Thrombo-inflammation in Acute Neurovascular Diseases: Definition of New Therapeutic Targets (TARGETS)

Thrombo-inflammation Des Maladies Neurovascualires aiguës : définition de Nouvelles Cibles thérapeutiques (TARGETS)

The objective of this observational study is to compare the relative concentrations of various thrombo-inflammatory markers at different follow-up time points in:

• patients with or without delayed cerebral ischemia after subarachnoid hemorrhage, and
• patients with or without rapid progression of necrotic volume after an ischemic stroke due to large- or medium-vessel occlusion in the anterior circulation.

The main question this study aims to answer is: How do thrombo-inflammatory marker concentrations evolve over time and differ between patients? Researchers will compare patients with or without delayed cerebral ischemia after subarachnoid hemorrhage, as well as patients with or without rapid progression of necrotic volume following an ischemic stroke due to large- or medium-vessel occlusion in the anterior circulation, to determine whether there are differences in thrombo-inflammatory marker concentrations and in their evolution over time.

Participants will undergo blood sampling at five different time points. In addition, participants will complete a Montreal Cognitive Assessment (MoCA) questionnaire during the 3-month follow-up visit.

Inclusion Criteria:

• Patients aged 18 years or older
• Admitted within 8 hours of an acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) or medium-vessel occlusion (MeVO) of the anterior circulation, with a NIHSS (National Institutes of Health Stroke Scale) score > 5 (M1, M2, M3, A1, A2, A3, P1, P2)
• Or admitted within 36 hours of acute symptoms related to aneurysmal subarachnoid hemorrhage (SAH)

Exclusion Criteria:

• Patients with pre-existing functional and/or cognitive disability (modified Rankin Scale, mRS > 1)
• Patients under legal protection or guardianship
• Patients with secondary hemorrhagic transformation of an acute ischemic stroke

Patients with acute ischemic stroke and NIHSS > 5 without LVO or MeVO of the anterior circulation on imaging will be secondarily excluded. Perfusion imaging will not be performed as part of the research protocol. Excluded patients will be replaced.