Cerebrovascular disease (CeVD) is a major public health issue. In France, about 130,000 new strokes occur each year, including 30,000 with chronic handicap requiring long-term health insurance coverage. Stroke is the main cause of acquired disability in adults, the second cause of dementia and cognitive decline, and the first cause of death in women.
The long-term burden and associated health care costs are likely to increase with aging populations, and many countries have called for improved prevention plans. The majority of strokes are cerebral infarcts due to arterial occlusion, whereas 15-20% correspond to cerebral or subarachnoid hemorrhage due to intracranial vessel rupture.
new strokes per year
CeVD is an extremely heterogeneous condition not only in terms of clinical presentation, but also in respect to pathophysiological mechanisms, prognosis and treatment strategies. Underlying causes include atherosclerosis, cardioembolic sources, ischemic or hemorrhagic small vessel disease, arterial dissection, cerebral venous thrombosis, vascular malformations, and rare or hereditary vasculopathies. In many patients, the underlying causes remain undetermined.
The FHU NeuroVasc is a joint « federation hospitalo-universitaire » combining: different clinical and imaging departments of Lariboisière hospital (AP-HP) and of Sainte-Anne hospital ( GHU-PPN), University of Paris, INSERM research laboratories as core members and a network clinical of partner teams : Neuroradiology and Unit Stroke at Fondation ophtalmomlogique de Rothschild, neurology departments at Foch hospital , Paris Saint Joseph hospital, CHU Amiens, CHU de Caen, Unit stroke at Pitie Salpetriere hospital (AP-HP), Bichat Hospital ( AP-HP) clinical research units and biological ressources centre at Lariboisière hospital ,sainte anne hospital and Caen as well as the imaging research centre Neurospin of CEA, all together as associate members.
The aims of FHU NeuroVAsc are
to reduce the “gap” between the different medical specialties
(neurology, neurosurgery, neuroradiology, critical care,rehabilitation, genetics) involved in the clinical management of CeVD, through sharing of competences, expertise, research, and innovation projects;
to promote both, vertical and horizontal translation of CeVD research
through a better integration of clinicians and basic scientists at different levels of research projects;
to foster ambitious research programs on well-defined CeVD subtypes
using cutting edge technologies and innovative methodologies including high throughput genetic studies, unique animal models, new generation biomarkers, advanced statistical analysis and multimodal imaging methods.
The care and research program will particularly focus on the following objectives, defined in four workpackages :
Develop innovative tools, experimental models and therapeutic approaches that can help tailoring individualized acute ischemic stroke therapy in future;
Better understand the pathophysiology of familial and common forms of SVD, their exact consequences at cerebral and clinical level through targeted experiments and innovative clinical and imaging approaches;
Refine risk stratification and preventive treatments in patients with carotid arterial disease and patent foramen ovale;
Optimize prognostication and improve therapeutic decisions in patients with intracranial hemorrhage;
Identify novel biomarkers that can help therapeutic evaluation through the set-up of common highly phenotyped cohorts of CeVD patients and shared biobanks.
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