Cerebrovascular Diseases最新文献

{"title":"Hair Follicle Mesenchymal Stem Cells Induce Neural Regeneration and Repair after Transient Ischemic Stroke.","authors":"Chen Yang, Lei Yu, Jia Wang, Xiaokun Wang, Yuhan Yang, Ni He, Shijing Zhang, Xu Gao, Hao Tang, Chendan Zou","doi":"10.1159/000543261","DOIUrl":"10.1159/000543261","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the increasing recognition of the promising characteristic of hair follicle mesenchymal stem cells (HFMSCs) as multipotential cells with differentiation capability, in this study, we sought to investigate their hitherto unexplored therapeutic potentials in a rat model of transient ischemic stroke.</p><p><strong>Methods: </strong>Rat transient ischemic stroke model was established to verify the effect of HFMSC transplantation. Behavioral experiment and triphenyltetrazolium chloride staining were used to estimate neurological outcome after HFMSC therapy. Pathological experiments were performed to investigate the therapeutic roles of HFMSCs.</p><p><strong>Results: </strong>HFMSCs inhibited neural apoptosis and promoted neural proliferation. The number of neural cells around ischemic core increased after HFMSC transplantation. Besides, the transplanted HFMSCs expressed neuron-specific marker in the penumbra. Finally, HFMSCs diminished infarct area and improved neurological scores.</p><p><strong>Conclusion: </strong>HFMSCs can improve neurological outcome via anti-apoptosis and promoting neural stem cells proliferation, highlighting their therapeutic promise for ischemic stroke treatment.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000790","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":"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":"9th World Intracranial Hemorrhage Conference (WICH) 2025, Wesley Conference Centre, Sydney, Australia, March 28-29, 2025: Abstracts.","authors":"","doi":"10.1159/000545895","DOIUrl":"10.1159/000545895","url":null,"abstract":"<p><p>Abstracts are uploaded as attachment.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":"54 Suppl 1","pages":"1-80"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101507","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":"Dose-Dependent Effect of Current Smoking on Enlarged Perivascular Space Identified on Brain Magnetic Resonance Imaging.","authors":"Naoki Omori, Fusao Ikawa, Masaaki Chiku, Naoyuki Kitamura, Hidekazu Tomimoto, Atsuo Aoyama, Yamaguchi Shuhei, Atsushi Nagai","doi":"10.1159/000541657","DOIUrl":"10.1159/000541657","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral small-vessel disease (CSVD) is a common cause of cognitive decline and stroke. Several studies have shown that smoking is a risk factor for CSVD progression. However, the extent to which smoking exacerbates CSVD lesions remains unclear. In this study, we aimed to clarify the association between total smoking exposure and the severity of CSVD in healthy participants.</p><p><strong>Methods: </strong>We analyzed the data of participants aged ≥50 years who underwent brain screening. The participants' age, sex, body mass index, alcohol consumption history, and medical history (hypertension, diabetes mellitus, and dyslipidemia) were investigated. Smoking status was assessed in pack-years, and smokers were classified as current or past smokers. CSVD findings on magnetic resonance imaging were used to evaluate the severity of periventricular hyperintensity (PVH), deep subcortical white matter hyperintensity (DSWMH), and enlarged perivascular spaces (EPVSs). The EPVSs were measured in the basal ganglia and centrum semiovale regions. Multivariable ordinal logistic regression analyses were performed to evaluate the effect of smoking, adjusted for the participants' baseline characteristics.</p><p><strong>Results: </strong>A total of 2,137 participants were included in this study. The mean age of the participants was 58.7 years. The mean pack-years were 20.5 for past smokers and 26.8 for current smokers. Among current smokers, increased pack-years were significantly associated with a high EPVS burden in the basal ganglia (odds ratio: 1.14, 95% confidence interval: 1.00-1.28), whereas no such significant association was found for past smokers. No statistically significant association was found between pack-years and the risks of PVH, DSWMH, or EPVS in the centrum semiovale.</p><p><strong>Conclusion: </strong>Current smoking was associated with a dose-dependent risk of EPVS in the basal ganglia in healthy participants.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"460-466"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342425","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-Stroke Frailty on Outcome Three Years after Acute Stroke: The Nor-COAST Study.","authors":"Ragnhild Munthe-Kaas, Stian Lydersen, Terry Quinn, Stina Aam, Sarah T Pendlebury, Hege Ihle-Hansen","doi":"10.1159/000541565","DOIUrl":"10.1159/000541565","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to explore the predictive value of pre-stroke frailty index (FI) on functional dependency and mortality 3 years after stroke.</p><p><strong>Methods: </strong>Based on the Rockwood 36-item FI score, we calculated the pre-stroke FI from medical conditions recorded at baseline in the multicenter prospective Nor-COAST study 2015-2017. Participants with a FI score and a modified Rankin scale (mRS) 0-6 3 years post-stroke were included in this study. We used logistic regression analysis with unfavorable mRS (over 2 vs. 0-2) at 3 years, or dead within 3 years, as dependent variable, and frailty and pre-stroke mRS, one at a time, and simultaneously, as predictors. The analyses were carried out unadjusted and adjusted for the following variables one at a time: Age, sex, years of education, stroke severity at admission, infections treated with antibiotics and stroke progression. We report odds ratio (OR) per 0.10 increase in FI.</p><p><strong>Results: </strong>At baseline, the 609 included patients had mean age 72.8 (standard deviation [SD] 11.8), 261 (43%) were females, and had a FI mean score of 0.16 (SD 0.12), range 0-0.69. During 3 years, 138 (23%) had died. Both the FI, and pre-stroke mRS, were strong predictors for unfavorable mRS (OR 4.1 and 2.7) and dead within 3 years (OR 2.2 and 1.7). Only adjusting for age affected the result. The OR for pre-stroke mRS decreased relatively more than the OR for FI when entered as predictors simultaneously.</p><p><strong>Conclusions: </strong>FI is a stronger predictor than premorbid mRS for prognostication after stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"527-535"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342427","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":"Acute Care, Secondary Prevention, and Outcomes after Ischaemic and Haemorrhagic Stroke in Men and Women: A Data-Linkage Study.","authors":"Kadie-Ann Sterling, Mary Joan MacLeod, Mark Barber, Melanie Turner","doi":"10.1159/000540371","DOIUrl":"10.1159/000540371","url":null,"abstract":"<p><strong>Introduction: </strong>There is evidence that sex differences exist in stroke presentation, risk factors, severity, treatment, and outcomes. To further understand this, we explored how sex differences influence acute stroke management, secondary prevention prescribing, and mortality outcomes in a well-characterised cohort of first-ever stroke patients in Scotland.</p><p><strong>Methods: </strong>This is a retrospective, population-based, data-linkage study of stroke admissions to acute care hospitals in Scotland between January 1, 2011, and December 31, 2018. Data sources included the Scottish Stroke Care Audit (SSCA), the Prescribing Information System (PIS), the Scottish Morbidity Record 01 (SMR01), and the National Records of Scotland (NRS) death records. Multivariable logistic regression was used to explore the association between patient sex, acute stroke care, and secondary prevention prescribing, while Cox proportional hazards models were used to explore the association between patient sex and all-cause mortality up to 1 year after index event.</p><p><strong>Results: </strong>This study included 5,901 patients with a first-ever intracerebral haemorrhage (ICH) and 47,087 patients with a first-ever acute ischaemic stroke (AIS). After an ICH, women had significantly lower odds of receiving all components of the stroke care bundle (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.69-0.87) and were less likely to be prescribed antihypertensives within 90 days after discharge to the usual place of residence (aOR, 0.78; 95% CI, 0.63-0.97). There was no sex difference in stroke care bundle achievement for those admitted with AIS; however, women had significantly lower odds of receiving antihypertensives, lipid-lowering drugs, or oral anticoagulants after discharge. The risk of all-cause mortality was lower in women at 1 year after both ICH (adjusted hazard ratio [aHR], 0.90; 95% CI, 0.83-0.98) and AIS (aHR, 0.91; 95% CI, 0.87-0.95) after adjusting for potential confounders.</p><p><strong>Conclusion: </strong>The sex differences in stroke treatment and outcomes may be partly explained by the older age of women at the time of stroke, which influences stroke presentation, severity, and prognosis. However, following adjustment, women had a reduced risk of all-cause mortality after both ICH and AIS.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"371-378"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632764","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 Differences in Stroke in a Sri Lankan Cohort.","authors":"Chamila Mettananda, Udaya K Ranawaka, Chamila D Mettananda, Miyurangi Nugawela, Jithmi Pathirana, Jayalath Chandrasiri, Champa Jayawardena, Deepa Amarasekara, Raja Hettarachchi, Gayani Premawansa, Arunasalam Pathmeswaran","doi":"10.1159/000542943","DOIUrl":"10.1159/000542943","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke characteristics, subtypes, and risk factors in women may differ from men. Data on sex differences in stroke are scarce in developing countries, especially the South Asian region. We aimed to describe the sex differences in patients with stroke admitted to a tertiary care hospital in Sri Lanka.</p><p><strong>Methods: </strong>Consecutive patients with stroke enrolled in the Ragama Stroke Registry over 3 years (2020-2023) were studied. Sex differences in demographics, presentation delays, clinical characteristics, stroke subtypes, risk factors, stroke severity, and early functional outcomes were compared using χ2 test, independent sample t test and Wilcoxon rank-sum test. Associations of early functional dependence were studied using multiple logistic regression.</p><p><strong>Results: </strong>Of 949 patients with stroke, 387 (40.8%) were women, with a median age of 66 (interquartile range [IQR] 57-73) years compared to 63 (IQR 54-70) years in men (p < 0.001). Women had more ischaemic strokes (85.8% vs. 78.6% in men, p = 0.005). Swallowing difficulty (p = 0.039) and bladder involvement (p = 0.001) were more common in women, whereas dysarthria (p = 0.002) and cerebellar signs (p = 0.005) were more common in men. More women had hypertension (74.4% vs. 59.4%, p < 0.001) and diabetes (52.2% vs. 41.6%, p = 0.001), whereas smoking (0.3% vs. 35.1%, p < 0.001), alcohol use (0.3% vs. 55.0%, p < 0.001), and other substance abuse (0.8% vs. 5.2%, p < 0.001) were almost exclusively seen in men. No differences were noted in delays to hospital admission (delay ≥4.5 h: women 45.4% vs. men 41.3%, p = 0.222). There were no sex differences in the rates of CT scanning (women 100% vs. men 99.6%, p = 0.516) or thrombolysis for ischaemic stroke (women 7.8% vs. men 10.2%, p = 0.458), but more men received stroke unit care (women 37.2% vs. men 45.4%, p = 0.012). No differences were noted between sexes in the clinical (Oxfordshire classification, p = 0.671) or aetiological (TOAST criteria, p = 0.364) subtypes of stroke. Stroke severity on admission was similar between sexes (median NIHSS score; women 8.0 vs. men 8.0, p = 0.897). More women had a discharge Barthel index (BI) <60 than men (62.6% vs. 53.5%, p = 0.007), but female sex was not associated with BI <60 on multivariate logistic regression (p = 0.134). There was no difference in in-hospital mortality (women 5.9% vs. men 5.9%, p = 0.963).</p><p><strong>Conclusions: </strong>Women with stroke in this Sri Lankan cohort were older, had different risk factor profiles and clinical stroke characteristics, and had more ischaemic strokes. Female sex was not independently associated with functional disability on discharge or in-hospital mortality.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"703-710"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806280","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}