Showing papers by "Maurice Giroud published in 2009"

Intra-cerebral haemorrhages: are there any differences in baseline characteristics and intra-hospital mortality between hospitaland population-based registries?

Abstract: A better understanding of the natural history of intracerebral haemorrhages (ICH) with cohorts representing the whole spectrum of the disease is necessary to improve treatment. Our aim was to identify potential differences in baseline characteristics and short-term outcomes of patients with non-traumatic ICH, included in a hospital- and in a population-based stroke registry.

Comparative epidemiology of stroke and acute myocardial infarction: the Dijon Vascular project (Diva)

Abstract: Background: Despite a common pathophysiological mechanism (ie, atherosclerosis) and similar vascular risk factors, few reliable studies have compared the epidemiology of stroke and acute myocardial infarction (AMI). Methods: All first ever cases of stroke and AMI in Dijon, France (151 846 inhabitants) from 2001 to 2006 were prospectively recorded. The 30 day case fatality rates (CFRs) and vascular risk factors were assessed in both groups. Results: Over the 6 years, 1660 events (1020 strokes and 640 AMI) were recorded. Crude incidence of stroke was higher than that of AMI (112 vs 70.2/100 000/year; p 65 years whereas it was 0.60 (95% CI 0.42 to 0.86; p 7.8 mmol/l) at onset was significantly associated with higher CFR in both stroke and AMI patients. The prevalence of male sex, hypercholesterolaemia and diabetes was higher in AMI patients whereas hypertension was more frequent in stroke patients. Conclusion: These findings will help health care authorities to evaluate future needs for stroke and AMI services, and to develop secondary prevention strategies.

Multiple cysts of the corpus callosum and psychomotor delay in a patient with a 3.1 Mb 15q24.1q24.2 interstitial deletion identified by array-CGH.

Abstract: We describe a 46-month-old child presenting with developmental delay, mild facial dysmorphism, micropenis, strabismus and striking multiple cysts of the corpus callosum who was found to have a de novo interstitial 3.1 Mb 15q24.1q24.2 microdeletion using a 244 K microarray-based comparative genomic hybridization (array-CGH). The cystic lesions were located in the anterior half of the corpus callosum and did not take up gadolinium contrast. There was no other brain abnormality, and the gyral pattern and myelination were normal. There was no history of infectious disease or vascular injury and a metabolic disease was ruled out. Such cystic lesions of the corpus callosum are exceptional in the pediatric literature. Although these brain abnormalities have not been described in other reports with 15q24 microdeletion, we believe that they might be related to the cytogenetic abnormality since the work-up for other causes was negative. We suggest that a chromosomal rearrangement should be ruled out when such corpus callosum lesions are identified.

Épidémiologie des accidents vasculaires cérébraux

Abstract: Stroke is a disabling and very heterogeneous disease that has beneficiated from major therapeutic improvements over the past 25 years both in terms of preventive strategies and acute care. The better knowledge of the epidemiology of stroke has allowed to recognize the worldwide burden of the disease, and to identify the vascular risk factors. This article reviews the main current data about the epidemiology of stroke.

Facilities available in French hospitals treating acute stroke patients: comparison with 24 other European countries

Abstract: The purpose of this study was to compare the proportion of French hospitals meeting criteria for primary (PSC) or comprehensive (CSC) stroke centres, with that of 24 other European countries. We surveyed 121 randomly selected hospitals admitting stroke patients routinely in France and 765 in other European countries. We determined the proportion of hospitals meeting criteria for CSC and PSC according to the EUSI experts definition. The 121 selected hospitals had treated 37,778 patients in 2005 (mean 312), i.e. approximately 25% of all strokes supposed to have occurred in France. Eleven hospitals had an acute stroke care unit, versus 448 of 765 other Hospitals (OR 0.07; 95% CI, OR 0.04–0.13). rt-PA was given to 622 patients (2.2% of ischaemic strokes, versus 3.3% for the other countries). No hospital met criteria for CSC, and only 2 (1.7%) met criteria for PSC. Many facilities considered as necessary by experts were less available, especially personnel, brain CT-scan, ECG monitoring and rt-PA protocols. However, CT angiography 24 h/24, and air ambulance were more often available. Only a few French hospitals offer an optimal level of care for stroke patients. This result contrasts with the high cost of stroke care in France, suggesting an inappropriate use of resources. Conclusions useful for health administrators are: (i) to offer more facilities in reasonably equipped hospitals; (ii) to prevent admission of stroke patients in small under-equipped hospitals; (iii) to promote specific stroke nurse instruction; and (iv) to promote a better organisation of stroke care over the territory.

Epidemiological implications of the new definition of transient ischemic attack.

Abstract: according to the proportion of patients with transient neurological symptoms who benefit from a brain MRI, especially since some of them would be classified as stroke patients if an ischemic lesion was found. Consequently, to avoid such biases and to allow comparisons between studies, it appears to be useful to ascertain all cerebrovascular events in population-based registries that evaluate the incidence of stroke. This challenge is of a great importance as it would provide a clear representation of the burden of the disease.