Publications by authors named "Benoit Guillon"
Complication after carotid artery revascularization is mainly represented by stroke. Reversible cerebral vasoconstriction syndrome triggering by carotid artery revascularization is exceptional but it is an unrecognized aetiology of stroke. It could be associated with brain edema and henceforth, a posterior reversible encephalopathy syndrome can be confused with post-carotid artery revascularization cerebral hyperperfusion syndrome.
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- Eagle syndrome involves the impingement of an elongated styloid process or calcified stylohyoid ligament on neck structures, impacting vascular elements, known as stylocarotid syndrome, is less understood by doctors.
- A review of cases at the hospital showed five instances of vascular issues linked to Eagle syndrome, including serious conditions like carotid perforation and internal carotid dissections.
- There's a call for a unified definition of Eagle syndrome to improve diagnosis and treatment, with styloidectomy often used for compression, but further research is needed for other circumstances.
Article Synopsis
- The study investigates the differences between cerebral amyloid angiopathy-related inflammation (CAA-RI) and biopsy-positive primary angiitis of the CNS (BP-PACNS), focusing on their clinical and radiologic presentations as well as relapse rates.
- It included 104 patients with CAA-RI and 52 with BP-PACNS, revealing that CAA-RI tends to show more white matter lesions and hemorrhagic features, while BP-PACNS is associated more with headaches and motor deficits.
- The results indicate significant differences in features between the two conditions, suggesting that they may require different diagnostic approaches and could have varying outcomes in terms of recurrence.
Background And Objectives: IV tenecteplase is an alternative to alteplase before mechanical thrombectomy (MT) in patients with large-vessel occlusion (LVO) ischemic stroke. Little data are available on its use in patients with large ischemic core. We aimed to compare the efficacy and safety of both thrombolytics in this population.
View Article and Find Full Text PDFBackground: The use of thrombectomy in patients with acute stroke and a large infarct of unrestricted size has not been well studied.
Methods: We assigned, in a 1:1 ratio, patients with proximal cerebral vessel occlusion in the anterior circulation and a large infarct (as defined by an Alberta Stroke Program Early Computed Tomographic Score of ≤5; values range from 0 to 10) detected on magnetic resonance imaging or computed tomography within 6.5 hours after symptom onset to undergo endovascular thrombectomy and receive medical care (thrombectomy group) or to receive medical care alone (control group).
Introduction: Data on prior use of Tenecteplase versus Alteplase in acute stroke management by mechanical thrombectomy are controversial. Our primary objective was to make a comprehensive comparative assessment of clinical and angiographic efficacy and safety outcomes in a large prospective observational study.
Methods: We included stroke patients who were eligible for intravenous thrombolysis and endovascular thrombectomy between 2019 and 2021, from an ongoing registry in twenty comprehensive stroke centers in France.
Article Synopsis
- The study investigates the prevalence and effects of pathogenic variants in a specific gene related to cardiomyopathy and sudden cardiac death among patients.
- Out of 9,516 tested individuals, 31 were found to carry pathogenic variants, mostly presenting with dilated cardiomyopathy, with some also experiencing severe cardiac issues.
- Although the overall prognosis for dilated cardiomyopathy in variant carriers seems favorable, severe conditions and early onset were noted, especially in those with double variants.
Article Synopsis
- The study aimed to determine which clinical and radiological features are linked to positive CNS biopsies in patients suspected of having primary angiitis of the central nervous system (PACNS).
- Out of 200 patients with PACNS, 100 underwent biopsies, with 61% returning positive; factors like being female, having seizures or cognitive impairment, and specific imaging findings were associated with positive results.
- The findings suggest that certain characteristics can aid doctors in deciding whether or not to perform a CNS biopsy for suspected PACNS cases.
Background: Although carotid web (CaW) is increasingly diagnosed as a cause of cryptogenic stroke, data are still limited to monocentric small sample cohort. To broaden knowledge on symptomatic CaW, CAROWEB registry has been recently implemented.
Aims: In a large cohort of symptomatic CaW patients, we described epidemiologic characteristics, admission clinical and imaging features, and the current management including the secondary preventive strategy choice made in comprehensive French Stroke Units.
Background: Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale.
Method: The France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year.
Results: The patients included (n = 602) represented 29.
Background: Lyme neuroborreliosis (LNB), due to infection of the nervous system by the spirochete Borrelia burgdorferi, occurs in 15% of Lyme disease cases. However, neurovascular involvement is uncommon, especially recurrent stroke related to cerebral vasculitis in the absence of CSF pleocytosis.
Case Presentation: We report the case of a 58-year-old man without any medical history who exhibited recurrent strokes in the same vascular territory (left internal carotid).
Introduction: Cerebral venous sinus thrombosis (CVST) is a rare disease with highly variable clinical presentation and outcomes. Clinical studies suggest a role of inflammation and coagulation in CVST outcomes. The aim of this study was to investigate the association of inflammation and hypercoagulability biomarkers with CVST clinical manifestations and prognosis.
View Article and Find Full Text PDFBackground & Purpose: Carotid Web (CaW) is a growingly recognized cause of ischemic stroke, associated with a high recurrence risk. Several therapeutic strategies have been proposed as a tertiary prevention including carotid stenting, endarterectomy and antithrombotic medications. Among these, carotid stenting with dual-layer stent may be promising to adequately cover the focal arterial dysplasia.
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- Intravenous thrombolysis (IVT) combined with mechanical thrombectomy (MT) for patients with M2 occlusions shows a significantly better 90-day functional outcome compared to MT alone, according to a study analyzing data from the Endovascular Treatment in Ischemic Stroke (ETIS) registry.
- The analysis included 1,132 patients, with 570 receiving prior IVT, and found that combining IVT with MT resulted in a 59.8% favorable outcome versus 44.7% for MT alone, without increasing complications.
- These findings suggest that administering IVT prior to MT in M2 occlusions could enhance patient recovery, highlighting the potential benefits of this combined treatment approach.
Article Synopsis
- The study examined how treatment delays affect the outcomes of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) in patients who suffered a stroke.
- Researchers analyzed data from the SWIFT-DIRECT trial involving 408 patients, comparing outcomes between those receiving IVT+MT and those undergoing MT alone, focusing on functional independence and safety outcomes.
- Results showed no significant interaction between treatment delays and the benefits of IVT, but there was some indication that shorter in-hospital delays might lead to better outcomes, suggesting the need for further investigations in future studies.
Background: Although acute stroke is a leading cause of morbidity and mortality worldwide, data on outcomes of stroke patients requiring ICU admission are limited. We aimed to identify factors associated with a good neurological outcome (defined as a modified Rankin Scale score [mRS] of 0-2) 6 months after ICU admission.
Methods: We retrospectively studied consecutive patients who were admitted to the ICU of a French university-affiliated hospital between January 2014 and December 2018 and whose ICD-10 code indicated acute stroke.
Article Synopsis
- The study looked at whether doing a procedure called thrombectomy by itself is just as good as doing thrombectomy with a medicine called alteplase for patients who have a stroke caused by a blocked blood vessel.
- Researchers in Europe and Canada tested this by randomly assigning stroke patients to either just thrombectomy or thrombectomy plus alteplase.
- They wanted to see if the patients who only had thrombectomy would have similar recovery outcomes to those who had both treatments, and they kept track of how well everyone was doing over 90 days.
Background: The best treatment for acute ischemic stroke (AIS) due to isolated cervical internal carotid artery occlusion (CICAO) (i.e., without associated occlusion of the circle of Willis) is still unknown.
View Article and Find Full Text PDFBackground: Increasing numbers of patients with cardiac implantable electronic devices (CIEDs) are undergoing radiotherapy (RT) for cancer. The aim of the study was to prospectively evaluate the incidence, characteristics, and associated factors of CIED dysfunctions related to RT.
Methods: Between April 2013 and March 2020, all patients with a CIED who underwent ≥1 RT session were enrolled.
Aim: We estimated the proportion and severity of cognitive disorders in an unselected population of patients referred for transcatheter aortic valve implantation (TAVI). Second, we describe clinical and cognitive outcomes at 1 year.
Methods: Eligible patients were aged ≥ 70 years, with symptomatic aortic stenosis and an indication for TAVI.
Objectives: To assess the risk of recurrence of cervical artery dissection (CAD) during pregnancy and puerperium in women with a history of CAD and then help physicians with providing medical information to women who wish to become pregnant.
Methods: Women aged 16-45 years who were admitted to our center for a CAD between 2005 and 2017 were identified from the hospital database, and those with spontaneous and symptomatic CAD were included. They were then contacted to answer a questionnaire that was specifically designed in regard to the recurrence of CAD and pregnancies after the primary CAD.
Cerebral Venous Thrombosis: Clinical, Radiological, Biological, and Etiological Characteristics of a French Prospective Cohort (FPCCVT)-Comparison With ISCVT Cohort.
Front Neurol
November 2021
Cerebral venous thrombosis (CVT) is a rare disease with highly variable clinical presentation and outcome. Etiological assessment may be negative. The clinical and radiological presentation and evolution can be highly variable.
View Article and Find Full Text PDFWe aimed to compare six available bleeding scores, in a real-life cohort, for prediction of major bleeding in the early phase of pulmonary embolism (PE). We recorded in-hospital characteristics of 2754 PE patients in a prospective observational multicenter cohort contributing 18,028 person-days follow-up. The VTE-BLEED (Venous Thrombo-Embolism Bleed), RIETE (Registro informatizado de la enfermedad tromboembólica en España; Computerized Registry of Patients with Venous Thromboembolism), ORBIT (Outcomes Registry for Better Informed Treatment), HEMORRHAGES (Hepatic or Renal Disease, Ethanol Abuse, Malignancy, Older Age, Reduced Platelet Count or Function, Re-Bleeding, Hypertension, Anemia, Genetic Factors, Excessive Fall Risk and Stroke), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol) scores were assessed at baseline.
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