📇 Rhumatologue · ORSAY · (91) · Libéral

MME Diana HRISOHO-FLAMARY

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50 articles scientifiques publiés — un praticien à la pointe de la recherche
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Top publications · les plus citées

Lidocaine for headache prevention during chronic subdural hematoma embolization

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026

📚 4 citations🔓 Open Access

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Background Middle meningeal artery embolization (MMAE) for the management of chronic subdural hematomas (CSDH) with ethylene vinyl alcohol (EVOH) causes an evident patient discomfort due to meningeal nociceptors stimulation. The aim of this study was to assess safety and efficacy of intra-arterial lidocaine (IAL) before MMAE of CSDH with EVOH. Methods We analyzed all consecutive patients with bilateral CSDH undergoing MMAE with EVOH. We used a monolateral IAL injection, with casual allocation. We assessed the headache felt by patients during embolization with the visual analog scale (VAS) and compared scores obtained after embolization of both sides. We followed the STROBE guidelines for case–control studies. Paired t-test and χ 2 test were used to compare the distribution of variables in IAL vs control group. Results Between September 2021 and March 2023, 32 patients underwent bilateral MMAE with EVOH for a CSDH. Lidocaine treatment resulted in a substantially lower VAS score compared to the control group (median 3 vs 7, p < 0.001), with no substantial side effect. Compliance also benefited from lidocaine administration. Conclusions In patients with CSDH undergoing MMAE, IAL seems to reduce pain sensation associated with EVOH injection and to increase patients’ compliance during treatment.

Arterial spin labeling MRI in patients undergoing carotid artery revascularization: a systematic review of the hemodynamic changes and clinical implications

European radiology · 2026

📚 2 citations🔓 Open Access📄 PDF gratuit ↗

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Abstract Objectives Arterial spin labeling (ASL) MRI is a non-invasive imaging modality that measures cerebral blood flow (CBF) without the need for contrast agents or radiation, offering insights into hemodynamic changes. Carotid revascularization procedures, carotid endarterectomy and carotid artery stenting, aim to improve cerebral perfusion and reduce the risk of ischemic events. This study explores ASL’s clinical potential in assessing CBF changes in carotid stenosis patients prior to revascularization procedures. Materials and methods A systematic review was conducted following PRISMA guidelines to identify studies that utilized ASL in patients undergoing carotid revascularization. Searches were performed in the MEDLINE/PubMed and Web of Science databases. Extracted data included patient demographics, ASL acquisition parameters, perfusion analysis methods, and study findings related to ASL results. Results Twenty studies involving 710 patients were included. Preoperative ASL consistently identified perfusion deficits ipsilateral to stenosis, which improved post-revascularization, particularly in eloquent brain regions. After revascularization, CBF increase was greatest in patients with severe baseline deficits and smaller in those with prior strokes. ASL metrics predicted post-procedural cerebral hyperperfusion (CH), though protocol variability influenced results. Visual assessment methods based on arterial transit artifacts (ATA) emerged as practical tools for hyperperfusion risk prediction without requiring extensive post-processing. Conclusion ASL MRI is a valuable tool for assessing hemodynamic changes in carotid artery stenosis and predicting treatment outcomes, particularly the risk of hyperperfusion. Its non-invasive nature and ability to evaluate collateral flow enhance its clinical value. Key Points Question Can arterial spin labeling (ASL) MRI reliably assess cerebral blood flow changes in patients with carotid stenosis undergoing revascularization, improving decision-making regarding risks and outcomes? Findings ASL detects pre-treatment perfusion deficits, quantifies post-revascularization blood flow increases, predicts hyperperfusion risk, and assesses collateral flow in carotid stenosis patients undergoing endarterectomy or stenting. Clinical relevance ASL MRI provides a non-invasive method to evaluate cerebral perfusion in carotid stenosis, aiding in risk assessment for cerebral hyperperfusion syndrome and optimizing treatment strategies by preoperatively assessing collateral circulation and post-treatment cerebral blood flow recovery.

Emergent Carotid Stenting for Acute Anterior Circulation Ischemic Stroke With Tandem Lesions: The Multicenter CERES-TANDEM Study

Neurology · 2026

📚 2 citations🩺 Clinique

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MME Diana HRISOHO-FLAMARY

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Publications scientifiques (50) — classées par pathologie

Transversal31

Revue générale10

Revue / méta-analyse6

Épidémiologie & registres5

Santé mentale / fatigue2

Activité physique / Rééducation1

Génétique1

IA en rhumatologie1

Vraie vie / RWE1

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