Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Polypharmacy and deprescribing attitudes among stroke survivors: Opportunities for enhanced patient centered care","authors":"Alyssa K. Chao BA ,&nbsp;James F. Burke MD, MS ,&nbsp;Ran Bi MS ,&nbsp;Chun Chieh Lin PhD, MBA ,&nbsp;Lesli E. Skolarus MD, MS","doi":"10.1016/j.jstrokecerebrovasdis.2025.108432","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108432","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to 1) describe the burden of polypharmacy among stroke survivors compared to older adults without a history of stroke and 2) assess their attitudes towards deprescribing.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study of US Medicare Beneficiaries aged ≥65 who participated in the National Health and Aging Trends Study. Polypharmacy was defined by the number of regular medications reported (no polypharmacy, ≤5; moderate, 6-10; severe, &gt;10). Deprescribing attitudes were elicited from the Medication Attitudes Module. Ordinal and logistic regression assessed the associations between polypharmacy, history of stroke, and deprescribing attitudes, adjusting for falls and comorbidities.</div></div><div><h3>Results</h3><div>Of the 2073 respondents, 253 reported a prior stroke. Compared to older adults without a history of stroke, stroke survivors were more likely to report polypharmacy (moderate: 39.4 % vs 29.8 %; severe: 22.6 % vs 9.8 %; <em>p</em> &lt; 0.01). Most stroke survivors (87.1 %) and older adults without stroke (89.0 %) would be willing to stop one or more medications. Polypharmacy had the strongest association with favorable attitudes toward deprescribing.</div></div><div><h3>Conclusion</h3><div>Stroke survivors report greater polypharmacy than older adults without a history of stroke. Both groups overwhelmingly favor deprescribing. Stroke survivors represent a key population that would welcome and benefit from efforts to deprescribe.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108432"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907839","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":"Association between occlusion site and clinical outcomes in patients with acute basilar artery occlusion","authors":"Qiuyu Su MD ,&nbsp;Haoxuan Zhu MD ,&nbsp;Linyu Li MD ,&nbsp;Guojian Liu MD ,&nbsp;Jie Yang MD ,&nbsp;Xiaolei Shi MD ,&nbsp;Shihai Yang MD ,&nbsp;Jinfu Ma MD ,&nbsp;Dahong Yang MD ,&nbsp;Zhenxuan Tian MD ,&nbsp;Boyu Chen MD ,&nbsp;Chawen Ding MD ,&nbsp;Jiaxing Song MD ,&nbsp;Changwei Guo MD ,&nbsp;Wenjie Zi MD ,&nbsp;Zhao Yang MD ,&nbsp;Zhenqian Liu MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108427","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108427","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to analyze the association between different occlusion sites and clinical outcomes in acute basilar artery occlusion (ABAO) patients.</div></div><div><h3>Patients and methods</h3><div>This study recruited ABAO patients from the BASILAR registry to evaluate outcomes by occlusion sites (distal, middle and proximal ABAO) and treatment modality. Primary effectiveness outcome was assessed by the modified Rankin Scale (mRS) score 0-3 and secondary effectiveness outcomes were mRS 0-2 and 0-1. Safety outcomes included the mortality at 90 days and the occurrence of symptomatic intracranial hemorrhage (sICH) within 48 h.</div></div><div><h3>Results</h3><div>In endovascular treatment (EVT) group, after multivariable regression analysis, compared to distal occlusions, middle occlusions were significantly and negatively associated with clinical outcomes (mRS 0-3, adjusted odds ratio (aOR) 0.36, 95 % confidence interval (CI) 0.20-0.63, <em>P</em> &lt; 0.001; mRS 0-2, aOR 0.51, 95 % CI 0.29-0.91, <em>P</em> = 0.023). However, mortality and sICH did not differ significantly between groups. Additionally, compared to standard medical therapy (SMT), patients following EVT significantly improved favorable outcomes (mRS 0-3) among 3 occlusion sites: distal (aOR 5.56, 95 % CI 1.74-17.79, <em>P</em> = 0.004), middle (aOR 5.06, 95 % CI 1.88-13.63, <em>P</em> = 0.001), and proximal (aOR 3.92, 95 % CI 0.94-24.05, <em>P</em> = 0.14). Similarly, the results of propensity score matching (PSM) were consistent with the above trends.</div></div><div><h3>Conclusion</h3><div>In patients treated with EVT, our findings showed that clinical outcomes significantly differed by occlusion site. Additionally, EVT demonstrated superior clinical effectiveness among 3 occlusion sites compared to SMT. These findings support occlusion site-specific EVT prioritization in ABAO management.</div><div>This study was registered with the Chinese Clinical Trial Registry (ChiCTR1800014759).</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108427"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878732","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":"Sex differences in endovascular thrombectomy: A comparative analysis of baseline characteristics, time metrics, interventional radiology techniques, and clinical outcomes","authors":"Theodore Liu ,&nbsp;Marlise P dos Santos MD ,&nbsp;Paulo Puac-Polanco MD ,&nbsp;Richard I Aviv MD, PhD ,&nbsp;Angela M Auriat PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108428","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108428","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate differences in the baseline risk factors, stroke characteristics, procedural techniques, workflow processing times, and clinical outcomes between male and female endovascular thrombectomy (EVT) patients.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study analyzed medical records of adult patients with acute ischemic stroke treated with EVT at a comprehensive stroke center from February 1, 2015, to May 31, 2022. The primary outcome was functional neurological disability, scored using the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included procedural workflow time delays, successful reperfusion rate, and other EVT technical aspects. Categorical data was evaluated through Fisher’s exact test and continuous data through Mann-Whitney U tests.</div></div><div><h3>Results</h3><div>A total of 943 patients consisting of 480 male and 463 female patients were included. Female patients were more likely to be older (<em>p</em> &lt; 0.0001), and present with atrial fibrillation (p = 0.0089), and cardioembolic strokes (p &lt; 0.0001). Male patients demonstrated higher rates of smoking (p = 0.030), coronary artery disease (p = 0.0004), large artery atherosclerotic strokes (p &lt; 0.0001), and posterior circulation occlusion (p = 0.03). Median mRS scores at 90 days were similar between groups (mRS 1, p = 0.15). There were no differences in EVT technique and workflow time metrics between groups, however, female patients were more likely to present during business versus on-call hours (44.1% vs 37.3%, p = 0.040).</div></div><div><h3>Conclusions</h3><div>Female patients undergoing EVT demonstrated no difference in EVT outcomes, and were more likely to present during business hours. Female patients were older, and were more likely to present with atrial fibrillation, and cardioembolic strokes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108428"},"PeriodicalIF":1.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903934","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":"Endovascular treatment of vertebral artery ostial stenosis with second generation drug-eluting coronary stents: Long-term follow up","authors":"Fatih ÖNCÜ MD ,&nbsp;Nezih YAYLI MD ,&nbsp;Taylan ALTIPARMAK MD ,&nbsp;Abdullah ÖZER MD ,&nbsp;Hale Zeynep BATUR ÇAĞLAYAN MD ,&nbsp;Mehmet Koray AKKAN MD ,&nbsp;Ahmet Baran ÖNAL MD ,&nbsp;Bijen NAZLIEL MD ,&nbsp;Erhan Turgut ILGIT MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108429","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108429","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>To evaluate the patency and clinical outcomes of drug-eluting stents (DES) in patients with symptomatic and significant vertebral artery ostial stenosis (VAOS).</div></div><div><h3>Methods</h3><div>This single-center, retrospective observational study included 31 patients (21 males, 10 females; mean age: 64 ± 10.56 years) who underwent DES placement for severe (&gt;70 %) symptomatic VAOS in our institution between 2013 and 2023. Patients who had received DES placement for other indications—such as dissection, aneurysm, or intracranial vertebral artery stenosis—were excluded. The primary outcomes were technical success, clinical response, and the incidence of peri‑procedural and post-procedural complications. Data were collected and assessed using the hospital's electronic medical records. Follow-up imaging was primarily performed using Doppler ultrasonography (DUS). In equivocal cases, digital subtraction angiography (DSA) and computed tomography angiography (CTA) were performed. Descriptive statistics were used to summarize the data. Continuous variables are presented as mean ± standard deviation, while categorical variables are expressed as counts and percentages.</div></div><div><h3>Results</h3><div>Technical success was achieved in all patients (100 %). The mean follow-up duration was 20 ± 4 months. Two patients were lost to follow-up and excluded from follow-up analysis. Although no significant restenosis was detected during follow-up, mild in-stent restenosis (&lt;30 %) was observed in two symptomatic patients (6.9 %), both of whom were successfully treated with medical therapy. Our findings demonstrate favorable short-term neurological improvement in acute stroke cases, along with sustained symptom control during long-term follow-up (93.1 %).</div></div><div><h3>Conclusion</h3><div>This study supports the long-term efficacy and safety of second-generation DES in treating VAOS. The results are consistent with the Vertebral Artery Ischaemia Stenting Trial (VIST), particularly in demonstrating low complication rates in extracranial vertebral artery stenosis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108429"},"PeriodicalIF":1.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893589","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":"Mortality rates and long-term disability after cerebrovascular events: A prospective cohort study in general Villegas, Buenos Aires, Argentina. The EstEPA population study","authors":"Matías J Alet ,&nbsp;Mario O Melcon ,&nbsp;Sebastián F Ameriso","doi":"10.1016/j.jstrokecerebrovasdis.2025.108426","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108426","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a major cause of death and disability worldwide, with a disproportionate burden in low- and middle-income countries. However, long-term, population-based outcome data are scarce in Latin America. We aimed to estimate mortality and disability after cerebrovascular events in a community-based cohort from Argentina.</div></div><div><h3>Methods</h3><div>We conducted a prospective, population-based cohort study in General Villegas, Buenos Aires, including all incident cerebrovascular events (ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, and transient ischemic attack) from June 1, 2017 to May 31, 2020. Patients were followed for up to five years, with annual assessment of mortality and disability. Mortality rates were calculated and age-standardized to national and WHO populations. Exploratory Cox regression identified baseline predictors of mortality.</div></div><div><h3>Results</h3><div>The five-year cumulative mortality was 50.5 %, with 38 % of deaths occurring within the first year. The crude mortality rate was 131.3 per 100,000 person-years, and 109.4 per 100,000 when standardized to the Argentine population. Older age and higher baseline disability were independently associated with increased mortality. Among survivors, 70.5 % (<em>n</em> = 72) had good functional outcomes (mRS ≤2) at one year, and 70.6 % (<em>n</em> = 24) at five years. A sensitivity analysis excluding transient ischemic attacks (<em>n</em> = 19) yielded similar mortality estimates.</div></div><div><h3>Conclusions</h3><div>Long-term mortality after cerebrovascular events in this Argentine population was high, highlighting gaps in stroke care and follow-up. Nonetheless, most survivors maintained functional independence over time. These findings underscore the need for integrated stroke systems and long-term monitoring strategies, especially in underserved settings.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108426"},"PeriodicalIF":1.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878003","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":"Preexisting dementia is not independently associated with short-term functional outcomes in acute anterior ischemic stroke with atrial fibrillation on oral anticoagulant therapy: A sub-analysis of the prospective analysis of stroke patients taking oral anticoagulants (PASTA) study results","authors":"Ryutaro Kimura MD ,&nbsp;Satoshi Suda MD ,&nbsp;Yasuyuki Iguchi MD ,&nbsp;Yoshiki Yagita MD ,&nbsp;Takao Kanzawa MD ,&nbsp;Seiji Okubo MD ,&nbsp;Shigeru Fujimoto MD ,&nbsp;Kazumi Kimura MD ,&nbsp;PASTA Investigators","doi":"10.1016/j.jstrokecerebrovasdis.2025.108425","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108425","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of patients with stroke and preexisting dementia (PED) increases with age. This study aimed to elucidate the unclear relationship between PED and functional outcomes of acute ischemic stroke (AIS) and atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>We analyzed data from 493 patients (median age, 80 years; 43.0 % women) with AF and acute anterior circulation stroke taking oral anticoagulants enrolled in the multicenter prospective analysis of stroke patients taking oral anticoagulants (PASTA) study. Poor outcome was defined as a modified Rankin scale (mRS) score of 3–5 or 6 (death). We compared clinical characteristics between the PED and non-PED groups and assessed PED’s impact on stroke outcomes.</div></div><div><h3>Results</h3><div>Patients with PED (17.4 %) were old (<em>p</em> &lt; 0.0001) and had a high incidence of congestive heart failure (<em>p</em> &lt; 0.001), increased disease severity at onset (<em>p</em> = 0.0015) and discharge (<em>p</em> &lt; 0.001), and increased frequency of poor functional outcomes (80.2 % vs. 57.0 %; <em>p</em> &lt; 0.0001). Multivariate analysis revealed that age (odds ratio [OR],1.05; 95 % confidence interval [CI], 1.01–1.09; <em>p</em> = 0.0261), pre-stroke mRS score (OR, 2.02; 95 % CI, 1.57–2.59; <em>p</em> &lt; 0.0001), and the initial National Institutes of Health Stroke Scale score (OR, 1.21; 95 % CI, 1.16–1.26; <em>p</em> &lt; 0.0001) were associated with poor outcomes, but PED was not (OR, 1.80; 95 % CI, 0.79–4.13; <em>p</em> = 0.1630).</div></div><div><h3>Conclusions</h3><div>PED showed no independent association with poor discharge outcomes in patients with AIS and AF after adjusting for baseline characteristics, pre-stroke dependency, initial stroke severity, or stroke management.</div></div><div><h3>Registration</h3><div><span><span>https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034958</span><svg><path></path></svg></span>; unique identifier: UMIN000030877</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108425"},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878005","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":"Non-linear association between aneurysm size ratio and in-stent stenosis after flow diverter treatment: A retrospective cohort study of patients with unruptured aneurysms","authors":"Jia-He Yin ,&nbsp;Zhi-Kun Jia ,&nbsp;Chi Huang ,&nbsp;Bin Luo ,&nbsp;Yan-Chao Liu ,&nbsp;Shi-Xing Su ,&nbsp;Xin Zhang ,&nbsp;Chuan-Zhi Duan","doi":"10.1016/j.jstrokecerebrovasdis.2025.108423","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108423","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Flow diversion (FD) treatment has emerged as an effective endovascular therapy for intracranial aneurysms, but in-stent stenosis remains a significant complication affecting patient outcomes. The size ratio (SR) of aneurysms may influence this outcome, but their relationship remains unclear. We investigate the association between intracranial aneurysm SR and in-stent stenosis after FD treatment.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 217 patients with unruptured aneurysms who underwent with flow-diversion treatment from January 2020 to January 2022. SR was the exposure variable, and in-stent stenosis within one year was the outcome. Covariates included demographic, clinical, and procedural factors. Binary logistic regression and two-piecewise linear models were used for analysis.</div></div><div><h3>Results</h3><div>Using binary logistic regression, we found that for every increase in SR by 1, there was on average an associated with a 37 % reduction in stenosis risk (RR = 0.63, 95 %CI: 0.40-0.99, <em>P</em> = 0.046). Further two-piecewise linear regression analysis identified a piecewise linear relationship between SR and in-stent stenosis with a threshold effect at SR = 3.50 (P for log likelihood ratio test = 0.037). In the low SR range (≤3.50), each unit increase in SR was significantly associated with a 54 % lower risk of in-stent stenosis (adjusted RR = 0.46, 95 % CI: 0.25-0.85, <em>P</em> = 0.013) after adjusting for potential confounders. However, in the high SR range (&gt;3.50), this association became non-significant (adjusted RR = 1.56, 95 % CI: 0.51-4.77, <em>P</em> = 0.438).</div></div><div><h3>Conclusion</h3><div>The relationship between aneurysm SR and in-stent stenosis risk demonstrates a piecewise linear pattern with a threshold effect at SR = 3.50. Among aneurysms with SR values of 3.50 or less, each unit increase in SR corresponded to a 54 % decrease in stenosis risk.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108423"},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878004","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":"Safety of thrombolysis in acute ischemic stroke patients with previous aortic abdominal aneurysm repair","authors":"Walter Duarte-Celada MD ,&nbsp;Katherine Rivas MD ,&nbsp;Pichatorn Suppakitjanusant MD ,&nbsp;Pamela Davila-Siliezar MD ,&nbsp;Myriam Vijil MD ,&nbsp;Ximena Gamboa MD ,&nbsp;Chanaka N. Kahathuduwa MD, PhD ,&nbsp;Riichi Ota MD ,&nbsp;Ross Raedeke ,&nbsp;Darko Quispe-Orozco MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108421","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108421","url":null,"abstract":"<div><h3>Objective</h3><div>Intravenous thrombolysis is the standard treatment for acute ischemic stroke (AIS), but its safety in patients with a history of abdominal aortic aneurysm (AAA) repair remains unclear. Many contraindications for thrombolysis stem from populations excluded in pivotal clinical trials, leaving uncertainty about the risk of AAA repair rupture. This study aims to assess the safety of intravenous thrombolysis in AIS patients with prior AAA repair.</div></div><div><h3>Methods</h3><div>This is a retrospective study of patients with a prior history of AAA repair who received intravenous thrombolysis for AIS between 2013 and 2023. Data collected included demographic and clinical characteristics, details of aneurysm repair, abdominal computed tomography angiography (CTA), and patient outcomes.</div></div><div><h3>Results</h3><div>Sixteen patients with a history of AAA repair who received intravenous thrombolysis for AIS were included. The median age was 86.5 years (IQR 80.8–89.8). Most patients (92.3 %) had undergone endovascular repair, with a median time of 10 years (IQR 4.4–14.8) between AAA repair and thrombolysis. No patients underwent abdominal CTA prior to thrombolysis; two patients had post-thrombolysis CTA, both revealing endoleaks, one of which led to aneurysm rupture. Only one patient (6 %) experienced AAA rupture post-thrombolysis. The median mRS was 3 (IQR 1.8–4) at three months.</div></div><div><h3>Conclusions</h3><div>The incidence of AAA rupture after thrombolytic therapy in patients with prior repair was low. Larger studies are needed to determine whether rapid abdominal CTA could identify high-risk features and prevent life-threatening complications.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108421"},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865617","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":"Neuronal intranuclear inclusion disease complicated by acute middle cerebral artery infarction: A case report","authors":"Xueming Li M.Med. ,&nbsp;Weijiang Ding M.D. ,&nbsp;Tao Jiang M.Med.","doi":"10.1016/j.jstrokecerebrovasdis.2025.108424","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108424","url":null,"abstract":"<div><h3>Background</h3><div>Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder with no prior reports linking it to acute large-vessel cerebral infarction.</div></div><div><h3>Methods</h3><div>A 65-year-old man with progressive limb numbness and acute neuropsychiatric symptoms underwent MRI, skin biopsy, and genetic testing.</div></div><div><h3>Results</h3><div>MRI revealed corticomedullary \"ribbon signs\" and right middle cerebral artery (MCA) stenosis. Follow - up imaging not only confirmed the occlusion of the MCA accompanied by an infarction in the basal ganglia but also indicated an enlargement of the \"ribbon signs\". Skin biopsy showed p62-positive intranuclear inclusions; genetic testing identified a NOTCH2NLC GGC expansion (&gt;41 repeats). Despite treatment, the patient died of pneumonia three months post-infarction.</div></div><div><h3>Conclusions</h3><div>This single-case, first-reported observational study of NIID with large-vessel stenosis illustrates a potential vasculopathic link. While robust histopathological validation is pending, the temporal correlation between NIID progression and vascular events warrants further investigation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108424"},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865618","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":"Intracerebral haemorrhage management practices and adherence to the INTERACT3 care bundle in Latin America: Results from an international survey","authors":"Julieta Rosales MD ,&nbsp;Leonardo Augusto Carbonera MD, MSc ,&nbsp;Ana Cláudia De Souza MD, PhD ,&nbsp;Eva Rocha MD, PhD ,&nbsp;Vanessa Cano-Nigenda MD, MSc ,&nbsp;Karen D. Orjuela MD, MSc, MBA ,&nbsp;Rodrigo Guerrero MD ,&nbsp;Carlos Delfino MD, PhD(c) ,&nbsp;Marilaura Nuñez MD, PhD(c) ,&nbsp;Paula Muñoz Venturelli MD, PhD ,&nbsp;Alejandro Gonzalez-Aquines MD, MPH","doi":"10.1016/j.jstrokecerebrovasdis.2025.108419","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108419","url":null,"abstract":"<div><h3>Objective</h3><div>To assess intracerebral hemorrhage (ICH) management practices and adherence to the INTERACT3 care bundle across Latin American countries.</div></div><div><h3>Methods</h3><div>We conducted a multi-national survey among neurologists, neurosurgeons, intensive care specialists, and emergency physicians. From August to December 2024, the survey was distributed across 19 Latin American countries. It assessed hospital characteristics, availability of an ICH code, adherence to INTERACT3 measures, and resource availability. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey.</div></div><div><h3>Results</h3><div>Out of 580 respondents (mean age 40.25 years; 61.6% male), most worked in teaching (86%) and public hospitals (53.6%). Only 27.9% reported an ICH code at their institution. Adherence to INTERACT3 measures ranged from 57.2% (anticoagulation reversal) to 84.7% (blood pressure control), with just 44.5% reporting adherence to all four measures. Time-to-target was not measured by 65%, and only 53.9% maintained interventions for one week. Neuroimaging, neurosurgery, and hematology services were higher in private compared to public and mixed hospitals (p&lt;0.001). ICH code availability was associated with private hospitals and emergency care specialists, while full adherence was more likely among intensive care specialists.</div></div><div><h3>Conclusions</h3><div>ICH management in Latin America is evolving, with increasing adoption of evidence-based practices. However, variability in adherence underscores the need for regional initiatives to standardize ICH care and ensure equitable implementation of best practices.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 10","pages":"Article 108419"},"PeriodicalIF":1.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850348","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}