Journal of the Neurological Sciences最新文献

{"title":"Impact of blood viscosity on wake-up stroke: Analysis stratified by age and stroke subtype","authors":"Motohiro Okumura,&nbsp;Takeo Sato,&nbsp;Takahiro Ishikawa,&nbsp;Teppei Komatsu,&nbsp;Kenichi Sakuta,&nbsp;Kenichiro Sakai,&nbsp;Hidetaka Mitsumura,&nbsp;Yasuyuki Iguchi","doi":"10.1016/j.jns.2025.123558","DOIUrl":"10.1016/j.jns.2025.123558","url":null,"abstract":"<div><h3>Objective</h3><div>Ischemic stroke occurring during sleep is termed wake-up stroke (WUS). Dehydration increases blood viscosity (BV) and evokes thrombogenesis, a common cause of WUS. This study aimed to investigate the association between BV and WUS, stratified by age and stroke subtype.</div></div><div><h3>Methods</h3><div>The subjects were consecutive patients with acute ischemic stroke onset-to-door time within 72 h. Hematocrit-derived BV at a high shear rate (300 s⁻¹) was calculated using hematocrit at admission. We assessed association of BV with WUS in the whole cohort, stratified by age (elderly group, ≥65 years; younger group, &lt;65 years) and by stroke subtype (small-vessel occlusion [SVO], large-artery atherosclerosis [LAA], cardioembolism [CE]) stratified by age.</div></div><div><h3>Results</h3><div>We included 1362 acute ischemic stroke patients (975 [72 %] male, median age 69 years). WUS was observed in 326 (24 %) patients. Multivariable logistic regression in the whole cohort showed no association of BV with WUS (OR 1.163, 95 %CI 0.925–1.462, <em>p</em> = 0.197). Higher BV was significantly associated with WUS in the elderly group (OR 1.455, 95 % CI 1.080–1.959, <em>p</em> = 0.014) but not the younger group (OR 0.848, 95 %CI 0.568–1.268, <em>p</em> = 0.423). Among the stroke subtypes, higher BV was associated with WUS only in SVO (all ages: OR 2.316, 95 %CI 1.251–4.288, <em>p</em> = 0.008; elderly group: OR 2.427, 95 %CI 1.011–5.821, <em>p</em> = 0.047; younger group: OR 3.190, 95 %CI 1.131–8.544, <em>p</em> = 0.028).</div></div><div><h3>Conclusions</h3><div>Higher BV contributed to WUS in elderly patients. Among the stroke subtypes, higher BV was associated with WUS only in SVO.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123558"},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admitting neutrophil/lymphocyte ratio and severity of first-ever acute ischemic stroke among indigenous West Africans","authors":"Oladotun V. Olalusi ,&nbsp;Joseph Yaria ,&nbsp;Adekunle Fakunle ,&nbsp;Akintomiwa Makanjuola ,&nbsp;Rufus Akinyemi ,&nbsp;Mayowa Owolabi ,&nbsp;Adesola Ogunniyi","doi":"10.1016/j.jns.2025.123554","DOIUrl":"10.1016/j.jns.2025.123554","url":null,"abstract":"<div><h3>Background</h3><div>We hypothesized that the neutrophil-lymphocyte ratio (NLR) alone, compared with a combination of the NLR and National Institutes of Health Stroke Scale score (NIHSS) [(NLR + NIHSS)], may help identify persons with severe stroke in a low-resource setting, with few personnel trained to assess the NIHSS score.</div></div><div><h3>Methods</h3><div>We studied 212 participants which included 106 patients with clinico-radiologic diagnosis of AIS and 106 comparative group. At inception, patients with clinico-laboratory features of sepsis, or infection were excluded. Stroke severity was assessed using the Stroke Levity Scale (SLS) and NIHSS scores while NLR was obtained at admission. Factors [beta coefficient (95 % CI)] associated with stroke severity (SLS ≤ 5) were reported using a multi-variable linear regression. A Receiver Operating Characteristics (ROC) curve was used to test the discriminatory ability of the NLR compared with the NLR + NIHSS score in identifying patients with severe stroke (using the SLS score).</div></div><div><h3>Results</h3><div>Median (IQR) NLR was 2.87 (3.0) among cases and 0.98(0.6) for controls, (<em>p</em> &lt; 0.001). The median (IQR) SLS score of stroke participants was [8.0 (6.0)]. Independent predictors of severe ischemic stroke were baseline NLR [−0.53 (−0.79, −0.26)], admitting GCS [0.31 (0.09, 0.53)], and infarct volume [−0.07 (−0.10, −0.03)]. The NLR alone had an AUC (95 % CI) of 0.82 (0.72–0.92) compared to the NLR + NIHSS score with 0.85 (0.76–0.94).</div></div><div><h3>Conclusion</h3><div>High admitting NLR is independently associated with severe AIS. In a low-resource setting, with few personnel trained to assess the NIHSS score, the NLR alone may help identify patients with severe AIS.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123554"},"PeriodicalIF":3.6,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in perceived general health of stroke survivors in the United States","authors":"Seyyed Sina Hejazian ,&nbsp;Alireza Vafaei Sadr ,&nbsp;Ajith Vemuri ,&nbsp;Vida Abedi ,&nbsp;Ramin Zand","doi":"10.1016/j.jns.2025.123556","DOIUrl":"10.1016/j.jns.2025.123556","url":null,"abstract":"<div><h3>Background</h3><div>General health can have a profound impact on daily life. We aimed to evaluate perceived general health, its trend, and associated factors among stroke survivors in the US to inform targeted interventions and guide health and social policy improvements.</div></div><div><h3>Method</h3><div>The BRFSS 2016–2022 was utilized for analysis. The study population included participants with stroke history. Logistic regression models were used to determine factors associated with poor general health. The time trend and geographical pattern of general health were also evaluated.</div></div><div><h3>Results</h3><div>Out of 128,988 individuals, 49.9 % were aged≥65 and 48.1 % were men. The prevalence of unfavorable general health was 50.9 %, with a 3.8 % reduction in 2016–2022. Most states with high rates of unfavorable general health were located Southeast of the country. Compared to men, only non-Hispanic-Black women (56.4 %vs.52.1 %,<em>p</em> = 0.011) and women aged “45–64”(58.5 %vs.56.3 %,<em>p</em> = 0.030) or “above74”(46.4 %vs.43.8 %,<em>p</em> = 0.024) had higher rates of unfavorable general health. Among both sexes, those aged 45–64 (Men:56.3 %,Women:58.5 %) and Hispanics (Men:57.8 %,Women:60.6 %) had the highest rates of unfavorable general health among different age and race groups. Based on the multivariate regression analysis, lower BMI(&lt;18Kg/m2), being unemployed or homemaker, residing in the “stroke belt,” physical inactivity, smoking, comorbidities/disabilities—including cardiovascular, pulmonary,and kidney diseases,diabetes, arthritis,cancer, blindness, difficulty walking/dressing—were associated with higher odds of unfavorable general health. In contrast, higher education and income, and heavy alcohol consumption were linked to lower odds.</div></div><div><h3>Conclusion</h3><div>This study highlights significant disparities in general health among stroke survivors in the US. Demographics, comorbidities/disabilities, physical activity, socioeconomic status, and environmental factors were associated with general health outcomes.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123556"},"PeriodicalIF":3.6,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Direct oral anticoagulants versus warfarin for the management of left atrial appendage thrombus in patients with acute stroke","authors":"Hibah Abid Imam","doi":"10.1016/j.jns.2025.123557","DOIUrl":"10.1016/j.jns.2025.123557","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123557"},"PeriodicalIF":3.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain under pressure: Insights into diving-related lesions: a descriptive study","authors":"Nesrine Kouki ,&nbsp;Meriam Messelmani ,&nbsp;Aloui Moncef ,&nbsp;Nour Elhouda Guediche ,&nbsp;Najiba Fekih Mrissa ,&nbsp;Hedi Gharsallah ,&nbsp;Jamel Zaouali","doi":"10.1016/j.jns.2025.123553","DOIUrl":"10.1016/j.jns.2025.123553","url":null,"abstract":"<div><h3>Background</h3><div>Diving-related injuries remain as a significant health threat, when involvement of the central nervous system (CNS). Decompression sickness (DCS), particularly type II involving neurological symptoms, can lead to brain lesions though specific patterns.</div></div><div><h3>Objective</h3><div>This study aims to characterize the clinical and radiological features of brain involvement in diving-related injuries, with a focus on corpus callosum lesions.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study from 2011 to 2023 in the neurology department of a military hospital in Tunis, including divers with acute neurological injuries. Data were collected on diving history, clinical presentations, and radiological findings. MRI protocols included T1, T2, FLAIR, gradient echo, and diffusion-weighted imaging (DWI) sequences.</div></div><div><h3>Results</h3><div>Among 41 enrolled patients, 10 exhibited cerebral involvement, all male professional divers with a mean age of 41 years. Symptoms manifested within 10 min of surfacing in 65.8 % of cases and included sensory-motor deficits, vertigo, and headache. MRI revealed diverse patterns: corpus callosum hyperintensities on T2 FLAIR in five cases, an acute ischemic stroke in one patient, and punctiform or nodular lesions in others. DWI abnormalities suggested both cytotoxic and vasogenic edema.</div></div><div><h3>Conclusion</h3><div>Cerebral DCI presents with variable clinical and radiological patterns. Corpus callosum involvement is a hallmark finding, reflecting its vulnerability to ischemia and vasogenic edema. Early detection through a detailed clinical examination allows targeted follow up and recompression therapy. Future research should focus on integrating clinical and imaging data to identify prognostic factors and improve management strategies<strong>.</strong></div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123553"},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extreme delta brush EEG pattern in anti-LGI1 encephalitis: A case report","authors":"Michael C. Li ,&nbsp;Aaron De Souza","doi":"10.1016/j.jns.2025.123542","DOIUrl":"10.1016/j.jns.2025.123542","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123542"},"PeriodicalIF":3.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal alterations of gray matter microstructure in newly diagnosed relapsing-remitting multiple sclerosis patients: A longitudinal diffusion kurtosis MRI study","authors":"Mikkel K.E. Nygaard ,&nbsp;Morten Riemenschneider ,&nbsp;Tobias Gaemelke ,&nbsp;Ulrik Dalgas ,&nbsp;Simon F. Eskildsen","doi":"10.1016/j.jns.2025.123551","DOIUrl":"10.1016/j.jns.2025.123551","url":null,"abstract":"<div><h3>Background</h3><div>In multiple sclerosis (MS), neurodegeneration occurs in both white matter (WM) and gray matter (GM). Altered GM microstructure, estimated using magnetic resonance imaging (MRI), correlates with clinical disability and demyelinating WM lesions. Therefore, MRI measurements of GM microstructure may be an early biomarker in MS.</div></div><div><h3>Objectives</h3><div>The study aims to investigate the association between the microstructural characteristics of cortical and subcortical GM and clinical disability in newly diagnosed patients with relapsing-remitting MS (RRMS). Secondarily, the study investigates potential longitudinal alterations of tissue microstructure in relation to clinical disability and changes in WM lesion volume.</div></div><div><h3>Methods</h3><div>Eighty-two newly diagnosed RRMS patients were physically and cognitively tested and brain scanned using structural and diffusion kurtosis MRI at baseline and after 48 weeks.</div></div><div><h3>Results</h3><div>At baseline, WM lesion volume correlated with mean diffusivity (MD) in cortex, thalamus (r² = 0.52), caudate (r² = 0.40) and putamen (r² = 0.37), and with thalamus volume (r² = 0.67). Longitudinally, increased lesion volume from baseline to 48 weeks was associated with a spatiotemporal increase in cortical MD.</div></div><div><h3>Conclusions</h3><div>The microstructure of cortical and subcortical GM is associated with both the degree and change of lesion volume in patients with RRMS. Diffusion MRI could serve as a surrogate measure of WM injury and longitudinal neurodegeneration in MS.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123551"},"PeriodicalIF":3.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of zilucoplan in patients with generalised myasthenia gravis who have not previously received immunoglobulin or plasma exchange: A subgroup analysis from the Phase 3 RAISE study","authors":"Kimiaki Utsugisawa ,&nbsp;Masayuki Masuda ,&nbsp;Babak Boroojerdi ,&nbsp;Fiona Grimson ,&nbsp;James F. Howard Jr. ,&nbsp;on behalf of the RAISE Study Team","doi":"10.1016/j.jns.2025.123550","DOIUrl":"10.1016/j.jns.2025.123550","url":null,"abstract":"<div><h3>Background</h3><div>RAISE (<span><span>NCT04115293</span><svg><path></path></svg></span>; <em>N</em> = 174) was a randomised, double-blind, placebo-controlled, Phase 3 study of zilucoplan, a macrocyclic peptide complement component 5 inhibitor, in patients with anti-acetylcholine receptor antibody-positive (AChR Ab+) generalised myasthenia gravis (gMG). Zilucoplan showed clinically meaningful improvements in myasthenia gravis (MG)-specific outcomes versus placebo in the overall population. We assessed the profiles of RAISE patients without and with prior immunoglobulin (intravenous and subcutaneous) or plasma exchange (PLEX) use.</div></div><div><h3>Methods</h3><div>Adults with anti-AChR Ab+ gMG were randomised 1:1 to daily, self-administered, subcutaneous zilucoplan 0.3 mg/kg or placebo for 12 weeks. The primary efficacy endpoint was change from baseline (CFB) to Week 12 in Myasthenia Gravis Activities of Daily Living (MG-ADL) score. We conducted a prespecified, descriptive analysis of subgroups without and with prior immunoglobulin/PLEX.</div></div><div><h3>Results</h3><div>At baseline, 54 patients had no prior immunoglobulin/PLEX (zilucoplan: <em>n</em> = 29; placebo: <em>n</em> = 25); this subgroup had experienced milder disease and shorter disease duration from diagnosis than the subgroup with prior immunoglobulin/PLEX. Mean (standard error) CFB in MG-ADL score was −4.22 (0.71) with zilucoplan versus −2.61 (0.50) with placebo in the subgroup without prior immunoglobulin/PLEX, and − 4.93 (0.54) versus −2.94 (0.50) in the subgroup with prior immunoglobulin/PLEX. Zilucoplan was well tolerated with a similar safety profile in both subgroups.</div></div><div><h3>Conclusions</h3><div>In the RAISE study, patients without prior immunoglobulin/PLEX, who had milder disease, experienced improvements in MG-specific outcomes with zilucoplan that were comparable to those seen in patients with prior immunoglobulin/PLEX. These findings may support early use of zilucoplan in the gMG treatment paradigm.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123550"},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term prognostic value of cranial volume in patients with cerebral hemorrhage based on propensity score matching","authors":"Jianda Sun ,&nbsp;Hongli Zhang ,&nbsp;Shouyue Wu ,&nbsp;Qiunan Yang ,&nbsp;Enzhou Lu ,&nbsp;Chunyang Liu ,&nbsp;Jinyi Guo ,&nbsp;Jian Zhang ,&nbsp;Boxian Zhao ,&nbsp;Qi Shao ,&nbsp;Guang Yang","doi":"10.1016/j.jns.2025.123534","DOIUrl":"10.1016/j.jns.2025.123534","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to investigate whether cranial volume can improve the accuracy of prognosis, and to explore the relationship between the prognosis of patients with cerebral hemorrhage and the cranial volume and anterior and posterior diameter.</div></div><div><h3>Methods</h3><div>We obtained data from patients diagnosed with spontaneous cerebral hemorrhage between 2018 and 2020 at the First Hospital of Harbin Medical University. The hematoma volume to cranial volume ratio (HVCVR) was calculated as the ratio of hematoma volume to cranial volume. Multivariate logistic regression models were developed to assess the predictive power of hematoma volume and HVCVR. Propensity score matching was employed to adjust for baseline differences in cranial volume. Multiple logistic regression models were used to explore the relationship between cranial diameter and prognosis.</div></div><div><h3>Results</h3><div>Among 3494 patients, 1,796 (51.4%) had poor outcomes. Poor outcomes were associated with larger HVCVR values, and multivariate analysis confirmed HVCVR as an independent predictor (OR 1.722, 95 % CI 1.471–2.206, <em>P</em> &lt; 0.001), outperforming hematoma volume alone (AUC 0.774 vs. 0.761, P &lt; 0.001). Propensity-matched cohorts (<em>n</em> = 1199 each) revealed that larger intracranial volume correlated with better prognosis (OR 0.802, 95 % CI 0.683–0.942, <em>P</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>Our study suggests that HVCVR provides a more accurate prediction of prognosis in spontaneous cerebral hemorrhage patients. Greater cranial volume and a more flattened cranial cavity may potentially influence positive prognoses in patients with cerebral hemorrhage.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123534"},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cerebral collateral recycle on outcomes for patients with large ischemic infarct undergoing endovascular treatment","authors":"Zhiyuan Wang ,&nbsp;Shuyu Jiang ,&nbsp;Chen Gong ,&nbsp;Zhongsong Xiao ,&nbsp;Liping Huang ,&nbsp;Lihong Wen ,&nbsp;Yi Luo ,&nbsp;Yunyi Huang ,&nbsp;Yuetao Wen ,&nbsp;Zhiyu Xiong ,&nbsp;Ziyi Li ,&nbsp;Jin Liu ,&nbsp;Jing Guo ,&nbsp;Shengli Chen ,&nbsp;Tao Xu ,&nbsp;Yangmei Chen","doi":"10.1016/j.jns.2025.123538","DOIUrl":"10.1016/j.jns.2025.123538","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Although several large clinical trials have shown that endovascular treatment (EVT) is beneficial for patients with large core infarction, their outcomes were still much worse than those with mild infarction. Therefore, given the cerebral collateral recycle (CCR) as an effective prognostic marker, this study explored the relationship between CCR and clinical outcomes in patients with large ischemic infarct.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). Extensive baseline infarction was defined by ASPECTS ≤5 on admission computed tomography (CT). CCR was determined by quantifying pial arterial collaterals and venous outflow (VO) based on admission CT angiography. Patients were divided into two groups by CCR status. The primary outcomes was the favorable outcomes (90-day modified Rankin Scale score of ≤3).</div></div><div><h3>Results</h3><div>Among 860 AIS-LVO patients receiving EVT, 140 patients met the inclusion criteria. In multivariable binary logistic regression analysis, compared with the unfavorable CCR group, the favorable CCR group had a higher rate of favorable outcomes at 90 days (84.62 % vs 32.46 %, aOR 8.08, 95 % CI 2.13–30.62, <em>P</em> = .002). In a subgroup analysis, similar results were found that favorable CCR group achieved a higher proportion of 90-day mRS 0–3.</div></div><div><h3>Conclusions</h3><div>The favorable collateral circulation including arterial inflow combined with venous outflow in AIS-LVO patients with extensive baseline infarction is associated with better clinical outcomes. CCR status could serve as a valuable imaging biomarker for outcomes prediction.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"474 ","pages":"Article 123538"},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}