Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB. We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up). Among 1,220 patients, 342 (28.0
Middle meningeal artery embolization (MMAE) has emerged as a treatment for chronic subdural hematoma (cSDH), but comprehensive real-world safety data remain limited. We performed a multicenter retrospective analysis of 1781 consecutive patients undergoing MMAE for cSDH (2019–2025). The primary outcome was any procedure-related complication within 30 days. Inverse probability of treatment weighting (IPTW) assessed the association between technical success and complications, adjusting for demographic, clinical, and procedural confounders. Mean age was 72.8 ± 12.4 years; 68.1
ABSTRACT:Sickle cell disease (SCD) is associated with severe systemic complications and increased mortality risk. Predicting SCD severity is currently difficult because of a lack of biomarkers. Here, we measured 5411 plasma proteins in 376 patients with SCD and 103 participants without SCD to find new predictors of SCD mortality. We used protein signatures of mortality that were developed in non-SCD populations to calculate predicted mortality risk scores in our SCD data set. The mortality scores were higher in patients with SCD than in individuals without SCD (P = 3.7 × 10-10) and were associated with increased mortality in patients with SCD (risk factor-adjusted hazard ratio, 2.2; 95% confidence interval, 1.3-3.6; P = .0032). The mortality scores correlated with several clinical variables (eg, white blood cell count and hemoglobin concentration) and complications (eg, leg ulcers and stroke) that are clinically relevant yet insufficient individually to predict SCD mortality. In addition to the protein signatures, we found 499 plasma proteins that associate with mortality in patients with SCD (false discovery rate of ≤5%), including many proteins involved in inflammatory responses, such as the interleukin-18 signaling cascade. Finally, we estimated biological age in patients with SCD and individuals without SCD using the plasma proteome data. We confirmed that SCD patients age prematurely (+6.0 ± 5.4 years older than their chronological age) and found that brain biological age positively associates with past occurrences of stroke. Altogether, our results support the use of the plasma proteome to monitor and predict clinical severity in SCD.
Introduction L’atteinte du système nerveux central (SNC) dans le lymphome de Hodgkin (LH) est rare. Nous rapportons ici un cas de LH révélé par une méningo-encéphalite à éosinophiles. Observation Une patiente de 37 ans consulte aux urgences en raison de céphalées holocrâniennes inhabituelles. L’examen clinique retrouve une température à 38,1°C, une confusion, des réflexes ostéotendineux vifs et un signe de Babinski bilatéral.L’IRM cérébrale révèle des hypersignaux bilatéraux et symétriques FLAIR supra tentoriels. La ponction lombaire rapporte une méningite aseptique avec 480 éléments (73 % lymphocytes, 19 % éosinophiles) et une hyperprotéinorachie à 1,33g/L. Le bilan sanguin retrouve un syndrome inflammatoire (leucocytes 14 G/L, CRP 129mg/L) sans hyperéosinophilie. Devant l’apparition de troubles de la vigilance, une corticothérapie intraveineuse est initiée permettant une régression rapide des symptômes. Les IRM réalisées après corticothérapie retrouvent une diminution des lésions cérébrales précédemment visualisées en FLAIR avec de multiples prises de contraste intraparenchymateuses punctiformes encéphaliques et médullaires. Les bilans auto-immuns, infectieux et la recherche d’hémopathie sont négatifs dans le sang et le liquide céphalo-rachidien. Le scanner thoraco-abdomino-pelvien retrouve une masse médiastinale antérieure et des adénopathies médiastinales. Une biopsie ganglionnaire confirme le diagnostic de LH. Huit mois après le traitement du lymphome, l’examen clinique est normal et les prises de contraste cérébromédullaires ont nettement régressé (Figure 1, Figure 2). Discussion Plusieurs formes d’atteinte du SNC sont décrites dans le LH, notamment les syndromes paranéoplasiques (avec ou sans auto-anticorps détecté) et l’infiltration neuroméningée. Nous rapportons ici un cas de méningo-encéphalite à éosinophiles dont le mécanisme d’action reste incertain. La corticosensibilité majeure, l’allure inflammatoire « ADEM-like » des lésions et l’absence d’infiltration neuroméningée fait évoquer une atteinte dysimmune satellite du lymphome. Conclusion Nous rapportons un cas de LH révélé par une méningo-encéphalite à éosinophiles corticosensible. Le diagnostic a permis un traitement précoce et une rémission complète à un an de la patiente.
