Journal of Stroke最新文献

{"title":"Medical Management of Adult Moyamoya Disease: A Review and Relevant Cases With Ischemic Events.","authors":"Oh Young Bang, Miki Fujimura","doi":"10.5853/jos.2024.04273","DOIUrl":"10.5853/jos.2024.04273","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is a rare and progressive cerebrovascular disorder characterized by stenosis or occlusion of the internal carotid arteries resulting in the development of fragile collateral vessels at the base of the brain. Surgical revascularization is the primary treatment option for preventing ischemic and hemorrhagic events; however, the role of medical management has become increasingly recognized, particularly in cases involving asymptomatic patients or those at a high risk for surgical complications. In this review, we aimed to investigate the current guidelines and evidence supporting various medical management strategies for MMD, including the importance of controlling risk factors and judicious use of antithrombotic therapy. Given the considerable variability in patient presentation, such as age of onset, symptomatology, and comorbid conditions, it is crucial to adopt tailored therapeutic approaches that address each patient's unique characteristics. The existing literature on medical management is limited. However, individualized strategies may effectively mitigate the risk of ischemic events and improve the overall patient outcomes. Further research is essential to develop comprehensive and standardized treatment protocols for medical management of adult patients with MMD. In addition, ongoing trials and efforts to develop disease-modifying agents are discussed.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"1-18"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364744","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":"Developing a Model of Advance Consent for Participation in Acute Stroke Trials.","authors":"Rena Seeger, Ubong Udoh, Brian Dewar, Stuart Nicholls, Mark Fedyk, Sophia Gocan, Victoria Shepherd, Dar Dowlatshahi, Michel Shamy","doi":"10.5853/jos.2024.02544","DOIUrl":"10.5853/jos.2024.02544","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"133-135"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364475","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":"Thrombolysis in Patients With Versus Without Visible Occlusion: A Secondary Analysis From the AcT Trial.","authors":"Anwer Zohaib Siddiqi, Katrina Ignacio, Chitapa Kaveeta, Fouzi Bala, Ayoola Ademola, Aleksander Tkach, Brian H Buck, Luciana Catanese, Gary Hunter, Dar Dowlatshahi, Michel Shamy, Atif Zafar, Thalia S Field, Ramana Appireddy, Ankur Wadhwa, Tolulope Sajobi, Rick Swartz, Mohammed Almekhlafi, Andrew Demchuk, Bijoy Menon, Nishita Singh","doi":"10.5853/jos.2024.03062","DOIUrl":"10.5853/jos.2024.03062","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"113-117"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365000","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":"Prevalence of Genetic Variants Causing Mendelian Stroke Among 15,548 Koreans Without Neurological Disorders.","authors":"Jin Ok Yang, Seul Hee Lee, Hong Jun Kim, Chul-Hoo Kang, Joong-Goo Kim, Jay Chol Choi","doi":"10.5853/jos.2024.03188","DOIUrl":"10.5853/jos.2024.03188","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"136-139"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364919","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":"Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?","authors":"Linxin Li, Vasileios-Arsenios Lioutas, Ralph K Akyea, Stefan Gerner, Kui Kai Lau, Emily Ramage, Aristeidis H Katsanos, George Howard, Philip M Bath","doi":"10.5853/jos.2024.03923","DOIUrl":"10.5853/jos.2024.03923","url":null,"abstract":"<p><p>Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the \"less traditional\" designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"41-51"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364809","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":"Parkinsonism in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy: Clinical Features and Biomarkers.","authors":"Chih-Hao Chen, Te-Wei Wang, Yu-Wen Cheng, Yung-Tsai Chu, Mei-Fang Cheng, Ya-Fang Chen, Chin-Hsien Lin, Sung-Chun Tang","doi":"10.5853/jos.2024.03944","DOIUrl":"10.5853/jos.2024.03944","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"122-127"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364817","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":"Recanalization Outcomes and Procedural Complications in Patients With Acute Ischemic Stroke and COVID-19 Receiving Endovascular Treatment.","authors":"João Pedro Marto, Davide Strambo, George Ntaios, Thanh N Nguyen, Pawel Wrona, Simon Escalard, Simona Marcheselli, Ossama Yassin Mansour, Blanca Fuentes, Malgorzata Dorobek, Marta Nowakowska-Kotas, Elena Oana Terecoasa, Jonathan M Coutinho, Mariana Carvalho-Dias, Patricia Calleja, João Sargento-Freitas, Ana Paiva-Nunes, Martin Šrámek, Priyank Khandelwal, Torcato Meira, Mohamad Abdalkader, Pascal Jabbour, Martin Kovář, Oscar Ayo-Martin, Patrik Michel, Roman Herzig, Anna Członkowksa, Jelle Demeestere, Raul G Nogueira, Alexander Salerno, Susanne Wegener, Philipp Baumgartner, Carlo W Cereda, Giovanni Bianco, Morin Beyeler, Marcel Arnold, Emmanuel Carrera, Paolo Machi, Valerian Altersberger, Leo Bonati, Henrik Gensicke, Manuel Bolognese, Nils Peters, Stephan Wetzel, Marta Magriço, João Nuno Ramos, Rita Machado, Carolina Maia, Egídio Machado, Patrícia Ferreira, Teresa Pinho-E-Melo, André Paula, Manuel Alberto Correia, Pedro Castro, Elsa Azevedo, Luís Albuquerque, José Nuno-Alves, Joana Ferreira-Pinto, Liliana Pereira, Miguel Rodrigues, André Araújo, Marta Rodrigues, Mariana Rocha, Ângelo Pereira-Fonseca, Luís Ribeiro, Ricardo Varela, Sofia Malheiro, Manuel Cappellari, Cecilia Zivelonghi, Giulia Sajeva, Andrea Zini, Mauro Gentile, Stefano Forlivesi, Ludovica Migliaccio, Maria Sessa, Sara La Gioia, Alessandro Pezzini, Davide Sangalli, Marialuisa Zedde, Rosario Pascarella, Carlo Ferrarese, Simone Beretta, Susanna Diamanti, Ghil Schwarz, Giovanni Frisullo, Pierre Seners, Candice Sabben, Michel Piotin, Benjamin Maier, Guillaume Charbonnier, Fabrice Vuillier, Loic Legris, Pauline Cuisenier, Francesca R Vodret, Gaultier Marnat, Jean-Sebastien Liegey, Igor Sibon, Fabian Flottmann, Gabriel Broocks, Nils-Ole Gloyer, Ferdinand O Bohmann, Jan Hendrik Schaefer, Christian H Nolte, Heinrich Audebert, Eberhard Siebert, Marek Sykora, Wilfried Lang, Julia Ferrari, Lukas Mayer-Suess, Michael Knoflach, Elke-Ruth Gizewski, Jeffrey Stolp, Lotte J Stolze, Paul J Nederkoorn, Ido van-den-Wijngaard, Joke de Meris, Robin Lemmen, Sylvie De Raedt, Fenne Vandervorst, Matthieu Pierre Rutgers, Antoine Guilmot, Anne Dusart, Flavio Bellante, Fernando Ostos, Guillermo Gonzalez-Ortega, Paloma Martín-Jiménez, Sebastian García-Madrona, Antonio Cruz-Culebras, Rocio Vera, Maria-Consuelo Matute, María Alonso-de-Leciñana, Ricardo Rigual, Exuperio Díez-Tejedor, Soledad Pérez-Sánchez, Joan Montaner, Fernando Díaz-Otero, Natalia Perez-de-la-Ossa, Belén Flores-Pina, Lucia Muñoz-Narbona, Angel Chamorro, Alejandro Rodríguez-Vázquez, Arturo Renú, Francisco Hernandez-Fernandez, Tomas Segura, Herbert Tejada-Meza, Daniel Sagarra-Mur, Marta Serrano-Ponz, Thant Hlaing, Isaiah See, Robert Simister, David J Werring, Espen Saxhaug Kristoffersen, Annika Nordanstig, Katarina Jood, Alexandros Rentzos, Libor Šimu Ne, Dagmar Krajíčková, Antonín Krajina, Robert Mikulík, Martina Cviková, Jan Vinklárek, David Školoudík, Martin Roubec, Eva Hurtikova, Rostislav Hrubý, Svatopluk Ostry, Ondrej Skoda, Marek Pernicka, Lubomír Kočí, Zuzana Eichlová, Martin Jíra, Michal Panský, Pavel Mencl, Hana Paloušková, Aleš Tomek, Petr Janský, Anna Olšerová, Roman Havlíček, Petr Malý, Lukáš Trakal, Jan Fiksa, Matěj Slovák, Michał Karlińsk, Maciej Nowak, Halina Sienkiewicz-Jarosz, Anna Bochynska, Tomasz Homa, Katarzyna Sawczynska, Agnieszka Slowik, Ewa Wlodarczyk, Marcin Wiącek, Izabella Tomaszewska-Lampart, Bartosz Sieczkowski, Halina Bartosik-Psujek, Marta Bilik, Anna Bandzarewicz, Justyna Zielińska-Turek, Krystian Obara, Paweł Urbanowski, Sławomir Budrewicz, Maciej Guziński, Milena Świtońska, Iwona Rutkowska, Paulina Sobieszak-Skura, Beata Łabuz-Roszak, Aleksander Dębiec, Jacek Staszewski, Adam Stępień, Jacek Zwiernik, Grzegorz Wasilewski, Cristina Tiu, Razvan-Alexandru Radu, Anca Negrila, Bogdan Dorobat, Cristina Panea, Vlad Tiu, Simona Petrescu, Atilla Özcan-Özdemir, Mostafa Mahmoud, Hussam El-Samahy, Hazem Abdelkhalek, Jasem Al-Hashel, Ismail Ibrahim Ismail, Athari Salmeen, Abdoreza Ghoreishi, Sergiu Sabetay, Hana Gross, Piers Klein, Kareem El Naamani, Stavropoula Tjoumakaris, Rawad Abbas, Ghada-A Mohamed, Alex Chebl, Jiangyong Min, Majesta Hovingh, Jenney-P Tsai, Muhib-A Khan, Krishna Nalleballe, Sanjeeva Onteddu, Hesham-E Masoud, Mina Michael, Navreet Kaur, Laith Maali, Michael Abraham, Ivo Bach, Melody Ong, Denis Babici, Ayaz-M Khawaja, Maryam Hakemi, Kumar Rajamani, Vanessa Cano-Nigenda, Antonio Arauz, Pablo Amaya, Natalia Llanos, Akemi Arango, Miguel A Vences, José-Domingo Barrientos, Rayllene Caetano, Rodrigo Targa, Sergio Scollo, Patrick Yalung, Shashank Nagendra, Abhijit Gaikwad, Kwon-Duk Seo","doi":"10.5853/jos.2024.04077","DOIUrl":"10.5853/jos.2024.04077","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"128-132"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364983","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":"Direct and Indirect Effects of Prolonged Exposure to Long Working Hours on Risk Stroke Subtypes in the CONSTANCES Cohort.","authors":"Marc Fadel, Grace Sembajwe, Jian Li, Annette Leclerc, Fernando Pico, Alexis Schnitzler, Eric Richard Fadel, Yves Roquelaure, Alexis Descatha","doi":"10.5853/jos.2024.02586","DOIUrl":"10.5853/jos.2024.02586","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"154-157"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364521","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":"Factors Influencing Nerinetide Effect on Clinical Outcome in Patients Without Alteplase Treatment in the ESCAPE-NA1 Trial.","authors":"Mayank Goyal, Bijoy K Menon, Johanna Ospel, Mohammed Almekhlafi, Charlotte Zerna, Raul Nogueira, Ryan McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Brian Buck, Kathy Heard, Manish Joshi, Diogo Haussen, Shawna Cutting, Shelagh B Coutts, Daniel Roy, Jeremy L Rempel, Thalia S Field, Dar Dowlatshahi, Brian van Adel, Richard Swartz, Ruchir Shah, Eric Sauvageau, Volker Puetz, Frank L Silver, Bruce Campbell, René Chapot, Michael Tymianski, Michael D Hill","doi":"10.5853/jos.2024.03139","DOIUrl":"10.5853/jos.2024.03139","url":null,"abstract":"<p><strong>Background and purpose: </strong>In the ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial, treatment with nerinetide was associated with improved outcomes in patients who did not receive intravenous alteplase. We compared the effect of nerinetide on clinical outcomes in patients without concurrent intravenous alteplase treatment within different patient subgroups.</p><p><strong>Methods: </strong>ESCAPE-NA1 was a multicenter randomized trial in which acute stroke patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) >4 undergoing endovascular treatment (EVT) were randomized to intravenous nerinetide or placebo. The primary outcome was independence (modified Rankin Scale [mRS] score 0-2) at 90 days. We assessed baseline, clinical, and imaging variables as predictors of outcome and for evidence of treatment effect modification. We constructed two multivariable models using variables known prior to randomization and variables known immediately post-EVT procedure to provide adjusted estimates of effect. We assessed for evidence of treatment effect modification using multiplicative interaction terms within each model.</p><p><strong>Results: </strong>Four hundred forty-six patients were included in the analysis. Clinical outcomes were better in patients randomized to the nerinetide arm (mRS 0-2: 59.4% vs. 49.8%). There was possible treatment effect modification by ASPECTS score; patients with ASPECTS 8-10 showed a larger treatment effect compared to those with lower ASPECTS score. Younger age, lower NIHSS score, lower baseline serum glucose, absence of atrial fibrillation at baseline, higher ASPECTS score, middle cerebral artery (vs. internal carotid artery) occlusion, use of conscious or no sedation (vs. general anesthesia), and faster treatment were all predictors of favorable outcome.</p><p><strong>Conclusion: </strong>Patients in the nerinetide arm who were not treated with concurrent alteplase showed improved clinical outcomes and the treatment effect was larger among patients with favorable ASPECTS profiles.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"95-101"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364523","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":"Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications.","authors":"Radosław Rzepliński, Sylwia Tarka, Michał Tomaszewski, Michał Kucewicz, Albert Acewicz, Jerzy Małachowski, Bogdan Ciszek","doi":"10.5853/jos.2024.01655","DOIUrl":"10.5853/jos.2024.01655","url":null,"abstract":"<p><strong>Background and purpose: </strong>The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries-arteries branching directly from high-pressure intracranial arteries, supplying vital neural structures such as the internal capsule, and characterized by a diameter of well below 1 mm, which makes them difficult to visualize with standard radiological examinations. This study aimed to analyze the morphology of the perforator origins, which constitute connection points between high-pressure intracranial arteries and microcirculation.</p><p><strong>Methods: </strong>Twenty-three human basal ganglia specimens with the middle cerebral artery (MCA, including 172 perforating arteries) and ten brainstem specimens with the basilar artery (BA, including 162 perforating arteries) were prepared and scanned using microcomputed tomography. The geometry and structure of the perforating arteries were analyzed using radiological images and additional histological studies.</p><p><strong>Results: </strong>The ostia of the perforating arteries were ellipsoidal in shape with median stenosis severity of 23% and 20% for MCA and BA perforators, respectively. The local narrowing structure was typical of neointimal hyperplasia. Statistical analysis revealed that the severity of stenosis may be related to age and cardiovascular health.</p><p><strong>Conclusion: </strong>Origins of the deep cerebral perforators are locally narrowed by neointimal hyperplasia, which may be a protective mechanism to adjust high blood pressure to the microcirculation. The narrowings may lead to chronic hypoperfusion and play a role in the pathophysiology of cerebral small vessel disease.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"52-64"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364681","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}