Thibault Coste
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
| | - Dominique Hervé
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
- AP-HP, CERVCO, Service de Neurologie, Hôpital Lariboisière, France
| | - Jean Philippe Neau
- Centre Hospitalier Universitaire de Poitiers, Service de Neurologie, Poitiers, France
| | - Eric Jouvent
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
- AP-HP, CERVCO, Service de Neurologie, Hôpital Lariboisière, France
| | - Fatoumata Ba
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
| | | | - Matthias Lamy
- Centre Hospitalier Universitaire de Poitiers, Service de Neurologie, Poitiers, France
| | - Julien Cogez
- Centre Hospitalier Universitaire de Caen, Service de Neurologie, Caen, France
| | - Nathalie Derache
- Centre Hospitalier Universitaire de Caen, Service de Neurologie, Caen, France
| | | | - Maude Grelet
- Centre Hospitalier Intercommunal de Toulon- La Seyne sur mer, Service de Génétique Médicale, Toulon, France
| | - Cédric Gollion
- Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France
| | - Livia Lanotte
- Hôpital De Hautepierre, Service de Neurologie, Strasbourg, France
| | - Valérie Lauer
- Hôpital De Hautepierre, Unité Neuro-Vasculaire, Strasbourg, France
| | - Valérie Layet
- Groupe Hospitalier Du havre, Service de Génétique Médicale, Le Havre, France
| | - Cédric Urbanczyk
- Centre Hospitalier Départemental La Roche-Sur-Yon, Service de Neurologie, La Roche-Sur-Yon, France
| | - Mira Didic
- APHM, Hôpital Timone Adultes, Service de Neurologie et Neuropsychologie, Marseille, France
- Aix Marseille Université, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Igor Raynouard
- Fondation Adolphe de Rothschild, Service de Neurologie, Paris, France
| | - Laure Delaval
- AP-HP, Hôpital Bichat, Service de Médecine Interne, France
| | - Jérémie Dassa
- Centre Hospitalier Emile Roux, Service de Neurologie, Le Puy-en-Velay, France
| | - Alexandru Florea
- Centre Hospitalier Marie Madeleine, Service de Neurologie, Forbach, France
| | - Carmen Badiu
- Centre Hospitalier Metz-Thionville, Service de Neurologie, Metz, France
| | - Karine Nguyen
- APHM, Hôpital Timone Adultes, Département de Génétique, Marseille, France
| | - Elisabeth Tournier-Lasserve
- AP-HP, Service de Génétique Moléculaire Neurovasculaire, Hôpital Saint-Louis, France
- Université de Paris, INSERM UMR-1141 Neurodiderot, Paris F-75019, France
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Hostettler IC, Wilson D, Fiebelkorn CA, Aum D, Ameriso SF, Eberbach F, Beitzke M, Kleinig T, Phan T, Marchina S, Schneckenburger R, Carmona-Iragui M, Charidimou A, Mourand I, Parreira S, Ambler G, Jäger HR, Singhal S, Ly J, Ma H, Touzé E, Geraldes R, Fonseca AC, Melo T, Labauge P, Lefèvre PH, Viswanathan A, Greenberg SM, Fortea J, Apoil M, Boulanger M, Viader F, Kumar S, Srikanth V, Khurram A, Fazekas F, Bruno V, Zipfel GJ, Refai D, Rabinstein A, Graff-Radford J, Werring DJ. Risk of intracranial haemorrhage and ischaemic stroke after convexity subarachnoid haemorrhage in cerebral amyloid angiopathy: international individual patient data pooled analysis. J Neurol 2021; 269:1427-1438. [PMID: 34272978 PMCID: PMC8857171 DOI: 10.1007/s00415-021-10706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
Objective To investigate the frequency, time-course and predictors of intracerebral haemorrhage (ICH), recurrent convexity subarachnoid haemorrhage (cSAH), and ischemic stroke after cSAH associated with cerebral amyloid angiopathy (CAA). Methods We performed a systematic review and international individual patient-data pooled analysis in patients with cSAH associated with probable or possible CAA diagnosed on baseline MRI using the modified Boston criteria. We used Cox proportional hazards models with a frailty term to account for between-cohort differences. Results We included 190 patients (mean age 74.5 years; 45.3% female) from 13 centers with 385 patient-years of follow-up (median 1.4 years). The risks of each outcome (per patient-year) were: ICH 13.2% (95% CI 9.9–17.4); recurrent cSAH 11.1% (95% CI 7.9–15.2); combined ICH, cSAH, or both 21.4% (95% CI 16.7–26.9), ischemic stroke 5.1% (95% CI 3.1–8) and death 8.3% (95% CI 5.6–11.8). In multivariable models, there is evidence that patients with probable CAA (compared to possible CAA) had a higher risk of ICH (HR 8.45, 95% CI 1.13–75.5, p = 0.02) and cSAH (HR 3.66, 95% CI 0.84–15.9, p = 0.08) but not ischemic stroke (HR 0.56, 95% CI 0.17–1.82, p = 0.33) or mortality (HR 0.54, 95% CI 0.16–1.78, p = 0.31). Conclusions Patients with cSAH associated with probable or possible CAA have high risk of future ICH and recurrent cSAH. Convexity SAH associated with probable (vs possible) CAA is associated with increased risk of ICH, and cSAH but not ischemic stroke. Our data provide precise risk estimates for key vascular events after cSAH associated with CAA which can inform management decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10706-3.
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Affiliation(s)
- Isabel Charlotte Hostettler
- Stroke Research Centre, University College London, National Hospital of Neurology and Neurosurgery, Institute of Neurology, Queen Square, London, WC1N, UK
| | - Duncan Wilson
- Stroke Research Centre, University College London, National Hospital of Neurology and Neurosurgery, Institute of Neurology, Queen Square, London, WC1N, UK
| | | | - Diane Aum
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Markus Beitzke
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Timothy Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia
| | - Thanh Phan
- Department of Neurology, Monash Health and Stroke and Ageing Research Group, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Sarah Marchina
- Department of Neurology, Stroke Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Maria Carmona-Iragui
- Memory Unit, Department of Neurology, Hospital de la Santa Creu I Sant Pau, Institut Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreas Charidimou
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Isabelle Mourand
- Department of Neurology, CHU de Montpellier, Hôpital Gui-de-Chauliac, Montpellier, France
| | - Sara Parreira
- Stroke Unit, Department of Neuroscience, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Gareth Ambler
- Department of Statistical Science, UCL, London, WC1E 6BT, UK
| | - Hans Rolf Jäger
- Neuroradiological Academic Unit, Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology, London, UK
| | - Shaloo Singhal
- Department of Neurology, Monash Health and Stroke and Ageing Research Group, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - John Ly
- Department of Neurology, Monash Health and Stroke and Ageing Research Group, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Henry Ma
- Department of Neurology, Monash Health and Stroke and Ageing Research Group, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Emmanuel Touzé
- Normandy University, UNICAEN, INSERM U1237, Caen, France
| | - Ruth Geraldes
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK.,Neurology department, Frimley Health Foundation Trust, Camberley, UK
| | - Ana Catarina Fonseca
- Stroke Unit, Department of Neuroscience, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Teresa Melo
- Stroke Unit, Department of Neuroscience, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Pierre Labauge
- Department of Neurology, CHU de Montpellier, Hôpital Gui-de-Chauliac, Montpellier, France
| | - Pierre-Henry Lefèvre
- Department of Neuroradiology, CHU de Montpellier, Hôpital Gui-de-Chauliac, Montpellier, France
| | - Anand Viswanathan
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Steven Mark Greenberg
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu I Sant Pau, Institut Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marion Apoil
- Department of Neurology, CHU Caen Normandie, Caen, France
| | - Marion Boulanger
- Department of Neurology, CHU Caen Normandie, Caen, France.,Normandy University, UNICAEN, INSERM U1237, Caen, France
| | - Fausto Viader
- Department of Neurology, CHU Caen Normandie, Caen, France
| | - Sandeep Kumar
- Department of Neurology, Stroke Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Velandai Srikanth
- Department of Neurology, Monash Health and Stroke and Ageing Research Group, Melbourne, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Ashan Khurram
- Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Veronica Bruno
- Institute for Neurological Research, Fleni, Buenos Aires, Argentina
| | - Gregory Joseph Zipfel
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Refai
- Department of Neurosurgery, Emory University, Atlanta, GA, USA
| | | | | | - David John Werring
- Stroke Research Centre, University College London, National Hospital of Neurology and Neurosurgery, Institute of Neurology, Queen Square, London, WC1N, UK.
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Boulanger M, Schneckenburger R, Join-Lambert C, Werring DJ, Wilson D, Hodel J, Zuber M, Touzé E. Diffusion-Weighted Imaging Hyperintensities in Subtypes of Acute Intracerebral Hemorrhage: Meta-Analysis. Stroke 2019; 50:135-142. [PMID: 30580720 DOI: 10.1161/strokeaha.118.021407] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Diffusion-weighted imaging (DWI) hyperintensities in intracerebral hemorrhage (ICH) are associated with increased risk of recurrent ICH, cognitive impairment, and death, but whether these lesions are specific to a subtype of ICH remains uncertain. We investigated the association between DWI lesions and ICH subtype and explored the risk factors for DWI lesions. Methods- In a systematic review of ICH studies, we identified those reporting prevalence of DWI lesions. Two reviewers independently assessed study eligibility and risk of bias and collected data. We determined the pooled prevalence of DWI lesions within 90 days after ICH onset for cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH using random-effects meta-analysis. We calculated odds ratios to compare prevalence of DWI lesions by ICH subtype and to assess risk factors for DWI lesions. Results- Eleven studies (1910 patients) were included. The pooled prevalence of DWI lesions was 18.9% (95% CI, 11.1-26.7) in cerebral amyloid angiopathy- and 21.0% (95% CI, 15.3-26.6) in hypertensive angiopathy-related ICH. There was no difference in the prevalence of DWI lesions between cerebral amyloid angiopathy- (64/292 [21.9%]) and hypertensive angiopathy-related ICH (79/370 [21.4%]; odds ratio, 1.25; 95% CI, 0.73-2.15) in the 5 studies reporting data on both ICH pathogeneses. In all ICH, presence of DWI lesions was associated with neuroimaging features of microangiopathy (leukoaraiosis extension, previous ICH, and presence, and number of microbleeds) but not with vascular risk factors or the use of antithrombotic therapies. Conclusions- Prevalence of DWI lesions in acute ICH averages 20%, with no difference between cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH. Detection of DWI lesions may add valuable information to assess the progression of the underlying microangiopathy.
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Affiliation(s)
- Marion Boulanger
- From the Normandie University, UNICAEN, Inserm U1237, Caen, France (M.B., M.Z., E.T.)
- CHU Côte de Nacre, Neurology Department, Caen, France (M.B., R.S., E.T.)
| | | | - Claire Join-Lambert
- Neurology Department, Hôpital Saint Joseph, Université Paris Descartes, France (C.J.-L., M.Z.)
| | - David J Werring
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, Institute of Neurology, Queen Square, London, United Kingdom (D.J.W., D.W.)
| | - Duncan Wilson
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, Institute of Neurology, Queen Square, London, United Kingdom (D.J.W., D.W.)
| | - Jérome Hodel
- Neuroradiology Department, Hôpital Henri Mondor, Université Paris-Est Créteil, France (J.H.)
| | - Mathieu Zuber
- From the Normandie University, UNICAEN, Inserm U1237, Caen, France (M.B., M.Z., E.T.)
- Neurology Department, Hôpital Saint Joseph, Université Paris Descartes, France (C.J.-L., M.Z.)
| | - Emmanuel Touzé
- From the Normandie University, UNICAEN, Inserm U1237, Caen, France (M.B., M.Z., E.T.)
- CHU Côte de Nacre, Neurology Department, Caen, France (M.B., R.S., E.T.)
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Schneckenburger R, Bouffard C, Francis E, Desgranges B, Aurelija J, Peggy Q. Cohérence temporelle et projection mentale chez un patient souffrant de lésions thalamiques. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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