Deep-Dive
GOLDEN BRIDGE II — Clinical Decision Support for Acute Ischaemic Stroke
GOLDEN BRIDGE II: a stroke CDSS improved care processes and reduced 3-month vascular events across 77 Chinese hospitals.
Short-term Risk of Recurrent Stroke in Symptomatic Carotid Near-Occlusion
Full-collapse near-occlusion marked higher 48-hour recurrence risk; pooled observational data do not prove revascularisation benefit.
Remote ischaemic conditioning in patients with supratentorial intracerebral haemorrhage (RICH-2): a multicentre, randomised, sham-controlled phase 3 trial in China
This sham-controlled phase 3 trial found no functional benefit from seven days of remote ischaemic conditioning in selected non-surgical supratentorial ICH, despite a radiographic haematoma-clearance signal.
Post-transfer reassessment for endovascular treatment: factors associated with changes in EVT eligibility
A single-network cohort links neurologic change and baseline imaging to interval recanalization or infarct progression after EVT transfer; prospective validation is needed before selective pathways are used.
Scalp acupuncture coupled with speech-language therapy modulates the ventral-dorsal structural brain network in patients with post-stroke anomia: a randomized clinical and DTI neuroimaging trial
A single-center randomized trial found greater immediate naming-score improvement when scalp acupuncture was added to speech-language therapy, but the small per-protocol analysis, lack of sham control and unblinded treatment limit causal interpretation.
Oedema reduction mediates thrombectomy benefit in large core stroke: secondary analysis of the TENSION trial
A selected CT-based secondary analysis of TENSION links EVT with less 24-hour net water uptake and estimates an oedema-mediated pathway to 90-day outcome, but the mediation is hypothesis-generating.
Anticoagulation Treatment Response Among Phenotypic ESUS Clusters: Evidence From CASPR
CASPR registry analysis found no significant overall anticoagulation advantage and no treatment-effect separation by phenotypic cluster.
Phenotypic determinants of atrial fibrillation in ischaemic stroke: a retrospective study
A retrospective stroke/TIA cohort links detected AF with stroke severity and cardiac-remodelling features; phenotypes remain hypothesis-generating.
The impact of levodopa on post-stroke depression: the ESTREL-depression-study
ESTREL-Depression found no reduction in three-month depressive symptoms with early levodopa; selection and imprecision limit the conclusion.
Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial
TRUST found no improvement in 90-day excellent functional outcome with one million units of intravenous urokinase versus guideline-based medical treatment for minor ischemic stroke within six hours; substantial crossover and sparse bleeding events limit stronger conclusions.
Influence of Support Surface Stability on Changes in Quadriceps Femoris Muscle Thickness During Progressive Squat Exercise in Patients with Stroke: A Randomized Controlled Trial — Thicker is not stronger
In a small stroke rehabilitation trial, unstable-surface squats increased rectus femoris and vastus medialis thickness more than stable-surface squats, without establishing strength or functional benefit.
Effects of blood flow restriction combined with visual feedback training on lower limb function and the serum levels of BDNF and VEGF in patients with stroke
A 40-patient trial found better four-week balance and lower-limb function when blood flow restriction was added to visual feedback training, but circulating biomarkers did not establish cerebral repair.
Neuronal autoantibodies associated with poorer neuropsychological and motor outcomes 6 months after stroke: results from the PHYS-STROKE trial
An exploratory PHYS-STROKE biomarker analysis links baseline neuronal autoantibodies to selected six-month outcomes, but only the NMDAR–subjective mobility association survives correction for multiple comparisons.
Edaravone dexborneol versus placebo on functional outcomes in patients with acute ischaemic stroke undergoing endovascular thrombectomy (TASTE-2): randomised controlled trial
In selected Chinese patients with anterior-circulation large-vessel occlusion treated by thrombectomy, edaravone dexborneol produced a borderline increase in 90-day functional independence without a detected increase in serious adverse events.
Transauricular Vagus Nerve Stimulation in Acute Ischaemic Stroke Requiring Mechanical Thrombectomy: Sham-Controlled, Randomised Device Trial — a neutral primary endpoint
In a 36-person sham-controlled thrombectomy pilot, auricular vagus stimulation was feasible and showed no serious device-related harm, but did not reduce 24-hour systolic blood-pressure variability.
Soft Robotic Glove Versus GRASP in Subacute Stroke: A Dose and Selection Question
In an under-enrolled, assessor-blinded trial, a soft robotic glove was not superior to supervised GRASP for upper-limb recovery after subacute stroke; a post-hoc distal-hand signal needs confirmation.
Tenecteplase in Minor Stroke: Does Vessel Occlusion Change the Answer? — TEMPO-2 Secondary Analysis
Baseline occlusion status did not identify a minor-stroke subgroup with improved 90-day recovery after tenecteplase versus non-thrombolytic care in TEMPO-2.
Speech Therapy Combined With Cerebrolysin in Enhancing Nonfluent Aphasia Recovery After Acute Ischemic Stroke: ESCAS Randomized Pilot Study
The ESCAS pilot found a 14.805-point greater mean 90-day Western Aphasia Battery–Aphasia Quotient gain with Cerebrolysin plus speech therapy, with uncertain generalizability and functional benefit.
DWI-Positive Lesions in Patients With Acute Intracerebral Hemorrhage — Associations With Cerebral Small Vessel Disease and Clinical Outcome
Remote DWI-positive lesions occurred in 21.6% of patients with acute intracerebral hemorrhage and independently marked greater small-vessel-disease burden and worse six-month functional outcome.
Action Observation Combined With Virtual Reality Promotes Motor Recovery After Stroke: A Randomized Controlled Trial
In this 48-participant randomized trial, adding action observation to virtual-reality rehabilitation produced a larger paretic-hand dexterity gain than virtual reality alone, exceeding the study's 7-block smallest-detectable-difference benchmark at treatment end and persisting at 6 months.
TREASURE — Allogeneic Stem Cell Therapy for Acute Ischemic Stroke
A multicenter double-blind phase 2/3 RCT in Japan found that allogeneic MultiStem cell therapy within 18–36 hours of acute ischemic stroke was safe but did not improve excellent-outcome rates at 90 days versus placebo, with exploratory subgroup signals in younger patients.
Defining the Therapeutic Ceiling of Endovascular Thrombectomy in Large-Core Stroke — Beyond the Limits of ASPECTS
Quantitative infarct volumetry — not NCCT-ASPECTS — sets the true ceiling for endovascular thrombectomy in large-core stroke: benefit holds up to a DWI core of roughly 110 mL, then collapses.
Immediate- vs Delayed-Intensive Statin in Acute Cerebral Ischemia: INSPIRES
In 6100 Chinese patients with mild ischemic stroke or high-risk TIA from presumed atherosclerosis, immediate-intensive atorvastatin (within 72 hours) did not reduce 90-day stroke recurrence versus a 3-day delayed start (8.1% vs 8.4%; HR 0.95; 95% CI 0.80-1.13; P = .58), with no excess bleeding — leaving functional outcome (OR 0.83) as hypothesis-generating.
Fibrinogenase for injection in the treatment of acute ischaemic stroke: a randomised clinical trial — the Chinese snake-venom fibrinolytic that beat placebo on mRS at 90 days
In a 235-patient Chinese RCT of fibrinogenase for injection within 72 hours of AIS onset, the ordinal mRS distribution at 90 days favoured fibrinogenase over placebo (OR 2.38, 95% CI 1.49–3.85; p<0.001), with no excess bleeding or mortality.
Impact of Ultra-Early Perioperative Antihypertensive Therapy in Acute Intracerebral Hemorrhage — INTERACT3 Secondary Analysis
In INTERACT3 surgical-evacuation patients, achieving systolic BP <140 mm Hg within 2 hours was associated with lower death or disability, better mRS shift, fewer serious adverse events, and no increase in mortality.
Semaglutide Drops hsCRP 37.8% and Lowers MACE — A Prespecified SELECT Inflammation Analysis
In a prespecified substudy of the 17,604-patient SELECT trial, semaglutide reduced hsCRP by 37.8% at 104 weeks — an effect independent of weight loss — and a 25% lower baseline hsCRP tracked a 8% lower MACE risk; hsCRP lowering explains only a fraction of the 20% MACE reduction.
Tenecteplase in Large-Vessel Occlusion — Bridging, Extended-Window, and the 4.5-Hour Wall
Meta-analysis of five RCTs (n=2,054) finds IV tenecteplase improves mRS outcomes in LVO versus no thrombolysis; bridging within 4.5 h before EVT and extended-window use without EVT show benefit, but bridging 4.5–24 h does not.
Effect of Proximal Blood Flow Arrest During Endovascular Thrombectomy (ProFATE): A Multicenter, Blinded-End Point, Randomized Clinical Trial
ProFATE: temporary proximal blood flow arrest via balloon guide catheter during anterior-circulation thrombectomy did not significantly improve eTICI 2c/3 (74.4% vs 70.8%; aOR 1.07, P=0.88) but reduced distal embolization (1.5% vs 12.3%) and tripled first-pass complete recanalization (33% vs 15.3%) in 131 patients across four UK centers.
Multicenter Translational Trial of Remote Ischemic Conditioning in Acute Ischemic Stroke (TRICS BASIC)
Multicenter preclinical RCT of remote ischemic conditioning in rodent stroke models: 55% vs 36% good functional outcome at 48 hours.
A Restrictive Versus a Liberal Transfusion Strategy in Patients With Spontaneous Intracerebral Hemorrhage: A Secondary Analysis of TRAIN Randomized Clinical Trial
Secondary analysis of the TRAIN RCT: in 144 anemic ICU patients with spontaneous ICH, a liberal transfusion strategy (Hb <9 g/dL) showed a nonsignificant 13-point absolute reduction in unfavorable 180-day GOS-E versus restrictive (Hb <7 g/dL).
Intra-Arterial Tenecteplase After Successful Reperfusion in Large Vessel Occlusion Stroke
DATE: adjunctive intra-arterial tenecteplase at 0.0313 or 0.0625 mg/kg after successful reperfusion is safe to advance to a phase 3 trial, with a numerically higher but non-significant 90-day no-disability rate (43.5% vs 33.8% control).
Prior Dual Antiplatelet Therapy and Mortality After Intracerebral Hemorrhage: A Danish Nationwide Cohort Study
A Danish nationwide cohort found that patients with intracerebral hemorrhage who were receiving dual antiplatelet therapy had higher early mortality than those receiving single antiplatelet therapy, although residual confounding and unmeasured hematoma characteristics limit causal interpretation.
Associations Between Cerebral Amyloid Angiopathy, Cognitive Impairment, and Depressive Symptoms
In a cross-sectional cohort, probable cerebral amyloid angiopathy was associated with substantially more depressive symptoms and poorer cognition, but depression explained only a small fraction of the cognitive association.
The RED 43 Catheter for Aspiration Thrombectomy of Distal Medium Vessel Occlusions (DMVOs): A Multicenter Experience
The RED 43 catheter achieved first-pass effect in 57% of primary and 61% of secondary DMVOs and final reperfusion in 83% and 87%, respectively, in a 102-case retrospective series without a medical-therapy control group.
Bilateral Transcutaneous Auricular Nerve Stimulation Promotes Motor Function Recovery After Stroke: A Randomized Controlled Trial
Among 102 completers, bilateral auricular stimulation plus rehabilitation produced higher 4-week FMA and WMFT scores and higher week-12 balance and Barthel …
Personalized Blood Pressure Targeting After Endovascular Therapy for Acute Ischemic Stroke — A Randomized Clinical Trial
In the HOPE randomized trial, reperfusion-guided systolic blood-pressure targets after thrombectomy increased 90-day functional independence from 47.1% to 60.0% without increasing symptomatic intracranial hemorrhage or mortality.
Young-onset stroke in the UAE: A single-centre retrospective analysis of risk factors and outcomes
In 419 patients younger than 50 years treated at one UAE hospital, hypertension and diabetes were common, nearly half of ischemic strokes remained of undetermined cause, and in-hospital mortality was 12.68%.
Dysphagia Care Processes on Acute Stroke Wards: Barriers and Facilitators Relevant to Stroke-Associated Pneumonia
An ethnographic study of 10 acute-stroke patients shows that dysphagia plans are often only partially enacted, making communication, mealtime preparation, oral care, and reliable resources central targets for preventing stroke-associated pneumonia.
Stroke and its consequences: protocol and pilot data of the observational Berlin Long-term Observation of Vascular Events (BeLOVE) stroke stratum
In the first 758 participants of the BeLOVE stroke cohort, 2-year cumulative incidence was 10.7% for major adverse cerebrovascular and cardiovascular events, with ischemic stroke the most common component.
Global Stroke Burden, 1990–2021 — GBD 2021: 84% of Stroke DALYs Trace to 23 Risk Factors, With Hypertension Still Dominant at 56.8%
GBD 2021 stroke burden across 204 countries: age-standardised incidence -21.8%, deaths -39.4%, DALYs -38.7% (1990-2021), but absolute counts up; 84.1% of stroke DALYs attributable to 23 risk factors (metabolic 68.8%, environmental 36.7%, behavioural 35.2%).
Cerebrovascular claudin-5 isoform expression correlates with worsened stroke outcomes following thromboembolic stroke
Preclinical study in male Wistar rats showing that the 35 kDa claudin-5 (CLDN5) isoform 1, produced by a novel intra-exonic splice junction conserved in human hypoxic endothelial cells, correlates with edema, neurological deficit, and hemorrhage at 24 h after thromboembolic stroke.
Longitudinal Cognitive Trajectories After Stroke: What the Oxford Cognitive Screen Shows
A longitudinal Oxford cohort found that cognitive recovery after stroke is common but heterogeneous: acute cognitive burden was the strongest predictor of chronic impairment, while a small subgroup declined over time.
Action Observation Combined With Virtual Reality Promotes Motor Recovery After Stroke: A Randomized Controlled Trial
In adults 3 to 18 months after stroke, adding action observation to virtual-reality training improved paretic-hand dexterity more than virtual reality alone, …
Impact of Cerebral Small Vessel Disease on Functional Decline: Bleeding With Antithrombotic Therapy 2 Study
In 4,765 patients receiving oral antithrombotic therapy, severe MRI-defined cerebral small vessel disease was associated with functional decline over 24 months even after accounting for major bleeding and ischemic events.
Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage — The MIND Randomized Clinical Trial
In the MIND trial, minimally invasive surgery with the Artemis device within 72 hours did not significantly reduce 30-day mortality or improve 180-day disability in supratentorial ICH versus medical management alone.
Thrombus Migration After Tenecteplase Versus Alteplase in Acute Large Vessel Occlusion
In a matched multicenter cohort of 746 large-vessel-occlusion patients undergoing bridging therapy, tenecteplase produced nearly twice the thrombus migration of alteplase (19.3% vs 11.3%), concentrated in the first 60 minutes after IVT, and migration independently predicted functional independence.
Deep-Dive: Argatroban in Acute Ischemic Stroke With Early Neurological Deterioration — A 2023 RCT From China
Argatroban + antiplatelet in END (n=601): 90-d mRS 0–3 80.5% vs 73.3% (aRR 1.10, P=0.03); sICH 0.9% vs 0.7% (P=0.78); mRS shift OR 0.71 (P=0.02).
Deep-Dive: Predictors of Hematoma Expansion and Response to Andexanet — ANNEXA-I Secondary Analyses
ANNEXA-I secondary analyses: andexanet benefit amplifies in highest-risk HE quartiles (NNT ~4) without amplifying thrombotic-event risk; authors propose an 11-to-1 rule.
Deep-Dive: Argatroban Plus DAPT in Branch Atherosclerosis Disease — Halves END
Argatroban+DAPT vs DAPT alone in high-risk branch atherosclerosis disease (n=100): END 20.4% vs 47.1% (P=0.006), mRS 0–1 87.8% vs 68.6% (P=0.025), no excess bleeding.
Deep-Dive: JX10 — A Late-Window Anti-Inflammatory Thrombolytic Hits Phase 2a Safety Mark
JX10 phase 2a (n=90) — late-window (5–12h) thrombolytic met its primary safety endpoint (0% sICH vs 2.6% placebo) and showed a day-90 mRS 0–1 signal (40.4% vs 18.4%, P=0.03).
Deep-Dive: ANNEXA-I Biomarker Substudy — Andexanet's Therapeutic Window Is 1 Hour, and It Cuts Both Ways
ANNEXA-I biomarker substudy: 1-hour reduction in anti-FXa (OR 0.69/100 ng/mL) and rise in ETP (OR 0.94/100 nmol/L-min) both predict fewer hematoma expansions; the ETP rise also independently predicts more thrombotic events (OR 1.08).
Deep-Dive: Perforator Territory Infarction Doubles 90-Day Disability Odds After LVO Thrombectomy
Post-hoc analysis of MR CLEAN-MED + MR CLEAN-NO IV: perforator-territory infarcts after LVO thrombectomy (n=397) triple the odds of worse 90-day mRS without affecting 24-h NIHSS.
Deep-Dive: MR CLEAN M2 Registry — Bridging Therapy Edges Out Direct EVT for M2 Occlusions
MR CLEAN Registry M2 analysis (n=539): bridging IV thrombolysis before EVT improves 90-day mRS vs direct EVT (aOR 1.52, P=0.03); sICH and recanalization similar.
OPTIMAS — Early vs. Delayed DOAC After Ischemic Stroke, by AF Subtype and Time of Diagnosis
OPTIMAS subgroup analysis: in 3,619 stroke patients with AF, neither the time of AF diagnosis nor AF subtype modifies the effect of early DOAC initiation versus delayed initiation.
Deep-Dive: ETLAS-2 — Tadalafil for CSVD Fails Feasibility, but the Imaging Signal Hints at a Better Trial
ETLAS-2 phase II: tadalafil 20 mg daily for 3 months in CSVD fails feasibility (compliance 68% vs 94% placebo) with 2-fold more AEs; per-protocol WMH volume trend suggests mechanistic signal at lower doses.
Deep-Dive: ZODIAC — Laying LVO Patients Flat Before Thrombectomy Cuts Pre-Procedure Deterioration 26-Fold
ZODIAC phase III RCT (n=92, stopped early for efficacy): 0° vs 30° head-of-bed positioning before thrombectomy — END HR 34.40 (95% CI 4.65–254.37), P<0.001; exploratory mortality P=0.03.
Deep-Dive: T-FLAVOR — Tenecteplase 0.25 mg/kg vs Low-Dose Alteplase in LVO Stroke
T-FLAVOR Japanese phase 2 (n=218): tenecteplase vs low-dose alteplase for LVO bridging — substantial reperfusion 10.3% vs 3.6% (90% CI 0.89–12.1; 95% CI −0.19% to 13.2%; mRS shift favors TNK numerically).
Deep-Dive: LAMP Post-Hoc — Liraglutide Cuts Recurrent Stroke in Insulin-Resistant Patients
LAMP post-hoc: liraglutide reduced recurrent stroke in insulin-resistant T2D stroke/TIA patients (HOMA-IR ≥ 2.5) but not in those with preserved insulin sensitivity.
Deep-Dive: Home-Based HIIT for Poststroke Fatigue — First RCT, Small N, Real Signal
First RCT of home-based HIIT for poststroke fatigue: 8-week intervention cut S-FAS by 5.35 points and improved VO2peak by 4.48 mL/kg/min in 43 completers.
Deep-Dive: ACTISAVE — Glenzocimab Fails to Beat Placebo on Top of tPA ± EVT
ACTISAVE failed to confirm a beneficial effect of glenzocimab on mRS in patients with acute ischemic stroke treated by thrombolysis ± thrombectomy.