Characteristics of peripheral immune response induced by large-vessel occlusion in patients with acute ischemic stroke.

Introduction: Despite improvements in the treatment of acute ischemic stroke (AIS), some patients still suffer from functional impairments, indicating the poor understanding of pathophysiologic process of AIS. Inflammation plays an important role in the pathophysiology of AIS. The purpose of the study was to investigate the peripheral inflammation in different subtypes of AIS.

Ischemic Stroke Prevention in Patients Atrial Fibrillation and a Recent Ischemic Stroke, TIA, or Intracranial Hemorrhage; a World Stroke Organisation (WSO) Scientific Statement.

Background: Secondary stroke prevention in patients with atrial fibrillation (AF) is one of the fastest growing areas in the field of cerebrovascular diseases. This Scientific statement from the World Stroke Organization Brain & Heart Task Force provides a critical analysis of the strength of current evidence this topic, highlights areas of current controversy, identifies knowledge gaps, and proposes priorities for future research.

Methods: We select topics with the highest clinical relevance and perform a systematic search to answer specific practical questions.

Prognostic value of beat-to-beat blood pressure variability parameters in patients after mechanical thrombectomy.

The relationship of beat-to-beat blood pressure variability (BPV) with prognosis after mechanical thrombectomy (MT) is unclear. Consecutive patients with acute ischemic stroke with large vessel occlusion treated with and without MT matched 1:1 by age, sex, and National Institutes of Health Stroke Scale were included. Beat-to-beat BPV was calculated for both systolic (SBP) and diastolic blood pressure (DBP) as standard deviation, coefficient of variation, successive variation (SV), and average real variability (ARV) at 24-72 h after MT.

Influence of prestroke glycemic status on outcomes by age in patients with acute ischemic stroke and diabetes mellitus.

Background: This study aimed to explore the association between admission HbA1c and the risk of 1-year vascular outcomes stratified by age group in patients with acute ischemic stroke (AIS) and diabetes mellitus (DM).

Methods: This study analyzed prospective multicenter data from patients with AIS and DM. Admission HbA1C were categorized as:≤6.

Selenium promotes neural development through the regulation of GPX4 and SEPP1 in an iPSC-derived neuronal model.

Selenium (Se) is incorporated into selenoproteins in the form of selenocysteine, which has biological functions associated with neural development. Unfortunately, the specific roles and mechanisms of selenoproteins at different stages of neuronal development are still unclear. Therefore, in this study, we successfully established a neuronal model derived from induced pluripotent stem cells (iPSC-iNeuron) and used Se nanoparticles (SeNPs@LNT) with high bioavailability to intervene at different stages of neural development in iPSC-iNeuron model.

Prognostic factors and impact of management strategies for status epilepticus: The STEPPER study in the Emilia-Romagna region, Italy.

Objective: The STEPPER (Status Epilepticus in Emilia-Romagna) study aimed to investigate the clinical characteristics, prognostic factors, and treatment approaches of status epilepticus (SE) in adults of the Emilia-Romagna region (ERR), Northern Italy.

Methods: STEPPER, an observational, prospective, multicentric cohort study, was conducted across neurology units, emergency departments, and intensive care units of the ERR over 24 months (October 2019-October 2021), encompassing incident cases of SE. Patients were followed up for 30 days.

Hypoperfusion intensity ratio to differentiate between stroke etiologies in patients with a large vessel occlusion.

Background: Collateral circulation plays a key role in acute ischemic stroke. We sought to determine the association between the arterial collateral status, estimated by the Hypoperfusion Intensity Ratio (HIR) on perfusion MRI, and stroke etiology in anterior circulation large vessel occlusion (LVO).

Methods: We retrospectively analyzed anterior circulation LVO acute stroke patients with a baseline perfusion MRI performed within 24 h from symptom onset.

The pleiotropic effects of statins: a comprehensive exploration of neurovascular unit modulation and blood-brain barrier protection.

The blood-brain barrier (BBB) is the most central component of the neurovascular unit (NVU) and is crucial for the maintenance of the internal environment of the central nervous system and the regulation of homeostasis. A multitude of neuroprotective agents have been developed to exert neuroprotective effects and improve the prognosis of patients with ischemic stroke. These agents have been designed to maintain integrity and promote BBB repair.

Pathway plaques and diffusion-weighted lesion analysis after endovascular treatment of unruptured intracranial aneurysms: a prospective study.

Objectives: To evaluate the prevalence and predictors of ischemic lesions on thin-slice DWI (2 mm) in endovascular treatments for unruptured intracranial aneurysms (UIA), particularly explore the potential relationship with pathway plaques.

Methods: Participants eligible for endovascular treatments with UIA at a national stroke center between March 2023 and August 2023 were prospectively enrolled. All participants performed thin-slice DWI (slice thickness of 2 mm) before and after procedures.

Microembolic signal detection in acute ischemic stroke: Clinical relevance and impact on treatment individualization-A narrative review.

Background: Microembolic signals (MES) can be detected using transcranial Doppler (TCD) ultrasound in several clinical scenarios, including acute ischemic stroke (AIS). This narrative review aims to provide insights into their role in AIS patient management and outcomes.

Methods: The present narrative review consolidates current observational and randomized evidence on the prevalence and clinical relevance of MES in different AIS subtypes and settings.

Natural history of dolichoectatic vertebrobasilar aneurysms: a multinational study.

Objective: Dolichoectatic vertebrobasilar aneurysms (DVBAs) are expansions of arterial tissue leading to aneurysmal formations without an obvious neck. Their natural history is poorly understood; usually patients are admitted with thromboembolic complications and/or neurological symptoms from the mass effect. There have not been international collective data, and correct timing for highly risky treatments has been under discussion.

Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis.

Background: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk transient ischemic attack stratified by risk profile.

Methods: This is a secondary post hoc analysis of the INSPIRES (Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracranial or Extracranial Atherosclerosis) randomized clinical trial that enrolled patients 35 to 80 years old with acute mild ischemic stroke or high-risk transient ischemic attack between 2018 and 2022.

Early vs Late Anticoagulation After Ischemic Stroke in Patients With Atrial Fibrillation and Covert Brain Infarcts.

Background And Objectives: Covert brain infarcts (CBIs) in patients with first-ever ischemic stroke (IS) and atrial fibrillation (AF) are associated with an increased risk of stroke recurrence. We aimed to assess whether CBIs modify the treatment effect of early vs late initiation of direct oral anticoagulants (DOACs) in patients with IS and AF.

Methods: We conducted a post hoc analysis of the international, multicenter, randomized-controlled ELAN trial, which compared early (<48 hours after ischemic stroke for minor and moderate stroke, 6-7 days for major stroke) vs late (>48 hours for minor, 3-4 days for moderate, 12-14 days for major stroke) initiation of DOACs in patients with IS and AF.

Association between perforator stroke after middle cerebral artery elective stenting and arterial remodeling patterns: a high-resolution MRI-based retrospective cohort study.

Background: Patterns of arterial remodeling may be associated with outcomes in patients with severe middle cerebral artery (MCA) stenosis after endovascular treatment (EVT). This study aims to investigate the potential correlation between arterial remodeling patterns in patients with severe MCA stenosis, and plaque characteristics and procedure-related perforator stroke (PS).

Methods: Consecutive patients with MCA atherosclerotic disease who underwent EVT at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2023 were retrospectively enrolled in this study.

Coffee consumption and adverse cardiovascular events in patients with atrial fibrillation.

Background: There is some evidence of reduced major cardiovascular event (MACE) rates associated with moderate coffee consumption in the general population. However, there is concern about the potential risks of coffee consumption in patients with atrial fibrillation (AF). Therefore, we aimed to investigate the association between coffee consumption and MACE in AF patients.

[A case of paroxysmal dysarthria and ataxia appeared late after treatment of myelin oligodendrocyte glycoprotein (MOG) antibody-related isolated rhombencephalitis].

A 49-year-old female was admitted to our hospital due to acute-onset dysarthria and unstable gait. Brain MR diffusion weighted imaging revealed high signal intensities in the midbrain. Brain tumors, abscess and demyelinating lesions was suspected firstly as etiology of the lesion and antibiotics and antiviral drug were started under consulting with the neurosurgeon about brain biopsy.

Diagnostic Performance of Clinical and Routine Laboratory Data in Acute Mesenteric Arterial Occlusion-An International Multicenter Study.

Background: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected.

Methods: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected.

A Case of Cavernous Sinus Fistula Caused by Ruptured Spontaneous Aneurysm on Persistent Primitive Trigeminal Artery.

The most frequent of the embryonic persistent arteries that connect the internal carotid artery to the posterior circulation is the persistent primitive trigeminal artery (PPTA), which is recognized on 0.1%-0.6% on the basis of conventional angiography or magnetic resonance imaging (MRI).

Endovascular therapy for acute vertebrobasilar occlusion (VERITAS): a systematic review and individual patient data meta-analysis.

Background: Trials of endovascular therapy for basilar artery occlusion, including vertebral occlusion extending into the basilar artery, have shown inconsistent results. We aimed to pool data to estimate safety and efficacy and to explore the benefit across pre-specified subgroups through individual patient data meta-analysis.

Methods: VERITAS was a systematic review and meta-analysis that pooled patient-level data from trials that recruited patients with vertebrobasilar ischaemic stroke who were randomly assigned to treatment with either endovascular therapy or standard medical treatment alone.

Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.

Background And Aims: We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.

Methods: Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients).

The role of nanomaterials in revolutionizing ischemic stroke treatment: Current trends and future prospects.

Ischemic stroke has a high disability rate, which leads to irreversible neuronal death. The efficacy of conventional stroke treatments, including thrombolytic and neuroprotective therapies, is constrained by a number of factors, including safety concerns and inefficient drug delivery. The advent of nanomaterials has created new avenues for stroke therapy, facilitating enhanced pharmacokinetic behavior of drugs, effective drug accumulation at the target site, augmented therapeutic efficacy, and concomitant reduction in side effects.

Comparison of HEmorrhage on CT versus MRI After ThrombEctomy: The HECATE study.

Background: The characterization of hemorrhage following acute stroke intervention has largely been CT-based. We sought to compare MRI- and CT-based scoring of hemorrhage after acute endovascular therapy (EVT) applying the Heidelberg Bleeding Classification (HBC) to assess inter-modal agreement and quantify inter-rater agreement.

Methods: Consecutive acute stroke patients were included in this retrospective study if they: i) had MRI and CT ≤12 hours of each other OR ii) had CT bracketed by MRI pre- and post-CT [i.