Neurology International最新文献

{"title":"Shifting Outcomes: Superior Functional Recovery in Embolic Stroke of Undetermined Source Compared to Cardioembolic Stroke.","authors":"Jessica Seetge, Balázs Cséke, Zsófia Nozomi Karádi, Edit Bosnyák, László Szapáry","doi":"10.3390/neurolint17030035","DOIUrl":"10.3390/neurolint17030035","url":null,"abstract":"<p><strong>Background/objectives: </strong>An embolic stroke of undetermined source (ESUS) is a subtype of ischemic stroke characterized by a non-lacunar infarct in the absence of a clearly identifiable embolic source, despite comprehensive diagnostic evaluation. While ESUS patients are typically younger, have fewer cardiovascular comorbidities, and experience milder strokes than those with cardioembolic strokes (CEs), their functional recovery remains underexplored.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 374 ischemic stroke patients (<i>n</i> = 94 ESUS, <i>n</i> = 280 CE) admitted to the Department of Neurology, University of Pécs, between February 2023 and September 2024. Functional recovery was assessed using the modified Rankin Scale (mRS). Propensity score matching (PSM) was performed to balance the baseline characteristics, and the mRS-shift was compared between groups. Independent predictors of mRS-shift were identified using Huber regression and extreme gradient boosting (XGBoost).</p><p><strong>Results: </strong>The ESUS patients were significantly younger (60.7 ± 13.8 years vs. 75.1 ± 11.3 years, <i>p</i> < 0.001), had lower pre-morbid modified Rankin Scale (pre-mRS) scores (0.34 ± 0.91 vs. 0.81 ± 1.23, <i>p</i> < 0.001), were less likely to have hypertension (75.5% vs. 86.1%, <i>p</i> = 0.027) and diabetes (23.4% vs. 36.8%, <i>p</i> = 0.024), and presented with milder strokes (National Institutes of Health Stroke Scale [NIHSS] score at admission: 5.4 ± 4.5 vs. 8.1 ± 6.3, <i>p</i> < 0.001, and 72 h post-stroke: 3.0 ± 4.4 vs. 6.5 ± 6.3, <i>p</i> < 0.001) compared to the CE patients. After adjusting for baseline differences, the ESUS patients demonstrated significantly greater functional recovery than the CE patients (adjusted mRS-shift: 1.84 ± 1.14 vs. 2.53 ± 1.69, <i>p</i> = 0.022). Age, pre-mRS score, and NIHSS score at 72 h post-stroke were the strongest predictors of mRS-shift, with an older age, a higher pre-mRS score, and a greater stroke severity significantly decreasing the odds of recovery.</p><p><strong>Conclusions: </strong>The ESUS patients showed superior functional recovery compared to the CE patients, even after accounting for baseline differences. These findings highlight the need for further research into the pathomechanisms underlying ESUSs and the development of optimal treatment strategies to improve patient outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Percutaneous Nerve Stimulation in Post-Stroke Spasticity: A Case Report.","authors":"Francesco Sartori, Albert Puig-Diví, Javier Picañol","doi":"10.3390/neurolint17030034","DOIUrl":"10.3390/neurolint17030034","url":null,"abstract":"<p><strong>Introduction: </strong>Post-stroke spasticity (PSS) significantly impacts the quality of life for stroke survivors. While various treatments exist, options for refractory cases are limited. Ultrasound-guided percutaneous peripheral nerve stimulation (pPNS), commonly used in pain management, has not been studied for its potential use in spasticity management. This case report aims to evaluate the sensorimotor effects of pPNS in a patient with severe PSS.</p><p><strong>Case description: </strong>A 38-year-old male with severe PSS and functional limitations post-ischemic stroke in the middle cerebral artery underwent a six-week pPNS protocol (12 sessions). Low-frequency (2 Hz) stimulation targeted the median, musculocutaneous, and anterior interosseous nerves, while medium-frequency (10 Hz) stimulation targeted the posterior interosseous and radial nerves. Spasticity was assessed using the Modified Ashworth Scale (MAS) and Tardieu Scale (TS). Somatosensory assessments included tactile thresholds, pressure pain thresholds, and conditioned pain modulation (CPM).</p><p><strong>Outcomes: </strong>Spasticity decreased significantly, with reductions of 60.4% and 67.0% in elbow and wrist MAS scores, respectively, and a 49.5% reduction in TS scores. However, spasticity levels returned to baseline between sessions. Somatosensory assessments revealed increased tactile thresholds, decreased pressure pain thresholds, and an 81.3% reduction in CPM. The intervention was well tolerated, with minor transient effects, and the patient preferred pPNS over botulinum toxin injections.</p><p><strong>Conclusions: </strong>pPNS may effectively reduce spasticity and modulate somatosensory thresholds in PSS. These preliminary findings highlight its potential as an alternative treatment for refractory PSS, warranting further research with larger sample sizes and control groups to assess its broader clinical applicability.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking Migraine Symptoms: A Longitudinal Comparison of Smartphone-Based Headache Diaries and Clinical Interviews.","authors":"Nicolas Vandenbussche, Jonas Van Der Donckt, Mathias De Brouwer, Bram Steenwinckel, Marija Stojchevska, Femke Ongenae, Sofie Van Hoecke, Koen Paemeleire","doi":"10.3390/neurolint17030033","DOIUrl":"10.3390/neurolint17030033","url":null,"abstract":"<p><p><b>Background/Objectives:</b> By leveraging the capabilities of a smartphone-based headache diary, the objective of this study was to determine the amount of agreement between migraine-associated symptomatology during headache events and the symptoms documented during clinician-led intake interviews. <b>Methods</b>: This was a 90-day longitudinal, smartphone-based headache calendar study for participants diagnosed with migraine. Registered headache events were labeled as \"definite migraine\", \"probable migraine\", and \"not migraine\" in accordance with the International Classification of Headache Disorders, Third Edition (ICHD-3) criteria. Symptoms' agreement with clinician-led intake interviews (agreement percentages and kappa coefficients), symptoms' similarity between headache events within users (percentage), and amount of newly registered ICHD-3 symptoms per participant were calculated. <b>Results</b>: Twenty-seven participants provided 505 headache events eligible for analysis. The median agreement between recorded headache event symptomatology and clinician-led intake interview phenotyping ranged between 40% (for events fulfilling \"not migraine\" criteria) and 55.5% (\"definite migraine\") (<i>p</i> < 0.001). Higher intraparticipant headache event pair similarity was observed for \"definite migraine\" pairs (<i>p</i> < 0.01), along with a decreasing trend in similarity as the attack-pair headache distance increases. Over half of the participants registered at least one new ICHD-3 symptom during the study. <b>Conclusions</b>: Electronic diary registrations show substantial longitudinal variability in intrapersonal headache symptomatology, with the similarity of headache events declining over time. The registration of a new ICHD-3 symptom was the rule rather than the exception.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Approach to Cerebral Vasospasm and Delayed Cerebral Ischemia: Milrinone as a Therapeutic Option-A Narrative Literature Review and Algorithm Treatment Proposition.","authors":"Pedro Batarda Sena, Marta Gonçalves, Bruno Maia, Margarida Fernandes, Luís Bento","doi":"10.3390/neurolint17030032","DOIUrl":"10.3390/neurolint17030032","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurocritical condition often complicated by cerebral vasospasm (CVS), leading to delayed cerebral ischemia (DCI) and significant morbidity and mortality. Despite advancements in management, therapeutic options with robust evidence remain limited. Milrinone, a phosphodiesterase type 3 (PDE3) inhibitor, has emerged as a potential therapeutic option. Intravenous milrinone demonstrated clinical and angiographic improvement in 67% of patients, reducing the need for mechanical angioplasty and the risk of functional disability at 6 months (mRS ≤ 2). Side effects, including hypotension, tachycardia, and electrolyte disturbances, were observed in 33% of patients, occasionally leading to early drug discontinuation. Based on the evidence, we propose a treatment algorithm for using milrinone to optimize outcomes and standardize its application in neurocritical care settings.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic Issue: \"Translational Advances in Neurodegenerative Dementias\".","authors":"Annibale Antonioni, Francesco Di Lorenzo","doi":"10.3390/neurolint17020031","DOIUrl":"10.3390/neurolint17020031","url":null,"abstract":"<p><p>Neurodegenerative dementia, a collective term for a range of disorders characterized by progressive cognitive and functional decline, is an urgent challenge in global healthcare [...].</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Metabolites as Potential Indicators of Recovery After Large Vessel Occlusion Stroke: A Pilot Study.","authors":"Evgeny V Sidorov, Kyle Smith, Chao Xu, Dharambir K Sanghera","doi":"10.3390/neurolint17020030","DOIUrl":"10.3390/neurolint17020030","url":null,"abstract":"<p><p><b>Introduction:</b> Serum metabolome changes after acute ischemic stroke (AIS), but the significance of this is poorly understood. We evaluated whether this change is associated with AIS outcomes in patients with large vessel occlusion (LVO). To improve validity, we combined cross-sectional and longitudinal designs and analyzed serum using Nuclear Magnetic Resonance (NMR) and Liquid Chromatography-Mass Spectrometry (LC-MS). <b>Methodology:</b> In the cross-sectional part, we compared serum metabolome from 48 LVO strokes, collected at 48-72 h, and analyzed with NMR, while in the longitudinal part, we compared metabolome from 15 LVO strokes, collected at <24 h, 48-72 h, 5-7 days, and 80-120 days, and analyzed with LC-MS between patients with modified Rankin Scores (mRS) of 0-3 and 4-6 at 90 days. We hypothesized that compounds elevated in patients with mRS 0-3 in the cross-sectional part would also be elevated in the longitudinal part, and vice versa. We used regression for the analysis and TSBH for multiple testing. <b>Results:</b> In the cross-sectional part, cholesterol, choline, phosphoglycerides, sphingomyelins, and phosphatidylethanolamines had lower levels in patients with an mRS of 0-3 compared to an mRS of 4-6. In the longitudinal part, lower levels of sphingomyelin (d18:1/19:0, d19:1/18:0)* significantly correlated with an mRS of 0-3 in patients with small infarction volume, while lower levels of sphingolipid N-palmitoyl-sphingosine (d18:1/16:0), 1-palmitoyl-2-docosahexaenoyl-GPC (16:0/22:6), 1-palmitoyl-2-docosahexaenoyl-GPE, palmitoyl-docosahexaenoyl-glycerol (16:0/22:6), campesterol, and 3beta-hydroxy-5-cholestenoate correlated with an mRS of 0-3 in patients with large infarction volume. <b>Conclusions:</b> This pilot study showed that lower levels of lipidomic components nerve cell membrane correlate with good AIS outcomes. If proven on large-scale studies, these compounds may become important AIS outcome markers.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology and Mortality of Nonconvulsive Status Epilepticus.","authors":"Firdevs Ezgi Uçan Tokuç, Emine Görgülü, Fatma Genç, Meltem Korucuk, Abidin Erdal, Yasemin Biçer Gömceli","doi":"10.3390/neurolint17020029","DOIUrl":"10.3390/neurolint17020029","url":null,"abstract":"<p><strong>Objectives: </strong>Nonconvulsive status epilepticus (NCSE) is a disease with a high mortality rate and a very diverse etiology. The disease prognosis is related to the etiology. We aimed to investigate the etiology, mortality rates, and factors affecting mortality in patients diagnosed with NCSE in a tertiary epilepsy center in Turkey.</p><p><strong>Methods: </strong>All electroencephalograms (EEGs) were taken in the EEG laboratory of the Department of Neurology, Antalya Training and Research Hospital, between June 2021 and February 2024. Patients who met the Salzburg Consensus Criteria (SCC) for NCSE were included. Demographic data, etiologic factors, comorbidities, neuroradiological imaging, laboratory data, treatments administered for NCSE and responses to treatment, short- and long-term outcomes, and EEG findings at follow-up, if any, were noted from the medical records of all patients who met the criteria.</p><p><strong>Results: </strong>A total of 200 patients were included in the study. Mortality was observed in 76 (38.4%) patients with NCSE. There was a statistically significant correlation between NCSE etiology and mortality (<i>p</i> < 0.001). Mortality was most common in patients with cerebral tumors as the etiology, with a rate of 63.6%. The lowest mortality rate was observed in patients with autoimmune encephalitis and epilepsy (14.3% and 17.2%, respectively). After appropriate antiseizure medication (ASM) treatment, 117 (58.5%) patients with NCSE improved. When post-treatment improvement and etiologic factors were analyzed, the highest rate of improvement was observed in the autoimmune encephalitis and CVD groups.</p><p><strong>Conclusions: </strong>Our study showed that advanced age and the presence of stroke are associated with mortality and that patients with NCSE due to autoimmune encephalitis respond well to treatment.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metachromatic Leukodystrophy Presenting with Multiple Cranial Nerve and Lumbosacral Nerve Root Enhancement Without White Matter Changes.","authors":"Ruben Jauregui, Mekka R Garcia, Thomas Mehuron, Steven L Galetta, Devorah Segal","doi":"10.3390/neurolint17020028","DOIUrl":"10.3390/neurolint17020028","url":null,"abstract":"<p><p><b>Background</b>: Metachromatic leukodystrophy (MLD) is a rare autosomal recessive disorder that causes demyelination of both the central (CNS) and peripheral nervous systems (PNS). <b>Objective</b>: This study aims to report a unique MLD case presenting with cranial neuropathies and ataxia, initially without white matter changes on MRI, leading to diagnostic uncertainty. <b>Results</b>: A 20-month-old presented with bilateral abduction deficits, facial diplegia, and ataxia, raising the possibility of an acquired demyelinating condition. An MRI scan showed the enhancement of multiple cranial nerves, but normal white matter. A follow-up MRI showed new white matter changes that spared the U-fibers, suggesting a leukodystrophy. Biochemical assays were suggestive of metachromatic leukodystrophy, which was confirmed with genetic testing demonstrating a homozygous c.848+3A > G variant in <i>ARSA</i>. <b>Conclusions</b>: Our patient suggests that the initial presentation of MLD may mimic an acquired demyelinating condition and manifest with multiple cranial nerve palsies before more typical white matter changes evolve.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11857969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Statin Therapy with Functional Outcomes and Survival in Intracerebral and Subarachnoid Hemorrhage.","authors":"Bahadar S Srichawla, Daksha Gopal, Majaz Moonis","doi":"10.3390/neurolint17020027","DOIUrl":"10.3390/neurolint17020027","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) are severe forms of stroke with high morbidity and mortality rates. HMG-CoA reductase inhibitors, commonly referred to as statins, known for their lipid-lowering abilities, also possess pleiotropic properties, including anti-inflammatory and neuroprotective effects. We aimed to evaluate the impact of statin therapy on the functional outcomes and survival in patients with ICH and SAH. <b>Methods</b>: This retrospective cohort study analyzed data from the Get With The Guidelines (GWTG) stroke registry at a tertiary care center, including patients diagnosed with ICH or SAH between January 2008 and June 2022. Patients were categorized based on prior initiation of statin therapy: no statin, low-intensity statin, or high-intensity statin. The primary outcome was the Modified Rankin Scale (mRS) score at discharge, dichotomized to good (0-2) and poor (3-6) outcomes. A multivariate logistic regression model controlled for age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission. <b>Results</b>: A total of 663 patients with ICH and 159 patients with SAH were included in the analysis. In the ICH patients, low-intensity statin therapy was associated with significantly higher odds of a good functional outcome (aOR 2.56, 95% CI 1.247-5.246, <i>p</i> = 0.0104), as was high-intensity statin therapy (aOR 2.445, 95% CI 1.313-4.552, <i>p</i> = 0.0048). Among the SAH patients, all 39 deaths occurred in the no statin therapy group. <b>Conclusions</b>: Both low- and high-intensity statin therapy are associated with improved functional outcomes in ICH and may offer a survival benefit in SAH. These findings highlight the potential neuroprotective role of statins in hemorrhagic stroke. Further prospective studies and randomized controlled trials are needed to confirm these observations and to clarify the optimal use of statins in this patient population.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac CT in Large Vessel Occlusion Stroke for the Evaluation of Non-Thrombotic and Non-Atrial-Fibrillation-Related Embolic Causes.","authors":"Karim Mostafa, Cosima Wünsche, Sarah Krutmann, Carmen Wolf, Schekeb Aludin, Naomi Larsen, Alexander Seiler, Domagoj Schunk, Olav Jansen, Hatim Seoudy, Patrick Langguth","doi":"10.3390/neurolint17020025","DOIUrl":"10.3390/neurolint17020025","url":null,"abstract":"<p><p><b>Background:</b> The purpose of this study is the evaluation of imaging findings of acute-phase cardiac CT (cCT) in stroke patients with large vessel occlusion (LVO) to identify potential cardioembolic sources (CES) in patients without intracardiac thrombi and atrial fibrillation (AF). <b>Material and Methods:</b> This retrospective study included 315 patients with LVO who underwent cCT imaging in the acute stroke setting. The images were analysed for 15 imaging findings following the established minor and major cardioembolic risk factors. The final stroke aetiology was determined using the TOAST classification through interdisciplinary consensus following a thorough clinical evaluation. Multivariate regression analysis was performed to identify imaging findings associated with CES. <b>Results:</b> A cardioembolic aetiology was identified on cardiac CT in 211 cases (70%). After adjustment for AF and intracardiac thrombi, the multivariate regression analysis revealed significant associations with left ventricular dilation (adjusted odds-ratio (AOR) 32.4; 95% CI 3.0-349; <i>p</i> = 0.004), visible interatrial right-to-left shunt (AOR 30.8; 95% CI 2.7-341.3; <i>p</i> = 0.006), valve implants (AOR 24.5; 95% CI 2.2-270.9; <i>p</i> = 0.009), aortic arch atheroma grade > II (AOR 6.9; 95% CI 1.5-32.8; <i>p</i> = 0.015) and post-ischaemic myocardial scars (AOR 6.3, 95% CI 1.2-34.1; <i>p</i> = 0.032) as independent risk factors for a cardioembolic aetiology. The combined model achieved an area under the ROC curve of 0.83. <b>Conclusions:</b> In patients with LVO without AF and intracardiac thrombi as a cause, the presence of left ventricular dilatation, interatrial right-to-left shunts, valve implants, post-ischaemic myocardial scarring and advanced aortic arch atheroma (grade > 2) in particular is significantly associated with a cardioembolic cause of stroke and should be add-on evaluated in acute-phase cCT. Further investigations are warranted to confirm these associations.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}