Cerebrovascular Diseases最新文献

{"title":"Perfusion Image-Aided Treatment Decision for Acute Ischemic Stroke: Validation of a Clinical Decision Support System.","authors":"Xiang Li, Chao Wei, Yuefei Wu, Xiang Gao, Jie Sun, Tianqi Xu, Chushuang Chen, Qing Yang, Mark W Parsons, Yi Huang, Jianhong Yang, Longting Lin","doi":"10.1159/000543142","DOIUrl":"10.1159/000543142","url":null,"abstract":"<p><strong>Introduction: </strong>Our collaborative team has previously developed a prognostic model for acute ischemic stroke (AIS). This model, known as the clinical decision support system (CDSS), aims to provide personalized assistance to clinicians in making treatment decisions and improving patient prognosis. The objective of this study was to externally validate the model using Chinese AIS patients.</p><p><strong>Methods: </strong>All enrolled patients arrived at the hospital within 24 h after stroke onset. The primary outcome was the likelihood of a favorable functional outcome, which was defined as a modified Rankin Scale (mRS) <2 at 90 days. The model's predictive performance was evaluated by assessing its discriminative power (area under the curve [AUC]) and calibration power (Hosmer-Lemeshow goodness-of-fit test, Brier score).</p><p><strong>Results: </strong>In the validation cohort of 298 patients, the model demonstrated a moderate discriminatory ability to predict a favorable functional outcome (mRS 0-1), with an AUC of 0.805 (95% CI, 0.756-0.849). The calibration performance of the model was assessed using the Hosmer-Lemeshow chi-squared test, yielding a value of 9.211 and a p value of 0.325, and additionally, the Brier score for the prediction of a good outcome was 0.153, further supporting the model's good calibration performance.</p><p><strong>Conclusion: </strong>The study introduces the CDSS that integrates clinical baseline data and imaging indicators of brain perfusion status. This CDSS provides clinicians with an intuitive risk assessment of different treatment strategies for AIS patients. Moreover, the CDSS highlights substantial variations in treatment outcomes among patients, suggesting that it has the potential to significantly enhance personalized treatment approaches.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000807","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":"Association of Right Bundle Branch Block with Ischemic Stroke Incidence: A UK Biobank Cohort Study.","authors":"Dougho Park, Sopheak Phoung, Phoeuk Borei, Myeonghwan Bang, Seungsoo Kim, Yousin Suh, Hyoung Seop Kim, Jong Hun Kim","doi":"10.1159/000543258","DOIUrl":"10.1159/000543258","url":null,"abstract":"<p><strong>Introduction: </strong>Right bundle branch block (RBBB) is often considered benign; however, its association with ischemic stroke (IS) remains unclear. We aimed to investigate the relationship between RBBB and the incidence of IS.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the UK Biobank database (2004-2021), which included 3,634 participants with new-onset RBBB and 3,643 matched controls. The primary outcome was the incidence of IS, while the secondary outcomes included atrial fibrillation (AF) and all-cause mortality. We applied a propensity score matching with variables such as age, sex, presence of hypertension, diabetes, dyslipidemia, and the Charlson Comorbidity Index. Subsequently, time-dependent Cox regression analyses were performed to assess the association between RBBB and the outcomes.</p><p><strong>Results: </strong>The cumulative incidence of IS was higher in the RBBB group. RBBB was independently associated with an increased risk of IS (adjusted hazard ratio [aHR], 3.57; 95% confidence interval [CI], 2.12-6.03; p < 0.001), as well as AF (aHR, 4.58; 95% CI, 3.86-5.43; p < 0.001) and all-cause mortality (aHR, 2.66; 95% CI, 2.35-3.02; p < 0.001).</p><p><strong>Conclusion: </strong>RBBB was associated with an increased risk of IS, independent of age, sex, and other comorbidities. These findings emphasize the need for careful monitoring and management of patients with RBBB to mitigate the risk of IS and other adverse outcomes. Further research is needed to elucidate the underlying mechanisms and better inform clinical management strategies for patients with RBBB.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982883","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":"Functional Outcome Prediction in Japanese Patients with Nonsurgical Intracerebral Hemorrhage: The FSR ICH Score.","authors":"Takuya Kiyohara, Ryu Matsuo, Fumi Irie, Kuniyuki Nakamura, Jun Hata, Yoshinobu Wakisaka, Takanari Kitazono, Masahiro Kamouchi, Tetsuro Ago","doi":"10.1159/000543362","DOIUrl":"10.1159/000543362","url":null,"abstract":"<p><strong>Introduction: </strong>There has been limited research on predicting the functional prognosis of patients with nonsurgical intracerebral hemorrhage (ICH) from the acute stage. The aim of this study was to develop a risk prediction model for the natural course in patients with nonsurgical ICH and to evaluate its performance using a multicenter hospital-based prospective study of stroke patients in Japan.</p><p><strong>Methods: </strong>We consecutively registered a total of 1,017 patients with acute ICH (mean age, 68 years) who underwent conservative treatment and followed them up for 3 months. The study outcome was a poor functional outcome (modified Rankin Scale score, 4-6) at 3 months after ICH onset. To develop the risk prediction model for natural course in patients with nonsurgical ICH, we included the following clinical common factors assessed on admission in daily clinical practice for ICH: age, sex, medical history (hypertension, diabetes mellitus, dyslipidemia, pre-stroke dementia, previous stroke, coronary artery disease, smoking status, alcohol drinking status, oral anticoagulation, and antiplatelet medication), admission status (time from onset to admission, systolic blood pressure, diastolic blood pressure, pulse pressure, plasma glucose levels, severity of the stroke), and neuroradiologic data (ICH location, intraventricular hemorrhage, and hematoma volume). The risk prediction model for poor functional outcome was developed using logistic regression analysis. In addition, the risk prediction model was translated into a point-based simple risk score (FSR ICH score) using the approach in the Framingham Heart Study.</p><p><strong>Results: </strong>At 3 months after the ICH onset, 323 (31.8%) patients developed a poor functional outcome. Age, diabetes mellitus, pre-stroke dementia, NIHSS score on admission, intraventricular hemorrhage, and hematoma volume were included in the risk prediction model. This model demonstrated excellent discrimination (C statistic = 0.884 [95% confidence interval, 0.863-0.905]; optimism-corrected C statistic based on 200 bootstrap samples = 0.877) and calibration (Hosmer-Lemeshow goodness-of-fit test: p = 0.72). The FSR ICH score, a point-based simple risk score, also showed excellent discrimination, with a C statistic of 0.882 (95% CI: 0.861-0.903).</p><p><strong>Conclusions: </strong>We developed a new risk prediction model for 3-month poor functional outcome in patients with nonsurgical ICH using a multicenter hospital-based prospective study in Japan. The current risk prediction model has the potential to be a useful tool for estimating the natural course in patients with nonsurgical ICH, aiding in making treatment decisions, including surgical options, early formulation of rehabilitation plans, and efficient utilization of medical resources.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945390","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 Music-Supported Therapy for Depression and Cognitive Disorders in People Living with Stroke and Its Impact on Quality of Life: A Systematic Evaluation and Meta-Analysis.","authors":"Zhen Wang, Yingxia Xue, Guiying Sun, Jiajia Yun, Yalei Li, Qi Chen, Ruiwen Wang, Jiahui Wang, Chao Ren","doi":"10.1159/000543361","DOIUrl":"https://doi.org/10.1159/000543361","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke not only leads to physical dysfunction in people living with stroke, but also causes emotional and cognitive abnormalities, which significantly affect survival and quality of life. Prior research has shown that music-supported therapy (MST) has the ability to improve depression and cognitive performance through stimulation of the central nervous system. Nevertheless, there is a dearth of rigorous systematic assessments of the effectiveness of MST in improving depression and cognitive impairments in people living with stroke, as well as the impact of these benefits on their overall quality of life. This systematic review and meta-analysis aimed to assess the impact of MST on emotional and cognitive impairments in people living with stroke, as well as its influence on their quality of life.</p><p><strong>Methods: </strong>The PRISMA 2020 guidelines were followed to search for articles on MST treating depression and cognitive issues in people living with stroke in the PubMed, Embase, Web of Science, Wanfang, CNKI, CSTJ, and SinoMed databases, with a cut-off date of July 11, 2024. Two researchers utilized the revised Cochrane RoB-I risk of bias technique to evaluate the quality of all relevant literature obtained. They subsequently extracted and meta-analyzed the data using Review Manager 5.4.1 software.</p><p><strong>Results: </strong>Seventy-two studies involving a total of 5,543 people living with stroke were included, and the meta-analysis revealed that MST had a significant effect on depression and cognitive deficits in people living with stroke (SMDHAMD = 1.49, 95% CI: 1.21-1.76, p < 0.001, MDMMSE = 2.53, CI: 1.60-3.45, p < 0.001, MDMoCA = 3.59, CI: 2.57-4.62, p < 0.001), which took effect from 2 weeks of treatment and was accompanied by an increase in serum 5-HT level (SMD5-HT = 2.22, CI: 1.47-2.96, p < 0.001) and improvements in depression and cognitive function, daily living abilities (SMDADL = 1.72, CI: 1.32-2.11, p < 0.001), limb motor function (SMDFMA = 1.25, CI: 0.47-2.02, p < 0.001), and neurological function (SMDNIHSS = -1.77, CI: -2.50 to -1.04, p < 0.001).</p><p><strong>Conclusion: </strong>MST effectively improves depression and cognitive function of people living with a stroke and enhances their ability to perform daily activities and limb motor function. Importantly, improvements in depression and cognitive function occur earlier than those in daily life ability and neurological function. Additionally, the level of serum 5-HT may serve as a potential indicator for assessing the effectiveness of MST.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-26"},"PeriodicalIF":2.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439936","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":"Cerebral Artery Overexpression of the NMUR1 Gene Is Associated with Moyamoya Disease: A Weighted Gene Co-Expression Network Analysis.","authors":"Samuel D Pettersson, Shunsuke Koga, Shan Ali, Alejandro Enriquez-Marulanda, Philipp Taussky, Christopher S Ogilvy","doi":"10.1159/000538035","DOIUrl":"10.1159/000538035","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to elucidate mechanisms underlying moyamoya disease (MMD) pathogenesis and to identify potential novel biomarkers. We utilized gene co-expression networks to identify hub genes associated with the disease.</p><p><strong>Methods: </strong>Twenty-one middle cerebral artery (MCA) samples from MMD patients and 11 MCA control samples were obtained from the Gene Expression Omnibus (GEO) dataset, GSE189993. To discover functional pathways and potential biomarkers, weighted gene co-expression network analysis (WGCNA) was employed. The hub genes identified were re-assessed through differential gene expression analysis (DGEA) via DESeq2 for further reliability verification. Additional 4 samples from the superficial temporal arteries (STAs) from MMD patients were obtained from GSE141025, and a subgroup analysis stratified by arterial type (MCA vs. STA) DGEA was performed to assess if the hub genes associated with MMD are expressed significantly greater on the affected arteries compared to healthy ones in MMD.</p><p><strong>Results: </strong>WGCNA revealed a predominant module encompassing 139 hub genes, predominantly associated with the neuroactive ligand-receptor interaction (NLRI) pathway. Of those, 17 genes were validated as significantly differentially expressed. Neuromedin U receptor 1 (NMUR1) and thyrotropin-releasing hormone were 2 out of the 17 hub genes involved in the NLRI pathway (log fold change [logFC]: 1.150, p = 0.00028; logFC: 1.146, p = 0.00115, respectively). MMD-only subgroup analysis stratified by location showed that NMUR1 is significantly overexpressed in the MCA compared to the STA (logFC: 1.962; p = 0.00053) which further suggests its possible localized involvement in the progressive stenosis seen in the cerebral arteries in MMD.</p><p><strong>Conclusion: </strong>This is the first study to have performed WGCNA on samples directly affected by MMD. NMUR1 expression is well known to induce localized arterial smooth muscle constriction and, recently, type 2 inflammation which can predispose to arterial stenosis potentially advancing the symptoms and progression of MMD. Further validation and functional studies are necessary to understand the precise role of NMUR1 upregulation in MMD and its potential implications.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971096","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":"Late Lesion Growth following Endovascular Therapy: Is 24 h Too Early to Assess Acute Infarct Size Including the Effects of Secondary Injury?","authors":"Marie Luby, Amie W Hsia, Carolyn A Lomahan, Victoria Uche, Rachel Davis, Yongwoo Kim, Sana Somani, Shannon Burton, Rainier Cabatbat, Veronica Craft, Jill B De Vis, Malik M Adil, Mariam M Afzal, Leila C Thomas, William Gandler, Evan S McCreedy, John K Lynch, Lawrence L Latour","doi":"10.1159/000536470","DOIUrl":"10.1159/000536470","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Stroke lesion volume on MRI or CT provides objective evidence of tissue injury as a consequence of ischemic stroke. Measurement of \"final\" lesion volume at 24-h following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. However, despite successful recanalization, a significant proportion of patients do not experience favorable clinical outcome. The goals of this study were to quantify lesion growth during the first week after treatment, identify early predictors, and explore the association with clinical outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a prospective study of stroke patients at two centers who met the following criteria: (i) anterior large vessel occlusion acute ischemic stroke, (ii) attempted EVT, and (iii) had 3T MRI post-EVT at 24-h and 5-day. We defined \"early\" and \"late\" lesion growth as ≥10 mL lesion growth between baseline and 24-h diffusion-weighted imaging (DWI) and between 24-h DWI and 5-day fluid attenuated inversion recovery imaging, respectively. Complete reperfusion was defined as &gt;90% reduction of the volume of tissue with perfusion delay (Tmax&gt;6 s) between pre-EVT and 24-h post-EVT. Favorable clinical outcome was defined as modified Rankin scale (mRS) of 0-2 at 30 or 90 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred twelve patients met study criteria with median age 67 years, 56% female, median admit NIHSS 19, 54% received IV or IA thrombolysis, 66% with M1 occlusion, and median baseline DWI volume 21.2 mL. Successful recanalization was achieved in 87%, and 68% had complete reperfusion, with an overall favorable clinical outcome rate of 53%. Nearly two-thirds (65%) of the patients did not have late lesion growth with a median volume change of -0.3 mL between 24-h and 5-day and an associated high rate of favorable clinical outcome (64%). However, ∼1/3 of patients (35%) did have significant late lesion growth despite successful recanalization (87%: 46% mTICI 2b/41% mTICI 3). Late lesion growth patients had a 27.4 mL change in late lesion volume and 30.1 mL change in early lesion volume. These patients had an increased hemorrhagic transformation (HT) rate of 68% with only 1 in 3 patients having favorable clinical outcome. Late lesion growth was independently associated with incomplete reperfusion, HT, and unfavorable outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Approximately 1 out of 3 patients had late lesion growth following EVT, with a favorable clinical outcome occurring in only 1 out of 3 of these patients. Most patients with no early lesion growth had no late lesion growth. Identification of patients with late lesion growth could be critical to guide clinical management and inform prognosis post-EVT. Additionally, it can serve as an imaging biomarker for the development of adjunctive therapies to mitigate reperfusion injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Stroke lesion volume on MRI or CT provides objective evidence o","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"129-137"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and Gender Publications in Brain Health: A Mapping Review of the Asia-Pacific Region.","authors":"Megan Heffernan, Mark Woodward, Deidre Anne De Silva, Christopher Chen, Craig S Anderson, Christine Kremer, Katie Harris, Else Charlotte Sandset, Maria Teresa Ferretti, Valeria Caso, Cheryl Carcel","doi":"10.1159/000537946","DOIUrl":"10.1159/000537946","url":null,"abstract":"<p><strong>Introduction: </strong>Reporting of sex and gender analysis in medical research has been shown to improve quality of the science and ensure findings are applicable to women and men. There is conflicting evidence on whether efforts by funding agencies and medical journals to encourage reporting of sex and gender analysis have resulted in tangible improvements. This study mapped the inclusion of sex and gender analysis in stroke and dementia research conducted in the Asia-Pacific region.</p><p><strong>Methods: </strong>A systematic search for Asia-Pacific stroke and dementia research was conducted in PubMed and papers included from the period 2012 to 2022. Eligible studies were reviewed for inclusion of a primary sex or gender focus and categorized by type of sex and gender analysis. Author gender was determined using an algorithm and its associations with inclusion of sex and gender analysis were examined.</p><p><strong>Results: </strong>Total Asia-Pacific publications increased from 109 in 2012 to 313 in 2022, but the rate of studies with a primary sex or gender focus did not increase significantly (R2 = 0.06, F(1, 9) = 0.59, p = 0.46). Australia, China, India, Japan, and South Korea produced the most publications over the study period and were the only countries with at least 50 publications. The impact of author gender was mixed, with female first authorship associated with inclusion of sex or gender analysis and last female authorship associated with studies having a primary sex or gender focus.</p><p><strong>Conclusions: </strong>In the Asia-Pacific, brain health research is currently centred around high-income countries, and efforts are needed to ensure research findings are applicable throughout the region. While there was a general increase in brain health publications over the last decade, the rate of sex and gender analysis was unchanged. This demonstrates that even with efforts in some countries in place, there is currently a lack of progress in the Asia-Pacific region to produce more research focussing on sex and gender analysis.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"89-95"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971097","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":"Outcome of Mechanical Thrombectomy for Acute Basilar Artery Occlusion in Patients with Intracranial Atherosclerotic Disease.","authors":"Huong Bich Thi Nguyen, Trung Quoc Nguyen, Vu Thanh Tran, Tra Son Vu Le, Anh Tuan Le Truong, Binh Nguyen Pham, Sang Hung Nguyen, Anit Kiran Behera, Thanh Thien Nguyen, Thang Ba Nguyen, Thanh N Nguyen, Thang Huy Nguyen","doi":"10.1159/000539112","DOIUrl":"10.1159/000539112","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial atherosclerotic disease (ICAD) has been identified as a major cause of acute basilar artery occlusion (BAO).This study compared the characteristics and treatment outcomes in acute BAO patients with and without ICAD.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at 115 People's Hospital, Ho Chi Minh city, Vietnam from August 2021 to June 2023. Patients with acute BAO who underwent endovascular treatment within 24 h from symptom onset were included (thrombectomy alone or bridging with intravenous alteplase). The baseline characteristics and outcomes were analyzed and compared between patients with and without ICAD. Good functional outcome was defined as mRS ≤3 at 90 days.</p><p><strong>Results: </strong>Among the 208 patients enrolled, 112 (53.8%) patients were categorized in the ICAD group, and 96 (46.2%) in the non-ICAD group. Occlusion in the proximal segment of the basilar artery was more common in patients with ICAD (55.4% vs. 21.9%, p < 0.001), whereas the distal segment was the most common location in the non-ICAD group (58.3% vs. 10.7%, p < 0.001). Patients in the ICAD group were more likely to undergo treatment in the late window, with a higher mean onset-to-treatment time compared to the non-ICAD group (11.6 vs. 9.5 h, p = 0.01). In multivariable logistic regression analysis, distal segment BAO was negatively associated with ICAD (aOR 0.13, 95% CI: 0.05-0.32, p < 0.001), while dyslipidemia showed a positive association (aOR 2.44, 95% CI: 1.15-5.17, p = 0.02). There was a higher rate for rescue stenting in the ICAD compared to non-ICAD group (15.2% vs. 0%, p < 0.001). However, no significant differences were found between the two groups in terms of good outcome (45.5% vs. 44.8%, p = 0.91), symptomatic hemorrhage rates (4.5% vs. 8.3%, p = 0.25), and mortality (42% vs. 50%, p = 0.25).</p><p><strong>Conclusion: </strong>ICAD was a common etiology in patients with BAO. The location segment of BAO and dyslipidemia were associated with ICAD in patients with BAO. There was no difference in 90-day outcomes between BAO patients with and without ICAD undergoing endovascular therapy.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"30-41"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851512","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 Relation between Vascular Risk Factors and Flow in Cerebral Perforating Arteries: A 7 Tesla MRI Study.","authors":"Laurien Onkenhout, Tine Arts, Doeschka Ferro, Sanne Kuipers, Eline Oudeman, Thijs van Harten, Matthias J P van Osch, Jaco Zwanenburg, Jeroen Hendrikse, Geert Jan Biessels, L Jaap Kappelle","doi":"10.1159/000537709","DOIUrl":"10.1159/000537709","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral perforating arteries provide blood supply to the deep regions of the brain. Recently, it became possible to measure blood flow velocity and pulsatility in these small arteries. It is unknown if vascular risk factors are related to these measures.</p><p><strong>Methods: </strong>We measured perforating artery flow with 2D phase-contrast 7 Tesla MRI at the level of the centrum semiovale (CSO) and the basal ganglia (BG) in seventy participants from the Heart Brain Connection study with carotid occlusive disease (COD), vascular cognitive impairment (VCI), or no actual cerebrovascular disease. Vascular risk factors included hypertension, diabetes, hyperlipidemia, and smoking.</p><p><strong>Results: </strong>No consistent relations were found between any of the vascular risk factors and either flow velocity or flow pulsatility, although there was a relation between lower diastolic blood pressure and higher pulse pressure and higher cerebral perforator pulsatility (p = 0.045 and p = 0.044, respectively) at the BG level. Results were similar in stratified analyses for patients with and without a history of cardiovascular disease, or only COD or VCI.</p><p><strong>Conclusion: </strong>We conclude that, cross-sectionally, cerebral perforating artery flow velocity and pulsatility are largely independent of the presence of common vascular risk factors in a population with a mixed vascular burden.</p><p><strong>Introduction: </strong>Cerebral perforating arteries provide blood supply to the deep regions of the brain. Recently, it became possible to measure blood flow velocity and pulsatility in these small arteries. It is unknown if vascular risk factors are related to these measures.</p><p><strong>Methods: </strong>We measured perforating artery flow with 2D phase-contrast 7 Tesla MRI at the level of the centrum semiovale (CSO) and the basal ganglia (BG) in seventy participants from the Heart Brain Connection study with carotid occlusive disease (COD), vascular cognitive impairment (VCI), or no actual cerebrovascular disease. Vascular risk factors included hypertension, diabetes, hyperlipidemia, and smoking.</p><p><strong>Results: </strong>No consistent relations were found between any of the vascular risk factors and either flow velocity or flow pulsatility, although there was a relation between lower diastolic blood pressure and higher pulse pressure and higher cerebral perforator pulsatility (p = 0.045 and p = 0.044, respectively) at the BG level. Results were similar in stratified analyses for patients with and without a history of cardiovascular disease, or only COD or VCI.</p><p><strong>Conclusion: </strong>We conclude that, cross-sectionally, cerebral perforating artery flow velocity and pulsatility are largely independent of the presence of common vascular risk factors in a population with a mixed vascular burden.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"121-128"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife Stereotactic Radiosurgery for Cerebral Cavernous Malformations: Meta-Analysis of Reconstructed Time-to-Event Data.","authors":"Gustavo da Fontoura Galvão, Gabriel Verly, Matheus Duque Bessa, Bernardo Lisboa Galvão Santos, Pablo Valença, Flávio Sampaio Domingues, Marcello Reis da Silva, Jorge Marcondes","doi":"10.1159/000539079","DOIUrl":"10.1159/000539079","url":null,"abstract":"<p><strong>Introduction: </strong>Cavernomas are vascular lesions with a genetic heritage that can be spotted on the central nervous system. Whenever these lesions are localized in eloquent regions, surgical resection is not recommended. In this type of situation, Gamma Knife stereotactic radiosurgery (GKSRS) could be a feasible option for treating patients. Thus, we aimed to explore the outcomes associated with this procedure.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of reconstructed time-to-event data based on Kaplan-Meier curves. A thorough search was conducted on PubMed, Cochrane, Web of Science, and Embase databases targeting papers that provided information regarding hemorrhagic outcomes associated with GKSRS through Kaplan-Meier curves.</p><p><strong>Results: </strong>After a systematic search in the specific databases, seven studies were included in this review. Notably, a total of 1,071 patients had 1,104 cavernomas treated by GKSRS. Assessment of short-term and long-term post-procedure outcomes was performed, with the estimated overall events-free rate at 2 years being 89.8% (95% CI: 87.7-91.5), while, at 10 years, the estimated overall events-free rate was 71.3% (95% CI: 67.2-75.1).</p><p><strong>Conclusion: </strong>GKSRS seems to be a good alternative for the control of symptomatic events in early and long-term follow-up, despite the need for further investigation provided by future studies.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"196-207"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847579","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}