Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Temporal trends in heart failure and stroke-related mortality in the United States, 1999–2023","authors":"Abdur Rafay Bilal MBBS ,&nbsp;Maryam Sajid MBBS ,&nbsp;Shaheer Qureshi MBBS ,&nbsp;Hateem Gaba MBBS ,&nbsp;Reja Ahmad MBBS ,&nbsp;Malik Alta’amreh MD ,&nbsp;Raheel Ahmed PhD,MRCP ,&nbsp;Mohammed Hammad Jaber Amin MBBS ,&nbsp;Gregg C Fonarow MD ,&nbsp;Saad Ahmed Waqas MBBS","doi":"10.1016/j.jstrokecerebrovasdis.2025.108538","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108538","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) and stroke remain among the leading causes of cardiovascular mortality in the U.S. However, the intersection of these two conditions has been underexplored in national mortality data. This study investigates temporal, demographic, and geographic trends in stroke-related deaths among individuals with HF from 1999 to 2023.</div></div><div><h3>Methods</h3><div>Using the CDC WONDER database, we extracted multiple cause-of-death records for adults ≥25 years where both HF and stroke were listed. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression identified significant trends and calculated average annual percent changes (AAPCs).</div></div><div><h3>Results</h3><div>From 1999 to 2023, 465,695 deaths were attributed to both HF and stroke. AAMRs declined steadily from 13.46 in 1999 to a low of 7.19 in 2019 (AAPC: –3.2%; 95% CI: –3.3 to –3.0; <em>p</em> &lt; 0.001) but then increased to 8.69 by 2023. Men had consistently higher AAMRs than women (2023: 9.88 vs. 7.71). NH Black individuals experienced the highest AAMRs (13.79 in 2023), slower declines, and an earlier mortality crossover compared to other groups. Adults aged 25–44 exhibited the steepest increase. Geographically, the South and rural counties bore the highest burden.</div></div><div><h3>Conclusion</h3><div>Despite long-term mortality declines, recent reversals—especially post-pandemic and among younger, male, and racially minoritized populations—signal urgent gaps in equity and access.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108538"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879870","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":"Longitudinal comparison of health-related quality of life at 3 and 12 months post-stroke using patient-reported outcome measures","authors":"Hojin Ju MD ,&nbsp;Won Kee Chang MD, MS ,&nbsp;Hee-Mun Cho MD ,&nbsp;Hyo Jong Kim MD ,&nbsp;Miji Kang RN ,&nbsp;Yun-Sun Jung MPH, PhD ,&nbsp;Nam-Jong Paik MD, PhD ,&nbsp;Won-Seok Kim MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108559","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108559","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) is a key outcome in stroke survivors, but evidence on distinct physical and mental recovery trajectories is limited. EuroQoL 5-dimension 3-level (EQ-5D-3L) is widely used but prone to ceiling effects and cannot separate physical (PH) and mental health (MH). We administered Patient-Reported Outcomes Measurement Information System 10-item short form (PROMIS-10) at 3 and 12 months post-stroke, identified discharge-related predictors of PROMIS-10 PH and MH to distinguish their recovery trajectories, and compared their discriminatory capacity with that of EQ-5D-3L.</div></div><div><h3>Methods</h3><div>We analyzed PROMIS-10 and EQ-5D-3L scores in a retrospective cohort of 741 stroke survivors discharged from a tertiary center and followed at 3 and 12 months. Discriminatory capacity across modified Rankin Scale (mRS) groups was assessed using effect sizes. Linear regression identified demographic and clinical predictors of PROMIS-10 PH and MH at 3 and 12 months.</div></div><div><h3>Results</h3><div>At 3 months, EQ-5D-3L demonstrated greater discriminatory capacity across mRS groups. At 12 months, PH exhibited better discriminatory capacity than EQ-5D-3L for mild disability (mRS 0–1 vs. 2), consistent with ceiling effects reducing EQ-5D-3L sensitivity in the mild impairment group. Discharge ambulation consistently predicted both PH and MH at 3 and 12 months. Comorbidity burden, employment status, respondent type (proxy vs. patient), and discharge destination were associated with PROMIS-10, particularly in 12-month MH.</div></div><div><h3>Conclusion</h3><div>Predictors and trajectories differed between PH and MH groups, supporting separate assessment. PROMIS-10 exhibited better discriminatory capacity of milder disability at 12 months by distinguishing physical and mental dimensions, supporting tailored care basis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108559"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992941","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 insights from a multi-centre national stroke surveillance initiative in Tanzania","authors":"Sarah Shali Matuja ,&nbsp;Azan Nyundo ,&nbsp;Emmanuel Assey ,&nbsp;Joel Bwelemo ,&nbsp;Marieke Dekker ,&nbsp;Sarah Urasa ,&nbsp;Emanuel Makarius ,&nbsp;Peter Kishimbo ,&nbsp;Yudathadei Baltazar ,&nbsp;Baraka Alphonce ,&nbsp;Joshua Ngimbwa ,&nbsp;Philip Adebayo ,&nbsp;Sipora Siha ,&nbsp;Anney Chagula ,&nbsp;Mary Libena ,&nbsp;Theresia Lutufyo ,&nbsp;Mohamed A Mnacho ,&nbsp;Faraja S Chiwanga ,&nbsp;Kigocha Okeng’o ,&nbsp;Brighton Mushengezi ,&nbsp;William Matuja","doi":"10.1016/j.jstrokecerebrovasdis.2026.108571","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108571","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a leading cause of death and disability globally, with sub-Saharan Africa, bearing the greatest burden. Tanzania has only one active stroke registry, limiting evidence-based care and policy development. We aimed to expand the registry into a multi-centre study across eight major tertiary hospitals to generate baseline data for a national stroke registry.</div></div><div><h3>Methods</h3><div>From January to August 2024, we analysed de-identified data from adults (≥18 years) admitted with a World Health Organisation defined stroke. Data collected included demographics, risk factors, imaging, and in-hospital mortality. Logistic regression identified predictors of mortality.</div></div><div><h3>Results</h3><div>A total of 1000 patients were registered with a mean age 60.2±15 years and 56.2% (562/1000) were females. Most strokes occurred in those aged 50-69 years 46.3% (463/1000). Hypertension was the most common risk factor 90.1% (901/1000), followed by diabetes 13.1% (131/1000), prior stroke 10.6% (106/1000) and HIV infection 3.5% (35/1000). Haemorrhagic and ischaemic strokes accounted for 57.9% (579/1000) and 38.3% (383/1000) of cases, respectively; and 5% (19/383) of ischaemic strokes presented within 4.5 h from symptom onset. In-hospital mortality was 31.5% (315/1000), highest among patients aged 50–59 years (23.2%). Independent predictors of mortality included previous cardiac disease (aOR 2.15; 95% CI: 1.18–3.94) and haemorrhagic stroke (aOR 1.38; 95% CI: 1.12–2.02).</div></div><div><h3>Conclusions</h3><div>Stroke imposes a high burden in Tanzania, with substantial mortality and delayed presentation. Strengthening hypertension control, early stroke recognition, and organized stroke unit care are critical priorities. These findings provide foundational data for the national stroke surveillance initiative and support evidence-based planning for stroke prevention, acute care, and system readiness across Tanzania.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108571"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042228","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":"Management of intracranial aneurysms: a 2024 nationwide study from China","authors":"Yu Gao MS ,&nbsp;Meihua Huyan MD ,&nbsp;Yina Wu MD ,&nbsp;Zhao Dai MS ,&nbsp;Yongwei Zhang MD ,&nbsp;Jianmin Liu MD ,&nbsp;Pengfei Yang MD ,&nbsp;Rui Zhao MD ,&nbsp;Qiang Li MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108546","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108546","url":null,"abstract":"<div><h3>Background</h3><div>Rising detection of unruptured intracranial aneurysms (UIAs) in China, driven by an aging population and increased neuroimaging utilization, coincides with significant regional disparities in neurointerventional resources. This study characterizes contemporary management practices nationwide.</div></div><div><h3>Methods</h3><div>A WeChat-based survey distributed to cerebrovascular specialists in 2024 assessed clinical decision-making, resource availability, and case-based preferences.</div></div><div><h3>Results</h3><div>Resource disparities were pronounced: while computed tomography angiography (CTA) was widely accessible (82.4%), dual-arm digital subtraction angiography (DSA=32.4%) and hybrid operating rooms (36.4%) remained limited. Domestic flow diverters surpassed international devices (47.1% vs. 31.4%). Clinician experience significantly influenced management: physicians with &gt;10 years’ experience intervened at smaller UIA sizes (&gt;5 mm; 55.5% vs. 40.1% in &lt;2-year cohort, p=0.03) and preferred flow diverters for incidental aneurysms (80.7% vs. 38.3%, p&lt;0.001). Coiling dominated acute aneurysmal subarachnoid hemorrhage (SAH) management, but senior neurosurgeons favored clipping with hematoma evacuation (66.5% vs. 35.3%, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Significant practice variations persist in China, driven by experience gaps and regional resource inequities. Standardized training and equitable resource allocation are urgently needed to optimize aneurysm care.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108546"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902070","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":"Determinants of health outcomes of stroke survivors in Africa: A systematic review and meta-analysis","authors":"Marufat Odetunde PhD ,&nbsp;Tadesse Gebrye MSc, MPH ,&nbsp;Chidozie Mbada PhD ,&nbsp;Faatihah Niyi-Odumosu PhD ,&nbsp;Francis Fatoye PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108569","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108569","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the determinants of stroke prognosis and outcomes is crucial for guiding treatment decisions and recovery expectations. This systematic review aimed to synthesise the key determinants of health outcomes for stroke survivors (SSVs) in low- and middle-income countries (LMICs), with a particular focus on Africa.</div></div><div><h3>Methods</h3><div>This review adhered to the PRISMA guidelines and was registered on PROSPERO (CRD42025629244). Literature search was conducted using EBSCOhost, Scopus, and Web of Science databases for studies published from inception to April 14, 2025. Original researches on SSVs in Africa were included. Methodological quality was assessed using the Newcastle–Ottawa Scale. Data was analysed using a narrative synthesis and summarised in tables and texts. A random-effects meta-analysis was conducted to quantitatively synthesise the findings from the included reviews.</div></div><div><h3>Results</h3><div>The literature search identified 979 articles published between October 1987 and April 2025. Of these, 52 studies conducted in seven African countries met the inclusion criteria. Clinical determinants were reported in 40 studies, while 12 studies assessed psychosocial factors. Risks of bias were classified as low in 47 of the studies and moderate in the remaining five. The key clinical determinants of health outcomes were stroke severity/neurological status (<em>n</em> = 19), biomarkers and blood parameters (<em>n</em> = 18), and abnormal radiological/imaging findings (<em>n</em> = 10). The psychosocial determinants were mental health and emotional well-being, especially from social support (<em>n</em> = 6) and quality-of-life domains (<em>n</em> = 5). The overall pooled estimates of clinical risk factors among SSVs indicated a statistically significant association, with an odds ratio (OR) of 1.446 (95% CI: 1.202-1.739, <em>P</em> &lt; 0.001) based on 11 studies.</div></div><div><h3>Conclusion</h3><div>The determinants of health outcomes among SSVs in Africa are multifactorial. The significance of these findings highlights the critical importance of comprehensive management approaches that target key factors to enhance health outcomes and reduce the burden of stroke in Africa.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108569"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041967","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":"Letter to the editor - Effectiveness of perception–interaction-enhanced rehabilitation in post-stroke recovery: A real-world propensity-matched cohort study","authors":"Tamanna Sharma BPT, MPT,&nbsp;Mandeep Kumar Jangra BPT, MPT, PhD,&nbsp;Akanksha Saxena BPT, MPT, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108566","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108566","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108566"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042203","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":"Protective association of higher frequency physical exercise with all-cause mortality risk in stroke patients: evidence from the health and retirement study","authors":"Jingtao Du ,&nbsp;Xiaofeng Jiang ,&nbsp;Binghua Shao ,&nbsp;Liu Zhenshun ,&nbsp;Liu Tianyu ,&nbsp;Jianwei Wu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108563","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108563","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between the different exercise frequency in daily life and all-cause mortality risk of the patients after stroke, and to analyze their dose-response relationship.</div></div><div><h3>Methods</h3><div>1,639 participants with stroke were selected from Health and Retirement Study (HRS) database. Based on physical exercise frequency questionnaires, participants were categorized into five groups: sedentary (n=152), low (n=276), moderate (n=212), high (n=205), and vigorous (n=794). Multivariate Cox proportional hazards regression models and survival analyses were applied to examine the associations between exercise frequency and all-cause mortality risk in stroke patients.</div></div><div><h3>Results</h3><div>Median follow-up time revealed that both median survival time and interquartile range increased progressively with higher exercise frequency. Multivariate Cox regression analysis demonstrated a significant dose-response relationship: Compared to the sedentary group, moderate, high, and vigorous exercise groups exhibited significantly reduced death risks of 28%, 35%, and 42%, respectively. Exercise score showed a significant negative correlation with mortality rate (r=-0.855). Kaplan-Meier survival analysis revealed significant divergence in survival curves among different exercise frequency groups (log-rank P&lt;0.001), with the vigorous exercise group demonstrating the highest cumulative survival rate. Age-stratified analysis indicated that patients aged ≤65 years had the most favorable survival prognosis, while survival rates significantly decreased with advancing age (log-rank P&lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Higher frequency physical exercise manifested a protective association with reduced all-cause mortality risk in stroke patients, with a clear dose-response relationship. These findings support incorporating regular moderate-to-high-frequency exercise into daily life to reduce the hazards of stroke and improve long-term prognosis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108563"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014206","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":"Impact of diabetes and hyperglycemia on acute stroke outcomes in a semi urban setting in Cameroon: Results of the Buea Stroke Study, Cameroon","authors":"Clovis Nkoke MD ,&nbsp;Cyrille Nkouonlack MD ,&nbsp;Ahmadou Musa Jingi MD ,&nbsp;Jean Jacques Noubiap MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108565","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108565","url":null,"abstract":"<div><h3>Background</h3><div>Data on the impact of diabetes mellitus and hyperglycemia on acute stroke outcomes are inconsistent. This study aimed to assess the prognostic impact of diabetes mellitus and admission hyperglycemia on in-hospital stroke outcomes in a semi-urban setting in Cameroon.</div></div><div><h3>Methods</h3><div>We included patients aged ≥18 years hospitalized for acute stroke at the Buea Regional Hospital, Southwest Region of Cameroon, from January 2021 to August 2023. Multivariable logistic regression analysis was used to assess the impact of known diabetes mellitus and admission hyperglycemia on in-hospital functional outcome, infections, length of hospital stay, and mortality. Risk estimates are presented as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). A p value of &lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>Out of the 369 patients recruited, 99 (26.8%) had diabetes. Of the 267 patients with blood glucose on admission, 81 (30.3%) had hyperglycemia. Patients with diabetes mellitus were significantly older (65.1 vs 61.1 years; p=0.03), had a higher prevalence of hypertension (84.9% vs 66.7%; p=0.001) and more commonly had ischemic stroke (85.9% vs 68.2%; p=0.001). In multivariable logistic regression analysis, diabetes mellitus was significantly associated with prolonged hospital stay (aOR= 2.20; 95% CI1.19-4.06; p=0.01) and infections (aOR= 2.36, 95% CI1.14-4.87; p=0.02) but not with in-hospital mortality and functional outcome. Admission hyperglycemia was not associated with any of the outcomes.</div></div><div><h3>Conclusion</h3><div>In this cohort of patients in a resource limited setting, diabetes mellitus was associated with longer hospital stay and more frequent infections but not mortality nor poor functional outcome after an acute stroke. Admission hyperglycemia was not associated with poor outcomes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108565"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021102","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":"Impact of prehospital comprehensive stroke center vs. primary stroke center triage protocol on outcome of patients with spontaneous intracerebral hemorrhage","authors":"Tracey H Fan ,&nbsp;Molly Lawrence ,&nbsp;Elena Badillo Goicoechea ,&nbsp;Angela Wick ,&nbsp;Shyam Prabhakaran","doi":"10.1016/j.jstrokecerebrovasdis.2026.108555","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108555","url":null,"abstract":"<div><h3>Purpose</h3><div>While prehospital triage protocols for suspected large vessel occlusion (LVO) improve ischemic stroke outcomes, their impact in spontaneous intracerebral hemorrhage (sICH) remain uncertain. We evaluated whether a regional LVO-focused emergency medical service (EMS) transport protocol affected time-based process outcomes and clinical outcomes in sICH patients.</div></div><div><h3>Method</h3><div>We conducted a multicenter pre-post implementation retrospective cohort study using the Get-With-The-Guidelines-Stroke database in Chicago (April 2017–January 2020). Included were EMS-transported sICH patients arriving ≤6 hours from last known normal at 8 comprehensive stroke centers (CSCs) and 15 primary stroke centers (PSCs). In September 2018, EMS implemented the 3-Item Stroke Scale (3I-SS) to triage suspected LVO stroke patients; those scoring ≥4 were routed to a CSC bypassing PSC. Primary outcome was favorable discharge disposition (home/acute rehabilitation). Secondary outcomes included in-hospital mortality, good neurologic outcome (independent ambulation) at discharge and time based process outcomes (door-to-CT, symptom-to-arrival, symptom-to-CT). Interrupted time series (ITS) analysis assessed changes while accounting for temporal trends.</div></div><div><h3>Findings</h3><div>Among 303 sICH patients (111 pre-, 192 post-implementation), there was no difference in favorable discharge disposition (58% vs. 64%, <em>p</em>=0.3), in-hospital mortality (12% vs. 9%, <em>p</em>=0.4) or good neurologic outcomes (13% vs. 19%, <em>p</em>=0.4) between pre-post implementation periods for both unadjusted or ITS analyses. Time based process outcomes showed no significant changes in unadjusted or ITS analyses. The protocol also did not impact CSC admission and inter-hospital transfer rates in ITS analyses.</div></div><div><h3>Discussion/Conclusion</h3><div>Implementation of an LVO-focused EMS transport protocol did not improve clinical outcomes or time-based process outcomes among sICH patients, nor did it influence CSC admission or transfer rates. These findings suggest that while beneficial for ischemic stroke care, LVO triage protocols may not confer the same advantages for sICH patients and may require tailored approaches for this population.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108555"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of recurrent stroke and immunoglobulin G4-related arteritis in the central nervous system: a case report","authors":"Qi Huang ,&nbsp;Hongjian Shen ,&nbsp;Pengfei Xing,&nbsp;Yi Jiang,&nbsp;Xiaolong Xu,&nbsp;Qiang Li,&nbsp;Yongwei Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2026.108556","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108556","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin G4–related disease (IgG4-RD) is a systemic immune-mediated fibroinflammatory disease. Histopathology is the key to diagnosis. Although aortitis/periaortitis is a phenotype of IgG4-related disease, the relationship between cerebrovascular disease and IgG4-related disease remains unclear.</div></div><div><h3>Methods</h3><div>We report a 60-year-old man with recurrent stroke induced by IgG4-related arteritis and present the pathological findings of the patient's superficial temporal artery and middle cerebral artery.</div></div><div><h3>Results</h3><div>Immunohistochemistry demonstrated scattered plasma cells in the intima and adventitia of the superficial temporal artery, with a small number of IgG4-positive cells observed (10–15 cells per high-power field).</div></div><div><h3>Conclusions</h3><div>Case reports and studies examining the association between IgG4-related neurological arteritis and stroke are limited. Although a definitive link between IgG4-related arteritis (IgG4-RA) and stroke has not been established, IgG4-related arteritis should be considered as an etiology in patients with recurrent idiopathic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108556"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981131","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}