Stroke

PurposeIntracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) presents distinct challenges, particularly regarding the high risk of reocclusion and the need for specific management strategies. While several prediction scores exist to differentiate ICAD-LVO from embolic LVO (EMB-LVO), their external validity remains unproven. We aimed to externally validate six established prediction scores for differentiating the two. MethodsWe analyzed data from a prospectively maintain...

BackgroundSuccessful recanalisation without functional independence is a frequent phenomenon following endovascular thrombectomy for large vessel occlusion stroke. AimTo demonstrate safety and efficacy of adjunct tirofiban therapy after endovascular thrombectomy in patients with anterior circulation large vessel occlusion stroke achieving successful recanalization defined as modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3. DesignThe study of adjunct tirofiban treatment after successf...

BackgroundStroke is a leading cause of mortality and disability globally. However, information about stroke burden in the Philippines is limited. We sought to analyze stroke burden in the Philippines from 1990 to 2023. MethodsIncidence, prevalence, mortality, and disability-adjusted life-years (DALYs) estimates from the Global Burden of Disease Study 2023 data were used as indicators to analyze the burden of stroke by sex and age. Temporal trends in both crude and age-standardized rates were an...

BackgroundLarge middle cerebral artery (MCA) infarctions can result in life-threatening cerebral edema. Quantitative brain atrophy may improve risk stratification for severe edema. We examined whether quantitative brain atrophy is associated with severe midline shift after large ischemic stroke and whether incorporating atrophy improves prediction beyond established clinical and radiographic predictors. MethodsThis was a retrospective observational cohort study of patients with [≥][1/2] MCA ...

ObjectiveTo compare early cerebrospinal fluid (CSF) cytokine profiles in intracerebral hemorrhage (ICH) versus subarachnoid hemorrhage (SAH), with a focus on angiography-negative SAH (anSAH). MethodsWe conducted a retrospective observational cohort study of adults with spontaneous hemorrhagic stroke (ICH or SAH). For cytokine analyses, we included patients with external ventricular drains (EVDs) and analyzed the first CSF sample obtained within 72 hours of symptom onset. Cytokines were measured...

BackgroundEndovascular thrombectomy (EVT) has transformed the treatment of acute ischemic stroke (AIS). However, a substantial proportion of AIS patients experience poor outcomes despite successful recanalization, often due to severe neurological deterioration or life-threatening complications. Early identification of these high-risk patients remains a major unmet need. In this study, we developed and validated machine-learning (ML) models that integrate automated quantitative cerebrovascular mo...

ImportancePrognosticating functional independence after an acute stroke is critical for anticipatory guidance and rehabilitation planning. Here we demonstrate that poor brain health at the time of incident stroke is linked to worse functional outcomes for women compared to men. ObjectiveTo determine if brain health at time of stroke presentation has a differential effect on functional outcomes between men and women. DesignRetrospective cross-sectional study. SettingAnalysis conducted in 2025 ...

Background: Platform trials are an efficient trial design which enable testing of multiple interventions simultaneously. They could advance knowledge of treatments for intracerebral haemorrhage (ICH). We aimed to investigate the views of clinicians involved in stroke research on recruitment to a future platform trial for ICH. Methods: Between April and July 2025, we conducted a UK-wide online survey of clinicians actively involved in stroke research using convenience sampling through professiona...

BackgroundSedentary behavior is highly prevalent following traumatic brain injury (TBI) and compounds existing risks for cardiovascular, neurodegenerative, and affective disorders. The cognitive and behavioral sequelae of TBI, including impaired decision-making, blunted reward processing, and cognitive fatigue, create particular barriers to adopting and maintaining an active lifestyle. Despite this, effective behavior change interventions targeting physical activity in community-dwelling TBI sur...

BackgroundAdapted dance is a promising rehabilitation intervention for physical and psychosocial impairments in people with chronic stroke. However, in-person attendance is hindered by limited community ambulation, transportation, and schedule conflicts. At-home participation with a live-streamed dance program could address these issues, but psychosocial benefits may be diminished because of reduced social interactions. The primary objective of this study was to assess the feasibility and safety...

IntroductionThe ischaemic penumbra is the principal therapeutic target in acute ischaemic stroke (AIS). Although perfusion imaging enables identification of salvageable tissue, its availability is limited and iodinated contrast exposure carries risk. Validated blood-based biomarkers could serve as scalable surrogates for imaging-defined penumbra. ObjectiveWe conducted a systematic review and meta-analysis to assess the association between blood-based biomarkers reported in the literature and th...

Cerebral small vessel diseases (CSVDs) are a group of disorders affecting the small arteries, veins, and capillaries supplying the white matter and deep grey matter structures. They are the most common form of cerebrovascular disease, accounting for almost half of vascular dementia cases worldwide and approximately 20% of stroke incidence. Whilst genetic testing is a routine diagnostic tool for monogenic CSVDs, less than 20% of patients have a causal variant in known CSVD genes. We performed wh...

BackgroundConventional evaluations of digital health interventions typically assess mean treatment effects, potentially masking heterogeneous impacts across the functional recovery distribution. Patients at the lower and upper tails of recovery trajectories may respond differently to AI-enhanced telerehabilitation, yet standard regression approaches cannot capture these distributional nuances. ObjectiveThis study applied Recentered Influence Function (RIF) quantile regression with Oaxaca-Blinde...

AbstractsO_ST_ABSBackgroundC_ST_ABSSelf-management is essential for stroke survivors to maintain a healthy lifestyle and reduce recurrence risk. Although theory-based self-management interventions are widely recommended, the theoretical frameworks underpinning them and their comparative effectiveness remain unclear. AimsTo systematically identify the theories, models, and frameworks (TMFs) used in self-management interventions for stroke survivors, to explore how they guide interventions, and e...

Centre of mass (COM) is a key measurement used to assess balance and mobility. Marker-based motion capture systems have traditionally been used to measure COM, but they are time-consuming and prone to marker error. Markerless motion capture systems offer a potential alternative, reducing setup time while maintaining accuracy. The ease of collecting markerless data may be particularly beneficial when study participants have limited mobility, such as those with stroke. This study aimed to determin...

BackgroundPost-stroke cognitive impairment (PSCI) affects nearly 30% of stroke survivors and significantly impairs functional recovery. Brain-derived neurotrophic factor (BDNF)-tropomyosin receptor kinase-{beta} (Trk{beta}) signalling is crucial for synaptic plasticity and cognitive function. While altered expression of truncated TRK{beta}-T1 isoforms has been linked to stroke, the contribution of the TRK{beta}-SHC isoform to PSCI in humans remains poorly understood. ObjectivesThis study aimed ...

Background and ObjectivesNotch homolog 3 (NOTCH3) gene variants were fully penetrant to produce the disease phenotype of CADASIL. Aberrant NOTCH3 protein leads to degeneration of vascular SMCs and pericytes, targeting microcirculation dysfunction and blood-brain barrier (BBB) leakage. MethodsWe evaluated neuroimaging data of forty patients with NOTCH3 gene variants including eighteen missense/insertion mutations in epidermal growth factor repeat (EGF), negative regulatory region (NRR), and diso...

BackgroundDespite recommendations in clinical guidelines, clinical experience indicates that engagement with splints and orthotics varies amongst people after stroke. ObjectivesThe aim of the study was to understand the factors that influence engagement with splints and orthotics in people after stroke. MethodsPeople after stroke who had been wearing a splint or orthotic (also known as devices) for at least 2 months under the care of one Community Neurosciences Team in the UKs National Health ...

BackgroundDynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables non-invasive characterization of carotid atherosclerotic plaque. PurposeTo evaluate the performance and reproducibility of a simplified DCE-MRI quantification method for carotid plaque assessment. MethodsT1-weighted black-blood DCE-MRI of the carotid arteries at 3T was performed at baseline and after six months in patients with mild-to-moderate atherosclerotic lesions in a pilot placebo-controlled randomized trial...

ImportanceLarge language models (LLMs) offer potential decision support, but their accuracy varies. Prompt engineering can generally enhance LLM behavior in a clinical context, yet best practices have yet to be formally explored in realistic neurology settings. ObjectiveTo evaluate the impact of structured prompting versus simple prompting on the performance of six LLMs (three closed-source: OpenAI GPT-4o, OpenAI o3, OpenAI GPT-5.2 Thinking; three open-source: Meta Llama-4-Scout-17B-16E-Instruc...