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Clin Neuroradiol 2022 Jun 24. Epub 2022 Jun 24.

Department of Neurology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.

Purpose: The angiographic appearance of the occlusion site was suggested to influence outcomes of stroke patients with large vessel occlusion (LVO) who undergo endovascular treatment (EVT). We aimed to study the impact of the meniscus sign (MS) on outcomes of stroke patients with anterior circulation LVO.

Methods: Based on two prospective registries of acute ischemic stroke, we selected patients with carotid‑T, M1 or M2 occlusion who underwent EVT. Read More

J Stroke Cerebrovasc Dis 2022 Jun 21;31(8):106606. Epub 2022 Jun 21.

Cooper Neurological Institute, Cooper University Hospital, Camden, NJ USA. Electronic address:

Background: Embolic stroke of undetermined source (ESUS) accounts for up to 20% of all strokes. Potential contributors to ESUS include patent foramen ovale (PFO) and non-stenotic plaque (<50%, NSP) of the ipsilateral internal carotid artery (ICA). To better differentiate these as unique mechanisms, we explored the prevalence of each in a multicenter observational cohort. Read More

Stroke 2022 Jun 24:101161STROKEAHA122038576. Epub 2022 Jun 24.

Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Australia (Z.T., M.P., A.B., G.S., L.C., B.Y.).

Background: In patients with acute stroke who undergo endovascular thrombectomy, the relative prognostic power of computed tomography perfusion (CTP) parameters compared with multiphase CT angiogram (mCTA) is unknown. We aimed to compare the predictive accuracy of mCTA and CTP parameters on clinical outcomes.

Methods: We included patients with acute ischemic stroke who had anterior circulation large vessel occlusion within 24 hours of onset in Melbourne Brain Centre at the Royal Melbourne Hospital. Read More

Ther Adv Neurol Disord 2022 16;15:17562864221093524. Epub 2022 Jun 16.

Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.

Background: Neurological deterioration (ND) after mechanical thrombectomy (MT) of acute ischemic stroke (AIS) in anterior circulation is an important complication associated with a poor outcome. Moreover, evident causes of ND may remain unexplained (UnND).

Objective: We sought to evaluate the association of the systolic blood pressure (SBP) parameters before MT, during MT, and during a 24-h period after MT with UnND. Read More

Diagnostics (Basel) 2022 Jun 13;12(6). Epub 2022 Jun 13.

Department of Radiology, Third Faculty of Medicine, Faculty Hospital Kralovske Vinohrady, Charles University, Srobarova 1150/50, 11000 Prague, Czech Republic.

The absolute majority of strokes in high-income countries, roughly 91%, are of ischemic origin. This review is focused on acute ischemic stroke (AIS) with large vessel occlusion (LVO) in the anterior circulation, which is considered the most devastating subtype of AIS. Moreover, stroke survivors impose substantial direct and indirect costs of care as well as costs due to productivity loss. Read More

AJNR Am J Neuroradiol 2022 Jun 23. Epub 2022 Jun 23.

From the Departments of Neurology (F.S., X.G., W.Z., Z.C., S,Y., M.L.)

Background And Purpose: Patients with stroke etiology of large-artery atherosclerosis were thought to have better collateral circulation compared with patients with other stroke etiologies. We aimed to investigate the association between stroke etiology and collateral circulation with a new quantitative collateral assessment method.

Materials And Methods: This retrospective study reviewed data from consecutive patients with proximal anterior artery occlusion who underwent CTP before reperfusion therapy. Read More

Ann Med Surg (Lond) 2022 Jun 21;78:103815. Epub 2022 May 21.

Ribat Neurospine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan.

Background: Sickle cell disease (SCD) is autosomal recessive hemolytic anemia due to hemoglobinopathy commonly in Sub-Saharan Africa, and particularly in Sudan. The disease induces a pro-inflammatory cascade in the intimal layer that leads to hyperplasia and progressive stenosis in the major vessel of the circle of Willis. This is associated with the development of Moyamoya collaterals. Read More

J Neurol 2022 Jun 22. Epub 2022 Jun 22.

Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China.

Background: Acute vertebrobasilar artery occlusion (VBAO) is a devastating disease in stroke patients. This study was aimed to identify the initial symptoms of patients with acute VBAO receiving endovascular treatment and determine its associations with clinical outcomes.

Methods: Patients with VBAO receiving endovascular treatment at 21 stroke centres in China were recruited for this derivation cohort A data-driven approach of latent class analysis was applied to identify distinct symptom typologies of VBAO patients. Read More

N Z Med J 2022 Jan 21;135(1548):13-18. Epub 2022 Jan 21.

Professor of Neurology, University of Auckland.

Aim: Stroke clot retrieval (SCR) is now considered a standard of care for select stroke patients with proximal large vessel occlusion (LVO) of the anterior circulation. Here we present the experience of regional Taranaki patients transferred by air for SCR and compare this to metropolitan Auckland patients who were transferred by road. The aim is to present and compare process metrics and outcomes between the regional and metropolitan centres. Read More

J Neurointerv Surg 2022 Jun 20. Epub 2022 Jun 20.

Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Background: In anterior circulation large vessel occlusion (LVO) in the extended time window, the guidelines recommend advanced imaging (ADVI) to select patients for endovascular therapy (EVT). However, questions remain regarding its availability and applicability in the real world. It is unclear whether an approach to the extended window EVT that does not use ADVI would be equivalent. Read More

J Stroke Cerebrovasc Dis 2022 Jun 17;31(8):106602. Epub 2022 Jun 17.

Department of Neurology, University of Tennessee Health Science Center, Memphis, TN USA; Department of Neurosurgery, University of Tennessee Health Science Center and Semmes-Murphey Clinic, Memphis USA. Electronic address:

Background: Recent extended window trials support the benefit of mechanical thrombectomy in anterior circulation large vessel occlusions with clinical-radiographic dissociation. Using trial imaging criteria, 6% were found eligible for MT in the EW in a hub-and-spoke system. We examined the eligibility and outcomes in consecutive extended window-mechanical thrombectomy patients using more pragmatic selection criteria. Read More

J Clin Neurosci 2022 Jun 17;102:49-53. Epub 2022 Jun 17.

Barrow Neurological Institute, Phoenix, AZ, United States. Electronic address:

Introduction: For patients undergoing endovascular thrombectomy (EVT), those who are recanalized with a successful single pass (first pass effect, FPE) have better functional outcomes than those who do not. There is a scarcity of data regarding predictors of FPE in basilar artery occlusion (BAO). We aim to determine what characteristics may predict FPE for posterior circulation thrombectomies in a cohort of patients undergoing EVT for BAO. Read More

Can J Neurol Sci 2022 Jun 20:1-28. Epub 2022 Jun 20.

Ann Transl Med 2022 May;10(10):591

Department of Cerebrovascular Disease and Neurosurgery, Zhengzhou University People's Hospital, Zhengzhou, China.

Background: Hemorrhagic transformation (HT) of acute ischemic stroke (AIS) is associated with poor outcome. Previous studies only reported the association of mean ischemic severity or total infarct volume with HT after endovascular therapy (EVT). We aimed to investigate the predictive value of preoperative apparent diffusion coefficient (ADC) map for HT by combinated ischemic severity and corresponding volume in AIS after successful recanalization with EVT. Read More

Front Neurol 2022 1;13:856403. Epub 2022 Jun 1.

Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China.

Objective: To explore the clinical prognosis and factors after mechanical thrombectomy (MT) in patients with large cerebral infarction assessed by computed tomographic perfusion (CTP)and the optimal threshold of cerebral blood flow (CBF) for estimating ischemic core.

Methods: We analyzed data from the anterior circulation database of our hospital (August 2018-June 2021). Multivariate logistic regression analyses identified the predictors of clinical outcomes for patients with large baseline infarcts (>50 ml) assessed by the MIStar software. Read More

Afr J Emerg Med 2022 Sep 6;12(3):216-224. Epub 2022 Jun 6.

Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia.

Background: Stroke is a leading cause of death and chronic disability worldwide. In Sub-Saharan Africa (SSA), which includes Somalia, stroke represents a significant part of the chronic disease burden. However, there is relatively little data on risk factors, demographics, and clinical profiles. Read More

Eur J Neurol 2022 Jun 19. Epub 2022 Jun 19.

Department of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.

Background: We aimed to assess the association of diabetes mellitus (DM) and admission hyperglycaemia (AH) respectively and outcome in patients with acute ischaemic stroke with large vessel occlusion in the anterior circulation treated with endovascular therapy (EVT) in daily clinical practice.

Methods: Consecutive EVT patients admitted to our stroke centre between 02/2015-04/2020 were included in this observational cohort study. Patients with vs. Read More

Neurology 2022 Jun 17. Epub 2022 Jun 17.

Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.

Objective: To investigate the safety and efficacy of normobaric hyperoxia (NBO) combined with endovascular treatment (EVT) in acute ischemic stroke (AIS) patients.

Methods: In this single-center, proof-of-concept, assessor-blinded, randomized controlled pilot study, patients with AIS in the acute anterior circulation with large vessel occlusion who had an indication for EVT were randomly assigned to the EVT alone group or the NBO+EVT group. The NBO+EVT group were given 100% oxygen via a face mask initiated before vascular recanalization (10L/min for 4h) while the EVT group were given room air. Read More

J Neurol 2022 Jun 17. Epub 2022 Jun 17.

Department of Neuroradiology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.

Background: Determining the cause of acute ischemic stroke is crucial for patient management, particularly for preventing future stroke. In recent years, carotid web (CW), a non-atherosclerotic disorder of the carotid wall, has been found to be an underestimated source of cerebral emboli.

Objective: The present study aimed to analyze the clinical, radiological, and pathological findings, along with the treatments performed in patients with CW and ipsilateral ischemic events. Read More

J Assoc Physicians India 2022 Jun;70(6):11-12

Professor, Department of General Medicine, R. G. Kar Medical College, Kolkata, West Bengal, India.

Introduction: Stroke is the third common cause of death in India after ischemic heart disease and chronic obstructive pulmonary disease. Clinical features and outcomes vary in different types of strokes.

Objectives: To compare the National Institutes of Health Stroke Scale (NIHSS) score of anterior and posterior circulation stroke patients (confirmed by neuroimaging) on the day of admission, admitted in Department of General Medicine, R. Read More

Clin Neuroradiol 2022 Jun 13. Epub 2022 Jun 13.

Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Purpose: Unfavorable vascular anatomy can impede thrombectomy in patients with acute ischemic stroke. The aim of this study was to determine the prevalence of aortic arch types, aortic arch branching patterns and supra-aortic arterial tortuosity in stroke patients with large vessel occlusion.

Methods: Computed tomography (CT) and magnetic resonance (MR) images of all stroke patients in an institutional thrombectomy registry were retrospectively reviewed. Read More

Ann Indian Acad Neurol 2022 Mar-Apr;25(2):256-260. Epub 2022 Mar 25.

Department of Neurology, Comprehensive Stroke Care Centre, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Background: Timely and effective recanalization to salvage the penumbra is the main determinant of outcome in acute ischemic strokes. Randomized controlled trials on late window mechanical thrombectomy (MT) have proved its safety and efficacy upto 24 h after stroke onset. We looked at the impact of time to reperfusion on vessel recanalization rates and short-term outcome in patients undergoing MT for large vessel occlusion. Read More

Child Neurol Open 2022 Jan-Dec;9:2329048X221105743. Epub 2022 Jun 7.

Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.

Arterial thoracic outlet syndrome is a rare condition characterized by compression of the subclavian artery, often with post-stenotic aneurysm formation. Artery-to-artery embolic strokes related to thoracic outlet syndrome have been reported in the posterior circulation and in the ipsilateral anterior circulation. We present a case in which a thrombus secondary to thoracic outlet syndrome caused a contralateral anterior circulation stroke in an adolescent and postulate mechanisms of this rare occurrence. Read More

Neurointervention 2022 Jun 13. Epub 2022 Jun 13.

Neurointervention Clinic, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Spontaneous cervicocephalic dissection (SCAD) is an important cause of stroke and shows various lesion locations and clinical features. The purpose of this study was to analyze the location of SCAD and its clinical and radiologic patterns in Korean patients.

Materials And Methods: Patients with SCAD who were evaluated between 2013 and 2018 at a tertiary center in Korea were reviewed. Read More

AJNR Am J Neuroradiol 2022 Jun 9. Epub 2022 Jun 9.

From the Department of Neuroradiology (A.P., E.S., C.S.W., U.N., C.H., M.A.M., M.B., F.S.)

Background And Purpose: Information of collateral flow may help to determine eligibility for thrombectomy. Our aim was to identify CT perfusion-based surrogate parameters of good collateral status in acute anterior circulation ischemic stroke.

Materials And Methods: In this retrospective study, we assessed the collateral status of 214 patients who presented with acute ischemic stroke due to occlusion of the MCA M1 segment or the carotid terminus. Read More

J Stroke 2022 May 31;24(2):245-255. Epub 2022 May 31.

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background And Purpose: We investigated the impact of stroke etiology on the endovascular treatment (EVT) procedure and clinical outcome of posterior circulation stroke (PCS) patients with EVT compared to anterior circulation stroke (ACS) patients.

Methods: We retrospectively analyzed ischemic stroke patients who underwent EVT between January 2012 and December 2020. Enrolled ACS and PCS patients were compared according to etiologies (intracranial arterial steno-occlusion [ICAS-O], artery-to-artery embolic occlusion [AT-O], and cardioembolic occlusion [CA-O]). Read More

J Stroke 2022 May 31;24(2):207-223. Epub 2022 May 31.

Department of Neurology, Ajou University School of Medicine, Suwon, Korea.

The efficacy of endovascular treatment (EVT) in patients with posterior circulation stroke has not been proven. Two recent randomized controlled trials failed to show improved functional outcomes after EVT for posterior circulation stroke (PC-EVT). However, promising results for two additional randomized controlled trials have also been presented at a recent conference. Read More

Dysphagia 2022 Jun 9. Epub 2022 Jun 9.

Stroke Unit-Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

In post-stroke dysphagia, early identification of patients at highest risk of failing swallowing recovery (SR) would be useful to decide which of them should undergo percutaneous endoscopic gastrostomy. The studies on this subject were numerous but generally based on small statistical samples. In this retrospective study, 1232 patients with ischemic or hemorrhagic stroke (73. Read More

J Comput Assist Tomogr 2022 Jun 4. Epub 2022 Jun 4.

From the Department of Radiology, The First Affiliated Hospital of Nanjing Medical University.

Objective: The aim of this study was to evaluate the performance of machine learning (ML) algorithms in predicting the functional outcome of mechanical thrombectomy (MT) outside the 6-hour therapeutic time window in patients with acute ischemic stroke (AIS).

Methods: One hundred seventy-seven consecutive AIS patients with large-vessel occlusion in the anterior circulation who underwent MT in the extended time window were enrolled. Clinical, neuroimaging, and treatment variables that could be obtained quickly in the real-world emergency settings were collected. Read More

Stroke 2022 Jun 8:101161TROKEAHA121036195. Epub 2022 Jun 8.

Department of Neurology (W.v.d.S., N.A.M.v.d.E., V.C., D.W.J.D., B.R.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Background: Symptomatic intracranial hemorrhage (sICH) is a serious complication after endovascular treatment for ischemic stroke. We aimed to identify determinants of its occurrence and location.

Methods: We retrospectively analyzed data from the Dutch MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) and MR CLEAN registry. Read More