Publications by authors named "Susanna Zuurbier"
Article Synopsis
- * Many low- and middle-income countries (LMICs) are beginning to establish telestroke services, indicating a potential shift in access to specialized stroke care.
- * The analysis identified significant variations in network structures and technologies used, with 75% employing real-time video and image transfer, and a focus on quality monitoring in 74% of networks.
Article Synopsis
- A significant portion of patients (1 in 10) experience epilepsy after having cerebral venous thrombosis (CVT), but it's challenging to predict who will be affected.* -
- Researchers created the DIAS3 prognostic score using clinical data from over 1,100 patients to assess the likelihood of developing post-CVT epilepsy based on six clinical variables.* -
- The study found a range of predicted risks for post-CVT epilepsy within one and three years, with successful validation of the score confirming its effectiveness in estimating individual risk.*
Article Synopsis
- Gene-gene interactions are believed to play a significant role in the development of multifactorial diseases like cerebral venous thrombosis (CVT), highlighting potential causes of unexplained heritability.
- A study involving 882 CVT patients and 1,205 control participants found that specific gene variants significantly increased the likelihood of developing CVT, particularly when individuals had certain blood types.
- The research concluded that the interactions between specific genes could raise the risk of CVT by as much as 14 times, underscoring the importance of understanding these genetic factors in disease etiology.
Article Synopsis
- - The study investigates how age, sex, and imaging features relate to coma in patients with cerebral venous thrombosis (CVT), using data from a large international study.
- - Among 596 adult CVT patients, 8.9% experienced coma, with a higher prevalence in men (13.1%) compared to women (7.5%), despite CVT being more common in women.
- - Findings suggest that male sex and older age are significant factors linked to coma in CVT cases, highlighting a complex interplay between gender and clinical outcomes.
Article Synopsis
- A new prognostic score, SI NCAL C, was created to estimate the risk of dependency and death in patients after cerebral venous thrombosis (CVT), aiding in future targeted therapies.
- The study used data from the International CVT Consortium, excluding patients with prior functional dependency, and employed logistic and Cox regression analyses to identify risk factors for poor outcomes.
- Results showed the score has good predictive accuracy (C-statistics around 0.80-0.84), but further external validation is needed to confirm its effectiveness before widespread use.
Article Synopsis
- Cerebral venous thrombosis (CVT) is a rare type of stroke primarily affecting young adults, and this study investigates how age and gender, along with specific risk factors, influence its onset.
- Data were collected from a large, international study (BEAST) involving 1,309 CVT patients, revealing that the average age at onset for women is significantly younger (37 years) than for men (46 years).
- Findings indicate that women with risk factors like pregnancy or oral contraceptive use experience CVT much earlier, sometimes up to 12 years before men, highlighting the critical role of gender in CVT onset.
Background And Objectives: Female hormone therapy (oral contraception in female patients of reproductive age and menopausal hormone therapy in postmenopausal patients) is not withheld from patients with cerebral cavernous malformations (CCMs), although the effects of these drugs on the risk of intracranial hemorrhage are unknown. We investigated the association between female hormone therapy and intracranial hemorrhage in female patients with CCM in 2 large prospective, multicenter, observational cohort studies.
Methods: We included consecutive patients with a CCM.
Pregnancy, postpartum and menopause are regarded as periods women are more vulnerable to ischaemic events. There are conflicting results regarding stroke risk and hormone replacement therapy (HRT) during menopause. Stroke in pregnancy is generally increasing with serious consequences for mother and child; therefore, recommendations for acute treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) are needed.
View Article and Find Full Text PDFRecurrent Ischemic Stroke and Bleeding in Patients With Atrial Fibrillation Who Suffered an Acute Stroke While on Treatment With Nonvitamin K Antagonist Oral Anticoagulants: The RENO-EXTEND Study.
Stroke
August 2022
Article Synopsis
- A study was conducted on patients with atrial fibrillation who had an ischemic stroke while using nonvitamin K antagonist oral anticoagulants to determine rates and risk factors for recurrent ischemic and bleeding events.
- Over an average follow-up of about 15 months, 15.5% of the 1,240 patients experienced 207 events, including ischemic strokes and major bleeding incidents, with specific risk factors identified for each type of event.
- The rates of ischemic and bleeding events did not significantly differ between patients who changed their anticoagulant treatment and those who continued with it.
Background: We aimed to determine the association between beta-blocker or statin drug use and the future risk of symptomatic intracranial hemorrhage or persistent/progressive focal neurological deficit from cerebral cavernous malformations (CCM).
Methods: The population-based Scottish Audit of Intracranial Vascular Malformations prospectively identified adults resident in Scotland first diagnosed with CCM during 1999 to 2003 or 2006 to 2010. We compared the association between beta-blocker or statin drug use after first presentation and the occurrence of new intracranial hemorrhage or persistent/progressive focal neurological deficit due to CCM for up to 15 years of prospective follow-up.
Article Synopsis
- The study investigates the prevalence and characteristics of dural arteriovenous fistulas (dAVFs) in patients with cerebral venous thrombosis (CVT), finding that 2.4% of CVT patients had dAVFs.
- It highlights that patients with dAVFs tend to be older, predominantly male, and more likely to experience chronic CVT onset, with specific imaging findings.
- Despite these associations, the clinical outcomes for patients with and without dAVFs were similar, with most fistulas identified either at the time of CVT diagnosis or afterward.
Article Synopsis
- Cerebral venous thrombosis (CVT) is a rare type of stroke primarily affecting young people, and its genetic causes are not well understood.
- A genome-wide association study involved 882 CVT patients and 1,205 matched controls to identify genetic factors associated with CVT risk.
- Significant findings highlighted 37 SNPs linked to the 9q34.2 region, with blood groups A, B, or AB having a higher risk for CVT compared to blood group O, suggesting important genetic insights into the condition.
Background And Purpose: The PROGRESS trial (Perindopril Protection Against Recurrent Stroke Study) conducted in the early 1990s showed that blood pressure (BP) lowering therapy reduced the risks of recurrent stroke by about 50% after spontaneous intracerebral hemorrhage (ICH). However, the ICH subgroup was a minority, and trial cohorts are invariably selective. Therefore, it is unclear whether the impact of BP control on risk of recurrent stroke in ICH observed in PROGRESS would be as great in real-world practice.
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- Cerebral venous sinus thrombosis cases combined with thrombocytopenia have emerged after vaccinations with the AstraZeneca and Johnson & Johnson COVID-19 vaccines, linked to an immune response involving platelet factor 4/heparin antibodies.
- The study aims to evaluate how often patients diagnosed with cerebral venous sinus thrombosis before the pandemic experienced thrombocytopenia and had the associated antibodies.
- Out of 865 patients analyzed, about 8.4% presented with thrombocytopenia, with varying severity levels (mild to moderate).
Sex-specific risk factors for cerebral venous thrombosis (CVT) in women include oral contraceptives, pregnancy, puerperium, and hormone replacement therapy. The acute treatment of CVT is anticoagulation using therapeutic doses of low molecular weight heparin, which is also the preferred treatment in the post-acute phase in pregnancy and during breastfeeding. In patients with imminent brain herniation decompressive surgery is probably life-saving.
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- A study examined late seizures (LS) after cerebral venous thrombosis (CVT) using data from 1,127 patients, focusing on their occurrence, characteristics, treatment, and predictors.
- About 11% of patients experienced LS during a median follow-up of 2 years, with the first seizure usually happening around 5 months post-CVT diagnosis.
- Key predictors for developing LS included having status epilepticus during the acute phase, undergoing decompressive hemicraniectomy, and experiencing acute seizures, highlighting a significant risk for recurrence which suggests the need for a proper epilepsy diagnosis.
Objective: To identify characteristics, predictors, and outcomes of acute symptomatic seizures (ASS) in cerebral venous thrombosis (CVT), we investigated 1,281 consecutive adult patients with CVT included from 12 hospitals within the International CVT Consortium.
Methods: We defined ASS as any seizure between symptom onset and 7 days after diagnosis of CVT. We stratified ASS into prediagnosis and solely postdiagnosis ASS.
Objective: To investigate prediction of cerebral venous thrombosis (CVT) by clinical variables and D-dimer levels.
Methods: This prospective multicenter study included consecutive patients with clinically possible CVT. On admission, patients underwent clinical examination, blood sampling for D-dimers measuring (ELISA test), and magnetic resonance/CT venography.
Importance: To date, only uncontrolled studies have evaluated the efficacy and safety of endovascular treatment (EVT) in patients with cerebral venous thrombosis (CVT), leading to the lack of recommendations on EVT for CVT.
Objective: To evaluate the efficacy and safety of EVT in patients with a severe form of CVT.
Design, Setting, And Participants: TO-ACT (Thrombolysis or Anticoagulation for Cerebral Venous Thrombosis) was a multicenter, open-label, blinded end point, randomized clinical trial conducted in 8 hospitals in 3 countries (the Netherlands, China, and Portugal).
Background: Patients with primary intracerebral haemorrhage (ICH) are at increased long-term risks of recurrent stroke and other comorbidities. However, available estimates come predominantly from hospital-based studies with relatively short follow-up. Moreover, there are also uncertainties about the influence of ICH location on risks of recurrent stroke, disability, dementia and quality of life.
View Article and Find Full Text PDFInterventions for treating brain arteriovenous malformations in adults.
Cochrane Database Syst Rev
September 2019
Background: Brain arteriovenous malformations (AVMs) are the single most common cause of intracerebral haemorrhage in young adults. Brain AVMs also cause seizure(s) and focal neurological deficits (in the absence of haemorrhage, migraine or an epileptic seizure); approximately one-fifth are incidental discoveries. Various interventions are used in an attempt to eradicate brain AVMs: neurosurgical excision, stereotactic radiosurgery, endovascular embolization, and staged combinations of these interventions.
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