Megan Heffernan, Mark Woodward, Deidre Anne De Silva, Christopher Chen, Craig S Anderson, Christine Kremer, Katie Harris, Else Charlotte Sandset, Maria Teresa Ferretti, Valeria Caso, Cheryl Carcel
INTRODUCTION: Reporting of sex and gender analysis in medical research has been shown to improve quality of the science and ensures findings are applicable to women and men. There is conflicting evidence on whether efforts by funding agencies and medical journals to encourage reporting of sex and gender analysis has resulted in tangible improvements. This study mapped the inclusion of sex and gender analysis in stroke and dementia research conducted in the Asia-Pacific region. METHODS: A systematic search for Asia-Pacific stroke and dementia research was conducted in PubMed and papers included from the period 2012 to 2022...
February 24, 2024: Cerebrovascular Diseases
Samuel D Pettersson, Shunsuke Koga, Shan Ali, Alejandro Enriquez-Marulanda, Philipp Taussky, Christopher S Ogilvy
INTRODUCTION: This study aimed to elucidate mechanisms underlying moyamoya disease (MMD) pathogenesis and to identify potential novel biomarkers. We utilized gene coexpression networks to identify hub genes associated with the disease. METHODS: Twenty-one middle cerebral artery (MCA) samples from MMD patients and 11 MCA control samples were obtained from the Gene Expression Omnibus (GEO) dataset, GSE189993. To discover functional pathways and potential biomarkers, weighted gene coexpression network analysis (WGCNA) was employed...
February 24, 2024: Cerebrovascular Diseases
Yunke Li, Yang Zhao, Xiaoxi Zhang, Lingli Sun, Yingfeng Wan, Yongwei Zhang, Pengfei Yang, Lili Song, Jianmin Liu, Craig S Anderson
BACKGROUND: Although guidelines recommend a target blood pressure 185-180/105-110 mmHg after mechanical thrombectomy for acute ischemic stroke (AIS), there is limited randomized evidence to support this level. We surveyed candidate institutions about the approach to blood pressure management in this patient group in preparation for inviting them to participate in the Enhanced Blood Pressure Control after Endovascular Thrombectomy for the Acute Ischemic Stroke Trial (ENCHANTED2/MT). METHODS: Physicians from a professional network of institutions that met mechanical thrombectomy qualification requirements were invited to participate in an online questionnaire covering basic clinical information as well as questions on blood pressure management...
February 20, 2024: Cerebrovascular Diseases
Mohammed A Almanna, Ziad S Aloraini, Robert W Regenhardt, Adam A Dmytriw, Mohammed A Bayounis, Mohammed A Bin-Mahfooz, Yousef I Alghamdi, Ysmeen T Bucklain, Abdulrahman Y Alhoumaily, Naif M Alotaibi
BACKGROUND: The use of Alteplase (ALT) bridging to endovascular mechanical thrombectomy (MT) has become the standard approach in treating patients with large vessel stroke (LVO). Tenecteplase (TNK) has emerged as an equivalent fibrinolytic agent in treating ischemic stroke due to its remarkable pharmacological characteristics. This study aims to compare the use of intravenous TNK to ALT bridging to MT in patients with LVO. METHODS: We included observational and randomized controlled trials of patients with LVO who received bridging TNK vs ALT before undergoing MT...
February 15, 2024: Cerebrovascular Diseases
Kun An, Chun Chen, Meijuan Dong, Wei Chen, Yongjun Cao
INTRODUCTION: Post-thrombectomy intraparenchymal hyperdense (PTIH) in patients with acute ischaemic stroke (AIS) is a common CT sign, making it difficult for physicians to distinguish intracerebral hemorrhage in the early post-thrombectomy period. The aim of this study is to develop an effective model to differentiate intracerebral hemorrhage from contrast extravasation in patients with PTIH. METHODS: We retrospectively collected information on patients who underwent endovascular thrombectomy (EVT) at two stroke centers between August 2017 and January 2023...
February 10, 2024: Cerebrovascular Diseases
Laurien Onkenhout, Tine Arts, Doeschka Ferro, Sanne Kuipers, Eline Oudeman, Thijs van Harten, Matthias J P van Osch, Jaco Zwanenburg, Jeroen Hendrikse, Geert Jan Biessels, L Jaap Kappelle
INTRODUCTION: Cerebral perforating arteries provide blood supply to the deep regions of the brain. Recently, it became possible to measure blood flow velocity and pulsatility in these small arteries. It is unknown if vascular risk factors are related to these measures. METHODS: We measured perforating artery flow with 2D phase contrast 7 Tesla MRI at the level of the centrum semiovale (CSO) and the basal ganglia (BG) in seventy participants from the Heart Brain Connection study with carotid occlusive disease (COD), vascular cognitive impairment (VCI), or no actual cerebrovascular disease...
February 9, 2024: Cerebrovascular Diseases
Masahiro Yabuki, Yosuke Akamatsu, Ikuko Uwano, Futoshi Mori, Makoto Sasaki, Kunihiro Yoshioka, Kohei Chida, Masakazu Kobayashi, Shunrou Fujiwara, Kuniaki Ogasawara
INTRODUCTION: While patients who experience improved cognition following carotid endarterectomy (CEA) typically demonstrate restored brain perfusion after the procedure, it is worth noting that less than 50% of patients in whom postoperative cerebral blood flow (CBF) restoration is achieved actually show improved cognition after postoperatively. This suggests that factors beyond the mere restoration of CBF may play a role in postoperative cognitive improvement. Increased iron deposition in the cerebral cortex may cause neural damage, and quantitative susceptibility mapping (QSM) obtained using magnetic resonance imaging (MRI) quantifies magnetic susceptibility in the cerebral cortex, allowing for the assessment of iron deposition in vivo...
February 2, 2024: Cerebrovascular Diseases
Sandra Elsheikh, Muath Alobaida, Tommaso Bucci, Benjamin J R Buckley, Dhiraj Gupta, Greg Irving, Andrew M Hill, Gregory Y H Lip, Azmil H Abdul-Rahim
Introduction Existing randomised controlled trials assessing the safety and efficacy of left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) were of relatively small sample size, or included patients who could receive oral anticoagulant treatment after device implantation. We compared the outcomes of patients with newly diagnosed AF who received percutaneous LAAO or direct oral anticoagulants (DOAC) treatment, in a large population from a global federated health network (TriNetX). Methods Patients with AF treated with percutaneous LAAO were matched with those treated with DOAC between 1st December 2010 and 1st October 2018...
February 2, 2024: Cerebrovascular Diseases
Xinan Ma, Yajun Li, Pan Zhang, Jilong Yi, Yingjie Xu, Miaomiao Hu, Jinjing Wang, Wenya Lan, Guoqiang Xu, Yanan Lu, Pengfei Xu, Feng Feng, Wen Sun, Hao Chen, Zongyi Wu
BACKGROUND: This research explored the factors influencing early neurological outcomes (ENO) in patients who had vertebrobasilar artery occlusion (VBAO) and received endovascular treatment (EVT), as well as examining the causal influence of ENO on the prognosis of VBAO patients. METHODS: A retrospective review was carried out on patients from 65 Chinese stroke centers, all within 24 hours of the estimated occlusion time. ENO includes early neurological improvement (ENI) and early neurological deterioration (END), defined as a decrease or an increase of at least 4 points in NIHSS score between baseline and 24 hours after EVT...
February 1, 2024: Cerebrovascular Diseases
Carlo Lucci, Ina Rissanen, Tim C van den Beukel, Richard Takx, Pim A de Jong, Jeroen Hendrikse, Mirjam I Geerlings
INTRODUCTION: Calcifications of the intracranial internal carotid artery (iICA) can lead to an increased risk for stroke. Two types of iICA calcification are known: those affecting the tunica intima or the tunica media. In extracranial arteries, risk factors and calcification patterns are different in women and men, but little is known regarding the iICA. In this study we aimed to identify sex-specific risk profiles and medications associated to intimal and medial iICA calcification in patients with cardiovascular disease (CVD)...
January 29, 2024: Cerebrovascular Diseases
Wei Xu, Xiaokun Geng, Aminah I Fayyaz, Yuchuan Ding
BACKGROUND: Acute ischemic stroke remains a major contributor to mortality and disability worldwide. The use of hypothermia has emerged as a promising neuroprotective strategy, with proven effectiveness in cardiac arrest and neonatal hypoxic-ischemic injury. SUMMARY: This review explores the therapeutic potential of hypothermia in ischemic stroke by examining its impact on post-stroke inflammatory responses. We synthesized evidence from basic and clinical studies to illustrate the inhibitory effects of hypothermia on post-stroke brain inflammation...
January 29, 2024: Cerebrovascular Diseases
Sonia Torres-Riera, Adrià Arboix, Olga Parra, Luís García-Erolesa, María-José Sánchez-López
INTRODUCTION: There are limited data on the outcome of acute ischemic stroke oldest old women. We assessed clinical risk factors for in-hospital mortality in women aged 85 years or more with acute ischemic stroke. METHODS: This single-center retrospective cohort study included 506 women aged ≥ 85 years collected from a total of 4,600 patients with acute cerebral infarction registered in an ongoing 24-year hospital stroke database. The identification of clinical risk factors for in-hospital mortality was the primary endpoint of the study...
January 29, 2024: Cerebrovascular Diseases
Junrao Li, Xing Wang, Ting Wang, Sen Lin, Changwei Zhang, Xiaodong Xie, Lu Ma, Chaohua Wang
OBJECTIVE: Aim of the present article was the demonstration of the institutional experience with the endovascular management of the anterior inferior cerebellar artery (AICA) aneurysms in order to propose a treatment algorithm. METHODS: Clinical data were obtained from 33 patients with 37 AICA aneurysms who had been surgically treated at the authors' hospital between 2010 and 2022. The patients' medical records, imaging data, and follow-up outcomes were retrospectively analyzed...
January 22, 2024: Cerebrovascular Diseases
Chen Chen, Xinwen Ren, Yang Zhao, Menglu Ouyang, Qiang Li Mbiostat, Xia Wang, Yunke Li, Shoujiang You, Yanan Wang, Thompson G Robinson, Richard Lindley, Hisatomi Arima, John Chalmers, Gang Li, Xiaoying Chen, Craig S Anderson, Lili Song
BACKGROUND: Renal failure is a major safety concern of intensive systolic blood pressure (SBP) lowering. We aimed to determine the effect of this treatment on early change in renal function in participants of the international Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). METHODS: Post-hoc analysis of the ENCHANTED BP-arm in which thrombolyzed patients with acute ischemic stroke (AIS) were randomized to intensive (target 130-140 mm Hg within 1 h) or guideline-recommended (target <180 mm Hg) management within 6 h of symptom onset...
January 16, 2024: Cerebrovascular Diseases
Vinícius Viana Abreu Montanaro, Gisele Sampaio Silva, Jamary Oliveira Filho, Octavio Marques Pontes-Neto, Maria do Carmo Pereira Nunes, Rodrigo de Paiva Bezerra, Eduardo Sousa de Melo, Luciana Valenca Patrizia Alves de Andrade, Wilson Alves de Oliveira Junior, Fidel Castro Alves de Meira, Antonio Lucio Teixeira, Eleonora Maria de Jesus Oliveira, Gabriel R de Freitas
INTRODUCTION: Strokes are traditionally attributed to risk factors like aging, hypertension, diabetes, and atherosclerosis. Chagas disease has emerged as an important risk factor for stroke in Latin American. Our study aims at describing the largest cohort of patients with Chagas disease and ischemic stroke and determining variables associated with stroke recurrence and cardioembolic cause. METHODS: This study is the result of a national multicenter cohort study conducted in Brazil...
January 16, 2024: Cerebrovascular Diseases
Heather Flowers, David Mikulis, Frank Silver, Kannika Hour, Jason Steffener, Julien Poublanc, Elizabeth Rochon, Rosemary Martino
INTRODUCTION: Post-stroke dysphagia and communication impairments occur in two-thirds of acute stroke survivors. Identifying the shared neuroanatomical substrate for related impairments could facilitate the development of cross-system therapies. Our purpose was to elucidate discrete brain regions predictive of the combined presence of dysphagia alongside dysarthria and/or aphasia post-stroke. METHODS: We included 40 right (RHS) and 67 left hemisphere (LHS) patients from an acute ischemic stroke cohort with lesions demarcated on diffusion weighted imaging...
January 16, 2024: Cerebrovascular Diseases
Zhentao Tan, Menghui Mao, Zhe Jiang, Huilin Hu, Chaojie He, Changlin Zhai, Gang Qian
Observational studies have suggested a possible relationship between gut microbiota (GM) and aneurysm development. However, the nature of this association remains unclear due to the inherent limitations of observational research, such as reverse causation and confounding factors. To address this knowledge deficit, this study aimed to investigate and establish a causal link between GM and aneurysm development.
January 16, 2024: Cerebrovascular Diseases
Hirokazu Nakatogawa, Kazuya Hokamura, Ryota Nomura, Kazuhiko Nakano, Kazuo Umemura, Akio Morita, Yoichiro Homma, Tokutaro Tanaka
OBJECTIVE: Streptococcus mutans (SM) with the collagen-binding protein Cnm is a unique member of the oral resident flora because it causes hemorrhagic vascular disorders. In the multicenter study, we examined the relationship between Cnm-positive SM (CP-SM) and intracranial aneurysm (IA) rupture, which remains unknown. METHODS: Between May 2013 and June 2018, we collected whole saliva samples from 431 patients with ruptured IAs (RIAs) and 470 patients with unruptured IAs (UIAs)...
January 12, 2024: Cerebrovascular Diseases
Qiang He, Wenjing Wang, Dingkang Xu, Yang Xiong, Chuanyuan Tao, Lu Ma, Chao You
INTRODUCTION: Glaucoma may be related to ischemic stroke (IS) and poor outcomes after IS in observational studies, while the causal association remains unclear. METHODS: We obtained single nucleotide polymorphisms (SNPs) related to glaucoma from the gene-wide association study (GWAS) conducted by the FinnGen consortium. The GWAS included a total of 13,614 cases and 295,540 controls. The summary-level of datasets regarding IS were collected from the MEGASTROKE consortium, including 34,217 cases and 406,111 controls...
January 10, 2024: Cerebrovascular Diseases
Eva Bettschen, Bernhard M Siepen, Martina B Goeldlin, Madlaine Mueller, Philipp Buecke, Ulrike Prange, Thomas R Meinel, Boudewijn R H Drop, David Bervini, Tomas Dobrocky, Johannes Kaesmacher, Aristomenis K Exadaktylos, Thomas C Sauter, Bastian Volbers, Marcel Arnold, Simon Jung, Urs Fischer, Werner Z'Graggen, David Seiffge
INTRODUCTION: Knowledge about uptake and workflow metrics of hyperacute treatments in patients with non-traumatic intracerebral haemorrhage (ICH) in the emergency department are scarce. METHODS: Single centre retrospective study of consecutive patients with ICH between 01/2018-08/2020. We assessed uptake and workflow metrics of acute therapies overall and according to referral mode (stroke code, transfer from other hospital or other). RESULTS: We enrolled 332 patients (age 73years, IQR 63-81 and GCS 14 points, IQR 11-15, onset-to-admission-time 284 minutes, IQR 111-708minutes) of whom 101 patients (35%) had lobar haematoma...
January 10, 2024: Cerebrovascular Diseases
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