Review
Clinical Neurology
Morteza Sadeh, Laura Stone McGuire, Philip B. Ostrov, Ali Alaraj, Fady T. Charbel
Summary: This retrospective review identified cases of ruptured cerebral aneurysms presenting with subdural hematomas (SDHs) between 2013 and 2021. The study included 8 patients, mostly female, with an average age of 48.5 years. The results showed that ruptured aneurysms can present with or without significant subarachnoid hemorrhage in association with SDHs. This study highlights the importance of early recognition and appropriate management of this challenging presentation.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Aayushi Garg, Marcelo Rocha, Matthew Starr, Santiago Ortega-Gutierrez
Summary: Intracranial hemorrhage occurs in nearly 42% of RCVS patients, and is associated with increased rates of other neurologic complications and adverse discharge disposition, challenging the prevailing notion that RCVS is generally a benign disorder with a self-limiting clinical course.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2021)
Article
Clinical Neurology
Christopher J. Love, Daniel Kirschenbaum, Magdy Selim, Eng H. Lo, Elisabeth Rushing, Myron Spector, Adriano Aguzzi
Summary: The study found that chronic hemorrhagic stroke lesions contain abundant collagenous material, primarily consisting of collagen 3. The collagenase rat model successfully reproduced the morphology and composition of chronic human hemorrhagic stroke lesions. By identifying new pathological features of hemorrhagic stroke lesions, these results are important for treatment and recovery strategies.
Article
Clinical Neurology
Jatinder S. Minhas, Tom J. Moullaali, Gabriel J. E. Rinkel, Craig S. Anderson
Summary: Blood pressure is an important factor in managing intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage. However, there are controversies surrounding the management of blood pressure for these conditions. Current research involves analyzing patient data to determine the strength and direction of blood pressure changes and provide recommendations for clinical practice and future research.
Article
Clinical Neurology
Lindsey R. Kuohn, Jens Witsch, Thorsten Steiner, Kevin N. Sheth, Hooman Kamel, Babak B. Navi, Alexander E. Merkler, Santosh B. Murthy, Stephan A. Mayer
Summary: This study examined the relationship between different locations (deep versus lobar) of intracerebral hemorrhage (ICH) and early neurological deterioration, hematoma expansion (HE), and outcome. The results showed that lobar ICH location was associated with more common HE and early neurological deterioration, while deep ICH location was associated with smaller hematoma size. However, after adjusting for prognostic variables, deep ICH was associated with worse outcome.
Article
Clinical Neurology
Sanjula D. Singh, Marco Pasi, Floris H. B. M. Schreuder, Andrea Morotti, Jasper R. Senff, Andrew D. Warren, Brenna N. McKaig, Kristin Schwab, M. Edip Gurol, Jonathan Rosand, Steven M. Greenberg, Anand Viswanathan, Catharina J. M. Klijn, Gabriel J. E. Rinkel, Joshua N. Goldstein, H. Bart Brouwers
Summary: In patients with spontaneous cerebellar ICH treated conservatively, the spot sign is associated with speed of hematoma expansion, case fatality, and poor functional outcome. In surgically treated patients, the spot sign is associated with 90-day case fatality.
Article
Clinical Neurology
Smit D. Patel, Karan Topiwala, Vasu Saini, Neel Patel, Mubashir Pervez, Fawaz Al-Mufti, Ameer E. Hassan, Priyank Khandelwal, Robert M. Starke
Summary: The study found that intracerebral hemorrhage is the most common vascular complication in hospitalized RCVS patients, leading to longer hospital stays, more invasive procedures, and higher healthcare costs. However, overall outcomes are excellent regardless of the type of intracerebral hemorrhage, with no inpatient mortality observed in patients with hemorrhagic RCVS. Female sex and middle to older age groups are associated with higher odds of intracerebral hemorrhage.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Christopher P. Kellner, Rui Song, Muhammad Ali, Dominic A. Nistal, Milan Samarage, Neha S. Dangayach, John Liang, Ian McNeill, Xiangnan Zhang, Joshua B. Bederson, J. Mocco
Summary: This retrospective analysis of 90 patients undergoing minimally invasive endoscopic intracerebral hemorrhage evacuation found that younger age, absence of intraventricular hemorrhage, lobar location, and early time to evacuation were independently associated with good long-term functional outcomes. The odds ratio for time to evacuation suggests a 5% reduction in the odds of achieving a favorable outcome for each additional hour.
Article
Clinical Neurology
Smit D. Patel, Karan Topiwala, Fadar Otite Oliver, Hamidreza Saber, Gregory Panza, Gracia Mui, David S. Liebeskind, Jeffrey L. Saver, Mark Alberts, Anne Ducros
Summary: RCVS is a well-established cause of stroke, affecting middle-aged women, with a portion of patients requiring rehabilitation or nursing home care, but inpatient mortality is low.
Review
Radiology, Nuclear Medicine & Medical Imaging
Teresa Perillo, Chiara Paolella, Giulia Perrotta, Antonietta Serino, Ferdinando Caranci, Andrea Manto
Summary: Reversible cerebral vasoconstriction syndrome is a group of disorders characterized by segmental narrowing and dilatation of cerebral arteries, clinically presenting with sudden-onset headaches and neurological deficits. The main imaging finding is segmental constriction of intracranial arteries, which can be associated with bleeding and cerebral edema.
Article
Clinical Neurology
Carmelo Lucio Sturiale, Alba Scerrati, Luca Ricciardi, Oriela Rustemi, Anna Maria Auricchio, Nicolo Norri, Amedeo Piazza, Fabio Ranieri, Alberto Benato, Alberto Tomatis, Alessio Albanese, Annunziato Mangiola, Vincenzo Di Egidio, Donato Carlo Zotta, Marco Farneti, Enrico Marchese, Antonino Raco, Lorenzo Volpin, Gianluca Trevisi
Summary: This study reviewed 163 patients with ruptured MCA aneurysms, finding that 52% had pure SAH and 48% had associated ICH or ISH. There were no significant differences in demographics or angioarchitectural features between the two groups, although patients with hematomas had higher Fisher grade and Hunt-Hess score. Good outcome was observed in a higher percentage of patients with pure SAH, but the mortality rates were comparable. Age, Hunt-Hess score, and treatment-related complications were the main outcome predictors.
WORLD NEUROSURGERY
(2023)
Article
Medicine, General & Internal
Jinghua Chen, Ping Xie, Jian Huang, Eryan Sheng, Kefu Liu
Summary: Subdural contrast extravasation is a rare complication following the intravascular injection of a contrast agent. In this case, a 71-year-old male patient with interhemispheric SCE after percutaneous coronary intervention showed improvement after receiving supportive treatment. Familiarity with the clinical features and CT findings of SCE can help increase awareness among clinicians, potentially avoiding misdiagnosis and mistreatment.
Article
Clinical Neurology
Luyuan Li, Vaelan A. Molian, Scott C. Seaman, Mario Zanaty, Matthew A. Howard, Jeremy D. Greenlee, David M. Hasan, Enrique C. Leira
Summary: In this retrospective study, the addition of hematoma evacuation during decompressive hemicraniectomy for spontaneous intracerebral hemorrhage did not significantly alter functional outcomes at 6 months, suggesting that the surgical approach may not affect patient outcomes.
Article
Surgery
Dominik A. Jakob, Meghan Lewis, Elizabeth R. Benjamin, Delbrynth P. Mitchao, Aristomenis K. Exadaktylos, Demetrios Demetriades
Summary: The present study found that early VTEp (<48 hours) is associated with a lower risk of VTE complications in patients with combined acute subdural and subarachnoid hemorrhage, without increasing the risk of craniectomies.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Clinical Neurology
Aayushi Garg, Santiago Ortega-Gutierrez, Mudassir Farooqui, Nandakumar Nagaraja
Summary: This study found that patients with intracerebral hemorrhage (ICH) and concomitant cerebral amyloid angiopathy (CAA) are three times more likely to have readmissions for recurrent ICH compared to patients without CAA.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Kristin Sophie Lange, Ophelie Forster, Jerome Mawet, Gabrielle Tuloup, Cecilia Burcin, Lucas Corti, Claire Duflos, Caroline Roos, Anne Ducros
Summary: Patients with reversible cerebral vasoconstriction syndrome (RCVS) who do not present with thunderclap headache (TCH) at onset have a higher risk for neurological complications, including cervical artery dissections, posterior reversible encephalopathy syndrome, seizures, and subarachnoid hemorrhage, compared to those with TCH. However, the functional outcome at 3 months is similar in both groups, with most patients having a good prognosis. Further multicentric studies are needed to confirm these findings.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Infectious Diseases
Rishma Amarsy, David Trystram, Emmanuelle Cambau, Catherine Monteil, Sandra Fournier, Juliette Oliary, Helga Junot, Pierre Sabatier, Raphael Porcher, Jerome Robert, Vincent Jarlier
Summary: This study measured the impact of the first wave of COVID-19 on the incidence of bloodstream infections at the largest multisite public healthcare institution in France. The results showed that the COVID-19 pandemic had a strong impact on hospital management and had unfavorable effects on severe infections, antimicrobial resistance, and laboratory work diagnostics.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Urology & Nephrology
Dorian Nezam, Raphael Porcher, Francois Grolleau, Pauline Morel, Dimitri Titeca-Beauport, Stanislas Faguer, Alexandre Karras, Justine Solignac, Noemie Jourde-Chiche, Francois Maurier, Hamza Sakhi, Khalil El Karoui, Rafik Mesbah, Pierre Louis Carron, Vincent Audard, Didier Ducloux, Romain Paule, Jean-Fracois Augusto, Julien Aniort, Aurelien Tiple, Cedric Rafat, Severine Beaudreuil, Xavier Puechal, Pierre Gobert, Ziad Massy, Catherine Hanrotel, Stephane Bally, Nihal Martis, Cecile-Audrey Durel, Geoffroy Desbuissons, Pascal Godmer, Aurelie Hummel, Francois Perrin, Antoine Neel, Claire De Moreuil, Tiphaine Goulenok, Dominique Guerrot, Steven Grange, Aurelie Foucher, Alban Deroux, Carole Cordonnier, Celine Guilbeau-Frugier, Anne Modesto-Segonds, Dominique Nochy, Laurent Daniel, Anissa Moktefi, Marion Rabant, Loic Guillevin, Alexis Regent, Benjamin Terrier
Summary: The study found that PLEX did not improve the primary outcome in the entire population, but identified a subset of patients who could benefit from PLEX. However, these findings need to be validated before being used in clinical decision making.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2022)
Article
Clinical Neurology
Florence Riant, Caroline Roos, Agathe Roubertie, Cecile Barbance, Jessica Hadjadj, Stephane Auvin, Guillaume Baille, Marion Beltramone, Cecile Boulanger, Alice Cahn, Florina Cata, Emmanuel Cheuret, Jean-Christophe Cuvellier, Antoine Defo, Genevieve Demarquay, Anne Donnet, Nicolas Gaillard, Evelyne Massardier, Nathalie Guy, Sylvie Lamoureux, Laurence Le Moigno, Christian Lucas, Diana Ratiu, Sylvain Redon, Caroline Rey, Christel Thauvin, Francois Viallet, Elisabeth Tournier-Lasserve, Anne Ducros
Summary: The study identified PRRT2 as the fourth autosomal dominant gene for hemiplegic migraine and highlighted the wide range of neurologic phenotypes that can be caused by the same loss-of-function PRRT2 variations, including paroxysmal movement disorder, epilepsy, learning disabilities, sleep disorder, and hemiplegic migraine. Further research is needed to better understand the role of PRRT2 in these conditions.
Article
Clinical Neurology
Chloe Hirtz, Gilles Adam, Nicolas Raposo, Nelly Fabre, Anne Ducros, Lionel Calviere, Vanessa Rousseau, Jean Francois Albucher, Jean-Marc Olivot, Fabrice Bonneville, Alain Viguier
Summary: This study evaluated the frequency, distribution, and clinical associations of the dilated appearance of cerebral cortical veins, termed cortical veins sign, on T2*-weighted gradient recalled-echo (T2*-GRE) in the acute setting of migraine with aura attack in adult patients. The results showed that the cortical veins sign was commonly observed in patients with migraine with aura and could be detected reliably. This imaging marker may assist clinicians in identifying the diagnosis of migraine with aura.
Article
Clinical Neurology
Celina Ducroux, Laurent Derex, Mikal Nourredine, Julie Haesebaert, Marielle Buisson, Walid Alese, William Boisseau, Nicole Daneault, Yan Deschaintre, Jose Danilo B. Diestro, Omer Eker, Johanna Eneling, Laura C. Gioia, Daniella Iancu, Gregory Jacquin, Celine Odier, Christian Stapf, Jean Raymond, Daniel Roy, Alain Weill, Bertrand Lapergue, Alexandre Y. Poppe
Summary: This study evaluated the prognostic factors and impact of successful reperfusion in stroke patients with pre-stroke disability. The results showed that successful reperfusion was associated with improved outcomes and lower mortality.
JOURNAL OF NEURORADIOLOGY
(2023)
Letter
Urology & Nephrology
Dorian Nezam, Raphael Porcher, Francois Grolleau, Benjamin Terrier, French Vasculitis Study Grp
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2022)
Article
Engineering, Manufacturing
Theodoros Evgeniou, Mathilde Fekom, Anton Ovchinnikov, Raphael Porcher, Camille Pouchol, Nicolas Vayatis
Summary: This study presents a framework that combines epidemiological and machine learning models to predict the risk of ICU treatment for individuals infected with COVID-19. Simulation results based on French data show that policies considering clinical risk predictions can relax isolation restrictions earlier without overwhelming the ICU capacity.
PRODUCTION AND OPERATIONS MANAGEMENT
(2022)
Article
Multidisciplinary Sciences
Viet-Thi Tran, Raphael Porcher, Isabelle Pane, Philippe Ravaud
Summary: About 10% of people infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) experience post COVID-19 disease. This study analyzed data from a French disease cohort and found that among patients symptomatic after 2 months, 85% still reported symptoms one year after their symptom onset. Symptoms showed different trends over time, with some decreasing, some remaining stable, and some increasing in prevalence. The study provides important insights into the natural history of post COVID-19 disease.
NATURE COMMUNICATIONS
(2022)
Letter
Respiratory System
Raphael Porcher, Philippe Ravaud, Matthieu Resche-Rigon, Pierre-Louis Tharaux, Xavier Mariette, Olivier Hermine
EUROPEAN RESPIRATORY JOURNAL
(2022)
Article
Clinical Neurology
Joel Neves Briard, Guillaume Plourde, Roy Nitulescu, J. Gordon Boyd, Francois Martin Carrier, Philippe Couillard, Mark R. Keezer, Andreas H. Kramer, Sam D. Shemie, Christian Stapf, Michael Chasse
Summary: A systematic review found that infratentorial brain injury is relatively uncommon among patients suspected of death by neurologic criteria (DNC), while isolated brainstem death is rare and carries a high risk of progression to whole-brain death.
Article
Health Care Sciences & Services
Dimitris Mavridis, Adriani Nikolakopoulou, Irini Moustaki, Anna Chaimani, Raphael Porcherd, Isabelle Boutron, Philippe Ravaud
Summary: This study presents graphical methods to group interventions and uses conjoint analysis to place weights on outcomes based on stakeholders' preferences. The results provide valuable information about the clustering of interventions. Grouping interventions helps decision makers identify optimal options in terms of benefit-risk balance and choose interventions from the best cluster based on other factors such as cost and implementation.
JOURNAL OF CLINICAL EPIDEMIOLOGY
(2023)
Review
Hematology
Jerome Lambert, Etienne Lengline, Raphael Porcher, Rodolphe Thiebaut, Sarah Zohar, Sylvie Chevret
Summary: In the past decade, it has become common practice to provide rapid answers and early patient access to innovative treatments in the absence of randomized clinical trials. This trend is particularly important in oncology when evaluating new targeted therapies. This article provides guidelines for the critical appraisal of comparisons or conducting single-arm trials, using the example of ciltacabtagene autoleucel for the treatment of relapsed or refractory multiple myeloma.
Article
Hematology
Florie Brion Bouvier, Raphael Porcher
Summary: The preferred approach to compare two treatments is a randomized controlled trial (RCT) which ensures similarity between groups and allows causal conclusions. When RCTs are not possible, observational data can be used to infer treatment effectiveness under certain assumptions, using regression modeling or propensity score methods. Target trial emulation principles are also discussed.
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
(2023)
Review
Medicine, General & Internal
Maryline Couette, Justine Roy, Damien Oudin Doglioni, Olena Bereznyakova, Christian Stapf, Gregory Jacquin, Valerie Fraile, Philippe Desmarais, Sara-Maude Desforges, Lahoud Touma, Benedicte Nauche, Pablo Bartolucci, Kevin H. M. Kuo, Stephanie Forte
Summary: Neurovascular diseases are common complications of sickle cell disease, and have significant impact on patients' quality of life. Guidance on cognitive screening strategies in adults is currently lacking, and further research is needed.