Objective:To investigate the association of monocyte-to-high-density lipoprotein cholesterol ratio (MHR) with the severity of white matter hyperintensities (WMHs) and its spatial distribution.Methods:Patients admitted to the Department of Neurology, Jiangning Hospital Affiliated to Nanjing Medical University due to various chronic diseases or physical examinations between January 2023 and December 2024 were included retrospectively. Past medical history, clinical and imaging data were collected. The Fazekas scale was used to assess the severity of WMHs. According to the scoring results of periventricular WMHs (PVWMHs) and deep WMHs (DWMHs), WMHs were divided into no/mild group (0-1 points) and moderate/severe group (2-3 points). Multivariate logistic regression analysis was used to determine independent correlation factors for the severity of WMHs, PVWMHs, and DWMHs. Results:A total of 357 patients were included, aged 65.42±9.95 years, with 198 males (55.5%). There were 193 patients (54.1%) in the no/mild group and 164 (45.9%) in the moderate/severe group. Univariate analysis showed that the proportion of patients with hypertension, diabetes, history of cerebral infarction and cerebral hemorrhage, carotid plaque, and age, serum creatinine, monocyte count and MHR in the moderate/severe group were significantly higher than those in the no/mild group (all P<0.05). Multivariate logistic regression analysis showed a significant positive correlation between MHR and the severity of WMHs (odds ratio 3.138, 95% confidence interval 1.042-9.451; P=0.042). Further analysis showed a significant positive correlation between MHR and PVWMHs (odds ratio 3.384, 95% confidence interval 1.111-10.305; P=0.032), but no independent correlation with DWMHs. In addition, age and hypertension, diabetes, history of cerebral infarction and cerebral hemorrhage were significantly positively correlated with the severity of WMHs, PVWMHs and DWMHs. Conclusion:MHR is correlated with the severity of WMHs, and higher MHR is significantly associated with PVWMHs, but not with DWMHs.

Objective:To investigate the correlation between serum soluble intercellular adhesion molecule-1 (sICAM-1) and the severity of white matter hyperintensities (WMHs).Methods:Medical examinees in the Department of Neurology, Suzhou Hospital Affiliated to Anhui Medical University from February 2021 to October 2022 were selected as the research subjects. Head MRI was performed and the severity of WMHs was assessed by Fazekas scale. The enzyme-linked immunosorbent assay was used to detect serum sICAM-1 expression level. Multivariate logistic regression analysis was used to determine the independent influencing factors of the severity of WMHs. Results:A total of 171 subjects were enrolled, including 112 males (65.5%), aged 65.50±9.07 years. There were 92 patients (53.8%) with no WMH or mild WMHs and 79 patients (46.2%) with moderate to severe WMHs. The serum sICAM-1 levels in the moderate to severe WMH group were significantly higher than those in the no or milds WMH group ( t=5.679, P<0.001). Ordinal multivariate logistic regression analysis showed that after adjusting for confounding factors, higher sICAM-1 level was independently correlated with the severity of WMHs (compared to the 1 st quartile group, the 3 rd quartile group: odds ratio 3.149, 95% confidence interval 1.147-8.645, P=0.026; the 4 th quartile group: odds ratio 6.087, 95% confidence interval 2.051-18.061; P=0.001). Conclusion:Elevated serum sICAM-1 level is an independent influencing factor of WMHs.

Objective:To investigate the safety and efficacy of flow diverter (FD) in the treatment of middle cerebral artery (MCA) dissection aneurysms.Methods:Patients with MCA dissection aneurysm received FD treatment at the Department of Neurosurgery, Jinjiang Hospital and the Cerebrovascular Disease Center of the First Affiliated Hospital of Naval Medical University from January 2021 to December 2023 were included retrospectively. The success rate of procedure, incidence of complications, occlusion rate of aneurysms, and clinical outcome were evaluated.Results:A total of 23 patients were included, with a success rate of 100% for FD implantation and a periprocedural complication rate of 8.7%. Nineteen patients (82.6%) completed angiography follow-up within an average of 7.2 months, of which the aneurysms of 16 patients (84.2%) were completely occluded, 3 (15.8%) were partial occluded, and 2 (10.5%) experienced in-stent restenosis; 14 (73.7%) showed stenosis of covered branch openings, of which 2 (10.5%) had branch occlusions, with no relevant clinical symptoms. The median clinical follow-up time was 23.2 months, with 95.7% of patients achieving good outcome (modified Rankin scale score ≤2).Conclusion:FD is safe and effective in the treatment of MCA dissection aneurysms, and precise device selection and release is the key to improving procedural safety.

Objective:To investigate the moyamoya disease (MMD) -related mitochondrial genes and to elucidate potential regulatory mechanisms.Methods:The GSE157628 and GSE189993 datasets of MMD from the Gene Expression Omnibus (GEO) database were downloaded as the training set and validation set, respectively. Mitochondrial-related gene sets were obtained from the MitoCarta 3.0 database. Weighted gene co-expression network analysis was used to screen the pathogenic module genes of MMD. Venn analysis was used to identify differentially expressed genes related to mitochondria. Functional enrichment analysis was used to elucidate potential molecular functions. Mitochondrial genes were screened using three machine learning methods, receiver operator characteristic (ROC) curve, and validation set expression analysis. A diagnostic nomogram model of MMD related features was developed based on diagnostic genes. The correlation between the identified genes and MMD immune infiltration characteristics, the biological pathways involved, and potential therapeutic drugs with interactions were analyzed.Results:A total of 15 differentially expressed mitochondria-related genes were identified based on GSE157628 dataset, involving the processes related to small molecule metabolism and mitochondrial function. Three machine learning algorithms, ROC curves and expression analysis finally identified two mitochondria-related diagnostic genes: NUDT8 and RDH13. The diagnostic nomogram model developed based on these two genes had good diagnostic ability for MMD. Immune infiltration analysis showed that there was significant difference in plasma cells between the MMD group and the control group. In addition, the two diagnostic genes interacted with several therapeutic drugs. Conclusion:NUDT8 and RDH13 are identified as potential mitochondrial-related genes of MMD, and they may serve as therapeutic targets for progressive vascular occlusion in MMD.

Patients with lacunar infarction (LI) have a higher risk of stroke recurrence compared to other types of stroke, and it is an important pathological basis for vascular dementia. Homocysteine (Hcy) is closely associated with the occurrence and development of LI. The mechanism by which Hcy causes LI involves multiple complex biological processes (including inflammation, oxidative stress, endothelial dysfunction, etc.) and synergistic effects with various risk factors (such as hypertension and hyperglycemia), but the specific mechanism is currently not fully elucidated.

Cognitive impairment caused by cerebral small vessel disease (CSVD) can affect the quality of life of patients and impose a huge economic burden on the families and society. Inflammation is an important pathological mechanism of cognitive impairment in CSVD and its associated cognitive impairment. This article reviews the peripheral blood inflammatory markers of cognitive impairment in patients with CSVD.

Cerebral sinovenous thrombosis (CSVT) in children is a rare but severe cerebrovascular disease with non-specific clinical manifestations and numerous etiology or risk factors. Anticoagulation is the main treatment for CSVT in children. This article reviews the epidemiology, clinical manifestations, etiology, risk factors, diagnosis, and treatment of CSVT in children.

Champagne bottle neck sign (CBNS) is an important morphological feature of extracranial artery damage in patients with moyamoya disease (MMD), and more than half of them have this sign. Carotid ultrasound is the most convenient imaging examination method for diagnosing CBNS. CBNS can have a serious impact on cerebral hemodynamics and is closely associated with the staging of MMD, stroke risk, stroke characteristics, MMD-related headaches, and the risk of postoperative complications. This article comprehensively reviews the pathology and pathogenesis, imaging examination, correlation with clinical symptoms, and intervention of CBNS in patients with MMD, aiming to provide reference for the clinical diagnosis, treatment, and research of MMD combined with CBNS.

Spontaneous intracerebral hemorrhage (ICH) is the second common subtype of stroke, characterized by high incidence, high mortality and high disability rates. The recurrent ICH not only brings physical pain to patients, but also increases the burden on families and society. In recent years, researches on the risk factors for recurrent ICH have been increasing day by day. This article reviews the risk factors for recurrent ICH from the perspectives of clinical features, biomarkers, and imaging characteristics, in order to provide a basis for the secondary prevention of ICH.

In recent years, significant progress has been made in pharmacological research on the treatment of ischemic stroke with monomeric components of traditional Chinese medicine, among which flavonoids have shown good neuroprotective effects. This article reviews the regulatory role of flavonoids in the signaling pathway of ischemic brain injury.