Neurologia最新文献

{"title":"Déficit de arginasa-1 de inicio en la edad adulta que simula una paraparesia espástica hereditaria","authors":"F. Castellanos-Pinedo , J.M. Morán-López , S. Moreno-Pulido , B. Rodríguez-Fúnez , I. Royo Boronat","doi":"10.1016/j.nrl.2025.501943","DOIUrl":"10.1016/j.nrl.2025.501943","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 501943"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148415691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Dysautonomia after COVID-19 infection: A case report”: The pathophysiology of COVID-19-related posterior reversible encephalopathy syndrome revisited","authors":"M. León-Ruiz, C. Castañeda-Cabrero, J. Benito-León","doi":"10.1016/j.nrl.2025.501944","DOIUrl":"10.1016/j.nrl.2025.501944","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 501944"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnóstico y tratamiento del infarto maligno de arteria cerebral media e infarto cerebeloso con efecto masa. Recomendaciones del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología","authors":"F. Moniche,&nbsp;A. Ponz,&nbsp;E. López-Cancio Martinez,&nbsp;M. Rubiera,&nbsp;M.A. de Leciñana,&nbsp;O. Ayo,&nbsp;M. Castellanos,&nbsp;J.C. López Fernández,&nbsp;J. Marta-Moreno,&nbsp;A.M. Morales,&nbsp;J.M. Ramirez-Moreno,&nbsp;S. Tur,&nbsp;Á. Ximénez-Carrillo,&nbsp;M. Freijo Guerrero","doi":"10.1016/j.nrl.2026.502014","DOIUrl":"10.1016/j.nrl.2026.502014","url":null,"abstract":"<div><h3>Objective</h3><div>To update the recommendations of the Cerebrovascular Diseases Study Group of the Spanish Society of Neurology on the diagnosis and treatment of malignant infarction of the middle cerebral artery (MCA) and malignant cerebellar infarction, including the role of decompressive craniectomy.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was conducted in PubMed, selecting clinical trials and meta-analyses that evaluated malignant infarction as an independent variable. PICO (Patient, Intervention, Comparison, Outcome) questions were formulated to identify practical aspects of diagnosis and medical and surgical management in patients with malignant infarction. Based on the results, recommendations were developed for each PICO question.</div></div><div><h3>Conclusions</h3><div>An evidence-based definition of malignant MCA infarction and malignant cerebellar infarction is proposed. Clinical trials evaluating anti-edema measures such as osmotherapy or hypothermia have not demonstrated a reduction in mortality or disability. The number needed to treat (NNT) to prevent one death with decompressive craniectomy in MCA infarctions in patients &lt;60 years is 2, and 4 to achieve survival with a modified Rankin Scale (mRS) score ≤3. In patients aged 60–75 years, decompressive craniectomy reduces mortality but at the cost of severe disability; therefore, it is not routinely recommended. Suboccipital decompressive craniectomy should be considered, either as a primary indication or after failure of ventricular drainage, in patients with extensive cerebellar infarction and neurological deterioration due to brainstem compression.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502014"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical determinants of decision-making for extended-window intravenous thrombolysis","authors":"I. Schonewille,&nbsp;J. Juega,&nbsp;M. Iza,&nbsp;M. Ribo,&nbsp;C. Molina,&nbsp;R. Simonetti,&nbsp;F. Rizzo,&nbsp;M. Olive,&nbsp;N. Rodríguez-Villatoro,&nbsp;D. Rodriguez,&nbsp;M. Rodrigo,&nbsp;A. Nevado,&nbsp;A. Garcia-Tornel,&nbsp;M.A. Muchada,&nbsp;J. Pagola,&nbsp;M. Rubiera","doi":"10.1016/j.nrl.2026.502013","DOIUrl":"10.1016/j.nrl.2026.502013","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent trials promote extending intravenous thrombolysis (IVT) window for acute ischemic stroke (AIS) beyond 4.5<!--> <!-->h in selected patients. We aimed to evaluate the extended-window (EWIVT) decision-making and outcomes in routine clinical practice.</div></div><div><h3>Methods</h3><div>Retrospective analysis of a prospective uni-center mandatory stroke registry. AIS patients presenting within 4.5–9<!--> <!-->h from symptoms or wake-up strokes with mismatch on computed tomography perfusion (CTP) and/or intracranial occlusion without indication for thrombectomy were selected. We studied factors related to EWIVT treatment decision and compared efficacy (24<!--> <!-->h clinical improvement, 3-months modified Rankin Scale) and safety outcomes (symptomatic intracranial hemorrhage (SICH)).</div></div><div><h3>Results</h3><div>We included 79 patients (51.9% male, mean age 72.2y). Fifty-four (68.4%) had intracranial occlusion and 25(31.6%) CTP-mismatch. Twenty-two patients (27.8%) received EWIVT. EWIVT patients had similar baseline severity [NIHSS 4.5 (2.0–6.0) vs. 4.0 (2.0–6.5); <em>p</em> <!-->=<!--> <!-->0.596], higher ASPECTS [10.0 (10.0–10.0) vs. 10.0 (9.0–10.0); <em>p</em> <!-->=<!--> <!-->0.010] and more often presented with aphasia (63.6% vs. 24.6%; <em>p</em> <!-->=<!--> <!-->0.001). An adjusted logistic regression analysis showed that main predictors of EWIVT were higher ASPECTS and left hemisphere stroke. Clinical improvement at 24<!--> <!-->h was more frequent in the EWIVT group (77.3% vs. 36.8%; aOR 5.02 [95%CI 1.33–18.90]; <em>p</em> <!-->=<!--> <!-->0.017) and no patient experienced SICH, but a non-significant better functional outcome was found in the control group (aOR 0.19 [95% CI 0.03–1.19]; <em>p</em> <!-->=<!--> <!-->0.076).</div></div><div><h3>Conclusions</h3><div>Patients with a left hemisphere stroke and/or higher ASPECTS were more likely to be treated with EWIVT. EWIVT was safe and induced early clinical improvement, but did not lead to better functional outcome at 3 months.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502013"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leucoencefalopatía extensa aguda secundaria a intoxicación por fentanilo transdérmico y tapentadol oral: a propósito de un caso","authors":"M. Massons,&nbsp;J.L. Núñez-Pizarro,&nbsp;J. Zapatero,&nbsp;N. Bargalló,&nbsp;C. Gaig,&nbsp;E. Muñoz","doi":"10.1016/j.nrl.2025.501945","DOIUrl":"10.1016/j.nrl.2025.501945","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 501945"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio Delphi sobre epidemiología, manejo clínico, carga de la enfermedad y tratamiento en pacientes pediátricos con distrofia muscular de Duchenne en España","authors":"I. Pitarch-Castellano,&nbsp;C.I. Ortez-González,&nbsp;A. Nascimento-Osorio,&nbsp;P. Aguilera López,&nbsp;M.O. Blanco Barca,&nbsp;A. Camacho-Salas,&nbsp;O. García-Campos,&nbsp;M.C. García-Jiménez,&nbsp;M. García-Romero,&nbsp;D. Gómez-Andrés,&nbsp;M.A. Grimalt-Calatayud,&nbsp;A. Hernández-Fabián,&nbsp;I. Málaga-Diéguez,&nbsp;M. Madruga-Garrido,&nbsp;I. Marti-Carrera,&nbsp;L. Martín-Viota,&nbsp;M.J. Martínez-García,&nbsp;J.M. Ramos-Fernández,&nbsp;R. Sánchez-Carpintero Abad,&nbsp;S. Vázquez-Martín,&nbsp;A. Giró-Perafita","doi":"10.1016/j.nrl.2025.502007","DOIUrl":"10.1016/j.nrl.2025.502007","url":null,"abstract":"<div><h3>Introduction</h3><div>Duchenne muscular dystrophy (DMD) is a rare hereditary disease caused by mutations in the DMD gene that lead to progressive muscle weakness and degeneration.</div></div><div><h3>Methodology</h3><div>Twenty paediatric neurologists with expertise in the management of patients with DMD in Spain participated in the two-round Delphi study. The first questionnaire was developed based on a literature review, and the responses were analysed using descriptive statistics. The prevalence and incidence of DMD were estimaded considering the number of patients reported by the experts and the population covered by the hospitals, and were extrapolated to the male population in Spain.</div></div><div><h3>Results</h3><div>And estimated 618 paediatric patients have b een diagnosed with DMD in Spain. The age of diagnosis is around 3 (IQR 3-3.9) years and the age of initiation of glucocorticoid treatment is 5 (IQR 4-5) years. Loss of ambulation is estimated at 13 (IQR 12-13.5) years. Deflazacort is the most widely used treatment in Spain. The main adverse effects are growth delay, weight gain, bone metabolism problems, and Cushingoid appearance.</div></div><div><h3>Conclusion</h3><div>The study reports uptaded data on the epidemiology and clinical management of DMD in Spain. It also highlights the importance of early diagnosis, multidisciplinary management and the need for a new therapy that improves the safety profile of traditional glucocorticoids to provide an improved quality of life for patients with DMD.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502007"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in plasma glutamate in hemodialysis-related-headache patients: A pilot study","authors":"M. Sobrado,&nbsp;P. Alcantara-Miranda,&nbsp;A.M. Ruiz-Tornero,&nbsp;I. Fernández-Lázaro,&nbsp;M. Giorgi,&nbsp;P. Sobrino,&nbsp;P. Zubiaur,&nbsp;D. Koller,&nbsp;A. Wojnicz,&nbsp;G. Zapata-Wainberg,&nbsp;F. Abad-Santos,&nbsp;J. Vivancos,&nbsp;B. Guillermina,&nbsp;A. Gago-Veiga","doi":"10.1016/j.nrl.2026.502015","DOIUrl":"10.1016/j.nrl.2026.502015","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to determine the profile of glutamate in hemodialysis-related headache (HDH) patients compared to those without HDH.</div></div><div><h3>Background</h3><div>HDH is a frequent complication in patients undergoing hemodialysis, although little is known about its pathophysiology.</div></div><div><h3>Methods</h3><div>Pilot observational and prospective study. Blood samples of patients consecutively recruited with end-stage renal disease undergoing hemodialysis were obtained at onset, at the first 30<!--> <!-->min, and at 4<!--> <!-->h of the hemodialysis session. Glutamate and ALT, AST plasma levels were analyzed at these three stages. Patients were classified into HDH and non-HDH groups. Hospital charts were revised for clinical history and other laboratory results.</div></div><div><h3>Results</h3><div>Thirty patients (60% males, mean age 70.2<!--> <!-->±<!--> <!-->10.5 years) attending the Hemodialysis Unit were included. Nine (30%) experienced HDH. The whole sample showed a significant reduction of glutamate and an increase of ALT and AST along hemodialysis. Specifically, the magnitude of the reduction of plasma glutamate levels concentration in HDH group was stable during the 30<!--> <!-->min and presented a significant posterior reduction, opposite to the evolution in non-HDH patients.</div></div><div><h3>Conclusions</h3><div>HDH was associated with a higher variation in plasma glutamate levels with a particular hemodialysis clearance profile, useful to detect patients with a higher susceptibility of developing HDH and receive preventive measures. In conclusion, HDH-group had a later drop in glutamate that could be related to HDH development. Other modalities with more prolonged solute clearance could be considered. We hope the findings of this study will help promote more research to interpret the role of glutamate variations in patients with hemodialysis related headaches.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502015"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148573371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myasthenia gravis in Spain: A survey of specialized neurologists to uncover unmet needs","authors":"E. Cortés-Vicente ,&nbsp;C. Casasnovas ,&nbsp;R. Juntas ,&nbsp;T. Sevilla ,&nbsp;J. Pardo ,&nbsp;F. Rodríguez de Rivera ,&nbsp;A. Guerrero Sola","doi":"10.1016/j.nrl.2025.501912","DOIUrl":"10.1016/j.nrl.2025.501912","url":null,"abstract":"<div><h3>Introduction</h3><div>Myasthenia gravis (MG) is a neuromuscular autoimmune disease that requires prompt diagnosis and management by neurologists. The challenges of MG management are associated with the diagnostic process and the selection of an effective form of therapy enabling long-term remission of the disease. The objective of this study was to assess the state of MG in Spain to identify unaddressed needs in the clinical progression, diagnosis, and treatment approaches.</div></div><div><h3>Methods</h3><div>A survey was distributed via email between 19 July and 25 October 2022 to neurologists belonging to the Spanish Society of Neurology. A comprehensive descriptive analysis was conducted on all collected data.</div></div><div><h3>Results</h3><div>In total, 69 completed surveys, representing 64 Spanish hospitals, were analyzed and included in the results. The study identified that economic difficulties, such as departmental budgets, have led to a lack of access to antibody testing during diagnosis. Furthermore, corticosteroids were found to achieve the best clinical response, despite also being associated with a higher frequency of adverse effects. The results show that 34% of patients with MG present active symptoms. Eighteen percent have symptoms that limit their daily activities. Additionally, 29% of patients have requested an unscheduled follow-up visit within the last year.</div></div><div><h3>Conclusions</h3><div>Several areas present unmet needs in terms of improving access to diagnostic assays, residual disease burden in treated patients, and the management and diagnosis of MG.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501912"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining therapeutics in vATTR: Evaluation of response predictors to tafamidis and patisiran treatment in a non-endemic area. A proposal for a novel individualised therapeutic approach","authors":"L. Martínez-Vicente ,&nbsp;V. Gajate-García ,&nbsp;G. Gutiérrez-Gutiérrez ,&nbsp;Á.L. Guerrero-Peral ,&nbsp;A. Horga ,&nbsp;A. Guerrero-Sola ,&nbsp;J. Álvarez-Troncoso ,&nbsp;M.A. Restrepo-Córdoba ,&nbsp;J. Goirigolzarri-Artaza ,&nbsp;S. Martín-Albarrán ,&nbsp;A. Valverde-Megías ,&nbsp;E. González-López ,&nbsp;P. García-Pavía ,&nbsp;J. Matías-Guiu ,&nbsp;L. Galán-Dávila","doi":"10.1016/j.nrl.2025.501920","DOIUrl":"10.1016/j.nrl.2025.501920","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary transthyretin amyloidosis (vATTR) is a progressive genetic disorder with several approved treatments. We investigated treatment responses to tafamidis and patisiran in vATTR patients to identify predictive response factors.</div></div><div><h3>Methods</h3><div>Retrospective analysis on vATTR patients treated with tafamidis or patisiran from October 2012 to September 2022. Treatment responses were assessed as “good,” “partial,” or “non-response.” We analysed pre-treatment clinical and laboratory data to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>Of the 53 patients, 44 received tafamidis and 23 received patisiran; 14 were treated with both drugs sequentially. Predictors of good response to tafamidis were shorter diagnostic delay (≤1 year), less severe neurological impairment (Coutinho stage 1, Neuropathy Impairment Score [NIS]<!--> <!-->≤<!--> <!-->7), and better sudomotor function in the feet (≥50<!--> <!-->μS) before treatment. Factors associated with non-response were greater disability (baseline Polyneuropathy Disability score<!--> <!-->=<!--> <!-->2), large fibre involvement, and significant weight loss. Predictors of a good response to patisiran included lower pre-treatment disease severity (Coutinho stage 1, NIS<!--> <!-->≤<!--> <!-->40). We propose an individualised therapeutic approach using predictive factors to guide initial treatment.</div></div><div><h3>Conclusions</h3><div>This study identifies predictive factors for response to tafamidis and patisiran in vATTR patients, highlighting baseline NIS as a critical predictor. We propose a novel therapeutic algorithm for personalised treatment strategies with potential to avoid years of ineffective treatment.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501920"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto de la hipertensión arterial en el ictus. ¿Existen distintos perfiles de edad?","authors":"L. Castilla-Guerra ,&nbsp;M.C. Fernandez-Moreno ,&nbsp;M. de la Serna Fito ,&nbsp;A. Palomino-Garcia ,&nbsp;G.A. Escobar Rodriguez ,&nbsp;M.D. Jiménez Hernandez","doi":"10.1016/j.nrl.2025.501913","DOIUrl":"10.1016/j.nrl.2025.501913","url":null,"abstract":"<div><h3>Introduction</h3><div>Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤<!--> <!-->50 years, between 51-79 years and ≥<!--> <!-->80 years.</div></div><div><h3>Results</h3><div>Of 42,855 strokes, 2,141 (4.9%) hypertensive patients with a first stroke, mean age 68 (±15) years, and 1,010 (47.2%) women, were included. Included were 1,274 (59.5%) ischemic strokes and 867 (40.5%) hemorrhagic strokes, 309 (14.4%) patients ≤<!--> <!-->50 years of age, 1,253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥<!--> <!-->80 years. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs. 51.3% vs. 79.4% (p<!--> <!-->&lt;<!--> <!-->0.001), with a mean time from diagnosis to stroke of 5.5 (±3.7) vs. 7.8 (±4.9) vs. 9.6 (±5.1) years (p<!--> <!-->&lt;<!--> <!-->0.001) respectively. The number of hemorrhagic strokes was: 171 (55.3%), 523 (41.7%) and 172 (29.7%) (p<!--> <!-->&lt;<!--> <!-->0.001), with mortality at one year being 3.2%, 10% and 35.6% respectively (p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>In hypertensive patients with a first stroke, the percentage of hemorrhagic strokes is higher than expected, especially in young patients, where it exceeds more than half of the cases. It is necessary to optimize prevention in these patients to reduce the enormous socio-sanitary burden that stroke represents.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501913"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}