Tenecteplase Thrombolysis for Stroke up to 24 Hours After Onset With Perfusion Imaging Selection: The CHABLIS-T II Randomized Clinical Trial.

Background: Whether it is effective and safe to extend the time window of intravenous thrombolysis up to 24 hours after the last known well is unknown. We aimed to determine the efficacy and safety of tenecteplase in Chinese patients with acute ischemic stroke due to large/medium vessel occlusion within an extended time window.

Methods: Patients with ischemic stroke presenting 4.

Inhibition of Bruton's tyrosine kinase restricts neuroinflammation following intracerebral hemorrhage.

Intracerebral hemorrhage (ICH) is a devastating form of stroke with a lack of effective treatments. Following disease onset, ICH activates microglia and recruits peripheral leukocytes into the perihematomal region to amplify neural injury. Bruton's tyrosine kinase (BTK) controls the proliferation and survival of various myeloid cells and lymphocytes.

Repeated non-hemorrhagic and non-contusional mild traumatic brain injury in rats elicits behavioral impairment with microglial activation, astrogliosis, and tauopathy: Reproducible and quantitative model of chronic traumatic encephalopathy.

Chronic traumatic encephalopathy (CTE) has attracted attention due to sports-related head trauma or repetitive mild traumatic brain injury (mTBI). However, the pathology of CTE remains underexplored. Reproducible and quantitative model of CTE has yet to be established.

Comparative analysis of hemorrhagic complications in DBS: Microelectrode Recording vs. Macrostimulation - Does the technique matter?

Background: Hemorrhage is a dangerous complication of deep brain stimulation (DBS) surgery, but a comprehensive explanation of the associated risk factors remains inconclusive, particularly application of microelectrode recording (MER) compared to macrostimulation (non-MER) based DBS procedures. We conducted a comparative analysis of MER and macrostimulation techniques, evaluating the impact of brain penetrations by microelectrode guiding cannulas on the occurrence of intracranial hemorrhagic events.

Methods: This retrospective study included all DBS procedures (MER-based and non-MER based) performed at a single medical center from November 2008 to June 2023.

Endovascular Treatment of Mirror Aneurysms in Subarachnoid Hemorrhage Patients: Single Stage or Multiple Stage?

Objective: The study evaluated the effectiveness and safety of single-stage versus multistage endovascular treatment in subarachnoid hemorrhage patients with Mirror Aneurysms.

Materials And Methods: Our research team performed a prospective study, focusing on the radiographic and clinical data of patients diagnosed with subarachnoid hemorrhage, specifically those who presented with Mirror Aneurysms upon admission to our institutions. According to the different endovascular treatment stages, these patients were grouped into the multistage cohort and the single-stage cohort.

Prevention of Stroke in Intracerebral Haemorrhage Survivors with Atrial Fibrillation: Rationale and Design for PRESTIGE-AF Trial.

Adequate secondary prevention in survivors of intracerebral hemorrhage (ICH) who also have atrial fibrillation (AF) is a long-standing clinical dilemma because these patients are at increased risk of recurrent ICH as well as of ischemic stroke. The efficacy and safety of oral anticoagulation, the standard preventive medication for ischemic stroke patients with AF, in ICH patients with AF are uncertain. PRESTIGE-AF is an international, phase 3b, multi-center, randomized, open, blinded end-point assessment (PROBE) clinical trial that compared the efficacy and safety of direct oral anticoagulants (DOACs) with no DOAC (either no antithrombotic treatment or any antiplatelet drug).

Invasive Intracranial Electroencephalography (EEG) Monitoring in the Child with a Bleeding Disorder: Challenges and Considerations.

Introduction: Hereditary bleeding disorders stem from the absence or insufficient levels of particular clotting proteins, essential for facilitating coagulation in the clotting cascade. Among the most prevalent are hemophilia A (deficiency of Factor VIII), hemophilia B (deficiency of Factor IX), and von Willebrand disease. Management of pharmacoresistant epilepsy is more difficult in a patient with bleeding disorder due to increased risk of bleeding during surgery.

Continuous quantitative electroencephalography for early detection of acute low-pressure obstructive hydrocephalus in aneurysmal subarachnoid hemorrhage: illustrative case.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is often associated with acute high-pressure hydrocephalus. Less commonly, an acute low-pressure hydrocephalus (ALPH) variant can develop and contribute to increased morbidity. ALPH is particularly challenging to diagnose and manage, as patients present with symptoms of increased intracranial pressure (ICP) despite the absence of corroborating evidence from ICP measurements.

Efficacy and safety of tirofiban in acute ischemic stroke due to intracranial atherosclerotic disease for patients undergoing endovascular treatment: a systematic review and meta-analysis.

Purpose: Tirofiban has emerged as an adjunct therapy for acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT). However, its benefits for AIS patients with intracranial atherosclerotic disease (ICAD) remains unclear. This meta-analysis evaluates its efficacy and safety in ICAD-related AIS patients undergoing EVT.

Progressive histological and behavioral deterioration of a novel mouse model of secondary hydrocephalus after subarachnoid hemorrhage.

Hydrocephalus commonly occurs after subarachnoid hemorrhage (SAH) and is associated with increased morbidity and disability in patients with SAH. Choroid plexus cerebrospinal fluid (CSF) hypersecretion, obliterative arachnoiditis occluding the arachnoid villi, lymphatic obstruction, subarachnoid fibrosis, and glymphatic system injury are considered the main pathological mechanisms of hydrocephalus after SAH. Although the mechanisms of hydrocephalus after SAH are increasingly being revealed, the clinical prognosis of SAH still has not improved significantly.

Kisspeptin is elevated in the brain after intracerebral haemorrhagic stroke.

Intracerebral haemorrhage (ICH) is the most severe subtype of stroke, with a 2-year mortality of nearly 50% and the greatest rate of disability amongst stroke survivors. Whilst treatment options for ICH remain limited, the condition requires prompt identification and rapid intervention to reduce permanent brain damage, with diagnosis traditionally confirmed by CT imaging. Although imaging is excellent at determining the presence of an intracranial bleed, biomarkers may help to identify the type of stroke or when the stroke began.

Mortality in Haemophilia Patients in India: A National Cohort Study.

Introduction: Mortality and morbidity in persons with haemophilia (PWH) have decreased due to improved diagnosis and treatment along with comprehensive population outreach efforts, but the impact is not uniform in different countries.

Aim: The study aims to assess all-cause and intracranial haemorrhage (ICH)-specific mortality of PWH in India.

Methods: This is a retrospective, observational, multi-centric cohort study of 1020 haemophilia patients from three centres in India.

Non-Invasive Diagnosis of Moyamoya Disease Using Serum Metabolic Fingerprints and Machine Learning.

Moyamoya disease (MMD) is a progressive cerebrovascular disorder that increases the risk of intracranial ischemia and hemorrhage. Timely diagnosis and intervention can significantly reduce the risk of new-onset stroke in patients with MMD. However, the current diagnostic methods are invasive and expensive, and non-invasive diagnosis using biomarkers of MMD is rarely reported.

Management of Spontaneous Epidural Hematoma in the Setting of Vaso-occlusive Crisis Among Pediatric Patients With Sickle Cell Disease: A Case Series and Scoping Literature Review.

Spontaneous epidural hematoma (EDH) is a rare sickle cell disease (SCD) complication. We report 3 pediatric cases with SCD and spontaneous EDH and 1 with subgaleal hematomas in the setting of vaso-occlusive crises and elaborate on their presentation and management. Through a scoping review, we identified 71 additional cases reported from 1970 to 2024 and highlighted notable features.

Elevated tissue factor pathway inhibitor is associated with intracerebral haemorrhage of unknown cause in young adults.

Clinical Rationale For Study: We have reported that intracerebral haemorrhage (ICH) of unknown cause at a young age is associated with lower prothrombin and factor VII and higher antithrombin activity, along with the formation of looser fibrin networks displaying enhanced lysability. Patients with mild-to-moderate bleeding of unknown cause have elevated levels of free plasma tissue factor pathway inhibitor alpha (fTFPIα), inhibiting the tissue factor-factor VII complex and prothrombinase.

Aim Of Study: We hypothesised that patients with an intracerebral haemorrhage (ICH) of unknown cause may also exhibit higher fTFPIα.

Fully endoscopic neurosurgery using a two-handed technique for cerebellopontine angle tumors via the retrosigmoid approach.

Background: Surgery for tumors in the cerebellopontine angle is always a significant challenge due to the densely packed neurovascular structures, the narrow deep location, and the complex relationship between the lesions and surrounding neurovascular structures. Recently, great attention has been given to the neuroendoscope for its exclusive advantages, which have added a new dimension to many classical microscopic surgeries. However, the feasibility and advisability of fully endoscopic neurosurgery for cerebellopontine angle tumors remain to be further evaluated.

"Mechanical thrombectomy beyond 6 hours for acute ischemic strokes due to M2 occlusions".

Background: The time frame for mechanical thrombectomy (MT) in acute ischemic stroke (AIS) is enlarging. Guidelines recommend MT until 6 h of symptom onset in M2 segment occlusions (grade IIB). In practice, it is frequently performed later.

ATP5J regulates microglial activation via mitochondrial dysfunction, exacerbating neuroinflammation in intracerebral hemorrhage.

Microglial-mediated neuroinflammation is crucial in the pathophysiological mechanisms of secondary brain injury (SBI) following intracerebral hemorrhage (ICH). Mitochondria are central regulators of inflammation, influencing key pathways such as alternative splicing, and play a critical role in cell differentiation and function. Mitochondrial ATP synthase coupling factor 6 (ATP5J) participates in various pathological processes, such as cell proliferation, migration, and inflammation.

Cerebral Venous Sinus Thrombosis Triggered by Severe Dehydration.

Cerebral venous sinus thrombosis (CVST) is the causative factor in a small proportion of strokes. It primarily affects individuals aged less than 55 years, with up to two-thirds of cases affecting females. It can be precipitated by a myriad of transient or permanent risk factors that result in a prothrombotic state.

Anticoagulation Reversal in Intracerebral Hemorrhage: A Case Report on the Efficacy of Andexanet Alfa in an Apixaban-Treated Patient.

Intracerebral hemorrhage (ICH) presents complex clinical challenges, particularly in patients receiving anticoagulation therapy. This case report discusses the management of acute ICH in a 60-year-old male patient on long-term apixaban therapy, who arrived at the emergency department with altered consciousness, right-sided hemiplegia, and mixed aphasia. Computed tomography (CT) imaging revealed a 70 ml left lenticular-capsular hematoma with significant mass effect, necessitating rapid intervention.

Resolvin D1 combined with exercise rehabilitation alleviates neurological injury in mice with intracranial hemorrhage via the BDNF/TrkB/PI3K/AKT pathway.

Resolvin D1 (RvD1) is an endogenous anti-inflammatory mediator that modulates the inflammatory response and promotes inflammation resolution. RvD1 has demonstrated neuroprotective effects in various central nervous system contexts; however, its role in the pathophysiological processes of intracerebral hemorrhage (ICH) and the potential protective mechanisms when combined with exercise rehabilitation remain unclear. A mouse model of ICH was established using collagenase, and treatment with RvD1 combined with three weeks of exercise rehabilitation significantly improved neurological deficits, muscle strength, learning, and memory in ICH mice while reducing anxiety-like behavior.