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From cryptogenic to ESUS: Toward precision medicine?
Rev Neurol (Paris). 2022 May 18:S0035-3787(22)00592-6. doi: 10.1016/j.neurol.2022.01.016. Online ahead of print.ABSTRACTCryptogenic infarctions are infarctions without a defined cause, despite a complete work-up. They differ from infarctions of undetermined causes, which may involve overlapping causes or an incomplete investigation. It is also different from uncommon heritable and non-heritable causes. The term embolic stroke of undetermined source (ESUS) proposed in 2014 is defined as a non-lacunar brain infarct without proximal arterial stenosis or cardioembolic sources. The major advantage of this definition compared to...
Source: Revue Neurologique - May 21, 2022 Category: Neurology Authors: S Timsit Source Type: research

Advancements in the Treatment of Cerebrovascular Complications of Cancer
AbstractPurpose of reviewTo present the new guidelines and therapeutic options regarding cerebrovascular complications of cancer, mainly ischemic stroke, cerebral venous thrombosis (CVT), and leptomeningeal carcinomatosis (LMC).Recent findingsA temporal trend study (2019) revealed that clinicians are still reluctant to apply thrombolysis to cancer patients, although two new studies (2018) reported no increased mortality. Several clinical trials on direct oral anticoagulants (DOACs) showed their superiority or, at least, non-inferiority compared with low molecular weight heparins in the treatment of venous thromboembolism (...
Source: Current Treatment Options in Neurology - April 29, 2020 Category: Neurology Source Type: research

Stroke Dysbiosis Index (SDI) in Gut Microbiome Are Associated With Brain Injury and Prognosis of Stroke
Conclusions: We developed an index to measure gut microbiota dysbiosis in stroke patients; this index was significantly correlated with patients' outcome and was causally related to outcome in a mouse model of stroke. Our model facilitates the potential clinical application of gut microbiota data in stroke and adds quantitative evidence linking the gut microbiota to stroke. Introduction Ischemic stroke imposes a heavy burden on society, with 24.9 million cases worldwide (1). Although intravenous thrombolysis and endovascular treatment greatly improve some patients' prognosis, the prognosis for most pa...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology
ConclusionsMulticentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of CVT.
Source: European Journal of Neurology - August 20, 2017 Category: Neurology Authors: J. M. Ferro, M. ‐G. Bousser, P. Canhão, J. M. Coutinho, I. Crassard, F. Dentali, M. Minno, A. Maino, I. Martinelli, F. Masuhr, D. Aguiar de Sousa, J. Stam, Tags: Guidelines Source Type: research

Venous Thrombotic Recurrence After Cerebral Venous Thrombosis Clinical Sciences
Conclusions—In our cohort of CVT patients followed on average for>6 years, subjects with a previous venous thrombotic event, cancer/malignant hemopathies, and unknown CVT causes were found to be at higher risk of recurrence.
Source: Stroke - January 22, 2017 Category: Neurology Authors: Paola Palazzo, Pierre Agius, Pierre Ingrand, Jonathan Ciron, Matthias Lamy, Aline Berthomet, Paul Cantagrel, Jean-Philippe Neau Tags: Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Pathobiology of tobacco smoking and neurovascular disorders: untied strings and alternative products
Tobacco smoke (TS) is the leading cause of preventable deaths worldwide. In addition to a host of well characterized diseases including chronic obstructive pulmonary disease, oral and peripheral cancers and cardiovascular complications, epidemiological evidence suggests that chronic smokers are at equal risk to develop neurological and neurovascular complications such as multiple sclerosis, Alzheimer’s disease, stroke, vascular dementia and small vessel ischemic disease (SVID). Unfortunately, few direct neurotoxicology studies of tobacco smoking and its pathogenic pathways have been produced so far. A major link between ...
Source: Cerebrospinal Fluid Research - October 31, 2015 Category: Neurology Authors: Pooja NaikLuca Cucullo Source Type: research

Recurrence of ICH after resumption of anticoagulation with VK antagonists: CHIRONE Study
Conclusions: Our results show that patients with a history of ICH carry a significant risk of recurrent ICH when treated with VKA anticoagulation. The risk is also present, though to a lower degree, in patients with previous posttraumatic events. All patients with a history of ICH require a careful evaluation of their thromboembolic risk to estimate the net clinical benefit of (re)starting anticoagulation with VKAs.
Source: Neurology - March 24, 2014 Category: Neurology Authors: Poli, D., Antonucci, E., Dentali, F., Erba, N., Testa, S., Tiraferri, E., Palareti, G., On behalf of the Italian Federation of Anticoagulation Clinics (FCSA) Tags: Stroke prevention, Intracerebral hemorrhage ARTICLE Source Type: research

Recurrent Ischemic Stroke in a Patient with the Trousseau Syndrome Treated with Dabigatran
A 70-year-old man with multiple ischemic strokes was diagnosed with cardiac embolism and treated with dabigatran. Three months later, he suddenly developed vertigo and vomiting. Magnetic resonance imaging, showed recurrent lesions and blood tests revealed hypercoagulability, hypoproteinemia, and elevated cytokeratin 19 fragments that serve as a tumor marker of lung cancer. Chest computed tomography showed there were small nodules in bilateral lungs and swollen mediastinal lymph nodes. A conclusive diagnosis was impossible because the patient declined invasive procedures. We suspected primary lung cancer and diagnosed conco...
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2014 Category: Neurology Authors: Kosuke Yoshida, Takashi Kimura, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Osamu Yahara Tags: Case Reports Source Type: research