Neurologist最新文献

{"title":"Study on Intermittent Theta Burst Stimulation Improves Expression Function and Mechanism in Patients With Aphasia After Stroke.","authors":"Guangtao Bai, Liang Jiang, Qi Li, Peiju Qiu","doi":"10.1097/NRL.0000000000000622","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000622","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of Intermittent Theta Burst Stimulation (iTBS) on the posterior inferior frontal gyrus of the left hemisphere on the expression function of patients with aphasia after stroke, and to explore the specific mechanism of fractional amplitude of low-frequency fluctuation (fALFF) analysis and degree centrality (DC) analysis of resting-state functional MRI.</p><p><strong>Methods: </strong>According to the inclusion and exclusion criteria, 40 patients with poststroke aphasia were randomized into a treatment group (iTBS group) and a control group (S-iTBS group). Patients in the iTBS group received iTBS +speech training, and patients in the S-iTBS group received sham iTBS + speech training. The Western aphasia test (Chinese version) was used to assess spontaneous language, naming, retelling, and aphasia quotient before and after treatment; resting-state fMRI scans were performed before and after treatment, and the scanned image data were analyzed to explore specific activated or suppressed brain regions.</p><p><strong>Results: </strong>Compared with before and after treatment, the scores of spontaneous language, naming, retelling, and aphasia quotient of the patients in iTBS group improved significantly, and the spontaneous language, naming, retelling, and aphasia quotient of the patients in S-iTBS group also improved. After the treatment, the scores of naming, retelling and aphasia quotient of the patients in the iTBS group improved significantly compared with that of the patients in the S-iTBS group. The resting-state fMRI results of the 2 groups before and after treatment were fALFF analysis found that the fALFF value increased in multiple brain regions in the left frontal and temporal lobes of the patients in iTBS group. Meanwhile, DC analysis also found increased DC values in multiple frontotemporal brain regions of the left hemisphere of patients in the iTBS group, indicating that the improved activation of the above brain regions of the patients in the iTBS group was significantly compared with that of the patients in the S-iTBS group.</p><p><strong>Conclusions: </strong>iTBS combined with conventional speech training significantly improved the expression function of patients with aphasia after stroke. After iTBS action on the left hemisphere, increased activation of multiple brain regions in the left hemisphere may be one of the important mechanisms by which iTBS improves expression function in poststroke aphasia patients.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659347","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":"Extracorporeal Counterpulsation Therapy Enhances Neurological Outcomes in Patients Experiencing Acute Ischemic Stroke.","authors":"Jiaxuan Li, Xinhui Jia, Xinyi Chen, Jie Hu, Xun He, Yueyu Zhang, Yi Tang, Juncang Wu","doi":"10.1097/NRL.0000000000000616","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000616","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the effects of extracorporeal counterpulsation therapy (ECP) on the short-term outcomes of patients with acute ischemic stroke in the mid-stroke phase.</p><p><strong>Methods: </strong>A total of 171 patients with acute ischemic stroke from the Department of Neurology at our hospital were selected and randomly assigned to 2 groups: 84 patients in the ECP group and 87 patients in the control group. Both groups received standard medication and rehabilitation. In addition, extracorporeal counterpulsation was incorporated into the treatment for the ECP group. At the conclusion of the treatment and after 90 days, both groups were evaluated based on the NIHSS and MRS scores.</p><p><strong>Results: </strong>No statistically significant differences were detected between the NIHSS and MRS scores of the 2 groups before and following treatment (P>0.05). However, on the 90th day, the NIHSS and MRS scores of the ECP group were significantly lower than those of the comparison group (P<0.05). The difference in the proportion of patients with NIHSS scores ≤1 between the 2 groups was 20.8%, whereas the absolute difference in MRS scores was 14.1%.</p><p><strong>Conclusion: </strong>Extracorporeal counter therapy effectively enhances neurological function in patients with ischemic stroke, thereby improving their ability to perform activities of daily living and overall prognosis.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659422","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":"Unilateral Weakness Caused By Spinal Cord Infarction in a Renal Transplant Recipient.","authors":"Seul Bi Kim, Seung Min Kim, Byoung-Soo Shin, Hyun Goo Kang","doi":"10.1097/NRL.0000000000000611","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000611","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord infarction has various clinical presentations, depending on the vascular territory involved at the spinal cord level. The most common symptom is bilateral weakness. However, unilateral hemiparesis can occur if the sulcal artery is involved. Stroke is the most common and serious cerebrovascular complication associated with kidney transplantation. Clinically asymptomatic renal transplant recipients may experience increased intima-media thickening, which is significantly associated with an increased prevalence of cerebrovascular diseases.</p><p><strong>Case report: </strong>Herein, we report the case of a 64-year-old adult male with a history of kidney transplantation who presented with sudden-onset right-sided hemiparesis. The patient presented with right shoulder pain, right fingertip paresthesia, and recent dysuria, necessitating catheterization. T2-weighted magnetic resonance imaging at the C2-C3 level revealed hyperintensity corresponding to the right sulcal artery. Diffusion-weighted imaging revealed hyperintensities corresponding to T2 signal abnormalities, with a decreased apparent diffusion coefficient. The patient was diagnosed with cervical spinal cord infarction involving the right sulcal artery at the C2-C3 level. Subsequently, pulsed intravenous methylprednisolone and dual antiplatelet treatment (aspirin and clopidogrel) were administered. The patient showed a rapid and marked improvement in neurological function within 3 days.</p><p><strong>Conclusion: </strong>The patient in this case report initially presented with unilateral hemiparesis. The symptoms mimicked those of stroke, making accurate diagnosis challenging. This case highlights the need to consider spinal cord infarction in the differential diagnosis of patients presenting with unilateral hemiparesis. In addition, our findings suggest that spinal cord infarction may be a long-term complication in kidney transplant recipients.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659401","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":"Nomogram Model for Predicting the Functional Outcomes in Patients With Minor Ischemic Stroke Based on Clinical Characteristics and Small Vessel Disease Burden.","authors":"Ruqian He, Xiaona Xu, Xiachan Chen, Haoye Cai, Xuerong Huang, Hao Shu","doi":"10.1097/NRL.0000000000000614","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000614","url":null,"abstract":"<p><strong>Objectives: </strong>Our purpose is to assess the role of total small vessel disease (SVD) burden affecting the clinical outcome and develop and validate a prognostic nomogram for minor ischemic stroke (MIS) patients.</p><p><strong>Methods: </strong>Between January 2018 and April 2023, 454 MIS patients were enrolled. The functional outcome was the modified Rankin scale (mRS) score at 90 days. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression model were used to identify prognostic predictors, and then a nomogram was drawn.</p><p><strong>Results: </strong>Our nomogram comprising of systolic blood pressure (SBP), baseline National Institutes of Health Stroke Scale score (NIHSS), total SVD burden scores, coronary heart disease, disabling stroke, progressive stroke, alteplase treatment, and infarction location demonstrated a good discriminative power in both the training set (AUC=0.870; 95% CI: 0.827-0.912) and the internal validation set (AUC=0.876; 95% CI: 0.817-0.935). The calibration curve and DCA in our result showed the model's high degree of calibration and clinical value. The DeLong test was used to compare the AUCs between the nomogram and non-SVD burden score model in the training (P=0.028) and internal validation sets (P=0.013), indicating that our nomogram performs significantly better than the non-SVD burden score model.</p><p><strong>Conclusions: </strong>The SVD burden is an important prognosis factor. Furthermore, the proposed nomogram has good discrimination, calibration, and clinical benefits and is better than the non-SVD burden score model in predicting the outcomes for MIS patients.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659432","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":"Thalamic Infarctions: A Case Study of Inferolateral and Posterior Choroidal Branch Involvement in a Patient Without Classic Vascular Risk Factors.","authors":"Igor Bueno Garrido, Brenda Lima do Espírito Santo, Vinicius Viana Abreu Montanaro","doi":"10.1097/NRL.0000000000000612","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000612","url":null,"abstract":"<p><strong>Introduction: </strong>Thalamic infarctions represent a rare subset of ischemic strokes, characterized by a diverse array of clinical manifestations and significant diagnostic challenges. These infarctions can lead to a wide range of neurological deficits, depending on the specific vascular territory involved. Infarctions within the posterior circulation territory of P2, particularly those affecting the inferolateral and posterior choroidal arteries, are associated with distinct neurological symptoms, including contralateral sensory loss, hemiparesis, hemiataxia, thalamic hand, and various sensory and motor disturbances.</p><p><strong>Case report: </strong>We present the case of a 47-year-old woman with a unilateral thalamic infarction involving occlusion of the P2 branch of the posterior cerebral artery. The infarction, caused by a paradoxical embolism secondary to a high-grade patent foramen ovale (PFO) with an interatrial septal aneurysm, occurred in the absence of classic vascular risk factors. The patient exhibited a clinical syndrome consistent with ischemic lesions in the inferolateral and posterior choroidal arteries, manifesting as right-sided hemiparesthesia, hemiataxia with neuropathic pain, thalamic hand, dystonia, and tremor in the upper right limb.</p><p><strong>Conclusion: </strong>Early and precise clinical identification of thalamic infarctions, especially in rare cases involving multiple vascular territories, is essential for improving patient care and outcomes. Recognizing the spectrum of potential symptoms facilitates effective symptom management, minimizes the risk of secondary complications, and optimize neurological rehabilitation.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651658","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":"Thrombolytic Imaging-to-Needle Time as a Metric for Comparing Telemedicine versus In-Person Evaluation in Acute Ischemic Stroke.","authors":"Andrea Loggini, Faddi G Saleh Velez, Jessie Henson, Julie Wesler, Jonatan Hornik, Amber Schwertnam, Karam Dallow, Joaquin Grimaldi, Alejandro Hornik","doi":"10.1097/NRL.0000000000000618","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000618","url":null,"abstract":"<p><strong>Objectives: </strong>Door-to-needle time (DTN) is standard for measuring the efficiency of thrombolytic administration in acute ischemic stroke, with guidelines recommending DTN <60 minutes. DTN can be divided into door-to-imaging time (DIT) and imaging-to-needle time (ITN), separated by arrival at the CT scanner. We hypothesize that ITN is more accurate for comparing the mode of evaluation for stroke patients treated with thrombolytics.</p><p><strong>Methods: </strong>This is a retrospective cohort study of stroke patients treated with thrombolytics at Southern Illinois Health care. Data on demographics, clinical presentation, stroke metrics, thrombolytic complications, and mRS at 1-month were reviewed. Multivariate logistic regression models were applied to evaluate predictors of DTN, ITN, and DIT, with OR and 95% CI. P-value was set at 0.05.</p><p><strong>Results: </strong>Out of 287 patients, 170 were evaluated by telemedicine, 117 in-person. The 2 groups were comparable in demographics and stroke severity. Telemedicine had longer median DTN, in minutes [55 (43 to 70) vs. 42 (34 to 62), P<0.01], and median ITN, in minutes [43 (35-58) vs. 32 (25-48), P<0.01]. There was no statistical difference in DIT between the 2 groups. Adjusted for stroke severity and age, telemedicine was associated with lower odds of DTN <60 minutes (OR: 0.553, 95% CI: 0.328-0.931, P=0.026) and ITN <35 minutes (OR: 0.265, 95% CI: 0.159-0.441, P<0.01). However, telemedicine was not independently associated with DIT <25 minutes, which was instead inversely correlated with age (OR: 0.974, 95% CI: 0.951-0.997, P=0.03).</p><p><strong>Conclusions: </strong>ITN represents a more accurate metric for comparing telemedicine and in-person evaluations than DTN, as it excludes stroke-specific processes of care and patient-specific factors that are intrinsic to DTN and unrelated to the modality of evaluation.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631002","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":"The Efficacy for Hypertensive Intracerebral Hemorrhage Between Neuroendoscopic Surgery and Conservative Treatment: A Retrospective Observational Study.","authors":"Guojin Huo, Yanping Lan, Yi Feng, Xiang Gao, Chen Chen","doi":"10.1097/NRL.0000000000000597","DOIUrl":"10.1097/NRL.0000000000000597","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the efficacy of neuroendoscopic surgery in the treatment of hypertensive intracerebral hemorrhage (HICH).</p><p><strong>Methods: </strong>A total of 193 patients diagnosed with HICH were divided into 2 groups in this study: the observation group (n=101) received neuroendoscopic surgery, whereas the control group (n=92) underwent conservative treatment. Then, the outcomes between these 2 groups were compared and assessed.</p><p><strong>Results: </strong>In the pretreatment phase, there were no significant differences in the levels of inflammation and neurological function scores between these 2 groups ( P >0.05). After 3 months of treatment, the observation group displayed significantly shorter median hospital stay, lower average hospital costs, and faster hematoma resorption time, along with reduced levels of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), interleukin (IL)-6 and IL-8, aquaporin-4 (AQP4), macrophage migration inhibitory factor (MIF), matrix metalloproteinase-9 (MMP-9), granulocyte macrophage colony stimulating factor (GM-CSF), Nerve Deficiency Scale (NDS), Graeb score, and national institute of health stroke scale (NIHSS) compared with the control group ( P <0.05). In addition, the observation group exhibited higher rate of hematoma clearance and better glasgow outcome scale (GOS) score compared with the control group ( P <0.05). The effective treatment rate in the observation group was notably superior to that in the control group (89.11% vs. 73.91%, P <0.05).</p><p><strong>Conclusions: </strong>Neuroendoscopic surgery is an effective treatment for HICH, with alleviating the inflammatory response and enhancing the neurological function. The treatment shows promising outcomes and justifies extensive implementation.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"109-115"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689561","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":"Ethnicity as a Risk Factor for Early Neurological Deterioration: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes Trial.","authors":"Eric D Goldstein, Sabrina Q R Liew, Liqi Shu, Alicia Rocha, Shadi Yaghi","doi":"10.1097/NRL.0000000000000605","DOIUrl":"10.1097/NRL.0000000000000605","url":null,"abstract":"<p><strong>Objectives: </strong>Nearly 25% of those with a small vessel stroke will develop early neurological deterioration (END). The objectives of this study were to identify clinical risk factors for small vessel stroke-related END and its associated impact on functional outcomes in an ethnically diverse data set.</p><p><strong>Methods: </strong>We performed a post hoc analysis of the \"Secondary Prevention of Small Subcortical Strokes\" trial. The primary outcome was END defined as progressive or stuttering stroke-related neurological symptoms. Standard descriptive and inferential statistical methods were used for analysis. Functional outcomes are reported by modified Rankin Scale score and analyzed by the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>In all, 69 participants met the inclusion criteria; 21 (30%) had END. Of the cohort, Spanish, Hispanic, or Latino ethnicity (grouping per trial definition) most frequently developed END [11 (52.4%) vs 4 (8.3%), P < 0.001] with a higher adjusted likelihood of END (odds ratio: 14.1, 95% CI: 2.57-76.7, P = 0.002). Black or African-American race less commonly had END [3 (14.3%) vs 21 (43.8%), P = 0.03] but lost significance after adjustment (odds ratio: 1.46, 95% CI: 0.26-8.17, P = 0.67) due to powering. END was associated with a higher mean modified Rankin Scale (2.06 ± 0.94 vs 1.17 ± 0.79, P = 0.006) but did not differ in the shift analysis.</p><p><strong>Conclusions: </strong>We found that Spanish, Hispanic, or Latino ethnicity was the most consistent risk factor for END though it was without meaningful functional outcome differences.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"116-120"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796509","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":"Syncope Induced by Dynamic Head and Shoulder Motion in the Setting of Left Subclavian Stenosis.","authors":"Forrest W Fearington, Katarina Alajbegovic, Jonathan M Scott, Waleed Brinjikji, Carmen R Holmes, Muhib Khan","doi":"10.1097/NRL.0000000000000607","DOIUrl":"10.1097/NRL.0000000000000607","url":null,"abstract":"<p><strong>Introduction: </strong>Dynamic vertebral artery insufficiency is a rare vascular phenomenon characterized by insufficient flow of the posterior cerebral circulation induced by dynamic motion of the head. Prior case reports have been limited to vertebral artery occlusion by cervical osteophytes or other structural impingements.</p><p><strong>Case report: </strong>In this case report, we discuss the unusual case of a 61-year-old female with a history of vertigo, diplopia, nystagmus, and left subclavian stenosis admitted to the hospital for syncope elicited by a left head turn and left shoulder raise. Transcranial Doppler (TCD) ultrasound and angiography showed evidence of dynamic vertebrobasilar insufficiency elicited by a left-head turn. Percutaneous stenting of the left subclavian artery led to the resumption of normal vessel flow as assessed by TCD and the resolution of the patient's symptoms.</p><p><strong>Conclusions: </strong>This case highlights an unusual cause of dynamic vertebrobasilar insufficiency induced by head turn and/or left shoulder raise due to subclavian stenosis, diagnosed by TCD and angiography, and successfully treated with subclavian artery stenting.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"121-122"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014732","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":"Diffusion-Weighted Imaging-Based Radiomics Features and Machine Learning Method to Predict the 90-Day Prognosis in Patients With Acute Ischemic Stroke.","authors":"Guirui Li, Yueling Zhang, Jian Tang, Shijian Chen, Qianqian Liu, Jian Zhang, Shengliang Shi","doi":"10.1097/NRL.0000000000000599","DOIUrl":"10.1097/NRL.0000000000000599","url":null,"abstract":"<p><strong>Objectives: </strong>The evaluation of the prognosis of patients with acute ischemic stroke (AIS) is of great significance in clinical practice. We aim to evaluate the feasibility and effectiveness of diffusion-weighted imaging (DWI) image-based radiomics features and machine learning methods in predicting 90-day prognosis among patients with AIS.</p><p><strong>Patients and methods: </strong>We enrolled a total of 171 patients with AIS in this study, including 134 patients with a good prognosis and 37 patients with a poor prognosis, and collected the patients' clinical and DWI image data. Radiomics features from manually sketched ischemic lesions were extracted using the Pyradiomics package of Python, and the best radiomics features were selected by a t test and the least absolute shrinkage and selection operator. The radiomics model and clinical model were constructed using support vector machine and logistic regression, respectively, and the predictive performance of each model was evaluated.</p><p><strong>Results: </strong>We selected 9 features from a total of 851 radiomics features to build the final radiomics model. For predicting the poor prognosis of patients with AIS, the area under the curves, accuracy, sensitivity and specificity of the clinical model, radiomics model in the training set and radiomics model in the testing set were 0.865, 0.930 and 0.906, 81.3%, 92.0% and 90.0%, 81.1%, 76.0% and 75.0%, and 81.3%, 97.0% and 95.0%, respectively.</p><p><strong>Conclusions: </strong>DWI image-based radiomics features and machine learning methods can accurately predict the 90-day prognosis of patients with AIS, and the radiomics model is superior to the clinical model in predicting prognosis.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 2","pages":"93-101"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544116","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}