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Objective A bibliometric analysis of the literature related to stroke and the blood-brain barrier was conducted to obtain a research map, explore hotspots and trends, and provide references for clinical treatment and research. Methods The literature related to stroke and blood-brain barrier from 1 January 2001 to 28 February 2023 was explored in the Web of Science core database. Using bibliometrics, CiteSpace V6.1.R6 was used to analyze the distribution of years, countries/regions, research institutions/system, authors, publications, cited literature, keywords and research trends. Results A total of 5028 papers were included after screening, with an overall upward trend in the number of published papers. The United States had the most research on this topic, followed by China’s mainland and Germany. Most of the top 10 research institutions/system were from the United States, France and China, with strong collaboration between countries/regions and research institutions/system. Among the authors, Chopp Michael from the United States ranked first with 49 papers. Among the research trends, ischemic stroke, miR-126 in non-coding RNA, blood-brain barrier dysfunction and drug delivery were the hot spots in the last three years. Conclusions Blood-brain barrier and stroke are inextricably linked. The dysfunction and repair mechanism of blood-brain barrier during stroke, the circulation biomarkers released by blood brain barrier and the use of blood-brain barrier opening time to increase drug absorption are worthy of further study [ABSTRACT FROM AUTHOR]

A prediction model is a statistical model used to predict the probability of an individual with a target event or to predict the outcome value. Visualization of prediction model results is an essential part of the whole process of developing a prediction model. A good presentation of a prediction model can not only make the prediction results more readable and interpretable, but also determine its use and convenience to a large extent. This paper provided a detailed introduction to various forms of prediction model presentation and reported their advantages and disadvantages. Combining clinical prediction model research on cerebrovascular disease, this paper introduced the application of each presentation in cerebrovascular disease research through research examples. [ABSTRACT FROM AUTHOR]

Ultrasound has been gradually applied to the field of cerebral small vessel disease (CSVD) due to its unique advantages. This paper summarized the studies related to ultrasound in CSVD, and summarized the relationship between CSVD and various evaluation indicators of vascular ultrasound. What’s more, this paper described the role of ultrasound in the evaluation and diagnosis of multi-system diseases such as heart, brain, and kidney coexisting with CSVD, and provided a theoretical basis for comprehensive and effective evaluation of CSVD by ultrasound. [ABSTRACT FROM AUTHOR]

Objective To analyze the peer review feedback of the non-funding of the National Natural Science Foundation of China (NSFC) in the field of nervous system at Beijing Tiantan Hospital, Capital Medical University, and put forward countermeasures to provide references for peers. Methods The content analysis method was employed to examine the peer review opinions of youth and general projects, which were not approved by NSFC in the field of nervous system from 2020 to 2023. A total of 867 expert opinions from 289 programs were categorized and analyzed. Results A total of 1219 reasons for not being funded were analyzed in this paper. It was found that among the youth and general projects, the five expert opinions with the highest mention rate and proportion were: “unreasonable research plans” (32.65%/85.12%), “insufficient research foundation” (18.54%/54.33%), “insufficient innovation” (15.67%/51.21%), “insufficient basis for project approval” (8.37%/30.10%) and “insufficient scientific and clinical value” (7.88%/28.72%). The mention rate and proportion of “insufficient innovation” (the mention rate: 17.13% vs. 13.84%; the proportion: 53.75% vs. 48.06%), “detailed problems” (the mention rate: 6.50% vs. 3.87%; the proportion: 23.13% vs. 15.50%) in youth projects were slightly higher than that in general projects. The mention rate of “the miss-selection of scientific problem” (4.28% vs. 4.06%) and the proportion of “insufficient summary of key scientific viewpoint” (24.38% vs. 23.26%) were also slightly higher in youth projects, but only the mention rate of “detailed problems” (χ² =4.322, P=0.038) was statistically significant between the two items. The expert consensus analysis showed that the top three feedback were consistent with the top three results above. Conclusions The problems in the peer review feedback of the hospital’s unfunded projects mainly focused on three aspects: “unreasonable research plans” “insufficient research foundation” and “insufficient innovation”. To improve the quality of the application forms and increase the rate of successful applications, many measures can be taken, including conducting multidimensional application training and detailed guidance to help applicants improve the scheme design; setting up incubation funds and strengthening the management of ongoing research projects, as well as other multi-channel supports to strengthen the research foundation; and promoting interdisciplinary integration to expand the research fields and ideas, and enhance the ability of source innovation. [ABSTRACT FROM AUTHOR]

Acute cerebral infarction is a common ischemic cerebrovascular disease and is closely related to platelet activity. Platelet activity has significant impact on occurrence, development, treatment and prognosis of acute cerebral infarction. Mean platelet volume (MPV)and platelet distribution width (PDW) are two important indicators that reflect platelet activity. Platelets with larger volume are considered to have higher activity for they can secrete more thrombosis factors and express more P-selections and platelet glycoprotein Ⅱb/Ⅲa receptors. Activated platelets increase PDW by protruding pseudopodia of varying sizes. Thus, both high MPV and PDW are the indications of platelet activation. This paper reviewed the effects of platelet activation on the occurrence, development and prognosis of acute cerebral infarction, in order to provide references for the subsequent study of the relationship between platelet activity and acute cerebral infarction. [ABSTRACT FROM AUTHOR]

In acute ischemic stroke patients with large vessel occlusion, mechanical thrombectomy can improve the hemodynamic status and clinical symptoms within the effective time, but mechanical thrombectomy is often associated with vascular re-occlusion, which affects the prognosis of patients. Platelet glycoprotein Ⅱb/Ⅲa (GP Ⅱb/Ⅲa) receptor antagonists prevent vascular re-occlusion by inhibiting the last common pathway of platelet aggregation. At present, the effects of GP Ⅱb/Ⅲa receptor antagonists on the clinical outcome during the perioperative period of mechanical thrombectomy in ischemic stroke remain controversial. This paper reviewd the efficacy and safety of tirofiban, a GP Ⅱb/Ⅲa receptor antagonist, in the treatment of vascular re-occlusion after mechanical thrombectomy in acute ischemic stroke. It was found that tirofiban combined with mechanical thrombectomy was safe for the treatment of acute ischemic stroke, but its therapeutic effectiveness still needs to be confirmed by standardized clinical research evidence. [ABSTRACT FROM AUTHOR]

Alcohol use disorder, as the fifth largest risk factor worldwide, is an important component of stroke prevention. In recent years, a large number of epidemiological and clinical studies have shown that there is a correlation between alcohol and stroke. Alcohol can affect cardiovascular and cerebrovascular health through various ways, resulting in stroke and even death. At the same time, some studies have shown that there may be different associations between alcohol and stroke, light drinking may be a cardiovascular and cerebrovascular protective factor, and moderate and heavy drinking may induce and aggravate stroke. This paper analyzed the current prevalence of stroke complicated with alcohol use disorder, reviewed the possible pathogenesis of alcohol use disorder affecting the incidence of stroke, and summarized alcohol intake monitoring biomarkers and treatments related to alcohol use disorder, in order to further explore the correlation between stroke and alcohol use disorder and provide ideas for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Advancing the reform of medical insurance payment methods is not only a necessity for the high-quality development of medical insurance, but also a requirement for alleviating the burden of people’s medical expenses and enhancing their well-being. In recent years, China has made positive progress in the reform of diversified and composite medical insurance payment methods, which has also raised higher requirements for the management of medical insurance funds and medical institutions. Against the backdrop of health big data, clinical prediction models have been maturely applied in areas such as drug trials, demonstrating good capabilities in quantitatively assessing the risk level of patients’ diseases and the intensity of medical resource consumption. This paper aims to draw lessons from international experiences in medical insurance risk adjustment mechanisms and risk prediction models, explore the feasibility of applying clinical prediction models to diagnosis related groups and medical insurance reimbursement risk adjustment under the reform of medical insurance payment methods, and provide corresponding references for further improving the quality of medical institution services and enhancing the efficiency of medical insurance fund utilization. [ABSTRACT FROM AUTHOR]

The presentation of statistical charts plays a crucial role in improving the quality of clinical prediction model research. This paper categorized statistical charts in clinical prediction models into four aspects: describing basic information, reporting model information, evaluating model performance, and demonstrating model application, accompanied by a brief overview of statistical chart templates. [ABSTRACT FROM AUTHOR]

The application of clinical prediction models in medical research is becoming increasingly widespread. To achieve good predictive performance, selecting the correct model is crucial. Regarding the choice of prediction model, the type of prediction outcome plays a decisive role. This paper, from the perspective of data types, divided outcomes into continuous variables (normal distribution, skewed distribution), categorical variables (binary, nominal, ordinal), and time-to-event variables (with or without competing risks), introducing the characteristics of different types of outcomes, the model types, examples and SAS programs to serve as a reference for researchers to develop prediction models. [ABSTRACT FROM AUTHOR]

The application of clinical prediction models in the medical field is receiving increasing attention. Reasonable and sufficient sample size is of great importance to the feasibility and quality assurance of prediction model research. Based on this, this paper summarized the strategies for sample size estimation in the development and validation of clinical prediction models, outlined the key issues that should be paid attention to in sample size estimation, and also discussed the problems related to insufficient sample size, to help researchers estimate the sample size reasonably and improve the quality of clinical prediction model research. [ABSTRACT FROM AUTHOR]

Clinical prediction models can predict individual outcomes or risks based on effect evidence obtained from the population, serving as a powerful tool linking evidence-based medicine and precision medicine. With the continuous advancement of data measurement, storage, interoperability, and analytical techniques, the application prospect for clinical prediction models is becoming increasingly clear. However, it also faces many problems and challenges. This paper aims to provide an overview of the fundamental concepts, application scenarios, current dilemmas, and development opportunities of clinical prediction models [ABSTRACT FROM AUTHOR]

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral small vessel disease caused by mutations in the NOTCH3 gene. The main vascular pathological changes in CADASIL are intracranial small arteries, with rare reports of involvement in the cerebral cortex and intracranial large/middle arteries. There is currently a lack of specific treatment for CADASIL. This paper reported a case of CADASIL patient who successfully received endovascular treatment for acute occlusion of middle cerebral artery, and discussed the literature with the aim of raising clinical awareness of the potential involvement of CADASIL in the cerebral cortex and intracranial large/middle arteries. [ABSTRACT FROM AUTHOR]

Fibroblast growth factor 23 (FGF23) -Klotho endocrine axis is involved in phosphate metabolism, and is closely related to the pathogenesis of stroke. FGF23 and Klotho levels are associated with the incidence and prognosis of stroke. The FGF23-Klotho endocrine axis is involved in the regulation of vascular inflammation and may be involved in the pathological process of stroke risk factors such as hypertension, insulin resistance, lipid metabolism and obesity. In this paper, the influence and mechanism of FGF23-Klotho endocrine axis on stroke were reviewed in order to bring new ideas for clinical treatment and prevention of stroke. [ABSTRACT FROM AUTHOR]

Currently, reperfusion therapy targeting the ischemic penumbra is the preferred treatment for acute ischemic stroke. The continuous advancements in neuroimaging techniques for the ischemic penumbra have provided more evidence for reperfusion therapy based on tissue window. This review summarized the significant progress of the ischemic penumbra over the past 50 years, focused on the current neuroimaging assessment methods of ischemic penumbra, including the widely used ischemic hypoperfusion-infarct core or clinical symptom-infarct core mismatch and emerging techniques such as multiphase CTA, ASL, etc. Additionally, this paper compared 5 mainstream automatic post-processing software of image in the market, aiming to provide reference for clinical reperfusion diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective To analyze the current research status, hotspots, and frontier fields of perivascular spaces from 2013 to 2023 based on bibliometric analysis. Methods The related English article of perivascular spaces was retrieved in the Web of Science Core Collection from January 1, 2013 to June 19, 2023. CiteSpace V6.3.R1 software was used to analyze the cooperation network among the publishing countries, institutions and authors; the co-citation network of reference, first author of reference and journals; the co-occurrence network of keywords, burst analysis of keywords and reference co-citation. VOSviewer 1.6.15 software was used for keywords cluster analysis. Results A total of 1549 papers were included. The annual publications from 2013 to 2023 showed an overall increasing trend. The United States ranked the first and China ranked the second. The top three prolific institutions were Harvard University, Massachusetts General Hospital and University of Edinburgh. Cooperative network analysis showed that the cooperation between countries was close and domestic institutions collaborated less with other institutions. Wardlaw Joanna M from University of Edinburgh ranked the first in publications. The top ten keywords in co-occurrence network were small vessel disease, enlarged perivascular spaces, MRI, brain, Virchow-Robin spaces, Alzheimer’s disease, dementia, risk, stroke and glymphatic system. Cluster analysis of keywords showed that cerebral small vessel disease, dementia and MRI were current hotspots, and glymphatic system was a new research direction. Burst analysis of keywords suggested diffusion imaging has got much attention since 2021. Conclusions The research on perivascular spaces has increased during the recent 10 years. Cerebral small vessel disease was the main hotspot and glymphatic system was a new direction. Diffusion tensor imaging was a frontier field. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease (CSVD) is a series of clinical, imaging and pathological syndrome caused by various causes affecting the small blood vessels in the brain. There is no unified diagnostic standard in the world for CSVD, and the symptoms are mild. Therefore, based on neuroimaging findings, it can be divided into recent small subcortical infarct, lacune of presumed vascular origin, white matter hyperintensity of presumed vascular origin, perivascular space, cerebral microbleed, cortical superficial siderosis, and brain atrophy. Evidence suggests that CSVD may be associated with a variety of neuropsychological manifestations. However, the relationship between neuropsychological symptoms and the occurrence and development of CSVD is not clear. In this paper, the research progress of the relationship between apathy, fatigue, anxiety, depression and psychological stress and the imaging of CSVD was reviewed. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease (CSVD) is a group of clinical, imaging and pathological syndromes mainly involving intracranial small vessels. The onset of CSVD is occult. It is closely related to stroke, cognitive decline, affective disorders, gait abnormalities and urinary and fecal incontinence. It brings heavy disease burden and economic burden to the family and society. However, the true pathogenesis of CSVD is still unclear, and the clinical diagnostic criteria are not uniform, which makes clinical diagnosis and treatment and experimental research face major challenges. The purpose of this paper is to discuss the progress and limitations of the etiology, pathogenesis, clinical diagnosis and treatment of CSVD, and to look forward to the possible clinical research direction of CSVD in the future. [ABSTRACT FROM AUTHOR]

Vascular cognitive impairment (VCI) is a decline in cognitive function caused by cerebrovascular disease and its risk factors, which has gradually become a major public health problem in the society. Neuropsychology and imaging findings are well-recognized standards of diagnosis and classification of VCI. This paper reviewed the advances in neuropsychology and imaging in clinical applications to accurately diagnose and predict the progression of VCI. In addition to post-stroke cognitive impairment and subcortical ischemic VCI, this paper also discussed the research advances in hypoperfusion cognitive impairment and mixed cognitive impairment. [ABSTRACT FROM AUTHOR]

Cerebral infarction and acute myocardial infarction are both ischemic vascular diseases, with common risk factors, and may occur simultaneously or successively. Medullary infarction induces autonomic nervous dysfunction that affects cardiac nerves, and stress response after infarction can also lead to myocardial ischemic infarction. This paper reported the diagnosis and treatment process of a patient with bilateral medial medullary infarction complicated with acute myocardial infarction. The patient had no lesions on the MRI examination in the early stage of the disease, and the “heart” shaped infarct was found after several days of MRI reexamination. After antiplatelet aggregation and lipid-regulating treatment, there was still limb hemiplegia. This case emphasizes that patients with cerebral infarction should be given detailed physical examination, accessory examination and comprehensive evaluation of cardiac indicators to prevent misdiagnosis and missed diagnosis. [ABSTRACT FROM AUTHOR]

The key to the treatment of acute ischemic stroke is to quickly restore the blood flow of ischemic brain tissue, intravenous thrombolysis therapy can be given in the time window, and bridging endovascular interventional therapy if the effect is not good. Stent implantation is an effective remedy when conventional methods such as stent thrombectomy, aspiration thrombectomy and balloon dilatation fail to open the vessel. However, in some cases, vascular reocclusion may occur after stent implantation. If the occlusive vessel can not be revascularization quickly, the patient’s outcome can only be severe disability or death. This paper reports the diagnosis and treatment of a patient with vascular reocclusion after carotid artery stenting for acute carotid artery occlusion by femoral-carotid artery bypass. Femoral-carotid artery bypass is a new and effective surgical method, which can quickly solve this unusual but very difficult situation and is worth popularizing. [ABSTRACT FROM AUTHOR]

Giant cell arteritis (GCA) is a systemic granulomatous vasculitis that mainly affects the superficial temporal artery and the ophthalmic artery. The typical manifestation is the triad of headache, visual symptom and mandibular movement disorder. It is a neuroophthalmic emergency since it can cause profound visual loss. Hormone pulse therapy is the mainstay of treatment. This paper presents a rare GCA patient manifests as posterior ischemic optic neuropathy, and makes a comprehensive analysis of its clinical manifestations, laboratory examination and imaging examination. This case suggests that the diagnosis of GCA should be taken into account for elderly patients with severe vision loss accompanied by headache and no edema or atrophy in the optic nerve. [ABSTRACT FROM AUTHOR]

Central retinal artery occlusion (CRAO) is a vascular neuro-ophthalmic emergency, characterized by acute painless monocular vision loss, which is one of the main causes of blindness in middle-aged and elderly people. Currently, the pathogenesis and pathophysiological mechanism of CRAO is unclear, making the selection of appropriate animal models particularly important for the research on CRAO pathogenesis and the screening of therapeutic drugs. This paper mainly reviews the modeling methods and research progress of CRAO animal models, aiming to provide a reference basis for accurate diagnosis and treatment of CRAO. [ABSTRACT FROM AUTHOR]

Neuro-ophthalmic emergency refers to the spectrum of neuro-ophthalmic clinical diseases that can seriously threaten patients’ vision or even endanger their lives if they are not diagnosed and treated in time, among which the neuro-ophthalmic emergency caused by vascular causes (vascular neuro-ophthalmic emergency) accounts for the vast majority. Due to the characteristics of interdisciplinary, patients with vascular neuro-ophthalmic emergency are often first referred to the department of ophthalmology or emergency, and the first doctors often have incomplete understanding of the disease, which is easy to lead to delayed diagnosis, misdiagnosis or missed diagnosis of such patients. When patients are referred to the department of neurology, if the neurologist’s diagnosis of the disease cannot be determined in time, it is easy to delay treatment. In this paper, the clinical manifestations, the examination methods and the treatment methods of the major diseases in the spectrum of vascular neuro-ophthalmic emergency were reviewed in order to provide the basis for the rapid diagnosis and accurate treatment of these diseases. [ABSTRACT FROM AUTHOR]

Objective By comparing the general situation and examination results of the master students in the field of cerebrovascular diseases between online remote enrollment and non-online remote enrollment, this paper discusses the influence of online remote enrollment on the quality of students. Methods The subjects of this study were the master students of cerebrovascular diseases in Beijing Tiantan Hospital, Capital Medical University from 2017 to 2022. According to the enrollment method, the master students enrolled from 2017 to 2019 are the non-online remote enrollment group, and the students enrolled from 2020 to 2022 are the online remote enrollment group. This study obtains research data through the list of reexaminations over the years, and collects basic information such as gender, age, ethnicity, graduated university, whether it is a fresh graduate, as well as preliminary examination results and reexamination results. The above indexes of the two groups are analyzed differently. Results From 2017 to 2022, the number of master students in the direction of cerebrovascular diseases in Beijing Tiantan Hospital, Capital Medical University showed an overall growth trend. Among the enrolled master students, 88 are female, accounting for 33.98%, the proportion is lower than that of males. The ethnic group is mainly Han (246, 94.98%), and the source is mainly fresh graduates (203, 78.38%). The differences of the above indexes were not statistically significant between the online remote enrollment group and the non-online remote enrollment group. The mean age of online remote enrollment group was significantly lower than that of non-online remote enrollment group [(23.1±1.1) years vs. (23.5±1.3) years, P=0.014]. The reexamination results of the master students majoring in neurology and surgery (neurosurgery) in the online remote enrollment group were significantly higher than those in the non-online remote enrollment group [neurology, (255.5±12.3) points vs. (241.0±13.8) points, P<0.001; surgery (neurosurgery), (259.9±11.6) points vs. (249.3±13.1) points, P<0.001]. Conclusions The reexamination results of online remote enrollment are better than those of non-online remote enrollment to some extent, which provides a reference for future graduate enrollment method. [ABSTRACT FROM AUTHOR]

The improvement of medical quality in stroke with the goal of facilitating the translation of guideline recommendations into clinical practice, has become a priority prevention and control strategy to address the global burden of stroke. This review introduces representative studies of multi-faceted quality improvement based on the concept of learning health system, strategies continuously improving the timeliness of reperfusion therapy for stroke, and applications of mobile health and telemedicine assisting in the quality management of the whole process of stroke in the context of the digital era. This paper summarizes the current advances and potential directions in the field of stroke medical quality improvement, in order to provide references for the design and implementation of medical quality improvement programs and the development of monitoring and improvement system of stroke medical quality in China. [ABSTRACT FROM AUTHOR]

In the evaluation of autopsy and MRA technology, researchers have identified variations in the circle of Willis and classified them into different types. Based on MRA technology, the circle of Willis can be divided into four types according to the diameter of the arterial segment. Studies have revealed that different types of circle of Willis are associated with the onset, location, and recurrence of ischemic stroke. However, the correlation between different types of circle of Willis and the severity and prognosis of ischemic stroke remains controversial. This paper provides a comprehensive review on the correlation between variation in the circle of Willis and ischemic stroke. [ABSTRACT FROM AUTHOR]

Preventing the occurrence and recurrence of stroke is the top priority of the treatment strategy for ischemic cerebrovascular disease. Patients with multiple cerebral vascular stenosis and aortic arch ulcer plaques have a significantly increased risk of recurrent ischemic stroke. This paper introduces a case of probucol combined with atorvastatin in the treatment of multiple cerebral vascular stenosis with aortic arch ulcer plaque. This acute ischemic stroke patient presented with mild neurological impairment. During his hospitalization, multiple cerebral vascular stenosis and aortic arch ulcer plaques were discovered. After 3 months of sequential dual antiplatelet therapy, aspirin therapy was continued and combined with probucol and atorvastatin throughout the course for enhanced lipid-lowering antioxidant therapy. After 25 months of follow-up, there was no recurrence of stroke in this patient, and all imaging and hematological indicators remained stable. [ABSTRACT FROM AUTHOR]

In clinical practice, medullary hemorrhage is very rare in intracerebral hemorrhage, and literature often presents it in the form of case reports. Bilateral medial medullary hemorrhage is even rarer. This paper presents a case of an elderly male patient with a long history of hypertension and poorly controlled blood pressure. This time, the patient developed an acute onset of “dizziness, headache accompanied by nausea, vomiting”, and later developed symptoms such as difficulty in swallowing, dysphagia, aphasia, quadriplegia. Cranial CT scan showed a high density area on both sides of the medulla oblongata with a “heart” shape, diagnosed as medullary hemorrhage, and it was considered that this onset is related to hypertension. The full text first introduces the diagnosis and treatment process of the patient, and then discusses the etiology, clinical manifestations, auxiliary examinations, treatment and outcome, aiming to increase clinical experience of clinicians in diagnosis and treatment of this disease. [ABSTRACT FROM AUTHOR]

Hyperthyroidism, as an endocrine disease that may affect blood coagulation, is not commonly associated with cerebral venous sinus thrombosis in clinical practice. This paper reports the diagnosis and treatment process of a 21-year-old male patient with hyperthyroidism complicated by cerebral venous sinus thrombosis. Following comprehensive treatment, including thiamazole and anticoagulation therapy, the patient experienced significant relief from symptoms such as headaches, particularly after undergoing the crucial treatment step of endovascular interventional thrombectomy. This case emphasizes the importance of a thorough assessment of patients with hyperthyroidism and also suggests the potential value of interventional treatment in specific circumstances. Future broader research will contribute to clarifying the management and preventive measures for such complications. [ABSTRACT FROM AUTHOR]

Cerebrovascular diseases are the leading cause of death and disability worldwide. A high proportion of cerebrovascular diseases is correlated with metabolism disorder. Cerebrometabolic disease refers to a clinical syndrome with cerebrovascular injury caused by traditional metabolic risk factors and residual metabolic risk factors, vascular structural injury and dysfunction as the main pathophysiological manifestations, and intervention of metabolic risk factors can effectively improve the prognosis. Metabolomics is a scientific method that uses high-throughput omics technology to identify and quantify all metabolites, which is an important starting point for future research on cerebro-metabolic disease. This paper summarizes the studies of metabolomics and lipidomics in cerebro-metabolic disease and cardiometabolic disease, aiming to provide references for the development of metabolomics studies and clinical prevention and treatment of cerebro-metabolic disease. [ABSTRACT FROM AUTHOR]

Cerebrovascular disease has become the second cause of death worldwide, and its risk is mainly attributed to metabolic disorders. This paper reviewed the pathogenesis of obesity-related chronic inflammation and cerebro-metabolic disease. The aggregation of immune cells, heightened secretion of pro-inflammatory factors and vascular endothelial injury are important pathogenic mechanisms of cerebro-metabolic disease in obesity state. New and effective prevention and treatment strategies such as lifestyle intervention, drug immunotherapy and weight reduction anti-inflammatory therapy targeting inflammation are expected to provide reference for reducing the incidence of cerebro-metabolic diseases while enhancing both patient survival rates and quality of life. [ABSTRACT FROM AUTHOR]

Mechanical thrombectomy is the standard treatment for acute ischemic stroke due to large vessel occlusion in the anterior circulation within 24 hours of onset, and hemorrhagic transformation is the most common and serious complication, which not only increases the length of hospital stay, but also leads to a poor prognosis and negates the benefits of mechanical thrombectomy. Therefore, it is of great importance to scientifically understand this complication. Recently, domestic and foreign scholars have carried out extensive investigations on the hemorrhagic transformation after mechanical thrombectomy. In this paper, the definition, classification, incidence, risk factors, prevention and management of hemorrhagic transformation were reviewed based on domestic and foreign literatures. [ABSTRACT FROM AUTHOR]

Morphological analysis of unruptured intracranial aneurysms is widely used in risk assessment and surgical design. Compared with the manual measurement in the two-dimensional perspective, the three-dimensional perspective can reflect the morphology changes of aneurysms more accurately. But the manual measurement in the three-dimensional perspective has poor accuracy and repeatability. Therefore, the measurement of artificial intelligence in the three-dimensional perspective has greater advantages than that of manual measurement. However, the method of aneurysm morphological measurement in the three-dimensional perspective based on artificial intelligence has not been proposed. The standardized measurement in the three-dimensional perspective is of great significance to the clinical and research application of morphological parameters. In this paper, a three-dimensional measurement method for unruptured intracranial aneurysms based on artificial intelligence is presented, in order to promote the homogenization of aneurysm research and the standardization of clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Cerebral infarction is one of the diseases with high rates of disability and death worldwide, but there is still a lack of more effective treatments. Many studies showed that remote ischemic preconditioning (RIPC) can significantly improve ischemic tolerance of target organs, reduce infarct size and improve prognosis. However, its role and mechanism in the development of cerebral infarction are still little studied. This paper will summarize the role and mechanism of RIPC in cerebral infarction from the following aspects: neural, humoral, immune and related signaling pathways, and review the current research progress of RIPC in clinical cerebral ischemic diseases to provide a reference for subsequent research. [ABSTRACT FROM AUTHOR]

Aneurysmal subarachnoid hemorrhage is a common neurosurgical disease. Its high mortality and disability rate and numerous complications bring a heavy burden to patients and society. Shunt-dependent hydrocephalus is one of the complications of this disease. Some patients may have no symptoms in the early stage of the disease, making it difficult to diagnose, leading to poor prognosis or even death. With the continuous progress of research, many indicators that have predictive value for shunt-dependent hydrocephalus have been reported in the literature. This paper aims to review these predictive indicators to help clinicians identify the patients with high risk of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage early, and take active intervention measures to improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

The incidence of intracerebral hemorrhage (ICH) is less than ischemic stroke, but its mortality and disability rate are high. In China, nearly 46% of patients with ICH died or left serious disability within one year. Therefore, it is particularly important to standardize the diagnosis and treatment of ICH. In 2018, the American Heart Association (AHA) /American Stroke Association (ASA) developed clinical management indicators for patients with ICH based on the higher level of evidence level Ⅰ or Ⅲ recommendations in the guidelines for the management of spontaneous ICH, translating the guidelines into clinically practical quantitative indicators. From July 2021, the National Center for Healthcare Quality Management in Neurological Diseases and the Management and Improvement of Chinese Medical Care Quality on Stroke, Chinese Stroke Association adopted the improved Delphi method and finally formulated an index system for medical quality control of ICH, including 11 indicators. This paper makes detailed interpretation of these 11 indicators in order to guide medical institutions to provide medical assistance for patients in the best time safely and effectively, improve the quality of medical assistance for patients with ICH, and improve the clinical outcome of patients. [ABSTRACT FROM AUTHOR]

Cerebrovascular clinicians from different countries all over the world made great progress in the diagnosis and treatment of cerebral vascular diseases in recent years. Numerous high-quality clinical studies cover multiple fields and hotspots of cerebral vascular disease, such as thrombectomy/thrombolysis in the acute phase of ischemic stroke, intervention for atrial fibrillation, blood pressure management and other acute phase intervention measures, providing solid and reliable evidence-based medical evidence for clinical diagnosis and treatment in cerebral vascular disease, and promoting the reduction of cerebral vascular disease burden. This paper reviews the important clinical research progress in the field of cerebral vascular disease in 2023, helping readers better understand the advantages and great significance of these clinical studies, and looking forward to more and better cerebral vascular disease clinical studies in the future. [ABSTRACT FROM AUTHOR]

Objective To analyze the completion condition of general projects in the field of cerebrovascular diseases of National Natural Science Foundation of China, and discuss the status and existing problems of basic research in this field. Predict the development trend and provide reference for decision-making. Methods Through the big data knowledge management service portal of the National Natural Science Foundation of China, the basic information of the concluding projects with application code H0906 (cerebrovascular structure, function abnormalities and related diseases) during 2019 to 2021 were obtained. Excel software and Power Query components were used to analyze the research achievements, supporting institution distribution, regional distribution and research direction distribution of the concluding project, and VOSviewer software was used to analyze research hotspots. Results There were 177 concluding projects with code H0906 during 2019 to 2021, supported by 51 institutions (14 of which undertook 110 projects, 62.15%). 1532 academic papers were produced and 324 talents were cultivated. Among the supporting institutions, comprehensive colleges and universities undertook 96 projects (54.24%), and each project produced 9.52 academic papers, with 1.91 papers more than that from medical colleges and universities. Among the supporting institutions from 19 provinces and cities, Shanghai, Jiangsu, Beijing, Guangdong, Hubei, Chongqing 6 provinces and cities completed 113 projects (63.84%), the number of authorized patents was 30 (90.91%), and 27 person-time participated in international conferences (75.00%). There were 18 research directions under H0906, involving 107 projects of ischemic cerebrovascular diseases (60.45%). Keyword cluster analysis showed that the basic research hotspots in the field of cerebrovascular diseases were inflammatory response, microglia, neuroprotection and nerve regeneration. Conclusions Research achievements of general projects in the field of cerebrovascular diseases of National Natural Science Foundation of China were of various types, were mainly papers and talent training, supported by comprehensive colleges and universities with unbalanced geographical distribution, and research directions were relatively concentrated, which were mainly ischemic cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

The neurocritical care working group of the National Center for Healthcare Quality Management in Neurological Diseases was established in 2018. The working group conducted national surveys of sentinel hospitals and investigations of neurocritical care resources, discovering issues in China's neurocritical care such as uneven distribution of medical resources and lack of specialized personnel. Based on the survey results, the working group developed a system of quality control indicators for neurocritical care using the Delphi method, covering process indicators, readmission indicators, and key disease-related indicators. In addition, the neurocritical care working group also formulated the core knowledge and competencies consensus in neurocritical care and the consensus on sedation and analgesia for neurocritical care patients, and carried out a series of training programs such as the Neuro-Shield Action to promote continuous improvement in the quality of neurocritical care. In the future, the working group will continue to carry out activities such as quality control programs, training and assessment, and regularly monitor the implementation of quality control indicators to promote continuous improvement of medical quality. This paper summarizes the work of the neurocritical care working group in promoting improvements in the quality of neurocritical care in China. [ABSTRACT FROM AUTHOR]

Stroke is one of the major diseases worldwide leading to lifelong disability, and providing effective rehabilitation for stroke patients is important to reduce long-term disability, promote functional independence, and reduce the healthcare burden. The national clinical guideline for stroke for the United Kingdom and Ireland (Edition 2023) developed clinical practice rules of stroke rehabilitation with good operability from six parts: principles of rehabilitation, activity and participation, motor recovery and physical effects of stroke, psychological effects of stroke, communication and language and sensory effects of stroke. This paper will explain the key points of the stroke rehabilitation and recovery. [ABSTRACT FROM AUTHOR]

Hemorrhagic stroke mainly includes intracerebral hemorrhage and subarachnoid haemorrhage. Although the incidence of hemorrhagic stroke is lower than that of ischemic stroke, the onset is more rapid, the symptoms are more severe, and the prognosis is worse. More importantly, few medical interventions proved efficacy for hemorrhagic stroke, especially intracerebral hemorrhage. Therefore, the updates of hemorrhagic stroke guidelines have drawn much attention. This paper will interpret the updated points of hemorrhagic stroke of the 2023 edition of the national clinical guideline for stroke for the United Kingdom and Ireland. [ABSTRACT FROM AUTHOR]

The treatment of ischemic stroke in acute phase has always been a highly discussed topic. In the seven years since the publication of the 2016 edition of the national clinical guideline for stroke for the United Kingdom and Ireland, there have been significant developments in reperfusion therapy for acute ischemic stroke patients. The 2023 edition of the guidelines updated some recommendations on the acute phase treatment of ischemic stroke based on the 2016 edition. This paper will provide an interpretation of the key update points in the 2023 edition and compare them with the 2019 American Heart Association (AHA) /American Stroke Association (ASA) guidelines for the early management of patients with acute ischemic stroke, and The Chinese Clinical Management Guidelines for Cerebrovascular Diseases (2nd Edition) published in 2023. [ABSTRACT FROM AUTHOR]

TIA is a transient neurological impairment caused by local cerebral or retinal ischemia, with symptoms lasting less than 24 hours. Minor stroke is usually measured by NIHSS score≤5 or NIHSS score≤3. The 2023 edition of the National Clinical Guideline for Stroke for the United Kingdom and Ireland provided detailed recommendations for the diagnosis, treatment, prevention and management of TIA and minor stroke. This paper provides an interpretation of these recommendations and highlights the updates compared with the 2016 edition of the National Clinical Guideline for Stroke for the United Kingdom and Ireland. [ABSTRACT FROM AUTHOR]

Stroke is a major fatal and disabling disease, bringing heavy burden to individuals, families, and society, which has become a serious public health problem and attracted great attention. To a certain extent, Organisation of stroke services could improve the medical quality of stroke service institutions, enhance the coherence, systematicity, and scientificity of stroke diagnosis, treatment, and rehabilitation, reduce the mortality and disability of stroke, and improve the clinical prognosis and living ability of stroke patients. The National Clinical Guideline for Stroke for the United Kingdom and Ireland (2023 edition) has updated the part of Organisation of stroke services. The paper will explain the update points of this part. [ABSTRACT FROM AUTHOR]

Patients with poor grade aneurysmal subarachnoid hemorrhage (PaSAH) are prone to rapid onset of critical symptoms such as consciousness disorder, increased intracranial pressure, and hyperthermia, which are associated with high rates of mortality and disability. Numerous evidences have shown that target temperature management (TTM) can improve the prognosis of diseases such as brain damage caused after cardiac arrest. However, whether TTM can be performed in PaSAH patients remains controversial. In this paper, indications and contraindications in PaSAH patients, multimodal monitoring modalities and prospects, outcomes of application, induction modalities, implementation protocols and adverse reactions were reviewed, with a view to providing some reference for the application of TTM in PaSAH. [ABSTRACT FROM AUTHOR]

Childhood stroke is a common critical disease, and is one of the main causes of disability and death in children. Its etiology is complex and diverse, meanwhile, cardiogenic stroke cannot be ignored. Ebstein’s anomaly is a rare congenital heart disease, mainly involving the tricuspid valve and the right ventricle, and a few patients may combine with atrial septal defect or patent foramen ovale, which leads cardiogenic stroke because of paradoxical embolism. This paper reported a case of childhood stroke caused by Ebstein’s anomaly combined with atrial septal defect. Echocardiography techniques can help to clarify the diagnosis, assess severity and identify other abnormalities. [ABSTRACT FROM AUTHOR]

Patients with branch atheromatous disease (BAD) are prone to arteriosclerosis early neurological deterioration (END), which leads to poor functional prognosis and poses a great challenge to clinicians. At present, the pathogenesis of END in patients with BAD has not been elucidated, and there is a lack of strong evidence-based medical evidence in terms of treatment, with some observational studies suggesting that strategies of enhanced antithrombotic therapy may be justified. This paper reviews the research on the mechanism, risk prediction and intervention strategy of END in BAD patients in order to improve the awareness and attention of clinicians. [ABSTRACT FROM AUTHOR]

Stroke rehabilitation quality indicator is an important part to improve the medical quality of stroke rehabilitation in China. Donabedian triad model is the basic theory for the establishment of stroke rehabilitation quality indicators. This paper summarized the role of structure, process and outcome of Donabedian triad model in the improvement of stroke rehabilitation medical quality. The existing stroke rehabilitation quality indicators at home and abroad were also reviewed in order to provide a new perspective for the development and improvement of the stroke rehabilitation quality indicators in China. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease (CSVD) is a common disease in the aging process that would result in stroke, cognitive disorder, neuropsychological disorders or symptoms, and other functional impairments. CSVD often co-exists with neurodegenerative diseases, further exacerbating cognitive impairment or other symptoms that affect the patient's ability to live independently. Standards for reporting vascular changes on neuroimaging 1 (STRIVE-1) classifies and standardizes the different features of CSVD seen on structural MRI. The STRIVE-2, published in 2023, further updates the neuroimaging guidelines for vascular changes in CSVD. This paper will explain the update points of STRIVE-2. [ABSTRACT FROM AUTHOR]