Cerebrovascular Diseases最新文献

{"title":"Enlarged translesional pressure gradient drives recruitment of leptomeningeal collaterals in medically treated patients with symptomatic middle cerebral artery stenosis.","authors":"Yuying Liu, Xuan Tian, Jill Abrigo, Shuang Li, Yu Liu, Linfang Lan, Haipeng Liu, Bonaventure Y M Ip, Sze Ho Ma, Karen Ma, Florence S Y Fan, Hing Lung Ip, Yannie O Y Soo, Howan Leung, Vincent C T Mok, Thomas W Leung, Xinyi Leng","doi":"10.1159/000547147","DOIUrl":"https://doi.org/10.1159/000547147","url":null,"abstract":"<p><strong>Aims: </strong>Evolution patterns and contributing factors of leptomeningeal collaterals (LMCs) in symptomatic intracranial atherosclerotic stenosis (sICAS) remain elusive.</p><p><strong>Methods: </strong>Patients with atherosclerotic M1 middle cerebral artery (MCA-M1) stenosis (50%-99%), who were treated medically and had CT angiography (CTA) at baseline and 1 year, were recruited. LMC status was determined by the laterality of distal vessels in anterior and posterior cerebral artery territories in baseline and 1-year CTA. Computational fluid dynamics models were constructed based on baseline and 1-year CTA, to quantify post-stenotic to pre-stenotic pressure ratio (PR) in MCA-M1 lesions. Decreased PR over 1 year indicated enlarged translesional pressure gradient.</p><p><strong>Results: </strong>Among 33 patients (median age 62 years), 18 (54.5%) and 15 (45.5%) had good and poor baseline LMCs; 11 (33.3%) and 22 (66.7%) had good and poor 1-year LMCs. Twelve (36.4%), 16 (48.5%) and 5 (15.2%) patients had worse, similar and better LMCs at 1 year versus baseline. Sixteen (48.5%) patients had decreased PR over 1 year, associated with good LMCs at 1 year (adjusted odds ratio 6.40; p=0.038), independent of baseline LMC status.</p><p><strong>Conclusion: </strong>LMCs may evolve over time in medically treated sICAS patients, when an enlarged translesional pressure gradient may be a driving force.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Intracranial Blood Clearance on Brain Edema as a Predictor of Delayed Cerebral Infarction Following Subararachnoid Hemorrhage.","authors":"Panagiotis Fistouris, Christian Scheiwe, Juergen Grauvogel, Istvan Csok, Juergen Beck, Peter C Reinacher, Roland Roelz","doi":"10.1159/000547091","DOIUrl":"https://doi.org/10.1159/000547091","url":null,"abstract":"<p><strong>Introduction: </strong>Brain edema is a common finding after intracranial aneurysm rupture and the severity of brain edema has been associated with the risk for delayed cerebral infarction (DCI). In this retrospective comparative study, we investigate a) the role of brain edema for DCI development and b) the impact of active blood clearance on the association between brain edema and DCI.</p><p><strong>Methods: </strong>This study included 799 aSAH patients treated between 10/2005 and 10/2019, excluding those with early mortality (<96h). The Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) was recorded in all patients. Delayed Cerebral Infarctions (DCI) were determined by an independent rating board and neurological outcome was independently assessed by modified Rankin Scale at 6 months. Active blood clearance by cisternal lavage therapy was introduced in 10/2015. 609 patients were treated before and 190 after implementation of cisternal lavage, with 61 high-risk patients (32.1%) receiving lavage. Multivariable regression models were applied to analyzed the role of brain edema for DCI and a matched pairs analysis assessed the impact of cisternal lavage.</p><p><strong>Results: </strong>DCI increased the risk of poor neurological outcome (mRS 4-6) by over 10 times (OR: 10.3, 95% CI 6.8 - 15.8, p<0.001). Poor WFNS scores on admission and high blood volume in the basal cisterns and ventricles were key DCI predictors. Brain edema raised the DCI risk by 2-3 times across all SEBES grades ≥1 (OR 1.90 to 2.80). Cisternal lavage was negatively associated with DCI development (OR: 0.23, 95% CI 0.13- 0.42, p<0.001). In patients selected for cisternal lavage, there was no association between brain edema severity and DCI risk.</p><p><strong>Conclusion: </strong>Brain edema following aSAH is strongly linked to an increased risk of DCI. However, this association disappears once the underlying cause of DCI-intracranial blood-is cleared. Thus, brain edema serves as a marker of bleeding severity rather than a direct causal factor in the development of DCI.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting DWI-Negative Strokes in Rat Models of Acute Internal Carotid Artery Occlusion using Magnetic Resonance Spectroscopy.","authors":"Haoyi Ye, Siqi Liu, Zhihua Wu, Yuping Liu, Xiaoling Li, Haili Yang, Yanyu Zhang, Rongjian Jiang, Zhengfei Yang, Zhifeng Liu","doi":"10.1159/000547134","DOIUrl":"https://doi.org/10.1159/000547134","url":null,"abstract":"<p><strong>Objective: </strong>To explore the potential of Magnetic Resonance Spectroscopy (MRS) for the early diagnosis of the ischemic brain tissue with negative Diffusion Weighted Imaging (DWI) results in the model of acute internal carotid artery occlusion (AICAO) in rats.</p><p><strong>Methods: </strong>Fifteen rats were randomly assigned to three groups: the sham group (SHAM, n=5), the 2-hour ischemia model group (CI2H, n=5), and the 12-hour ischemia model group (CI12H, n=5). In the experimental group, the method of acute internal carotid artery occlusion was adopted to establish a right cerebral ischemia model. After the successful establishment of the model, DWI and MRS scans were first performed, and then the MRS results were recorded. Immunohistochemical analysis of zonula occludens-1 (ZO-1), neuron-specific enolase (NSE), S-100β protein, and cytochrome C (CytC) was conducted on paraffin-embedded brain sections, followed by Spearman correlation analysis between relevant parameters and these proteins.</p><p><strong>Results: </strong>Lipid (Lip) levels were lower in the SHAM group compared to the CI2H group (P<0.05), but no significant difference was observed between the SHAM and CI12H groups. Lip was negatively correlated with ZO-1 across all groups (ρ=-0.768, P<0.001). Lactate (Lac) levels were lower in the SHAM group than in the CI2H and CI12H groups (P<0.05), and Lac was positively correlated with CytC across all groups (ρ=0.801, P<0.001). Apparent Diffusion Coefficient (ADC) values on the right side of the brain were lower in the CI12H group than in the SHAM group (P<0.05), with no significant difference compared to the CI2H group.The level of N-acetyl aspartate (NAA) in the CI12H group was lower than that in the SHAM group and the CI2H group (P < 0.05), and there was no statistically significant difference in the level of NAA between the CI2H group and the SHAM group. The Cho level in the CI12H group exhibited a statistically significant increase compared to both the SHAM and CI2H groups (P < 0.05), and there was no statistically significant difference in the level of Choline (Cho) between the CI2H group and the SHAM group.</p><p><strong>Conclusion: </strong>Brain damage in AICAO rats became evident at two hours after successful modeling. MRS detected brain damage earlier than DWI, with Lac and Lip as the most sensitive markers, preceding changes in NAA, Cho, and ADC values.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of fast progressors receiving endovascular treatment for acute large vessel occlusion: a systematic review and meta-analysis.","authors":"Mingming Zha, Shuaiyu Chen, Jinhua Wang, Yi Xie, Zhihang Huang, Yan E, Ziqi Xu, Benyan Luo, Xiaohao Zhang","doi":"10.1159/000547117","DOIUrl":"https://doi.org/10.1159/000547117","url":null,"abstract":"<p><p>Background Acute large vessel occlusion patients can be categorized into fast and slow progressors based on infarction growth rate (IGR) before endovascular treatment (EVT). However, the characteristics of fast progressors remain uncertain, and a comprehensive review investigating the adverse effects of fast IGR is needed. Methods A systematic search of studies published before March 24, 2025 was conducted using PubMed, Web of Science, Embase, and Cochrane Library following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies comparing fast and slow progressors before EVT were screened. Baseline characteristics and clinical outcomes were collected. Meta-analysis was performed to pool the results. Weighted odds ratio (OR), mean difference (MD), and confidence intervals (CI) were calculated. This study was registered on the International Prospective Register of Systematic Reviews platform (CRD420251016945). Results A total of 8 studies involving 2718 patients were pooled. Age and gender were similar between fast and slow progressors. Fast progressors had significantly higher baseline National Institute of Health Stroke Scale scores (MD, 2.7; 95%CI, 2.0-3.4; I2=0), higher intravenous thrombolysis rates (OR, 1.41; 95%CI, 1.07-1.86; I2=62%), larger proportions of internal carotid artery occlusion (OR, 1.74; 95%CI, 1.39-2.19; I2=0), and lower percentages of good collateral status (OR, 0.33; 95%CI, 0.22-0.50; I2=53%). Cardioembolism etiology was also prevalent in fast progressors (OR, 1.42; 95%CI, 1.10-1.83; I2=0). Regarding outcomes, fast IGR was associated with significantly lower rates of successful reperfusion (OR, 0.70; 95%CI, 0.57-0.86; I2=0) and modified Rankin Scale (mRS) score 0-2 at 90-day (OR, 0.34; 95%CI, 0.28-0.42; I2=0). Meanwhile, the proportions of symptomatic intracranial hemorrhage (OR, 3.54; 95%CI, 1.78-7.01; I2=33%) and 90-day mRS scores (MD, 0.94; 95%CI, 0.61-1.26; I2=51%) were higher in fast progressors. Conclusion Increased stroke severity, proximal vessel occlusion, worse collateral status, and cardioembolism etiology were key features of fast progressors before EVT. Fast progressors exhibit significantly elevated risks of poor outcomes. Taking IGR into consideration during clinical practice and research is essential.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Endovascular Treatment versus Best Medical Treatment in Patients with Large-Vessel Occlusion Stroke: A meta-analysis.","authors":"Can Tang, Chao Liu, Hengzhu Zhang, Wenmiao Luo","doi":"10.1159/000546720","DOIUrl":"https://doi.org/10.1159/000546720","url":null,"abstract":"<p><strong>Background: </strong>For patients with acute ischemic stroke caused by large vessel occlusion (LVO), there is limited evidence regarding the long-term outcomes of endovascular treatment (EVT) compared with best medical treatment (BMT). The objective of this study was to evaluate the long-term efficacy and safety of EVT in LVO stroke patients.</p><p><strong>Methods: </strong>This study systematically searched electronic databases from January 2015 to August 2024 and included seven eligible trials. These studies reported 1-2 year of follow-up data on functional independence (modified Rankin Scale [mRS] score 0-2), distribution of mRS on shift analysis, quality of life (European Quality of Life 5 Dimensions Questionnaire score), and mortality.</p><p><strong>Results: </strong>A total of 1,236 patients who received EVT and 1,122 who received BMT were included in the analysis. Compared with BMT, EVT was associated with a significantly greater likelihood of functional independence (odds ratio [OR] 2.55, 95% confidence interval [CI], 1.76-3.70), improved distribution of mRS scores on shift analysis (common OR 1.67, 95% CI, 1.37-2.02), and a better quality of life (beta coefficient 0.13, 95% CI, 0.07-0.19) at 1-2 years of follow-up. Compared with BMT, EVT was also associated with lower rates of all-cause mortality (OR 0.67, 95% CI, 0.56-0.81). Compared with 90-day follow-up, long-term follow-up demonstrated an improvement in functional independence among LVO stroke patients (1.7% vs. 0.2%), whereas the increase in mortality was slower (9.3% vs. 11.3%).</p><p><strong>Conclusions: </strong>This meta-analysis indicated that LVO stroke patients can achieve long-term benefits following EVT. The findings provide valuable evidence to inform clinical decision-making.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and outcome of cerebral microbleeds in antiphospholipid syndrome.","authors":"Jonathan Naftali, Rani Barnea, Ruth Eliahou, Sivan Bloch, Tzippy Shochat, Adi Wilf-Yarkoni, Michael Findler, Avi Leader, Walid Saliba, Eitan Auriel","doi":"10.1159/000546784","DOIUrl":"https://doi.org/10.1159/000546784","url":null,"abstract":"<p><strong>Introduction: </strong>Antiphospholipid syndrome (APS) is an acquired autoimmune disease characterized by arterial and venous thrombosis. Acute ischemic stroke (AIS) and transient ischemic attack (TIA) are common neurological manifestations in APS patients. Cerebral microbleeds (CMB) are indicators for cerebral small vessel disease and associated with intracerebral hemorrhage (ICH) and AIS. In the present study, we aimed to look at the association and clinical significance of CMB in patients with APS.</p><p><strong>Methods: </strong>This is a retrospective cohort study that utilized data obtained from health service data of more than 5 million patients. We included patients aged 18 and older diagnosed with APS who underwent brain MRI between January 2014 and April 2020 and an age-matched control group with negative APS laboratory results. APS diagnosis was confirmed by positive laboratory findings from two separate tests conducted at least 12 weeks apart. The first available brain MRI was assessed for the presence of CMB. We compared the prevalence of CMB between patients with APS and controls. Among APS patients, we assessed the association between CMB and future AIS/TIA or ICH during 48-months follow-up using cox proportional hazards models.</p><p><strong>Results: </strong>The study included 276 patients, of which 195 were in the APS group and 81 in the control group. Patients with APS exhibited a higher prevalence of CMB (16% vs. 4%, p<0.01). Among the APS group, those with CMB had a significantly higher risk of subsequent AIS/TIA (Hazard ratio = 8.5, 95% CI 3.1-23, cumulative incidence 30% (95% CI, 13%-50%). None of the patients with APS had ICH during follow-up.</p><p><strong>Conclusion: </strong>Patients with APS have a higher prevalence of CMB compared with non-APS individuals, and the presence of CMB in APS patients is associated with an increased risk of AIS/TIA.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Disparities in Acute Stroke Treatments and Outcomes: A Propensity Score-Matched Analysis of a Nationwide Sample.","authors":"Andrea Loggini, Jonatan Hornik, Amber Schwertman, Alejandro Hornik","doi":"10.1159/000546950","DOIUrl":"https://doi.org/10.1159/000546950","url":null,"abstract":"<p><p>Purpose To investigate the rural-urban differences in acute stroke care in a large cohort of patients hospitalized for acute ischemic stroke (AIS), using a nationwide inpatient sample. Methods In this retrospective cohort study, the National Inpatient Sample database was investigated for patients admitted with AIS from 2016 to 2022. Socio-demographics and comorbidities were reviewed. Interventions (rtPA and thrombectomy) were investigated. Outcome measures were prolonged length of stay (PLOS) and mortality. PLOS was defined as length of stay exceeding the 75th percentile of the entire cohort. The cohort was divided in rural and urban location Propensity-score matching (PSM) was applied to balance demographics and comorbidities between the two groups, and outcomes were analyzed between the two matched groups. Multivariable logistic models were used to determine the association between each intervention and rural location. Risk ratio was calculated for PLOS and mortality. Subgroup analyses were performed by age, race, and income. P value as set at 0.05 for all analyses. Results Of 897,206 AIS patients, 64,640 (7.2%) were cared for in rural location. Rural group was older (74 [64-83] vs. 71 [60-81], p<0.01) years. Rural group had higher rate of females (51.8% vs. 49%), white racial group (79.8% vs. 64.5%), lower median household income (54.3% vs. 29.1%), and lower private insurance (14.3% vs. 19.2%), p<0.01 for all. After PSM 1:1, rural group independently retained lower odds of rtPA (OR: 0.532, 95%CI: 0.505 - 0.561), lower odds of thrombectomy (OR: 0.074, 95%CI: 0.061 - 0.089), lower risk of PLOS (RR: 0.887, 95%CI: 0.882 - 0.892) and higher risk of mortality (RR: 1.149, 95%CI: 1.122 - 1.177), p<0.01 for all. Older patients in rural setting had lowest odds of interventions, whereas younger, Black, and Hispanic rural patients had highest risk of mortality after AIS. Conclusions Socio-demographic differences are present between rural and urban acute stroke care. Profound inequalities exist in the use of reperfusion therapy and outcomes. Great effort is needed by the stroke community to fill this gap and provide equality in acute stroke care.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of body mass index on functional outcomes in patients with acute cerebral large vessel occlusion.","authors":"Yu Kinoshita, Fumihiro Sakakibara, Shinichi Yoshimura, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Takeshi Morimoto","doi":"10.1159/000546728","DOIUrl":"https://doi.org/10.1159/000546728","url":null,"abstract":"<p><strong>Background and purpose: </strong>The effect of body mass index (BMI) on the outcome of acute cerebral large vessel occlusion (LVO) was uncertain in the era of endovascular therapy (EVT). We investigated the association between BMI and functional outcomes in patients with acute cerebral LVO.</p><p><strong>Methods: </strong>We performed a post-hoc analysis of the RESCUE-Japan Registry 2 including 2,420 LVO patients among 46 stroke centers in Japan. The patients were categorized into 3 groups depending on their BMI (kg/m2); Low-BMI group: BMI < 18.5, Normal-BMI group: 18.5 ≤ BMI < 25, and High-BMI group: BMI ≥ 25. We estimated the effect of Low-BMI and High-BMI groups relative to Normal-BMI group. The primary outcome was a modified Rankin scale (mRS) score of 5 or 6 at 90 days from the onset. The secondary outcomes consisted of an mRS score of 0 to 2 at 90 days, symptomatic intracranial hemorrhage (ICH), and any ICH within 72 hours from the onset.</p><p><strong>Results: </strong>Among total 2,234 analyzed patients, Low-BMI, Normal-BMI, and High-BMI groups accounted for 14.5%, 63.7%, and 21.9%, respectively. The patients in Low-BMI group were older, more female, poorer premorbid status, severer symptom presentation, and more dominant of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. The Low-BMI group less used rt-PA and EVT. The primary outcome occurred 46.4%, 31.2%, and 23.7% in Low-BMI, Normal-BMI, and High-BMI groups, respectively. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of the primary outcome of Low-BMI and High-BMI groups relative to Normal-BMI group were 1.59 (1.18-2.13) and 0.80 (0.60-1.07), respectively. The mRS score of 0 to 2 in Low-BMI, Normal-BMI, and High-BMI groups consisted of 26.3%, 38.8%, and 41.9%, respectively. The adjusted OR (95% CIs) of an mRS score of 0 to 2 of Low-BMI and High-BMI groups relative to Normal-BMI group were 0.72 (0.53-0.99) and 0.83 (0.64-1.06), respectively. The adjusted OR (95% CIs) of symptomatic ICH of Low-BMI and High-BMI groups relative to Normal-BMI group were 1.57 (0.84-2.95) and 1.31 (0.75-2.29), respectively.</p><p><strong>Conclusions: </strong>The low BMI was associated with a severity and poorer functional outcomes in patients with acute cerebral LVO.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic values of the \"to and fro\" conflict sign on intraoperative indocyanine green video angiography as a warning sign of the focal cerebral hyperperfusion and watershed shift phenomenon after STA-MCA bypass for adult patients with Moyamoya disease.","authors":"Ryosuke Tashiro, Miki Fujimura, Taketo Nishizawa, Keita Tominaga, Atushi Kanoke, Hidenori Endo","doi":"10.1159/000546826","DOIUrl":"https://doi.org/10.1159/000546826","url":null,"abstract":"<p><strong>Introduction: </strong>The focal cerebral hyperperfusion (CHP) is a potential complication after Superficial temporal artery-middle cerebral artery (STA-MCA) bypass for Moyamoya disease (MMD) that can result in delayed intracerebral hemorrhage and/or neurological deterioration. The focal CHP could accompany hemodynamic ischemia due to the \"watershed shift (WS) phenomenon\". Preoperative prediction of the focal CHP and WS phenomenon remains challenging. Here, we aimed to assess the diagnostic value of the \"to and fro\" conflict sign, conflicting blood flow around the vascular territory of the recipient arteries on an indocyanine green video angiography (ICG-VA) for predicting the focal CHP and WS phenomenon.</p><p><strong>Methods: </strong>Ninety-seven consecutive adult patients with MMD, undergoing 106 surgeries, were enrolled. Serial quantitative analysis of cerebral blood flow (CBF) was routinely conducted using N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography preoperatively and postoperative day 1 and 7 after STA-MCA bypass. The association between the \"to and fro\" conflict sign on ICG-VA and the focal CHP/WS phenomenon incidence was then analyzed.</p><p><strong>Results: </strong>The incidence of the fokal CHP and WS phenomenon was 29.2% (31/106) and 10.4% (11/106), respectively. The \"to and fro\" conflict sign was evident in 35.5% (11/31) and 54.5% (6/11) of MMD patients with the focal CHP and WS phenomenon, respectively. The \"to and fro\" conflict sign was significantly associated with both the focal CHP and WS phenomenon.</p><p><strong>Conclusion: </strong>The \"to and fro\" conflict sign on ICG-VA may serve as an intraoperative warning sign of the focal CHP and WS phenomenon after STA-MCA bypass in adult patients with MMD, providing neurosurgeons with a valuable tool for early detection.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pre-miR-218 rs11134527 polymorphism on ischemic stroke in a Chinese Han population: a case-control study.","authors":"Kaiyan Jin, Zhiquan Yan, Yuyang Li, Qiujun Lu, Jian Hai","doi":"10.1159/000546143","DOIUrl":"https://doi.org/10.1159/000546143","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke (IS) exhibits a high mortality rate, and its pathogenesis is intricately linked to genetic factors. This study examined the association between the precursor microRNA-218 (pre-miR-218) rs11134527 polymorphism and IS in the Han Chinese population.</p><p><strong>Methods: </strong>The study employed polymerase chain reaction (PCR) to detect the pre-miR-218 rs11134527 polymorphism. Student's t-test was used to compare continuous measurement data between the two groups, while the chi-square test was utilized to compare categorical variables. Additionally, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to measure the expression levels of miR-218-5p. Logistic regression analysis was conducted to identify independent risk factors for IS. Furthermore, a Receiver Operating Characteristic (ROC) curve was constructed to evaluate the clinical diagnostic value of serum miR-218-5p levels in IS.</p><p><strong>Results: </strong>The GG and AG genotypes of rs11134527 were identified as pathogenic variants for IS, and individuals carrying the G allele exhibited a significantly elevated risk of developing IS. Hypertension, hyperlipidemia, and the rs11134527 locus were independent risk factors for IS onset. The rs11134527 locus may influence the progression of IS by modulating lipid metabolism. The GG genotype of pre-miR-218 rs11134527 was potentially associated with more severe functional deficits. Furthermore, the serum miR-218-5p levels were significantly increased in IS patients. Serum miR-218-5p has a certain clinical diagnostic value for IS.</p><p><strong>Conclusion: </strong>The rs11134527 polymorphism in pre-miR-218 was strongly associated with genetic susceptibility to IS.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}