Clinical characteristics, Risk factors, and outcomes of Posterior circulation stroke: A retrospective study between younger and older adults in Saudi Arabia

后循环卒中的临床特征，危险因素和结果: 沙特阿拉伯年轻人和老年人的回顾性研究

Posterior circulation stroke (PCS) may be less prevalent than its anterior counterpart but contributes to substantial morbidity and mortality. The aim was to characterize PCS's demographics, clinical presentation, management, and outcomes between younger and older adults in Saudi Arabia. Our investigation of 160 PCS patients in Saudi Arabia uncovers notable trends: a mere 22.4 % received thrombolysis and/or thrombectomy and a significant prevalence of posterior cerebral artery involvement due to large artery atherosclerosis. The study further reveals younger patients disproportionately had severe outcomes. Highlighting the need for improved stroke care and heightened awareness, this research contributes vital data to an underexplored domain, urging further study to optimize care and understand PCS dynamics in Saudi Arabia.

后循环中风 (PCS) 可能不如前循环中风流行，但会导致大量的发病率和死亡率。目的是描述沙特阿拉伯年轻人和老年人之间PCS的人口统计学，临床表现，管理和结果。我们对沙特阿拉伯160名PCS患者的调查发现了显着的趋势: 仅22.4% 人接受了溶栓和/或血栓切除术，并且由于大动脉粥样硬化而导致大脑后动脉受累的患病率很高。该研究进一步表明，年轻患者的严重后果不成比例。这项研究强调了改善中风护理和提高意识的必要性，为一个未被充分探索的领域提供了重要数据，敦促进一步研究以优化护理并了解沙特阿拉伯的PCS动态。

REF: Aldriweesh MA, Aldbas AA, Khojah O, et al. Clinical characteristics, Risk factors, and outcomes of Posterior circulation stroke: A retrospective study between younger and older adults in Saudi Arabia. J Stroke Cerebrovasc Dis. 2024;33(6):107676. doi:10.1016/j.jstrokecerebrovasdis.2024.107676 PMID: 38492657

Pathology-based brain arterial disease phenotypes and their radiographic correlates

基于病理学的脑动脉疾病表型及其影像学相关性

Brain arterial diseases, including atherosclerosis, vasculitis, and dissections, are major contributors to cerebrovascular morbidity and mortality worldwide. These diseases not only increase the risk of stroke but also play a significant role in neurodegeneration and dementia. Clear and unambiguous terminology and classification of brain arterial disease phenotypes is crucial for research and clinical practice. Arteriosclerosis refers to hardening of the arteries but does not specify the underlying etiology. Specific terms such as atherosclerosis, calcification, or non-atherosclerotic fibroplasia are preferred. Atherosclerosis is defined pathologically by an atheroma. Other brain arterial pathologies occur and should be distinguished from atherosclerosis given therapeutic implications. On brain imaging, intracranial arterial luminal stenosis is usually attributed to atherosclerosis in the presence of atherosclerotic risk factors but advanced high-resolution arterial wall imaging has the potential to more accurately identify the underlying pathology. Regarding small vessel disease, arteriosclerosis is ambiguous and arteriolosclerosis is often used to denote the involvement of arterioles rather than arteries. Lipohyalinosis is sometimes used synonymously with arteriolosclerosis, but less accurately describes this common small vessel thickening which uncommonly shows lipid. Specific measures of small vessel wall thickness, the relationship to the lumen as well as changes in the layer composition might convey objective, measurable data regarding the status of brain small vessels.

脑动脉疾病，包括动脉粥样硬化，血管炎和夹层，是全球脑血管发病率和死亡率的主要原因。这些疾病不仅会增加中风的风险，而且在神经退行性疾病和痴呆中也起着重要作用。脑动脉疾病表型的清晰和明确的术语和分类对于研究和临床实践至关重要。动脉硬化是指动脉硬化，但没有指明潜在的病因。具体术语如动脉粥样硬化、钙化或非动脉粥样硬化性纤维增生是优选的。动脉粥样硬化在病理学上被定义为动脉粥样化。发生其他脑动脉病变，应与动脉粥样硬化区分开来。在脑成像中，在存在动脉粥样硬化危险因素的情况下，颅内动脉管腔狭窄通常归因于动脉粥样硬化，但是先进的高分辨率动脉壁成像具有更准确地识别潜在病理的潜力。关于小血管疾病，动脉硬化是不明确的，并且动脉硬化通常用于表示小动脉而不是动脉的受累。脂透明症有时与小动脉硬化同义使用，但不太准确地描述这种常见的小血管增厚，这种增厚不常见地显示脂质。小血管壁厚度的具体测量、与管腔的关系以及层组成的变化可能传达关于脑小血管状态的客观、可测量的数据。

REF: Gutierrez J, Bos D, Turan TN, et al. Pathology-based brain arterial disease phenotypes and their radiographic correlates. J Stroke Cerebrovasc Dis. 2024;33(6):107642. doi:10.1016/j.jstrokecerebrovasdis.2024.107642 PMID: 38395095

Impact of fludrocortisone on the outcomes of subarachnoid hemorrhage patients: A retrospective analysis

氟氢可的松对蛛网膜下腔出血患者预后影响的回顾性分析

Whether the use of fludrocortisone affects outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). The risk of disability or death at 90 days was lower with the use of fludrocortisone in aSAH patients.

氟氢可的松的使用是否会影响动脉瘤性蛛网膜下腔出血 (aSAH) 患者的预后。在aSAH患者中使用氟氢可的松，90天时残疾或死亡的风险较低。

REF: Mistry AM, Naidugari J, Feldman MJ, et al. Impact of fludrocortisone on the outcomes of subarachnoid hemorrhage patients: A retrospective analysis. J Stroke Cerebrovasc Dis. 2024;33(6):107643. doi:10.1016/j.jstrokecerebrovasdis.2024.107643 PMID: 38387759

Trends in stroke-related journals: Examination of publication patterns using topic modeling

中风相关期刊的趋势: 使用主题模型检查出版模式

This study aims to demonstrate the capacity of natural language processing and topic modeling to manage and interpret the vast quantities of scholarly publications in the landscape of stroke research. These tools can expedite the literature review process, reveal hidden themes, and track rising research areas. The methodology can assist researchers, funders, and publishers by documenting the evolution and specialization of topics. The findings illustrate the significance of animal models, the expansion of rehabilitation research, and the centrality of reperfusion therapy. Limitations include a five-journal cap and a reliance on high-quality metadata.

本研究旨在证明自然语言处理和主题建模的能力，以管理和解释中风研究领域中大量的学术出版物。这些工具可以加快文献综述过程，揭示隐藏的主题，并跟踪不断上升的研究领域。该方法可以通过记录主题的演变和专业化来帮助研究人员，资助者和出版商。这些发现说明了动物模型的重要性，康复研究的扩展以及再灌注治疗的中心地位。限制包括五个期刊上限和对高质量元数据的依赖。

REF: Ozkara BB, Karabacak M, Margetis K, Smith W, Wintermark M, Yedavalli VS. Trends in stroke-related journals: Examination of publication patterns using topic modeling. J Stroke Cerebrovasc Dis. 2024;33(6):107665. doi:10.1016/j.jstrokecerebrovasdis.2024.107665 PMID: 38412931

Assessing left atrial size and pump function in ischemic stroke patients: Is cardiac MRI superior to transthoracic echocardiography?

评估缺血性卒中患者的左心房大小和泵功能: 心脏MRI是否优于经胸超声心动图？

Current guidelines recommend transthoracic echocardiography (TTE) following an ischemic stroke as the primary technique to identify cardiac abnormalities associated with an increased risk of cerebral embolism. It is unclear whether cardiac magnetic resonance imaging (cMRI), a technique shown to provide increased imaging resolution, may also enhance the cardiac assessment of ischemic stroke patients. We compared cMRI with TTE in the evaluation of Left Atrial (LA) size and pump function in a cohort of 44 patients with ischemic stroke. Using TTE alone leads to an underestimation of LA abnormalities important in the evaluation of ischemic stroke patients. Nearly one in every five ischemic stroke patients evaluated based on the current guidelines may have a missed potential source of cardiac embolism.

目前的指南建议缺血性中风后经胸超声心动图 (TTE) 作为识别与脑栓塞风险增加相关的心脏异常的主要技术。目前尚不清楚心脏磁共振成像 (cMRI)，一种被证明可以提高成像分辨率的技术，是否也可以增强缺血性中风患者的心脏评估。我们比较了44例缺血性卒中患者的cMRI和TTE评估左心房 (LA) 大小和泵功能。单独使用TTE会导致对缺血性中风患者评估中重要的LA异常的低估。根据当前指南评估的缺血性卒中患者中，近五分之一可能错过了心脏栓塞的潜在来源。

REF: Isaac M, Kumar SA, Petroski GF, Shinn A, Mehra A, Gomez CR. Assessing left atrial size and pump function in ischemic stroke patients: Is cardiac MRI superior to transthoracic echocardiography?. J Stroke Cerebrovasc Dis. 2024;33(6):107674. doi:10.1016/j.jstrokecerebrovasdis.2024.107674 PMID: 38484943

Endovascular outcomes for anterior choroidal artery aneurysms: systematic review and meta-analysis

脉络膜前动脉瘤的血管内预后: 系统回顾和荟萃分析

Anterior choroidal artery (AchoA) aneurysms are relatively rare compared to other types of aneurysms. However, the occurrence of transient or permanent occlusion of the choroidal artery during endovascular or surgical treatment is an uncommon but potentially serious complication. In this study, we aim to investigate the safety and efficacy profile of endovascular treatment (EVT) for AchoA aneurysms. Our study included 10 studies with 416 patients with 430 AchoA aneurysms. The overall good clinical outcome rate (mRS score 0-2) is 94.5 % with a retreatment rate of 2.0 %. A subgroup analysis showed no statistical difference between coiling(75.3 %) and flow diverter(80.9 %) treatment in terms of complete occlusion(p-value:0.62). Overall permanent complication rate is 1.4 % (p-value:0.54) and transient ischemic complications rate is 4.2 %(p-value:0.61). Symptomatic choroidal artery occlusion rate is 0.8 %(p-value:0.51)Type 2 AchoA aneurysms had a significantly higher complication rate of 9.8 % (p-value<0.05) compared to Type 1 aneurysms. Unruptured aneurysms have significantly better clinical outcomes than ruptured aneurysms(OR: 0.11; [0.02;0.5], p-value:<0.05) CONCLUSION: Endovascular treatment of AchoA aneurysms demonstrated positive clinical results, with low rates of retreatment and complications. Coiling and flow diverters proved similar outcomes in achieving aneurysm occlusion. Ruptured aneurysms have lower good clinical outcomes comparing to unruptured aneurysms. Type 2 AchoA aneurysms had a higher risk of complications compared to Type 1.

与其他类型的动脉瘤相比，脉络膜前动脉 (AchoA) 动脉瘤相对罕见。然而，在血管内或手术治疗期间发生脉络膜动脉短暂或永久性闭塞是一种罕见但潜在严重的并发症。在这项研究中，我们旨在研究血管内治疗 (EVT) 对AchoA动脉瘤的安全性和有效性。我们的研究包括10项研究，涉及416例430 AchoA动脉瘤患者。总体良好的临床结局率 (mRS评分0-2) 与2.0% 的再治疗率94.5%。亚组分析显示，就完全闭塞而言，盘绕 (75.3%) 和血流导向装置 (80.9%) 治疗之间没有统计学差异 (p值: 0.62)。总体永久性并发症发生率为1.4% (p值: 0.54)，短暂性脑缺血并发症发生率为4.2% (p值: 0.61)。症状性脉络膜动脉闭塞率为0.8% (p值: 0.51) 与1型动脉瘤相比，2型AchoA动脉瘤的并发症发生率为9.8% (p值 <0.05)。未破裂动脉瘤的临床疗效明显优于破裂动脉瘤 (OR: 0.11; [0.02;0.5]，p值:<0.05) 结论: 血管内治疗AchoA动脉瘤显示出积极的临床效果，再次治疗和并发症发生率低。盘绕和分流器在实现动脉瘤闭塞方面证明了相似的结果。与未破裂的动脉瘤相比，破裂的动脉瘤具有较低的良好临床结果。与1型相比，2型AchoA动脉瘤的并发症风险更高。

REF: Senol YC, Orscelik A, Musmar B, et al. Endovascular outcomes for anterior choroidal artery aneurysms: systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2024;33(6):107679. doi:10.1016/j.jstrokecerebrovasdis.2024.107679 PMID: 38499080 PMCID: PMC11088492

Delirium in acute stroke is associated with increased cognitive and psychiatric symptoms over time: The Nor-COAST study

随着时间的推移，急性中风的谵妄与认知和精神症状的增加有关: Nor-COAST研究

Delirium, an acute and fluctuating mental disturbance of attention, cognition, and consciousness, commonly occurs in acute stroke. Research on long-term outcomes of stroke patients experiencing delirium is limited, especially regarding cognitive and psychiatric symptoms. Patients with delirium in the acute phase of stroke may be particularly vulnerable to developing cognitive and psychiatric symptoms in the chronic phase.

谵妄是一种急性的、波动性的注意力、认知和意识方面的精神障碍，常见于急性卒中。对发生谵妄的中风患者的长期结果的研究是有限的，特别是关于认知和精神症状。中风急性期的谵妄患者在慢性期可能特别容易出现认知和精神症状。

REF: Gjestad E, Nerdal V, Saltvedt I, et al. Delirium in acute stroke is associated with increased cognitive and psychiatric symptoms over time: The Nor-COAST study. J Stroke Cerebrovasc Dis. 2024;33(6):107667. doi:10.1016/j.jstrokecerebrovasdis.2024.107667 PMID: 38423153

Optimal intraventricular hemorrhage volume cutoff for predicting poor outcome in patients with intracerebral hemorrhage

预测脑出血患者不良预后的最佳脑室内出血体积临界值

The prognosis of patients with spontaneous intracerebral hemorrhage (ICH) is often influenced by hematoma volume, a well-established predictor of poor outcome. However, the optimal intraventricular hemorrhage (IVH) volume cutoff for predicting poor outcome remains unknown. Optimal IVH volume cutoff represents a powerful tool for improving the prediction of poor outcome in patients with ICH, particularly in the absence of clot evacuation or common use of EVD. Small amounts of intraventricular blood are not independently associated with poor outcome in patients with intracerebral hemorrhage. The utilization of optimal IVH volume cutoffs may improve the clinical trial design by targeting ICH patients that will obtain maximal benefit from therapies.

自发性脑出血 (ICH) 患者的预后通常受血肿体积的影响，血肿体积是预后不良的公认预测指标。然而，用于预测不良结果的最佳脑室内出血 (IVH) 体积截止值仍然未知。最佳IVH容量截止值是改善ICH患者不良预后预测的有力工具，尤其是在没有清除血块或普遍使用EVD的情况下。少量脑室内血液与脑出血患者的不良预后并不独立相关。利用最佳IVH体积截止值可以通过靶向ICH患者来改善临床试验设计，这些患者将从治疗中获得最大益处。

REF: Deng L, Zhang JT, Lv XN, et al. Optimal intraventricular hemorrhage volume cutoff for predicting poor outcome in patients with intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2024;33(6):107683. doi:10.1016/j.jstrokecerebrovasdis.2024.107683 PMID: 38513767

Unveiling the evolving landscape of stroke care costs: A time-driven analysis

揭示中风护理成本的演变前景: 一项时间驱动的分析

Stroke is a common cause of mortality in the United States. However, the economic burden of stroke on the healthcare system is not well known. In this study, we aim to calculate the annual cumulative and per-patient cost of stroke. Strokes place an increasing financial burden on the US healthcare system. Certain patient demographics including age, male gender, more comorbidities, and insurance type were significantly associated with increased cost of care.

中风是美国常见的死亡原因。然而，中风对医疗保健系统的经济负担尚不清楚。在这项研究中，我们的目的是计算中风的年度累积和每名患者的费用。中风给美国医疗保健系统带来了越来越大的经济负担。某些患者的人口统计资料，包括年龄，男性，更多的合并症和保险类型与护理费用的增加显着相关。

REF: Hum B, Taneja K, Bunachita S, et al. Unveiling the evolving landscape of stroke care costs: A time-driven analysis. J Stroke Cerebrovasc Dis. 2024;33(6):107663. doi:10.1016/j.jstrokecerebrovasdis.2024.107663 PMID: 38432489