Stroke Recurrence in First-Ever Symptomatic Carotid Web: A Cohort Study.

Background And Purpose: Carotid web (CaW) is an intimal variant of fibromuscular dysplasia responsible for ipsilateral cerebral ischemic events (CIE). Symptomatic CaW likely has a high risk of recurrent CIE, but no salient prospective data are available. We aimed to assess recurrence rate and its predictors after a first-ever CIE.

Temporal trends in Human T-Lymphotropic virus 1 (HTLV-1) associated myelopathy/tropical spastic paraparesis (HAM/TSP) incidence in Martinique over 25 years (1986-2010).

Background: Human T-lymphotropic virus type 1 (HTLV-1) has been discovered in 1980 and has been linked to tropical spastic paraparesis (HAM/TSP) in 1985 in Martinique. There is no data on HAM/TSP incidence trends. We report, in the present work, the temporal trends incidence of HAM/TSP in Martinique over 25 years.

One-year disability, death and recurrence after first-ever stroke in a Black Afro-Caribbean population.

Background Few data on stroke outcomes and no data on stroke recurrence are available in Black mono-racial population with high socio-economic status. Aims We investigated outcomes and stroke recurrence at one year in the Black Afro-Caribbean population of Martinique and examined potential predictors of poor prognosis and recurrence. Methods Patients from ERMANCIA II (Etude Réalisée en MArtinique et Centrée sur l'Incidence des Accidents vasculaires cérébraux), a Black population-based and prospective observational study, were followed up at 28-days, three months and one year post stroke.

Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke.

Background And Purpose: An atypical form of fibromuscular dysplasia located in the internal carotid-bulb (CaFMD) is thought to be uncommon and is poorly described as a cause of ischemic stroke in the young. This study aimed to obtain a better description of CaFMD in Afro-Caribbean population, who could be particularly affected by it.

Methods: This study included consecutive patients <55 years consulting at Fort-de-France University Hospital Stroke Center (Martinique, FWI) found to have CaFMD as the only cause after a comprehensive work-up.

Trends in incidence and early outcomes in a Black Afro-Caribbean population from 1999 to 2012: Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents Vasculaires Cérébraux II Study.

Background And Purpose: Seldom studies are available on trends in stroke incidence in blacks. We aimed to evaluate whether stroke risk prevention policies modified first-ever stroke incidence and outcomes in the black Afro-Caribbean population of Martinique.

Methods: Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents Vasculaires Cérébraux (ERMANCIA) I and II are 2 sequential prospective population-based epidemiological studies.

Infarction in the anterior choroidal artery territory: clinical progression and prognosis factors.

This study was undertaken to describe the still poorly known evolving profile of anterior choroidal artery (AChA) infarctions, identify their prognosis factors, and evaluate responses to intravenous (IV) thrombolysis. During 42 months, we prospectively enrolled patients with an isolated AChA stroke. Clinical and radiologic parameters were compared between patients with or without progression, defined as any clinical worsening.

Safety of standard-dose (.9-mg/kg) alteplase intravenous thrombolysis for acute ischemic stroke in Afro-Caribbeans, French West Indies.

Background: Pharmacobiologic data suggested that people of African ancestry were more sensitive to the recombinant tissue plasminogen activator, alteplase, than Caucasians. Furthermore, the higher incidences of hypertension and diabetes mellitus in black populations could contribute to a higher cerebral bleeding risk. However, standard-dose (.

Prehospital transfer medicalization increases thrombolysis rate in acute ischemic stroke. A French stroke unit experience.

Objectives: Narrow therapeutic window is a major cause of thrombolysis exclusion in acute ischemic stroke. Whether prehospital medicalization increases t-PA treatment rate is investigated in the present study.

Patients And Methods: Intrahospital processing times and t-PA treatment were analyzed in stroke patients calling within 6h and admitted in our stoke unit.

Fluid-attenuated inversion recovery vascular hyperintensity: an early predictor of clinical outcome in proximal middle cerebral artery occlusion.

Background: Few data are available on the relationship between fluid-attenuated inversion recovery vascular hyperintensities and proximal middle cerebral artery occlusion prognosis.

Objectives: To assess a fluid-attenuated inversion recovery vascular hyperintensities score (FVHS) and explore its relationship with recanalization status and clinical outcomes after intravenous thrombolysis.

Design: Retrospective study.

A new therapeutic strategy for acute ischemic stroke: sequential combined intravenous tPA-tenecteplase for proximal middle cerebral artery occlusion based on first results in 13 consecutive patients.

Background And Purpose: Intravenous tissue-type plasminogen activator (IV tPA) frequently fails to recanalize proximal middle cerebral artery (MCA-M1) obstructions, preventing favorable outcomes. Only neurointerventional procedures prevail in these cases, but well-equipped centers remain scarce. A new therapeutic strategy consisting of a second IV thrombolysis with low-dose tenecteplase was applied.

Five-year outcome of a stroke cohort in Martinique, French West Indies: Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents vasculaires cérebraux, Part 2.

Background And Purpose: Limited information exists on stroke among black populations outside the United States and United Kingdom. Part 1 of the Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents vasculaires cérebraux (ERMANCIA) provided strong epidemiologic data on the incidence of first-ever stroke in a black Caribbean population and showed a 40% greater incidence of stroke in Martinique than in continental France. In ERMANCIA part 2, we evaluated the long-term outcomes of our cohort.

Sequential combination of two intravenous thrombolytics (recombinant tissue plasminogen activator/tenecteplase) in a patient with stroke and cardioembolic basilar artery occlusion.

Stroke caused by acute occlusion of basilar artery (AOBA) produces high risk of death. In eligible patients, thrombolysis significantly reduces mortality and disability rate. In most hospitals, thrombolysis is limited to intravenous (IV) route of recombinant tissue plasminogen activator, without any therapeutic alternative in cases of treatment failure.

Natural history of human T-lymphotropic virus 1-associated myelopathy: a 14-year follow-up study.

Background: The progression of neurological disability in human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) remains undefined.

Objectives: To determine the time course of disability scores and to identify predictors of outcome among patients with HAM/TSP.

Design: Clinical 14-year follow-up study.

HTLV-1 proviral load in peripheral blood mononuclear cells quantified in 100 HAM/TSP patients: a marker of disease progression.

A high proviral load of human T cell lymphotropic virus type 1 (HTLV-1) in peripheral blood mononuclear cells (PBMCs) has been reported in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The aim of the present study was to investigate the role of HTLV-1 proviral load in PBMCs (expressed as the number of copies per 10(6) PBMCs) in HAM/TSP disease course. One hundred consecutive HAM/TSP patients were recruited and assigned on the basis of the disability score and disease duration to either a rapid (n=38) or a slow (n=62) progression group.