Brain Circulation最新文献

{"title":"Protective effects of hypoxic conditioning treatment on brain and cardiac tissues following thoracic aorta occlusion.","authors":"Jun Xu, Fang Tong, Yumeng Wang, Sijie Li, Wenbo Zhao, Xiaomei Tian, Fengyong Liu, Xunming Ji, Changhong Ren","doi":"10.4103/bc.bc_133_24","DOIUrl":"https://doi.org/10.4103/bc.bc_133_24","url":null,"abstract":"<p><strong>Background: </strong>Thoracic aortic ischemia-reperfusion (I/R) injury occurs in clinical scenarios and can lead to damage in organs such as the spinal cord, kidneys, and intestines. Hypoxic postconditioning (HyP) has shown promise in reducing organ I/R injury, suggesting its potential applicability in thoracic aortic I/R injury. However, the pathological damage caused by thoracic aorta occlusion (TAO) to the heart and brain is not yet well understood. This study aims to investigate the protective effects of hypoxic conditioning (HyP) treatment on brain and cardiac tissues following TAO-induced I/R injury.</p><p><strong>Materials and methods: </strong>Male C57BL/6 mice were used to construct the TAO model by blocking the thoracic aorta for 0.5 or 1 h, followed by 24 h of reperfusion. The mice were divided into five groups: sham, TAO (0.5 h), TAO (0.5 h) +HyP, TAO (1 h), and TAO (1 h) +HyP. Hematoxylin and eosin, Masson, and Sirius red staining were performed to assess morphological changes and collagen deposition in brain and heart tissues. Protein expression assays were conducted to quantify inflammation-related proteins in the serum.</p><p><strong>Results: </strong>The results showed that TAO caused significant neuronal damage in the hippocampal regions (CA1, CA3, and DG) and myocardial cell damage with collagen deposition. HyP treatment significantly alleviated these damages, particularly with shorter ischemic durations (0.5 h). Specifically, in cardiac tissues, HyP treatment reduced myocardial injury and collagen deposition. In addition, HyP treatment modulated systemic inflammatory responses, as evidenced by the increased expression of anti-inflammatory proteins such as interleukin 13 (IL-13) and the decreased expression of pro-inflammatory proteins such as IL-6, IL-12p70, IL-17, and tumor necrosis factor-α.</p><p><strong>Conclusion: </strong>HyP treatment significantly mitigates brain and cardiac tissue damage caused by TAO, especially with shorter ischemic durations. These findings highlight the potential clinical application of HyP treatment in reducing TAO-induced tissue damage and inflammation, offering a novel therapeutic option for patients with thoracic aortic I/R injury. Future studies should further investigate the mechanisms and optimal implementation protocols of HyP treatment to maximize its clinical value.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"64-76"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving imaging of rapidly improving posterior reversible encephalopathy syndrome: A case report.","authors":"Yilong He, Langtao He, Yetao Lin, Yitao He","doi":"10.4103/bc.bc_74_24","DOIUrl":"10.4103/bc.bc_74_24","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disorder with no specific clinical symptoms in the early stage; thus, early imaging identification is of great importance. A 29-year-old pregnant woman at 37 weeks experienced sudden generalized seizures accompanied by impaired consciousness. Brain computed tomography, conducted around 3 h after the onset, revealed symmetric areas of decreased density in the basal ganglia, brainstem, and suboccipital cortex, along with cerebral swelling. Following treatment with positive inotrope, diuretics, antihypertensives, and dehydration therapy, the patient regained clear consciousness on the 2^nd day. On the 9^th day postonset, a follow-up contrast-enhanced magnetic resonance imaging (MRI) showed slightly elevated signals in the bilateral occipital lobes on the T2 fluid-attenuated inversion recovery sequence. A subsequent brain MRI on day 47 postonset indicated no significant abnormal changes. Neuroimaging is pivotal for PRES diagnosis, revealing typical signs of widespread vasogenic edema in the posterior brain white matter, affecting the occipital lobes, cerebellum, brainstem, thalamus, and basal ganglia. With timely treatment, these lesions can partially or completely resolve within days or weeks.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 3","pages":"240-242"},"PeriodicalIF":4.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of N2H3 nomogram to predict outcomes in patients with acute ischemic stroke treated by intravenous thrombolysis.","authors":"Huai-Mei Zhang, Zi-Duo Shen, Yang Qu, Peng Zhang, Reziya Abuduxukuer, Li-Juan Wang, Yu Li, Yu-Mei Chen, An-Ran Liu, Xiao-Dong Liu, Li-Li Zhao, Chun-Yu Yang, Jing Yao, An-Ying Wang, Yong-Fei Jiang, Jin-Cheng Wang, Chen-Peng Dong, Fang-Fang Liu, Li Li, Ying-Bin Qi, Chun-Fei Wang, Hao Li, Li-Ying Zhang, Wen-Juan Ma, Zhen-Ni Guo, Yi Yang","doi":"10.4103/bc.bc_81_24","DOIUrl":"10.4103/bc.bc_81_24","url":null,"abstract":"<p><strong>Background: </strong>The N2H3 model was evaluated for forecasting the 3-month outcomes for patients experiencing acute ischemic stroke who received intravenous thrombolysis (IVT), in our previous study. The present study aimed to validate the predictive ability of the N2H3 model and to compare its accuracy to the THRIVE-c and START models (both of which are widely employed for prognostic predictions following IVT).</p><p><strong>Methods: </strong>Our study prospectively enrolled consecutive stroke patients who received IVT from 16 hospitals. Cases from one hospital were included in External Validation Dataset 1, whereas External Validation Dataset 2 included patients from the other 15 hospitals. The effectiveness of each model in distinguishing outcomes was assessed by calculating the area under the receiver operating characteristic curve (AUC-ROC). In addition, the overall performance of the N2H3 model was assessed through the scaled Brier score.</p><p><strong>Results: </strong>Finally, 794 patients were included, of which 582 were included in External Validation Dataset 1 and 212 in External Validation Dataset 2. The N2H3 model's AUC-ROC for forecasting unfavorable outcomes at 3-months was 0.810 (95% confidence interval [CI]: 0.771-0.848) in the first dataset and 0.782 (95% CI: 0.699-0.863) in the second dataset. For the START model, the AUC-ROCs in the two validation datasets were 0.729 (95% CI: 0.685-0.772) and 0.731 (95% CI: 0.649-0.772), respectively. The THRIVE-c model showed AUC-ROCs of 0.726 (95% CI: 0.682-0.770) and 0.666 (95% CI: 0.573-0.759), respectively. The Brier scores of the N2H3 model were 0.153 and 0.147 in cohorts 1 and 2, respectively.</p><p><strong>Conclusions: </strong>The N2H3 model exhibited good predictive ability in both external validation cohorts. Moreover, it demonstrated advantages over the THRIVE-c and is not inferior to the START nomogram in this regard.</p><p><strong>Trial registration: </strong>Clinical Research of Intravenous Thrombolysis for Ischemic Stroke in Northeast of China (CRISTINA) (identifier: NCT05028868).</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 3","pages":"212-218"},"PeriodicalIF":4.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occipital sinus dural arteriovenous fistulas.","authors":"Xin Su, Yongjie Ma, Hongqi Zhang, Peng Zhang","doi":"10.4103/bc.bc_18_24","DOIUrl":"10.4103/bc.bc_18_24","url":null,"abstract":"","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 3","pages":"228-230"},"PeriodicalIF":4.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management of endovascular embolization in a patient of neurofibromatosis with associated aortic and multisystemic vasculopathy: A case report.","authors":"Sangeetha R Palaniswamy, Meshwa Desai, Ankit Arora, H R Aravinda","doi":"10.4103/bc.bc_76_24","DOIUrl":"10.4103/bc.bc_76_24","url":null,"abstract":"<p><p>Patients with neurofibromatosis undergo multiple surgeries during their lifetime, presenting as challenging scenarios to the perioperative team. We present the case report of a young male patient with type 1 neurofibromatosis scheduled for endovascular embolization of thoracic spinal arteriovenous malformation under general anesthesia. Associated vasculopathy included stented descending thoracic aortic coarctation, an unrepaired saccular aortic aneurysm (AA) distal to the stent suggestive of a type 1 endoleak, bilateral segmental pulmonary arterial thrombosis, bilateral subclavian artery stenosis, and a retroperitoneal neurofibroma compressing the coeliac artery. Our primary concerns were a possible periprocedural AA rupture becoming a surgical emergency, difficult vascular access, and perioperative thromboembolism. Periprocedural hemodynamic surges were avoided using continuous hemodynamic monitoring, adequate anesthetic depth, and analgesia. After an uneventful procedure, the patient was extubated with a smooth postoperative course. An in-depth knowledge about underlying pathophysiology, anticipation and preparedness for potential complications, and interdisciplinary coordinated teamwork serve to preserve patient outcomes.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 2","pages":"162-165"},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective strategies in acute ischemic stroke: A narrative review of recent advances and clinical outcomes.","authors":"Min Zhao, Yue Qiao, Alexander Weiss, Wenbo Zhao","doi":"10.4103/bc.bc_165_24","DOIUrl":"10.4103/bc.bc_165_24","url":null,"abstract":"<p><p>Reperfusion therapy, which substantially promotes the vessel recanalization rate and improves clinical outcomes, remains the most effective treatment of acute ischemic stroke (AIS). However, a substantial number of patients are either unsuitable for recanalization therapy or experience limited recovery postreperfusion. There is growing recognition that adjunctive neuroprotective therapies may further improve the outcomes in AIS patients by protecting brain tissue during ischemia. Recent advancements in neuroprotective approaches, including pharmacologic agents such as nerinetide edaravone, and uric acid, as well as nonpharmacological interventions, such as remote ischemic conditioning and normobaric hyperoxia, offer promising potentials in stroke care. This review provides an overview of the current neuroprotective therapies, examines recent clinical evidence, and discusses the strengths and weaknesses of certain clinical trials aimed at cerebral protection.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 4","pages":"296-302"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and gender disparities in patients undergoing mechanical thrombectomy for large vessel occlusion at a comprehensive stroke center.","authors":"Olivia Duru, Ryan G Eaton, Nathan Ritchey, Sharon Heaton, Ciarán J Powers","doi":"10.4103/bc.bc_66_24","DOIUrl":"10.4103/bc.bc_66_24","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke for select patients with large vessel occlusion (LVO). Although racial disparities in the utilization of thrombectomy have been previously identified, disparities in the utilization of thrombectomy in a single center with a standardized patient selection protocol have not been described in the literature.</p><p><strong>Methods: </strong>Using the American Heart Association Quality Improvement Programs Registry, we retrospectively reviewed the records of 1,143 patients with LVO between December 1, 2014, and May 31, 2021. Patient records were assessed for demographic data, stroke risk factors, process metrics, and success of thrombectomy. A Pearson's Chi-Squared and an independent two-sample <i>t</i>-test were used to determine the significance. Following this, a multivariate logistic regression was run to determine predictably of thrombectomy outcomes.</p><p><strong>Results: </strong>Of the 1,143 LVO patients, 567 were male (49.6%), 576 were female, (50.4%), 963 were white (84.3%), and 180 were nonwhite (15.7%). Based on our Pearson's Chi-squared analysis, female patients were more like to undergo thrombectomy compared to male patients (62.4% vs. 48.9%; <i>P</i> < 0.001). White patients were also more likely to undergo thrombectomy compared to nonwhite patients (58.7% vs. 39.7%; <i>P</i> < 0.001). After the multivariate logistic regression analysis and after controlling for comorbidities, insurance status, age, time to presentation (last known well to arrival), transfer from outside hospital, and zip codes, white patients were 2.29 times more likely to receive a thrombectomy compared to nonwhite patients (odds ratio [OR], 2.29, 95% confidence interval [CI], 1.33, 3.944). Patients with Medicare insurance were 33.57 times more likely to receive a thrombectomy compared to those without medicare (OR, 33.57, 95% CI, 20.37, 55.327). In the regression model, sex did not contribute significantly to the likelihood of receiving a thrombectomy.</p><p><strong>Conclusions: </strong>White patients were more likely to undergo MT. Female patients tended to have higher rates of MT, accounting for the fact that other variables could have influenced this. These disparities may result from a multitude of other factors such as eligibility for MT, delayed presentation, and adequate diagnosis of LVO in the emergency department. This study highlights the importance of and potential causes of these disparities. Further investigation with data from multiple centers is necessary to validate these findings and identify strategies for improving utilization of thrombectomy.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 4","pages":"330-335"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral arterial collateral status, but not venous outflow profiles, modifies the effect of intravenous tissue plasminogen activator in acute ischemic stroke.","authors":"Elif Sarionder Gencer, Ezgi Yilmaz, Ethem Murat Arsava, Rahsan Gocmen, Mehmet Akif Topcuoglu","doi":"10.4103/bc.bc_46_24","DOIUrl":"10.4103/bc.bc_46_24","url":null,"abstract":"<p><strong>Background: </strong>The role of arterial collateral and venous outflow status on the response to intravenous tissue plasminogen activator (IV-tPA) has not been sufficiently clarified in acute major cerebral occlusions.</p><p><strong>Patients and methods: </strong>A total of 130 patients (mean age: 71 years; 73 females) with acute middle cerebral artery M1/M2 segment or terminal internal carotid artery occlusion treated solely with IV-tPA were analyzed. Regional leptomeningeal score (rLMC) was used for cerebral arterial collateral scoring, and the cortical vein opacification score (COVES) and modified Prognostic Evaluation based on Cortical vein score difference In Stroke (PRECISE) superficial and deep scores were used for venous outflow profile. Exploratory logistic models for response to IV-tPA [positive response: National Institutes of Health Stroke Scale (NIHSS) decrease 4 (or decrease to 0) at 24 h; dramatic response: NIHSS decrease ≥8 (or decrease to 0 or 1)], functional outcome (modified Rankin's score 0-1 as \"excellent\" and 0-2 \"good\") and tPA-associated hemorrhagic transformation were constructed.</p><p><strong>Results: </strong>IV-tPA efficacy was positive in 47% and dramatic in 32%. Dramatic response was linked to better arterial collateral status (exp[B] =1.115 [95% confidence interval (CI), 1.016-1.223]). Excellent outcome was noted in 26% and good in 45%. One-point increase in rLMC score independently increased good prognosis (exp[B] =1.209 [1.034-1.412]). Patients with good prognosis had higher (by 0.5 points) modified PRECISE deep score (<i>P</i> = 0.047) and less frequent nonsufficient modified PRECISE deep score (0-2) (<i>P</i> = 0.017) in univariate analyses. However, these associations failed to survive in multiple regression. Any type tPA-associated cerebral hemorrhagic transformation was observed in 23% and parenchymal hemorrhage type 2 in 5.4%. While rLMC score showed a borderline strength correlation to hemorrhage (exp[B] =0.899 [95% CI, 0.808-1.001]), outflow scores not.</p><p><strong>Conclusion: </strong>While arterial collateral status modifies the effect of tPA in acute anterior circulation major artery occlusions, venous outflow capacity is not so critical.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 4","pages":"336-342"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moyamoya disease manifesting with bilateral involvement of the proximal vertebral arteries: A case report.","authors":"Omar Alwakaa, Felipe Ramirez-Velandia, Jean Filo, Michael Young, Christopher S Ogilvy, Justin H Granstein","doi":"10.4103/bc.bc_37_24","DOIUrl":"10.4103/bc.bc_37_24","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is a cerebrovascular disorder characterized by progressive occlusion of intracranial arteries, often leading to stroke and intracerebral hemorrhage. While MMD classically affects the intracranial vasculature, we present an unusual case of bilateral vertebral steno-occlusion, resulting in vertebrobasilar insufficiency in a 37-year-old man with MMD and treated with angioplasty and stenting of the dominant vertebral artery. Review of the literature demonstrates proximal vertebral artery involvement to be a rare manifestation of moyamoya disease. This report contributes to the understanding of the clinical spectrum of MMD and emphasizes the need for vigilance and awareness of the possibility of extracranial vascular complications in affected individuals.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 4","pages":"372-377"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral blood flow change with fluid resuscitation in acute ischemic stroke.","authors":"Joseph Miller, John Aidan Moloney, Noah Elagamy, Jacob Tuttle, Sam Tirgari, Sean Calo, Richard Thompson, Bashar Nahab, Christopher Lewandowski, Phillip Levy","doi":"10.4103/bc.bc_30_24","DOIUrl":"10.4103/bc.bc_30_24","url":null,"abstract":"<p><strong>Background: </strong>In acute ischemic stroke (AIS), cerebral autoregulation becomes dysfunctional, impacting the brain's ability to maintain cerebral blood flow (CBF) at adequate levels. Reperfusion of affected and nearby brain tissue in AIS is currently the aim of treatment in AIS, but the effectiveness of fluid resuscitation on increasing the CBF is debated.</p><p><strong>Objective: </strong>We investigated the hypothesis that early fluid resuscitation with normal saline bolus would improve CBF velocity in the initial resuscitation of patients with AIS.</p><p><strong>Methods: </strong>We conducted a prospective, quasi-experimental study on 30 patients in the early stages of AIS management. Patients had a National Institutes of Health Stroke Scale (NIHSS) score of 3 or higher. Patients met inclusion criteria if they were 18-90 years old and had time of stroke onset within 12 h. Patients with a severe underlying disability, hemorrhagic stroke, advanced directives for comfort care/hospice, as well as pregnant patients were excluded. Noninvasive hemodynamic monitoring was performed. We performed transcranial Doppler (TCD) insonation of the middle cerebral arteries (MCAs) to measure CBF velocity. Each patient received a 500-ml normal saline crystalloid bolus as a standardized intervention, then had hemodynamic and TCD measurements repeated. Analysis was limited to patients with stroke confirmed with neuroimaging. Mean flow velocity (MFV) was compared before and postreceiving the bolus in the MCA ipsilateral to the ischemic location.</p><p><strong>Results: </strong>Thirty patients were analyzed who had confirmed AIS. The mean age was 53 ± 13 years, 50% were female, and the median NIHSS was 6 (interquartile range: 4-7). Outcomes measured included various cerebrovascular and cardiovascular parameters. Infusion of 500-mL normal saline bolus produced increases in systolic blood pressure (+7 mmHg, 95% confidence interval [CI] 0.6-13 mmHg) and stroke volume (SV) index (+2.2 ml/m², 95% CI 0.3-4.1 ml/m²). The mean change in MFV was not statistically significant (+0.3 cm/s, 95% CI-3.7-4.3 cm/s). An adjusted model showed higher age and lower baseline SV index were not associated with improved MFV following administration of the fluid bolus.</p><p><strong>Conclusion: </strong>Our prospective study of AIS patients revealed that a fluid bolus improves hemodynamic parameters, but did not significantly increase CBF velocity.</p><p><strong>Trial registration: </strong>clinicaltrials.gov (identifier: NCT02056821).</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 4","pages":"303-307"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}