SATURN MRI: study protocol for the statin use in intracerebral hemorrhage patients MRI ancillary study.

Background: The benefit-risk of statins in patients with lobar intracerebral hemorrhage (ICH) is under investigation in the StATins Use in intRacerebral hemorrhage patieNts (SATURN) trial. The relationship between statin use in ICH survivors, MRI markers of cerebral small vessel disease (CSVD), and outcomes such as recurrent ICH or major adverse cardiovascular or cerebrovascular events (MACCE) is unclear. The ancillary study, SATURN-MRI, intends to evaluate the interrelationship between statin use, the progression of MRI markers of CSVD, and cognitive and functional outcomes.

The World Stroke Organization Future Leaders Programme: Building Leadership Capacity in Global Stroke Care.

Background: Leadership development is essential to advancing stroke care globally. The World Stroke Organisation (WSO) Future Stroke Leaders Programme (FSLP) was established to identify and support global early-career professionals in stroke care worldwide. The program offers structured leadership training, mentorship, and seed funding for implementation projects.

Prevalent Cardiovascular Disease and Atrial Fibrillation in Relation to Cerebral Small Vessel Disease Burden.

Background/objectives: Cardiovascular disease (CVD) contributes to stroke and dementia. Individuals with CVD have high risk for adverse cognitive outcomes and stroke, possibly due to shared risk factors between CVD, stroke, and dementia, which may be attributed to cerebral small vessel disease (CSVD). We aim to determine the association between prevalent CVD and atrial fibrillation (AF) with CSVD.

Evolution of Perihematomal Edema Mean Hounsfield Unit and Its Association with Clinical Outcome in Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial.

Background: Lower mean Hounsfield unit (mHU) values, indicating greater computed tomography (CT) hypodensity of perihematomal edema (PHE), have been proposed as a novel quantitative imaging marker in intracerebral hemorrhage (ICH). We explored its evolution and prognostic importance in a post hoc analysis of the Intracerebral Hemorrhage-Deferoxamine trial (NCT02175225).

Methods: We included participants with primary supratentorial ICH who had available CT scans at baseline and follow-up after 72-96 h and 90-days and/or 180-days outcome data.

Minimally invasive evacuation for intracerebral hemorrhage: current practice and perspectives after ENRICH.

Background: The results of the Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) trial have renewed interest in minimally invasive hematoma evacuation (MIE) as a treatment option for intracerebral hemorrhage (ICH). However, variability persists in the surgical management of ICH among clinicians, and the impact of ENRICH on current practice is unclear. We conducted a survey to better understand current practices and perspectives on MIE for ICH.

Long-Term Incidence of Dementia Following Transient Ischemic Attack: A Longitudinal Cohort Study.

Background: The association between transient ischemic attack (TIA) and dementia is incompletely characterized. Determining the cognitive sequalae of TIA is important as it can function as an early warning sign or additional risk factor for dementia. We sought to determine the long-term incidence of post-TIA dementia and examined whether TIA prompts changes in vascular risk factors.

Deep Learning-Based Automated Detection of the Middle Cerebral Artery in Transcranial Doppler Ultrasound Examinations.

Objective: Transcranial Doppler (TCD) ultrasound has significant clinical value for assessing cerebral hemodynamics, but its reliance on operator expertise limits broader clinical adoption. In this work, we present a lightweight real-time deep learning-based approach capable of automatically identifying the middle cerebral artery (MCA) in TCD Color Doppler images.

Methods: Two state-of-the-art object detection models, YOLOv10 and Real-Time Detection Transformers (RT-DETR), were investigated for automated MCA detection in real-time.

Early neurological improvement with deferoxamine after intracerebral hemorrhage: A post hoc analysis of the i-DEF trial.

Background: Little is known about early major neurological improvement (EMNI) after intracerebral hemorrhage (ICH).

Aims: We performed a post hoc analysis of the Intracerebral Hemorrhage-Deferoxamine trial (i-DEF; NCT02175225) to comprehensively evaluate EMNI and assess whether deferoxamine treatment affects it.

Methods: Comparing repeated assessments of National Institutes of Health Stroke Scale (NIHSS) on days 2, 3, 4, and 7 (or discharge, if it was earlier) versus NIHSS score at presentation, and defining EMNI as an NIHSS score decrement of an absolute ⩾4 points from presentation, we determined its presence or absence on day 2, day 3, day 4, and day 7(/discharge).

Hemoglobin and Perihematomal Edema After Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial.

Background: Anemia is common after intracerebral hemorrhage (ICH). It has been attributed to inflammation and is associated with poor outcomes. We investigated whether this could be related to the effects of hemoglobin (Hb) on perihematomal edema (PHE).

Gestational Diabetes and Risk of Stroke Among US Black Women.

Background: There is a paucity of evidence on whether gestational diabetes (GDM) is a risk factor for cerebral vascular disease for Black women and lack of data on incident stroke as end point.

Methods: We conducted a large prospective cohort study of Black women across the United States and assessed the association between self-reported history of GDM and incident stroke. The study began when participants became parous or enrolled in 1995.

Long-Term Risk of Stroke After Transient Ischemic Attack or Minor Stroke: A Systematic Review and Meta-Analysis.

Importance: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke is not well-known.

Objective: To determine the annual incidence rates and cumulative incidences of stroke up to 10 years after TIA or minor stroke.

Data Sources: MEDLINE, Embase, and Web of Science were searched from inception through June 26, 2024.

Trends in Ischemic Stroke Hospitalization and Outcomes in the United States Pre- and Peri-COVID-19 Pandemic: A National Inpatient Sample Study.

The COVID-19 pandemic impacted healthcare systems globally, disrupting the management and treatment of acute ischemic stroke (AIS). Understanding how AIS admissions, treatments, and outcomes were affected is critical for improving stroke care in future crises. The objective of this work was to assess the COVID-19 pandemic's impact on AIS admissions, treatment patterns, complications, and patient outcomes in the U.

Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?

Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the "less traditional" designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging.

Global challenges in the access of endovascular treatment for acute ischemic stroke (global MT access).

Background: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

Aim: Our aim was to determine the key challenges for MT implementation and access worldwide.

Methods: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network and as invited by co-authors between December 2022 and March 2023.

Association of Anticoagulant Use With Hemorrhage Location and Etiology in Incident Spontaneous Intracerebral Hemorrhage.

Background: It is unknown whether hypertensive microangiopathy or cerebral amyloid angiopathy (CAA) predisposes more to anticoagulant-associated intracerebral hemorrhage (AA-ICH). The purpose of our study was to determine whether AA-ICH is associated with lobar location and probable CAA.

Methods: This was a cross-sectional analysis of patients with first-ever spontaneous ICH admitted to a tertiary hospital in Boston, between 2008 and 2023.

Clinical Characteristics, Functional Outcome, and Socioeconomic Impact of Ischemic Stroke among Young Egyptian Adults.

Background: Stroke in young patients results in disproportionately high societal cost given the productive life-years lost. Little is known about stroke in young Egyptian patients. We aimed to analyze clinicodemographic characteristics, functional outcome, and socioeconomic impact of ischemic stroke among young Egyptian adults.

Cognitive Outcome after Acute Spontaneous Intracerebral Hemorrhage: Analysis of the iDEF Randomized Trial.

Introduction: The impact of intracerebral hemorrhage (ICH) on cognition and the determinants of cognitive recovery early after ICH remain elusive. In this post hoc analysis of the intracerebral hemorrhage deferoxamine (iDEF) trial, we examined the trajectories of cognitive impairment and the determinants of early cognitive recovery after ICH.

Methods: We examined baseline factors associated with a 90-day cognitive outcome and constructed generalized linear mixed models to examine the trajectory of cognitive function over time among iDEF participants.

Rationale and Design of the Statin Use in Intracerebral Hemorrhage Patients (SATURN) Trial.

Introduction: The benefits and risks of HMG-CoA reductase inhibitor (statin) drugs in survivors of intracerebral hemorrhage (ICH) are unclear. Observational studies suggest an association between statin use and increased risk of lobar ICH, particularly in patients with apolipoprotein-E (APOE) ε2 and ε4 genotypes. There are no randomized controlled trials addressing the effects of statins after ICH leading to uncertainty as to whether statins should be used in patients with lobar ICH who are at high risk for ICH recurrence.

The role of hyperglycemia in the outcome of intracerebral hemorrhage: A causative analysis.

Background: Hyperglycemia in the acute phase of intracerebral hemorrhage (ICH) has been associated with poor functional outcomes, however all interventions to lower glucose have yielded neutral or negative results. We attempt an explanation of the causal role of hyperglycemia in ΙCH outcome using generalized structural equation modeling.

Materials And Methods: Consecutive primary ICH patients admitted to an academic hospital between 2007 and 2018 were identified.

Hypertensive Disorders of Pregnancy and Risk of Stroke in U.S. Black Women.

BACKGROUND: Black women have a disproportionately higher burden of both preeclamptic pregnancy and stroke compared with White women, but virtually all existing evidence on this possible association has been generated from women of European ancestry. METHODS: In the Black Women’s Health Study, a prospective cohort of U.S.

Perceived Interpersonal Racism and Incident Stroke Among US Black Women.

Importance: Black individuals in the US experience stroke and stroke-related mortality at younger ages and more frequently than other racial groups. Studies examining the prospective association of interpersonal racism with stroke are lacking.

Objective: To examine the association of perceived interpersonal racism with incident stroke among US Black women.

Hypertension Trends and White Matter Brain Injury in the Offspring Framingham Heart Study Cohort.

Background: Hypertension is the most potent stroke risk factor and is also related to cerebral small vessel disease. We studied the relation between mid-to-late-life hypertension trends and cerebral white matter injury in community-dwelling individuals from the FHS (Framingham Heart Study).

Methods: FHS Offspring cohort participants with available mid-life and late-life blood pressure measurements and brain magnetic resonance imaging were included.