Objective: To identify independent predictors of clinical or cerebral lesion progression in a large sample of adult patients with moyamoya angiopathy (MMA) prior to decisions regarding revascularization surgery.
Methods: Ninety participants (median age, 37.5 years) were assessed at baseline and followed for a median time of 42.8 months. Incident ischemic and hemorrhagic strokes, death, as well as any incident ischemic and hemorrhagic lesions on MRI were recorded. Multiple demographic, clinical, and cerebral imaging measures at baseline were considered as potential predictors of clinical or cerebral tissue change at follow-up. Data were analyzed based on the Andersen-Gill counting process model, followed by internal validation of the prediction model.
Results: Among multiple potential predictive measures considered in the analysis, Asian origin, a history of TIAs, and a reduction in hemodynamic reserve, as detected by imaging, were found to be significantly associated with an increased risk of combined clinical and imaging events. While the model estimated the risk of clinical or cerebral lesion progression to be approximately 0.5% per year when none of these factors was present, this risk exceeded 20% per year when all factors were present.
Conclusion: A simple combination of demographic, clinical, and cerebral perfusion imaging measures may aid in predicting the risk of incident stroke and cerebral lesion progression in adult patients with MMA. These results may help to improve therapeutic decisions and aid in the design of future trials in adults with this rare condition.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669931 | PMC |
http://dx.doi.org/10.1212/WNL.0000000000007819 | DOI Listing |
Mol Neurodegener
January 2025
Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA.
Alzheimer's disease (AD) is a debilitating neurodegenerative disease that is marked by profound neurovascular dysfunction and significant cell-specific alterations in the brain vasculature. Recent advances in high throughput single-cell transcriptomics technology have enabled the study of the human brain vasculature at an unprecedented depth. Additionally, the understudied niche of cerebrovascular cells, such as endothelial and mural cells, and their subtypes have been scrutinized for understanding cellular and transcriptional heterogeneity in AD.
View Article and Find Full Text PDFBMC Med Inform Decis Mak
January 2025
Great Ormond Street Institute of Child Health, University College London, London, UK.
Introduction: Unsupervised feature learning methods inspired by natural language processing (NLP) models are capable of constructing patient-specific features from longitudinal Electronic Health Records (EHR).
Design: We applied document embedding algorithms to real-world paediatric intensive care (PICU) EHR data to extract patient-specific features from 1853 patients' PICU journeys using 647 unique lab tests and medication events. We evaluated the clinical utility of the patient features via a K-means clustering analysis.
BMC Complement Med Ther
January 2025
Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Background: Suhexiang (SHX) pill is widely used for treating acute ischemic stroke (AIS). Experimental and randomized controlled trials suggested that SHX pill was beneficial for patients with AIS. However, the effectiveness of SHX pill in real-world practice setting remains unclear.
View Article and Find Full Text PDFJ Neuroinflammation
January 2025
Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic.
Background: Tick-borne encephalitis (TBE) is the most common tick-borne viral infection in Eurasia. Outcomes range from asymptomatic infection to fatal encephalitis, with host genetics likely playing a role. BALB/c mice have intermediate susceptibility to TBE virus (TBEV) and STS mice are highly resistant, whereas the recombinant congenic strain CcS-11, which carries 12.
View Article and Find Full Text PDFBMC Neurol
January 2025
Neurological Disorder Center, Department of Cerebrovascular Disease, Suining Central Hospital, Sichuan, 629000, China.
Background: Hyponatremia (< 135 mmol/L) is the most common electrolyte disturbance in patients with stroke. However, few studies have reported the relationship between hyponatremia at admission and outcomes in patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). This study is aimed to explore the association between hyponatremia and clinical outcomes following MT.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!