Stroke

BackgroundMechanical thrombectomy has become standard-of-care in the treatment of emergent large vessel occlusion. However, it is not yet known if social factors impact post-thrombectomy recovery. We studied the association between clinical and sociodemographic factors with 3-month functional outcomes post thrombectomy. MethodsIn this prospective cohort study, 291 patients who underwent mechanical thrombectomy at Montefiore-Einstein Hospital in NYC between 1/1/2021 and 4/1/2024 were analyzed. T...

BackgroundAmong patients with acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO) who undergo successful reperfusion following endovascular thrombectomy (EVT), only one-third are disability-free at 90 days, which may be related to persistent microvascular hypoperfusion after thrombectomy known as the "no-reflow phenomenon". Adenosine is administered to prevent percutaneous coronary intervention (PCI)-related no-reflow through microvasculature dilation and neutrophil-mediated in...

BackgroundTandem lesion strokes (TLS), defined by the coexistence of an intracranial large- or medium-vessel occlusion and a concomitant cervical internal carotid artery (ICA) stenosis or occlusion, represent a challenging subtype of acute ischemic stroke. Optimal endovascular management remains controversial, particularly regarding the role of emergent carotid artery stenting (eCAS) during mechanical thrombectomy. ObjectiveTo compare the safety and efficacy of emergent carotid artery stenting ...

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...

BackgroundStroke is a leading cause of public health burden in China, particularly among the elderly. This study aims to examine long-term trends in stroke incidence and the impact of population aging. MethodsUsing the Global Burden of Disease (GBD) Study 2021, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) for ischemic stroke (IS), cerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) from 1990 to 2021. We applied the estimated annual percentage change ...

BackgroundRecurrent ischemic stroke remains a major concern in patients with nonvalvular atrial fibrillation (NVAF) despite anticoagulation. However, not all NVAF-related strokes are purely cardioembolic--concomitant large artery steno-occlusion (cLASO) is frequently observed and may represent an independent contributor to stroke recurrence. Current guidelines address these cases but focusing almost exclusively on the cardioembolic source. This approach contrasts sharply with the management of a...

ObjectiveWe aimed to do an updated meta- analysis comparing outcomes of mechanical thrombectomy (MT) associated with standard medical treatment (SMT), compared to SMT alone, in adult patients with acute ischemic stroke (AIS) due to medium or distal vessel occlusion (MDVO). MethodologyWe systematically searched PubMed, LILACS, Scielo, Cochrane, and ClinicalTrials.gov databases. Randomized controlled trials (RCTs), retrospective cohort studies, and systematic reviews with meta-analysis comparing ...

BackgroundThe optimal noninvasive screening strategy for detecting patent foramen ovale (PFO) in patients with cryptogenic stroke (CS) remains uncertain. Although transthoracic echocardiography (TTE) and transcranial Doppler (TCD) are widely used, whether combining both modalities improves diagnostic performance has not been fully established. MethodsAmong 432 consecutive CS patients, 399 underwent collaborative screening with both TTE and TCD bubble tests performed by a multidisciplinary Heart...

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...

BackgroundThe one-year SINEMA trial demonstrated improved blood pressure (BP) control and reduced mortality up to 72 months after the intervention. This article aims to assess between-arm differences in mean annual cumulative BP and to explore whether the associations between cumulative BP and biofunctional outcomes differed by trial arm. MethodsPost-hoc secondary analysis of the SINEMA cluster-randomized trial, which recruited 1299 adults with stroke from 50 rural villages in Hebei, China, bet...

BackgroundSuboptimal adherence to preventive medications and inadequate management of risk factors are major barriers to effective post-discharge care for individuals at high risk of stroke, particularly in resource-constrained settings. Digital health interventions delivered via widely accessible platforms offer a promising scalable approach. We conducted this trial to evaluate the efficacy of Social Network based patient care in improving medication adherence in high-risk populations for strok...

Aim/backgroundEthnic inequalities in stroke incidence are well-established, but long-term trends and the impact of socioeconomic status (SES) remain understudied. We estimated incidence rates by ethnicity over 30-years, and differences by SES, using the South London Stroke Register (1995-2024). MethodsWe conducted a population-based study including all residents of a geographically defined area of South London, calculating standardised incidence rates using census-derived denominators and the 2...

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...

BackgroundAtrial cardiopathy is an important cause of embolic stroke and a potential cause of cognitive dysfunction. Increased left atrial volume indexed to body surface area (LAVi) has been widely used as marker for atrial cardiopathy. However, since physiological remodeling may also increase LAVi, it lacks specificity. Left atrial to left ventricular volume (LA:LV) ratio was recently suggested as a better marker of atrial cardiopathy allowing a more accurate detection of imbalanced, pathologic...

Background and PurposeEmbolic stroke of undetermined source (ESUS) emains a major diagnostic challenge in vascular neurology, as a substantial proportion of patients lack an identifiable embolic source despite standardized diagnostic workup. The failure of empiric anticoagulation strategies highlights the need for individualized, mechanism-oriented risk stratification. We aimed to develop a machine learning-based framework to estimate the most likely embolic source in ESUS using routinely availa...

IntroductionThe Rhode Island Stroke Prevention and Treatment Act aimed to establish a standardized system of care for stroke patients through designated stroke centers, revise emergency medical services (EMS) protocols, and establish a centralized stroke database. While Stroke Systems of Care (SSOC) laws have proven effective in reducing overall stroke mortality, their benefits among racial minorities and economically disadvantaged groups remain unclear. This study investigates the impact of the...

Pediatric stroke disrupts ongoing neurodevelopment and often results in long-term cognitive challenges. For bilingual children navigating healthcare systems that underserve linguistically diverse families, these impacts raise critical health equity considerations. While bilingualism has historically been framed as a burden, research suggests it may support development in clinical populations. This cross-sectional study investigated how linguistic diversity relates to language and cognitive outco...

ObjectivesTo investigate long-term trends in ethnic and socioeconomic inequalities in pre-stroke risk factors and treatments. Designpopulation-based cohort study Settinggeographically defined area of London, UK, 1995-2024 Participants8,515 adults with first stroke, stratified by self-reported ethnicity (62.4% White [N=5,255], 15.5% Black Caribbean [N=1,303], 13.3% Black African [N=1,122]), occupation (60.7% routine/manual occupations [N=3,964]), education (44.6% lower education [N=1,929]), an...

BackgroundStenosis and dolichoectasia of cranial arteries likely reflect distinct mechanisms. Their contributions to lacunar stroke and cerebral small vessel disease (cSVD) remain contentious. We investigated associations of large artery stenosis (LAS) and arterial widening with stroke subtype, cSVD markers, incident infarcts, and clinical outcomes. MethodsWe prospectively recruited patients with lacunar or mild non-lacunar stroke, with demographic, stroke-related, cognitive, functional, and MR...

ObjectiveA comparative analysis was conducted on the rehabilitation effects of limb functions in patients with post-stroke yawning-induced parakinesia brachialis oscitansysis (PBO), patients without PBO, and patients whose PBO naturally disappeared after the onset of the disease. MethodsThe study included ischemic stroke patients diagnosed and treated in our hospital from March 2024 to June 2024. Patients were divided into two groups: the PBO group and the non-PBO group, based on whether PBO wa...