Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association最新文献

{"title":"Impact of repetitive transcranial magnetic stimulation on cognitive impairment in stroke patients: A meta-analysis of randomized controlled trials.","authors":"Zhi-Qiang Zhao, Huai-Nan Li, Yun Ye, Jun-Lin Wang, Peng Xu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108415","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108415","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of repetitive transcranial magnetic stimulation (rTMS) on cognitive impairment in stroke patients using meta-analysis.</p><p><strong>Methods: </strong>Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched up to October 20, 2024. Randomized controlled trials assessing the effect of rTMS on cognitive impairment in stroke patients were included. Pooled effect sizes were calculated using standardized mean differences (SMD) or mean differences (MD) based on fixed or random effects models.</p><p><strong>Results: </strong>Fourteen studies involving 597 stroke patients were included in this meta-analysis. The results showed that rTMS significantly improved global cognitive function in stroke patients (SMD: 0.54; 95 % CI: 0.28, 0.79), particularly with high-intensity rTMS (SMD: 0.41; 95 % CI: 0.07, 0.76) and intermittent theta-burst stimulation (iTBS) (SMD: 0.94; 95 % CI: 0.62, 1.27). In terms of different rating scales, rTMS significantly increased scores on the Modified Barthel Index (MBI) (MD: 10.54; 95 % CI: 4.85, 16.23) and the Montreal Cognitive Assessment (MoCA) (MD: 1.96; 95 % CI: 0.91, 3.01), while the effects on the Mini-Mental State Examination (MMSE), Rivermead Behavioral Memory Test (RBMT), and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were not statistically significant.</p><p><strong>Conclusion: </strong>This meta-analysis confirms that rTMS can effectively improve cognitive function in stroke patients. However, due to the limited number of studies included, further high-quality research is needed to substantiate our findings.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"108415"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden and trends of of stroke in adolescents and young adults from 1992 to 2021.","authors":"Yang Li, Yushi Wang, Shuning Wang, Hui Zhu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108414","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108414","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aims to examine the global, regional, and national burden of stroke in young adults from 1992 to 2021.</p><p><strong>Method: </strong>We conducted a comprehensive assessment of stroke metrics among individuals aged 15-49 using data from the 2021 Global Burden of Disease (GBD) database, covering 204 countries at global, regional, and national levels. The metrics evaluated included age-standardized incidence rates (ASIR), death rates (ASDR), disability-adjusted life years (DALYs), average annual percentage changes (AAPCs), and joinpoint regression analysis.</p><p><strong>Results: </strong>Between 1992 and 2021, the ASIR, ASDR, and DALYs for ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) among young adults globally decreased. The incidence, mortality, and DALYs for all three stroke types declined in both young females and males. In countries with low-middle and middle Socio-demographic Index (SDI), the ASIR for IS showed an upward trend, while the ASIR for ICH and SAH decreased across different SDI countries. Nationally, the incidence, death, and DALYs for all three types of stroke decreased in the vast majority of countries, with only a few countries showing an increased trend.</p><p><strong>Conclusion: </strong>From 1992 to 2021, the overall trend in stroke burden among young adults was downward. However, in certain countries and regions, incidence, death, and DALYs related to stroke still rose. It is crucial for nations around the globe to adopt comprehensive, easily accessible, and cost-effective strategies aimed at improving stroke monitoring, prevention, emergency treatment, and rehabilitative care, ultimately alleviating the impact of stroke.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"108414"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between lipid accumulation product and stroke incidence: A national cohort study based on CHARLS.","authors":"Zhixian Zhu, Xiaofan Miao, Heng Wang, Yajing Deng, Hengfang Shi, Siyang Li","doi":"10.1016/j.jstrokecerebrovasdis.2025.108411","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108411","url":null,"abstract":"<p><strong>Background: </strong>Several studies have identified a correlation between the lipid accumulation product (LAP) and cardiovascular disease. However, there have been few large cohort studies on the LAP and the risk of stroke in middle-aged and elderly Chinese individuals.</p><p><strong>Objective: </strong>This study aimed to explore the association between LAP and the risk of stroke in the middle-aged and elderly population in China.</p><p><strong>Methods: </strong>The study included subjects aged ≥45 years who were participants in the China Health and Retirement Longitudinal Study (CHARLS) and had no history of stroke at baseline. Basic information, physical findings, laboratory data, and follow-up results in 2013, 2015, 2018, and 2020 were collected for the study participants. The correlation between LAP and stroke onset was examined using a Cox proportional hazards regression model and the dose-response relationship between LAP and stroke onset by restricted cubic spline analysis. Subgroup analyses were also performed.</p><p><strong>Results: </strong>The 6,726 study participants had a median age of 60 years, and 498 (7.40 %) had new strokes. Cox proportional hazards regression showed that for every standard deviation increase in LAP, the risk of stroke increased by 27.9 % (HR= 1.279, 95 % CI=1.086-1.505, P = 0.003). Restricted cubic spline analysis revealed a nonlinear association between LAP and the risk of stroke, and the inflection point was identified at a LAP of 28.140 (P for nonlinear <0.001). Subgroup analyses showed the same positive correlation between LAP and stroke incidence regardless of age, sex, hypertension, or diabetes. The association between LAP and stroke was also independent of heart disease, smoking, and drinking.</p><p><strong>Conclusions: </strong>This study found a positive nonlinear relationship between the LAP and the risk of stroke, with the incidence of stroke increasing when the LAP was >28.140. These findings enable LAP to play a supportive role in screening of the population at high risk of stroke.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"108411"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Physical Activity in Vascular Cognitive Impairment: Systematic Review with Meta-Analysis\" [Journal of Stroke and Cerebrovascular Diseases, Vol 32, No.8 (August), 2023: 107133].","authors":"Joana Vítor, Catarina Melita, Mário Rodrigues, Diana Aguiar de Sousa, João Costa, J M Ferro, Ana Verdelho","doi":"10.1016/j.jstrokecerebrovasdis.2025.108370","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108370","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"108370"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombectomy for Stroke Caused by Cardiac Myxoma.","authors":"Biao Zhou,&nbsp;Shanshan Huang,&nbsp;Shuyun Liu,&nbsp;Lijie Ren,&nbsp;Can Huang,&nbsp;Zongde Lian","doi":"10.1016/j.jstrokecerebrovasdis.2020.105407","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105407","url":null,"abstract":"<p><p>Large vessel occlusion stroke, caused by cardiac myxoma, is a rare and severe condition with poor neurological outcomes. Currently, there are no clear guidelines for treating patients with this condition. In our case, we describe a rare case of acute ischemic stroke caused by cardiac myxoma which was successfully treated with mechanical thrombectomy. At the end of a 6 months' follow-up, her National Institutes of Health Stroke Scale score (NIHSS) had significantly improved, from 20 to 3. This result is encouraging and suggests that mechanical thrombectomy may be a feasible therapy for large vessel occlusion stroke induced by cardiac myxoma emboli.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105407"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38315488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Brain Death Determination and Apnea Testing for Patients with COVID-19.","authors":"Yazan Radaideh,&nbsp;Rajeev Garg,&nbsp;Amina A Abdalla,&nbsp;Ankeet D Patel,&nbsp;Sayona John,&nbsp;Ivan Da Silva","doi":"10.1016/j.jstrokecerebrovasdis.2020.105419","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105419","url":null,"abstract":"<p><strong>Introduction: </strong>Apnea testing remains essential for the clinical evaluation of brain death determination. In patients who test positive for SARS-CoV-2, disconnecting the patient from the ventilator and introducing high flow oxygen into the endotracheal tube increases the risk for aerosolization of airway secretions and exposure of the examiner.</p><p><strong>Methods: </strong>Case report of a patient with an intracerebral hemorrhage that evolved to significant cerebral edema and herniation, who underwent apnea test using a method involving a t-piece and an HME filter.</p><p><strong>Results: </strong>Patient successfully pronounced brain dead using a safe method to minimize exposure to SARS-CoV-2.</p><p><strong>Conclusion: </strong>At a time where healthcare workers are at high risk of exposure to COVID-19, the above described method is a safe process for apnea testing in declaration of brain death.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105419"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38315487","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":"Letter to the Editor Response.","authors":"Abdul Salam,&nbsp;Sadat Kamran,&nbsp;Rubina Bibi,&nbsp;Hesham M Korashy,&nbsp;Aijaz Parray,&nbsp;Adbulla Al Mannai,&nbsp;Abdulrahman Al Ansari,&nbsp;Krishna Kumar Kanikicharla,&nbsp;Arta Zogaj Gashi,&nbsp;Ashfaq Shuaib","doi":"10.1016/j.jstrokecerebrovasdis.2020.104768","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104768","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"104768"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38494380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Brain Injury Following Carbon Dioxide Angiography.","authors":"Madihah Hepburn,&nbsp;Naresh Mullaguri,&nbsp;Anusha Battineni,&nbsp;Dhimant Dani,&nbsp;Pravin George,&nbsp;Christopher R Newey","doi":"10.1016/j.jstrokecerebrovasdis.2020.105350","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105350","url":null,"abstract":"<p><strong>Introduction: </strong>Carbon dioxide (CO₂) as a contrast agent has been in use as early as the 1920s for visualization of retroperitoneal structures. Digital subtraction angiography (DSA) using CO₂ as a contrast agent for vascular imaging was developed in the 1980s. Currently, CO₂  angiography is an alternative agent in patients with chronic kidney disease (CKD) and those who are at risk of developing contrast-induced nephropathy. However, CO₂ causes neurotoxicity if the gas inadvertently enters the cerebrovascular circulation leading to fatal brain injury.</p><p><strong>Case presentation: </strong>A 71-year-old female with h/o sickle cell trait, hypertension, obesity, metastatic renal cell cancer status post nephrectomy, bone metastasis, chronic kidney disease was admitted for elective embolization of the humerus bone metastasis. Given the high probability of contrast-induced nephropathy, CO₂ angiography was chosen for embolization of the metastasis. During the procedure, the patient became unresponsive. Emergent medical management with hyperventilation, 100% fraction oxygen inhalation was performed. Her neuroimaging showed global cerebral edema. An intracranial pressure monitor was placed which confirmed intracranial hypertension. Hyperosmolar therapy was administered with no improvement in clinical examination. She progressed to brain stem herniation. Given poor prognosis, the family opted for comfort measures and the patient expired.</p><p><strong>Discussion and conclusions: </strong>Inadvertent carbon dioxide entry into cerebrovascular circulation during angiography can cause fatal brain injury. Caution must be exercised while performing CO₂  angiography in blood vessels above the diaphragm.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105350"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38666082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Pontine Strokes in a Young Male.","authors":"Marcus Grobe-Einsler,&nbsp;Horst Urbach,&nbsp;Sebastian Paus","doi":"10.1016/j.jstrokecerebrovasdis.2020.105386","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105386","url":null,"abstract":"<p><p>A 34-year-old patient presented to the emergency department with recurrent neurologic symptoms of sudden onset. MRI showed white matter hyperintensities consistent with small vessel disease, predominantly in the pons. There were no known cardiovascular risk factors (CVRF) and extensive workup for vasculitis was negative. The preliminary diagnosis was small vessel primary central nervous system vasculitis, but immunosuppressive treatment did not stop a progression of the disease over 6 months. Repeated negative diagnostic workup for vasculitis, lack of response to therapy, young age, and predominant involvement of the pons were compatible with pontine autosomal dominant microangiopathy and leukoencephalopathy (PADMAL), which is a very rare monogenic cause of cerebral small vessel disease due to upregulation of collagen type-IV. Correspondingly, a COL4A1 mutation was found. Therapy was immediately stopped in favour of more strict adjustment of the CVRF including lowering of LDL < 70 mg/dl and extensive monitoring of blood-pressure.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105386"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38666083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrocephalous as a Complication of Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage.","authors":"Guilherme Zini Reis,&nbsp;Fernanda Subtil de Moraes Machado,&nbsp;Wladimir Kummer de Paula,&nbsp;Flávio Diniz Ribas,&nbsp;Felipe Ibiapina Dos Reis","doi":"10.1016/j.jstrokecerebrovasdis.2020.105381","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105381","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105381"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38523835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}