Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Analysis and comparison of trends in the burden of subarachnoid hemorrhage in china and globally, 1990–2021","authors":"Zhihua Cheng ,&nbsp;Liang Wang ,&nbsp;Xiang Wang,&nbsp;Jialong Xuan,&nbsp;Bin Xu,&nbsp;Longfei You","doi":"10.1016/j.jstrokecerebrovasdis.2025.108303","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108303","url":null,"abstract":"<div><h3>Background</h3><div>Subarachnoid hemorrhage (SAH), the rarest form of hemorrhagic stroke, is associated with high mortality and disability rates. Therefore, it is a major public health concern.</div></div><div><h3>Methods</h3><div>This study reviewed the epidemiological characteristics of SAH in China and worldwide, focusing on the 2021 Global Burden of Disease (GBD) database. Researchers, using the GBD database, conducted epidemiological studies that included joinpoint regression analyses covering the incidence, mortality, prevalence, and disability-adjusted life years of SAH in the years 1990-2021. This analysis revealed the trends and effects of SAH in China and globally.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 17.96 to 7.81 per 100,000 people. The age-standardized mortality rate (ASMR) decreased from 27.29 to 4.72 per 100,000 people. This resulted in a 51.58 % reduction in mortality. In contrast, both the ASIR and ASMR showed a slower decline at the global level. China has reported that women aged 70 years and older are at a high risk for SAH. Furthermore, middle-aged men have high prevalence and mortality rates.</div></div><div><h3>Conclusions</h3><div>The current observations warrant the design of focused interventions for both the elderly and female patients with oblique stroke. They can be useful for addressing the SAH burden globally. This study provides valuable information regarding the effectiveness of existing healthcare interventions. This information can also inform future strategies for the prevention and management of SAH.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108303"},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740058","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":"Circulating Mucosal-associated Invariant T Cells Predict Early Neurological Deterioration in Acute Ischemic Stroke.","authors":"Ruihua Liu, Lulu Pei, Jiacheng Liu, Liang Peng, Cairu Guo, Yan Li, Zhihui Duan, Yanjiao Du, Dandan Shang, Shao Li, Yunting Zhang, Bo Song","doi":"10.1016/j.jstrokecerebrovasdis.2025.108301","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108301","url":null,"abstract":"<p><strong>Background: </strong>Mucosal-associated invariant T (MAIT) cells are innate-like T cells that rapidly produce cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17) upon activation. The immune response is crucial in stroke-related injury. However, few studies have investigated the role of MAIT cells in ischemic brain injury. This study assessed the predictive value of circulating MAIT cells in acute ischemic stroke (AIS) and early neurological deterioration (END).</p><p><strong>Methods: </strong>We prospectively and continuously enrolled AIS patients within 72 h of stroke onset and included controls. END was defined as a ≥2-point increase in the National Institutes of Health Stroke Scale score within the first 72 h. Receiver operating characteristic curves were used to evaluate the predictive value of MAIT cells for END.</p><p><strong>Results: </strong>This study included 188 AIS patients and 135 controls, with 50 (26.6%) AIS patients experiencing END. After adjusting for all potential confounders, circulating MAIT cell frequencies were lower in AIS patients than in controls (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.70-0.97, P = 0.02). IL-17 and TNF-α levels were significantly higher in AIS patients and negatively correlated with MAIT cell frequencies (R = -0.26, P < 0.05; R = -0.19, P < 0.05). Multivariate logistic regression analysis revealed that MAIT cell frequencies were lower in patients with END compared to those without END (OR: 0.74, 95% CI: 0.55-0.96, P = 0.03). The area under the curve for MAIT cells in END prediction was 0.641 (95% CI: 0.548-0.725, P < 0.05).</p><p><strong>Conclusions: </strong>MAIT cell frequency was reduced in AIS patients and may serve as a predictive marker for END. Modulating these cells could be a novel AIS treatment strategy.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108301"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744437","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":"Tenecteplase versus alteplase in patients with acute ischemic stroke: An updated meta-analysis of randomized controlled trials","authors":"Maheen Sheraz MBBS ,&nbsp;Nawal Asif MBBS ,&nbsp;Ariba Khan MBBS ,&nbsp;Muhammad Khubaib Khan MBBS ,&nbsp;Muhammad Maaz Bin Rehan MBBS ,&nbsp;Muhammad Tayyab Amer Ch MBBS ,&nbsp;Ahmed Sadain Khalid MBBS ,&nbsp;Caterina Oriana Alfieri MBBCh BAO ,&nbsp;Elmehdi Bouyarden MD ,&nbsp;Mohamed Amine Ghenai MD ,&nbsp;Ahmad Alareed MBBS, MRCP ,&nbsp;Raheel Ahmed MRCP ,&nbsp;Mushood Ahmed MBBS ,&nbsp;Muhammad Ehsan MBBS","doi":"10.1016/j.jstrokecerebrovasdis.2025.108300","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108300","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. While alteplase has been widely used for acute management, recent clinical trials suggest that tenecteplase (TNK) may offer improved clinical outcomes. This study aims to compare the efficacy and safety of TNK compared with alteplase.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using PubMed, Embase and Cochrane Library from inception to October 2024 to identify randomized controlled trials that compared TNK at 0.25 mg/kg dosage with alteplase. Data about clinical outcomes was extracted from both groups and assessed by generating forest plots using the random-effects model and pooling odds ratios (ORs).</div></div><div><h3>Results</h3><div>A total of 11 RCTs with 7,546 patients were included in the analysis. TNK showed statistically significant improvement in excellent functional outcome (mRS 0-1) compared with alteplase (OR= 1.14, 95 % CI= 1.03-1.25). No statistically significant difference was observed for good functional outcome (mRS 0-2) (OR= 1.11, 95 % CI= 0.9-1.25), early neurological improvement (OR=1.08, 95 % CI= 0.93-1.26), all-cause death (OR=0.99, 95 % CI= 0.81-1.19), symptomatic intracranial hemorrhage (OR=1.11, 95 % CI=0.81-1.52) and poor functional outcome (mRS=4-6) (OR=0.95, 95 % CI=0.79-1.14).</div></div><div><h3>Conclusion</h3><div>In patients with acute ischemic stroke, TNK demonstrated a significant advantage over alteplase in achieving excellent functional outcomes. The incidence of early neurological improvement, symptomatic intracranial hemorrhage, all-cause death, and poor functional outcome remained comparable across the two groups.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108300"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725889","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":"Factors and Outcomes Associated with National Institutes of Health Stroke Scale Scores in Acute Ischemic Stroke Patients Undergoing Thrombectomy in United States.","authors":"Adnan I Qureshi, Ibrahim A Bhatti, Syed A Gillani, Rami Fakih, Camilo R Gomez, Chun Shing Kwok","doi":"10.1016/j.jstrokecerebrovasdis.2025.108292","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108292","url":null,"abstract":"<p><strong>Background and purpose: </strong>The National Institutes of Health Stroke Scale (NIHSS) is the standard for assessing neurological deficits in acute ischemic stroke patients undergoing thrombectomy. However, data on NIHSS scores in patients undergoing thrombectomy at national-level studies in the United States are lacking.</p><p><strong>Methods: </strong>Acute ischemic stroke patients admitted between 2018 and 2021 were identified using ICD-10-CM codes from the Nationwide In-patient Sample, with NIHSS scores categorized into specific strata (0-9, 10-19, 20-29, 30-42). We analyzed the effect of NIHSS scores on in-hospital mortality, routine discharge without palliative care (based on discharge disposition), poor outcome defined by NIS SAH outcome measure, and length and costs of hospitalization after adjusting for potential confounders.</p><p><strong>Results: </strong>The NIHSS score strata among 108,990 acute ischemic stroke patients undergoing thrombectomy were: NIHSS score 0-9 (29.6%), 10-19 (40.6%), 20-29 (26.4%), and 30-42 (3.4%). Patients in the Midwest and West regions (adjusted odds ratio [adjusted OR] = 1.51, p=0.002 and adjusted OR = 1.63, p<0.001, respectively), those treated in rural hospitals (adjusted OR = 1.35, p=0.009) and those who were self-pay (adjusted OR = 1.51, p=0.048) had higher odds of being in higher NIHSS score strata. Patients in higher NIHSS score strata (NIHSS score 10-19, 20-29, and 30-42 had significantly lower odds of discharge home without palliative care (adjusted OR= 0.50, 0.32, and 0.22 respectively, all p<0.001) and higher odds of in-hospital mortality (adjusted OR = 1.51, 2.30, and 3.80 respectively, all p<0.001) compared to those in NIHSS score strata of 0-9. Patients in higher NIHSS score strata had significantly higher hospital stays and higher hospitalization costs.</p><p><strong>Conclusions: </strong>We provide a comprehensive national-level analysis of NIHSS scores in acute ischemic stroke patients undergoing thrombectomy which may assist in understanding variations in outcomes and resource utilizations in United States.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108292"},"PeriodicalIF":2.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694511","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":"Morphologic variation of the circle of Willis is associated with cognitive impairment in a general population: the J-SHIPP study","authors":"Yoko Okada MD, PhD ,&nbsp;Yasuharu Tabara PhD ,&nbsp;Katsuhiko Kohara MD, PhD ,&nbsp;Satoko Takei MD ,&nbsp;Masayuki Ochi MD, PhD ,&nbsp;Michiya Igase MD, PhD ,&nbsp;Yasumasa Ohyagi MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108287","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108287","url":null,"abstract":"<div><h3>Background</h3><div>An incomplete circle of Willis (CoW) is associated with ischemic stroke severity and patient prognosis. However, the clinical significance of an incomplete CoW in healthy adults remains unclear. We examined the association between incomplete CoW and cognitive decline in community-dwelling, apparently healthy, older adults.</div></div><div><h3>Methods</h3><div>A cross sectional study in 829 community-dwelling, functionally independent ≥50 years older adults (mean age: 67.4 ± 8.2 years) who voluntarily participated in the health checkup program provided by the Anti-Aging Center of Ehime University Hospital. Variations in CoW and the degree of cerebral small vessel diseases by Fazekas grading scale were assessed using magnetic resonance imaging. Cognitive function was assessed using a computer-based questionnaire.</div></div><div><h3>Results</h3><div>A total of 317 participants had complete CoW. Cognitive impairment was frequently observed in participants with absent CoW vessels (complete CoW: 5.7%, absent 1 vessel: 9.0%, absent ≥2 vessels: 12.2%; P = 0.023). Grade 2 or higher white matter lesions in subcortical and periventricular regions were frequent in participants without multiple vessels. However, the association between incomplete CoW and cognitive impairment was independent of white matter lesions and conventional risk factors (absent 1 vessel: odds ratio = 1.76, P = 0.09; absent ≥2 vessels: odds ratio = 2.21, P = 0.014).</div></div><div><h3>Conclusion</h3><div>The absence of 2 or more vessels was independently associated with cognitive impairment in a general population, which suggests that CoW variation is a risk factor for cognitive decline.</div></div><div><h3>Funding</h3><div>This work was supported by a Grant-in-Aid for Scientific Research (20390185, 21H04850, 25293141) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108287"},"PeriodicalIF":2.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658776","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":"Menopausal hormone therapy in women with CADASIL: a health system-wide retrospective cross-sectional study","authors":"Md Manjurul Islam Shourav M.B.B.S. ,&nbsp;Dinith D. Mendis B.S. ,&nbsp;Maria A. Caruso M.S. ,&nbsp;Roaa Zayat M.D. ,&nbsp;Zhongwei Peng M.S. ,&nbsp;Olga P. Fermo M.D. ,&nbsp;Stephanie S. Faubion M.D.M.B.A. ,&nbsp;Michelle P. Lin M.D.M.P.H. ,&nbsp;Kevin M. Barrett M.D. ,&nbsp;James F. Meschia M.D.","doi":"10.1016/j.jstrokecerebrovasdis.2025.108284","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108284","url":null,"abstract":"<div><h3>Background</h3><div>Menopausal hormone therapy (HT) alleviates menopause symptoms but may alter stroke risk and migraines. Concerns of compounding risk in patients with CADASIL may deter physicians from prescribing HT. We aimed to describe HT use patterns in women with CADASIL.</div></div><div><h3>Methods</h3><div>We reviewed women ≥45 years with genetically or dermato-pathologically confirmed CADASIL. Clinical features, menopause symptoms, and HT use were collected from the electronic health record across Mayo Clinic. Characteristics were compared between non-HT users and HT users using the Wilcoxon rank-sum test for continuous variables and Fisher's exact test for categorical variables.</div></div><div><h3>Results</h3><div>Among 89 CADASIL patients, 45 met demographic criteria. Of these, 10 (22.2 %) ever received HT and 35 (77.8 %) did not. There was no significant age difference between HT and non-HT users (53.3 ± 11.8 vs. 54.1 ± 8.3 years; <em>P</em> ≥ 0.05). Migraine history was more common in HT users (100.0 % vs. 51.4 %; <em>P</em> = 0.007). Menopause symptoms were documented in 48.6 % of non-HT users, but HT use was discussed in only 23.5 %. Among HT users, non-systemic local vaginal formulations were most common (60.0 %), followed by the systemic transdermal (30.0 %). In follow-up, 50 % of patients either changed formulations or stopped HT. CADASIL was noted as a reason for the change in 40 %.</div></div><div><h3>Conclusions</h3><div>Many CADASIL patients experiencing menopause symptoms did not receive HT. About one-fourth of women received HT, most commonly with non-oral formulations. Transdermal and vaginal formulations and other non-hormonal medications used to treat vasomotor symptoms may be safer than oral HT for women with CADASIL.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108284"},"PeriodicalIF":2.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658174","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":"The frequency of carotid web in cryptogenic stroke and its association with stroke risk factors","authors":"Ekin Öykü Baylam Yirmibeş (Doctor of Medicine) ,&nbsp;Nihat Şengeze (Associate Professor) ,&nbsp;Burak Gürel (Doctor of Medicine)","doi":"10.1016/j.jstrokecerebrovasdis.2025.108295","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108295","url":null,"abstract":"<div><h3>Background</h3><div>The carotid web (CaW) is considered a rare source of cerebral embolism. The aim of this study is to determine the prevalence of CaW, clinical data of CaW cases, risk factors, morphological features of CaW and its relationship with cerebrovascular disease and to contribute to the classification of CaW and the most appropriate treatment approaches in the future.</div></div><div><h3>Methods</h3><div>Angiographic images of 1,520 patients who were evaluated with a preliminary diagnosis of cerebrovascular disease and underwent carotid computed tomographic angiography (CTA) and/or digital subtraction angiography (DSA) at Süleyman Demirel University Medical Faculty Hospital and Isparta City Hospital between 2016 and 2022 were examined. 31 CaW patients were included in the study. Radiological imaging, laboratory findings and clinical information of the patients were evaluated retrospectively.</div></div><div><h3>Results</h3><div>The prevalence of CaW was found to be 2.03 %. 35.5 % of CaW cases were symptomatic and the most common risk factor in these patients were hypertension. The optimum threshold value for CaW length in symptomatic patients was ≥ 2.86 mm. There was a moderate positive linear relationship between CaW length and the degree of CaW stenosis. The optimum threshold value for the degree of web stenosis in symptomatic patients was determined as ≥ 31.33 %.</div></div><div><h3>Conclusion</h3><div>This study showed that some morphological features of CaW increase the risk of stroke. These findings suggest that the evaluation and classification of the morphological features of CaW and the development of risk scoring systems based on these features may be effective in estimating the risk of stroke and planning treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108295"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652001","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":"Assessing changes on large cerebral arteries in CADASIL: Preliminary insights from a case-control analysis","authors":"Edgar R. Lopez-Navarro MD ,&nbsp;Silvia V. Mayer MD ,&nbsp;Brenno R. Barreto MD ,&nbsp;Kevin H. Strobino MPH ,&nbsp;Antonio Spagnolo-Allende MD ,&nbsp;Pedro G. Bueno MD ,&nbsp;Kursat Gurel MD ,&nbsp;Khrystyna Kozii MD ,&nbsp;Salwa Rahman MD ,&nbsp;Farid Khasiyev MD ,&nbsp;Jane S. Paulsen PhD ,&nbsp;Jose Gutierrez MD, MPH","doi":"10.1016/j.jstrokecerebrovasdis.2025.108294","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108294","url":null,"abstract":"<div><h3>Introduction</h3><div>Parent large brain arteries are intimately related to their offspring's small arteries. Whether the CADASIL phenotype is confined to small vessels is unclear, and the involvement of large arteries in CADASIL has not been systematically studied.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study with patients with CADASIL and randomly selected controls with acute lacunar stroke from the New York-Presbyterian Hospital/Columbia University Irving Medical Center Stroke Registry. We measured the diameters of both groups' basilar artery (BA) and intracranial internal carotid artery (ICA) on T2-weighted images. Z-scores of the arteries were calculated to derive a Brain Arterial Remodeling (BAR) score. We rated cervical ICA tortuosity as 0=no tortuosity, 1 = 45-90° deviation, and 2= &gt;90°. Generalized linear models compared large artery characteristics, adjusting for demographics and clinical variables.</div></div><div><h3>Results</h3><div>We matched 37 patients with CADASIL with 104 controls. Patients with CADASIL were less likely to be Hispanic/Latino (<em>p</em> &lt; 0.001), hypertensive (<em>p</em> &lt; 0.001), or current smokers (<em>p</em> = 0.02) but more likely to have a prior stroke (<em>p</em> &lt; 0.001) than controls. In adjusted models, patients with CADASIL had larger BA diameters than controls (<em>p</em> = 0.002), but there were no differences in the right and left ICA diameters (<em>p</em> = 0.73, <em>p</em> = 0.88). There was a statistical trend for higher cervical ICA tortuosity in patients with CADASIL compared to controls (<em>p</em> = 0.08).</div></div><div><h3>Conclusions</h3><div>Traditionally considered a small-vessel disease, patients with CADASIL have larger BA diameters and possibly higher cervical ICA tortuosity than controls. Whether these changes are part of the NOTCH-3 mutation phenotype or influence the clinical course is uncertain but should be further investigated.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108294"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651999","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":"Moyamoya disease: Understanding patient experiences through thematic analysis of Instagram, TikTok, and Twitter posts","authors":"Neo Y. Hou ,&nbsp;Avi A. Gajjar ,&nbsp;Eli Hou ,&nbsp;Arnav Barpujari ,&nbsp;Mohamed M. Salem MD, MPH ,&nbsp;Georgios Sioutas MD ,&nbsp;Visish M. Srinivasan MD ,&nbsp;Brian T. Jankowitz MD ,&nbsp;Jan-Karl Burkhardt MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108293","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108293","url":null,"abstract":"<div><h3>Introduction</h3><div>Physicians aim to provide optimal care, considering patient experiences and satisfaction. Traditional in-clinic surveys assessing surgical experiences face numerous limitations, including response bias, and inadequate inclusion of diverse demographics. Social media is an emerging platform for patients to share their healthcare experiences, providing an alternative method for gathering patient feedback. This study explores the prevalent themes of moyamoya disease experiences shared on social media.</div></div><div><h3>Methods</h3><div>Posts containing \"#moyamoya\" and \"#moyamoyawarrior\" from Instagram, TikTok, and Twitter were analyzed. Posts unrelated to direct patient experiences were excluded. Relevant posts were categorized by themes and analyzed based on the platform, gender, and identity of the poster (patient or someone else). Chi-squared tests were used to determined significance of theme prevalence.</div></div><div><h3>Results</h3><div>Of the 1,005 social media posts analyzed, 63.8 % were by patients, and 75.0 % were by females. Most patients (83.0 %) had undergone one surgery. Instagram posts most often focused on Recovery/Rehabilitation (69.7 %), Survival (66.7 %), and Spreading Positivity (45.8 %), while TikTok posts more frequently discussed Survival (97.2 %), Recovery/Rehabilitation (81.3 %), and Spreading Positivity (84.1 %) (<em>p</em> &lt; 0.001). Females were less likely to post on these themes than males, who discussed religious topics more frequently (<em>p</em> = 0.029). Patients discussed appearance (<em>p</em> &lt; 0.001), resiliency (<em>p</em> = 0.002), and quality of life (<em>p</em> = 0.014) more than their loved ones.</div></div><div><h3>Conclusion</h3><div>This study demonstrates social media's use among moyamoya patients, and can supplement traditional methods of obtaining patient feedback. Despite limitations, leveraging social media can enhance understanding patient needs, ultimately improving care quality for Moyamoya disease patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108293"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652000","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":"Comparing the effectiveness and safety of direct oral anticoagulants and warfarin in patients with cerebral venous thrombosis: A real-world study","authors":"Jheng-yan Wu ,&nbsp;Chih-cheng Lai ,&nbsp;Huey-Juan Lin ,&nbsp;Kuan-Hsien Lu ,&nbsp;Wan-Hsuan Hsu ,&nbsp;Ting-ying Chu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108290","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108290","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral venous thrombosis (CVT), a rare stroke variant, poses treatment challenges, especially in young individuals. While guidelines recommend heparin followed by warfarin, warfarin has limitations. Direct oral anticoagulants (DOACs) offer a potential alternative, but evidence on their use in CVT management is limited. The TriNetX study aimed to provide real-world insights into DOAC efficacy and safety for CVT.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study utilizing data from TriNetX to identify patients with CVT. Propensity score matching (PSM) was used to balance the covariates between patients receiving DOACs and those receiving warfarin. The primary outcome was recurrent CVT, with secondary outcomes including intracerebral hemorrhage and all-cause mortality.</div></div><div><h3>Results</h3><div>Among 1,507 patients with CVT, PSM generated 551 matched individuals in both the study and control groups. The study group that received DOACs exhibited a lower risk of CVT recurrence (Hazard Ratio [HR], 0.77; 95 % Confidence Interval [CI], 0.628–0.97) and a higher 360-day event-free survival rate (p &lt; 0.001). Subgroup analyses revealed significantly reduced recurrent CVT risk in the study group, particularly among females (HR, 0.67; 95 % CI, 0.50-0.89), individuals aged 41–64 years (HR, 0.52; 95 % CI, 0.35–0.75), and patients with normal weight (HR, 0.65; 95 % CI, 0.50–0.84). Moreover, recipients of DOACs had a lower risk of intracerebral hemorrhage (HR, 0.62; 95 % CI, 0.43–0.91) and comparable all-cause mortality (HR, 1.03; 95 % CI, 0.67-1.59).</div></div><div><h3>Conclusions</h3><div>This study underscores the potential of DOACs as a promising treatment for CVT, demonstrating reduced recurrence and intracerebral hemorrhage risks with comparable all-cause mortality.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108290"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639848","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}