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Mahawish et al examine ethnic differences in intracerebral haemorrhage (ICH) incidence in Auckland, New Zealand using data from three Auckland Regional Community Stroke (ARCOS) cohorts (2002-2021). A total of 717 first-ever ICH cases were identified. Pacific peoples consistently had the highest incidence, with about 60% greater risk than Europeans. Maori and Asian/Other groups showed lower incidence compared with Europeans, although Maori findings should be interpreted cautiously due to small sample sizes and methodological limitations. Importantly, these ethnic disparities remained stable over time. Clinical characteristics changed modestly: diabetes prevalence increased, while age and other risk factors remained similar. Mortality at 28 days and 1 year declined, likely reflecting improvements in stroke care. The study highlights persistent ethnic inequities in ICH burden, particularly among Pacific communities. However, interpretation of trends is limited by improved diagnostic accuracy over time and lack of age-standardization. The findings emphasize the need for targeted prevention and consideration of ethnic variation in stroke risk in clinical practice.

aim: The predictive risk model CHA2DS2 VASc helps clinicians assess the risk of stroke in patients with atrial fibrillation (AF). Originally developed and validated in predominantly European populations, it may not accurately reflect the stroke risk for diverse ethnic groups; in Aotearoa New Zealand, Māori and Pacific peoples with AF are at higher stroke risk. As part of global efforts to address health inequities, there is growing interest in adapting predictive models to suit local- and ethnic-specific risks better. Our objectives were to determine: 1) if stroke risk from AF varies by ethnic background/race, 2) stroke rates in non-anticoagulated AF cohorts, and 3) model performance of CHA2DS2 VASc across different geographical regions. Finally, we provide an overview of methodological considerations for risk model development. methods: We searched English language peer-reviewed studies reporting stroke rates in unselected cohorts with AF, published between 1995 and 2024. For stroke risk, we included cohorts with over 5,000 non-anticoagulated patients. The sources of evidence were PubMed, Scopus and EMBASE. results: Twenty-seven studies were eligible for inclusion. We found significantly elevated stroke risk in African Americans and Hispanics with AF compared with whites (odds ratio [OR] 1.44 [95% confidence interval (CI) 1.25–1.66] and OR 1.11 [95% CI 1.05–1.18] respectively). In Māori and Pacific peoples with AF, the risk of stroke was higher than in New Zealand Europeans, but this difference was not significant (OR 1.28 [95% CI 0.89–1.82], p=0.18 and OR 1.29 [95% CI 0.93–1.52], p=0.17 respectively). Stroke risk (0.6/100–6.8/100 person-years) and CHA2DS2 VASc performance (c-statistics 0.55–0.8) varied substantially between studies. conclusion: We support the local refinement of risk prediction models in line with cardiology society recommendations.

Describes a quality improvement collaboration with a search and rescue services (SRSL) helicopter utilising the Taranaki model for stroke clot retrieval (SCR), which involves pre-hospital alert, notification to the stroke team, standardised imaging protocol and rapid image transfer, and activation of the helicopter transfer team once large vessel occlusion (LVO) is confirmed prior to acceptance by the SCR neurologist. Reports the tailored application of the Taranaki model at Te Pae Hauora o Ruahine o Tararua, MidCentral, the cohort of patients referred for SCR to date, and ongoing challenges and opportunities. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Presents the cases of two haemodynamically stable patients with vertebrobasilar stenosis and with recurrent events on intensive medical therapy who responded favourably to therapeutic anticoagulation. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Describes stroke admission trends at Palmerston North (PNH) Hospital from 2013 to 2021. Illustrates the sequence of service improvements undertaken during this period. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Aims to determine if a short stroke protocol (SSP) introduced at Palmerston North Hospital was associated with a difference in length-of-stay (LOS) or in hospital admission costs compared to standard magnetic resonance imaging (MRI) protocol for the diagnosis of ischaemic stroke. Explores any differences in the safety outcomes for 1) readmissions with a neurological diagnosis, or 2) death, in the subsequent 6 months. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Reports a successful case of thrombolysis in a patient on dabigatran reversed with idarucizumab, following a wake-up stroke, guided by computed tomography (CT) perfusion imaging. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Presents a case of a man who presented with a left hemiparesis and severe hypertension, ultimately diagnosed with hypertensive small vessel disease causing simultaneous ischaemic and haemorrhagic strokes. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Viral meningitis is increasingly recognised, but little is known about the frequency with which it occurs, or the causes and outcomes in the UK. We aimed to determine the incidence, causes, and sequelae in UK adults to improve the management of patients and assist in health service planning. We did a multicentre prospective observational cohort study of adults with suspected meningitis at 42 hospitals across England. Nested within this study, in the National Health Service (NHS) northwest region (now part of NHS England North), was an epidemiological study. Patients were eligible if they were aged 16 years or older, had clinically suspected meningitis, and either underwent a lumbar puncture or, if lumbar puncture was contraindicated, had clinically suspected meningitis and an appropriate pathogen identified either in blood culture or on blood PCR. Individuals with ventricular devices were excluded. We calculated the incidence of viral meningitis using data from patients from the northwest region only and used these data to estimate the population-standardised number of cases in the UK. Patients self-reported quality-of-life and neuropsychological outcomes, using the EuroQol EQ-5D-3L, the 36-Item Short Form Health Survey (SF-36), and the Aldenkamp and Baker neuropsychological assessment schedule, for 1 year after admission. 1126 patients were enrolled between Sept 30, 2011, and Sept 30, 2014. 638 (57%) patients had meningitis: 231 (36%) cases were viral, 99 (16%) were bacterial, and 267 (42%) had an unknown cause. 41 (6%) cases had other causes. The estimated annual incidence of viral meningitis was 2·73 per 100 000 and that of bacterial meningitis was 1·24 per 100 000. The median length of hospital stay for patients with viral meningitis was 4 days (IQR 3–7), increasing to 9 days (6–12) in those treated with antivirals. Earlier lumbar puncture resulted in more patients having a specific cause identified than did those who had a delayed lumbar puncture. Compared with the age-matched UK population, patients with viral meningitis had a mean loss of 0·2 quality-adjusted life-years (SD 0·04) in that first year. Viruses are the most commonly identified cause of meningitis in UK adults, and lead to substantial long-term morbidity. Delays in getting a lumbar puncture and unnecessary treatment with antivirals were associated with longer hospital stays. Rapid diagnostics and rationalising treatments might reduce the burden of meningitis on health services. Meningitis Research Foundation and UK National Institute for Health Research.

Aims to identify the factors that lead to time delays in seeking help when stroke or transient ischaemic attack (TIA) symptoms arise. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.