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Article ; Online: The post-resuscitation VASOGRADE: a more accurate scale to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Ritzenthaler, Thomas / Gobert, Florent / Balança, Baptiste / Dailler, Frederic

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2023 Volume 44, Issue 12, Page(s) 4385–4390

Abstract: Background: Predicting the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage is of interest to adjust the level of care. The VASOGRADE, a simple grading scale using admission World Federation of Neurosurgical ... ...

Abstract	Background: Predicting the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage is of interest to adjust the level of care. The VASOGRADE, a simple grading scale using admission World Federation of Neurosurgical Societies (WFNS) grading score and modified Fisher scale (mFS) on first CT scan, could help to select patients at risk of DCI. However, using data after initial resuscitation (initial complication treatment, aneurysm exclusion) may be more relevant. Methods: We calculated a post-resuscitation VASOGRADE (prVG) using WFNS grade and mFS after early brain injury treatment and aneurysm exclusion (or at day 3). Patients were categorized as green, yellow, or red. Results: Using our prospective observational registry, 566 patients were included in the study. Two hundred six (36.4%) were classified as green, 208 (36.7%) as yellow, and 152 (26.9%) as red, and DCI was experienced in 22 (10.7%), 67 (32.2%), and 45 (29.6%) cases respectively. Patients classified as yellow had higher risk of developing DCI (OR 3.94, 95% CI 2.35-6.83). Risk was slightly lower in red patients (OR 3.49, 95% CI 2.00-6.24). The AUC for prediction was higher with prVG (0.62, 95% CI 0.58-0.67) than with VASOGRADE (0.56, 95% CI 0.51-0.60) (p < 0.01). Conclusion: By using simple clinical and radiological scale evaluated at subacute stage, prVG is more accurate to predict the occurrence of DCI.
MeSH term(s)	Humans ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/therapy ; Cerebral Infarction/complications ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/epidemiology ; Brain Ischemia/etiology ; Head ; Aneurysm/complications
Language	English
Publishing date	2023-07-11
Publishing country	Italy
Document type	Observational Study ; Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-023-06945-z
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Zs.A 1877: Show issues

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Article ; Online: Lymphome palpébral anaplasique à grandes cellules : à propos d’un cas et revue de la littérature.

Tricard, D / Corby, A / Riols, M / Gobert, F / Palacin, A

Journal francais d'ophtalmologie

2021 Volume 44, Issue 8, Page(s) e451–e454

Title translation	Cutaneous anaplastic large-cell lymphoma of the eyelid: A case report and literature review.
MeSH term(s)	Eyelid Neoplasms/diagnosis ; Eyelids ; Humans ; Lymphoma, Large-Cell, Anaplastic/diagnosis ; Skin Neoplasms/diagnosis
Language	French
Publishing date	2021-05-14
Publishing country	France
Document type	Case Reports ; Letter ; Review
ZDB-ID	426662-6
ISSN	1773-0597 ; 0181-5512
ISSN (online)	1773-0597
ISSN	0181-5512
DOI	10.1016/j.jfo.2020.11.028
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Zs.A 1417: Show issues

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Article ; Online: Prise en charge en urgence d’une perte traumatique de greffon cornéen à l’aide de membranes amniotiques lyophilisées.

Ducloux, A / Gobert, F / Tarfaoui, N / Carbonnière-Rouyer, C

Journal francais d'ophtalmologie

2020 Volume 44, Issue 1, Page(s) e37–e39

Title translation	Emergency management of traumatic corneal graft loss with lyophilized amniotic membranes.
MeSH term(s)	Amnion/transplantation ; Corneal Diseases/surgery ; Corneal Transplantation ; Corneal Ulcer/surgery ; Epithelium, Corneal ; Humans
Language	French
Publishing date	2020-10-20
Publishing country	France
Document type	Letter
ZDB-ID	426662-6
ISSN	1773-0597 ; 0181-5512
ISSN (online)	1773-0597
ISSN	0181-5512
DOI	10.1016/j.jfo.2020.03.015
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Zs.A 1417: Show issues

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Article ; Online: Etiology matters for neuroprognostication: A multimodal electrophysiological investigation in a case of Bickerstaff's brainstem encephalitis.

Cluse, Florent / Pegat, Antoine / Ritzenthaler, Thomas / Gobert, Florent / Jung, Julien

Neurophysiologie clinique = Clinical neurophysiology

2022 Volume 52, Issue 5, Page(s) 398–403

Abstract: We report the case of a 19-year-old patient with an acute-onset non-traumatic coma. Brain MRI scan was normal, CSF showed mild pleocytosis and moderately elevated protein, and continuous EEG-monitoring was compatible with spindle-coma. Cortical ... ...

Abstract	We report the case of a 19-year-old patient with an acute-onset non-traumatic coma. Brain MRI scan was normal, CSF showed mild pleocytosis and moderately elevated protein, and continuous EEG-monitoring was compatible with spindle-coma. Cortical somatosensory evoked potentials (SSEPs) and middle-latency auditory evoked potentials (MLAEPs) were bilaterally absent, and brainstem auditory evoked potentials suggested a brainstem dysfunction. Serum anti-GQ1b and anti-GT1a IgG antibodies positivity suggested Bickerstaff's brainstem encephalitis (BBE). The clinical and functional outcomes were favorable and normal cortical SSEPs/MLAEPs reappeared in a few weeks. Based on this report, in cases of unexplained MRI-negative coma with neurophysiological evidence of brainstem dysfunction, BBE should be eliminated before considering withdrawal of life-sustaining therapy (WLST).
MeSH term(s)	Humans ; Young Adult ; Adult ; Gangliosides ; Coma/diagnosis ; Coma/etiology ; Encephalitis/diagnosis ; Brain Diseases ; Brain Stem ; Immunoglobulin G
Chemical Substances	Gangliosides ; Immunoglobulin G
Language	English
Publishing date	2022-10-07
Publishing country	France
Document type	Case Reports ; Journal Article
ZDB-ID	639421-8
ISSN	1769-7131 ; 0987-7053
ISSN (online)	1769-7131
ISSN	0987-7053
DOI	10.1016/j.neucli.2022.09.004
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Zs.A 1049: Show issues

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Article ; Online: Amount of blood during the subacute phase and clot clearance rate as prognostic factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Ritzenthaler, Thomas / Gobert, Florent / Bouchier, Baptiste / Dailler, Frédéric

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2021 Volume 87, Page(s) 74–79

Abstract: Delayed cerebral ischemia (DCI) is a poorly predictable complication occurring after aneurysmal subarachnoid hemorrhage (SAH) that can have dramatic functional consequences. Identifying the patients with the highest risk of DCI may help to institute more ...

Abstract	Delayed cerebral ischemia (DCI) is a poorly predictable complication occurring after aneurysmal subarachnoid hemorrhage (SAH) that can have dramatic functional consequences. Identifying the patients with the highest risk of DCI may help to institute more suitable monitoring and therapy. Early brain injuries and aneurysm-securing procedure complications could be regarded as confounding factors leading to severity misjudgment. After an early resuscitation phase, a subacute assessment may be more relevant to integrate the intrinsic SAH severity. A retrospective analysis was performed upon patients prospectively included in the registry of SAH patients between July 2015 to April 2020. The amount of cisternal and intraventricular blood were assessed semi-quantitatively on acute and subacute CT scans performed after early resuscitation. A clot clearance rate was calculated from their comparison. The primary endpoint was the occurrence of a DCI. A total of 349 patients were included in the study; 80 (22.9%) experienced DCI. In those patients, higher Fisher grades were observed on acute (p = 0.026) and subacute (p = 0.003) CT scans. On the subacute CT scan, patients who experienced DCI had a higher amount of blood, either at the cisternal (median Hijdra sum score: 11 vs 5, p < 0.001) or intraventricular (median Graeb score: 4 vs 2, p < 0.001) level. There was a negative linear relationship between the cisternal clot clearance rate and the risk of DCI. The assessment of the amount of subarachnoid blood and clot clearance following resuscitation after aneurysmal SAH can be useful for the prediction of neurological outcome.
MeSH term(s)	Adult ; Aged ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/etiology ; Brain Ischemia/therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Prospective Studies ; Retrospective Studies ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/therapy ; Thrombosis/diagnostic imaging ; Thrombosis/etiology ; Thrombosis/therapy ; Time Factors ; Tomography, X-Ray Computed/methods ; Tomography, X-Ray Computed/trends
Language	English
Publishing date	2021-03-11
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2021.02.007
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Zs.A 3999: Show issues

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Article ; Online: Buying time to save a life: a 3-month "call in the dark for awareness" : A moral dilemma in predicting consciousness recovery.

Gobert, F / Le Cam, P / Guérin, C

Intensive care medicine

2016 Volume 42, Issue 10, Page(s) 1634–1636

MeSH term(s)	Adult ; Advance Directives/ethics ; Amyotrophic Lateral Sclerosis/therapy ; Consciousness ; Ethics, Medical ; Forecasting ; Glasgow Coma Scale ; Humans ; Male ; Nonverbal Communication ; Time Factors ; Tracheostomy/ethics
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Case Reports ; Editorial
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-016-4259-x
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Zs.A 1089: Show issues

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Article ; Online: Locked-in syndrome after central pontine myelinolysis, an outstanding outcome of two patients.

Chabert, Maïlys / Dauleac, Corentin / Beaudoin-Gobert, Maude / De-Quelen, Mélaine / Ciancia, Sophie / Jacquesson, Timothée / Bertrand, Simon / Vivier, Emmanuel / De-Marignan, Donatien / Jung, Julien / Andre-Obadia, Nathalie / Gobert, Florent / Cotton, François / Luauté, Jacques

Annals of clinical and translational neurology

2024 Volume 11, Issue 3, Page(s) 826–836

Abstract: Objective: Central pontine myelinolysis (CPM) is a rare demyelinating disease that affects the pons and which can cause extreme disabilities such as locked-in syndrome (LIS) in the initial phase. The aim of the study was to describe the evolution over a ...

Abstract	Objective: Central pontine myelinolysis (CPM) is a rare demyelinating disease that affects the pons and which can cause extreme disabilities such as locked-in syndrome (LIS) in the initial phase. The aim of the study was to describe the evolution over a 12-month period of two patients with CPM causing an initial LIS. Method: We retrospectively report the unexpected clinical outcome of these two patients in relation with the anatomical damages documented by brain MRI, associated with diffusion tensor imaging and reconstruction of corticospinal tracts in tractography. The following clinical parameters systematically assessed at 3, 6, 9, and 12 months: muscle testing on 12 key muscles (Medical Research Council), prehension metrics (box and block test and purdue pegboard), and independence for acts of daily living (functional independence measure). Results: Both patients showed a progressive recovery beginning between 2 and 3 months after the onset of symptoms, leading to almost complete autonomy at 12 months (FIM > 110), with motor strength greater than 4/5 in all joint segments (MRC > 50/60). On brain MRI with tractography, CST appeared partially preserved at pons level. Interpretation: The possibility of a near-complete functional recovery at 12 months is important to consider given the ethical issues at stake and the discussions about limiting care that may take place initially. It seems to be the consequence of reversible myelin damage combined with partially preserved neurons. Development of collateral pathways or resolution of conduction block may explain this recovery. MRI comprising DTI and tractography could play a key role in the prognosis of motor recovery.
MeSH term(s)	Humans ; Myelinolysis, Central Pontine/diagnostic imaging ; Myelinolysis, Central Pontine/etiology ; Diffusion Tensor Imaging ; Locked-In Syndrome ; Retrospective Studies ; Pyramidal Tracts/diagnostic imaging
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2740696-9
ISSN	2328-9503 ; 2328-9503
ISSN (online)	2328-9503
ISSN	2328-9503
DOI	10.1002/acn3.51994
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Article ; Online: "Vasospasm Mimic" After Aneurysmal Subarachnoid Hemorrhage.

Ritzenthaler, Thomas / Gobert, Florent / Dailler, Fréderic

World neurosurgery

2019 Volume 124, Page(s) 295–297

Abstract: Background: Secondary brain injuries, such as delayed cerebral infarction (DCI), are the leading causes of disability after subarachnoid hemorrhage (SAH). Detecting DCI may be challenging, especially for patients presenting an altered level of ... ...

Abstract	Background: Secondary brain injuries, such as delayed cerebral infarction (DCI), are the leading causes of disability after subarachnoid hemorrhage (SAH). Detecting DCI may be challenging, especially for patients presenting an altered level of consciousness. Case description: We describe herein the case of a patient who developed acute hemiplegia 4 days after SAH, with raised blood flow velocities on transcranial Doppler, compatible with vasospasm. Finally, full work-up, using computed tomography (CT) scan with perfusion CT and continuous electroencephalography, was consistent with nonconvulsive seizures. Conclusions: Multiple secondary complications (DCI, seizures, hydrocephalus) may occur after SAH but are clinically difficult to diagnose. A multimodal evaluation (transcranial Doppler, CT or magnetic resonance imaging, electroencephalography) is useful in order to detect and treat late complications.
Language	English
Publishing date	2019-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2019.01.034
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Zs.A 1159: Show issues

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Article: Massive subcutaneous emphysema and septic shock revealed by a stroke-mimic episode.

Gobert, F / Tancredi, I / Malick, P / Thobois, S / Monneuse, O

Revue neurologique

2016 Volume 172, Issue 2, Page(s) 162–165

MeSH term(s)	Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Shock, Septic/complications ; Shock, Septic/diagnosis ; Shock, Septic/diagnostic imaging ; Shock, Septic/pathology ; Stroke/complications ; Stroke/diagnosis ; Stroke/diagnostic imaging ; Subcutaneous Emphysema/complications ; Subcutaneous Emphysema/diagnosis ; Subcutaneous Emphysema/diagnostic imaging ; Tomography, X-Ray Computed
Language	English
Publishing date	2016-02
Publishing country	France
Document type	Case Reports ; Journal Article
ZDB-ID	4593-7
ISSN	2213-0004 ; 0035-3787
ISSN (online)	2213-0004
ISSN	0035-3787
DOI	10.1016/j.neurol.2015.09.004
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Ui II Zs.45: Show issues

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Article ; Online: Virtually spatialized sounds enhance auditory processing in healthy participants and patients with a disorder of consciousness.

Heine, Lizette / Corneyllie, Alexandra / Gobert, Florent / Luauté, Jacques / Lavandier, Mathieu / Perrin, Fabien

Scientific reports

2021 Volume 11, Issue 1, Page(s) 13702

Abstract: Neuroscientific and clinical studies on auditory perception often use headphones to limit sound interference. In these conditions, sounds are perceived as internalized because they lack the sound-attributes that normally occur with a sound produced from ... ...

Abstract	Neuroscientific and clinical studies on auditory perception often use headphones to limit sound interference. In these conditions, sounds are perceived as internalized because they lack the sound-attributes that normally occur with a sound produced from a point in space around the listener. Without the spatial attention mechanisms that occur with localized sounds, auditory functional assessments could thus be underestimated. We hypothesize that adding virtually externalization and localization cues to sounds through headphones enhance sound discrimination in both healthy participants and patients with a disorder of consciousness (DOC). Hd-EEG was analyzed in 14 healthy participants and 18 patients while they listened to self-relevant and irrelevant stimuli in two forms: diotic (classic sound presentation with an "internalized" feeling) and convolved with a binaural room impulse response (to create an "externalized" feeling). Convolution enhanced the brains' discriminative response as well as the processing of irrelevant sounds itself, in both healthy participants and DOC patients. For the healthy participants, these effects could be associated with enhanced activation of both the dorsal (where/how) and ventral (what) auditory streams, suggesting that spatial attributes support speech discrimination. Thus, virtually spatialized sounds might "call attention to the outside world" and improve the sensitivity of assessment of brain function in DOC patients.
MeSH term(s)	Adult ; Auditory Perception ; Consciousness ; Consciousness Disorders/physiopathology ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Sound ; Sound Localization ; Speech Perception ; Young Adult
Language	English
Publishing date	2021-07-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-93151-6
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