Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Aspirin-ticagrelor use after mild acute ischemic stroke: Findings from the get with the guidelines-stroke registry","authors":"Ava L. Liberman MD ,&nbsp;Cenai Zhang BS ,&nbsp;Sara K. Rostanski MD ,&nbsp;Hooman Kamel MD MS ,&nbsp;Babak B. Navi MD MS ,&nbsp;Natalie T. Cheng MD ,&nbsp;Radhika Sundararajan MD PhD ,&nbsp;Steven R. Messe MD ,&nbsp;Gregg C. Fonarow MD ,&nbsp;Shyam Prabhakaran MD MS ,&nbsp;Ying Xian MD PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108564","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108564","url":null,"abstract":"<div><h3>Background</h3><div>Recent guidelines suggest that aspirin-ticagrelor may be considered for stroke prevention after mild acute ischemic stroke. However, it is unclear how commonly this dual antiplatelet therapy (DAPT) regimen is used in practice.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional analysis of the Get With The Guidelines-Stroke registry 2017-2023. Patients with a non-cardioembolic mild ischemic stroke (defined as NIHSS &lt;6) who presented within 24 hours of last known well without a contraindication to DAPT were included. The primary study outcome was the proportion of patients prescribed aspirin-ticagrelor at hospital discharge; temporal patterns of prescribing aspirin-ticagrelor and aspirin-clopidogrel over time are also described. In addition to standard tests of comparison, we used multiple logistic regression to evaluate associations between patient and facility factors and aspirin-ticagrelor use reported as odds ratios (OR) with 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>Among 1,018,736 patients meeting study criteria, 478,049 (46.9%) were female and median age was 68 (IQR: 59, 78) years. A total of 12,845 (1.3%) patients were discharged on aspirin-ticagrelor whereas 448,348 (44.0%) were discharged on aspirin-clopidogrel. Prescriptions for aspirin-ticagrelor and for aspirin-clopidogrel significantly increased over the study time-period. In regression analysis, coronary artery disease/prior myocardial infarction (OR: 2.6 [95% CI: 2.5-2.7]), Asian race (OR: 2.1 [95% CI: 1.9-2.2]), aspirin-clopidogrel prescription upon admission (OR: 2.0 [95% CI:1.9-2.1]), and history of stroke/TIA (OR: 1.98 [95% CI: (1.9-2.1)]), were substantially associated with aspirin-ticagrelor use whereas lacking insurance/self-pay (OR: 0.7 [95% CI: 0.6-0.8]), rural setting (OR: 0.8 [95% 0.7-0.9]), and primary stroke centers (OR: 0.3 [95% CI: 0.3-0.4]) were inversely associated with aspirin-ticagrelor. In the subgroup of 176,897 (17.4%) patients with NIHSS 4-5, 74,912 (50.8%) were discharged on aspirin-clopidogrel and 2,394 (1.4%) on aspirin-ticagrelor.</div></div><div><h3>Conclusion</h3><div>Unlike aspirin-clopidogrel, aspirin-ticagrelor is infrequently administered after mild acute ischemic stroke (NIHSS &lt;6) despite current guidelines, though the use of both DAPT regimens increased over time.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108564"},"PeriodicalIF":1.8,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021149","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}

{"title":"Protective association of higher frequency physical exercise with all-cause mortality risk in stroke patients: evidence from the health and retirement study","authors":"Jingtao Du ,&nbsp;Xiaofeng Jiang ,&nbsp;Binghua Shao ,&nbsp;Liu Zhenshun ,&nbsp;Liu Tianyu ,&nbsp;Jianwei Wu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108563","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108563","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between the different exercise frequency in daily life and all-cause mortality risk of the patients after stroke, and to analyze their dose-response relationship.</div></div><div><h3>Methods</h3><div>1,639 participants with stroke were selected from Health and Retirement Study (HRS) database. Based on physical exercise frequency questionnaires, participants were categorized into five groups: sedentary (n=152), low (n=276), moderate (n=212), high (n=205), and vigorous (n=794). Multivariate Cox proportional hazards regression models and survival analyses were applied to examine the associations between exercise frequency and all-cause mortality risk in stroke patients.</div></div><div><h3>Results</h3><div>Median follow-up time revealed that both median survival time and interquartile range increased progressively with higher exercise frequency. Multivariate Cox regression analysis demonstrated a significant dose-response relationship: Compared to the sedentary group, moderate, high, and vigorous exercise groups exhibited significantly reduced death risks of 28%, 35%, and 42%, respectively. Exercise score showed a significant negative correlation with mortality rate (r=-0.855). Kaplan-Meier survival analysis revealed significant divergence in survival curves among different exercise frequency groups (log-rank P&lt;0.001), with the vigorous exercise group demonstrating the highest cumulative survival rate. Age-stratified analysis indicated that patients aged ≤65 years had the most favorable survival prognosis, while survival rates significantly decreased with advancing age (log-rank P&lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Higher frequency physical exercise manifested a protective association with reduced all-cause mortality risk in stroke patients, with a clear dose-response relationship. These findings support incorporating regular moderate-to-high-frequency exercise into daily life to reduce the hazards of stroke and improve long-term prognosis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108563"},"PeriodicalIF":1.8,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014206","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}

{"title":"Transcatheter closure versus antithrombotic therapy for cryptogenic stroke in elderly patients with patent foramen ovale: a systematic review and meta-analysis of non-randomized studies","authors":"Yang Dong MD ,&nbsp;Cong Lu MD ,&nbsp;Tiantian Luo PhD ,&nbsp;Hao Huang MD ,&nbsp;Yan Xiong MD ,&nbsp;Jie Zeng MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108562","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108562","url":null,"abstract":"<div><h3>Background</h3><div>There is lacking of robust clinical evidence comparing transcatheter closure with antithrombotic therapy in elderly patent foramen ovale (PFO) patients with cryptogenic stroke.</div></div><div><h3>Methods</h3><div>The Pubmed, Embase, Web of Science, clinicaltrials.gov and Cochrane Library databases were systematically searched. Studies comparing transcatheter closure therapy with antithrombotic drug therapy in PFO patients in older age (≥55 years old) were included. The number of patients with and without events in both experimental group and control group were extracted. There were three study endpoints: composite endpoint of recurrent ischemic stroke and transient ischemic attack (TIA); all-cause death; new-onset atrial fibrillation. A random-effect model was performed. Heterogeneity among selected publications was assessed using Q-test based on a χ² test. I²&gt;50% was defined as high heterogeneity. P &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Nine studies of 7275 elderly PFO patients with cryptogenic stroke were included. Patients undergoing PFO closure had significantly lower risk of a composite endpoint of recurrent stroke and TIA (4.74% versus 8.08%, OR=0.517, 95% CI:0.325-0.821) and all-cause death (1.17% versus 1.24%, OR=0.531, 95% CI: 0.317-0.891). There was no significant different occurrence of new-onset atrial fibrillation between the two groups (3.81% versus 2.82%, OR=1.218, 95% CI: 0.826-1.798). None of the studies measuring the three endpoints manifested high heterogeneity.</div></div><div><h3>Conclusions</h3><div>PFO closure might reduce the risk of composite endpoint of recurrent stroke and TIA and all-cause death, while not increase the risk of new-onset atrial fibrillation comparing with medication therapy in elderly PFO patients with cryptogenic stroke. PFO closure should be considered part of a comprehensive secondary prevention strategy in elderly patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108562"},"PeriodicalIF":1.8,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994757","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}

{"title":"Rapid enlargement of a pre-existing intracranial aneurysm during infective endocarditis: a case report","authors":"Mamoru Ishida MD, PhD,&nbsp;Ryosuke Nishiwaki MD,&nbsp;Hisashi Mizutani MD,&nbsp;Yuichi Kawasaki MD,&nbsp;Takahiro Oyama MD,&nbsp;Mitsuhiro Yoshida MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108561","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108561","url":null,"abstract":"<div><h3>Background</h3><div>Infectious intracranial aneurysms (IIAs) are generally thought to develop de novo as a consequence of septic embolization during infective endocarditis (IE). Rapid infection-related enlargement of a pre-existing unruptured aneurysm during IE has not been previously documented. We report a case in which a small middle cerebral artery (MCA) aneurysm, previously identified on imaging, enlarged rapidly in the course of IE.</div></div><div><h3>Case Description</h3><div>A 67-year-old woman with a history of mitral valve repair presented with progressive general malaise and mild left hemiparesis. MRI demonstrated acute infarctions in the right caudate nucleus and putamen, and MRA showed occlusion of the right M2 superior branch. A previously identified 2.2-mm right MCA bifurcation aneurysm was not visualized on admission MRA. Infective endocarditis was subsequently diagnosed, and the aneurysm reappeared on day 9 at 5.5 mm and enlarged further to 9.5 mm by day 15. Endovascular coil embolization was performed on day 16, achieving complete aneurysm occlusion. The patient later underwent mitral valve surgery without complications.</div></div><div><h3>Conclusion</h3><div>This case demonstrates infection-related enlargement of a pre-existing intracranial aneurysm during IE, documented chronologically with serial MRA. These findings highlight the need for careful interval imaging in patients with IE and known aneurysms, and rapid morphological change should prompt urgent aneurysm treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108561"},"PeriodicalIF":1.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994753","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}

{"title":"Longitudinal comparison of health-related quality of life at 3 and 12 months post-stroke using patient-reported outcome measures","authors":"Hojin Ju MD ,&nbsp;Won Kee Chang MD, MS ,&nbsp;Hee-Mun Cho MD ,&nbsp;Hyo Jong Kim MD ,&nbsp;Miji Kang RN ,&nbsp;Yun-Sun Jung MPH, PhD ,&nbsp;Nam-Jong Paik MD, PhD ,&nbsp;Won-Seok Kim MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108559","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108559","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) is a key outcome in stroke survivors, but evidence on distinct physical and mental recovery trajectories is limited. EuroQoL 5-dimension 3-level (EQ-5D-3L) is widely used but prone to ceiling effects and cannot separate physical (PH) and mental health (MH). We administered Patient-Reported Outcomes Measurement Information System 10-item short form (PROMIS-10) at 3 and 12 months post-stroke, identified discharge-related predictors of PROMIS-10 PH and MH to distinguish their recovery trajectories, and compared their discriminatory capacity with that of EQ-5D-3L.</div></div><div><h3>Methods</h3><div>We analyzed PROMIS-10 and EQ-5D-3L scores in a retrospective cohort of 741 stroke survivors discharged from a tertiary center and followed at 3 and 12 months. Discriminatory capacity across modified Rankin Scale (mRS) groups was assessed using effect sizes. Linear regression identified demographic and clinical predictors of PROMIS-10 PH and MH at 3 and 12 months.</div></div><div><h3>Results</h3><div>At 3 months, EQ-5D-3L demonstrated greater discriminatory capacity across mRS groups. At 12 months, PH exhibited better discriminatory capacity than EQ-5D-3L for mild disability (mRS 0–1 vs. 2), consistent with ceiling effects reducing EQ-5D-3L sensitivity in the mild impairment group. Discharge ambulation consistently predicted both PH and MH at 3 and 12 months. Comorbidity burden, employment status, respondent type (proxy vs. patient), and discharge destination were associated with PROMIS-10, particularly in 12-month MH.</div></div><div><h3>Conclusion</h3><div>Predictors and trajectories differed between PH and MH groups, supporting separate assessment. PROMIS-10 exhibited better discriminatory capacity of milder disability at 12 months by distinguishing physical and mental dimensions, supporting tailored care basis.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108559"},"PeriodicalIF":1.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992941","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}

{"title":"RKIP regulates the ERK/MAPK signaling pathway to improve neuroinflammatory injury in male rats with ischemic stroke","authors":"Rui Mao,&nbsp;Xin Tan,&nbsp;Rong Li,&nbsp;Zhiyong Yang,&nbsp;Hua Liu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108560","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108560","url":null,"abstract":"<div><h3>Background</h3><div>To explore the mechanism by which RAF kinase inhibitory protein (RKIP) alleviates neuroinflammatory damage in male rats with ischemic stroke (IS).</div></div><div><h3>Methods</h3><div>Male rats were subjected to middle cerebral artery occlusion (MCAO) to establish an IS model. Two weeks before MCAO, a single tail-vein injection of lentivirus or an equivalent volume of normal saline was administered to rats. The neurological deficit scores, infarct volume fractions, and pathological changes of the ischemic penumbra were evaluated in the rats. Immunohistochemstry, double-labeled immunofluorescence, ELISA, and Western blot were performed to assess microglial polarization, neuroinflammation and ERK/MAPK-related protein expressions.</div></div><div><h3>Results</h3><div>IS rats exhibited elevated neurological deficit scores and enlarged infarct volume fractions, accompanied by aggravated histopathological damage in the ischemic penumbra. Microglial M1 polarization was enhanced, meanwhile, IL-6 and TNF-α were up-regulated, whereas the anti-inflammatory mediator IL-10 was down-regulated, indicating a pronounced neuroinflammatory response. In particular, Western blot results showed that the ischemic penumbra expression of RKIP in IS rats was markedly lower in IS group than that in Control group. After achieving RKIP overexpression via lentivirus mediation, the polarization direction of microglia in the ischemic penumbra of IS rats shifted toward the M2 phenotype. This was specifically manifested by a significant decrease in the proportion of iNOS⁺/Iba1⁺ double-positive microglia, while the proportion of Arg-1⁺/Iba1⁺ double-positive microglia was significantly increased, and the neuroinflammatory response was alleviated. Moreover, its overexpression significantly reduced the expressions of p-ERK1/2 and p-p38 MAPK in ischemic penumbra. Interestingly, rmEGF-activated ERK elevated the protein levels of p-ERK1/2 and p-p38 MAPK in ischemic penumbra without altering RKIP expression itself. Consequently, the proportion of iNOS⁺/Iba1⁺ double-positive microglia rebounded, while that of Arg-1⁺/Iba1⁺ double-positive microglia decreased . Finally, functional experiments demonstrated that ERK partially reversed the neuroinflammatory protection conferred by RKIP overexpression in IS rats.</div></div><div><h3>Conclusion</h3><div>Overexpression of RKIP may alleviate the neuroinflammatory damage in IS rats by inhibiting ERK/MAPK pathway, thereby improving neurological function.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108560"},"PeriodicalIF":1.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992973","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}

{"title":"Methodological contextualization and interpretation of early gastrostomy timing in nontraumatic intracerebral hemorrhage","authors":"Andrea Loggini MD MPH MBA ,&nbsp;Victor J. Del Brutto MD ,&nbsp;Faddi G. Saleh Velez MD ,&nbsp;Jonatan Hornik MD ,&nbsp;Awni D. Shahait MD ,&nbsp;Denise Battaglini MD PhD ,&nbsp;Shawn S. Wallery MD ,&nbsp;Alejandro Hornik MD ,&nbsp;Christos Lazaridis MD ,&nbsp;Adnan I. Qureshi MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108558","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108558","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108558"},"PeriodicalIF":1.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981132","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}

{"title":"Assessment of perioperative outcome factors after hemicraniectomy confirms age as the prognostic factor in patients with middle cerebral artery infarction: Evidence from real-world data","authors":"Regina Isemann MD ,&nbsp;Florian Wild MD ,&nbsp;Paul Bronzlik MD ,&nbsp;Joachim K. Krauss MD ,&nbsp;Thomas Stüber MD ,&nbsp;Kurt-Wolfram Sühs MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108557","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108557","url":null,"abstract":"<div><h3>Background</h3><div>Malignant middle cerebral artery (MCA) infarction is a serious condition for which hemicraniectomy can improve survival and outcome. However, it remains unclear to what extent other perioperative factors contribute to the outcome.</div></div><div><h3>Methods</h3><div>This monocentric, retrospective observational study included patients with MCA infarction and subsequent hemicraniectomy. Perioperative parameters were collected from 68 patients between 01/2012 and 12/2020. Logistic regression analysis was performed to establish determinants for the outcome measured by the Modified Rankin Scale (mRS) (dichotomized in mRS 0-3: favorable outcome, mRS 4-6: poor outcome) 12 months after stroke.</div></div><div><h3>Results</h3><div>Before event, most patients had no impairment (mRS 0, 75 %) or mild impairment (mRS 1-3, 23.5 %). 12 months after stroke, 18 patients (32 %) had favorable outcome (mRS 0-3). In univariable analysis, age (OR[95 %CI]: 1.124[1.045,1.208], p = 0.002) and the pre-existing conditions diabetes (OR[95 %CI]: 10.625[1.279,88.293], p = 0.029) and hypertension (OR[95 %CI]: 3.875[1.159,12.961], p = 0.028) were associated with poor outcome, as were more points of effort for intensive care complex treatment in the Simplified Acute Physiology Score (SAPS) in the first two days after stroke (OR_day1[95 %CI_day1]: 1.109[1.023,1.203], p_day1 = 0.012) (OR_day2[95 %CI_day2]: 1.209[1.078,1.355], p_day2 = 0.001). All other collected periinterventional parameters (i.e. sedation, fever) did not influence the outcome. In multivariable analysis, older age (OR[95 %CI]: 1.107[1.029,1.190], p = 0.006) was found to be an independent predictor of higher mRS (4-6). For age, our ROC analysis showed a cut-off point of 57 years.</div></div><div><h3>Conclusion</h3><div>Our data provide information about changes in the degree of impairment and its improvement over time beyond the acute phase of stroke. Of all included parameters, age emerged as the most important prognostic factor.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108557"},"PeriodicalIF":1.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981130","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}

{"title":"The association of recurrent stroke and immunoglobulin G4-related arteritis in the central nervous system: a case report","authors":"Qi Huang ,&nbsp;Hongjian Shen ,&nbsp;Pengfei Xing,&nbsp;Yi Jiang,&nbsp;Xiaolong Xu,&nbsp;Qiang Li,&nbsp;Yongwei Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2026.108556","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108556","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin G4–related disease (IgG4-RD) is a systemic immune-mediated fibroinflammatory disease. Histopathology is the key to diagnosis. Although aortitis/periaortitis is a phenotype of IgG4-related disease, the relationship between cerebrovascular disease and IgG4-related disease remains unclear.</div></div><div><h3>Methods</h3><div>We report a 60-year-old man with recurrent stroke induced by IgG4-related arteritis and present the pathological findings of the patient's superficial temporal artery and middle cerebral artery.</div></div><div><h3>Results</h3><div>Immunohistochemistry demonstrated scattered plasma cells in the intima and adventitia of the superficial temporal artery, with a small number of IgG4-positive cells observed (10–15 cells per high-power field).</div></div><div><h3>Conclusions</h3><div>Case reports and studies examining the association between IgG4-related neurological arteritis and stroke are limited. Although a definitive link between IgG4-related arteritis (IgG4-RA) and stroke has not been established, IgG4-related arteritis should be considered as an etiology in patients with recurrent idiopathic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108556"},"PeriodicalIF":1.8,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981131","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}

{"title":"Metabolic syndrome severity and stroke risk: a longitudinal analysis in middle-aged and older chinese adults","authors":"Wang Rong MD ,&nbsp;Zhanlan Zhu MD ,&nbsp;Dongji Wang MD ,&nbsp;Wenbin Shang MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108553","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108553","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic syndrome (MetS) contributes to cerebrovascular disease in older adults. Traditional binary diagnostic criteria may not fully capture metabolic dysfunction or its impact on stroke risk.</div></div><div><h3>Objective</h3><div>This study explores the relationship between MetS severity and stroke risk.</div></div><div><h3>Methods</h3><div>Data were derived from the China Health and Retirement Longitudinal Study (2011–2018). MetS severity was quantified using a validated scoring algorithm, and a cumulative severity score was calculated as the average of MetS scores at waves 1 and 3, weighted by the interval between waves. Cox proportional hazards models evaluated the relationship between baseline MetS severity and stroke events, while logistic regression assessed cumulative score in relation to incident stroke occurring after wave 3. Restricted cubic spline (RCS) functions were applied to explore nonlinear associations. Subgroup and interaction analyses were performed, and sensitivity analyses excluded participants receiving metabolic-related medications or with stroke occurring within two years prior to follow-up.</div></div><div><h3>Results</h3><div>During a median follow-up of 7 years, 459 stroke cases were documented (7.04%). Each interquartile increase in baseline MetS score was associated with a 33.4% higher stroke risk (HR = 1.334; 95% CI 1.239–1.436). Stroke risk increased significantly across quartiles (P for trend &lt; 0.0001), with the highest quartile exhibiting nearly a threefold greater risk compared with the lowest (HR = 2.923; 95% CI 2.208–3.871). Cumulative MetS score was also positively associated with stroke (OR = 1.034; 95% CI 1.025–1.043), with the highest quartile showing significantly elevated odds (OR = 1.069; 95% CI 1.049–1.092). RCS analyses demonstrated significant nonlinear associations between baseline and cumulative MetS scores and stroke risk in the overall population, whereas linear associations were observed in stratified analyses according to MetS status. Additional analyses assessing changes in MetS score between waves 1 and 3 showed no significant association with stroke risk.</div></div><div><h3>Conclusion</h3><div>Greater MetS severity is independently associated with increased stroke risk among middle-aged and older Chinese adults. These findings highlight the need for continuous surveillance of MetS severity and timely intervention to mitigate stroke burden in aging populations.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108553"},"PeriodicalIF":1.8,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954926","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}