Neurologist最新文献_第2页

Outcomes and Antithrombotic Regimens in Nonvalvular Atrial Fibrillation Patients With Acute Ischemic Stroke and Competing Large-Artery Atherosclerosis. 急性缺血性卒中合并大动脉粥样硬化的非瓣膜性心房颤动患者的预后和抗血栓治疗方案

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000590

Sufang Xue, Risu Na, Jing Dong, Xue Qiu, Min Wei, Qi Kong, Qiujia Wang, Fangyu Li, Yan Wang

{"title":"Outcomes and Antithrombotic Regimens in Nonvalvular Atrial Fibrillation Patients With Acute Ischemic Stroke and Competing Large-Artery Atherosclerosis.","authors":"Sufang Xue, Risu Na, Jing Dong, Xue Qiu, Min Wei, Qi Kong, Qiujia Wang, Fangyu Li, Yan Wang","doi":"10.1097/NRL.0000000000000590","DOIUrl":"10.1097/NRL.0000000000000590","url":null,"abstract":"Objectives: This study aimed to investigate the outcomes and effectiveness of different antithrombotic regimens at discharge in nonvalvular atrial fibrillation (NVAF) patients with acute ischemic stroke (AIS) and competing large artery atherosclerosis (LAA) mechanisms.Methods: In an observational study, we retrospectively analyzed the clinical and follow-up data of NVAF patients with AIS from January 2018 to December 2021 (NCT04080830). The subjects were grouped into 2 groups based on the presence or absence of competing LAA mechanisms. Stroke severity, short-term prognosis, and ischemic recurrence (a composite of ischemic stroke/TIA, myocardial infarction, or systemic embolism after index stroke), were compared between the 2 groups. Antithrombotic regimens at discharge were further categorized into antiplatelet and anticoagulant subgroups to analyze their effectiveness.Results: Five hundred-one NVAF patients with AIS (129 with and 372 without competing LAA mechanisms) were included. Compared with the other group, the group with competing LAA mechanisms had a higher proportion of patients with a nondisabling mRS score (P <0.001), lower mortality rates at the 90-day follow-up ( P =0.048), and higher 180-day ischemic outcomes ( P =0.023). Subgroup analysis showed that the ischemic outcomes were not significantly different ( P =0.166) between the anticoagulant and antiplatelet subgroups in patients with competing LAA mechanisms. In contrast, it was numerically higher in the anticoagulant subgroup.Conclusion: NVAF patients with AIS due to competing LAA mechanisms had mild severity and a comfortable short-term prognosis; however, these patients had a higher risk of ischemic events. The optimal antithrombotic regimens in these patients remain unclear, and stroke mechanisms should be considered.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"102-108"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683504","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}

引用次数: 0

Multiphase CTA Collateral Score to Identify Intracranial Atherosclerotic Stenosis-Related Large Vessel Occlusion.

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000592

Jiajie Xia, Chuanjian Tu, Hui Qian, Zhiwei Gu, Dagang Song, Lei Xu

{"title":"Multiphase CTA Collateral Score to Identify Intracranial Atherosclerotic Stenosis-Related Large Vessel Occlusion.","authors":"Jiajie Xia, Chuanjian Tu, Hui Qian, Zhiwei Gu, Dagang Song, Lei Xu","doi":"10.1097/NRL.0000000000000592","DOIUrl":"10.1097/NRL.0000000000000592","url":null,"abstract":"Objective: Identification of acute ischemic stroke with large vessel occlusion (AIS-LVO) etiology is crucial for effective revascularization therapy. As collaterals are pivotal in maintaining cerebral perfusion in intracranial atherosclerotic stenosis (ICAS), we investigated whether multiphase CT angiography (mCTA) collateral score can be a diagnosis marker of ICAS-related LVO.Methods: We reviewed clinical and imaging data from 92 patients who presented with AIS-LVO and underwent mCTA (57 ICAS-related LVO and 35 embolic LVO). Logistic regression was used to identify ICAS-related LVO. The diagnostic accuracy of the mCTA collateral score for identifying ICAS-related LVO was determined using receiver operating characteristic (ROC) analysis.Results: Compared with patients with embolic LVO, those with ICAS-related LVO had a high median mCTA collateral score (4 vs. 3; P<0.0001). The multinomial logistic regression analysis revealed a significant increase in the mCTA collateral score (OR: 3.717, 95% CI: 2.009-6.876, P<0.0001) in patients with ICAS-related LVO. ROC analysis revealed that the optimal cutoff point of the mCTA collateral score to diagnosis the ICAS-related LVO was 3.5, the area under the curve (AUC) was 0.817 (95% CI: 0.736-0.899; P<0.0001), sensitivity was 80.7%, and specificity was 74.3%. Further analysis revealed that patients with a 4 to 5 mCTA collateral score exhibited a significantly higher median modified Rankin Scale (mRS) at discharge compared with those with a 0 to 3 score (P=0.0464).Conclusions: The mCTA collateral score may be associated with ICAS-related LVO and could be beneficial in identifying the etiology of AIS-LVO.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 2","pages":"87-92"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544061","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}

引用次数: 0

Stem Cells Treatment for Subarachnoid Hemorrhage. 干细胞治疗蛛网膜下腔出血。

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000589

Wei Wang, Ying Wang, Liansheng Gao

{"title":"Stem Cells Treatment for Subarachnoid Hemorrhage.","authors":"Wei Wang, Ying Wang, Liansheng Gao","doi":"10.1097/NRL.0000000000000589","DOIUrl":"10.1097/NRL.0000000000000589","url":null,"abstract":"Background: Subarachnoid hemorrhage (SAH) refers to bleeding in the subarachnoid space, which is a serious neurologic emergency. However, the treatment effects of SAH are limited. In recent years, stem cell (SC) therapy has gradually become a very promising therapeutic method and advanced scientific research area for SAH.Review summary: The SCs used for SAH treatment are mainly bone marrow mesenchymal stem cells (BMSCs), umbilical cord mesenchymal stem cells (hUC-MSCs), dental pulp stem cells (DPSCs), neural stem cells (NSCs)/neural progenitor cell (NPC), and endothelial progenitor cell (EPC). The mechanisms mainly included differentiation and migration of SCs for tissue repair; alleviating neuronal apoptosis; anti-inflammatory effects; and blood-brain barrier (BBB) protection. The dosage of SCs was generally 10 6 orders of magnitude. The administration methods included intravenous injection, nasal, occipital foramen magnum, and intraventricular administration. The administration time is generally 1 hour after SAH modeling, but it may be as late as 24 hours or 6 days. Existing studies have confirmed the neuroprotective effect of SCs in the treatment of SAH.Conclusions: SC has great potential application value in SAH treatment, a few case reports have provided support for this. However, the relevant research is still insufficient and there is still a lack of clinical research on the SC treatment for SAH to further evaluate the effectiveness and safety before it can go from experiment to clinical application.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"80-86"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511729","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}

引用次数: 0

Predictive Value of Serum Inflammatory Factors and FT 3 for Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke. 急性缺血性脑卒中患者血清炎症因子和 FT3 对脑卒中相关肺炎的预测价值

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000570

Xin Li, Xiaomei Xie, Shenju Cheng, Shan Luo, Yancui Zhu, Kun Wu

{"title":"Predictive Value of Serum Inflammatory Factors and FT 3 for Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke.","authors":"Xin Li, Xiaomei Xie, Shenju Cheng, Shan Luo, Yancui Zhu, Kun Wu","doi":"10.1097/NRL.0000000000000570","DOIUrl":"10.1097/NRL.0000000000000570","url":null,"abstract":"Objective: The ability of serum inflammatory factors and free triiodothyronine (FT 3 ) in predicting the occurrence of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS) was assessed in this study.Methods: A retrospective analysis was conducted on 285 consecutive patients with AIS initially diagnosed and admitted to our hospital from January to December 2022. Patients were categorized into SAP and non-SAP groups based on the presence of SAP. Both groups were compared in terms of baseline characteristics, including National Institute of Health Stroke Scale (NIHSS) score, SAP risk assessment (A 2 DS 2 ), TOAST classification. Independent risk factors for SAP were identified using multivariate logistic regression analysis, and the predictive value of inflammatory markers was evaluated through ROC curves.Results: Among 285 patients with AIS, 40 (14.03%) were found to have developed SAP. Higher NIHSS and A 2 DS 2 scores, elevated serum IL-1β, IL-8, and IL-33 levels, increased age, atrial fibrillation, swallowing difficulties, and a higher proportion of patients with low FT 3 levels were observed in the SAP group compared with the non-SAP group (all P <0.05). Significant risk factors for SAP in patients with AIS were identified through multivariate logistic regression analysis, including age, swallowing difficulties, NIHSS, A 2 DS 2 , IL-1β, IL-8, IL-33, and FT 3 ( P <0.05). The highest predictive values were observed for A 2 DS 2 , FT 3 , and IL-8 with AUC values of 0.854, 0.844, and 0.823, respectively.Conclusion: SAP can be highly predicted by A 2 DS 2 , FT 3 , and IL-8, enabling the early identification of patients with high-risk SAP and facilitating timely intervention and treatment.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"69-74"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297180","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}

引用次数: 0

MELAS Presenting as Bilateral Symmetric Occipital and Temporal Cortices Lesions: A Case Report and Literature Review. 表现为双侧对称性枕叶和颞叶皮质病变的 MELAS：病例报告与文献综述

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000588

Qing Liu, Zhaoxia Wang, Jing Shi, Wenxia Wang, Chao Wen, Yanping Zhu, Xuan Chen, Xiaolian Xing, Yangli Su

{"title":"MELAS Presenting as Bilateral Symmetric Occipital and Temporal Cortices Lesions: A Case Report and Literature Review.","authors":"Qing Liu, Zhaoxia Wang, Jing Shi, Wenxia Wang, Chao Wen, Yanping Zhu, Xuan Chen, Xiaolian Xing, Yangli Su","doi":"10.1097/NRL.0000000000000588","DOIUrl":"10.1097/NRL.0000000000000588","url":null,"abstract":"Introduction: Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode (MELAS) is one of the most common maternally inherited mitochondrial diseases. The stroke-like episode affecting the cortical cortex is the hallmark of MELAS; however, it rarely presents as simultaneously bilateral symmetric cortices lesions.Case report: We reported a case of MELAS in a 46-year-old female patient with bilateral symmetric occipital and internal temporal cortices involvements on brain magnetic resonance imaging (MRI). A literature review of MELAS patients and a retrospective analysis were performed. She had a family history of diabetes. Although she denied a history of diabetes, elevated blood glucose was noted after admission, and diabetes was diagnosed. Laboratory examination revealed elevated lactate acid and creatine kinase levels in blood. Cranial computed tomography (CT) image demonstrated basal ganglia calcification, as well as subtle decreased attenuation in bilateral symmetric occipital and internal temporal cortices. Brain magnetic resonance imaging (MRI) demonstrated symmetric gyriform hyperintensity in bilateral occipital lobes and internal temporal lobes in both grey and white matter on fluid-attenuated inversion recovery (FLAIR) images with restricted diffusion on diffusion weighted images (DWI). A genetic test revealed a point mutation in the mtDNA(3243A > G) by blood examination. Literature review showed that there were 231 eligible patients with MELAS identified from 212 published papers. Symmetric cortical involvements were seen in 15 (6.5%) patients on brain MRI.Conclusions: MELAS should be considered as a potential diagnosis in the patients with bilateral symmetric stroke-like cortices lesions.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"75-79"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511728","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}

引用次数: 0

Validation of an Artificial Intelligence-Powered Virtual Assistant for Emergency Triage in Neurology.

IF 1.1 4区医学

Neurologist Pub Date : 2025-02-06 DOI: 10.1097/NRL.0000000000000594

Lucas Alessandro, Santiago Crema, Juan I Castiglione, Daiana Dossi, Federico Eberbach, Alejandro Kohler, Alfredo Laffue, Abril Marone, Vanesa Nagel, José M Pastor Rueda, Francisco Varela, Diego Fernandez Slezak, Sofía Rodríguez Murúa, Carlos Debasa, Pensa Claudio, Mauricio F Farez

{"title":"Validation of an Artificial Intelligence-Powered Virtual Assistant for Emergency Triage in Neurology.","authors":"Lucas Alessandro, Santiago Crema, Juan I Castiglione, Daiana Dossi, Federico Eberbach, Alejandro Kohler, Alfredo Laffue, Abril Marone, Vanesa Nagel, José M Pastor Rueda, Francisco Varela, Diego Fernandez Slezak, Sofía Rodríguez Murúa, Carlos Debasa, Pensa Claudio, Mauricio F Farez","doi":"10.1097/NRL.0000000000000594","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000594","url":null,"abstract":"Objectives: Neurological emergencies pose significant challenges in medical care in resource-limited countries. Artificial intelligence (AI), particularly health chatbots, offers a promising solution. Rigorous validation is required to ensure safety and accuracy. Our objective is to evaluate the diagnostic safety and effectiveness of an AI-powered virtual assistant (VA) designed for the triage of neurological pathologies.Methods: The performance of an AI-powered VA for emergency neurological triage was tested. Ten patients over 18 years old with urgent neurological pathologies were selected. In the first stage, 9 neurologists assessed the safety of the VA using their clinical records. In the second stage, the assistant's accuracy when used by patients was evaluated. Finally, VA performance was compared with ChatGPT 3.5 and 4.Results: In stage 1, neurologists agreed with the VA in 98.5% of the cases for syndromic diagnosis, and in all cases, the definitive diagnosis was among the top 5 differentials. In stage 2, neurologists agreed with all diagnostic parameters and recommendations suggested by the assistant to patients. The average use time was 5.5 minutes (average of 16.5 questions). VA showed superiority over both versions of ChatGPT in all evaluated diagnostic and safety aspects (P<0.0001). In 57.8% of the evaluations, neurologists rated the VA as \"excellent\" (suggesting adequate utility).Conclusions: In this study, the VA showcased promising diagnostic accuracy and user satisfaction, bolstering confidence in further development. These outcomes encourage proceeding to a comprehensive phase 1/2 trial with 100 patients to thoroughly assess its \"real-time\" application in emergency neurological triage.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257174","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}

引用次数: 0

Stroke-Related Factors Influencing Thrombolysis Eligibility and Outcomes.

IF 1.1 4区医学

Neurologist Pub Date : 2025-02-06 DOI: 10.1097/NRL.0000000000000609

Maurizio Giorelli, Maria Stella Aniello, Daniele Liuzzi, Alfredo De Liso, Donatella Accavone, Francesco Negri

{"title":"Stroke-Related Factors Influencing Thrombolysis Eligibility and Outcomes.","authors":"Maurizio Giorelli, Maria Stella Aniello, Daniele Liuzzi, Alfredo De Liso, Donatella Accavone, Francesco Negri","doi":"10.1097/NRL.0000000000000609","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000609","url":null,"abstract":"Objective: Intravenous thrombolysis (IVT) improves outcomes of acute ischemic stroke (AIS) when timely administered. The aim of this study was to collect and analyze data of stroke-related factors which may influence the performance of stroke-related rescue chains, the use of IVT, and patients' outcomes.Methods: This study enrolled patients with AIS admitted to our Stroke Unit (SU) between January 1, 2023, and December 31, 2023. We investigated whether age, occurrence of baseline disabling deficits, stroke severity, or stroke location influenced the median Onset-to-Door Time (ODT), the chance of receiving IVT, or the outcomes of AIS in our facility.Results: A total of 208 patients were enrolled. Patients who received IVT had higher baseline National Institute of Health Stroke Scale (NIHSS) scores (12.26±1.2) than those who did not (6.77±0.51) (P<0.0001). Patients with IVT further showed a greater strength deficit, less ataxia, and lower median ODT (108±20 min) than patients with NO IVT (720±67) (P<0.0001). Weakness of the lower limbs and higher total NIHSS predicted ODT≤ 3.5 hours and the use of IVT. Ataxia and Posterior Circulation Stroke slowed the rescue chain and were negatively correlated with the use of IVT.Conclusions: Stroke-related factors may slow the rescue chain and affect the application of IVT for AIS. New evaluation strategies are warranted to overcome the detrimental effects of these factors and to allow clinicians to effectively manage strokes of any severity and location.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257156","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}

引用次数: 0

Determining Outcomes in Patients With Large Vessel Occlusion and Mild Stroke Who Did or Did Not Receive Thrombolytics and/or Thrombectomy. 确定接受或未接受溶栓和/或取栓治疗的大血管闭塞和轻度卒中患者的预后。

IF 1.1 4区医学

Neurologist Pub Date : 2025-01-01 DOI: 10.1097/NRL.0000000000000598

Cleo Zarina A Reyes, Ramiro Gabriel Castro-Apolo, Hope Kincaid, Navid Tabibzadeh, Hussam A Yacoub

{"title":"Determining Outcomes in Patients With Large Vessel Occlusion and Mild Stroke Who Did or Did Not Receive Thrombolytics and/or Thrombectomy.","authors":"Cleo Zarina A Reyes, Ramiro Gabriel Castro-Apolo, Hope Kincaid, Navid Tabibzadeh, Hussam A Yacoub","doi":"10.1097/NRL.0000000000000598","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000598","url":null,"abstract":"Objectives: The utility of thrombolysis and/or thrombectomy in patients with mild stroke and large vessel occlusion (LVO) remains inconclusive. This retrospective study compared short-term and long-term outcomes in patients treated with best medical therapy (BMT group) versus with intravenous thrombolytics and/or endovascular thrombectomy (intervention group).Methods: Patients with acute ischemic stroke (AIS), LVO, and National Institutes of Health Stroke Score (NIHSS) ≤5 were included. Data collected includes demographics; hospital length of stay (LOS); modified Rankin scale (mRS) at admission, discharge, and follow-up; hemorrhagic conversion; and disposition. Bivariate analyses were conducted to compare outcomes between groups.Results: Of the 29 patients, 15 were treated with BMT and 14 underwent intervention. Median hospital LOS was slightly longer in the intervention group (6.5 [IQR=4 to 12] vs. 5 [IQR=3 to 5] d, P=0.070). Everyone in the BMT group had a favorable outcome (mRS 0 to 2) at discharge and follow-up, unlike the intervention group's rate at discharge (100% vs. 71.4%, P=0.042), This gap was closed at follow-up between BMT group (median=33 d, IQR=28 to 48) and intervention group (median=44.5 days, IQR=30 to 48) (100% vs. 85.7%, P=0.224). Hemorrhagic conversion rates were similar between groups. More patients in the BMT group were discharged home (80% vs. 42.9%, P=0.079).Conclusions: Patients with AIS, low NIHSS, and LVO, who received thrombolytics and/or thrombectomy had longer hospital LOS, higher mRS at discharge and follow-up, and were less likely to be discharged home, though these trends were not statistically significant. Our study is limited by a small sample size and these findings should be further explored in larger studies.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 1","pages":"23-27"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933356","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}

引用次数: 0

Safety and Efficacy of Intensive Blood Pressure-Lowering After Successful Endovascular Therapy in AIS: A Meta-Analysis. AIS 血管内治疗成功后强化降压的安全性和有效性：一项 Meta 分析。

IF 1.1 4区医学

Neurologist Pub Date : 2025-01-01 DOI: 10.1097/NRL.0000000000000569

Zhouzan Liao, Li Tian, Ming Wen, Bing Wang, Kai Ding, Qionglin Song

{"title":"Safety and Efficacy of Intensive Blood Pressure-Lowering After Successful Endovascular Therapy in AIS: A Meta-Analysis.","authors":"Zhouzan Liao, Li Tian, Ming Wen, Bing Wang, Kai Ding, Qionglin Song","doi":"10.1097/NRL.0000000000000569","DOIUrl":"10.1097/NRL.0000000000000569","url":null,"abstract":"Objectives: Higher blood pressure has been proven to be associated with poorer functional outcomes after successful reperfusion by EVT. However, the effect of intensive blood pressure-lowering regimens in these patients remains controversial and ambiguous in clinical practice. We propose further analysis aimed at determining the effect of an intensive blood pressure-lowering regimen after EVT in AIS.Methods: The protocol registered in PROSPERO CRD42023360989. We performed a systematic search that was comprehensively executed in online databases for studies published up to June 2022. Eligibility criteria were established based on the PICOS model. The Cochrane risk of bias algorithm was used to evaluate the risk of bias. The effect models were applied to calculate the pooled ORs and CIs via Review Manager 5.4 software.Results: A total of 1582 citations were identified, 3 randomized clinical trials and 2 retrospective cohort studies were included. Data from 3211 patients were analyzed. We revealed that intensive blood pressure-lowering interventions could significantly reduce symptomatic intraparenchymal hemorrhage compared with standard blood pressure lowering. Nevertheless, favorable functional outcome, poor outcome, all-cause mortality within 3 months and intraparenchymal hemorrhage in 24 hours showed no significant differences. Subgroup analysis revealed the variability of systolic blood pressure within 24 hours after EVT was not associated with odds of poor outcome and intraparenchymal hemorrhage.Conclusions: Based on the current evidence, intensive blood pressure-lowering regimen was superior to standard blood pressure-lowering regimen for a reduced risk of symptomatic intraparenchymal hemorrhage in AIS patients treated with EVT, but there was no statistically significant difference found between the 2 regimens for the other outcomes.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"60-67"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066396","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}

引用次数: 0

Increased Intracranial Pressure in Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease. 髓鞘-少突胶质细胞糖蛋白抗体相关疾病患者颅内压增高。

IF 1.1 4区医学

Neurologist Pub Date : 2025-01-01 DOI: 10.1097/NRL.0000000000000577

Torge Rempe, Aisha Elfasi, Samir Alkabie, Alison Christy, Elsa Rodriguez, Rhaisa Castrodad-Molina, Bryce Buchowicz, Fernando X Cuascut, George Hutton, Revere Kinkel, Jennifer Graves

{"title":"Increased Intracranial Pressure in Myelin-Oligodendrocyte Glycoprotein Antibody-Associated Disease.","authors":"Torge Rempe, Aisha Elfasi, Samir Alkabie, Alison Christy, Elsa Rodriguez, Rhaisa Castrodad-Molina, Bryce Buchowicz, Fernando X Cuascut, George Hutton, Revere Kinkel, Jennifer Graves","doi":"10.1097/NRL.0000000000000577","DOIUrl":"10.1097/NRL.0000000000000577","url":null,"abstract":"Objectives: To assess characteristics of increased intracranial pressure (ICP) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).Methods: This is a multicenter retrospective review of 84 MOGAD cases at the University of Florida, Baylor College of Medicine, the University of California San Diego, and Providence Health and Services, Portland, Oregon, to identify cases with a documented increased opening pressure >25 cm H2O. A literature review was conducted to identify previously reported MOGAD cases with an opening pressure >25 cm H2O.Results: Of 28 MOGAD cases with available opening pressures, 6 (21.4%) patients (age: 5 to 36 y; 2/6 females) had documented increased ICP with an opening pressure of 26 to 46 cm H2O and optic nerve head edema on funduscopic examination. The increased ICP occurred in the setting of bilateral optic neuritis in all cases. In 5/6 patients, this was the initial presentation of the disorder. Anti-MOG titers were 1:40 (n = 1), 1:100 (n = 4), and 1:1000 (n = 1). In our literature review, we identified 13 additional MOGAD cases with ICP elevations in the setting of meningo-cortical presentations (n = 10), as well as bilateral optic neuritis (n = 3).Conclusions: Increased ICP may occur in MOGAD and may be more common in patients with optic neuritis or meningoencephalitis.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"17-22"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774245","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}

引用次数: 0