Frontiers in stroke最新文献

{"title":"Sex differences in location of initial diagnosis and discharge destination among medicare fee-for-service beneficiaries with post-stroke aphasia.","authors":"Molly M Jacobs, Charles Ellis","doi":"10.3389/fstro.2026.1904901","DOIUrl":"10.3389/fstro.2026.1904901","url":null,"abstract":"<p><strong>Objective: </strong>To characterize sex differences in the clinical setting of initial aphasia diagnosis and the discharge destination of fee-for-service (FFS) Medicare beneficiaries diagnosed with post-stroke aphasia.</p><p><strong>Methods: </strong>Data for this project were obtained from 100% of FFS Medicare claims and included all beneficiaries who incurred an inpatient claim between January 2016 and October 2019 listing stroke as the primary diagnosis and had a claim listing aphasia diagnosis within 90 days of stroke.</p><p><strong>Results: </strong>Among those diagnosed with stroke (745,917), 14.5% (<i>N</i> = 107,753) were also diagnosed with aphasia within 90 days. Approximately 60.96% of men and 56.47% of women had their initial aphasia-related claim in an inpatient facility; 15.12% of men and 19.47% of women in a skilled nursing facility; and 8.44% of men and 7.03% of women in an outpatient facility. Roughly 14.99% of men and 11.50% of women with aphasia were discharged home; 25.38% of men and 31.37% of women were discharged to a skilled nursing facility; and 42.94% of men and 38.24% of women were discharged to a long-term care or rehabilitation facility (χ² =904.70, <i>p</i> < 0.0001). Relative to men, women were significantly more likely to be discharged to a skilled nursing facility (OR = 1.35, 95% CI = 1.31, 1.39), but less likely to be discharged to a long-term care or rehabilitation facility (OR = 0.83, 95% CI = 0.81, 0.86).</p><p><strong>Discussion: </strong>Sex differences existed in the location of aphasia diagnosis and their destination following acute care discharge. However, the cause of these differences is unknown or how they related to quality-of-care.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1904901"},"PeriodicalIF":1.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemia impacts short-term and long-term mortality risk after acute ischemic stroke.","authors":"Chen Ee Low, Hon Jen Wong, Chun En Yau, Jia Yang Tan, Yao Neng Teo, Yao Hao Teo, Jasper R Senff, Reinier Tack, Andrew F W Ho, Bernard P L Chan, Leonard L L Yeo, Joshua Y P Yeo, Ching-Hui Sia, Benjamin Y Q Tan","doi":"10.3389/fstro.2026.1859301","DOIUrl":"10.3389/fstro.2026.1859301","url":null,"abstract":"<p><strong>Background: </strong>The relationship between hemoglobin concentration and all-cause mortality in acute ischemic stroke (AIS) patients remains unclear due to conflicting findings. This study aims to evaluate the impact of hemoglobin concentration on the risk of both short-term and long-term all-cause mortality in AIS patients from a nationwide stroke registry.</p><p><strong>Method: </strong>We utilized data from the Singapore Stroke Registry (SSR), including patients >18years old at first AIS onset, and received treatment at a local hospital between 2005 and 2020. Patients were stratified according to sex-specific hemoglobin concentration cut-offs on anemia severity and polycythemia from the World Health Organization. Multivariate logistic regression and Cox proportional hazards modeling were performed, adjusting for demographics and cardiovascular risk factors.</p><p><strong>Results: </strong>A total of 56,884 ischemic stroke patients were included, of which 66.8% had no anemia, 15.7% had mild anemia, 12.2% had severe anemia, and 5.3% had polycythemia. The cohort was predominantly male (57%), with a median age of 68 years. The median follow-up duration was 10-years (IQR 7-13). Compared to patients with normal-range hemoglobin, both mild and severe anemia was associated with elevated short-term and long-term risks of all-cause mortality. Severe anemia was associated with the highest risk of all-cause mortality, with hazard ratios of 1.99 (95%CI:1.92-2.06) at 30-days, 1.73 (95%CI:1.66-1.81) at 1-year, and 1.52 (95%CI:1.41-1.64) at 5-years. However, the excess risk associated with severe anemia appeared to attenuate at 10-years, whilst the elevated risk persisted among patients with mild anemia.</p><p><strong>Conclusion: </strong>In this nationwide stroke registry, anemia is prevalent among AIS patients and is significantly associated with both short-term and long-term mortality.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1859301"},"PeriodicalIF":1.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between hearing difficulty, labor force status, and health burden in young stroke survivors.","authors":"Elizabeth Tobener, Molly Jacobs, Charles Ellis","doi":"10.3389/fstro.2026.1807741","DOIUrl":"10.3389/fstro.2026.1807741","url":null,"abstract":"<p><strong>Background: </strong>Young adults with stroke often experience functional impairments, which may be exacerbated by hearing loss. This study examined associations between employment disruptions and functional, physical, and mental health limitations among young stroke survivors with and without self-reported hearing difficulty.</p><p><strong>Methods: </strong>This analysis used data from the 2020 to 2023 Behavioral Risk Factor Surveillance System (BRFSS) for adults aged 18-49 with self-reported stroke. Outcome measures included functional limitations-including concentration/memory, mobility/walking, dressing/bathing, and completing errands-and the number of days with poor physical, mental, and overall health. Logistic and negative binomial regressions examined the associations between these outcomes, employment status, and hearing difficulty, controlling for sample heterogeneity. Interactions between hearing difficulty and employment status were assessed to examine potential differential effects.</p><p><strong>Results: </strong>Respondents who reported hearing difficulty had significantly greater odds of functional limitations, including difficulty concentrating (OR = 2.60, 95% CI: 1.56-4.35), doing errands independently (OR = 3.71, 95% CI: 2.22-6.21), dressing or bathing (OR = 6.09, 95% CI: 3.30-11.24), and walking or climbing stairs (OR = 3.66, 95% CI: 1.89-7.09). Hearing difficulty was also independently associated with a greater number of poor physical health days (IRR = 1.39, 95% CI: 1.02-1.89) and poor mental health days (IRR = 1.67, 95% CI: 1.30-2.14). Being out of work or out of the labor force was independently associated with poorer functional, physical, and mental health outcomes.</p><p><strong>Conclusions: </strong>These findings underscore the need for integrated post-stroke rehabilitation strategies that address sensory, cognitive, and social dimensions.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1807741"},"PeriodicalIF":1.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and frequent risk factors in young adult patients with stroke at a tertiary care hospital in Honduras.","authors":"Kivian Obed Matamoros Padilla, Roberto Daniel Padilla Valeriano, Eleonora Espinoza-Turcio, Henry Noel Castro-Ramos, Lysien Ivania Zambrano, Selvin Z Reyes-Garcia","doi":"10.3389/fstro.2026.1887056","DOIUrl":"10.3389/fstro.2026.1887056","url":null,"abstract":"<p><strong>Background: </strong>Stroke has become the third leading cause of death, accounting for 10% of all deaths. The prevalence of intracranial hemorrhage, subarachnoid hemorrhage, and ischemic stroke has increased by 20.5%, 11.5%, and 7.4%, respectively, in the 20-54 age group, making it a worldwide problem for the young adult population.</p><p><strong>Aim: </strong>To describe the clinical characteristics, diagnostic findings, stroke subtypes, and frequent risk factors among young adult patients with stroke treated at a tertiary care hospital in Honduras.</p><p><strong>Methods: </strong>Cross-sectional, non-probability convenience sample study of 70 patients aged 18-55 years. An ethical opinion was obtained (079-2024). The information was supplemented with clinical examinations, laboratory tests, neuroimaging, carotid Doppler, and transcranial Doppler with bubble test. Descriptive statistics were obtained.</p><p><strong>Results: </strong>Young adults accounted for 30.0% of stroke cases evaluated. The mean age was 43.4 ± 9.1 years. The 61.4% were women, 55.7% had a history of hypertension, 31.4% had type 2 diabetes mellitus, and 24.3% had migraines. A total of 21.4% were smokers, and 15.7% of women used oral contraceptives. Ischemic stroke occurred in 71.4% of cases, with a cardioembolic etiology in 21.4%. A patent foramen ovale (PFO) was identified in 5 of 17 cases, corresponding to 29.4% of the tested subgroup and 7.1% of the total sample and mortality was 15.7%.</p><p><strong>Conclusions: </strong>A high proportion of strokes were observed in women, with a predominance of ischemic strokes of cardioembolic etiology. Modifiable factors associated with stroke were identified, which can be controlled, contributing to a decrease in morbidity and mortality from this pathology.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1887056"},"PeriodicalIF":1.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autophagy in ischemic stroke: pathophysiology, therapeutics, and challenges ahead.","authors":"Tshibambe N Tshimbombu, Arsene Daniel Nyalundja, Gates Mulume Iragi, Josué Aganze Mwambali, Samira Braimah Shardow, Melissa Ewurakua Amoako, Kyle E Thurmann, Daniel I Gonzalez, Paige Banyas, Judea Wiggins, Supreet Kaur","doi":"10.3389/fstro.2026.1769395","DOIUrl":"10.3389/fstro.2026.1769395","url":null,"abstract":"<p><p>Autophagy is a fundamental cellular homeostatic process that exerts a dual, context-dependent influence on the pathophysiology of ischemic stroke. Functioning as both a neuroprotective survival mechanism and a neurotoxic pathway, autophagy presents a complex therapeutic challenge as well as a potential target for molecular intervention. This narrative review synthesizes preclinical and emerging clinical evidence to summarize key mechanisms regulating autophagy in ischemic injury, evaluate therapeutic strategies, and identify promising molecular pathways and druggable targets for translational development. In the early ischemic phase, moderate autophagic activation facilitates neuronal survival by clearing damaged mitochondria and protein aggregates, thereby reducing oxidative stress and modulating neuroinflammation. This protective response is primarily mediated by regulators such as Beclin-1, the conversion of LC3-I to LC3-II, and the energy-sensing AMP-activated protein kinase pathway. Conversely, sustained or excessive autophagy, particularly during late-stage reperfusion, exacerbates neuronal injury through impaired lysosomal fusion, autophagosome accumulation, and the triggering of autophagic cell death and ferroptosis. Preclinical evidence highlights a critical Goldilocks zone of activation, suggesting that therapeutic success hinges on maintaining autophagic flux within narrow physiological limits. Advancing these therapies into clinical practice requires precise spatiotemporal modulation, potentially as an adjunct to mechanical thrombectomy, as well as the development of robust, real-time biomarkers. A comprehensive understanding of the molecular and genetic determinants of autophagy, including sex-specific responses, is essential to bridge the translational gap and establish autophagy as a viable target for precision stroke medicine.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1769395"},"PeriodicalIF":1.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired left atrial strain is associated with acute ischemic stroke in patients without atrial fibrillation.","authors":"Robert Trueick, Jonathan Shpigelman, Omar Dabash, John McCallig, Muhammad Ahmad Ashfaque, Muneeb Quidwai, Lisa Donaghy, Patricia Guilfoyle, Lavanya Saiva, James O'Neill, Michael J Daly","doi":"10.3389/fstro.2026.1838151","DOIUrl":"10.3389/fstro.2026.1838151","url":null,"abstract":"<p><strong>Background: </strong>Cryptogenic stroke, defined as a stroke with an unknown cause, poses a significant clinical challenge in cardiology and neurology. Left atrial (LA) dysfunction, as measured by left atrial strain (LAS), may identify patients who are at high risk for acute ischemic stroke (AIS), even if they do not have documented atrial fibrillation (AF).</p><p><strong>Methods: </strong>This retrospective, cross-sectional and cohort study (known as the ASSISTANT Study) was conducted at a single, tertiary-care referral center. The study included patients who tested positive on the Face Arm Speech Test (FAST) and who did not have high-risk stroke mechanisms. These patients presented acutely and underwent a transthoracic echocardiogram. Speckle-tracking echocardiography was used to measure LAS in three phases: reservoir (LASr), conduit (LAScd), and contractile (LASct). The associations of LAS with imaging-confirmed acute ischemic stroke (AIS) at presentation and incident AIS during follow-up were evaluated using multivariable logistic and Cox regression analyses, respectively.</p><p><strong>Results: </strong>Among the 415 patients (251 cases and 164 controls), LASr and LAScd were both independently associated with AIS at presentation [OR per 5% increase: 0.789 (95% CI, 0.674-0.920) and 0.573 (95% CI, 0.450-0.718), respectively]. During a median follow-up of 3.59 years, 31 patients developed incident AIS. The incidence of AIS increased as the tertiles of LASr (<i>P</i> _trend = 0.021) and LAScd (<i>P</i> _trend < 0.001) worsened. Only LAScd remained independently associated with incident AIS [HR per 5% increase: 0.682 (95% CI, 0.478-0.953)].</p><p><strong>Conclusion: </strong>Impaired LAScd is independently associated with prevalent and incident AIS in patients without identified high-risk stroke mechanisms. Prospective studies are needed to determine whether LAScd can guide risk stratification and preventive strategies in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT07102693).</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1838151"},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between educational attainment and discharge disposition following incident stroke hospitalization: the Atherosclerosis Risk in Communities study.","authors":"Ning Li, Erin L Abner, Silvia Koton, Lena Mathews, Kunihiro Matsushita, Anna M Kucharska-Newton","doi":"10.3389/fstro.2026.1847066","DOIUrl":"10.3389/fstro.2026.1847066","url":null,"abstract":"<p><strong>Background: </strong>The relationship between educational attainment and discharge disposition after stroke hospitalization remains unclear. This study examined whether educational attainment is associated with discharge disposition after incident stroke and whether stroke severity modifies this association.</p><p><strong>Methods: </strong>The study included Atherosclerosis Risk in Communities (ARIC) participants with an incident stroke hospitalization from 1991 to 2020 who were enrolled in fee-for-service (FFS) Medicare at discharge. Discharge disposition was obtained from hospitalization claims. Educational attainment was categorized as \"less than high school\" vs. \"high school or more.\" Multivariable logistic regression models were used to estimate associations between educational attainment and discharge disposition, adjusting for age at stroke, sex, race, and study center. Stroke severity was measured using the Stroke Administrative Severity Index (SASI) derived from Medicare discharge diagnosis codes and assessed as an effect modifier.</p><p><strong>Results: </strong>Among 976 stroke survivors (mean age 75.5 years; 56.6% women; 31.8% Black), the mean hospital stay was 9.3 days, and 30.1% had an intensive care unit (ICU) stay. Overall, 58.9% were discharged home. The median Elixhauser Comorbidity Index was 3, and 55.5% had a SASI score of zero. Compared with those with at least a high-school education, participants with less than high-school education had similar odds of being discharged home (AOR 0.95; 95% CI: 0.7-1.28). Stroke severity did not significantly modify the association.</p><p><strong>Conclusion: </strong>Educational attainment was not significantly associated with discharge disposition after incident stroke hospitalization in this cohort, although sample size limits the ability to rule out associations.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1847066"},"PeriodicalIF":1.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age, race, and education as moderators of post-stroke cognitive decline following dental care.","authors":"Michael H Parrish, Leonardo Bonilha, Karly Pikel, Caitlin Scott, Stefanie Wood, Haley N VerKuilen, Souvik Sen","doi":"10.3389/fstro.2026.1807730","DOIUrl":"10.3389/fstro.2026.1807730","url":null,"abstract":"<p><p>Post-stroke cognitive decline (PSCD) poses a significant challenge to long-term recovery and quality of life following stroke, influenced by both fixed biological factors and modifiable health behaviors such as oral and dental care. In this data-driven exploratory analysis of the PREMIERS Phase II randomized trial (ClinicalTrials.gov NCT#02541032), we examined the moderating effects of clinical, biological, and demographic characteristics on the relationship between dental care and PSCD over a 12-month period. The study included 280 stroke/transient ischemic attack (TIA) survivors who received either intensive or standard dental care. Cognitive outcomes were assessed using the Montreal Cognitive Assessment (MoCA) at baseline and follow-up, with change in MoCA score as the primary outcome. Lasso regression was applied for empirically based feature selection of moderators, and bootstrapped multiple linear regression demonstrated that increased dental visits predicted relatively better cognitive outcomes in older adults (age interaction-term <i>b</i> = -0.664, <i>p</i> < 0.001), Black participants (race interaction-term <i>b</i> = -0.475, <i>p</i> < 0.05), and those with low-intermediate education levels (education interaction-term <i>b</i> = 0.413, <i>p</i> < 0.05). Exploratory graphs revealed that older adults, Black adults, and adults with low-intermediate education showed greater cognitive improvement with higher dental visit frequency, with the final model (including selected moderators) significantly predicting PSCD [<i>F</i> _{(11, 268)} = 10.51, <i>p</i> < 0.001]. These findings highlight the potential of equity-focused, precision-medicine interventions that incorporate dental care to mitigate PSCD in vulnerable stroke populations.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1807730"},"PeriodicalIF":1.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparison of admitting neutrophil/lymphocyte ratio with baseline NIH stroke scale score in discriminating poor 30-day stroke outcome among Nigerian Africans.","authors":"Oladotun V Olalusi, Joseph Yaria, Akintomiwa Makanjuola, Rufus Akinyemi, Mayowa Owolabi, Adesola Ogunniyi","doi":"10.3389/fstro.2026.1917786","DOIUrl":"10.3389/fstro.2026.1917786","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fstro.2025.1562048.].</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1917786"},"PeriodicalIF":1.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute treatment of ischemic stroke in 19 Sámi language administrative municipalities in the rural inland of Northern Sweden.","authors":"Elisabeth Ronne Engström, Christoffer Nyberg, Mia von Euler","doi":"10.3389/fstro.2026.1759945","DOIUrl":"10.3389/fstro.2026.1759945","url":null,"abstract":"<p><strong>Objects: </strong>The effective treatment of acute stroke requires a series of events, including the recognition of stroke symptoms, following known action plans, and the rapid transfer to a hospital with sufficient medical competence. This is challenging in rural areas with long distances between hospitals with emergency departments. We studied the availability and effectiveness of acute stroke treatment in the most rural parts of northern Sweden. Some of the population in the study area belong to the Sámi, Sweden's indigenous people. Our aim was to study the yearly incidence of ischemic stroke, time window from start of symptoms to arrival at first hospital, and rate of revascularization treatment in the study population and compare to the rest of Sweden.</p><p><strong>Methods: </strong>Statistics Sweden defined the study group which was 142,127 individuals registered as living in the study area sometimes during 2019-2021. We used data from the National Board of Health and Welfare (NBHWF) regarding incidence and from the Swedish Stroke Register (Riksstroke, RS), for time windows and treatments. The study area was compared with the Swedish national data. Transfer times between municipalities, first hospitals, and thrombectomy centers were assessed using open data.</p><p><strong>Results: </strong>The incidence of ischemic stroke in the study group was 280/100.000/year which was significantly higher than national data for the same age group. 1,153 stroke incidents were registered in RS. In the study group 21.1% arrived at the first hospital >24 h from start of symptoms compared to 4.5% in national data. Three percent were treated with thrombectomy and 11.1% with thrombolysis. The numbers were small but those with the lowest percentage of arrival < 3 h, and of reperfusion treatment, all had the longest distances to the first hospital. 26.1 and 17.9% in two municipalities had an unknown time window from start of symptoms. A majority of the population would have shorter distances to thrombectomy centers outside Sweden.</p><p><strong>Conclusion: </strong>Our data shows a higher incidence of ischemic stroke in the study area in the rural northern Sweden. Persons with stroke in this area are unlikely to receive acute care in accordance with the Swedish national stroke guidelines.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1759945"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}