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We found that recanalisation occurs over time, until month 11. Complete recanalisation may influence functional outcome.

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Spontaneous cervico-cerebral artery dissection (CCAD) is a common condition found among young patients with ischemic stroke. We examined the possible association between the polymorphism of methylenetetrahydrofolate reductase (MTHFR)-C677T and the gene mutation in transforming growth factor beta receptor II (TGFBR2) in a cohort of CCAD patients. One-hundred CCAD cases (65 males; mean age: 38.08 ± 10.68 years) and 100 matching controls were included. Ancestry informative markers (AIMs) were used to increase internal validity of the genetic analysis. Genotypes of the C677T polymorphism in the MTHFR gene were determined by polymerase chain reaction and restriction fragment length polymorphism; direct sequencing was used for a mutation analysis of the TGFBR2 gene. Associations were evaluated using a multivariate statistics, and Hardy-Weinberg equilibrium was analyzed. We also incorporated our data into a meta-analysis of the MTHFR-C677T. Sixty-three patients presented with vertebral and 37 with carotid artery dissection. Ancestry markers found a call rate on each over 95 %. All AIMs did not deviate from Hardy-Weinberg equilibrium (p > 0.05). The homozygous TT genotype was more frequent in cases (OR 2.04, CI 95 % 1.53-2.72, p = 0.005), whereas no significant difference was found on heterozygous CT genotype. TGFBR2 mutation was not present in our samples. In the meta-analysis of MTHFR/C677T variant, a total 613 cases and 1547 controls were analyzed; we found a moderate association for the recessive model genotype (OR 2.04, CI 95 % 1.53-2.72; p = 0.342; Z = 4.83; I (2) = 11.3). This study supports a positive association between the MTHFR-C677T polymorphism and genetically confirmed Mexican mestizo CCAD patients.

Background and Purpose: Cerebral venous thrombosis (CVT) comprises around 0.5% of strokes. Early initiation of anticoagulants, is safe and ensues a better functional prognosis. Different studies have addressed the issue, the rate and moment of recanalization has not been sufficiently defined, and it may have relevancy regarding treatment decisions. Our purpose was to estimate the time to recanalization of adults with acute CVT at one year follow-up. Methods: We prospectively studied a group of patients with confirmed diagnoses of CVT. Neuroimaging and clinical follow-up were performed at 3, 6, 9 and 12 months. All patients were treated with oral anticoagulant for 12 months or until complete recanalization. Statistical analysis used Kaplan-Meier method for survival tables. Results: We included 101 patients; median age was 33.6+11, women 79 (78.2%); 99 (98.0%) were evaluated and follow-up with MR venography. Complete recanalization at one year was accomplished in 65 (64.4%), partial in 29 (28.7%) and no recanalization in 7 (6.9%). We found that the proportion of any recanalization at 3 months was 65.3±4.7%, 6 months 89.1±3.1%, 9 months 91.5%±2.8% and 12 months 93.9%±6.1%. Complete recanalization at 3 months was 27.7±4.5%, 6 months 55.6±5.0%, 9 months 63.2%±5.0% and 12 months 68.5%±4.9%. Conclusions: Our result displays that at least partial recanalization in CVT occurs mainly within the first 6 months. However, there is a significant proportion of patients that achieve complete recanalization until 9 months of treatment regardless of the site of occlusion.