Journal of Stroke最新文献

{"title":"ABCD-GENE Score Stratifying Risk-Benefit Profile of Clopidogrel-Aspirin Therapy in Ischemic Stroke Within 24-72 Hours.","authors":"Yun Chen, Lingling Jiang, Ying Gao, Weiqi Chen, Hongyi Yan, Tingting Wang, Yingying Yang, Yuesong Pan, Yilong Wang","doi":"10.5853/jos.2025.05092","DOIUrl":"10.5853/jos.2025.05092","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"316-320"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156894","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":"Divergent Small Vessel Disease Burden in Warfarin-Associated and Direct Oral Anticoagulant-Associated Intracerebral Hemorrhage.","authors":"Sung-Chun Tang, Ya-Fang Chen, Chih-Hao Chen, Ching-Hua Kuo, Yuan-Chang Chao, Yu-Fong Peng, Shu-Wen Lin, Shin-Yi Lin, Jiann-Shing Jeng","doi":"10.5853/jos.2025.05785","DOIUrl":"10.5853/jos.2025.05785","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"334-338"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156956","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":"Cortical Microinfarcts Are Related to Amyloid Pathology and Cognitive Decline in Spontaneous Intracerebral Hemorrhage.","authors":"Pu-Tien Chiang, Hsin-Hsi Tsai, Bo-Ching Lee, Chia-Ju Liu, Syu-Jyun Peng, Sheng-Sian Lin, Jiann-Shing Jeng, Li-Kai Tsai","doi":"10.5853/jos.2025.04308","DOIUrl":"10.5853/jos.2025.04308","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"326-329"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156912","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":"Treatment Modalities and Long-Term Outcomes in Unruptured Vertebrobasilar Fusiform Aneurysms: A Nationwide Observational Cohort Study.","authors":"Linggen Dong, Dachao Wei, Xiheng Chen, Mingtao Li, Yang Zhao, Yong Sun, Qingbin Nie, Jun Feng, Guomin Xiao, Jinghua Zhou, Shengli Hu, Lifei Feng, Lifeng Qi, Hongen Liu, Geng Guo, Yufang Li, Renfu Tian, Jianghua Yu, Dianshi Jin, Liang Hao, Tian Tian, Shizhong Zhang, Yang Wang, Liping Liu, Ming Lv","doi":"10.5853/jos.2025.04385","DOIUrl":"10.5853/jos.2025.04385","url":null,"abstract":"<p><strong>Background and purpose: </strong>Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis.</p><p><strong>Methods: </strong>This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed.</p><p><strong>Results: </strong>Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; P=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; P=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; P=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I-II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III-IV VBFAs.</p><p><strong>Conclusions: </strong>Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I-II VBFAs, although residual confounding cannot be excluded.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"250-262"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156993","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":"Outcomes of Early Versus Later Anticoagulation in Asian Atrial Fibrillation-Related Stroke: ELAN Subgroup Analysis.","authors":"Takeshi Yoshimoto, Masafumi Ihara, P N Sylaja, Jean-Benoît Rossel, Shigeru Fujimoto, Yasuyuki Iguchi, Rajsrinivas Parthasarthy, Vijaya Pamidimukkala, Yusuke Yakushiji, Thomas Iype, Makoto Nakajima, Dheeraj Khurana, Vivek Nambiar, Hisanao Akiyama, Kazunori Toyoda, Angelika Alonso, Sven Poli, Caterina Kulyk, Nicoletta G Caracciolo, Dimitri Hemelsoet, Ana Paiva Nunes, Jeyaraj Durai Pandian, Jesse Dawson, Urs Fischer, Masatoshi Koga","doi":"10.5853/jos.2025.05848","DOIUrl":"10.5853/jos.2025.05848","url":null,"abstract":"<p><strong>Background and purpose: </strong>We aimed to evaluate whether early versus late initiation of direct oral anticoagulant (DOAC) after acute ischemic stroke (AIS) yields different safety and efficacy outcomes in Asian versus non-Asian patients.</p><p><strong>Methods: </strong>We analyzed Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN) trial data from 2,013 AIS patients with atrial fibrillation (AF) randomized to early (≤48 hours for minor/moderate stroke, 6-7 days for major stroke) or late DOAC initiation (3-4 days for minor ischemic stroke, 6-7 days for moderate ischemic stroke, 12-14 days for major ischemic stroke). Patients were categorized by region as Asian (Japan and India) or non-Asian. The primary outcome was a composite of major extracranial bleeding, symptomatic intracranial hemorrhage (SICH), recurrent ischemic stroke, systemic embolism (SE), or vascular death at 30 days (trial registration: ClinicalTrials.gov number, NCT03148457).</p><p><strong>Results: </strong>Among 1,975 patients, 245 were Asian (192 from Japan and 53 from India) and 1,730 were non-Asian. The primary outcome occurred in 6.5% of Asian patients (4.8% early vs. 8.3% late) and 3.1% of non-Asian patients (2.7% vs. 3.6%) (P<0.01). Higher rates of recurrent ischemic stroke (4.1% [2.4% vs. 5.8%] vs. 1.7% [1.3% vs. 2.1%], P=0.02) and SE (2.0% [0.8% vs. 3.3%] vs. 0.5% [0.4% vs. 0.6%], P=0.02) accounted for this difference. No significant differences were observed in major extracranial bleeding, SICH, recurrent ischemic stroke, SE, or vascular death. No significant interaction was observed between region and treatment allocation.</p><p><strong>Conclusions: </strong>Although Asian patients had worse baseline profiles and outcomes, treatment effects did not differ by region, supporting the generalizability of early DOAC initiation in Asian AIS patients without region-specific timing modifications.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"293-302"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157024","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":"Oxidative Stress Markers and the Risk of Incident Stroke and Ischemic Heart Disease: A Case-Cohort Study.","authors":"Shuai Guo, Hitomi Kimura, Kazumasa Yamagishi, Tomomi Kihara, Isao Muraki, Yoshihiro Kokubo, Isao Saito, Hiroshi Yatsuya, Hiroyasu Iso, Taiki Yamaji, Manami Inoue, Shoichiro Tsugane, Norie Sawada, Motoki Iwasaki","doi":"10.5853/jos.2025.05162","DOIUrl":"10.5853/jos.2025.05162","url":null,"abstract":"<p><strong>Background and purpose: </strong>To investigate the association between derivatives of reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP) and the risk of stroke by subtype, and ischemic heart disease (IHD).</p><p><strong>Methods: </strong>We employed a case cohort design consisting of cardiovascular disease cases (n=1,521; stroke, n=1,271; IHD, n=265) and a random sub-cohort (n=4,761) in a large Japanese population-based study. d-ROMs and BAP were measured in plasma samples collected between 1995 and 1999. Hazard ratios (HRs) were estimated using weighted Cox proportional hazards.</p><p><strong>Methods: </strong>according to d-ROMs and BAP quartiles, adjusted for age, sex, area, and potential confounding factors.</p><p><strong>Results: </strong>Analysis revealed a positive association between d-ROMs and the risk of total stroke, ischemic stroke, IHD, and the composite outcome of ischemic stroke and IHD. The multivariable HRs and 95% confidence intervals (CIs) for the highest versus lowest quartiles for d-ROMs were 1.34 (95% CI: 1.11-1.63) for total stroke (P for trend<0.001), 1.47 (1.16-1.86) for ischemic stroke (P for trend<0.001), 1.47 (1.02-2.11) for IHD (P for trend=0.072), 1.47 (0.87-2.49) for subarachnoid hemorrhage (P for trend=0.101), and 1.01 (0.72-1.41) for intraparenchymal hemorrhage (P for trend=0.618). In contrast, no significant association was detected between BAP levels and the risk of cardiovascular disease.</p><p><strong>Conclusions: </strong>Analysis revealed that d-ROMs levels were positively associated with the risk of ischemic stroke and heart disease but not with hemorrhagic stroke.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":" ","pages":"273-282"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839553","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 Anticoagulation in Acute Ischemic Stroke With Atrial Fibrillation.","authors":"Hong-Kyun Park, Masatoshi Koga, Keun-Sik Hong","doi":"10.5853/jos.2025.05211","DOIUrl":"10.5853/jos.2025.05211","url":null,"abstract":"<p><p>Patients with atrial fibrillation who experience acute ischemic stroke (AIS) are at high risk of early recurrent ischemic stroke or systemic embolism. Timely initiation of anticoagulation is essential to prevent subsequent ischemic events but must be carefully balanced against the risk of hemorrhagic transformation or intracranial hemorrhage. Historically, early anticoagulation therapy with heparin or vitamin K antagonists for AIS has shown uncertain benefits. The safety and efficacy of early initiation of non-vitamin K oral anticoagulants, initially suggested by observational studies, have been confirmed by randomized controlled trials and further supported by an individual patient data meta-analysis. However, uncertainties remain in specific populations, including those with severe stroke, hemorrhagic transformation, and Asian patients, who are at an increased risk of intracranial bleeding and are underrepresented in clinical trials.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":" ","pages":"193-200"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774875","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":"Genetically Determined Levels of Inflammation-Related Proteins and Functional Outcome After Ischemic Stroke: A Mendelian Randomization Study.","authors":"Annelie Angerfors, Björn Andersson, Sofia Furutjäll, Michael Chong, Christina Jern, Tara M Stanne","doi":"10.5853/jos.2025.05036","DOIUrl":"10.5853/jos.2025.05036","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":" ","pages":"312-315"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839526","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":"Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.","authors":"Zoe Soulé, Siyu Wang, Mingfeng Cao, Han-Gil Jeong, Yaman B Ahmad, Leon Fan, Glenn Whitman, Sung-Min Cho","doi":"10.5853/jos.2025.05428","DOIUrl":"10.5853/jos.2025.05428","url":null,"abstract":"<p><p>Acute brain injury (ABI) affects up to one-third of patients using mechanical circulatory support (MCS). In venoarterial extracorporeal membrane oxygenation (VA ECMO), ABI incidence (11%-40%) has not improved in two decades. Conversely, improvements in left ventricular assist devices (LVADs) have reduced the incidence of stroke, although it remains a major complication (10%-30%). The failure of MCS to ensure adequate cerebral protection may impair cerebrovascular autoregulation (CVAR) and disrupt microcirculatory function affected by reduced pulsatility, endothelial injury, acute perturbations in partial pressure of arterial carbon dioxide (PaCO2), and cerebral venous congestion. Here, we review evidence demonstrating that these factors alter microcirculatory dynamics and CVAR, thereby contributing to ABI through shared mechanistic pathways. Current methods for assessing CVAR are reviewed, including invasive indices such as the pressure reactivity index (PRx) from intracranial pressure monitoring and noninvasive metrics such as the cerebral oximetry index (COx) from near-infrared spectroscopy or flow-velocity correlations from transcranial Doppler. Each method is limited by feasibility, signal artifacts, and inter-modality variability. Our review identifies three priority areas for cerebral protection in MCS: preservation of pulse pressure, cautious titration of PaCO2, and integration of CVAR-informed blood pressure management. Preliminary evidence suggests that very low pulse pressure, rapid carbon dioxide correction, and persistent microcirculatory impairment are each associated with ABI risk. Future investigations should focus on validating bedside tools to assess CVAR and microcirculatory integrity, and on determining whether physiological targets derived from these measures can improve neurological outcomes in patients using MCS.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"28 2","pages":"201-217"},"PeriodicalIF":11.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156941","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":"RNF213 p.R4810K Variant and Intracranial Atherosclerosis: Increased Risk in Obese Variant Carriers.","authors":"Masamitsu Takashima, Takuya Kiyohara, Kuniyuki Nakamura, Yuichi Ozaki, Fumitaka Yoshino, Go Hashimoto, Masaoki Hidaka, Noriyuki Sahara, Fumi Irie, Yoshinobu Wakisaka, Ryu Matsuo, Masahiro Kamouchi, Takanari Kitazono, Tetsuro Ago","doi":"10.5853/jos.2025.02607","DOIUrl":"10.5853/jos.2025.02607","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":" ","pages":"172-175"},"PeriodicalIF":8.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889347","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}