Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Association between plain water intake and stroke among American adults: National health and nutrition examination survey 1999-2020","authors":"Yahui Pan ,&nbsp;Yanzhen Sun ,&nbsp;Xiaohua Pan ,&nbsp;Yongchao Yin ,&nbsp;Qianqian Liu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108372","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108372","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a leading cause of disability and mortality. While plain water intake has been linked to stroke-related risk factors—including hypertension, diabetes, and obesity—its direct relationship with stroke remains unclear. This study aimed to evaluate the association between plain water intake and stroke.</div></div><div><h3>Methods</h3><div>We analyzed data from adults aged over 20 years who participated in the National Health and Nutrition Examination Survey between 1999 and 2020. Information on stroke status, plain water intake, and other relevant variables was collected. We used weighted logistic regression models, restricted cubic spline analysis, stratified analysis with interaction testing, threshold effect analysis, and sensitivity analyses to evaluate the association.</div></div><div><h3>Results</h3><div>A total of 29,489 participants were included, of whom 1,268 (3.18 %) reported having been diagnosed with stroke. Significant differences in stroke prevalence and participant characteristics were observed across quartiles of water intake (<em>P</em> &lt; 0.001). Multivariable regression indicated a negative association between plain water intake and stroke risk in all adjusted models. The relationship followed an l-shaped curve, with an inflection point at approximately 1,382.86 mL/day (non-linearity, <em>P</em> = 0.005). For those consuming ≤1,382.86 mL/day, the odds ratio for stroke was 0.97 (95 % CI: 0.93 – 0.99, <em>P</em> = 0.03). Subgroup, interaction, and sensitivity analyses supported the stability of the results.</div></div><div><h3>Conclusion</h3><div>The association between plain water intake and stroke among U.S. adults follows an L-shaped curve, with an inflection point near 1,382.86 mL/day. Further research is warranted to investigate the mechanisms underlying this association.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108372"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259887","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":"Atrial premature complex burden as a risk stratification predictor of paroxysmal atrial fibrillation and embolic stroke","authors":"Jin Un Kim ,&nbsp;Alice Snell ,&nbsp;Peter Kabunga ,&nbsp;Md Shajedur Rahman Shawon ,&nbsp;Saeedur Rahman","doi":"10.1016/j.jstrokecerebrovasdis.2025.108369","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108369","url":null,"abstract":"<div><h3>Introduction</h3><div>Investigating the aetiology of cryptogenic stroke is challenging. Occult paroxysmal atrial fibrillation (pAF) is likely a significant contributor, but is often missed by standard 24 h cardiac monitoring. Atrial premature complexes (APC) are markers of atrial myopathy and predictors of AF. We employ 14-day ambulatory cardiac monitoring as a novel monitoring modality to assess the association between APC burden and pAF. In the absence of pAF detection, APC burden may be a useful surrogate marker for risk stratification in patients with embolic stroke.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from April 2022 to October 2023 on adults (≥18 years) with confirmed or suspected stroke or transient ischemic attack (TIA) who underwent 14-day cardiac monitoring using Zio XT® (iRhythm Technologies, UK). Patients with 100 % atrial fibrillation (AF) burden were excluded.</div></div><div><h3>Results</h3><div>A total of 454 patients (male: 268, 59 %; median age: 67 years [IQR: 56–76]) were included. 29 were diagnosed with pAF. In adjusted analysis, APC runs &gt;20 was associated with a 270 % increase in the odds of pAF (OR: 3.70, 95 % CI: 1.47–9.36, <em>p</em> &lt; 0.01), with APC runs &gt;110 showing the strongest association (OR: 7.71, 95 % CI: 2.49–23.86, <em>p</em> = 0.04). High APC burden showed a strong correlation with radiologically embolic appearing strokes with increasing strength of association with higher APC run counts [APC runs &gt;20 was associated with 265 % increased odds of embolic stroke (OR: 3.65, 95 % CI: 2.06-6.46, <em>p</em> &lt; 0.01)]. Age and hypertension were significant predictors of pAF, while obesity and smoking were not significant.</div></div><div><h3>Discussion</h3><div>The presence and burden of APC run are strongly associated with embolic strokes. High APC burden displays similar aetiological stroke presentation to those with pAF. This appears to be distinct from those with low APC burden, where the majority had alternative identified aetiology. This is likely due to downstream consequences of atrial myopathy. In the absence of pAF, APC identification may be important in the diagnostic and therapeutic considerations of cryptogenic stroke patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108369"},"PeriodicalIF":2.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251946","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":"Factors associated with adverse outcomes following perioperative stroke after noncardiac surgery","authors":"Jaycee R. Farmer MSc ,&nbsp;Jason M. Sutherland PhD ,&nbsp;Thalia S. Field MD, FRCPC ,&nbsp;Daniel I. McIsaac MD, FRCPC ,&nbsp;Adrian W. Gelb MD, FRCPC ,&nbsp;Lily W. Zhou MD, FRCPC ,&nbsp;Terri Sun MD, FRCPC ,&nbsp;Stephan K.W. Schwarz MD, PhD, FRCPC ,&nbsp;Alana M. Flexman MD, MBA, FRCPC","doi":"10.1016/j.jstrokecerebrovasdis.2025.108346","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108346","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative stroke is associated with high rates of adverse outcomes. Our objective was to identify factors associated with 30-day mortality, adverse discharge, and length of hospital stay following perioperative stroke among noncardiac surgical patients, and to analyze trends in these outcomes from 2005 to 2020.</div></div><div><h3>Study design</h3><div>A retrospective cohort study of noncardiac perioperative stroke patients was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2020). Data included patient demographics, comorbidities, stroke, and surgical variables. Elastic net penalization identified variables associated with 30-day mortality (primary outcome), adverse discharge (death or non-home facility) and length of hospital stay in multivariable models.</div></div><div><h3>Results</h3><div>We identified 14,386 patients with perioperative stroke. Strokes occurred a median [interquartile range] of 5 days [2 days to 12 days] after surgery, 24.6 % (<em>N</em> = 3,540) of patients died, and 39.8 % (<em>N</em> = 4,773) were discharged to a non-home facility. Factors significantly associated with 30-day mortality included age, body mass index, postoperative complications, stroke closer to surgery and perioperative blood transfusion (c-statistic = 0.749, 95 % CI 0.739 to 0.758). We did not identify significant changes in mortality and adverse discharge over the study period.</div></div><div><h3>Conclusion</h3><div>Several factors were significantly associated with increased risk of poor outcome following perioperative stroke, including potentially modifiable factors such as perioperative anemia, and transfusion. Further research is warranted to identify mechanisms and possible interventions to improve outcome in this population.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108346"},"PeriodicalIF":2.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221375","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":"Early versus delayed direct oral anticoagulant initiation in nonvalvular atrial fibrillation–associated acute ischemic stroke: A systematic review and meta-analysis","authors":"Ekdanai Uawithya ,&nbsp;Weerawat Saengphatrachai ,&nbsp;Karan Srisurapanont ,&nbsp;Kulsatree Praditukrit ,&nbsp;Chitapa Kaveeta","doi":"10.1016/j.jstrokecerebrovasdis.2025.108371","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108371","url":null,"abstract":"<div><h3>Background</h3><div>Early initiation of direct oral anticoagulants (DOACs) after acute ischemic stroke (AIS) in patients with nonvalvular atrial fibrillation (NVAF) can prevent early recurrent AIS but may increase the risk of intracerebral hemorrhage (ICH). The appropriate DOAC initiation time remains uncertain. This systematic review and meta-analysis aimed to determine the optimal timing for DOAC initiation following NVAF-associated AIS.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, Scopus, and the Cochrane Library from inception to March 2025. Eligible studies were randomized controlled trials and prospective cohort studies examining the effects of DOAC initiation timing in patients with NVAF-associated AIS. The primary outcome was the pooled risk ratio for a composite measure of ischemic and hemorrhagic events. Secondary outcomes were the pooled risk ratios for symptomatic ICH, recurrent AIS, major extracranial bleeding, and mortality. Subgroup analyses examined patients initiating DOACs within 3 days of stroke onset and compared outcomes based on baseline stroke severity (NIHSS &lt; 5 vs ≥ 5).</div></div><div><h3>Results</h3><div>Eleven studies from ten cohorts (12,388 participants) met the inclusion criteria. No significant differences were found between early and delayed DOAC initiation for the composite outcomes or for any secondary endpoint. Subgroup analyses revealed a nonsignificant increase in ICH risk among patients with early treatment and higher stroke severity (NIHSS ≥ 5). No significant differences in early ischemic stroke rate were observed in both subgroups.</div></div><div><h3>Conclusions</h3><div>Early DOAC initiation appears to be safe following NVAF-associated AIS, including in patients with moderate stroke severity. However, the rate of early recurrent ischemic stroke remains comparable between early and delayed initiation groups.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108371"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251948","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":"Changing patterns of stroke and subtypes attributable to smoking from 1990 to 2021 in China and projections to 2050","authors":"Bo Hei ,&nbsp;Jiayu Liu ,&nbsp;Jixia Fang ,&nbsp;Qun Gao ,&nbsp;Bin Wang ,&nbsp;Wu Zhou ,&nbsp;Jingru Zhou","doi":"10.1016/j.jstrokecerebrovasdis.2025.108368","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108368","url":null,"abstract":"<div><h3>Background</h3><div>It is uncertain whether smoking exerts similar effects on the stroke and subtypes. The aim of this study was to assess the long-term trends of stroke and subtypes attributable to smoking in China from 1990 to 2021 and to predict changes to 2050.</div></div><div><h3>Methods</h3><div>Data on stroke and its subtypes mortality attributable to smoking in China were extracted from the Global Burden of Disease (GBD) 2021. Linear regression and age-period-cohort models were used to calculate age-standardised mortality rate (ASMR) trends, and the BAPC (Bayesian age-period-cohort) model was used to predict trends from 2022 to 2050.</div></div><div><h3>Results</h3><div>The changing trend of ASMR on stroke attributable to smoking in China differed among subtypes, with an estimated annual percentage change (EAPC) of -2.40 for intracerebral hemorrhage (ICH); -0.67 for ischemic stroke (IS); -0.65 for subarachnoid hemorrhage (SAH). The local drift curves reflect the average annual percentage change in stroke mortality attributable to smoking in all age groups, with a decreasing trend in stroke and subtypes. The decline in SAH mortality was much greater than for IS and ICH across all age groups. The period rate ratio (PRR) and cohort rate ratio (CRR) varied by subtype, showing the decline for all subtypes. Mortality rates for IS and ICH increase significantly with age; the mortality rate for SAH increases followed by a decrease, peaking in the 65-70 year age group. Finally, the ASMR and ASDR for stroke and subtypes attributable to smoking in China will continue to decline from 2022 to 2050.</div></div><div><h3>Conclusions</h3><div>Our study shows that stroke burden attributable to smoking in China declined from 1990 to 2021 but remained higher than global levels, with continue to decline from 2022 to 2050. IS showed the least reduction, especially among older men. Projections suggest continued improvement, though rising adolescent smoking—particularly among women—poses a threat. Strengthened tobacco control, smoking cessation, and targeted IS prevention, especially in older males, are crucial.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108368"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251947","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":"Sticky Platelet Syndrome: An important consideration for otherwise unexplained thrombotic events in young stroke patients","authors":"Diana Yang DO ,&nbsp;Anjana Shriram ,&nbsp;Yu Lee Ra ,&nbsp;Cindy Rivas ,&nbsp;Ava Elahi ,&nbsp;Christopher James Gorospe ,&nbsp;Jocelyn Ho ,&nbsp;Benedict Pereira MD ,&nbsp;Shlee Song MD ,&nbsp;Alexis N. Simpkins MD, PhD, MSCR","doi":"10.1016/j.jstrokecerebrovasdis.2025.108364","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108364","url":null,"abstract":"<div><h3>Introduction</h3><div>This case highlights the importance of considering platelet function and aggregability in patients with recurrent ischemic stroke and deep vein thrombosis.</div></div><div><h3>Results</h3><div>We present a case of a 47-year-old man with history of hypertension, hyperlipidemia, and multiple thrombotic events but no family history of clotting events. Over a period of eight years, he was diagnosed with deep vein thrombosis, pulmonary embolism, and occipital lobe, cerebellar, and parietal lobe infarcts. After presenting with new embolic strokes, platelet aggregometry demonstrated hyperactivity to three agonists, including adenosine-diphosphate (ADP)— indicative of Sticky Platelet Syndrome. Repeat platelet aggregometry demonstrated poor response to clopidogrel, so the patient was discharged on triple therapy with aspirin, clopidogrel, and enoxaparin to warfarin bridge. Two years later, the patient was diagnosed with right eye central retinal artery occlusion two months after an outpatient provider discontinued the clopidogrel and switched warfarin to apixaban. He was discharged back on triple therapy with re-initiation of clopidogrel and apixaban switched to warfarin.</div></div><div><h3>Conclusion</h3><div>Thrombosis in unusual sites and despite anticoagulant use, coupled with platelet hyperactivity to ADP, were suggestive of Sticky Platelet Syndrome. Due to lack of testing standardization, diagnosis of a persistent, hyperreactive platelet phenotype remains challenging. However, improvements in diagnostic approaches for Sticky Platelet Syndrome can be highly beneficial in enabling faster treatment with an appropriate antithrombotic regimen, reducing the risk of subsequent thrombotic events.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108364"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188807","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":"Burden of perceived stress among stroke survivors in Ghana: Insights from a multicentre, cross-sectional study","authors":"Jude Domfeh Darkwah ,&nbsp;Akpalu Albert ,&nbsp;Ansumana Bockarie ,&nbsp;Nana Kwame Ayisi-Boateng ,&nbsp;Emmanuel Konadu ,&nbsp;Rexford Adu-Gyamfi ,&nbsp;Agnes Arthur ,&nbsp;Kwadwo Agyenim-Boateng ,&nbsp;Christiana Neizer ,&nbsp;Timothy Fiattor ,&nbsp;Priscilla Opare-Addo ,&nbsp;Nathaniel Adusei-Mensah ,&nbsp;Raelle Tagge ,&nbsp;Michael Ampofo ,&nbsp;Hilda Kwapong ,&nbsp;Evans MacCready ,&nbsp;Martin Agyei ,&nbsp;John Akassi ,&nbsp;John Humphrey Amuasi ,&nbsp;Samuel Blay Nguah ,&nbsp;Bruce Ovbiagele","doi":"10.1016/j.jstrokecerebrovasdis.2025.108365","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108365","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke incidence is rising rapidly in low- and middle-income countries, including Ghana. Stroke survivors face significant challenges in daily life, heightening their risk for stress. This study aims to examine the burden of perceived stress and its associated factors among stroke survivors in Ghana.</div></div><div><h3>Methods</h3><div>This cross-sectional study analysed baseline data from 486 recent stroke survivors enrolled within 1 month of stroke onset, across ten hospitals in Ghana. Perceived stress was measured using the 4-item Perceived Stress Scale (PSS-4). Associations between variables and perceived stress were analysed using Fisher's exact test, Wilcoxon rank sum, and Pearson's Chi-squared test. Binary logistic regression was performed to determine factors associated with perceived stress.</div></div><div><h3>Results</h3><div>204 (42.0%) of study participants experienced high perceived stress. Stroke severity (measured by the NIH Stroke Scale) and depression were significantly associated with high perceived stress. For each unit increase in the NIH stroke score, the odds of high perceived stress increased by 14% (AOR = 1.14, 95% CI = 1.08, 1.20; p = 0.001). Survivors with moderate to severe depression were five times more likely to experience high perceived stress compared to those without depression (AOR = 4.75, 95% CI = 1.90, 13.1; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>4 out of 10 recent Ghanaian stroke survivors experience high psychological stress strongly associated with stroke severity and depression. These findings emphasise the need for integrating psychological support and stress management into comprehensive stroke care programs in Ghana and similar resource-limited settings.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108365"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188805","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":"Gut microbiota-derived phenylacetylglutamine mitigates neuroinflammation induced by intracerebral hemorrhage in mice","authors":"Weiwei Zhang ,&nbsp;Haopu Lin ,&nbsp;Xuchao He ,&nbsp;Qiuping Gu ,&nbsp;Yan Ma ,&nbsp;Xiongjie Fu ,&nbsp;Linfeng Fan","doi":"10.1016/j.jstrokecerebrovasdis.2025.108357","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108357","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence highlights the pivotal role of gut microbiota and its metabolites in the pathogenesis of brain injury following intracerebral hemorrhage (ICH). Microglia-mediated neuroinflammation stands out as a crucial pathophysiological process post-ICH. However, the effects of gut microbiota on microglia-mediated neuroinflammation after ICH remain elusive. This study aims to address three key aspects: 1) the alteration in gut microbiota-related metabolites following ICH. 2) the impact of phenylacetylglutamine (PAGIn), a gut microbiota-derived compound, on microglia-mediated neuroinflammation after ICH, and 3) the detailed mechanism by which PAGIn regulates microglia-mediated neuroinflammation via β2 adrenergic receptor (β2AR) after ICH.</div></div><div><h3>Methods</h3><div>Young male mice were subjected to ICH through the administration of type VII collagenase. Plasma samples were collected for metabolomic profiling on day 3 after ICH. Microglia phenotype and neuroinflammation were assessed after ICH. Brain tissues were collected for bulk RNA sequencing following PAGIn treatment. Behavioral functions were assessed using the cylinder, corner and forelimb placement tests.</div></div><div><h3>Results</h3><div>Following ICH, levels of PAGIn in the plasma, brain tissues decreased. The supplementation of PAGIn exhibited a significant reduction in neuroinflammation, facilitated the transformation of microglia to anti-inflammatory phenotype, and alleviated neurological dysfunction. Furthermore, the protective effects of PAGIn post-ICH were mediated through the regulation of β2AR.</div></div><div><h3>Conclusion</h3><div>Gut microbiota-derived PAGIn played a crucially regulatory role in microglia-mediated neuroinflammation via β2AR after ICH. The supplementation of PAGIn following ICH in mice emerged as a potential therapeutic strategy to mitigate ICH-induced brain injury.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108357"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188806","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":"Usefulness of non-contrast-enhanced ultrashort echo time magnetic resonance angiography for assessing cerebral aneurysms after woven endobridge device treatment","authors":"Yasuhiko Nariai ,&nbsp;Tomoji Takigawa ,&nbsp;Kazuma Sasaki ,&nbsp;Akio Hyodo ,&nbsp;Kensuke Suzuki","doi":"10.1016/j.jstrokecerebrovasdis.2025.108361","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108361","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Digital subtraction angiography (DSA) is the gold standard follow-up modality for assessing aneurysm occlusion state after Woven EndoBridge (WEB; MicroVention/Terumo, Aliso Viejo, CA, USA) treatment. However, because of the invasiveness of DSA, time-of-flight (TOF) magnetic resonance angiography (MRA) is also used, although it has limited diagnostic accuracy: signal loss in MRA due to the WEB device hinders clear assessment of aneurysm remnants post-treatment. This study aimed to determine whether the non-contrast-enhanced (non-CE) ultrashort echo time (UTE)-MRA sequence, with its ability to reduce metal-induced susceptibility artifacts in MRA, is a reliable follow-up modality to assess aneurysm occlusion status after WEB device treatment.</div></div><div><h3>Materials and methods</h3><div>From June 2024 to February 2025 at our institution, 12 consecutive patients with 14 aneurysms underwent TOF-MRA, UTE-MRA, and DSA for occlusion assessment 6 months after WEB treatment. Angiographic assessments were independently performed by two observers using the WEB Occlusion Scale (WOS). Visibility of the parent vessel at the WEB placement site in TOF-MRA and UTE-MRA was also evaluated.</div></div><div><h3>Results</h3><div>According to DSA, the rates of WOS grade A/B (complete occlusion), C, and D aneurysms were 64.3 %, 28.6 %, and 7.1 %, respectively. Regarding intermodality agreement between TOF-MRA and DSA, the κ coefficient was 0.19, indicative of poor agreement. Intermodality agreement between UTE-MRA and DSA was excellent (κ = 0.88). The parent vessel adjacent to the WEB device tended to be visible more often with UTE-MRA (85.7 %) than with TOF-MRA (50.0 %) (<em>p</em> = 0.10).</div></div><div><h3>Conclusions</h3><div>Non-CE UTE-MRA may be a reliable and less invasive imaging modality after WEB treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108361"},"PeriodicalIF":2.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177429","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":"Clinical presentation and patient outcomes following endovascular intervention for venous sinus diverticula: A single center experience","authors":"Erin N. Walker BS ,&nbsp;Jaskeerat Gujral ,&nbsp;Om Gandhi ,&nbsp;Sandeep Kandregula MD ,&nbsp;Douglas Bigelow MD ,&nbsp;Michael Ruckenstein MD ,&nbsp;Tiffany Hwa MD ,&nbsp;Jason Brant MD ,&nbsp;Kevin Wong MD ,&nbsp;Omar Choudhri MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108363","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108363","url":null,"abstract":"<div><h3>Introduction</h3><div>Venous diverticula are rare neurovascular anomalies consisting of outpouchings in venous sinus walls, occurring with a prevalence of 23 % in the sigmoid sinus. However, venous diverticula can develop in the transverse sinus and jugular bulb, as well often with skull base bony dehiscence. Debilitating pulsatile tinnitus can be associated with the presence of venous sinus diverticula warranting open or endovascular treatment. We report our experience with patient presentation and outcomes with successful endovascular treatment modalities for diverticula cure.</div></div><div><h3>Materials and Methods</h3><div>23 patient cases with confirmed diagnosis of venous sinus diverticula were reviewed. Diverticula characteristics, procedural details, and outcomes were assessed through descriptive and statistical analysis. From this analysis, prevalence of dehiscence, laterality of diverticula, predominant symptoms at presentation, and treatment modalities were determined.</div></div><div><h3>Results</h3><div>69.6 % (16/23) of patients had a transverse/sigmoid diverticulum and 30.4 % (7/23) had a jugular bulb diverticulum. Ipsilateral stenosis was concurrently observed in 30.4 % (7/23) of patients. Analysis revealed a higher likelihood 60.9 % (14/23) of complete symptom resolution with diverticula located in the sigmoid and transverse sinuses compared to 52.2 % (12/23) in the jugular bulb. Additionally, dominance of venous system was associated with a higher likelihood (<em>p</em> = 0.0528) of symptomatic diverticula occurring in the dominant venous sinus. Treatment for all diverticula patients involved the use of either Precise (Cordis) stents, Luminexx Biliary stents or Zilver (Cook) stents in combination with detachable coils. 30.4 % (7/23) of patients contained venous stenosis and all patients who experienced stenosis had complete symptom resolution following intervention. There were no postoperative complications, and all patients were discharged the following day.</div></div><div><h3>Conclusion</h3><div>Understanding clinical factors that influence venous diverticula presentation and neuro-interventional response is critical to treating and counseling patients. We present twenty-three cases of venous diverticula, contributing to the growing body of venous diverticulum literature. We conclude that venous diverticula are more likely to occur in dominant venous sinuses and respond well to treatment, particularly when located in the transverse or sigmoid sinuses, especially if accompanied by bony dehiscence or stenosis. Additionally, we identify stent-assisted coiling as a safe and reliable treatment approach for treating symptomatic venous sinus diverticula.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108363"},"PeriodicalIF":2.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182956","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}