Journal of Stroke & Cerebrovascular Diseases最新文献_第10页

Association between life’s crucial 9 and stroke: results from the NHANES 2005–2018 生命关键因素与中风之间的联系：NHANES 2005-2018的结果。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-10-01 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108462

Xiaodong Chen , Yifan Xu , Chao Wang , Wencong Guo , Yancheng Song , Bing Chen

Background

Life’s Crucial 9 (LC9) is a composite cardiovascular health score comprising nine modifiable factors. This study examines the relationship between LC9 scores and stroke prevalence in US adults.

Methods

This study conducted a cross-sectional analysis of National Health and Nutrition Examination Survey data from 2005 to 2018. To facilitate analysis, LC9 values were separated into four quartiles. The relationship between LC9 scores and the prevalence of stroke was evaluated using subgroup analysis, restricted cubic spline (RCS) modeling, and weighted multivariable logistic regression.

Results

Among 19 207 participants with an average LC9 score of 70.70 ± 0.22, the overall stroke prevalence was 2.87 %. Each one-point increase in LC9 score was associated with a 4.7 % reduction in stroke odds (95 % CI 0.943–0.963; p < 0.001). Compared with the lowest LC9 quartile (Q1), individuals in the highest quartile (Q4) had a 72.6 % lower stroke prevalence (95 % CI 0.169–0.446; p < 0.001). Stratified analyses and interaction assessments indicated that the inverse association remained consistent across age, sex, BMI, diabetes, and hypertension categories, with no significant interactions observed. Furthermore, curve fitting analysis identified a linear correlation between LC9 scores and the risk of stroke.

Conclusions

Our findings indicated that higher LC9 scores were associated with a reduced likelihood of stroke. Preserving a favorable LC9 score may serve as a potential strategy for stroke prevention. To substantiate these observations and establish clinically applicable LC9 thresholds, additional large-scale prospective studies with prolonged follow-up are needed.

背景：Life's critical 9 （LC9）是一个由9个可修改因素组成的心血管健康综合评分。本研究探讨了美国成人LC9评分与卒中患病率之间的关系。方法：对2005 - 2018年全国健康与营养调查数据进行横断面分析。为了便于分析，LC9值被分成4个四分位数。采用亚组分析、限制性三次样条（RCS）模型和加权多变量logistic回归评估LC9评分与卒中患病率之间的关系。结果：19 207名参与者的平均LC9得分为70.70±0.22，卒中总患病率为2.87%。LC9评分每增加1分，卒中几率降低4.7% （95% CI 0.943-0.963; p < 0.001）。与最低LC9四分位数（Q1）相比，最高四分位数（Q4）的个体卒中患病率降低72.6% （95% CI 0.169-0.446; p < 0.001）。分层分析和相互作用评估表明，在年龄、性别、BMI、糖尿病和高血压类别中，负相关保持一致，没有观察到显著的相互作用。此外，曲线拟合分析发现LC9评分与卒中风险之间存在线性相关。结论：我们的研究结果表明，较高的LC9评分与卒中可能性降低有关。保持有利的LC9评分可能是预防脑卒中的潜在策略。为了证实这些观察结果并建立临床适用的LC9阈值，需要更多的大规模前瞻性研究和长时间随访。

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引用次数: 0

Indirect revascularization after bypass surgery for intracranial atherosclerotic steno-occlusive disease 颅内动脉粥样硬化性狭窄闭塞性疾病旁路手术后间接血运重建术

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108482

Yuwhan Chung M.D., Sung Ho Lee M.D., Ph.D., Kangmin Kim M.D., Ph.D., Hyun-Seung Kang M.D., Ph.D., Jeong Eun Kim M.D., Ph.D., Won-Sang Cho M.D., Ph.D.

Objectives

Indirect revascularization after bypass surgery for intracranial atherosclerotic steno-occlusive disease (ICAD) remains controversial. We aimed to evaluate indirect revascularization after direct bypass surgery in patients with ICAD.

Methods

Among 245 patients with ICAD who underwent direct bypass surgery between 2003 and 2022, 191 patients were ultimately enrolled in this study. Treatment outcomes were compared between combined bypass (n = 162 [84.8 %]) and direct bypass alone (n = 29) groups. Multivariable analyses were performed to identify significant predictors of indirect revascularization and favorable clinical outcomes.

Results

There were no significant differences in overall baseline characteristics or treatment outcomes between the two groups. At the last angiographic follow-up at 27.1 ± 27.1 months (range, 5.0–97.3 months), the rate of indirect revascularization was significantly higher in the combined bypass group than in the direct bypass alone group (39.5 % versus 17.2 %, P = .022). Significant predictors of indirect revascularization included combined bypass (OR 3.175, 95 % CI 1.142–8.826; P = .027) rather than direct bypass alone, and significant stenosis and occlusion in the middle cerebral artery rather than the internal carotid artery (OR 1.961, 95 % CI 1.022–3.763; P = .043). An additional analysis revealed that a good preoperative clinical status (OR 0.141, 95 % CI 0.066–0.302, P < .001) and indirect revascularization (OR 5.508, 95 % CI 1.003–30.245, P = .050) were independent predictors of favorable clinical outcomes.

Conclusion

Indirect revascularization was more pronounced after combined bypass than direct bypass alone and was a significant predictor of favorable clinical outcomes.

目的颅内动脉粥样硬化性狭窄闭塞病（ICAD）旁路手术后间接血运重建术仍有争议。我们的目的是评估ICAD患者直接搭桥手术后的间接血运重建。方法在2003年至2022年期间接受直接搭桥手术的245例ICAD患者中，191例患者最终入选本研究。比较联合搭桥组（n = 162[84.8%]）和单纯搭桥组（n = 29）的治疗结果。进行多变量分析以确定间接血运重建的重要预测因素和良好的临床结果。结果两组患者的总体基线特征和治疗结果无显著差异。在最后一次血管造影随访（27.1±27.1个月，范围5.0 ~ 97.3个月）时，联合搭桥组间接血运重建率明显高于单独搭桥组（39.5% vs 17.2%, P = 0.022）。间接血运重建的重要预测因素包括联合搭桥（OR 3.175, 95% CI 1.142-8.826; P = 0.027）而不是单独直接搭桥，以及大脑中动脉明显狭窄和闭塞而不是颈内动脉（OR 1.961, 95% CI 1.022-3.763; P = 0.043）。另一项分析显示，良好的术前临床状态（OR 0.141, 95% CI 0.066-0.302, P < 001）和间接血运重建（OR 5.508, 95% CI 1.003-30.245, P = 0.050）是良好临床结果的独立预测因子。结论联合搭桥术后间接血运重建比单独直接搭桥术后更为明显，是良好临床预后的重要预测指标。

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引用次数: 0

Research progress on the role of oxidative stress in the pathogenesis of vascular dementia and its treatment 氧化应激在血管性痴呆发病机制及治疗中的作用研究进展。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108475

Hongxiao Lv , Yutong Liu , Xinyu Yang , Xingchao Xu , Junwei Zhou , Wentao Yu

Background

Vascular dementia (VaD) is the second most common type of dementia after Alzheimer's disease, imposing a substantial burden on global health. Accumulating evidence indicates that oxidative stress, characterized by an imbalance between reactive oxygen species (ROS) production and antioxidant defense, plays a pivotal role in the pathogenesis of VaD.

Objective

This review aims to summarize the latest research progress on the involvement of oxidative stress in the pathogenesis of VaD and explore emerging therapeutic strategies targeting oxidative stress.

Results

Oxidative stress is deeply involved in multiple pathological processes of VaD. Its root cause lies in chronic cerebral hypoperfusion (CCH), which leads to mitochondrial dysfunction and excessive ROS production. Such oxidative damage exacerbates blood-brain barrier (BBB) disruption, neuroinflammation, and neuronal apoptosis, ultimately resulting in cognitive decline. Key molecular mechanisms include the activation of NADPH oxidase, impairment of the Nrf2 antioxidant pathway, and dysregulation of SIRT1. Therapeutic strategies have evolved from traditional antioxidants (e.g., α-lipoic acid) to novel approaches, including targeting the Nrf2/HO-1 pathway (e.g., using saffron-rich GJ-4 extract), regulating mitochondrial function, utilizing natural compounds (e.g., resveratrol acting via SIRT1 activation), and non-pharmacological interventions such as acupuncture. These strategies alleviate oxidative stress through multi-target mechanisms and have demonstrated significant efficacy.

Conclusion

The central role of oxidative stress in VaD provides new targets for treatment, but a shift from single-target antioxidant therapy to multi-level intervention is required. Future research should focus on developing targeted antioxidant therapies, exploring combination treatment regimens, and validating biomarkers applicable for early detection and therapeutic efficacy assessment.

背景：血管性痴呆（VaD）是仅次于阿尔茨海默病的第二大常见痴呆类型，对全球健康造成重大负担。越来越多的证据表明，以活性氧（ROS）产生和抗氧化防御失衡为特征的氧化应激在VaD的发病机制中起着关键作用。目的：综述氧化应激参与VaD发病机制的最新研究进展，探讨针对氧化应激的治疗策略。结果：氧化应激深度参与VaD的多个病理过程。其根本原因是慢性脑灌注不足（CCH），导致线粒体功能障碍和ROS过量产生。这种氧化损伤加剧了血脑屏障（BBB）破坏、神经炎症和神经元凋亡，最终导致认知能力下降。关键的分子机制包括NADPH氧化酶的激活、Nrf2抗氧化途径的损伤和SIRT1的失调。治疗策略已经从传统的抗氧化剂（例如α-硫辛酸）发展到新的方法，包括靶向Nrf2/HO-1途径（例如，使用富含藏红花的GJ-4提取物），调节线粒体功能，利用天然化合物（例如，白藜芦醇通过SIRT1激活起作用），以及非药物干预，如针灸。这些策略通过多靶点机制缓解氧化应激，并已显示出显著的疗效。结论：氧化应激在VaD中的核心作用为治疗提供了新的靶点，但需要从单靶点抗氧化治疗转向多层次干预。未来的研究应侧重于开发靶向抗氧化疗法，探索联合治疗方案，以及验证可用于早期检测和治疗效果评估的生物标志物。

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引用次数: 0

Public awareness of stroke risk factors in high-income countries: A systematic review 高收入国家公众对中风危险因素的认识：一项系统回顾。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108501

Mc Lernon S , Appiah B , Moorley C , Thomas N , Mussa R , Gonzales S , Werring D , Olawade D․B , Flood C

Purpose

Stroke remains a significant health concern in high-income countries (HICs) and is increasing among younger adults. Although largely preventable, public awareness of stroke risk factors in HICs is not well established. We assessed awareness levels in World Bank-classified HICs and identified associated factors.

Methods

Systematic searches used Ovid MEDLINE, PsycINFO, Academic Search Complete, CINAHL, Cochrane Review Library, Emcare, and ASSIA. Two authors independently screened studies and extracted data. Risk of bias was assessed using Critical Appraisal Skills Programme checklists. Due to heterogeneity, narrative synthesis was conducted. Exploratory analyses including visual mapping and descriptive cross-country comparisons were performed despite methodological heterogeneity. Protocol registered on PROSPERO (CRD42025621931).

Findings

Of 2146 papers screened, 23 met inclusion criteria. Most studies reported low stroke risk factor awareness. Hypertension was most frequently identified, followed by smoking, dyslipidaemia, and diabetes. Sedentary lifestyle, alcohol consumption, ethnicity, and atrial fibrillation were least recognised. Risk of bias assessment revealed sampling and generalisability concerns in most studies. Most reported associations were unadjusted for potential confounders. Higher education was linked to greater awareness. Marked geographical clustering occurred, with 65 % of studies from Middle Eastern countries, predominantly Saudi Arabia.

Discussion

This review uniquely identifies critical evidence gaps including under-representation of diverse populations, lack of standardised awareness metrics, and predominance of unadjusted analyses in HIC stroke risk factor awareness research.

Conclusion

Stroke risk factor awareness gaps are prevalent and may limit prevention efforts. Large-scale, methodologically robust studies across diverse geographical, socioeconomic, and ethnic populations within HICs are urgently needed, as awareness characteristics may vary dramatically even within high-income settings. Targeted education is necessary for primary prevention strategies.

目的：卒中在高收入国家（HICs）仍然是一个重要的健康问题，并且在年轻人中正在增加。虽然在很大程度上是可以预防的，但公众对高收入国家中风危险因素的认识还没有很好地建立起来。我们评估了世界银行分类的高收入国家的意识水平，并确定了相关因素。方法：使用Ovid MEDLINE、PsycINFO、Academic Search Complete、CINAHL、Cochrane Review Library、Emcare和ASSIA进行系统检索。两位作者独立筛选研究并提取数据。使用关键评估技能项目清单评估偏倚风险。由于异质性，进行了叙事综合。尽管方法存在异质性，但仍进行了探索性分析，包括视觉制图和描述性跨国比较。在PROSPERO上注册的协议（CRD42025621931）。结果：在筛选的2146篇论文中，23篇符合纳入标准。大多数研究报告显示，人们对中风危险因素的认识较低。最常见的是高血压，其次是吸烟、血脂异常和糖尿病。久坐不动的生活方式、饮酒、种族和心房颤动是最不被认可的。偏倚风险评估揭示了大多数研究的抽样和普遍性问题。大多数报道的关联都没有考虑潜在的混杂因素。高等教育与更强的意识联系在一起。出现了明显的地理聚类，65%的研究来自中东国家，主要是沙特阿拉伯。讨论：本综述独特地确定了关键的证据差距，包括不同人群的代表性不足，缺乏标准化的意识指标，以及在HIC卒中危险因素意识研究中未调整分析的优势。结论：卒中危险因素认识差距普遍存在，可能限制预防工作。迫切需要在高收入国家的不同地理、社会经济和种族人群中进行大规模、方法学上可靠的研究，因为即使在高收入环境中，意识特征也可能存在巨大差异。有针对性的教育对于初级预防战略是必要的。

{"title":"Public awareness of stroke risk factors in high-income countries: A systematic review","authors":"Mc Lernon S , Appiah B , Moorley C , Thomas N , Mussa R , Gonzales S , Werring D , Olawade D․B , Flood C","doi":"10.1016/j.jstrokecerebrovasdis.2025.108501","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108501","url":null,"abstract":"<div><h3>Purpose</h3><div>Stroke remains a significant health concern in high-income countries (HICs) and is increasing among younger adults. Although largely preventable, public awareness of stroke risk factors in HICs is not well established. We assessed awareness levels in World Bank-classified HICs and identified associated factors.</div></div><div><h3>Methods</h3><div>Systematic searches used Ovid MEDLINE, PsycINFO, Academic Search Complete, CINAHL, Cochrane Review Library, Emcare, and ASSIA. Two authors independently screened studies and extracted data. Risk of bias was assessed using Critical Appraisal Skills Programme checklists. Due to heterogeneity, narrative synthesis was conducted. <strong>Exploratory analyses including visual mapping and descriptive cross-country comparisons were performed despite methodological heterogeneity.</strong> Protocol registered on PROSPERO (CRD42025621931).</div></div><div><h3>Findings</h3><div>Of 2146 papers screened, 23 met inclusion criteria. Most studies reported low stroke risk factor awareness. Hypertension was most frequently identified, followed by smoking, dyslipidaemia, and diabetes. Sedentary lifestyle, alcohol consumption, ethnicity, and atrial fibrillation were least recognised. <strong>Risk of bias assessment revealed sampling and generalisability concerns in most studies. Most reported associations were unadjusted for potential confounders.</strong> Higher education was linked to greater awareness. <strong>Marked geographical clustering occurred, with 65 % of studies from Middle Eastern countries, predominantly Saudi Arabia.</strong></div></div><div><h3>Discussion</h3><div>This review uniquely identifies critical evidence gaps including under-representation of diverse populations, lack of standardised awareness metrics, and predominance of unadjusted analyses in HIC stroke risk factor awareness research.</div></div><div><h3>Conclusion</h3><div>Stroke risk factor awareness gaps are prevalent and may limit prevention efforts. <strong>Large-scale, methodologically robust studies across diverse geographical, socioeconomic, and ethnic populations within HICs are urgently needed, as awareness characteristics may vary dramatically even within high-income settings.</strong> Targeted education is necessary for primary prevention strategies.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108501"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcending traditional prognostic assessments: Predictive efficacy of MRA-based BATMAN and PCCS scores in basilar artery occlusive stroke 超越传统的预后评估：基于mri的BATMAN和PCCS评分在基底动脉闭塞性卒中中的预测作用。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108492

Lichao Hong , Lina Geng , Shuyan Jing , Zhai Liu , Yong Wang , Qian Wang

Aim

This study evaluated the application of Magnetic Resonance Angiography (MRA)-based BATMAN and PCCS scoring systems to predict individual neurological functional prognosis in patients with Basilar Artery Occlusive (BAO) stroke.

Materials and methods

Forty patients with BAO were enrolled, with prognosis assessed at 3 months post-stroke using the modified Rankin Scale (mRS). Prognostic scores were classified as good (mRS ≤ 3) or poor (mRS > 3). MRA-based BATMAN and PCCS scores were used to predict outcomes, and their predictive efficacy was assessed via Receiver Operating Characteristic (ROC) curve analysis.

Results

Among the 40 BAO patients, 24 (60%) had a good prognosis and 16 (40%) had a poor prognosis. Both BATMAN-MRA and PCCS-MRA scores were significantly negatively correlated with the 3-month mRS score (BATMAN-MRA: r = -0.487, P < 0.001; PCCS-MRA: r = -0.503, P < 0.001). ROC analysis showed that the BATMAN-MRA score had slightly higher predictive efficacy (AUC = 0.849) than the PCCS-MRA score (AUC = 0.807), with an optimal cutoff value of 6.5 for both scoring systems.

Conclusion

MRA-based BATMAN and PCCS scores are effective tools for predicting neurological outcomes in BAO patients, with BATMAN-MRA demonstrating superior predictive accuracy in this study.

目的：本研究评估基于磁共振血管造影（MRA）的BATMAN和PCCS评分系统在预测基底动脉闭塞性（BAO）脑卒中患者个体神经功能预后中的应用。材料与方法：入选40例BAO患者，卒中后3个月采用改良Rankin量表（mRS）评估预后。预后评分分为好（mRS≤3）和差（mRS bb0.3）。基于mra的BATMAN和PCCS评分用于预测预后，并通过受试者工作特征（ROC）曲线分析评估其预测效果。结果：40例BAO患者中，预后良好24例（60%），预后不良16例（40%）。BATMAN-MRA和PCCS-MRA评分与3个月mRS评分均呈显著负相关（BATMAN-MRA: r = -0.487,P < 0.001; PCCS-MRA: r = -0.503,P < 0.001）。ROC分析显示，BATMAN-MRA评分的预测效能（AUC = 0.849）略高于PCCS-MRA评分（AUC = 0.807），两种评分系统的最佳截止值均为6.5。结论：基于mra的BATMAN和PCCS评分是预测BAO患者神经预后的有效工具，BATMAN- mra在本研究中显示出更高的预测准确性。

{"title":"Transcending traditional prognostic assessments: Predictive efficacy of MRA-based BATMAN and PCCS scores in basilar artery occlusive stroke","authors":"Lichao Hong , Lina Geng , Shuyan Jing , Zhai Liu , Yong Wang , Qian Wang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108492","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108492","url":null,"abstract":"<div><h3>Aim</h3><div>This study evaluated the application of Magnetic Resonance Angiography (MRA)-based BATMAN and PCCS scoring systems to predict individual neurological functional prognosis in patients with Basilar Artery Occlusive (BAO) stroke.</div></div><div><h3>Materials and methods</h3><div>Forty patients with BAO were enrolled, with prognosis assessed at 3 months post-stroke using the modified Rankin Scale (mRS). Prognostic scores were classified as good (mRS ≤ 3) or poor (mRS > 3). MRA-based BATMAN and PCCS scores were used to predict outcomes, and their predictive efficacy was assessed via Receiver Operating Characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>Among the 40 BAO patients, 24 (60%) had a good prognosis and 16 (40%) had a poor prognosis. Both BATMAN-MRA and PCCS-MRA scores were significantly negatively correlated with the 3-month mRS score (BATMAN-MRA: r = -0.487, P < 0.001; PCCS-MRA: r = -0.503, P < 0.001). ROC analysis showed that the BATMAN-MRA score had slightly higher predictive efficacy (AUC = 0.849) than the PCCS-MRA score (AUC = 0.807), with an optimal cutoff value of 6.5 for both scoring systems.</div></div><div><h3>Conclusion</h3><div>MRA-based BATMAN and PCCS scores are effective tools for predicting neurological outcomes in BAO patients, with BATMAN-MRA demonstrating superior predictive accuracy in this study.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108492"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Serum Cardiotrophin-1 as a novel biomarker for intracranial aneurysm 血清心肌营养因子-1作为颅内动脉瘤的新生物标志物。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108493

Weidong Men , Xuehao Zhang , Lijian Zhang , Shuo Sun , Yatong Wang , Pengfei Zhao , Jia Zuo , Chunhui Li , Xiaosong Shan

Background

Intracranial aneurysms (IAs) carry a high risk of rupture leading to subarachnoid hemorrhage, yet current diagnostic methods are invasive and costly. This study aimed to evaluate the potential of serum inflammatory markers and cardiotrophin-1 (CT-1) as non-invasive biomarkers for IA presence and rupture risk.

Methods

A total of 131 IA patients (33 unruptured, 98 ruptured) and 21 healthy controls were enrolled. Serum levels of IL-6, IL-10, IL-33, S100B, E-selectin, and CT-1 were measured by ELISA. Statistical analyses included Kruskal-Wallis tests, ROC curve evaluation, and logistic regression for risk factors.

Results

Serum CT-1 levels were significantly elevated in IA patients versus controls (p = 0.0002), with the highest levels in ruptured IAs (p = 0.0001 vs controls). ROC analysis demonstrated CT-1’s diagnostic potential for IA (AUC = 0.7801, sensitivity 75.57%) and ruptured IA (AUC = 0.7911, sensitivity 79.59%). No significant differences were observed for IL-6, IL-10, IL-33, S100B, or E-selectin. Older age (OR = 1.072) and smoking (OR = 9.659) were significant IA risk factors.

Conclusions

CT-1 is a promising serum biomarker for IA detection and rupture risk stratification. Its elevation, particularly in ruptured cases, suggests potential clinical utility for non-invasive screening. Further validation in larger cohorts is warranted.

背景：颅内动脉瘤（IAs）具有很高的破裂风险，导致蛛网膜下腔出血，但目前的诊断方法是侵入性的和昂贵的。本研究旨在评估血清炎症标志物和心肌营养因子-1 （CT-1）作为IA存在和破裂风险的非侵入性生物标志物的潜力。方法：131例IA患者（未破裂33例，破裂98例）和21例健康对照。ELISA法检测血清IL-6、IL-10、IL-33、S100B、e -选择素、CT-1水平。统计分析包括Kruskal-Wallis检验、ROC曲线评价和危险因素的logistic回归。结果：与对照组相比，IA患者血清CT-1水平显著升高（p = 0.0002），破裂IAs患者血清CT-1水平最高（p = 0.0001）。ROC分析显示，CT-1对IA （AUC = 0.7801，敏感性75.57%）和IA破裂（AUC = 0.7911，敏感性79.59%）具有诊断潜力。IL-6、IL-10、IL-33、S100B或E-selectin均无显著差异。年龄（OR = 1.072）和吸烟（OR = 9.659）是IA的显著危险因素。结论：CT-1是一种很有前途的用于IA检测和破裂风险分层的血清生物标志物。它的升高，特别是在破裂病例中，表明非侵入性筛查的潜在临床应用。需要在更大的队列中进一步验证。

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引用次数: 0

In Memoriam: Sebastián F. Ameriso 纪念：Sebastián F. Ameriso

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108487

Maximiliano A Hawkes MD , Mark Fisher MD

引用次数: 0

MRI patterns in ischemic spinal cord injury after thoracoabdominal aorta repair: Narrative review with illustrative case series 胸腹主动脉修复后缺血性脊髓损伤的MRI模式：说明性病例系列的叙述性回顾。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108479

Hamdy Awad MD, FASA , Suzanne Lowes MD , Bradley Gigax BS , Matthew Greene BS , Amar Dabbagh BS , Michael Essandoh MD , Esmerina Tili PhD , Cassidy Wernke DO , Amardeep Mudhar BS , Edison Lin , Eric Bourekas MD

Background

Ischemic spinal cord injury (ISCI) is a serious complication following thoracoabdominal aortic aneurysm (TAAA) repair, whether by open (OR) or endovascular (TEVAR) approaches. Although MRI can detect spinal cord ischemia, it’s not routinely used. Emerging evidence suggests MRI may offer insights into ISCI mechanisms, lesion pattern, and prognosis. This narrative review integrates published literature with our illustrative institutional case series to evaluate MRI’s diagnostic and clinical role in postoperative ISCI.

Observations

Records from October 2011 to August 2023 were reviewed and 10 patients (7 OR, 3 TEVAR) were identified who developed postoperative ISCI and underwent spinal MRI. Diffuse infarction patterns predominated (9/10 cases), and partial neurologic recovery occurred only in TEVAR patients. Prophylactic CSF drains were used in most OR cases (6/7), while rescue drains were more common in TEVAR cases (2/3). Across the literature, MRI classifications by Mawad, Tanaka, Yasuda, and others link lesion pattern and tissue involvement to prognosis, whereas experimental and anatomic studies highlight the influence of vascular variability and watershed physiology.

Conclusions

MRI clarifies the mechanism, extent, and timing of spinal cord ischemia after aortic repair and helps differentiate infarction from other causes of myelopathy. Differences in recovery between OR and TEVAR likely reflect underlying vascular anatomy and ischemic dynamics. Future multicenter studies using standardized MRI and vascular mapping could refine risk stratification, optimize CSF drainage strategies, and improve outcomes in this high-risk population.

背景：缺血性脊髓损伤（ISCI）是胸腹主动脉瘤（TAAA）修复后的严重并发症，无论是通过开放（OR）还是血管内（TEVAR）入路。虽然MRI可以检测脊髓缺血，但它并没有被常规使用。越来越多的证据表明，MRI可能有助于了解ISCI的机制、病变模式和预后。这篇叙述性综述整合了已发表的文献和我们的说明性机构病例系列，以评估MRI在术后ISCI中的诊断和临床作用。观察：回顾了2011年10月至2023年8月的记录，确定了10例（7例OR， 3例TEVAR）术后发生ISCI并接受脊柱MRI检查的患者。弥漫性梗死模式占主导地位（9/10例），部分神经功能恢复仅发生在TEVAR患者中。预防性脑脊液引流在大多数OR病例（6/7）中使用，而抢救性脑脊液引流在TEVAR病例中更常见（2/3）。在文献中，Mawad、Tanaka、Yasuda等人的MRI分类将病变模式和组织累及与预后联系起来，而实验和解剖研究则强调血管变异性和分水岭生理学的影响。结论：MRI明确了主动脉修复后脊髓缺血的机制、程度和时间，有助于区分梗死与其他原因的脊髓病。OR和TEVAR之间的恢复差异可能反映了潜在的血管解剖和缺血动力学。未来的多中心研究使用标准化的MRI和血管测绘可以细化风险分层，优化脑脊液引流策略，并改善这一高危人群的预后。

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引用次数: 0

A blast from the past: Incidental Pantopaque deposition in a patient with acute stroke who underwent successful thrombectomy 来自过去的冲击波：一例成功取栓的急性中风患者偶然的Pantopaque沉积。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-10-07 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108467

Rainier Mark Loidor L. Rapal MD , James Siegler MD , Michael Hurley MD

Background

Pantopaque (iofendylate) was an oil-based myelographic contrast used until the 1980s. Residual deposits can persist for decades and mimic acute pathology on neuroimaging.

Clinical Case

An 86-year-old woman with vascular risk factors and lung cancer presented with acute left hemiparesis and facial droop (NIHSS 17). Non-contrast CT showed multiple cortical and sulcal hyperdensities, raising concern for hemorrhage or metastases. CT angiography revealed a right M1 occlusion. She underwent successful thrombectomy (TICI 3) with excellent recovery (NIHSS 1 at discharge). Further review revealed a prior Pantopaque myelogram in the 1980s, and the hyperdensities were recognized as retained contrast droplets.

Conclusion

Residual Pantopaque may mimic hemorrhage or metastases on CT. Recognition of its characteristic appearance, combined with awareness of historical myelography, is essential to prevent misdiagnosis. This case is unusual for its right-sided dependence, a rarely reported distribution pattern.

背景：Pantopaque （iofendylate）是一种油基脊髓造影造影剂，一直使用到20世纪80年代。残留沉积物可以持续数十年，并在神经影像学上模仿急性病理。临床病例：86岁女性，伴有血管危险因素和肺癌，表现为急性左偏瘫和面部下垂（NIHSS 17）。非对比CT显示多发皮质及脑沟高密度，提示出血或转移的可能性。CT血管造影显示右侧M1闭塞。她接受了成功的血栓切除术（TICI 3），出院时恢复良好（NIHSS 1）。进一步复查发现在20世纪80年代有过Pantopaque骨髓显像，高密度被认为是残留的造影剂液滴。结论：残留的Pantopaque可能在CT上模拟出血或转移。认识其特征性的外观，并结合历史的意识，是必不可少的，以防止误诊。这种情况是不寻常的右侧依赖，一个很少报道的分布模式。

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引用次数: 0

Preoperative and intraoperative risk factor assessment and model for predicting stroke risk in patients diagnosed with cancer after surgery 术前及术中危险因素评估及预测癌症患者术后卒中风险的模型

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-12-01 Epub Date: 2025-11-19 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108495

Shangqi Chen , Yuxuan Mo , Xiangman Zeng , Ping Chen , Feng Wu , Xiaoyu Li , Hua Ye , Yuan Yuan , Qi Zheng

Background

Perioperative stroke is a devastating surgical complication associated with high mortality rates. The goals of our study were to identify the predictors of postoperative stroke and to explore the possible role of intraoperative hypotension (IOH).

Methods

Medical records of patients undergoing non-cardiovascular, non-neurological surgery at Ningbo No.2 Hospital (January 1st, 2012—December 31st, 2023) were retrospectively analyzed. Logistic regression was used to screen for independent risk factors. The nomogram is used for the visualization of the model.

Results

This retrospective cohort study included 574,102 patients. Among 419,358 patients from 2012 to 2019, 848 (0.2 %) experienced postoperative stroke; cancer-related surgeries increased this incidence by 67 % (P < 0.001). In the cancer subgroup (multivariate analysis), significant predictors included age, history of stroke, atrial fibrillation, renal failure, elevated preoperative D-Dimer, and sustained IOH (>40 % decrease in mean arterial pressure [MAP] from baseline for >15 min) (all P < 0.05). Furthermore, the nomogram model developed based on the above variables demonstrated effective performance in predicting the occurrence of postoperative stroke in both the training set (January 1st, 2012—December 31st, 2019; n = 65,312) and the validation set (January 1st, 2020—December 31st, 2023; n = 28,326), with areas under the curve (AUCs) of 0.843 and 0.852, respectively.

Conclusion

This study confirms that cancer-related surgeries significantly increase postoperative stroke risk and demonstrates IOH's independent association in this subgroup. A validated nomogram provides an effective tool for prediction.

背景：围手术期卒中是一种毁灭性的手术并发症，死亡率高。本研究的目的是确定术后卒中的预测因素，并探讨术中低血压（IOH）的可能作用。方法：回顾性分析宁波市第二医院2012年1月1日至2023年12月31日行非心血管、非神经外科手术患者的病历。采用Logistic回归筛选独立危险因素。模态图用于模型的可视化。结果：该回顾性队列研究纳入了574,102例患者。在2012-2019年的419,358例患者中，848例（0.2%）发生了术后卒中；癌症相关手术使该发生率增加67% （P < 0.001）。在癌症亚组（多因素分析）中，显著的预测因素包括年龄、卒中史、心房颤动、肾衰竭、术前d -二聚体升高和持续IOH（平均动脉压[MAP]较基线下降40%，持续>15分钟）（均P < 0.05）。在训练集（2012年1月1日- 2019年12月31日，n=65,312）和验证集（2020年1月1日- 2023年12月31日，n=28,326）中，基于上述变量建立的nomogram模型均能有效预测术后卒中的发生，曲线下面积（auc）分别为0.843和0.852。结论：本研究证实癌症相关手术显著增加术后卒中风险，并证实IOH在该亚组中具有独立相关性。经过验证的模态图为预测提供了有效的工具。

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