Yu Liu, Shuang Li, Haipeng Liu, Xuan Tian, Yuying Liu, Ziqi Li, Thomas W Leung, Xinyi Leng
BACKGROUND: Recently, computational fluid dynamics (CFD) has been used to simulate blood flow of symptomatic intracranial atherosclerotic stenosis (sICAS) and investigate the clinical implications of its haemodynamic features, which were systematically reviewed in this study. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology statements, we searched PubMed and Embase up to March 2024 and screened for articles reporting clinical implications of haemodynamic parameters in sICAS derived from CFD models...
May 28, 2024: Stroke and Vascular Neurology
Qian Jia, Peng Lei, Li Sun, Wei Li Jia, Yuesong Pan, Baoshi Yuan, Yinkai Wang, Qi Zhou, Xia Meng, Jing Jing, Jinxi Lin, Anxin Wang, Shuting Zhang, Zhen Hong, Yu Yang, Yunyun Xiong, Zixiao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang
BACKGROUND: The incidence of vascular cognitive impairment (VCI) is high in patients suffering from ischaemic stroke or transient ischaemic attack (TIA) or with vascular risk factors. Effective prevention strategies for VCI remain limited. Anaemia or low haemoglobin was found as an independent risk factor for adverse outcomes after acute stroke. Anaemia or low haemoglobin was possibly associated with an increased risk of poststroke cognitive impairment. Whether supplement of ferrous iron to correct anaemia reduces the risk of VCI and improves adverse outcomes in patients with ischaemic cerebrovascular disease remains uncertain...
May 24, 2024: Stroke and Vascular Neurology
Allice Nyborg Rosenkrans Lind, Mathias Green Krabbenhøft, Jan Brink Valentin, Mette Haldrup, Stig Dyrskog, Mads Rasmussen, Claus Ziegler Simonsen, Anders Rosendal Korshoej
BACKGROUND: Subarachnoid haemorrhage (SAH) and intraventricular haemorrhage (IVH) are associated with poor patient outcomes. Intraventricular fibrinolysis is effective in clearing IVH and improving patient survival and neurological outcome. By similar rationale, cisternal irrigation has been proposed as a potential method to accelerate haematoma clearance in SAH. We aimed to provide a comprehensive review and meta-analysis evaluating the effect of intraventricular and cisternal irrigation on clinical outcomes in patients with SAH and IVH...
May 23, 2024: Stroke and Vascular Neurology
Aglae Velasco Gonzalez, Cristina Sauerland, Dennis Görlich, Joaquin Ortega-Quintanilla, Astrid Jeibmann, Andreas Faldum, Werner Paulus, Walter Heindel, Boris Buerke
BACKGROUND: We investigated differences in intracranial embolus distribution through communicating arteries in relation to supra-aortic vessel (SAV) patency. METHODS: For this experimental analysis, we created a silicone model of the extracranial and intracranial circulations using a blood-mimicking fluid under physiological pulsatile flow. We examined the sequence of embolus lodgment on injecting 104 frangible clot analogues (406 emboli) through the right internal carotid artery (CA) as SAV patency changed: (a) all SAV patent (baseline), (b) emboli from a CA occlusion, (c) emboli contralateral to a CA occlusion and (d) occlusion of the posterior circulation...
May 23, 2024: Stroke and Vascular Neurology
Ali Majdi, Hossein Mostafavi, Ali Moharrami, Shahin Yaraghi, Amirreza Ghaffari Tabrizi, Morteza Dojahani, Erfan Alirezapour, Kamyar Mansori
BACKGROUND: Stroke is a major cause of global mortality and disability. Currently, the treatment of acute ischaemic stroke through reperfusion has posed several challenges, raising the need for complementary options to protect the ischaemic penumbra. Recent investigations have indicated that certain epigenetic factors, specifically, histone deacetylases (HDACs) and sirtuins, can be promising for ischaemic stroke therapy, with recent studies suggesting that inhibitors of HDACs or sirtuins may provide neuronal protection after ischaemic stroke...
May 23, 2024: Stroke and Vascular Neurology
Luke Kiefer, David Daniel, Sai Polineni, Mandip Dhamoon
BACKGROUND: Racism contributes to higher comorbid risk factors and barriers to preventive measures for black Americans. Advancements in systems of care, tissue plasminogen activator (tPA) availability and endovascular thrombectomy (ET) have impacted practice and outcomes while outpacing contemporary investigation into acute ischaemic stroke (AIS) care disparities. We examined whether recent data suggest ongoing disparity in AIS interventions and outcomes, and if hospital characteristics affect disparities...
May 21, 2024: Stroke and Vascular Neurology
Guangxiong Yuan, Jun Zhang, Zekang Ye, Jingping Sun, Xiaochuan Huo, Yuesong Pan, Mengxing Wang, Xiao Peng, Chanjuan Zheng, Xueyao Lei, Zhongrong Miao, Xueli Cai
BACKGROUND AND PURPOSE: The benefits of thrombolytic therapy before endovascular thrombectomy in cases of acute ischaemic stroke, with a large infarction volume, remain unclear. This analysis aims to evaluate the effectiveness and safety of bridging therapy and endovascular therapy among patients with large cerebral infarctions. METHODS: In this post-hoc analysis of the multicentre prospective study of ANGEL-ASPECT (Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core), participants were divided into two groups: an endovascular therapy group and a bridging therapy group...
May 21, 2024: Stroke and Vascular Neurology
Wenbo Li, Yang Liu, Jie Liu, Qirui Guo, Jing Li, Anxin Wang, Huaguang Zheng
BACKGROUND: Remnant cholesterol (RC) is considered to be one of the most significant and important risk factors for atherosclerotic cardiovascular disease (ASCVD). Nonetheless, the association between RC and unstable carotid plaque remains unclear. Our primary objective is to ascertain whether RC exhibits an independent and significant association with unstable carotid plaque in a neurologically healthy population. METHODS: In the cross-sectional study, we enrolled neurologically healthy participants who visited our centre for health checkups between 2021 and 2022...
May 16, 2024: Stroke and Vascular Neurology
Chunwang Li, Lingyun Zhuo, Yaqing Kang, Penghui Liu, Weilin Huang, Qixuan Li, Ke Ma, Shuna Huang, Xinru Lin, Weiheng Zhuang, Haojie Wang, Darong Chen, Huimin Wang, Qiu He, Zhuyu Gao, Xuegang Niu, Yajun Jing, Lingjun Yan, Bin Gao, Dengliang Wang, Shaowei Lin, Siying Wu, Yuanxiang Lin, Dezhi Kang, Fuxin Lin
OBJECTIVE: This study aims to investigate the prevalence of familial cerebral cavernous malformations (FCCMs) in first-degree relatives (FDRs) using familial screening, to describe the distribution of initial symptoms, lesion count on cranial MRI and pathogenic gene in patients. METHODS: Patients with multiple CCMs who enrolled from the Treatments and Outcomes of Untreated Cerebral Cavernous Malformations in China database were considered as probands and FDRs were recruited...
May 15, 2024: Stroke and Vascular Neurology
Zhongfang Deng, Xiaoyu Chen, Ran Zhang, Lingchao Kong, Yang Fang, Jizheng Guo, Bing Shen, Lesha Zhang
BACKGROUND: Local brain tissue can suffer from ischaemia/reperfusion (I/R) injury, which lead to vascular endothelial damage. The peptide δ opioid receptor (δOR) agonist [D-ala2, D-leu5]-Enkephalin (DADLE) can reduce apoptosis caused by acute I/R injury in brain microvascular endothelial cells (BMECs). OBJECTIVE: This study aims to explore the mechanism by which DADLE enhances the level of mitophagy in BMECs by upregulating the expression of transient receptor potential vanilloid subtype 4 (TRPV4)...
May 2, 2024: Stroke and Vascular Neurology
Nicole Yun Ching Chen, Melissa Yi Ling Tan, Jing Xu, Lijun Zuo, Yanhong Dong
INTRODUCTION: Vascular diseases, such as stroke and heart failure (HF), are associated with cognitive decline. Vascular cognitive impairment (CI) is commonly found in patients who had a stroke and with HF, ranging from mild CI to dementia. Early detection of CI is crucial for effective management and rehabilitation. This study aimed to develop the VasCog Screen test, a screening tool to detect CI in patients who had a stroke and with HF. METHOD: 427 patients who had a stroke and with HF were assessed using cognitive measures including Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery...
April 22, 2024: Stroke and Vascular Neurology
Beini Fei, Yu Cheng, Ying Liu, Guangzheng Zhang, Anyan Ge, Junyi Luo, Shan Wu, He Wang, Jing Ding, Xin Wang
BACKGROUND AND OBJECTIVE: The injury of the cholinergic white matter pathway underlies cognition decline in patients with silent cerebrovascular disease (SCD) with white matter hyperintensities (WMH) of vascular origin. However, the evaluation of the cholinergic white matter pathway is complex with poor consistency. We established an intelligent algorithm to evaluate WMH in the cholinergic pathway. METHODS: Patients with SCD with WMH of vascular origin were enrolled...
April 3, 2024: Stroke and Vascular Neurology
Gordon Blair, Jason P Appleton, Iris Mhlanga, Lisa J Woodhouse, Fergus Doubal, Philip M Bath, Joanna M Wardlaw
Cerebral small vessel disease (cSVD) causes lacunar stroke (25% of ischaemic strokes), haemorrhage, dementia, physical frailty, or is 'covert', but has no specific treatment. Uncertainties about the design of clinical trials in cSVD, which patients to include or outcomes to assess, may have delayed progress. Based on experience in recent cSVD trials, we reviewed ways to facilitate future trials in patients with cSVD.We assessed the literature and the LACunar Intervention Trial 2 (LACI-2) for data to inform choice of Participant, Intervention, Comparator, Outcome, including clinical versus intermediary endpoints, potential interventions, effect of outcome on missing data, methods to aid retention and reduce data loss...
April 3, 2024: Stroke and Vascular Neurology
Ya Su, Yi Dong, Xin Cheng
Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a relatively rare and treatable subtype of CAA. We have herein reported a case of CAA-ri with repeated recurrent lobar haemorrhages within a short time as the main manifestations and effectively treated with immunosuppressive therapy. Our case expanded the clinical spectrum of CAA-ri and indicated that leptomeningeal inflammation might be a trigger and bleeding source for recurrent haemorrhage in CAA.
March 29, 2024: Stroke and Vascular Neurology
Zhixin Cao, David Wang, Xueyan Feng, Pengfei Yang, Hao Wang, Ziqi Xu, Yahui Hao, Wanxing Ye, Fengwei Chen, Liyuan Wang, Manjun Hao, Na Wu, Kai-Xuan Yang, Yunyun Xiong, Yongjun Wang
INTRODUCTION: To compare the perfusion volumes assessed by a new automated CT perfusion (CTP) software iStroke with the circular singular value decomposition software RAPID and determine its predictive value for functional outcome in patients with acute ischaemic stroke (AIS) who underwent endovascular treatment (EVT). METHODS: Data on patients with AIS were collected from four hospitals in China. All patients received CTP followed by EVT with complete recanalisation within 24 hours of symptom onset...
March 28, 2024: Stroke and Vascular Neurology
Xinmin Liu, Zhaoxia Li, Yi Ju, Xingquan Zhao
BACKGROUND AND PURPOSE: Acute vestibular syndrome (AVS) typically manifests as isolated dizziness or vertigo with no apparent neurological impairments. However, distinguishing life-threatening stroke from innocuous peripheral vestibular lesions in the emergency room (ER) remains challenging. This study aimed to explore the ability of the head impulse-nystagmus-test of skew (HINTS) combined with truncal ataxia or ABCD2 score to differentiate stroke from peripheral vestibular disease in patients with AVS in the ER...
March 25, 2024: Stroke and Vascular Neurology
Tianchi Tang, Huaijun Chen, Libin Hu, Jingya Ye, Chaohui Jing, Chaoran Xu, Xinyan Wu, Yike Chen, Zihang Chen, Hang Zhou, Linfeng Fan, Xiongjie Fu, Cong Qian, Jingsen Chen, Zhongju Tan, Jing Liu, Hanhai Zeng, Gao Chen, Fuyi Liu
BACKGROUND: Astrocytes regulate blood-brain barrier (BBB) integrity, whereas subarachnoid haemorrhage (SAH) results in astrocyte dysregulation and BBB disruption. Here, we explored the involvement of tissue inhibitor of matrix metalloprotease-1 (TIMP1) in astrocyte-mediated BBB protection during SAH, along with its underlying mechanisms. METHODS: C57BL/6J mice were used to establish a model of SAH. The effects of TIMP1 on SAH outcomes were analysed by intraperitoneal injection of recombinant mouse TIMP1 protein (rm-TIMP1; 250 µg/kg)...
March 14, 2024: Stroke and Vascular Neurology
Chunjuan Wang, Hong-Qiu Gu, Qiang Dong, Anding Xu, Ning Wang, Yi Yang, Feng Wang, Yongjun Wang
BACKGROUND: Edaravone dexborneol is believed to be a novel cytoprotective drug, demonstrating a synergistic combination of antioxidative and anti-inflammatory properties in animal models. The Treatment of Acute Ischaemic Stroke with Edaravone Dexborneol (TASTE) trial demonstrated its superior efficacy over edaravone alone for acute ischaemic stroke (AIS) patients. However, its efficacy in individuals undergoing endovascular therapy (EVT) remains uncertain. AIM: To clarify the rationale and design of the TASTE II (TASTE-2) trial...
March 11, 2024: Stroke and Vascular Neurology
Si-Meng Liu, Gan Gao, Fang-Bin Hao, Shi-Tong Liu, Ri-Miao Yang, Hou-di Zhang, Min-Jie Wang, Zheng-Xing Zou, Dan Yu, Qian Zhang, Qing-Bao Guo, Xiao-Peng Wang, He-Guan Fu, Jing-Jie Li, Cong Han, Lian Duan
BACKGROUND: The relationship between anterior cerebral artery (ACA) occlusion and moyamoya disease (MMD) has rarely been studied. In this study, we focused on a special type of MMD: isolated ACA-occlusive MMD. We investigated clinical attributes, genotypes and progression risk factors in patients with ACA-occlusive MMD, providing initial insights into the relationship between ACA occlusion and MMD. METHODS: We retrospectively analysed digital subtraction angiography (DSA) from 2486 patients and diagnosed 139 patients with ACA-occlusive MMD...
March 9, 2024: Stroke and Vascular Neurology
Jason Philip Appleton, Lisa J Woodhouse, Craig S Anderson, Sandeep Ankolekar, Lesley Cala, Mark Dixon, Timothy J England, Kailash Krishnan, Grant Mair, Keith W Muir, John Potter, Christopher I Price, Marc Randall, Thompson G Robinson, Christine Roffe, Else C Sandset, Jeffrey L Saver, Angela Shone, Aloysius Niroshan Siriwardena, Joanna M Wardlaw, Nikola Sprigg, Philip M Bath
BACKGROUND: The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2). METHODS: RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4 hours of onset...
February 27, 2024: Stroke and Vascular Neurology
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