Jose M. Ferro (Portugal)
Hospital de Santa Maria, CHULN; Universidade de Lisboa Department of Neurosciences (Neurology)Author Of 2 Presentations
Post-stroke Depression, Apathy and Anxiety
Abstract
Abstract Body
The aim of this lecture is to update the audience on the most common neuropsychiatric disorders after stroke, namely poststroke depression, apathy and anxiety, which affect more than 1/3 of stroke survivors. We will detail the epidemiological and clinical features of these disturbances, and describe available screening instruments and DSM V diagnostic criteria. Recent advances on pathophysiology will be discussed, based on neuroimaging mapping of stroke lesions and functional MR studies. Recent evidence on the management of depression, apathy and anxiety will be reviewed. Depression, apathy and anxiety may persist despite best available management and may relapse. These neuropsychiatric disturbance have a negative impact on the rehabilitation and Quality of Life of persons who survived an acute stroke
POST-SARS-COV-2-VACCINATION CEREBRAL VENOUS SINUS THROMBOSIS: AN ANALYSIS OF CASES NOTIFIED TO THE EUROPEAN MEDICINES AGENCY
Abstract
Background and Aims
Cerebral venous sinus thrombosis (CVST) has been described after vaccination against SARS-CoV-2. We report clinical characteristics of 213 post-vaccination CVST cases notified to the European Medicines Agency (EMA).
Methods
Data on Adverse Drug Reactions (ADRs) after SARS-CoV-2 vaccination notified until 8 April 2021 under the Medical Dictionary for Regulatory Activities Term ‘Central nervous system vascular disorders’ were obtained from the EudraVigilance database. We compared post-vaccination CVST to 100 European patients with CVST from before the COVID-19 pandemic (2015-2018) derived from the International CVST Consortium.
Results
We identified 213 CVST cases: 187 after ChAdOx1 nCov-19 vaccination and 26 after a mRNA vaccine (25 BNT162b2 and 1 mRNA-1273).. Thrombocytopenia was reported in 107 CVST cases (57%, 95%CI 50-64%) in the ChAdOx1 nCov-19 group, in none in the mRNA vaccine group (0%, 95%CI 0-13%), and in 7 (7%, 95%CI 3-14%) in the pre-COVID-19 group. In the ChAdOx1 nCov-19 group, there were 39 (21%) reported COVID-19 PCR tests performed within 30 days of CVST symptom onset, all were negative. Of the 117 patients with a reported outcome in the ChAdOx1 nCov-19 group, 44 (38%, 95%CI 29-47%) had died, compared to 2/10 (20%, 95%CI 6-51%) in the mRNA vaccine group and 3/100 (3%, 95%CI 1-8%) in the pre-COVID-19 group. Mortality among patients with thrombocytopenia in the ChAdOx1 nCov-19 group was 49% (95%CI 39-60%).
Conclusions
Analysis of EMA data shows that CVST occurring after ChAdOx1 nCov-19 vaccination has a clinical profile distinct from CVST unrelated to vaccination. Thrombocytopenia was associated only with CVST after ChAdOx1 nCov-19 vaccination.
Presenter of 1 Presentation
Post-stroke Depression, Apathy and Anxiety
Abstract
Abstract Body
The aim of this lecture is to update the audience on the most common neuropsychiatric disorders after stroke, namely poststroke depression, apathy and anxiety, which affect more than 1/3 of stroke survivors. We will detail the epidemiological and clinical features of these disturbances, and describe available screening instruments and DSM V diagnostic criteria. Recent advances on pathophysiology will be discussed, based on neuroimaging mapping of stroke lesions and functional MR studies. Recent evidence on the management of depression, apathy and anxiety will be reviewed. Depression, apathy and anxiety may persist despite best available management and may relapse. These neuropsychiatric disturbance have a negative impact on the rehabilitation and Quality of Life of persons who survived an acute stroke