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Background and purpose: Unawareness of the risk factors is one of the most important issues that need to be settled for stroke prevention. We aimed to evaluate the awareness of risk factors for cerebrovascular diseases (CVDs) among acute ischemic stroke patients and to investigate the characteristics of patients who were unaware of their risk factors in Shenzhen, China. Methods: Registered data on awareness of CVD risk factors of patients with confirmed acute ischemic stroke (AIS) from June 2020 to December 2022 were analyzed in May 2023. The data were extracted from the database of Shenzhen Quality Control Center for Management of Cerebrovascular Diseases. Results: Totally, there were 5147 AIS patients with complete data eligible for this study. AIS patients' awareness regarding existing hypertension, diabetes, dyslipidemia, and atrial fibrillation (AF) was 76.1%, 76.2%, 24.2%, and 53.4%, respectively. Patients who were lack of awareness of the CVD risk factors were more likely to be males, individuals with younger ages, and those without medical insurance or a CVD history. Conclusions: The overall awareness of the CVD risk factors was suboptimal among AIS patients in Shenzhen, especially for the existing dyslipidemia. The health education of AIS should be further improved in males as well as individuals without medical insurance or any CVD histories. Age was an independent factor associated with the lack of awareness of the CVD risk factors. The stroke screening program should be extended to younger people. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resveratrol, a naturally occurring polyphenolic compound, has captivated the scientific community with its promising therapeutic potential across a spectrum of diseases. This review explores the complex role of resveratrol in modulating ferroptosis, a newly identified form of programmed cell death, and its potential implications for managing cardiovascular and cerebrovascular disorders, cancer, and other conditions. Ferroptosis is intricately linked to the pathogenesis of diverse diseases, with resveratrol exerting multifaceted effects on this process. It mitigates ferroptosis by modulating lipid peroxidation, iron accumulation, and engaging with specific cellular receptors, thereby manifesting profound therapeutic benefits in cardiovascular and cerebrovascular conditions, as well as oncological settings. Moreover, resveratrol's capacity to either suppress or induce ferroptosis through the modulation of signaling pathways, including Sirt1 and Nrf2, unveils novel therapeutic avenues. Despite resveratrol's limited bioavailability, advancements in molecular modification and drug delivery optimization have amplified its clinical utility. Future investigations are poised to unravel the comprehensive mechanisms underpinning resveratrol's action and expand its therapeutic repertoire. We hope this review could furnish a detailed and novel insight into the exploration of resveratrol in the regulation of ferroptosis and its therapeutic prospects. [ABSTRACT FROM AUTHOR]

Cardio‐cerebrovascular disease (CCVD) is a serious threat to huma strategy to prevent the occurrence and development of disease by giving electroacupuncture intervention before the disease occurs. EAP has been shown in many preclinical studies to relieve ischemic symptoms and improve damage from ischemia–reperfusion, with no comprehensive review of its mechanisms in cardiovascular disease yet. In this paper, we first systematically discussed the meridian and acupoint selection law of EAP for CCVD and focused on the progress of the mechanism of action of EAP for the prevention and treatment of CCVD. As a result, in preclinical studies, AMI and MCAO models are commonly used to simulate ischemic injury in CCVD, while MIRI and CI/RI models are used to simulate reperfusion injury caused by blood flow recovery after focal tissue ischemia. According to the meridian matching rules of EAP for CCVD, PC6 in the pericardial meridian is the most commonly used acupoint in cardiovascular diseases, while GV20 in the Du meridian is the most commonly used acupoint in cerebrovascular diseases. In terms of intervention parameters, EAP intervention generally lasts for 30 min, with acupuncture depths mostly between 1.5 and 5 mm, stimulation intensities mostly at 1 mA, and commonly used frequencies being low frequencies. In terms of molecular mechanisms, the key pathways of EAP in preventing and treating cardiovascular and cerebrovascular diseases are partially similar. EAP can play a protective role in cardiovascular and cerebrovascular diseases by promoting autophagy, regulating Ca2+ overload, and promoting vascular regeneration through anti‐inflammatory reactions, antioxidant stress, and anti‐apoptosis. Of course, both pathways involved have their corresponding specificities. When using EAP to prevent and treat cardiovascular diseases, it involves the metabolic pathway of glutamate, while when using EAP to prevent and treat cerebrovascular diseases, it involves the homeostasis of the blood–brain barrier and the release of neurotransmitters and nutritional factors. I hope these data can provide experimental basis and reference for the clinical promotion and application of EAP in CCVD treatment. [ABSTRACT FROM AUTHOR]

Background: Post-diagnostic care for people with vascular cognitive impairment (VCI) typically involves multiple professions and disjointed care pathways not specifically designed to aid VCI needs. Objective: Exploring perspectives of healthcare professionals on post-diagnostic care for people with VCI. Methods: We conducted a qualitative focus group study. We used purposive sampling to include healthcare professionals in different compositions of primary and secondary care professionals per focus group. Thematic saturation was reached after seven focus groups. Transcripts were iteratively coded and analyzed using inductive thematic analysis. Results: Forty participants were included in seven focus groups (4–8 participants). Results showed knowledge and awareness of VCI as prerequisites for adequate post-diagnostic care, and for pre-diagnostic detection of people with VCI (theme 1). In light of perceived lack of differentiation between cognitive disorders, participants shared specific advice regarding post-diagnostic care for people with VCI and informal caregivers (theme 2). Participants thought current care for VCI was fragmented and recommended further integration of care and collaboration across settings (theme 3). Conclusions: People with VCI and their caregivers risk getting stuck in a "no man's land" between post-diagnostic care pathways; challenges lie in acknowledgement of VCI and associated symptoms, and alignment between healthcare professionals. Education about the symptoms and consequences of VCI, to healthcare professionals, people with VCI and caregivers, may increase awareness of VCI and thereby better target care. Specific attention for symptoms common in VCI could further tailor care and reduce caregiver burden. Integration could be enhanced by combining expertise of dementia and stroke/rehabilitation pathways. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of hippotherapy simulator on balance, postural control, mobility, functional capacity and independence level in people with stroke. This study involved 26 people with stroke aged 18–65, who were randomly assigned to a Hippotherapy Simulator Group (HSG; n = 13) and a Conventional Exercise Group (CEG; n = 13). Patients underwent assessments using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PAS-S), Timed Up and Go Test (TUG), Rivermead Mobility Index (RMI), 2-Minute Walking Test (2-MWT), and Barthel Daily Living Activity Index (BI) to evaluate balance, postural control, mobility, functional capacity, and independence before and after treatment. In the HSG, participants received 30 sessions of conventional exercises and hippotherapy simulator – a mechanical and robotic equipment with a dynamic saddle simulating horse movement – exercises over 6 weeks. Meanwhile, the CEG underwent 30 sessions of conventional exercises alone for 6 weeks. In the post-therapy evaluation between groups, BBS (p = 0.004) and 2-MWT (p < 0.001) scores were higher in HSG compared to CEG. However, no statistically significant difference was found between the two groups in terms of PAS-S, RMI, TUG and BI scores (p > 0.05). Statistically significant differences were found between BBS, PAS-S, RMI, TUG, BI and 2-MWT scores before and after treatment in both groups (p < 0.05). Hippotherapy simulator can be added to conventional exercises to improve balance and functional capacity in people with stroke. [ABSTRACT FROM AUTHOR]

Home care and telemedicine are crucial for physical and mental health. Although there is a lot of information on these topics, it is scattered across various sources, making it difficult to identify key contributions and authors. This study conducts a scientometric analysis to consolidate the most relevant information. The methodology is divided into two parts: first, a scientometric mapping that analyzes scientific production by country, journal, and author; second, the identification of prominent contributions using the Tree of Science (ToS) tool. The goal is to identify trends and support decision-making in the health sector by providing guidelines based on the most relevant research. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the the measurements of the circle of Willis (CW) arteries diameters in a Romanian population. Material and methods: We performed a retrospective study on a sample of 221 adult patients (≥18 years-old), hospitalized in the Emergency Clinical Hospital “Prof. Dr. N. Oblu” from Iași, Romania, over a period of 12 years, who died during hospitalization and on whom an autopsy was performed. Demographic data (age, gender, residence), causes of death and the outer diameters of CW constituent arteries were collected. There were 221 subjects, who were divided into four groups, according to the association of patient’s cause of death with the presence of anatomical variants of CW. 76.01% of all subjects presented cerebrovascular disease (CVDs) and anatomical variant of the CW, thus representing the great majority. Patients “with CVDs and anatomical variants of CW” were older with about 4 years compared to the other three categories of patients, having an average age of 64.17 ±14.22 years. 56.3% of those “without CVDs and with anatomical variant of CW” and 62.5% of those patients deceased ”with CVDs and anatomical variants of CW” had rural residences. 68.8% of all cases ”without CVDs, but with anatomical variants of CW” were female patients. 37.5% of the patients “with CVDs and anatomical variants of CW” and 43.8% of the patients “without CVDs, but with anatomical variants of CW” lived in the urban environment. Statistically significant differences were observed between the mean outer diameters of the arteries of CW and the patient’s cause of death (p

Abstract Background Police officers face an increased risk of developing cerebro-cardiovascular diseases (CVD). However, current literature lacks population-based cohort studies specifically focusing on this association. This study aimed to investigate the association between police officers and the risk of developing CVD compared with education officers, while accounting for socioeconomic and demographic factors. Methods We used the Korean National Health Insurance Service data spanning from 2009 to 2020. In this population-based retrospective matched cohort study, we identified age, sex, and calendar years of job-enrollment–matched education officers for each police officer. This study evaluated the CVD occurrence, including acute myocardial infarction, ischemic stroke, and hemorrhagic stroke. Using multivariable Cox regression analysis, we determined the risk of developing CVD, expressed as a hazard ratio (HR) and 95% confidence interval (CI). Results Among 104,134 police officers and 104,134 education officers, 4,391(42.2%) cases and 3,631(34.9%) cases of CVD occurred, respectively. The mean ± standard deviation age was 38.4 ± 9.4 years in police officers and 38.6 ± 9.5 years in education officers. The proportion of men was 84.8 % in both groups. Police officers were significantly associated with a higher risk of developing CVD compared with education officers, with an adjusted HR of 1.15 (95% CI, 1.09–1.22). In addition, police officers had significantly higher risks for acute myocardial infarction (adjusted HR, 1.16; 95% CI, 1.06–1.26) and ischemic stroke (adjusted HR, 1.17; 95% CI, 1.09–1.25). Conclusions The findings of our study highlight a significant increase in the risk of developing CVD among police officers, particularly among those aged 45 years and older and those with uncontrolled blood pressure compared to their education officer counterparts. Future cohort studies are required to confirm this association.

Abstract Cardiac‐cerebral vascular diseases (CCVDs) are acknowledged as a major threat to public health, leading to more than one‐third of all deaths worldwide. The complex anatomical structure and immune features of blood vessels significantly affect the development of CCVDs, and magnetic resonance angiography (MRA) is one of the main diagnostic approaches for the accurate diagnosis and prognosis of CCVDs. However, MRA suffers from intrinsic problems derived from its blood flow‐dependency, and the clinical Gd‐chelating contrast agents are limited by their rapid vascular extravasation. Over the past decade, spurred on by nanoscience and nanotechnology, numerous contrast agents based on magnetic nanomaterials have been developed to enhance the contrast of MRA, with these including iron oxide nanoparticles, rare earth‐doped nanoparticles, and metal‐organic coordination polymers. The molecular MR imaging of vasculopathy using specific nanoprobes has been explored to obtain a better understanding of the molecular aspects of CCVDs. In this review, the state of the art in MRA nanoprobes is introduced, and recent achievements in the diagnosis of CCVDs using MR imaging are summarized. Additionally, the future prospects and limitations of MRA based on nanoprobes are discussed. The current review provides methodological designs and ideas for subsequent MRA nanoprobes.

INTRODUCTION: We investigated the effect of perivascular spaces (PVS) volume on speeded executive function (sEF), as mediated by white matter hyperintensities (WMH) volume and plasma glial fibrillary acidic protein (GFAP) in neurodegenerative diseases. METHODS: A mediation analysis was performed to assess the relationship between neuroimaging markers and plasma biomarkers on sEF in 333 participants clinically diagnosed with Alzheimer's disease/mild cognitive impairment, frontotemporal dementia, or cerebrovascular disease from the Ontario Neurodegenerative Disease Research Initiative. RESULTS: PVS was significantly associated with sEF (c = ‐0.125 ± 0.054, 95% bootstrap confidence interval [CI] [‐0.2309, ‐0.0189], p = 0.021). This effect was mediated by both GFAP and WMH. DISCUSSION: In this unique clinical cohort of neurodegenerative diseases, we demonstrated that the effect of PVS on sEF was mediated by the presence of elevated plasma GFAP and white matter disease. These findings highlight the potential utility of imaging and plasma biomarkers in the current landscape of therapeutics targeting dementia. Highlights: Perivascular spaces (PVS) and white matter hyperintensities (WMH) are imaging markers of small vessel disease.Plasma glial fibrillary protein acidic protein (GFAP) is a biomarker of astroglial injury.PVS, WMH, and GFAP are relevant in executive dysfunction from neurodegeneration.PVS's effect on executive function was mediated by GFAP and white matter disease. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to evaluate the the measurements of the circle of Willis (CW) arteries diameters in a Romanian population. Material and methods: We performed a retrospective study on a sample of 221 adult patients (≥18 years-old), hospitalized in the Emergency Clinical Hospital "Prof. Dr. N. Oblu" from Iași, Romania, over a period of 12 years, who died during hospitalization and on whom an autopsy was performed. Demographic data (age, gender, residence), causes of death and the outer diameters of CW constituent arteries were collected. There were 221 subjects, who were divided into four groups, according to the association of patient's cause of death with the presence of anatomical variants of CW. 76.01% of all subjects presented cerebrovascular disease (CVDs) and anatomical variant of the CW, thus representing the great majority. Patients "with CVDs and anatomical variants of CW" were older with about 4 years compared to the other three categories of patients, having an average age of 64.17 ±14.22 years. 56.3% of those "without CVDs and with anatomical variant of CW" and 62.5% of those patients deceased ”with CVDs and anatomical variants of CW” had rural residences. 68.8% of all cases ”without CVDs, but with anatomical variants of CW” were female patients. 37.5% of the patients "with CVDs and anatomical variants of CW" and 43.8% of the patients "without CVDs, but with anatomical variants of CW" lived in the urban environment. Statistically significant differences were observed between the mean outer diameters of the arteries of CW and the patient's cause of death (p <.001) in case of anterior communicating artery (AcoA), right anterior cerebral artery (ACA), right and left posterior communicating arteries (PcoAs), and right posterior cerebral artery (PCA). The smallest external diameters of ACoA, right ACA and left PcoA were identified in patients ”with CVDs and anatomical variants of CW”. Our research has provided evidence that a smaller diameter of the right ACA and left PcoA are associated with the occurrence of cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

AbstractPan-vascular diseases, based on systems biology theory, explore the commonalities and individualities of important target organs such as cardiovascular, cerebrovascular and peripheral blood vessels, starting from the systemic and holistic aspects of vascular diseases. The purpose is to understand the interrelationships and results between them, achieve vascular health or sub-health, and comprehensively improve the physical and mental health of the entire population. Post-translational modification (PTM) is an important part of epigenetics, including phosphorylation, acetylation, ubiquitination, methylation, etc., playing a crucial role in the pan-vascular system. Crotonylation is a novel type of PTM that has made significant progress in the research of pan-vascular related diseases in recent years. Based on the review of previous studies, this article summarises the various regulatory factors of crotonylation, physiological functions and the mechanisms of histone and non-histone crotonylation in regulating pan-vascular related diseases to explore the possibility of precise regulation of crotonylation sites as potential targets for disease treatment and the value of clinical translation. [ABSTRACT FROM AUTHOR]

Aim: To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. Design: A descriptive, qualitative approach. Methods: Semi‐structured in‐person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. Results: The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two‐way communication. Conclusion: New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. Impact: The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. Reporting Method: We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. Patient or Public Contribution: Patients were involved as the study population. [ABSTRACT FROM AUTHOR]

Background and Aims: Marital status has been shown to be associated with mortality, but evidence in critically ill elder intensive care unit (ICU) patients with cerebrovascular diseases (CeVD) is limited. This study was to explore the correlation between marital status and the prognosis of patients with CeVD aged 65 years and over in the ICU. Methods: In the present study, 3564 patients were enrolled in the Medical Information Mart for Intensive Care IV database (version 2.2). Patients were divided into four groups based on marital status: married, single, divorced, and widowed. The primary outcome was all‐cause mortality as patients were followed up for 3‐, 6‐, 9‐, and 12‐month. All‐cause mortality risk for patients with different marital status was compared. Univariate and multivariable logistic regression analyses, survival curves and stratified analyses were performed to determine the correlation between marital status and mortality in critically ill patients with CeVD aged ≥65 years. Results: Of the patients, 51.2% (1825/3564) were married, followed by 23.8% (847/3564) were widowed, 18.2% (647/3564) were single, and 6.9% (245/3567) were divorced. Compared with the married, the unmarried had a higher proportion of female (p < 0.001), older (p < 0.001), and less proportion of mechanical ventilation (p = 0.045). Multivariate analyses showed that no differences were observed for mortality risk among different marital statuses (p > 0.05), while at late follow‐up, widowed had a significance higher mortality risk than the married (9‐month: odds ratio [OR]: 1.30, 95% confidence interval [CI]: 1.05–1.61, p = 0.02; 12‐month: OR: 1.38, 95% CI: 1.12–1.71, p = 0.003). Stratified analyses indicated a stable correlation between marital status and 12‐month mortality rate in sub‐analysis for gender (p = 0.46) and age (p = 0.35). Conclusion: Marital status is associated with long‐term prognosis in older patients with CeVD admitted to ICU. Widowed people should receive more societal attention irrespective of sex or age. [ABSTRACT FROM AUTHOR]

miR-135 is a highly conserved miRNA in mammals and includes miR-135a and miR-135b. Recent studies have shown that miR-135b is a key regulatory factor in cardio-cerebrovascular diseases. It is involved in regulating the pathological process of myocardial infarction, myocardial ischemia/reperfusion injury, cardiac hypertrophy, atrial fibrillation, diabetic cardiomyopathy, atherosclerosis, pulmonary hypertension, cerebral ischemia/reperfusion injury, Parkinson's disease, and Alzheimer's disease. Obviously, miR-135b is an emerging player in cardio-cerebrovascular diseases and is expected to be an important target for the treatment of cardio-cerebrovascular diseases. However, the crucial role of miR-135b in cardio-cerebrovascular diseases and its underlying mechanism of action has not been reviewed. Therefore, in this review, we aimed to comprehensively summarize the role of miR-135b and the signaling pathway mediated by miR-135b in cardio-cerebrovascular diseases. Drugs targeting miR-135b for the treatment of diseases and related patents, highlighting the importance of this target and its utility as a therapeutic target for cardio-cerebrovascular diseases, have been discussed.

Calpain, a key member of the Calpain cysteine protease superfamily, performs limited protein hydrolysis in a calcium-dependent manner. Its activity is tightly regulated due to the potential for non-specific cleavage of various intracellular proteins upon aberrant activation. A thorough review of the literature from 2010 to 2023 reveals 121 references discussing cardiovascular and cerebrovascular diseases. Dysregulation of the Calpain system is associated with various pathological phenomena, including lipid metabolism disorders, inflammation, apoptosis, and excitotoxicity. Although recent studies have revealed the significant role of Calpain in cardiovascular and cerebrovascular diseases, the precise mechanisms remain incompletely understood. Exploring the potential of Calpain inhibition as a therapeutic approach for the treatment of cardiovascular and cerebrovascular diseases may emerge as a compelling area of interest for future calpain research.

ABSTRACT Vascular cognitive impairment (VCI) is the second most common cause of cognitive impairment after Alzheimer's disease. The VCI spectrum involves a decline in cognition attributable to vascular pathologies (e.g., large infarcts or hemorrhages, microinfarcts, microbleeds, lacunar infarcts, white matter hyperintensities, and perivascular space dilation). Pathophysiological mechanisms include direct tissue injury, small vessel disease, inflammaging (inflammation + aging), atrophy, and altered neurotransmission. VCI is diagnosed using distinct clinical and radiological criteria. It may lead to long-term disability and reduced quality of life. An essential factor for reducing cognitive impairment incidence is preventing stroke by managing traditional and non-traditional cerebrovascular risk factors. This article reviews the spectrum of VCI, epidemiology, risk factors, pathophysiology, diagnosis, available treatment, and preventive strategies.

Izzeddin Qtaish,1 Mohammad Ayasrah,2 Noat R Qtaish3 1Radiology and Interventional Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3College of Medicine, Al Balqa Applied University, Salt, JordanCorrespondence: Mohammad Ayasrah, Department of Allied Medical Sciences-Radiologic Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan, Tel +96227201000-26939, Fax +96227201087, Email maayasrah@just.edu.joBackground: Differences in dominance and stenosis in the complex vertebral artery (VA) network pose challenges in diagnosing and treating cerebrovascular diseases crucial for brain nutrition. This research examines these intricacies, highlighting the importance of detailed diagnosis and treatment methods.Objective: To analyze the prevalence of the dominant VA, evaluate the influence of gender and age on steno-occlusion, and explore the correlation between the dominant VA and stenosed VA segments.Methods: A retrospective study of 249 angiograms from patients with VA stenosed at King Abdullah University Hospital between August 2019 and December 2022. The patients presenting symptoms of vertigo, migraines, headaches, or transient ischemic attacks (TIA) were included, 182 cases were classified based on VA dominance and stenosis severity. The data were analyzed using IBM SPSS 27.Results: Out of the 182 participants, 64.8% were male, with an average age of 61.3 years and 35.2% were female. The prevalence of stenosis was distributed as follows: 26.4% mild, 44.0% moderate, and 29.7% severe. Statistically significant correlations were observed between hypertension, smoking, hyperlipidemia, and the degree of stenosis (p < 0.05), but not with diabetes. The prevalence of left vertebral artery (VA) dominance was found to be 41.1%. Additionally, there was no gender connection observed in the distribution of steno-occlusion (p = 0.434). There is no notable correlation between the degree of stenosis and the dominant vertebral artery (p > 0.05).Conclusion: Angiographic findings reveal the complex relationship between the dominance of the VA, patterns of stenosis, and demographic factors. Individuals with a dominant VA had a greater likelihood of developing stenosis on the opposite non-dominant side. The high occurrence of severe stenosis highlights the need for tailored diagnostic and treatment approaches. Understanding vertebral stenosis as a multifaceted interaction of demographic, lifestyle, and anatomical variables is essential for enhancing treatment strategies.Keywords: Vertebral artery dominance, stenosis, cerebrovascular diseases, risk factors, retrospective angiographic study

Objective: The aim of this research was to investigate whether sublingual varices (SV) are associated with new events of ischaemic heart disease (IHD) and new events of cerebrovascular disease. Methods: A prospective observational study was conducted amongst 1139 dental patients aged between 48 and 84 years across 2 cohorts (201 enrolled from 2010–2013 and 938 from 2018–2020). Participants provided baseline data on demographics, risk factors, and medical diagnoses, followed by an assessment of their tongue's ventral surface to classify veins as either having no sublingual varices (nSV) or having sublingual varices (SV). Information regarding medical diagnoses was gathered during the follow-up period from both participants and their medical records. The primary outcome variables were the onset of new IHD and new cerebrovascular disease events. Comparisons were made between participants with SV and nSV. Results: The study population comprised 54% women with an average age of 66 years. SV were present in 33% of participants. Those with SV predominantly were male, older, and smokers; had a higher body mass index, and exhibited more instances of hypertension, diabetes, and dyslipidaemia than those with nSV. New occurrences of IHD (4.5% vs 1.8%, P = .009) and cerebrovascular disease (4.2% vs 2.0%, P = .026) were more prevalent in the SV group compared with the nSV group. The link between SV and new IHD events persisted even after adjustments for sex, age, and smoking habits (OR, 2.26; 95% CI, 1.074.76), but not for new cerebrovascular disease events (OR, 1.77; 95% CI, 0.843.71). Conclusions: Our study identifies a correlation between SV and new events of IHD, but not new events of cerebrovascular disease. The detection of SV occurred prior to the IHD events, suggesting a temporal relationship. This novel finding proposes a potential shared pathophysiology between IHD and SV.

Abstract Background Transcranial color-coded duplex ultrasonography (TCCD) is an important diagnostic tool in the investigation of cerebrovascular diseases. TCCD is often hampered by the temporal window that ultrasound cannot penetrate. Rapidly determine whether ultrasound can penetrate the temporal window in order to determine whether to use other acoustic windows to complete the examination process. In this study, Skull thickness can be measured simultaneously during TCCD examination, which makes it possible to use skull thickness to rapidly determine whether the temporal window is penetrated by ultrasound. Methods This retrospective study included 301 patients with clinical symptoms of cerebrovascular diseases. These 301 patients were divided into an impenetrable temporal window (ITW) group and a penetrable temporal window group according to the results of the TCCD examination. Results The area under the receiver operating characteristic (ROC) curve (AUC) for skull thickness was 0.887 (cutoff value 1.045 cm). Following multivariate logistic regression, sex, age, and skull thickness were used to develop a nomogram. The AUC for the nomogram was 0.923 (cutoff value 0.407). Conclusions The skull thickness at the temporal window was measured by ultrasound, which was convenient and accurate. The probability of ITW in females was higher than that in males, and it increased with age. In this study, a prediction model incorporating sex, age and skull thickness could predict ITW probability well. If the patient’s temporal window was rapidly predicted as an ITW, other acoustic window examinations were used to complete the TCCD examination process to optimize the TCCD examination process of cerebrovascular diseases and facilitate the popularization of TCCD in clinical application.

• The incidence of stroke in Qatar is lower than in most Western countries. • The Non-Qatari population is younger, with more ischemic and hemorrhagic strokes. • Use of ambulance services is high in Qatar, especially in Non-Qatari population. • Higher prevalence of diabetes in the region as compared to the western population. • Thrombolysis rates in Qatar are higher with shorter door-to-needle times. Stroke prevalence is progressively increasing in developing countries due to increased vascular risk factors. This study aims to describe the epidemiology, prevalent risk factors, and outcomes of stroke in a multi-ethnic society of Qatar. We conducted a retrospective analysis of all patients with suspected stroke admitted to stroke services between January 2014 and September 2020. A total of 11,892 patients were admitted during this period with suspected stroke. Of these, the diagnosis was ischemic stroke (48.8 %), transient ischemic attack (10.3 %), intracerebral hemorrhage (10.9 %), cerebral venous sinus thrombosis (1.3 %), and stroke mimics (28.6 %). The median age was 52 (43–62), with a male–female ratio of 3:1. The study population was predominantly Asian (56.8 %) and Arab (36 %). The majority of the patients were hypertensive (66.8 %), diabetic (47.9 %), and dyslipidemic (45.9 %). A history of prior stroke was observed in 11.7 %, while 0.9 % had prior transient ischemic attack. Among ischemic strokes, 31.7 % arrived within 4.5 h, 12.5 % received thrombolysis, and 4.6 % underwent thrombectomy. Median Door-to-Needle time was 51 (33–72) minutes. The average length of stay was 5.2 ± 9.0 days, with 71.5 % discharged home, 13.8 % transferred to rehabilitation, 9.3 % to other specialties, 3 % to long-term care, and 2.4 % suffered in-hospital mortality. Stroke in Qatar is characterized by a younger, expatriate-dominant cohort, with notable prevalence of ischemic and hemorrhagic stroke and a distinct risk factor profile. Further analysis of epidemiological differences among different population groups can inform targeted policies for prevention and management to reduce the burden of disease. [ABSTRACT FROM AUTHOR]

Background and objectives: Many studies suggested that short-term exposure to fine particulate matter (PM2.5) and coarse particulate matter (PM2.5–10) was linked to elevated risk of cerebrovascular disease. However, little is known about the potentially differential effects of PM2.5 and PM2.5–10 on various types of cerebrovascular disease. Methods: We collected individual cerebrovascular death records for all residents in Shanghai, China from 2005 to 2021. Residential daily air pollution data were predicted from a satellite model. The associations between particulate matters (PM) and cerebrovascular mortality were investigated by an individual-level, time-stratified, case-crossover design. The data was analyzed by the conditional logistic regression combined with the distributed lag model with a maximum lag of 7 days. Furthermore, we explored the effect modifications by sex, age and season. Results: A total of 388,823 cerebrovascular deaths were included. Monotonous increases were observed for mortality of all cerebrovascular diseases except for hemorrhagic stroke. A 10 μg/m3 rise in PM2.5 was related to rises of 1.35% [95% confidence interval (CI): 1.04%, 1.66%] in mortality of all cerebrovascular diseases, 1.84% (95% CI: 1.25%, 2.44%) in ischemic stroke, 1.53% (95% CI: 1.07%, 1.99%) in cerebrovascular sequelae and 1.56% (95% CI: 1.08%, 2.05%) in ischemic stroke sequelae. The excess risk estimates per each 10 μg/m3 rise in PM2.5–10 were 1.47% (95% CI: 1.10%, 1.84%), 1.53% (95% CI: 0.83%, 2.24%), 1.93% (95% CI: 1.38%, 2.49%) and 2.22% (95% CI: 1.64%, 2.81%), respectively. The associations of both pollutants with all cerebrovascular outcomes were robust after controlling for co-pollutants. The associations were greater in females, individuals > 80 years, and during the warm season. Conclusions: Short-term exposures to both PM2.5 and PM2.5–10 may independently increase the mortality risk of cerebrovascular diseases, particularly of ischemic stroke and stroke sequelae.

Background: Hemiballism (HB) and hemichorea (HC) are the most frequent secondary movement disorders, usually caused by cerebrovascular diseases. In only a minority of cases, these involuntary movements are not self-limited, and they may severely compromise patients' quality of life, so that symptomatic treatments are required. Typical and atypical neuroleptics as well as tetrabenazine are considered therapies of choice. However, anecdotal reports of antiseizures medications and botulinum neurotoxin injection effectiveness have been described. Methods: We described a case of severely disabling acute-onset lesional HB/HC, where high dosage of first- and second-line therapies was contraindicated due to patient's comorbidities. Results: After botulin neurotoxin (BoNT) injections in his left upper limb muscles (biceps brachii, triceps brachii, teres major, and deltoid), the patient experienced gradual reduction of hyperkinetic movements. The gradual discontinuation of topiramate (TPM) did not worsen the clinical picture. Discussion: The reduction of hyperkinetic movements led to rhabdomyolysis resolution as well as cutaneous injuries healing with renal function improvement, so that the patient was able to be eligible for rehabilitation, which was prevented by HB/HC itself. The clinical improvement was consistent with BoNT pharmacokinetic. The administration of BoNT early after the onset of lesional HB/HC remarkably modified the clinical management and drove toward comorbidities resolution and rehabilitation. Conclusion: The present case highlights the effectiveness of unconventional therapeutic options in disabling acute onset lesional HB/HC when first-line therapies are contraindicated. Particularly, this report may encourage BoNT application in the early stage of movement disorder emergencies. [ABSTRACT FROM AUTHOR]

In preclinical and clinical studies, choline alfoscerate (CA) has proven to be highly effective in the correction of cognitive impairment (CI). The clinical effect of CA is seen in the improvement of mental activity, concentration, ability to remember and recall information, cognitive and behavioural responses, elimination of emotional instability and apathy. Experimental studies have shown the effectiveness of CA in preventing atrophic changes in the cerebral cortex. Based on several studies conducted on the use of CA in the treatment of CI, it can be concluded that oral administration of CA at a dose of 600 mg/day can be recommended both as monotherapy and as part of complex therapy in patients with cerebrovascular diseases such as chronic cerebral ischemia. As part of complex therapy for CI in Alzheimer's disease, a combination of CA at a dose of 1200 mg/day with donepezil at a dose of 10 mg/day may be recommended. Several studies have demonstrated the efficacy of CA in the treatment of post-COVID and post-traumatic CI. The efficacy of CA administration in the treatment of CI (including vascular dementia) following ischemic stroke and transient ischemic attacks has been demonstrated. When CA is taken, there is also a reduction in anxiety and depressive disorders, asthenia, the severity of pain symptoms and changes in coordination. The duration of therapy should be 60 to 90 days, depending on the severity of CI, followed by an observation phase of up to 2 years. For successful treatment with CA, it is necessary to carry out repeated courses of CI treatment. Today, a new drug Cerpechol (600 mg/7 ml) has appeared on the Russian market, which has all the effects of CA. The convenience of the new form (oral solution) makes it possible to use it in patients with swallowing disorders.

Relevance. During the implementation of the program for the prevention and treatment of cardiovascular diseases in the Stavropol Territory, measures were taken to prevent hemorrhagic and ischemic strokes, train medical personnel in methods of timely detection of cerebrovascular diseases (CVD), recognition (including through training of the general population) and routing patients with acute cerebrovascular accidents; during a pandemic, opening specialized departments. This organizational experiment required an assessment of its impact on the most medically complex group of the population - rural residents. The aim was to study in dynamics the epidemic situation of CVD among the rural population in the Stavropol Territory in comparison with the Russian Federation. Materials and Methods. Information from official statistical observation forms on the incidence of CVD and mortality from them was studied. Results and Discussion. In the period from 2010 to 2022, there was an increase in the incidence of CVD in the rural population from 464.6 to 1045.1 per 100,000 rural population, which is partly due to the aging of the population, and partly due to improved diagnosis of CVD. The overall incidence of CVD increased from 1275.5 to 3416.1, which suggests an improvement in patient survival. The incidence of strokes of all types tended to decrease, which indicates the effectiveness of the impact on the risk factors for their development. The incidence of unspecified strokes decreased significantly, which led to an increase in the primary incidence of cerebral infarctions (which, however, grew more slowly in the Stavropol Territory than in the Russian Federation as a whole; the coefficients of the regression equations were 2.5 and 4.3, respectively). Between 2015 and 2022. the mortality rates (from 208.4 to 161.1) and mortality (from 5.8 to 2.8) from CVD decreased rapidly (relative to mortality from CVD in the Russian Federation). Conclusion. The proposed set of measures for the prevention and treatment of CVD, including preventive measures, a system of social mobilization, FAST-test, patient routing systems with the delivery of eligible persons to vascular centers within an hour, timely response to new risk factors for the development of CVD, was effective and can be recommended for implementation in similar areas with a high proportion of rural population.

Introduction. The relevance of conducting this study is determined by the necessity to create organizational conditions and optimize the clinical-diagnostic aspect of medical care for patients with traumatic brain injury (TBI) and acute stroke. This aims to improve patients' quality of life by enhancing the effectiveness of medical care provision in Ukraine. This improvement is based on identifying the causes and analyzing deficiencies in medical care for these conditions. The aim of the research is to investigate the specificity of deficiencies in providing medical care to patients with isolated traumatic brain injury and acute hemorrhagic stroke due to the rupture of cerebral arterial aneurysms based on a retrospective analysis of medical documentation, as well as the results of patient treatment in cases of discrepancies between clinical and forensic diagnoses concerning the primary, concomitant diseases, and their complications. Materials and methods. Clinical assessment of the results of providing care to patients with traumatic brain injury and stroke was conducted through a retrospective analysis of medical documentation of patients who were hospitalized with these pathologies. The applied methods include clinical and laboratory investigations of homeostasis and metabolism parameters, and instrumental techniques. Results. In the identified influence of the timing of the operation (within the first few days) and the breakthrough of blood in the subarachnoid space of the brain, including with intracranial hemorrhage as a result of a re-rupture of a cerebral arterial aneurysm, on the risk of lethal outcomes of surgical treatment, a rationale for searching ways to optimize therapeutic tactics in this category of patients was provided. This includes identifying defects and shortcomings in the organizational aspect of medical care. Conclusions. Based on the analysis and identification of the most informative factors influencing the results of surgical treatment of cerebral aneurysms, a prediction system has been developed that allows calculating the probability of its outcome. The application of the forecast is advisable to consider in the prevention and timely detection of possible deficiencies in providing medical care to patients with stroke.

New predictors of ischemic incidents are constantly sought since they raise the awareness of patients and their doctors of stroke occurrence. The goal was to verify whether Advanced Glycation End Products (AGEs), in particular AGE10, could be one of them. The AGE10 measurement was conducted using a non-commercial ELISA assay in the blood serum of neurological patients without cerebrovascular event (n = 24), those with transient brain attack (TIA) (n = 17), and severe ischemic stroke (n = 35). Twice as many of the people with TIA or severe stroke presented high AGE10 serum concentrations compared to the patients with other neurological conditions (χ2 = 8.2, p = 0.004; χ2 = 8.0, p = 0.005, respectively). The risk of ischemic incident was significantly risen in people with higher levels of AGE10 (OR = 6.5, CI95%: 1.7–24.8; OR = 4.7, CI95%: 1.5–14.5 for TIA and stroke subjects, respectively). We observed a positive correlation (r = 0.40) between high AGE10 levels and diabetes. Moreover, all the diabetic patients that had a high AGE10 content experienced either a severe ischemic stroke or TIA. The patients with high levels of AGE10 exhibited higher grades of disability assessed by the NIHSS scale (r = 0.35). AGE10 can be considered a new biomarker of ischemic stroke risk. Patients with diabetes presenting high AGE10 levels are particularly prone to the occurrence of cerebrovascular incidents. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the relationship between driving skills and cognitive function in patients with cerebrovascular disease and provide driving rehabilitation strategies based on actual vehicle driving training. Methods: Participants included 25 patients with cerebrovascular disease who wished to resume driving. The Mini-Mental State Examination (MMSE), Frontal Assessment Battery, and Trail Making Test were administered to assess cognitive function. Driving rehabilitation consisted of two driving sessions and verbal instruction from the driving school instructor between the first and second driving sessions. All of these sessions took place on the same day. The evaluation of actual vehicle driving was based on quantified point reduction items. This evaluation method is the evaluation scale used in the skill test for obtaining a Japanese automobile license and is based on the Japanese National Police Agency. Results: MMSE scores were extracted as a factor influencing actual vehicle driving performance. Furthermore, the MMSE scores were entered into a stepwise multiple regression model, which revealed That MMSE scores were an important predictor of actual vehicle driving performance. Driving rehabilitation resulted in improved actual vehicle driving performance. Moreover, the number of participants who passed the test increased from two to 11 (p < 0.001). Conclusions: Driving rehabilitation was found to have some positive effects, such as an increase in the pass rate for actual vehicle driving. However, it is necessary to consider the possibility that this effect could be due to the repetition of two driving sessions conducted on the same day. [ABSTRACT FROM AUTHOR]

Background: Existing studies have already shown a connection between nitrogen dioxide (NO2) exposure and cerebrovascular mortality. However, the differential effects of NO2 on cerebrovascular disease and its subtypes remain unclear and require further exploration. Methods: Daily stroke mortality data between 2013 and 2021 in Shanghai, China were collected. Residential daily air pollution data for each decedent were predicted from a satellite model. An individual-level, time-stratified, case-crossover design was applied to examine the relationship between NO2 exposure and cerebrovascular mortality. A combination of conditional logistic regression and distributed lag models with a maximum lag of 7 days was used for data analysis. Results: A total of 219,147 cases of cerebrovascular mortality were recorded. Among them, the proportion of sequelae of cerebrovascular disease, hemorrhagic stroke and ischemic stroke was 50.7%, 17.1% and 27.5%, respectively. The monotonic increases in mortality risks of cerebrovascular diseases, sequelae of cerebrovascular disease and ischemic stroke were observed, without any discernible thresholds. Each 10 μg/m3 increase in NO2 concentration was associated with increments of 3.62% [95% confidence interval (CI): 2.56%, 4.69%] for total cerebrovascular mortality, 4.29% (95% CI: 2.81%, 5.80%) for sequelae of cerebrovascular disease mortality and 4.30% (95% CI: 2.30%, 6.33%) for ischemic stroke mortality. No positive associations between NO2 exposure and hemorrhagic stroke mortality were observed. A greater risk of NO2 was observed in the warm season, in patients with less than 9 years of education and in those with single marital status. The effects of NO2 were robust to mutual adjustment of co-pollutants. Conclusions: Short-term exposures to NO2 may increase the risk of cerebrovascular mortality, specifically for ischemic stroke and sequelae of cerebrovascular disease. [ABSTRACT FROM AUTHOR]

Cerebrovascular diseases, including ischemic strokes, hemorrhagic strokes, and vascular malformations, are major causes of morbidity and mortality worldwide. The advancements in neuroimaging techniques have revolutionized the field of cerebrovascular disease diagnosis and assessment. This comprehensive review aims to provide a detailed analysis of the novel imaging methods used in the diagnosis and assessment of cerebrovascular diseases. We discuss the applications of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography, highlighting their strengths and limitations. Furthermore, we delve into the emerging imaging techniques, including perfusion imaging, diffusion tensor imaging (DTI), and molecular imaging, exploring their potential contributions to the field. Understanding these novel imaging methods is necessary for accurate diagnosis, effective treatment planning, and monitoring the progression of cerebrovascular diseases.

Background: There are many risk factors for the development of delirium. According to the definition given by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, delirium is defined as “disturbances in attention and awareness over a short period of time, representations of changes from baseline attention, and awareness with a tendency to fluctuate over a period of time.” Aim: The aim of the study was to assess the prevalence of risk factors among patients of delirium in a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted among patients of delirium in a tertiary care hospital of the city of Ahmedabad using the Confusional Assessment Method-Severity scale and sociodemographic questionnaire. A total of 100 patients were recruited in the study. The analysis was done using Microsoft Excel 2019. Results: In the study, we found that the majority of patients of delirium were of age >65 years, males, suffering from cerebrovascular illness, and having dementia. It was reported from the study that the majority patients of delirium were admitted to the intensive care unit and having a prolonged hospital stay. Conclusions: Identification of risk factors and early intervention can have better outcomes in patients suffering from delirium and lead to better prognosis.

Objective: This study aimed to explore the mortality prediction of patients with cerebrovascular diseases in the intensive care unit (ICU) by examining the important signals during different periods of admission in the ICU, which is considered one of the new topics in the medical field. Several approaches have been proposed for prediction in this area. Each of these methods has been able to predict mortality somewhat, but many of these techniques require recording a large amount of data from the patients, where recording all data is not possible in most cases; at the same time, this study focused only on heart rate variability (HRV) and systolic and diastolic blood pressure. Methods: The ICU data used for the challenge were extracted from the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) Clinical Database. The proposed algorithm was evaluated using data from 88 cerebrovascular ICU patients, 48 men and 40 women, during their first 48 hours of ICU stay. The electrocardiogram (ECG) signals are related to lead II, and the sampling frequency is 125 Hz. The time of admission and time of death are labeled in all data. In this study, the mortality prediction in patients with cerebral ischemia is evaluated using the features extracted from the return map generated by the signal of HRV and blood pressure. To predict the patient's future condition, the combination of features extracted from the return mapping generated by the HRV signal, such as angle (α), area (A), and various parameters generated by systolic and diastolic blood pressure, including DBPMax−Min SBPSD have been used. Also, to select the best feature combination, the genetic algorithm (GA) and mutual information (MI) methods were used. Paired sample t-test statistical analysis was used to compare the results of two episodes (death and non-death episodes). The P-value for detecting the significance level was considered less than 0.005. Results: The results indicate that the new approach presented in this paper can be compared with other methods or leads to better results. The best combination of features based on GA to achieve maximum predictive accuracy was m (mean), LMean, A, SBPSVMax, DBPMax-Min. The accuracy, specificity, and sensitivity based on the best features obtained from GA were 97.7%, 98.9%, and 95.4% for cerebral ischemia disease with a prediction horizon of 0.5–1 hour before death. The d-factor for the best feature combination based on the GA model is less than 1 (d-factor = 0.95). Also, the bracketed by 95 percent prediction uncertainty (95PPU) (%) was obtained at 98.6. Conclusion: The combination of HRV and blood pressure signals might increase the accuracy of the prediction of the death episode and reduce the minimum hospitalization time of the patient with cerebrovascular diseases to determine the future status.

Abstract Single-cell ribonucleic acid sequencing (scRNA-seq) has emerged as a transformative technology in neurological and neurosurgical research, revolutionising our comprehension of complex neurological disorders. In brain tumours, scRNA-seq has provided valuable insights into cancer heterogeneity, the tumour microenvironment, treatment resistance, and invasion patterns. It has also elucidated the brain tri-lineage cancer hierarchy and addressed limitations of current models. Neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis have been molecularly subtyped, dysregulated pathways have been identified, and potential therapeutic targets have been revealed using scRNA-seq. In epilepsy, scRNA-seq has explored the cellular and molecular heterogeneity underlying the condition, uncovering unique glial subpopulations and dysregulation of the immune system. ScRNA-seq has characterised distinct cellular constituents and responses to spinal cord injury in spinal cord diseases, as well as provided molecular signatures of various cell types and identified interactions involved in vascular remodelling. Furthermore, scRNA-seq has shed light on the molecular complexities of cerebrovascular diseases, such as stroke, providing insights into specific genes, cell-specific expression patterns, and potential therapeutic interventions. This review highlights the potential of scRNA-seq in guiding precision medicine approaches, identifying clinical biomarkers, and facilitating therapeutic discovery. However, challenges related to data analysis, standardisation, sample acquisition, scalability, and cost-effectiveness need to be addressed. Despite these challenges, scRNA-seq has the potential to transform clinical practice in neurological and neurosurgical research by providing personalised insights and improving patient outcomes.

Background Cerebral angiography is an important means for the assessment of cerebrovascular diseases. In recent years, distal transradial artery approach (dTRA) has gradually been used in cerebral angiography, but there are few reports on its effectiveness and safety. Objective To compare the effectiveness, patient safety and satisfaction between transradial artery approach (TRA) and dTRA in cerebral angiography. Methods Totally 135 patients who were hospitalized in Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University from January 2020 to June 2022 for cerebral angiography were selected. They were divided into TRA group (n=72) and dTRA group (n=63) by the approach used in cerebral angiography, and the puncture time, duration of cerebral angiography, puncture success rate, X-ray exposure time, incidence of puncture site complications and serious cardiovascular and cerebrovascular events within three days after cerebral angiography, and levels of pain and satisfaction within 24 hours after cerebral angiography were compared between the groups. Results The mean puncture time in dTRA group was much longer than that of TRA group (P0.05) . No serious cardiovascular and cerebrovascular events occurred in both groups within three days after cerebral angiography. dTRA group had much lighter pain level and significantly higher satisfaction within 24 hours after cerebral angiography than TRA group (P

Abstract Background Surgical management is one of the mainstay management options for cerebrovascular diseases, which is not only curative but also preventive. However, there's a gap between the surgical management of cerebrovascular disease in Africa when compared to the developed parts of the world. Methods A literature search was done on the state of Cerebrovascular surgery in Africa from databases such as Pubmed, Embase, and Google Scholar, articles we fetched and meticulously reviewed. Results We found gaps in the surgical management of cerebrovascular diseases such as stroke in African countries when compared to developed countries. The challenges facing the surgical management of cerebrovascular disease in Africa include a low number of neurosurgeons and vascular surgeons trained in the surgical management of these diseases, a lack of adequate facilities for surgical management, and others. The burden of cerebrovascular diseases in Africa is great, and this warrants an improvement in the surgical management of the conditions, which includes primary prevention of such diseases through public health education on risk factors, improvement of health facilities to accommodate recent advances in the cerebrovascular surgeries, establishments of several neurosurgery training centers. Conclusion The practice of surgical management of cerebrovascular disease in Africa needs to be optimized for it to be at the global standard and for better outcomes and management of patients.

Introduction. Chronic cerebral ischemia (CCI) is considered a syndrome that develops as a result of a slowly progressive reduction in cerebral blood flow. This reduction occurs due to the gradual accumulation of ischemic and secondary degenerative changes in the brain, which are caused by repeated ischemic episodes resulting from the development of atherosclerosis and arterial hypertension. These changes lead to impairment of brain functions, manifested by progressive neurological, neuropsychological, and mental disorders. The aim. To analyze the problems of pathogenesis, diagnosis, and treatment of CCI from the sources of modern literature in order to optimize the treatment of this group of patients. Materials and methods. Bibliosemantic, comparative and method of system analysis. Results. The pathogenetic mechanisms underlying CCI remain controversial due to the heterogeneity of causes and the complexity of the neuropathology associated with the disease. However, one common reason that can be named is dysregulation of cerebral blood flow, that results in chronic cerebral hypoperfusion, which can lead to the development of vascular cognitive impairment and dementia. Detection of biological markers in the patients' blood in combination with neuropsychological testing, neurophysiological (CEP P300, EEG) and neuroimaging (CT, MRI, Doppler Ultrasound of the head and neck) methods, which confirms the morphological substrate of vascular disease (leukoareosis, focal changes, multi-infarct condition, cerebral atrophy) and provides the possibility of choosing an effective pathogenetically-justified treatment. Conclusions. The rating of effectiveness of treatment in CCI is complicated considering difficulties in the selection of the efficiency criteria due to the significant differences in the methodology and research formats, as well as problem of a significant medication-related burden in the case of comorbidities. In this regard, the main direction in therapy is combined neuroprotection, which allows to optimize the possibilities of this strategy and to increase its clinical significance in angioneurology.

Cerebrovascular diseases are among the most frequent nosological forms of modern neurology. One of the most important components of their clinical picture is cognitive impairment. At the same time, the most frequent is the development of mild and moderate cognitive disorders. This is especially true for the initial stages of the disease. The pathogenetic basis of the violation of higher cortical functions is a complex of pathophysiological and pathochemical reactions formed within the cascade of ischemic damage to the brain substance. One of the central places among them is occupied by the development of energy deficiency due to a decrease in ATP synthesis and the formation of oxidative stress. This makes it necessary to prescribe pharmacological drugs that can have a multimodal effect. Among such drugs, idebenone is distinguished, which can stimulate the mitochondrial respiratory chain and, in addition, exhibits antioxidant properties. which has demonstrated its effectiveness in the treatment of pre-segment cognitive impairment in patients with cerebrovascular pathology, especially in the framework of combined administration with drugs having other mechanisms of action.

Background: Mounting evidence has demonstrated the associations between gut microbiota, gut microbiota-derived metabolites, and cerebrovascular diseases (CVDs). The major categories of CVD are ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). However, the causal relationship is still unclear. Methods: A two-sample Mendelian randomization (MR) study was conducted leveraging the summary data from genome-wide association studies. The inverse variance-weighted, maximum likelihood, weighted median, and MR.RAPS methods were performed to detect the causal relationship. Several sensitivity analyses were carried out to evaluate potential horizontal pleiotropy and heterogeneity. Finally, reverse MR analysis was conducted to examine the likelihood of reverse causality, and multivariable MR was performed to adjust the potential confounders. Results: We collected 1,505 host single nucleotide polymorphisms (SNPs) linked to 119 gut microbiota traits and 1,873 host SNPs associated with 81 gut metabolite traits as exposure data. Among these, three gut bacteria indicated an elevated risk of IS, two of ICH, and one of SAH. In contrast, five gut bacteria were associated with a reduced risk of IS, one with ICH, and one with SAH. Our study also demonstrated the potential causal associations between 11 gut microbiota-derived metabolites and CVD. Conclusions: This study provided evidence of the causal relationship between gut microbiota, gut microbiota-derived metabolites, and CVD, thereby offering novel perspectives on gut biomarkers and targeted prevention and treatment for CVD. [ABSTRACT FROM AUTHOR]

Single-cell ribonucleic acid sequencing (scRNA-seq) has emerged as a transformative technology in neurological and neurosurgical research, revolutionising our comprehension of complex neurological disorders. In brain tumours, scRNA-seq has provided valuable insights into cancer heterogeneity, the tumour microenvironment, treatment resistance, and invasion patterns. It has also elucidated the brain tri-lineage cancer hierarchy and addressed limitations of current models. Neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis have been molecularly subtyped, dysregulated pathways have been identified, and potential therapeutic targets have been revealed using scRNA-seq. In epilepsy, scRNA-seq has explored the cellular and molecular heterogeneity underlying the condition, uncovering unique glial subpopulations and dysregulation of the immune system. ScRNA-seq has characterised distinct cellular constituents and responses to spinal cord injury in spinal cord diseases, as well as provided molecular signatures of various cell types and identified interactions involved in vascular remodelling. Furthermore, scRNA-seq has shed light on the molecular complexities of cerebrovascular diseases, such as stroke, providing insights into specific genes, cell-specific expression patterns, and potential therapeutic interventions. This review highlights the potential of scRNA-seq in guiding precision medicine approaches, identifying clinical biomarkers, and facilitating therapeutic discovery. However, challenges related to data analysis, standardisation, sample acquisition, scalability, and cost-effectiveness need to be addressed. Despite these challenges, scRNA-seq has the potential to transform clinical practice in neurological and neurosurgical research by providing personalised insights and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Cerebrovascular dysfunction and diseases are major causes of mortality, morbidity, and poor quality of patient life. Despite the enormous socioeconomic burden imposed by these conditions, therapeutic options remain scarce. However, rigorous preclinical and clinical research has augmented our mechanistic understanding of cerebrovascular diseases and underlying pathophysiological processes, and there is some optimism that novel therapeutic strategies may be developed in the next decade. This special collection comprises preclinical and clinical studies from investigators who presented their work at the Brain & BrainPET 2022 conference. It highlights recent research on cerebrovascular disease mechanisms, diagnosis, and treatments. A focus is set on cerebroprotective strategies during acute and chronic cerebral ischemia and predicting stroke risk and unfavorable outcomes. The special collection also sheds light on emerging novel treatment targets and management strategies in the pursuit of better clinical outcomes for patients with cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

Cardiovascular and cerebrovascular diseases (CCVDs) are two major vasculature‐related diseases that seriously affect public health worldwide, which can cause serious death and disability. Lack of targeting effect of the traditional CCVD treatment drugs may damage other tissues and organs, thus more specific methods are needed to solve this dilemma. Micro/nanomotors are new materials that can convert external energy into driving force for autonomous movement, which can not only enhance the penetration depth and retention rates, but also increase the contact areas with the lesion sites (such as thrombus and inflammation sites of blood vessels). Physical field‐regulated micro/nanomotors using the physical energy sources with deep tissue penetration and controllable performance, such as magnetic field, light, and ultrasound, etc. are considered as the emerging patient‐friendly and effective therapeutic tools to overcome the limitations of conventional CCVD treatments. Recent efforts have suggested that physical field‐regulated micro/nanomotors on CCVD treatments could simultaneously provide efficient therapeutic effect and intelligent control. In this review, various physical field‐driven micro/nanomotors are mainly introduced and their latest advances for CCVDs are highlighted. Last, the remaining challenges and future perspectives regarding the physical field‐regulated micro/nanomotors for CCVD treatments are discussed and outlined. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility of 0.2-mm isotropic lenticulostriate arteries (LSAs) imaging using compressed sensing time-of-flight (CS TOF) at around 10 min on 7T, and compare the delineation and characterization of LSAs using conventional TOF and CS TOF. Methods : Thirty healthy volunteers were examined with CS TOF and conventional TOF at 7T for around 10 min each. CS TOF was optimized to achieve 0.2-mm isotropic LSA imaging. The numbers of LSA stems and branches were counted and compared on a vascular skeleton. The length and distance were measured and compared on the most prominent branch in each hemisphere. Another patient with intracranial artery stenosis was studied to compare LSA delineation in CS TOF and digital subtraction angiography (DSA). Results: The number of stems visualized with CS TOF was significantly higher than with conventional TOF in both left (p = 0.002, ICC = 0.884) and right (p < 0.001, ICC = 0.938) hemispheres. The number of branches visualized by conventional TOF was significantly lower than that by CS TOF in both left (p < 0.001, ICC = 0.893) and right (p < 0.001, ICC = 0.896) hemispheres. The lengths were statistically higher in CS TOF than in conventional TOF (left: p < 0.001, ICC = 0.868; right: p < 0.001, ICC = 0.876). Conclusions: The high-resolution CS TOF improves the delineation and characterization of LSAs over conventional TOF. High-resolution LSA imaging using CS TOF can be a promising tool for clinical research and applications in patients with neurologic diseases. Key Points: • 0.2-mm isotropic LSA imaging for around 10 min using CS TOF at 7T is feasible. • More stems and branches of LSAs with longer lengths can be delineated with CS TOF than with conventional TOF at the same scan time. • High-resolution CS TOF can be a promising tool for research and applications on LSA. [ABSTRACT FROM AUTHOR]

Background: Surgical management is one of the mainstay management options for cerebrovascular diseases, which is not only curative but also preventive. However, there's a gap between the surgical management of cerebrovascular disease in Africa when compared to the developed parts of the world. Methods: A literature search was done on the state of Cerebrovascular surgery in Africa from databases such as Pubmed, Embase, and Google Scholar, articles we fetched and meticulously reviewed. Results: We found gaps in the surgical management of cerebrovascular diseases such as stroke in African countries when compared to developed countries. The challenges facing the surgical management of cerebrovascular disease in Africa include a low number of neurosurgeons and vascular surgeons trained in the surgical management of these diseases, a lack of adequate facilities for surgical management, and others. The burden of cerebrovascular diseases in Africa is great, and this warrants an improvement in the surgical management of the conditions, which includes primary prevention of such diseases through public health education on risk factors, improvement of health facilities to accommodate recent advances in the cerebrovascular surgeries, establishments of several neurosurgery training centers. Conclusion: The practice of surgical management of cerebrovascular disease in Africa needs to be optimized for it to be at the global standard and for better outcomes and management of patients. [ABSTRACT FROM AUTHOR]

Objective: To elucidate whether occupational noise exposure increases the mortality from ischemic heart disease (IHD) and stroke, and if exposure to paper dust modified the risks. Methods: We studied 6686 workers from soft paper mills, with occupational noise exposure, < 85 dBA, 85–90 dBA and > 90 dBA, and high (> 5 mg/m3) exposure to paper dust. Person-years 1960–2019 were stratified according to gender, age, and calendar-year. Expected numbers of deaths were calculated using the Swedish population as the reference and standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were assessed. Results: SMR for IHD was 1.12 (95% CI 0.88–1.41) for noise < 85 dBA, 1.18 (95% CI 0.90–1.55) for 85–90 dBA, and 1.27 (95% CI 1.10–1.47) among workers exposed > 90 dBA. Joint exposure to high noise exposure and high exposure to paper dust resulted in slightly higher IHD mortality (SMR 1.39, 95% CI 1.15–1.67). SMR for ischemic stroke was 0.90 (95% CI 0.37–2.15) for noise < 85 dBA, 1.08 (95% CI 0.45–2.59) for 85–90 dBA, and 1.48 (95% CI 0.99–2.00) among workers exposed > 90 dBA. High noise exposure and high exposure to paper dust resulted in higher ischemic stroke mortality (SMR 1.83, 95% CI 1.12–2.98). Conclusion: Noise levels > 90 dBA was associated with increased IHD mortality. Combined exposures of noise and paper dust may further increase the risks. Our results do not provide support for a causal relationship for ischemic stroke. Residual confounding from smoking has to be considered. Workers need to be protected from occupational noise levels exceeding 90 dBA. [ABSTRACT FROM AUTHOR]