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Hugues Chabriat - One of the best experts on this subject based on the ideXlab platform.

  • Labbé vein thrombosis
    Neuroradiology, 2020
    Co-Authors: Monique Boukobza, Isabelle Crassard, Marie-germaine Bousser, Hugues Chabriat
    Abstract:

    Purpose Evaluate the prevalence of Labbé vein thrombosis (LVT) and its liability for the lesions observed in the case of associated ipsilateral transverse sinus thrombosis (TST). Methods MRI findings of 58 consecutive patients (≥ 18 years) with acute LVT and TST (group 1) were compared with those of 149 patients with acute TST-no LVT (group 2) observed during the same period. Results The prevalence of LVT was 15.2%. Group 1: TST extended to sigmoid sinus in 94.8%, resulting in complete sinuses occlusion. Any lesion was observed in 81% within LV territory: swelling ( n  = 5, 8.6%), edema ( n  = 9; 15.5%), non-Hemorrhagic Infarct ( n  = 1; 1.7%), multiple temporal lobe hemorrhages ( n  = 31; 53.5%), temporal lobe hematoma ( n  = 13; 22.4%), and pericerebral hemorrhages ( n  = 28; 50%). The Hemorrhagic lesions were not related to dominant TST or to extensive venous thrombosis. There was a prevalence of left TST- LVT ( n  = 32; 55.2%) and a higher prevalence of Hemorrhagic lesions in this subset (59.4%). Risk factors were also associated ( p  = 0.03). Group 2: the TST resulted in an occlusion of the TS: (i) complete ( n  = 16; 10.7%); (ii) incomplete ( n  = 97; 82.8%); and (iii) segmental, involving the TS before ( n  = 32; 21.5%) or after ( n  = 10; 6.7%) LV ending within the TS. No parenchymal/pericerebral lesions were associated. Conclusion This study shows a strong association between the following: (i) the extent of thrombosis in the TS and the presence of LVT ( p  

  • Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases
    Neuroradiology, 2016
    Co-Authors: Monique Boukobza, Isabelle Crassard, Marie-germaine Bousser, Hugues Chabriat
    Abstract:

    Introduction The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Methods Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with Hemorrhagic Infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of Hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. Results CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. Conclusion This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it.

Gaia Sirimarco - One of the best experts on this subject based on the ideXlab platform.

  • Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature
    Journal of Thrombosis and Thrombolysis, 2019
    Co-Authors: Francisco Bernardo, Stefania Nannoni, Davide Strambo, Bruno Bartolini, Patrik Michel, Gaia Sirimarco
    Abstract:

    Efficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) due to intracranial artery dissection (IAD) are currently not established. We aimed to present a single-center experience on IAD-related AIS treated by IVT. We selected all consecutive patients with IAD-related AIS treated by IVT from a prospectively constructed single-center acute stroke registry from 2003 to 2017. We reviewed demographical, clinical and neuroimaging data and recorded Hemorrhagic complications, mortality within 7 days and modified Rankin Scale at 3-months. Out of 181 AISs related to cervicocephalic dissections, 10 (5.5%) were due to IAD and five of these patients received IVT. Among these five patients, median age was 62 years; hypertension and dyslipidemia were the most frequent vascular risk factors. IAD locations were distal internal carotid artery, middle cerebral artery (M1), anterior cerebral artery (A2), and, in two cases, the basilar artery. All anterior circulation IADs were occlusive or subocclusive, while the two basilar artery IADs caused arterial stenosis. After IVT, there were no subarachnoid or symptomatic intracranial hemorrhages. One patient had an asymptomatic Hemorrhagic Infarct type 1. Two patients died within 7 days from ischemic mass effect. The other three patients had favorable clinical outcomes at 3-months. In this small single-center case series of IAD-related AIS, thrombolysis seemed relatively safe. However, IVT efficacy and the likelihood of arterial recanalization are still uncertain in this context. Further studies are needed to assess the safety and efficacy of IVT in these patients.

Omer Kitis - One of the best experts on this subject based on the ideXlab platform.

  • the clinical spectrum of intracerebral hematoma Hemorrhagic Infarct non Hemorrhagic Infarct and non lesional venous stroke in patients with cerebral sinus venous thrombosis
    European Journal of Neurology, 2012
    Co-Authors: Emre Kumral, F. Polat, C. Uzunköprü, Cem Calli, Omer Kitis
    Abstract:

    Background and purpose:  The clinical spectrum of different neuroradiological features of cerebral sinus–venous thrombosis (CSVT) varies considerably. We sought the relationship between different neuroradiological aspects and clinical presentations in these patients. Methods:  The diagnosis of cerebral sinus–venous thrombosis has been confirmed by conventional angiography, MRI combined with MR venography following established diagnostic criteria. We analyzed clinical data, symptoms and signs, imaging findings, location and extent of the thrombus, and parenchymal lesions, retrospectively. Results:  There were 220 consecutive patients with cerebral sinus–venous thrombosis; 98 (45%) had non-lesional sinus–venous thrombosis (NL CSVT), 51 (23%) had non-Hemorrhagic Infarct (NHI), 45 (20%) had Hemorrhagic Infarct (HI), and 26 (12%) had intracerebral hemorrhage (ICH). In patients with Hemorrhagic lesion (HI+ICH), advanced age, headache (99%), behavioral disturbances (55%), consciousness disturbances (35%), seizures (41%), and language deficits (42%) were significantly higher than the other patients (NL+NHI) (P < 0.001). High blood pressure at admission, puerperium, sigmoid and straight sinus thrombosis, multiple sinus and vein involvement were more frequent in patients with Hemorrhagic lesion than those with non-Hemorrhagic lesion. Patients with Hemorrhagic lesion were more dependent or died (32%) than the other patients (12%) (P < 0.001), and most of the patients with NL and NHI had no disability compared with the other patients at the 3 month of follow-up (96% and 65%; P < 0.001). Conclusion:  Headache, convulsion, behavioral disorder, seizures, and speech disorders were the most frequent clinical symptoms of patients with Hemorrhagic CSVT. Specific risk factors, including pregnancy/puerberium, early and extended thrombosis of large sinus, and presence of high blood pressure at admission, are associated with Hemorrhagic lesion and unfavorable outcome.

  • The clinical spectrum of intracerebral hematoma, Hemorrhagic Infarct, non-Hemorrhagic Infarct, and non-lesional venous stroke in patients with cerebral sinus-venous thrombosis.
    European journal of neurology, 2011
    Co-Authors: Emre Kumral, F. Polat, C. Uzunköprü, Cem Calli, Omer Kitis
    Abstract:

    Background and purpose:  The clinical spectrum of different neuroradiological features of cerebral sinus–venous thrombosis (CSVT) varies considerably. We sought the relationship between different neuroradiological aspects and clinical presentations in these patients. Methods:  The diagnosis of cerebral sinus–venous thrombosis has been confirmed by conventional angiography, MRI combined with MR venography following established diagnostic criteria. We analyzed clinical data, symptoms and signs, imaging findings, location and extent of the thrombus, and parenchymal lesions, retrospectively. Results:  There were 220 consecutive patients with cerebral sinus–venous thrombosis; 98 (45%) had non-lesional sinus–venous thrombosis (NL CSVT), 51 (23%) had non-Hemorrhagic Infarct (NHI), 45 (20%) had Hemorrhagic Infarct (HI), and 26 (12%) had intracerebral hemorrhage (ICH). In patients with Hemorrhagic lesion (HI+ICH), advanced age, headache (99%), behavioral disturbances (55%), consciousness disturbances (35%), seizures (41%), and language deficits (42%) were significantly higher than the other patients (NL+NHI) (P 

Monique Boukobza - One of the best experts on this subject based on the ideXlab platform.

  • Labbé vein thrombosis
    Neuroradiology, 2020
    Co-Authors: Monique Boukobza, Isabelle Crassard, Marie-germaine Bousser, Hugues Chabriat
    Abstract:

    Purpose Evaluate the prevalence of Labbé vein thrombosis (LVT) and its liability for the lesions observed in the case of associated ipsilateral transverse sinus thrombosis (TST). Methods MRI findings of 58 consecutive patients (≥ 18 years) with acute LVT and TST (group 1) were compared with those of 149 patients with acute TST-no LVT (group 2) observed during the same period. Results The prevalence of LVT was 15.2%. Group 1: TST extended to sigmoid sinus in 94.8%, resulting in complete sinuses occlusion. Any lesion was observed in 81% within LV territory: swelling ( n  = 5, 8.6%), edema ( n  = 9; 15.5%), non-Hemorrhagic Infarct ( n  = 1; 1.7%), multiple temporal lobe hemorrhages ( n  = 31; 53.5%), temporal lobe hematoma ( n  = 13; 22.4%), and pericerebral hemorrhages ( n  = 28; 50%). The Hemorrhagic lesions were not related to dominant TST or to extensive venous thrombosis. There was a prevalence of left TST- LVT ( n  = 32; 55.2%) and a higher prevalence of Hemorrhagic lesions in this subset (59.4%). Risk factors were also associated ( p  = 0.03). Group 2: the TST resulted in an occlusion of the TS: (i) complete ( n  = 16; 10.7%); (ii) incomplete ( n  = 97; 82.8%); and (iii) segmental, involving the TS before ( n  = 32; 21.5%) or after ( n  = 10; 6.7%) LV ending within the TS. No parenchymal/pericerebral lesions were associated. Conclusion This study shows a strong association between the following: (i) the extent of thrombosis in the TS and the presence of LVT ( p  

  • Hemorrhagic Infarct of basal ganglia in cardiac arrest. CT and MRI findings. 2 cases
    Neurologia i neurochirurgia polska, 2017
    Co-Authors: Monique Boukobza, Frédéric J. Baud
    Abstract:

    Abstract We report the CT and MRI findings in two cases of Hemorrhagic Infarct of the basal ganglia (BG), following out-of-hospital cardiac arrest (CA). In case 1, Brain-CT realized at day 2 showed bilateral and almost symmetric Hemorrhagic Infarct of the BG and Infarct of the tectum of the mesencephalon. In case 2, MRI realized at day 6 showed Hemorrhagic Infarct of both lenticular nuclei on T2 GE images. In both cases there was no medical history and the cardiovascular and the coagulation profile were normal. In these cases, the lesions are observed earlier than reported in a few previous radiological cases. Similar lesions have been reported in pathological studies. These lesions seem occur early after CA. Reperfusion is probably responsible for the Hemorrhagic transformation. The reason why some patients present either BG or brainstem Infarct or both remains unclear. Bilateral and symmetric Hemorrhagic Infarct of the BG, especially of the Lenticular nuclei, and Infarct of the dorsal pons and mesencephalic tegmentum seem to be a characteristic feature of profound and prolonged hypotension or of CA.

  • Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases
    Neuroradiology, 2016
    Co-Authors: Monique Boukobza, Isabelle Crassard, Marie-germaine Bousser, Hugues Chabriat
    Abstract:

    Introduction The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Methods Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with Hemorrhagic Infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of Hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. Results CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. Conclusion This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it.

Bejoy Thomas - One of the best experts on this subject based on the ideXlab platform.

  • Ischemic hyperintensities on T1-weighted magnetic resonance imaging of patients with stroke: New insights from susceptibility weighted imaging
    Neurology India, 2010
    Co-Authors: Neeraj N Baheti, Ajith Cherian, Pandurang R Wattamwar, Chandrasekharan Kesavadas, Bejoy Thomas
    Abstract:

    Hyperintensities on T1-weighted magnetic resonance imaging (MRI) in the setting of brain ischemia are usually considered Hemorrhagic transformations. Such changes can also be seen due to incomplete Infarction with selective neuronal loss. Arguments regarding the cause of these T1 hyperintensities have shuttled between gemistocytic astrocyte accumulation, tissue calcification and paramagnetic substance deposition. Susceptibility weighted imaging (SWI), a sensitive modality for detecting paramagnetic agents and blood products, has never been used to resolve this issue. The study was aimed to evaluate the SWI signal changes of T1 hyperintense lesion in stroke patients and understand its usefulness in differentiating a Hemorrhagic Infarct and an incomplete Infarct. All the seven patients with Infarct, having hyperintensities on T1 weighted MRI seen over the last one year were subjected to SWI. In none of the patients SWI failed to show any blooming. By doing SWI for T1-weighted hyperintensities, we can differentiate Hemorrhagic Infarct and a non-Hemorrhagic incomplete Infarct. This differentiation will immensely help in planning management strategy and prognostication.

  • Isolated left vein of Labbe thrombosis
    Neurology, 2005
    Co-Authors: Bejoy Thomas, T. Krishnamoorthy, Sukalyan Purkayastha, Arun Kumar Gupta
    Abstract:

    A 23-year-old man developed sudden onset of fever and headache. He was alert but had slight difficulty with naming and had agraphia and acalculia. The provisional diagnosis was viral encephalitis. MRI showed a left posterior temporal Hemorrhagic Infarct with thrombosis of left vein of Labbe (figure 1). This was confirmed by MR venography (figure 1, D, E) and digital subtraction angiography (figure …