Intracranial artery stenosis (ICAS) in youth is an under-explored condition. ICAS is one of the leading causes of stroke in young people worldwide and confers a higher risk of stroke recurrence, leading to a poor prognosis for individuals and a great burden to society. The etiology and risk factors of ICAS in youth differ from those of older patients, thus resulting in a difference in the progression and prognosis of the disease. Even though the diagnosis of ICAS is lumen-based, it is sometimes difficult to identify in young patients based on imaging alone. Notably, novel vessel wall imaging techniques play an important role in determining the cause of stenosis and screening patients at high risk of recurrence. Moreover, pharmacologic regimens and risk factor control goals for ICAS in young adults are largely consistent with those in older patients. Thus, considering the poor prognosis, there is an urgent need for high-quality studies in the young ICAS population to analyze the high-quality observational data collected.

Early or ultra-early pharmacological thrombolysis together with mechanical thrombectomy are key treatments for ischemic stroke, and both are aimed at vascular recanalization and improved collateral circulation. While these methods enhance tissue perfusion in the ischemic penumbra, they also trigger complex neurotoxic reactions, including apoptosis, acidosis, ion imbalance, oxidative stress, and pyroptosis, exacerbating cerebral ischemia-reperfusion injury (CIRI). Pyroptosis, a recently discovered form of programmed cell death driven by inflammation, plays a significant role in neuronal death during CIRI. This study reviews the regulatory mechanisms of pyroptosis in CIRI.

Objective: To evaluate the basic appearance and variation of the venous sinuses and veins in healthy individuals. Methods: Prospectively-recruited healthy volunteers completed a questionnaire and underwent magnetic resonance imaging plus contrast-enhanced magnetic resonance venography (CE-MRV) to measure their sinus diameters. Anatomical variations of cerebral venous sinuses were evaluated. Results: Fifty-eight individuals were included. The mean diameter of the left transverse sinus (LTS) (5.37±1.35 mm) was significantly smaller than that of the right transverse sinus (RTS) (6.65±1.57 mm) (P<0.001), and the average discrepancy was 19.2%. RTS dominance was noted in 55.1% of cases. Four superior sagittal sinus (SSS) anatomical variations were found. Type A was the most common and was present in 43 participants (74.1%). The SSS preferentially drained into the RTS in 32 patients (55.2%), and arach-noid granulation was observed in the transverse sinus (TS) and SSS in patients. According to our reclassification combined with Osborn’s previous research, we found that the SSS commonly drained into the RTS and that the straight sinus (StS) branched into both TSs. Conclusions: A 19% difference between the LTS and RTS provides a threshold for TS lateral dominance instead of a TS abnormality. Clinicians and radiologists should not ignore the influence of acquired pathology when the SSS drains in a non-RTS-dominant manner. Anatomical variations of the torcular herophili are frequent; the most commonly observed was the StS branching into both TSs, with the SSS draining into the RTS.

Objective: To explore the clinical and pathological characteristics of cerebral venous sinus thrombosis (CVST) with subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), and to investigate the diagnosis, radiographic changes, and prognosis over the course of treatment. Methods: The clinical data and radiographic findings of a young male CVST patient, who presented with initial symptoms of SAH and ICH, were collected and analyzed. The relevant literature was also reviewed. Results: The patient had no specific clinical symptoms except for headache. The brain computed tomography (CT) scan revealed SAH, a high-density shadow in the right posterior fossa and cerebellar hemisphere, and ICH in the left frontal lobe. Magnetic resonance venography (MRV) further revealed bilateral thrombosis in the transverse and sigmoid sinuses. Conclusion: CVST with SAH and ICH is rare and difficult to diagnose. Careful radiological study and clinical analysis are important for the correct and early diagnosis of this condition. Anticoagulation therapy is considered the primary treatment for CVST.

Objective: To summarize the clinical features, imaging manifestations, therapeutic options, and prognosis of the primary angiitis of the central nervous system (PACNS) and to explore the role of high-resolution magnetic resonance imaging (HR-MRI) in the PACNS diagnosis and treatment. Methods: One patient with PACNS treated by HR-MRI was retrospectively analyzed and summarized by combining relevant literature. Results: The patient was a young female who was hospitalized with progressive cerebral infarction and multiple intracranial arterial stenosis. HR-MRI indicated vasculitic changes. After excluding other diseases, hormone shock combined with immunosuppression was given, followed by long-term rehabilitation treatment. The patient’s condition tended to stabilize, and the prognosis was satisfactory. Conclusion: PACNS is challenging to diagnose and is characterized by poor prognosis and easy recurrence. HR-MRI plays an important role in the clinical diagnosis and treatment adjustment for PACNS.

Ischemic stroke is characterized by high incidence, high mortality, and high disability and is the primary cause of death and disability among adults in China. Endogenous neural stem cells (NSCs) are a group of cells that have the potential to self-renew and differentiate into functional nerve cells. Under normal circumstances, NSCs are in a quiet state. When the body is subjected to specific stimulation or injury, NSCs can be activated, proliferate, migrate to the damaged site, and differentiate into functional nerve cells to repair the injured tissue. NSCs induced by ischemic stimulation have limited regenerative capacity and cannot completely restore damaged tissues. Exogenous NSC transplantation has some effect. However, it is limited by the low survival rate of transplanted NSCs, immune rejection, ethics, and risk of tumor formation. Therefore, it is necessary to study fur- ther the strategies and mechanisms of endogenous NSC activation to promote nerve function repair after stroke. This article reviews recent advancements in drug therapy, hypoxic/ischemic conditioning, Chinese medicine, and rehabilitation strategies for NSC treatment. Furthermore, it explores new strategies and mechanisms developed recently, offering innovative plans and ideas to enhance clinical stroke treatment.

Cerebral venous thrombosis (CVT) is a rare condition that can be fatal in severe cases. The limited occurrence of CVT poses challenges in conducting randomized controlled trials, leading to uncertainty regarding the effectiveness of endovascular thrombectomy (EVT) in specific subgroups of patients with CVT. Currently, a growing body of new evidence has been published on various aspects of CVT diagnosis and treatment, including studies on prognosis assessment scales and EVT therapy. Anticoagulation remains the primary treatment during the acute phase of CVT, as demonstrated by the thrombolysis or anticoagulation for cerebral venous thrombosis (TO-ACT) clinical trial. This study revealed that EVT combined with standard medical care did not improve functional outcomes for patients with severe CVT. Several risk screening scores have been developed to predict CVT prognosis, and some of these scales have been shown to perform adequately. The question of whether EVT is beneficial for patients with CVT, and to which subgroups of patients it should be offered, still remains unsettled. Large global research collaborations should be established to address current challenges and facilitate the execution of clinical trials.

Cerebral amyloid angiopathy (CAA) is a small vessel disease of the brain characterized by the progressive deposition of amyloid-β (Aβ) plaques in the walls of cerebral blood vessels. It presents with a subtle course and sudden onset, and currently, there are no specific therapeutic interventions available. Accurate diagnosis of CAA could enable targeted interventions in the early stages of the disease, potentially mitigating the disease’s effects. Herein, we review the primary imaging biomarkers used in the diagnosis of CAA, including their mechanisms, imaging characteristics, and significance. We also provide an interpretation of the latest version (v2.0) of the Boston criteria, which are commonly used in the clinical diagnosis of CAA. Additionally, this study introduces various positron emission tomography (PET) tracers for CAA and reviews their application values in the diagnosis of CAA.

Single-cell transcriptome sequencing has been a rapidly developing and powerful biological tool in recent years, and it plays a vital role in describing tissue development, cell heterogeneity, stress response, etc. Cerebrovascular disease is one of the leading causes affecting human health in the world. Thus, it is important to understand the characteristics of cerebrovascular structure, function, and environmental response. Notably, single-cell transcriptome sequencing provides deeper insights into cerebrovascular research in health and disease states. This article will briefly introduce the basic structure and function of cerebrovascular endothelial cells (ECs), summarize the current research and new findings on cerebrovascular ECs at the single-cell transcriptome level, and discuss the challenges in this field.

Objective: To systematically review the etiology of anterior choroidal artery (AChA) infarction. Methods: A systematic literature search up to May 11, 2024, for AChA infarction with its etiology. Epidemiologic and clinical data of patients, anatomic distribution of the lesions, and etiologic classification of AChA infarction were extracted. Results: A total of 1 007 individual patient data was included (967 from retrospective clinical studies and 40 from case reports). Among the clinical research, patients’ mean age was 64.7. There were 62.24% of male and 37.76% of female patients. Hypertension (66.04%) was the most common risk factor for patients with AChA infarction. Dyslipidemia (32.92%), diabetes mellitus (30.93%), and smoking (26.54%) were also common risk factors. Moreover, the posterior limb of the internal capsule was the most frequently affected structure. Undetermined etiology (n =173, 38.02%), according to the trial of org 10172 in acute stroke treatment (TOAST) etiological classification, was the most common etiology, followed by small vessel disease (n =117, 25.71%), large artery atherosclerosis (n =84, 18.46%), and cardioembolism (n =63, 13.85%). Furthermore, eighteen strokes were caused by other determined etiologies (3.96%). Conclusions: Undetermined etiology was the most common etiology of AChA infarction. Hypertension, dyslipidemia, diabetes mellitus, and smoking were common risk factors for patients with AChA infarction. It is necessary to prevent the risk factors.

This review discusses the functions of blood vessels such as coagulation, regulation, immunity, endocrinology, and nerve conduction from a new perspective and suggests that hypoxia plays a common role in the changes in vascular function in various cardiovascular and cerebrovascular diseases. Therefore, it is oxygen therapy regulation may be a particularly beneficial means by which to regulate vascular function due to its low risk of harm and ease of implementation. Further, the authors have identified a link between vascular function and diseases caused by endogenous hypoxia and analyzed it in depth. The potential effects of hypoxia regulation schemes such as hyperxia, hyperoxic-hypoxia alternations, hypoxia preconditioning, and intermittent hypoxia on vascular function are also discussed, and we present theoretical support for targeted vascular therapy.

Increasing evidence demonstrated that the blood-brain barrier (BBB) was involved in developing cerebral amyloid angiopathy (CAA). The BBB participates in the neurovascular coupling and regulates the transport of substances, which is closely related to neurodegenerative diseases. In CAA, the deposition of amyloid beta (Aβ) in arteries, capillaries, and arterioles of meninges and cerebral cortex results in the destruction of the BBB, chronic inflammatory response, chronic cerebral hypoperfusion, and dysfunction of the neurovascular unit, which eventually leads to neurodegeneration. At the same time, CAA is an age-related disease. Patients with CAA often have some risk factors for cerebrovascular diseases, such as hypertension and diabetes, which can further aggravate the damage to the BBB. Thus, it is of great significance to pay attention to the BBB in the pathogenesis and future intervention targets of CAA. Therefore, this manuscript reviewed the dysfunction of the BBB in CAA.

Insomnia is currently a common phenomenon, which manifests itself as difficulty in falling asleep, problems remaining asleep, or early awakening, and has a serious impact on people’s lives. Neurotransmitters play a key role in regulating the sleep-wake cycle, among which gamma-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT), noradrenaline (NE), acetylcholine (ACh), and melatonin have been widely studied. This review analyzes the research results in recent years and reveals the role of neurotransmitters in the occurrence of insomnia and their relevance. It provides new perspectives for further discussion on the diagnosis and treatment strategies of insomnia and research on targeted drugs.

Objective: Early and accurate identification of large vessel occlusion (LVO) acute ischemic stroke (AIS) patients is critically important for stroke management. Practicable scales with simple items can facilitate prehospital paramedics distinguishing LVO-AIS patients with high efficiency and help to avoid unnecessary and costly delays. The current study aims to develop a screening tool to predict AIS-LVO patients based on prehospital available data. Method: A total of 251 suspected stroke patients who were transported to the emergency department of our hospital via emergency medical services were consecutively enrolled from August, 2020 to January, 2022. Data including demographic information, medical history, clinical manifestations, and vital signs were collected. A multivariate logistic regression model was developed based on statistically significant variables selected from univariate analysis. Result: Forty-two patients (16.7%) were diagnosed as LVO-AIS based on imaging validation at admission. A comprehensive model was developed with past medical history factors such as atrial fibrillation and coronary heart disease, vital signs such as systolic blood pressure, and prominent symptoms and signs such as gaze palsy, facial paralysis, and dysarthria. The model showed better diagnostic performance in terms of area under the receiver operating characteristic curves (0.884, 95% CI, 0.830 – 0.939), which was higher than other common prehospital prediction scales such as the Face, Arm, Speech, Time test (FAST), the Field Assessment Stroke Triage for Emergency Destination (FAST-ED) scale, and the Gaze-Face-Arm-Speech-Time test (G-FAST). Calibration curve analysis, decision curve analysis, and clinical impact curve analysis further validated the reliability, net benefit, and potential clinical impact of the prediction model, respectively. Conclusion: We conducted a prediction model based on prehospital accessible factors including past history of atrial fibrillation and coronary heart disease, systolic blood pressure, and signs such as gaze palsy, facial palsy, and dysarthria. The prediction model showed good diagnostic power and accuracy for identification of the high-risk patients with LVO and may become an effective tool for the LVO recognition in prehospital settings. Future studies are warranted to refine and validate the model further in order to enhance the accuracy and objectivity of clinical judgments.

Objective: To investigate the regulatory role of cyclic adenosine monophosphate responsive element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway in acute sleep deprivation (SD)-induced anxiety-like behavior mice (SD group) to study the mechanism of anxiety-like behavior better. Methods: The SD chamber was used to deprive the mice of sleep, and the anxiety-like behavior of the mice was verified using an open field test (OFT), elevated plus maze (EPM), forced swim test (FST), and tail suspension test (TST). Finally, proteins were detected by Western blotting. Result: OFT showed that the active distance and the time of stay in the central area were significantly reduced (P<0.05). EPM showed that the time and number of open arms in the SD group were significantly lower than in the control group (P<0.05). The FST showed that the forced swimming immobility time of the SD group was significantly lower than that of the control (P<0.05). Moreover, the TST showed that the immobility time of the tail suspension experiment in the SD group was significantly higher than that in the control group (P<0.05). Conclusion: Acute SD can regulate anxiety-like behavior in mice through the CREB/BDNF signaling pathway.

Intracranial atherosclerotic disease (ICAD) manifests systemic atherosclerosis in the intracranial arterial bed. It is the most common risk factor for ischemic stroke in Chinese population, with symptomatic ICAD (sICAD) patients at higher stroke risk. Continuous cerebral hypoperfusion and hemodynamic decompensation caused by arterial stenosis or occlusion are the main pathological mechanisms for stroke recurrence and cognitive impairment in sICAD patients. Despite receiving reinforced medical therapy, about 10% of sICAD patients still suffer stroke recurrence. Blood flow reconstruction techniques are not yet established as routine stroke prevention for sICAD due to complex perioperative complications. Limb remote ischemic conditioning (LRIC) can effectively reduce the incidence of ischemic stroke, and composite cerebrovascular diseases, and improve cerebral perfusion, brain metabolism, and cerebrovascular reserve (CVR) in sICAD patients, serving as a novel therapeutic strategy. However, the protective mechanisms of LRIC and the optimal treatment regimen for sICAD still require further exploration. Exploring imaging biomarkers with high sensitivity and specificity for diagnosis is of great significance in evaluating and predicting stroke risk in sICAD patients.

Microglia are immune-competent cells involved in maintaining brain homeostasis through their capacity to prune synapses and continuously survey the brain environment. The activation of microglia is one of the most prominent characteristics of Alzheimer’s disease (AD), a severe neurodegenerative disease featuring extracellular deposits of amyloid-β plaques (Aβ plaques) and intracellular neurofibrillary tangles (NFTs) as the result of tau hyperphosphorylation. Whether microglia activation is beneficial or detrimental for brains with AD is still controversial. In this article, we review recent studies focusing on microglia phenotypes in AD by single-cell omics, to understand the signature genes, functions, and regulatory factors of each phenotype. A profound understanding of the heterogeneity of microglial phenotypes will suggest new avenues for treatments for AD.

Postoperative delirium (POD) is a common postoperative complication that can lead to adverse consequences such as prolonged hospitalization, increased medical costs, and higher patient mortality. Chemical medications have demonstrated effectiveness as an intervention in the prevention and treatment of POD, and as a result, have garnered much research attention in recent years. The purpose of this paper is therefore to review and evaluate the research on chemical medications for the treatment of POD systematically, to summarize the current findings, and to discuss future directions.

While accumulating evidence indicates a relationship between ulcerative colitis (UC) and Parkinson’s disease (PD), the interactions between them have not been thoroughly examined. In this study we explored their association via genetic characterization and functional enrichment. Assessment and validation were conducted in a novel dataset comprising whole blood RNA sequencing (RNAseq) data and in three datasets retrieved from the Gene Expression Omnibus database (GSE107499, GSE75214, and GSE100054). Weighted gene co-expression network analysis was used to determine the most relevant differentially expressed genes (DEGs) for the clinical features. Hub genes were identified using molecular complex detection (MCODE) application. In the training and validation datasets, we found two hub genes platelet factor 4 (PF4) and C-X-C motif chemokine ligand 5 (CXCL5), which showed significant upregulation in all four datasets. The receiver operating characteristic curve indicated a diagnostic role for PF4 and CXCL5 in UC and PD. Therefore, PF4 and CXCL5 may provide key insights into the relationship between UC and PD.

Objective: To investigate the changes of mRNA expression level of zinc finger and SCAN domain containing 12 (ZSCAN12) in peripheral blood of first-episode schizophrenia (SCZ). Methods: For our study we selected 17 individuals who had a first episode of SCZ and were hospitalized in the Affiliated Mental Hospital of Kunming Medical University from January 2024 to June 2024; we measured the mRNA expression level of ZSCAN12 in peripheral lymphocytes by quantitative real-time polymerase chain reaction (Q-PCR) method in the study group and compared it to a control group consisting of 15 healthy patients. Results: There was no significant difference in the expression of ZSCAN12 mRNA in peripheral blood lymphocytes of SCZ patients and healthy controls (P > 0.05). Conclusion: The expression of ZSCAN12 mRNA was not significantly abnormal in SCZ patients in this study.

Objective: To describe the clinical features of delayed post-hypoxic leukoencephalopathy after smoke inhalation from dry burning. Methods: We collected the clinical history and examination data of a patient who presented with delayed post-hypoxic leukoencephalopathy due to smoke poisoning. Results: Patients exposed to heavy smoke from dry burning carbonization can develop delayed post-hypoxic leukoencephalopathy. Conclusion: Delayed post-hypoxic leukoencephalopathy after smoke poisoning during cooking is rare. Family should bring patients to a hospital as soon as possible when observing abnormal neurologic symptoms after smoke inhalation to prevent irreversible damage to the brain.