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ARISE I Consensus Statement on the Management of Chronic Subdural Hematoma Stroke (IF 8.3) Pub Date : 2024-04-22 Peter Kan, David Fiorella, Guilherme Dabus, Edgar A. Samaniego, Giuseppe Lanzino, Adnan H. Siddiqui, Huanwen Chen, Alexander A. Khalessi, Vitor Mendes Pereira, Johanna T. Fifi, Mark D. Bain, Geoffrey P. Colby, Ajay K. Wakhloo, Adam S. Arthur, on behalf of the ARISE I Academic Industry Roundtable
ARISE (Aneurysm/AVM/cSDH Roundtable Discussion With Industry and Stroke Experts) organized a one-and-a-half day meeting and workshop and brought together representatives from academia, industry, and government to discuss the most promising approaches to improve outcomes for patients with chronic subdural hematoma (cSDH). The emerging role of middle meningeal artery embolization in clinical practice
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Stroke Literature Synopsis (Clinical) Stroke (IF 8.3) Pub Date : 2024-04-22 Fariha Naeem, Terence J. Quinn
Stroke is predominantly a disease of older people, and many people who experience stroke are also living with frailty or disability. Frailty is a clinical syndrome characterized by a decrease in physiological reserve and reduced ability to cope with stressors such as stroke. A related, but distinct construct to physical frailty is brain frailty, which refers to diminished neurocognitive reserve and
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May 2024 Stroke Highlights Stroke (IF 8.3) Pub Date : 2024-04-22 José Rafael Romero
Aaron and colleagues evaluated the role of decompressive craniectomy or hematoma evacuation as a life-saving procedure in patients with cerebral venous thrombosis and acute stroke (large infarct or hemorrhages) and impending herniation. The study was based on data from an international prospective multicenter cohort study. The outcomes included modified Rankin Scale score, mortality, and patient-reported
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ARISE I Consensus Review on the Management of Intracranial Aneurysms Stroke (IF 8.3) Pub Date : 2024-04-22 Stavropoula I. Tjoumakaris, Ricardo Hanel, J Mocco, M. Ali-Aziz Sultan, Michael Froehler, Barry B. Lieber, Alexander Coon, Satoshi Tateshima, David J. Altschul, Sandra Narayanan, Kareem El Naamani, Phil Taussky, Brian L. Hoh, Philip Meyers, Matthew J. Gounis, David S. Liebeskind, Victor Volovici, Gabor Toth, Adam Arthur, Ajay K. Wakhloo, for the ARISE I Consortium
BACKGROUND:Intracranial aneurysms (IAs) remain a challenging neurological diagnosis associated with significant morbidity and mortality. There is a plethora of microsurgical and endovascular techniques for the treatment of both ruptured and unruptured aneurysms. There is no definitive consensus as to the best treatment option for this cerebrovascular pathology. The Aneurysm, Arteriovenous Malformation
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Stroke Recovery–Related Changes in Cortical Reactivity Based on Modulation of Intracortical Inhibition Stroke (IF 8.3) Pub Date : 2024-04-19 Sylvain Harquel, Andéol Cadic-Melchior, Takuya Morishita, Lisa Fleury, Adrien Witon, Martino Ceroni, Julia Brügger, Nathalie H. Meyer, Giorgia G. Evangelista, Philip Egger, Elena Beanato, Pauline Menoud, Dimitri Van de Ville, Silvestro Micera, Olaf Blanke, Bertrand Léger, Jan Adolphsen, Caroline Jagella, Christophe Constantin, Vincent Alvarez, Philippes Vuadens, Jean-Luc Turlan, Andreas Mühl, Christophe
BACKGROUND:Cortical excitation/inhibition dynamics have been suggested as a key mechanism occurring after stroke. Their supportive or maladaptive role in the course of recovery is still not completely understood. Here, we used transcranial magnetic stimulation (TMS)-electroencephalography coupling to study cortical reactivity and intracortical GABAergic inhibition, as well as their relationship to
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Implementing Telestroke in the Inpatient Setting: Identifying Factors for Success Stroke (IF 8.3) Pub Date : 2024-04-19 Deborah L. Pestka, Samuel Boes, Solmaz Ramezani, Maya Peters, Michael G. Usher, Joseph S. Koopmeiners, Timothy J. Beebe, Genevieve B. Melton, Christopher D. Streib
BACKGROUND:Inpatient telestroke programs have emerged as a solution to provide timely stroke care in underserved areas, but their successful implementation and factors influencing their effectiveness remain underexplored. This study aimed to qualitatively evaluate the perspectives of inpatient clinicians located at spoke hospitals participating in a newly established inpatient telestroke program to
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Exploring Genetic Associations of 3 Types of Risk Factors With Ischemic Stroke: An Integrated Bioinformatics Study Stroke (IF 8.3) Pub Date : 2024-04-09 Yi Liu, Weili Wang, Xin Cui, Jian Lyu, Yanming Xie
BACKGROUND:Ischemic stroke (IS) is a major cause of disability and mortality worldwide. Increasing evidence suggests a strong association between blood pressure, blood glucose, circulating lipids, and IS. Nonetheless, the genetic association of these 3 risk factors with IS remains elusive.METHODS:We screened genetic instruments related to blood pressure, blood glucose, and circulating lipids and paired
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Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study Stroke (IF 8.3) Pub Date : 2024-04-09 Hao Sun, Bing Ma, Chenye Jin, Zhenning Li, Xinying Song, Yifan Bu, Tingting Liu, Xu Han, Xue Yang, Kaijie Yang, Dongchu Xu, Jing Zhang, Yongze Li
BACKGROUND:Stroke is one of the leading causes of death among children, yet evidence on stroke incidence and prognosis in this population is largely neglected worldwide. The aim of this study was to estimate the latest burden of childhood stroke, as well as trends, risk factors, and inequalities from 1990 to 2019, at the global, regional, and national levels.METHODS:The Global Burden of Disease 2019
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Near-Infrared II Photobiomodulation Preconditioning Ameliorates Stroke Injury via Phosphorylation of eNOS Stroke (IF 8.3) Pub Date : 2024-04-04 Shinya Yokomizo, Timo Kopp, Malte Roessing, Atsuyo Morita, Seeun Lee, Suin Cho, Emiyu Ogawa, Eri Komai, Kazumasa Inoue, Masahiro Fukushi, Susanne Feil, Hyung-Hwan Kim, Denis E. Bragin, Dmitry Gerashchenko, Paul L. Huang, Satoshi Kashiwagi, Dmitriy N. Atochin
BACKGROUND:The current management of patients with stroke with intravenous thrombolysis and endovascular thrombectomy is effective only when it is timely performed on an appropriately selected but minor fraction of patients. The development of novel adjunctive therapy is highly desired to reduce morbidity and mortality with stroke. Since endothelial dysfunction is implicated in the pathogenesis of
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Genetically Determined Plasma Hepatocyte Growth Factor Levels Are Associated With the Risk and Prognosis of Ischemic Stroke Stroke (IF 8.3) Pub Date : 2024-04-04 Qingyun Xu, Daoxia Guo, Mengyao Shi, Yinan Wang, Pinni Yang, Yiming Jia, Lulu Sun, Yi Liu, Xinyue Chang, Yu He, Li Hui, Yonghong Zhang, Zhengbao Zhu
BACKGROUND:Observational studies suggest that hepatocyte growth factor (HGF) is associated with the risk and prognosis of ischemic stroke, but the causality of these associations remains unclear. Therefore, we conducted Mendelian randomization (MR) analyses to explore the associations of genetically determined plasma HGF levels with the risk and prognosis of ischemic stroke.METHODS:A total of 13 single-nucleotide
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Risk of Recurrent Stroke and Mortality Among Black and White Patients With Poststroke Depression Stroke (IF 8.3) Pub Date : 2024-04-03 Jack Gomberg, Laura K. Stein, Mandip S. Dhamoon
BACKGROUND:Poststroke depression (PSD) is a treatable and common complication of stroke that is underdiagnosed and undertreated in minority populations. We compared outcomes of Black and White patients with PSD in the United States to assess whether race is independently associated with the risk of recurrent stroke and mortality.METHODS:We used deidentified Medicare data from inpatient, outpatient
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Does Reperfusion Benefit Patients Without Perfusion Mismatch? Stroke (IF 8.3) Pub Date : 2024-04-04 Amrou Sarraj, Bruce C.V. Campbell
See related article, page 1317 Perfusion mismatch is an operationalization of the concept of ischemic core and penumbra that is the underlying principle for reperfusion therapies, including IV thrombolytics and endovascular thrombectomy (EVT). Patients whose perfusion lesion was substantially larger than the diffusion lesion (termed mismatch1) were more likely to benefit from reperfusion with alteplase
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Outcomes of Decompressive Surgery for Patients With Severe Cerebral Venous Thrombosis: DECOMPRESS2 Observational Study Stroke (IF 8.3) Pub Date : 2024-04-04 Sanjit Aaron, Jorge M. Ferreira, Jonathan M. Coutinho, Patrícia Canhão, Adriana B. Conforto, Antonio Arauz, Marta Carvalho, Jaime Masjuan, Vijay K. Sharma, Jukka Putaala, Maarten Uyttenboogaart, David J. Werring, Rodrigo Bazan, Sandeep Mohindra, Jochen Weber, Bert A. Coert, Prabhu Kirubakaran, Mayte Sanchez van Kammen, Pankaj Singh, Diana Aguiar de Sousa, José M. Ferro
BACKGROUND:Decompressive neurosurgery is recommended for patients with cerebral venous thrombosis (CVT) who have large parenchymal lesions and impending brain herniation. This recommendation is based on limited evidence. We report long-term outcomes of patients with CVT treated by decompressive neurosurgery in an international cohort.METHODS:DECOMPRESS2 (Decompressive Surgery for Patients With Cerebral
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LDL-c Lowering, Ischemic Stroke, and Small Vessel Disease Brain Imaging Biomarkers: A Mendelian Randomization Study Stroke (IF 8.3) Pub Date : 2024-04-04 Marie-Joe Dib, Loukas Zagkos, Devendra Meena, Stephen Burgess, Julio A. Chirinos, Dipender Gill
BACKGROUND:The effects of lipid-lowering drug targets on different ischemic stroke subtypes are not fully understood. We aimed to explore the mechanisms by which lipid-lowering drug targets differentially affect the risk of ischemic stroke subtypes and their underlying pathophysiology.METHODS:Using a 2-sample Mendelian randomization approach, we assessed the effects of genetically proxied low-density
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Uncommon Causes of Nontraumatic Intracerebral Hemorrhage Stroke (IF 8.3) Pub Date : 2024-04-04 Hugo Tartarin, Andrea Morotti, Ellis S. Van Etten, Moran Hausman-Kedem, Andreas Charidimou, Eric Jouvent, Sophie Susen, Charlotte Cordonnier, Marco Pasi, Grégoire Boulouis
Nontraumatic intracerebral hemorrhage is an important health issue. Although common causes such as hypertension and cerebral amyloid angiopathy predominantly affect the elderly, there exists a spectrum of uncommon etiologies that contribute to the overall incidence of intracerebral hemorrhage. The identification of these rare causes is essential for targeted clinical management, informed prognostication
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Mechanism of Action and Translational Potential of (S)-Meclizine in Preemptive Prophylaxis Against Stroke Stroke (IF 8.3) Pub Date : 2024-04-04 Jeong Hyun Lee, Vishal M. Gohil, Pedram Heidari, Jessica L. Seidel, Mohammad Zulkifli, Ying Wei, Yuhua Ji, Ali Daneshmand, Umar Mahmood, Clary B. Clish, Vamsi K. Mootha, Cenk Ayata
BACKGROUND:Mild chemical inhibition of mitochondrial respiration can confer resilience against a subsequent stroke or myocardial infarction, also known as preconditioning. However, the lack of chemicals that can safely inhibit mitochondrial respiration has impeded the clinical translation of the preconditioning concept. We previously showed that meclizine, an over-the-counter antivertigo drug, can
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Thrombectomy in Patients With Ischemic Stroke Without Salvageable Tissue on CT Perfusion Stroke (IF 8.3) Pub Date : 2024-04-04 Gabriel Broocks, Rosalie V. McDonough, Matthias Bechstein, Susan Klapproth, Tobias D. Faizy, Gerhard Schön, Helge C. Kniep, Maxim Bester, Uta Hanning, André Kemmling, Kamil Zeleñák, Jens Fiehler, Lukas Meyer
BACKGROUND:Computed tomography perfusion (CTP) imaging is regularly used to guide patient selection for mechanical thrombectomy (MT). However, the effect of MT in patients without salvageable tissue on CTP has not been investigated. The purpose of this study was to assess the effect of MT in patients with stroke without perfusion mismatch profiles.METHODS:This observational study analyzed patients
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Incidence and Outcomes of Posterior Circulation Involvement in Moyamoya Disease Stroke (IF 8.3) Pub Date : 2024-04-03 Seth S. Tigchelaar, Allan R. Wang, Silvia D. Vaca, Yiping Li, Gary K. Steinberg
BACKGROUND:Moyamoya disease (MMD) is a progressive, occlusive disease of the internal carotid arteries and their proximal branches, with the subsequent development of an abnormal vascular network that is rupture-prone. Steno-occlusive changes in the posterior cerebral arteries (PCAs) may contribute to worsened outcomes in patients with MMD; however, there is little information on the incidence and
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Caring for Stroke Survivors: Ethnic Differences in Informal Caregiver Needs Among Mexican American and Non-Hispanic White Communities Stroke (IF 8.3) Pub Date : 2024-04-03 Roshanak Mehdipanah, Lewis B. Morgenstern, Janet Prvu Bettger, Madeline Kwicklis, Erin Case, Elizabeth Almendarez, Lynda D. Lisabeth
BACKGROUND:After stroke, Mexican American (MA) individuals have worse 90-day neurological, functional, cognitive, and quality of life outcomes and a higher prevalence of poststroke depression compared with non-Hispanic White (NHW) individuals. MA individuals receive more help through informal, unpaid caregiving than NHW individuals. We examined ethnic differences in needs identified by MA and NHW stroke
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Exploring the Inclusion of Person-Centered Care Domains in Stroke Transitions of Care Interventions: A Scientific Statement From the American Heart Association Stroke (IF 8.3) Pub Date : 2024-04-01 Michelle L.A. Nelson, Evan MacEachern, Janet Prvu Bettger, Michelle Camicia, James J. García, Moira K. Kapral, Claranne Mathiesen, Jill I. Cameron, on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Quality of Care and Outcomes Research
BACKGROUND:Health care teams along the stroke recovery continuum have a responsibility to support care transitions and return to the community. Ideally, individualized care will consider patient and family preferences, best available evidence, and health care professional input. Person-centered care can improve patient-practitioner interactions through shared decision-making in which health professionals
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PRERISK: A Personalized, Artificial Intelligence–Based and Statistically–Based Stroke Recurrence Predictor for Recurrent Stroke Stroke (IF 8.3) Pub Date : 2024-03-28 Giorgio Colangelo, Marc Ribo, Estefanía Montiel, Didier Dominguez, Marta Olivé-Gadea, Marian Muchada, Álvaro Garcia-Tornel, Manuel Requena, Jorge Pagola, Jesús Juega, David Rodriguez-Luna, Noelia Rodriguez-Villatoro, Federica Rizzo, Belén Taborda, Carlos A. Molina, Marta Rubiera
BACKGROUND:Predicting stroke recurrence for individual patients is difficult, but individualized prediction may improve stroke survivors’ engagement in self-care. We developed PRERISK: a statistical and machine learning classifier to predict individual risk of stroke recurrence.METHODS:We analyzed clinical and socioeconomic data from a prospectively collected public health care–based data set of 41 975
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Impact of Off-Hour Admission on In-Hospital Outcomes for Patients With Stroke Receiving Reperfusion Therapy in China Stroke (IF 8.3) Pub Date : 2024-03-28 Zeyu Liu, Kaixuan Yang, Hongqiu Gu, Minping Wei, Xianjing Feng, Fang Yu, Yang Du, Zixiao Li, Jian Xia
BACKGROUND:The structure and staffing of hospitals greatly impact patient outcomes, with frequent changes occurring during nights and weekends. This retrospective cohort study assessed the impact of admission timing on in-hospital management and outcomes for patients with stroke receiving reperfusion therapy in China using data from a nationwide registry.METHODS:Data from patients receiving reperfusion
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Introducing the Concept of Sanctuary Sites in Ischemic Stroke Stroke (IF 8.3) Pub Date : 2024-03-27 Tharani Thirugnanachandran, Henry Ma, Geoffrey A. Donnan, David C. Reutens, Thanh G. Phan
BACKGROUND:The topography of arterial territories has been defined using digital maps of supratentorial infarcts. Regions with a high probability of infarction (Pi) exist in the deep compartment due to a paucity of collaterals. However, less attention has been given to regions with a low Pi.METHODS:Using published digital maps, patients with cortical stroke and documented vessel occlusion were included
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Physical Activity, Mental Activity, and Risk of Incident Stroke: A Prospective Cohort Study Stroke (IF 8.3) Pub Date : 2024-03-27 Zhi Cao, Jing Zhang, Zuolin Lu, Han Chen, Jiahao Min, Yabing Hou, Xiaohe Wang, Chenjie Xu
BACKGROUND:Cumulative evidence suggests a correlation between physical or mental activity and the risk of stroke. However, the combined impact of these activities on stroke onset remains unexplored. This study identified physical and mental activity patterns using principal component analysis and investigated their associations with risk of incident stroke in the general population.METHODS:Our study
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Glymphatic System Impairment Contributes to the Formation of Brain Edema After Ischemic Stroke Stroke (IF 8.3) Pub Date : 2024-03-27 Juan Zhu, Jiaying Mo, Kewei Liu, Quanfeng Chen, Zheqi Li, Yihua He, Yuan Chang, Chuman Lin, Mingjia Yu, Yikai Xu, Xiangliang Tan, Kaibin Huang, Suyue Pan
BACKGROUND:Blood-brain barrier damage has traditionally been considered to determine the occurrence and development of poststroke brain edema, a devastating and life-threatening complication. However, no treatment strategy targeting blood-brain barrier damage has been proven clinically effective in ameliorating brain edema.METHODS:In mice with stroke models induced by transient middle cerebral artery
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April 2024 Stroke Highlights Stroke (IF 8.3) Pub Date : 2024-03-25 Nicole B. Sur
Occult atrial fibrillation (AF) is a common cause of cryptogenic stroke. AF can be detected by various methods of cardiac monitoring, including ECG, 24-hour Holter monitoring, 30-day event recorders, wearable devices, and implantable cardiac monitors (ICM). Identifying patients with cryptogenic stroke at high risk of having underlying AF is crucial for optimizing evaluation, treatment, and prevention
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Soluble Biomarkers of Cerebrovascular Pathologies Stroke (IF 8.3) Pub Date : 2024-03-25 Kate E. Foley, Donna M. Wilcock
Vascular contributions to cognitive impairment and dementia (VCID) is an all-encompassing term that describes cognitive impairment due to cerebrovascular origins. With the advancement of imaging and pathological studies, we now understand that VCID is often comorbid with Alzheimer disease. While researchers in the Alzheimer disease field have been working for years to establish and test blood-based
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Remote Ischemic Conditioning for Acute Ischemic Stroke: Does Stroke Etiology Matter? Stroke (IF 8.3) Pub Date : 2024-03-25 Aravind Ganesh, Fernando D. Testai
See related article, p 874 It is well recognized that early initiation of treatment is an important predictor of stroke outcome. However, many patients incur prehospital delays in their transport to stroke centers even under the best of circumstances due to geographic realities.1,2 Thus, the prehospital setting is a key untamed frontier for therapeutic development in neurovascular research. Unfortunately
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Data Over Dogma in Treatment of Cervical Artery Dissections Stroke (IF 8.3) Pub Date : 2024-03-25 Richard A. Bernstein, Lauren Previch, Fan Z. Caprio
Cervical artery dissections (CADs) account for up to 25% of strokes in adults younger than 50 years, but the choice of antithrombotic therapy for the prevention of subsequent strokes remains controversial.1,2 A generation ago, it was dogma that patients with dissections should be treated with anticoagulation, but this was based on expert opinion rather than data from randomized trials. In retrospect
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Does Thrombosis Play a Causal Role in Lacunar Stroke and Cerebral Small Vessel Disease? Stroke (IF 8.3) Pub Date : 2024-03-25 Fatemeh Koohi, Eric L. Harshfield, Alexey Shatunov, Hugh S. Markus
BACKGROUND:The importance of thromboembolism in the pathogenesis of lacunar stroke (LS), resulting from cerebral small vessel disease (cSVD), is debated, and although antiplatelets are widely used in secondary prevention after LS, there is limited trial evidence from well-subtyped patients to support this approach. We sought to evaluate whether altered anticoagulation plays a causal role in LS and
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Challenging Antiplatelet Therapy for Small Vessel Stroke Through Genetics Stroke (IF 8.3) Pub Date : 2024-03-25 Guido J. Falcone, Daniel Woo
Cerebral small vessel disease (CSVD) encompasses a spectrum of highly prevalent vasculopathies affecting the brain’s microvasculature, leading to a variety of clinical manifestations.1 Among the primary subtypes of CSVD, cerebral amyloid angiopathy2 and deep perforator arteriopathy,3 the latter frequently referred to as hypertension-related vasculopathy or lipohyalinosis, are the most significant.
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Outdoor Light at Night, Air Pollution, and Risk of Cerebrovascular Disease: A Cohort Study in China Stroke (IF 8.3) Pub Date : 2024-03-25 Yonghao Wu, Peng Shen, Zongming Yang, Luhua Yu, Lisha Xu, Zhanghang Zhu, Tiezheng Li, Dan Luo, Hongbo Lin, Liming Shui, Mengling Tang, Mingjuan Jin, Kun Chen, Jianbing Wang
BACKGROUND:We sought to explore the associations of outdoor light at night (LAN) and air pollution with the risk of cerebrovascular disease (CeVD).METHODS:We included a total of 28 302 participants enrolled in Ningbo, China from 2015 to 2018. Outdoor LAN and air pollution were assessed by Satellite-derived images and land-use regression models. CeVD cases were confirmed by medical records and death
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Diagnostic Performance of Carotid Ring Sign on CT-Angiography in Internal Carotid True Occlusion Stroke (IF 8.3) Pub Date : 2024-03-25 Tingyu Yi, Yi Sui, Dinghuan Zheng, Xinwen Ren, Xiaohui Lin, Yanmin Wu, Dinglai Lin, Zhinan Pan, Xiufen Zheng, Ganji Hong, Meihua Wu, Lisan Zeng, Wenhuo Chen
BACKGROUND:To differentiate between pseudo occlusion (PO) and true occlusion (TO) of internal carotid artery (ICA) is important in thrombectomy treatment planning for patients with acute ischemic stroke. Although delayed contrast filling has been differentiated carotid PO from TO, its application has been limited by the implementations of multiphasic computed tomography angiography. In this study,
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Invaluable Benefits of 10 Years of the International Collaboration of Aphasia Trialists (CATs) Stroke (IF 8.3) Pub Date : 2024-03-25 Caterina Breitenstein, Sarah J. Wallace, Natalie Gilmore, Emma Finch, Kathryn Pettigrove, Marian C. Brady
Aphasia research has traditionally been considered a (unidisciplinary) niche topic in medical science. The international Collaboration of Aphasia Trialists (CATs) is a global collaboration of multidisciplinary aphasia researchers. Over the past 10 years, CATs has collectively taken a rigorous approach to systematically address persistent challenges to aphasia research quality. This article summarizes
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Stroke Literature Synopses (Preclinical) Stroke (IF 8.3) Pub Date : 2024-03-25 Kathiresh Kumar Mani, Farida Sohrabji
This synopsis summarizes preclinical studies that examine the immune response after stroke and, specifically, the role of the cytokine IL-17A (interleukin 17A) in modifying stroke outcomes. In the publication, Beuker et al (Beuker C, et al. Stroke induces disease-specific myeloid cells in the brain parenchyma and pia. Nat Commun. 2022;13:945. doi: 10.1038/s41467-022-28593-1) found tissue-specific leukocyte
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Correction to: Pericyte Microvesicles as Plasma Biomarkers Reflecting Brain Microvascular Signaling in Patients With Acute Ischemic Stroke Stroke (IF 8.3) Pub Date : 2024-03-25
In the article by Gaceb et al, “Pericyte Microvesicles as Plasma Biomarkers Reflecting Brain Microvascular Signaling in Patients With Acute Ischemic Stroke,” which published online on February 7, 2024, and appeared in the March 2024 issue of the journal (Stroke.2024;55:558–568. doi: 10.1161/STROKEAHA.123.045720), a correction is needed. The disclosure section should read: Dr Lindgren reports personal
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Prevalence and Outcomes of Patients With Acute Ischemic Stroke With Concomitant ST-Segment–Elevation Myocardial Infarction (Results From National Inpatient Sample 2016–2019) Stroke (IF 8.3) Pub Date : 2024-03-26 Shivani Mehta, Nikolaos Kakouros, Tanveer Mir, Stacy Loree, Waqas Qureshi
BACKGROUND:Acute myocardial infarction may concomitantly occur with acute ischemic stroke. The prevalence, complications, and outcomes of acute ST-segment–elevation myocardial infarction (STEMI) in patients hospitalized with acute ischemic stroke are not well studied.METHODS:We examined hospitalized patients with acute ischemic stroke who were included in the National Inpatient Sample from 2016 to
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Treatment Modalities and Outcomes in Brainstem Cavernous Malformations: A Large Multicenter Observational Cohort Study Stroke (IF 8.3) Pub Date : 2024-03-26 Junlin Lu, Zongze Li, Hao Deng, Guangchao Shi, Wei Wang, Chao You, Wei Zhu, Rui Tian
BACKGROUND:Symptomatic brainstem cavernous malformations (BSCMs) pose a high risk of morbidity and mortality due to recurrent hemorrhage, warranting aggressive management. However, few studies have compared the effectiveness of different treatment modalities for BSCMs. We aimed to assess the association of treatment modalities with recurrent hemorrhage and neurological outcomes in patients with BSCM
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UDP-Glucose/P2Y14 Receptor Signaling Exacerbates Neuronal Apoptosis After Subarachnoid Hemorrhage in Rats Stroke (IF 8.3) Pub Date : 2024-03-25 Hideki Kanamaru, Shiyi Zhu, Siyuan Dong, Yushin Takemoto, Lei Huang, Prativa Sherchan, Hidenori Suzuki, Jiping Tang, John H. Zhang
BACKGROUND:Subarachnoid hemorrhage (SAH) is a severe subtype of stroke with poor outcomes. Abnormal glucose metabolism often occurs after SAH, but the strict control of blood glucose levels is not always beneficial. This study aimed to investigate the contribution of uridine diphosphate glucose (UDP-G), an intermediate of glucose/glycogen metabolism, and its receptor P2Y14 (P2Y purinoceptor 14) to
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R-tPA Resistance Is Specific for Platelet-Rich Stroke Thrombi and Can Be Overcome by Targeting Nonfibrin Components Stroke (IF 8.3) Pub Date : 2024-03-25 Sarah Vandelanotte, Olivier François, Linda Desender, Senna Staessens, Alexander Vanhoorne, Fréderick Van Gool, Claudia Tersteeg, Karen Vanhoorelbeke, Peter Vanacker, Tommy Andersson, Simon F. De Meyer
BACKGROUND:Resistance to r-tPA (recombinant tissue-type plasminogen activator) is a well-known but poorly understood phenomenon that hampers successful recanalization in patients with acute ischemic stroke. Using clinically relevant thrombi from patients with acute ischemic stroke, we investigated if and how thrombus composition impacts r-tPA-mediated lysis. In addition, we explored strategies to overcome
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Back to the Future: Observational Studies and Anticoagulant Selection for Nonvalvular Atrial Fibrillation Stroke (IF 8.3) Pub Date : 2024-03-21 Melina Gattellari
Direct oral anticoagulants (DOACs) have mostly lived up to their hype as game changers for stroke risk prevention in nonvalvular atrial fibrillation.1,2 With up to 4 available DOACs,3 patients in high-income countries are seemingly spoilt for choice while the World Health Organization’s listing of DOACs as essential medications4 hopefully means that eligible people in resource limited settings may
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Strategic Lacunes Associated With Mild Cognitive Impairment in Rural Chinese Older Adults: A Population-Based Study Stroke (IF 8.3) Pub Date : 2024-03-21 Jiafeng Wang, Xiaodong Han, Yuanjing Li, Wenxin Fa, Mingqing Zhao, Chunyan Li, Ming Mao, Tingting Hou, Yongxiang Wang, Lin Cong, Lin Song, Yifeng Du, Chengxuan Qiu
BACKGROUND:Lacunes are associated with cognitive impairment. We sought to identify strategic lacune locations associated with mild cognitive impairment (MCI) and subtypes of MCI among older adults, and further to examine the role of white matter hyperintensities and perivascular spaces in the association.METHODS:This population-based cross-sectional study included 1230 dementia-free participants in
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Subtype-Specific Association of Mitochondrial DNA Copy Number With Poststroke/TIA Outcomes in 10 241 Patients in China Stroke (IF 8.3) Pub Date : 2024-03-21 Yi Jiang, Si Cheng, Yanfeng Shi, Zhe Xu, Huihui Wang, Yanran Li, Yang Liu, Zixiao Li, Yong Jiang, Xia Meng, Shanshan Cheng, Hao Li, Chaolong Wang, Yongjun Wang
BACKGROUND:Mitochondrial DNA copy number (mtDNA-CN) is associated with the severity and mortality in patients with stroke, but the associations in different stroke subtypes remain unexplored.METHODS:We conducted an observational prospective cohort analysis on patients with ischemic stroke or transient ischemic attack enrolled in the Third China National Stroke Registry. We applied logistic models to
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Rupture-Related Features of Cerebral Arteriovenous Malformations and Their Utility in Predicting Hemorrhage Stroke (IF 8.3) Pub Date : 2024-03-21 Yupeng Zhang, Haoyu Zhu, Tingliang Cao, Longhui Zhang, Yuzhou Chang, Shikai Liang, Chao Ma, Fei Liang, Yuqi Song, Jiarui Zhang, Changxuan Li, Chuhan Jiang
BACKGROUND:Evaluating rupture risk in cerebral arteriovenous malformations currently lacks quantitative hemodynamic and angioarchitectural features necessary for predicting subsequent hemorrhage. We aimed to derive rupture-related hemodynamic and angioarchitectural features of arteriovenous malformations and construct an ensemble model for predicting subsequent hemorrhage.METHODS:This retrospective
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Individual Patient Data Meta-Analysis of Dynamic Cerebral Autoregulation and Functional Outcome After Ischemic Stroke Stroke (IF 8.3) Pub Date : 2024-03-21 Lucy Beishon, Terrie Vasilopoulos, Angela S.M. Salinet, Brooke Levis, Samuel Barnes, Eleanor Hills, Pranav Ramesh, Panagoula Gkargkoula, Jatinder S. Minhas, Pedro Castro, Patrice Brassard, Nicolai Goettel, Erik D. Gommer, Jose Luis Jara, Jia Liu, Martin Mueller, Nathalie Nasr, Stephen Payne, Andrew D. Robertson, David Simpson, Thompson G. Robinson, Ronney B. Panerai, Ricardo C. Nogueira
BACKGROUND:The relationship between dynamic cerebral autoregulation (dCA) and functional outcome after acute ischemic stroke (AIS) is unclear. Previous studies are limited by small sample sizes and heterogeneity.METHODS:We performed a 1-stage individual patient data meta-analysis to investigate associations between dCA and functional outcome after AIS. Participating centers were identified through
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Influence of Infarct Morphology and Patterns on Cognitive Outcomes After Endovascular Thrombectomy Stroke (IF 8.3) Pub Date : 2024-03-21 Johanna Maria Ospel, Leon Rinkel, Aravind Ganesh, Andrew Demchuk, Manish Joshi, Alexandre Poppe, Ryan McTaggart, Raul Nogueira, Bijoy Menon, Michael Tymianski, Michael Douglas Hill, Mayank Goyal
BACKGROUND:To assess the association of qualitative and quantitative infarct characteristics and 3 cognitive outcome tests, namely the Montreal Cognitive Assessment (MOCA) for mild cognitive impairment, the Boston Naming Test for visual confrontation naming, and the Sunnybrook Neglect Assessment Procedure for neglect, in large vessel occlusion stroke.METHODS:Secondary observational cohort study using
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Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study Stroke (IF 8.3) Pub Date : 2024-03-21 Hongji Zeng, Weijia Zhao, Junfa Wu, Jihong Wei, Heping Li, Liugen Wang, Xi Zeng
BACKGROUND:Nasogastric tube feeding (NG) has been widely used in patients with bulbar palsy after ischemic stroke but is associated with a significant risk of complications including malnutrition and pneumonia. Intermittent oro-esophageal tube feeding (IOE) can help alleviate these concerns. This study explored the clinical effect of IOE versus NG on nutritional status, swallowing function, stroke-associated
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Utilization and Reporting of Patient-Reported Outcome Measures in Randomized Clinical Trials of Acute Stroke (2010–2020) Stroke (IF 8.3) Pub Date : 2024-03-21 Joseph S. Hostnik, Brent Strong, Mathew J. Reeves
BACKGROUND:Patient-reported outcome measures (PROMs) describe health status from the perspective of the patient. There is growing interest in incorporating PROMs into clinical trials, but the extent that such measures are used in contemporary stroke trials is uncertain. We sought to determine how often acute stroke trials included PROMs as outcome measures and assessed the completeness of methodological
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Effectiveness and Safety of Edoxaban Compared With Apixaban in Elderly Patients With Nonvalvular Atrial Fibrillation: A Real-World Population-Based Cohort Study Stroke (IF 8.3) Pub Date : 2024-03-21 Richard Chiv, Sarah Beradid, Samy Suissa, Christel Renoux
BACKGROUND:The very elderly (≥80 years) are at high risk of nonvalvular atrial fibrillation and thromboembolism. Given its recent approval, the comparative effectiveness and safety of edoxaban in this population, relative to the commonly used apixaban, remain unknown.METHODS:Using the United Kingdom Clinical Practice Research Datalink, we identified a cohort of patients aged ≥80 with incident nonvalvular
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Treating Hypertension: Important for Heart Health, Fundamental for Brain Health Stroke (IF 8.3) Pub Date : 2024-03-15 Sanjula D. Singh, Jasper R. Senff, Cornelia M. van Duijn, Jonathan Rosand
The Brain Health crisis stands as one of humankind’s most pressing threats, with age-related noncommunicable brain diseases, particularly stroke, and dementia, affecting hundreds of millions annually and jeopardizing the economic well-being of populations worldwide. Epidemiological studies indicate that ≈40% of dementia and 60% of stroke cases are attributable to modifiable risk factors. In this Comments
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Moving From CT to MRI Paradigm in Acute Ischemic Stroke: Feasibility, Effects on Stroke Diagnosis and Long-Term Outcomes Stroke (IF 8.3) Pub Date : 2024-03-15 Costanza Maria Rapillo, Vincent Dunet, Silvia Pistocchi, Alexander Salerno, Vincent Darioli, Bruno Bartolini, Steven David Hajdu, Patrik Michel, Davide Strambo
BACKGROUND:The relative value of computed tomography (CT) and magnetic resonance imaging (MRI) in acute ischemic stroke (AIS) is debated. In May 2018, our center transitioned from using CT to MRI as first-line imaging for AIS. This retrospective study aims to assess the effects of this paradigm change on diagnosis and disability outcomes.METHODS:We compared all consecutive patients with confirmed diagnosis
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Long-Term Outcomes in Patients With Spontaneous Cerebellar Hemorrhage: An International Cohort Study Stroke (IF 8.3) Pub Date : 2024-03-15 Jasper R. Senff, Sanjula D. Singh, Marco Pasi, Wilmar M.T. Jolink, Mark A. Rodrigues, Floris H.B.M. Schreuder, Julie Staals, Tobien Schreuder, Jules P.J. Douwes, Jelmer Talsma, Brenna N. McKaig, Christina Kourkoulis, Nirupama Yechoor, Christopher D. Anderson, Laurent Puy, Charlotte Cordonnier, Marieke J.H. Wermer, Peter M. Rothwell, Jonathan Rosand, Catharina J.M. Klijn, Rustam Al-Shahi Salman, Gabriël
BACKGROUND:Spontaneous intracerebral hemorrhage (ICH) in the cerebellum has a poor short-term prognosis, whereas data on the long-term case fatality and recurrent vascular events are sparse. Herewith, we aimed to assess the long-term case fatality and recurrence rate of vascular events after a first cerebellar ICH.METHODS:In this international cohort study, we included patients from 10 hospitals (the
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CTP-Defined Large Core Is a Better Predictor of Poor Outcome for Endovascular Treatment Than ASPECTS-Defined Large Core Stroke (IF 8.3) Pub Date : 2024-03-15 Yi Sui, Wenhuo Chen, Chushuang Chen, Yanting Chang, Andrew Bivard, Peng Wang, Yu Geng, Mark Parsons, Longting Lin, on behalf of INSPIRE Investigators
BACKGROUND:Recent trials confirmed the effectiveness of endovascular therapy in patients with large ischemic cores. Yet the optimal neuroimaging modalities to define large core remains unclear. We tried to address this question by comparing the functional outcomes in patients receiving thrombectomy selected by either noncontrast computed tomography Alberta Stroke Program Early Computed Tomography Score
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Health Inequity and Time From Pediatric Stroke Onset to Arrival Stroke (IF 8.3) Pub Date : 2024-03-15 Akshat M. Pai, Teresa To, Gabrielle A. deVeber, Daniel Nichol, Andrea Kassner, Birgit Ertl-Wagner, Mubeen F. Rafay, Nomazulu Dlamini
BACKGROUND:Time from stroke onset to hospital arrival determines treatment and impacts outcome. Structural, socioeconomic, and environmental factors are associated with health inequity and onset-to-arrival in adult stroke. We aimed to assess the association between health inequity and onset-to-arrival in a pediatric comprehensive stroke center.METHODS:A retrospective observational study was conducted
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Association of Posttraumatic Stress Disorder and Race on Readmissions After Stroke Stroke (IF 8.3) Pub Date : 2024-03-14 Chen Lin, Peter H. King, Joshua S. Richman, Lori L. Davis
BACKGROUND:There is limited research on outcomes of patients with posttraumatic stress disorder (PTSD) who also develop stroke, particularly regarding racial disparities. Our goal was to determine whether PTSD is associated with the risk of hospital readmission after stroke and whether racial disparities existed.METHODS:The analytical sample consisted of all veterans receiving care in the Veterans
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Plasma Metabolites and Life’s Simple 7 in REGARDS Stroke (IF 8.3) Pub Date : 2024-03-14 Naruchorn Kijpaisalratana, Zsuzsanna Ament, Amit Patki, Varun M. Bhave, Alana C. Jones, Catharine A. Couch, Ana-Lucia Garcia Guarniz, Mary Cushman, D. Leann Long, Suzanne E. Judd, M. Ryan Irvin, W. Taylor Kimberly
BACKGROUND:The American Heart Association’s Life’s Simple 7 (LS7) is a health metric that captures important factors associated with cardiovascular and cerebrovascular health. Previous studies highlight the potential of plasma metabolites to serve as a marker for lifestyle and health behavior that could be a target for stroke prevention. The objectives of this study were to identify metabolites that
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Law and Disorder in the Wild West of Stroke Certification: Is It Time to Standardize the Designation Processes? Stroke (IF 8.3) Pub Date : 2024-03-12 Gillian L. Gordon Perue, Andrew M. Southerland
See related article, p 1051 Every 40 s, someone in the United States will experience a stroke.1 What happens in the next 60 minutes (the golden hour) is often the difference between stroke-related disability/death versus a good outcome.2 The Stroke Unit Trialists’ Collaboration recognized this in the late 1990s3 and began standardizing an evidence-based approach to stroke care through the creation
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Heterogeneity of State Stroke Center Certification and Designation Processes Stroke (IF 8.3) Pub Date : 2024-03-12 Madeline Feldmeier, Anthony S. Kim, Kori S. Zachrison, Mark J. Alberts, Yu-Chu Shen, Renee Y. Hsia
BACKGROUND:Stroke centers are critical for the timely diagnosis and treatment of acute stroke and have been associated with improved treatment and outcomes; however, variability exists in the definitions and processes used to certify and designate these centers. Our study categorizes state stroke center certification and designation processes and provides examples of state processes across the United
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Thrombolysis Is Not Indicated for Minor Strokes If They Are Truly Nondisabling Stroke (IF 8.3) Pub Date : 2024-03-11 Sherri A. Braksick, Alejandro A. Rabinstein
Emergency reperfusion therapy is unquestionably indicated for any patient with disabling deficits from acute ischemic stroke without contraindications for treatment. In those cases, the evidence speaks for itself, and international guidelines are consistent in their recommendations.1–3 However, not all patients with acute cerebral ischemia present with disabling deficits. In such cases, balancing risks
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Neutrophil Extracellular Traps and Thrombolysis Resistance: New Insights for Targeting Therapies Stroke (IF 8.3) Pub Date : 2024-03-11 Luca Mengozzi, Ilaria Barison, Martin Malý, Giulia Lorenzoni, Marny Fedrigo, Chiara Castellani, Dario Gregori, Petr Malý, Radoslav Matěj, Petr Toušek, Petr Widimský, Annalisa Angelini
BACKGROUND:Thrombosis is linked to neutrophil release of neutrophil extracellular traps (NETs). NETs are proposed as a mechanism of resistance to thrombolysis. This study intends to analyze the composition of thrombi retrieved after mechanical thrombectomy, estimate the age and organization of thrombi, and evaluate associations with the use of thrombolysis, antiplatelets, and heparin.METHODS:This retrospective