Explore the vast range of titles available.

Calcitonin gene-related peptide (CGRP)-targeted monoclonal antibodies (CGRP-mAbs) effectively prevent migraine, but treatment interruption often leads to symptom recurrence. We evaluated the onset and magnitude of response after restarting CGRP-mAbs following an insurer-mandated cessation after one year of use. In this single-center retrospective cohort study, we analyzed 42 patients who restarted the same CGRP-mAb after a median pause of 140 days. The main outcomes were change in monthly migraine days (MMD) versus baseline (pre-treatment) and time to achieve a 50% reduction in MMD. Across months 1-12, reductions in MMD during the second treatment year were comparable to those during the first year (no statistically significant year-by-month differences). Mean time to achieve a 50% reduction in MMD was also comparable in both years (1.84 months in year 2 vs 2.20 months in year 1; P=0.41). In this exploratory cohort, restarting the same CGRP-mAb after an insurer-mandated pause was associated with a comparable reduction in MMD and comparable time to response as during the first treatment year.

Stem cells, renowned for their unique regenerative capabilities, present significant hope in treating stroke, a major cause of disability globally. This review offers a detailed analysis of stem cell applications in stroke (ischemic and hemorrhagic) recovery. It examines therapies based on autologous (patient-derived), allogeneic (donor-derived), and Granulocyte-Colony Stimulating Factor (G-CSF) based stem cells, focusing on cell types such as Mesenchymal Stem/Stromal Cells (MSCs), Bone Marrow Mononuclear Stem Cells (BMMSCs), and Neural Stem/Progenitor Cells (NSCs). The paper compiles clinical trial data to evaluate their effectiveness and safety and addresses the ethical concerns of these innovative treatments. By explaining the mechanisms of stem cell-induced neurological repair, this review underscores stem cells' potential in revolutionizing stroke rehabilitation and suggests avenues for future research.

The global deployment of SARS-CoV-2 vaccines has been pivotal in curbing the COVID-19 pandemic, reducing morbidity and mortality associated with the virus. While most of these vaccines have demonstrated high efficacy and overall safety, emerging reports have highlighted potential neurovascular adverse effects, albeit uncommon, associated with these vaccinations. This review aims to assess and summarize the current knowledge on the neurovascular complications arising post-SARS-CoV-2 vaccination. We conducted an extensive literature review, focusing on clinical studies and case reports to identify reported neurovascular events, such as ischemic stroke, cerebral sinus venous thrombosis, intracerebral hemorrhage, pituitary apoplexy and primary CNS angiitis Despite the relative rarity of these events, their impact on affected individuals underscores the importance of ongoing surveillance, early detection, and management strategies. We aim to provide healthcare professionals with the latest evidence on neurovascular adverse effects, facilitating informed decision-making in the context of SARS-CoV-2 vaccination programs. Furthermore, we highlight areas requiring further research to understand the pathophysiology of these adverse events better and to develop targeted prevention and treatment strategies.

Purpose Internal carotid artery dissection (ICA-D) frequently leads to ischemic stroke in individuals under 50 years. There is mounting evidence on the role of the styloid process (SP) in ICA-D, particularly SP length and the SP–ICA distance. Despite having clear guidelines on the treatment of SP-related Eagle syndrome and ICA-D, the concept of SP-related ICA-D is relatively new and no therapeutic guidelines exist. Methods A narrative literature search was performed to identify all articles pertaining to the diagnosis and treatment of ICA-D linked to an ipsilateral elongated SP or short SP-ICA distance. The treatments were evaluated in terms of symptom recurrence after the treatment. As illustrative examples of clinical management, we present an in-house case series of patients with suspected ICA-D related to SP. Results Treatment efficacy was assessed, with an in-house case series provided. Seventy-five reports and case studies involving 84 patients were analyzed. Conservative treatments were common (52%) but had a high symptom recurrence rate (33%). It is noteworthy that no patients treated initially with styloidectomy exhibited symptom recurrence. Conclusion In case of a correctly diagnosed SP-related ICA-D, a styloidectomy may offer a curative option, but more research is needed for clear indications and standardized guidelines to prevent recurrent symptoms or strokes.

Background: Calcitonin gene-related peptide (CGRP)-targeted monoclonal antibodies (CGRP-mAbs) effectively prevent migraine, but treatment interruption often leads to symptom recurrence. We evaluated the onset and magnitude of response after restarting CGRP-mAbs following an insurer-mandated cessation after one year of use. Methods: In this single-center retrospective cohort study, we analyzed 42 patients who restarted the same CGRP-mAb after a median pause of 140 days. The main outcomes were change in monthly migraine days (MMD) versus baseline (pre-treatment) and time to achieve a 50% reduction in MMD. Results: Across months 1-12, reductions in MMD during the second treatment year were comparable to those during the first year (no statistically significant year-by-month differences). Mean time to achieve a 50% reduction in MMD was also comparable in both years (1.84 months in year 2 vs 2.20 months in year 1; P=0.41). Conclusion: In this exploratory cohort, restarting the same CGRP-mAb after an insurer-mandated pause was associated with a comparable reduction in MMD and comparable time to response as during the first treatment year. Keywords: migraine, calcitonin gene-related peptide, monoclonal antibodies, monthly migraine days, treatment interruption, retreatment

•Myxoma histology in brain biopsy can be obscured by inflammatory changes.•Elevated CRP might indicate cardiac myxoma, but not subsequent cerebral manifestations.•Low-dose fractionated whole brain radiotherapy may be helpful for myxoma-related cerebral tumors and aneurysms. Cardiac myxoma can embolize and cause early and delayed sequelae including stroke, growth into intracranial fusiform aneurysms and cerebral tumors with risk of hemorrhage and mass effect. Here, we report the rare coincidence of all these manifestations in a 63-year-old man who presented with cognitive and behavioral changes, and seizures 9 months after an embolic stroke from the heart tumor. C-reactive protein (CRP) was elevated at the time of stroke and cardiac myxoma diagnosis but was normal at late neurologic manifestation with isolated myxoma-related intracranial tumors and aneurysms. Low-dose whole-brain radiotherapy can be helpful to diminish cerebral myxoma tumors and fusiform aneurysms despite reported increased risk of aneurysm rupture.

BackgroundPatients with chronic kidney disease are at increased risk of stroke and frequently have cerebral microbleeds. Whether such patients also encounter an increased risk of recurrent stroke has not been firmly established. We aimed to determine whether impaired kidney function is associated with the risk of recurrent stroke, and microbleed presence, distribution and severity.MethodsWe used pooled data from the Microbleeds International Collaborate Network to investigate associations of impaired kidney function, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Our primary outcome was a composite of recurrent ischaemic stroke (IS) and intracranial haemorrhage (ICrH). Secondary outcomes included: (1) individual components of the primary outcome; (2) modification of the primary outcome by microbleed presence or anticoagulant use and (3) microbleed presence, distribution and severity.Results11 175 patients (mean age 70.7±12.6, 42% female) were included, of which 2815 (25.2%) had impaired kidney function. Compared with eGFR ≥60, eGFR <60 was associated with a higher risk of the primary outcome (adjusted HR, aHR 1.33 (95% CI 1.14 to 1.56), p<0.001) and higher rates of the recurrent IS (aHR 1.33 (95% CI 1.12 to 1.58)). Reduced eGFR was not associated with ICrH risk (aHR 1.07 (95% CI 0.70 to 1.60)). eGFR was also associated with microbleed presence (adjusted OR, aOR 1.14 (95% CI 1.03 to 1.26)) and severity (aOR 1.17 (95% CI 1.06 to 1.29)). Compared with having no microbleeds, eGFR was lower in those with strictly lobar microbleeds (adjusted mean difference (aMD) −2.10 mL/min/1.73 cm2 (95% CI −3.39 to −0.81)) and mixed microbleeds (aMD −2.42 (95% CI −3.70 to −1.15)), but not strictly deep microbleeds (aMD −0.67 (95% CI −1.85 to 0.51)).ConclusionsIn patients with IS or transient ischaemic attack, impaired kidney function was associated with a higher risk of recurrent stroke and higher microbleeds burden, compared with those with normal kidney function. Further research is needed to investigate potential additional measures for secondary prevention in this high-risk group.

Abstract Introduction Glomerular hyperfiltration has previously been associated with cardiovascular events and mortality but has scarcely been investigated in patients with stroke. Patients and methods We used pooled data from an individual patient data meta-analysis of prospective, cohort studies of stroke or TIA populations. For this analysis, we included participants from study sites that collected estimated glomerular filtration rate (eGFR) at stroke presentation. Using Cox proportional hazards regression, we investigated the risk of death, any stroke and vascular death according to glomerular hyperfiltration, defined as having an eGFR greater than the age- and sex-adjusted 95th percentile. We also investigated these outcomes according to eGFR as a continuous variable, modelled using fractional polynomials. Results A total of 11,175 patients (mean age 70.7 years, 42% female) were included in the analysis, 554 (4.9%) with hyperfiltration. Compared to the normofiltration group (absence of hyperfiltration and eGFR ≥ 60 mL/min/1.73 m2), the hyperfiltration group had a higher rate of all-cause death, 147 per 1000 person-years (95% CI, 119–180) vs 61 (95% CI, 57–66). Compared to normofiltration, hyperfiltration was independently associated with the risk of death from any cause (adjusted hazard ratio [HR] 1.76; 95% CI, 1.46–2.11; P < .001) and the risk of vascular death (adjusted HR 1.68; 95% CI, 1.29–2.17; P < .001). There were non-linear associations of eGFR with risk of death and vascular death, with increasing risk at both low and high eGFR (Pnon-linearity < .001 for both). Discussion and conclusion Glomerular hyperfiltration was associated with a 76% increased risk of death and a 68% increased risk of vascular death in multivariable models adjusted for age, sex and comorbidities. Glomerular hyperfiltration may be associated with adverse health outcomes, specifically in patients with ischaemic stroke. Further research is needed to confirm these findings. Graphical Abstract Graphical Abstract

Improving the charge carrier mobility of solution‐processable organic semiconductors is critical for the development of advanced organic thin‐film transistors and their application in the emerging sector of printed electronics. Here, a simple method is reported for enhancing the hole mobility in a wide range of organic semiconductors, including small‐molecules, polymers, and small‐molecule:polymer blends, with the latter systems exhibiting the highest mobility. The method is simple and relies on admixing of the molecular Lewis acid B(C6F5)3 in the semiconductor formulation prior to solution deposition. Two prototypical semiconductors where B(C6F5)3 is shown to have a remarkable impact are the blends of 2,8‐difluoro‐5,11‐bis(triethylsilylethynyl)anthradithiophene:poly(triarylamine) (diF‐TESADT:PTAA) and 2,7‐dioctyl[1]‐benzothieno[3,2‐b][1]benzothiophene:poly(indacenodithiophene‐co‐benzothiadiazole) (C8‐BTBT:C16‐IDTBT), for which hole mobilities of 8 and 11 cm2 V−1 s−1, respectively, are obtained. Doping of the 6,13‐bis(triisopropylsilylethynyl)pentacene:PTAA blend with B(C6F5)3 is also shown to increase the maximum hole mobility to 3.7 cm2 V−1 s−1. Analysis of the single and multicomponent materials reveals that B(C6F5)3 plays a dual role, first acting as an efficient p‐dopant, and secondly as a microstructure modifier. Semiconductors that undergo simultaneous p‐doping and dopant‐induced long‐range crystallization are found to consistently outperform transistors based on the pristine materials. Our work underscores Lewis acid doping as a generic strategy towards high performance printed organic microelectronics. Admixing the Lewis acid B(C6F5)3 with various organic conjugated small‐molecules, polymers, and small‐molecule:polymer blends leads to a remarkable increase in their field‐effect hole mobility. In the case of small‐molecule:polymer blends, the effect is shown to be due to the synergistic processes of p‐doping and dopant‐induced long‐range crystallinity in the composite layer yielding transistor with hole mobility of up to 11 cm2 V−1 s−1.