Journal of Stroke最新文献

{"title":"Optimal Low-Density Lipoprotein Cholesterol Level: Time to Reconsider Stroke Subtypes.","authors":"Jong S Kim","doi":"10.5853/jos.2025.02159","DOIUrl":"10.5853/jos.2025.02159","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"159-160"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Density Lipoprotein Cholesterol Level, the Lower the Better? Analysis of Korean Patients in the Treat Stroke to Target Trial.","authors":"Hanim Kwon, Jae-Chan Ryu, Jae-Kwan Cha, Sang Min Sung, Tae-Jin Song, Kyung Bok Lee, Eung-Gyu Kim, Yong-Won Kim, Ji Hoe Heo, Man Seok Park, Kyusik Kang, Byung-Chul Lee, Keun-Sik Hong, Oh Young Bang, Jei Kim, Jong S Kim","doi":"10.5853/jos.2025.00409","DOIUrl":"10.5853/jos.2025.00409","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Treat Stroke to Target (TST) was a randomized clinical trial involving French and Korean patients demonstrating that a lower low-density lipoprotein cholesterol (LDL-C, <70 mg/dL) target group (LT) experienced fewer cerebro-cardiovascular events than a higher target (90-110 mg/dL) group (HT). However, whether these results can be applied to Asian patients with different ischemic stroke subtypes remains unclear.</p><p><strong>Methods: </strong>Patients from 14 South Korean centers were analyzed separately. Patients with ischemic stroke or transient ischemic attack with evidence of atherosclerosis were randomized into LT and HT groups. The primary endpoint was a composite of ischemic stroke, myocardial infarction, coronary or cerebral revascularization, and cardiovascular death.</p><p><strong>Results: </strong>Among 712 enrolled patients, the mean LDL-C level was 71.0 mg/dL in 357 LT patients and 86.1 mg/dL in 355 HT patients. The primary endpoint occurred in 24 (6.7%) of LT and in 31 (8.7%) of HT group patients (adjusted hazard ratio [HR]=0.78; 95% confidence interval [CI]=0.45-1.33, P=0.353). Cardiovascular events alone occurred significantly less frequently in the LT than in the HT group (HR 0.26, 95% CI 0.09-0.80, P=0.019), whereas there were no significant differences in ischemic stroke events (HR 1.12, 95% CI 0.60-2.10, P=0.712). The benefit of LT was less apparent in patients with small vessel disease and intracranial atherosclerosis than in those with extracranial atherosclerosis.</p><p><strong>Conclusion: </strong>In contrast to the French TST, the outcomes in Korean patients were neutral. Although LT was more effective in preventing cardiovascular diseases, it was not so in stroke prevention, probably attributed to the differences in stroke subtypes. Further studies are needed to elucidate the efficacy of statins and appropriate LDL-C targets in Asian patients with stroke.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"228-236"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premature Ischemic Stroke in Sjögren's Disease.","authors":"Sonja Beider, Nadine Zehrfeld, Franziska Maria Tapken, Fiona Engelke, Tabea Seeliger, Thomas Skripuletz, Torsten Witte, Diana Ernst","doi":"10.5853/jos.2024.03797","DOIUrl":"10.5853/jos.2024.03797","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"257-260"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged Benefit of Endovascular Treatment for Acute Basilar Artery Occlusion With Large Ischemic Infarcts: One-Year Outcomes From the PERSIST Registry.","authors":"Pan Zhang, Yingjie Xu, Miaomiao Hu, Jinghui Zhong, Xinfeng Liu, Wen Sun","doi":"10.5853/jos.2024.04140","DOIUrl":"10.5853/jos.2024.04140","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"250-252"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Computed Tomography Perfusion and Baseline National Institutes of Health Stroke Scale to Assess the Clinical Penumbra in Ischemic Stroke.","authors":"Umberto Pensato, Alexander Stebner, Salome Bosshart, Ruchir Shah, Axel Rohr, Ricardo Hanel, Michael E Kelly, Aditya Bharatha, Michael D Hill, Mayank Goyal, Andrew M Demchuk, Johanna M Ospel","doi":"10.5853/jos.2024.03720","DOIUrl":"10.5853/jos.2024.03720","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"270-274"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Administration of Nelonemdaz May Improve the Stroke Outcomes in Patients With Acute Stroke.","authors":"Jin Soo Lee, Ji Sung Lee, Seong Hwan Ahn, Hyun Goo Kang, Tae-Jin Song, Dong-Ick Shin, Hee-Joon Bae, Chang Hun Kim, Sung Hyuk Heo, Jae-Kwan Cha, Yeong Bae Lee, Eung Gyu Kim, Man Seok Park, Hee-Kwon Park, Jinkwon Kim, Sungwook Yu, Heejung Mo, Sung Il Sohn, Jee Hyun Kwon, Jae Guk Kim, Young Seo Kim, Jay Chol Choi, Yang-Ha Hwang, Keun Hwa Jung, Soo-Kyoung Kim, Woo Keun Seo, Jung Hwa Seo, Joonsang Yoo, Jun Young Chang, Mooseok Park, Kyu Sun Yum, Chun San An, Byoung Joo Gwag, Dennis W Choi, Ji Man Hong, Sun U Kwon","doi":"10.5853/jos.2024.05113","DOIUrl":"10.5853/jos.2024.05113","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"279-283"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Measurement of Serum Neurofilament Light Chain in Patients With CADASIL.","authors":"Jung Seok Lee, Ji-Hoon Kang, Chul-Hoo Kang, Joong-Goo Kim, Sang Won Seo, Yu Hyun Park, Jihwan Yun, So Young Yun, Jay Chol Choi","doi":"10.5853/jos.2024.05666","DOIUrl":"10.5853/jos.2024.05666","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"261-265"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenecteplase Beyond 4.5 Hours in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Mohammad Aladawi, Mohammad T Abuawwad, Mohammad J J Taha, Yasmeena Abdelall Kozaa, Warda A Alrubasy, Abdullah Hamad, Fatema Ahmad Alhnidi, Mohamed Elfil, Zaid Najdawi, Xiaohan Peng, Felicia Hataway, Ekaterina Bakradze, Michael J Lyerly","doi":"10.5853/jos.2024.05715","DOIUrl":"10.5853/jos.2024.05715","url":null,"abstract":"<p><strong>Background and purpose: </strong>Acute ischemic stroke (AIS) is a leading cause of disability worldwide. While intravenous thrombolysis is recommended within 4.5 hours of last known well (LKW) time, many patients present beyond this window.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating tenecteplase (TNK) administration in AIS patients within 4.5 to 24 hours of LKW. The primary outcomes assessed functional independence and ordinal modified Rankin Scale (mRS) shift at 90 days. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality at 90 days.</p><p><strong>Results: </strong>Three RCTs were included, comprising 1,054 patients (532 TNK and 522 standard medical therapy) with a mean age of 69 years, 59% males, and median baseline National Institutes of Health Stroke Scale score of 10.5. TNK treatment was associated with mRS 0-2 at 90 days (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.04-1.70, P=0.023), indicating a 33% higher likelihood of achieving functional independence. However, the ordinal mRS shift showed no significant difference (standardized mean difference: 0.01, 95% CI: -0.37-0.39, P=0.09). Safety outcomes indicated no difference in the rates of sICH (OR: 2.07, 95% CI: 0.86-5.00, P=0.1), and no difference in 90-day mortality (OR: 1.08, 95% CI: 0.76-1.53, P=0.67).</p><p><strong>Conclusion: </strong>This meta-analysis suggests TNK might be safe and effective for selected AIS patients in the 4.5- to 24-hour time window, offering improved functional outcomes without a significant increase in hemorrhagic complications.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 2","pages":"184-194"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Cerebral Amyloid Angiopathy From Alzheimer's Disease Using Dual Amyloid and Tau Positron Emission Tomography.","authors":"Hsin-Hsi Tsai, Marco Pasi, Chia-Ju Liu, Ya-Chin Tsai, Ruoh-Fang Yen, Ya-Fang Chen, Jiann-Shing Jeng, Li-Kai Tsai, Andreas Charidimou, Jean-Claude Baron","doi":"10.5853/jos.2024.02376","DOIUrl":"10.5853/jos.2024.02376","url":null,"abstract":"<p><strong>Background and purpose: </strong>Although amyloid positron emission tomography (PET) might provide a molecular diagnosis for cerebral amyloid angiopathy (CAA), it does not have sufficient specificity for this condition relative to incipient Alzheimer's disease (AD). To identify a regional amyloid uptake pattern specific to CAA, we attempted to reduce this overlap by selecting \"pure CAA\" (i.e., fulfilling the criteria for probable CAA but without tau PET AD signature) and \"pure AD\" (i.e., positive amyloid PET and presence of tau PET AD signature, but without lobar hemorrhagic lesions). We hypothesized that occipital tracer uptake relative to the whole cortex (WC) would be higher in patients with pure CAA and may serve as a specific diagnostic marker.</p><p><strong>Methods: </strong>Patients who fulfilled these criteria were identified. In addition to the occipital region of interest (ROI), we assessed the frontal and posterior cingulate cortex (PCC) ROIs that are sensitive to AD. Amyloid PET uptake was expressed as the absolute standardized uptake value ratio (SUVR) and ROI/WC ratio. The diagnostic utility of amyloid PET was assessed using the Youden index cutoff.</p><p><strong>Results: </strong>Eighteen patients with AD and 42 patients with CAAs of comparable age were eligible. The occipital/WC was significantly higher in CAA than AD (1.02 [0.97-1.06] vs. 0.95 [0.87-1.01], P=0.001), with an area under curve of 0.762 (95% confidence interval [CI] 0.635-0.889) and a specificity of 72.2% (95% CI 46.5-90.3) at Youden cutoff (0.98). The occipital lobe, frontal lobe, PCC and WC SUVRs were significantly lower in CAA than in AD. The frontal/WC and PCC/WC ratios did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>Using stringent patient selection to minimize between-condition overlap, this study demonstrated the specificity of higher relative occipital amyloid uptake in CAA than in AD.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"65-74"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurovascular Complications of Acute Aortic Syndrome.","authors":"Dean Zeldich, Matthew Bierowski, Leah Shabo, Sridhara Yaddanapudi, Gregary Marhefka","doi":"10.5853/jos.2024.02915","DOIUrl":"10.5853/jos.2024.02915","url":null,"abstract":"<p><p>Acute aortic syndromes (AAS) such as aortic dissection, intramural hematoma, and penetrating aortic ulcer pose significant neurovascular risks, affecting patient outcomes. This review examines the incidence, clinical presentation, and outcomes of neurovascular complications in AAS patients. Common complications include stroke, spinal cord ischemia, and transient ischemic attacks, with stroke being the most prevalent. Managing aortic dissection necessitates careful blood pressure control to prevent dissection progression while avoiding compromised cerebral and spinal perfusion. Carotid involvement, particularly dissection, increases stroke and transient ischemic attack risks. Emergency surgical interventions, though essential to prevent rupture or repair dissection, carry risks of perioperative neurovascular complications. The use of electroencephalography and transcranial Doppler can aid in the early detection and monitoring of neurovascular events. We discuss the pros and cons of certain blood pressure medications in the acute treatment of aortic dissection. A multidisciplinary approach involving cardiovascular surgeons, neurologists, and critical care specialists is vital for optimizing outcomes and mitigating risks. Early recognition and management of neurovascular complications are crucial, and further research is needed to develop targeted prevention and treatment strategies.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"19-29"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}