Objective:To investigate the association of white matter hyperintensities (WMHs) with long-term stroke recurrence in patients with recent subcortical small infarcts (RSSIs).Methods:Consecutive patients admitted to the Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University between January 2019 and August 2022 and met the clinical and imaging manifestations of RSSIs were collected. The demographic characteristics, baseline clinical data, and MRI features were collected. Using stroke recurrence as the endpoint event, the recurrence time was recorded, and Cox regression model was used to analyze relevant factors affecting stroke recurrence in patients with RSSIs.Results:A total of 202 patients were enrolled, including 138 males (68.3%), aged 67.9±10.5 years. Seventy-seven patients (38.1%) were mild WMHs, 64 (31.7%) were moderate WMHs, and 61 (30.2%) were severe WMHs. There were statistically significant differences in age, history of stroke, hypertension, hyperlipidemia, total cholesterol, infarct thickness, and infarct distribution among different WMHs severity groups (all P<0.05). The median follow-up time was 40.5 months (interquartile range, 27.7-49.0 months), and a total of 55 patients (27.2%) had stroke recurrence (ischemic stroke 54, occipital hemorrhage 1). Recurrence rates of stroke in the mild, moderate, and severe WMHs groups were 18.2%, 31.3%, and 34.4%, respectively. Cox regression analysis showed that WMHs were an independent risk factor for stroke recurrence (compared to the mild group, the risk ratio of the severe group was 2.225, 95% confidence interval was 1.116-4.436; P=0.023). Conclusion:The risk of long-term stroke recurrence in patients with RSSI is associated with the severity of WMHs.

Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune-mediated demyelinating diseases of the central nervous system. A growing number of studies have identified asymptomatic lesions on imaging in patients with NMOSD, including asymptomatic optic neuropathy, asymptomatic spinal lesions, and asymptomatic brain lesions, even in the absence of clinical symptoms. The characteristics of asymptomatic lesions of NMOSD, influencing factors, relationship with relapse and disability progression, and management strategies were reviewed in this article.

Because the brain and kidneys share a common basis for small vessel lesions, the related research on cerebral microbleeds (CMBs) in patients with chronic kidney disease (CKD) is gradually increasing. The development of neuroimaging technology has significantly increased the detection rate of CMBs, but there is still controversy over whether CKD will increase the incidence of CMBs. This article reviews the relationship between CKD and CMBs, pathogenesis, biomarkers, and treatment.

Objective:To investigate the correlation of fluid-attenuation inversion recovery (FLAIR) vascular hyperintensity (FVH) and clinical outcome in patients with middle cerebral artery M1 occlusive stroke.Methods:Patients with acute middle cerebral artery M1 occlusive stroke admitted to the Department of Neurology, the Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2019 were enrolled retrospectively. The demographic and clinical data were collected. Diffusion-weighted imaging (DWI)-Alberta Stroke Program Early CT Score (ASPECTS) and FVH score were performed with MRI images. The modified Rankin Scale (MRS) was used to evaluate the clinical outcome at 90 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent correlation between FVH and the outcome. Results:A total of 65 patients with acute middle cerebral artery M1 occlusive stroke were enrolled, including 37 males (56.9%). Their age was 64.35±12.13 years. Twenty-nine patients (44.6%) had a good outcome, and 36 (55.4%) had a poor outcome. There were significant differences in triglyceride ( P=0.037), antihypertensive drug treatment ( P=0.037), baseline National Institutes of Health Stroke Scale (NIHSS) score ( P<0.001), DWI-ASPECTS ( P=0.017) and FVH score ( P<0.001) between the poor outcome group and the good outcome group. Multivariate logistic regression analysis showed that FVH score (odds ratio 6.477, 95% confidence interval 1.570-26.716; P=0.010) and NIHSS score (odds ratio 1.869, 95% confidence interval 1.326-2.635; P<0.001) were significantly independently correlated with the poor outcome. However, there was no significant independent correlation between DWI-ASPECTS and the outcome (odds ratio 0.451, 95% confidence interval 0.068-2.988; P=0.410). Conclusions:FVH score is an independent risk factor for poor outcome in patients with acute middle cerebral artery M1 occlusive stroke.

Intraocular silicone oil injection is a common method for treating retinal detachment. Cataracts, increased intraocular pressure, corneal lesions, and silicone oil emulsification are relatively common complications of intraocular silicone oil tamponade. The migration of silicone oil from the vitreous body into the ventricles along the optic nerve is extremely rare, which is easily misdiagnosed as intraventricular hemorrhage, and colloidal cyst. This paper reviews the overview, migration pathway, clinical characteristics, imaging features, treatment and outcomes of silicone oil migration into the ventricular system in order to improve the understanding of this phenomenon among clinical colleagues.

Objective:To investigate the correlation between basilar artery (BA) dolichosis and clinical outcome of patients with acute isolated pontine infarction.Methods:Consecutive patients with acute isolated pontine infarction within 7 d after onset admitted to the Department of Neurology, the Affiliated Hefei Hospital of Anhui Medical University were enrolled. The demographic, clinical and MRI data were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 3 months after the onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. A binary multivariate logistic regression model was used to analyze the correlation between BA dolichosis and clinical outcome of the patients. Results:A total of 116 patients with acute isolated pontine infarction were enrolled. There were 69 (59.5%) males and 47 (40.5%) females, with a median age of 65 years (interquartile range: 57-76 years). There were 39 patients (33.6%) in BA dolichosis group and 77 (66.4%) in non-BA dolichosis group. The BA diameter ( P=0.021), theoretical length (basilar artery length, BAL) ( P<0.001), bending length (BL) ( P<0.001) and the proportion of patients with BA bending ( P<0.001) in the BA dolichosis group were significantly higher than those of the non-BA dolichosis group. There were 93 (80.2%) patients in good outcome group and 23 (19.8%) in poor outcome group. The baseline National Institute of Health stroke scale (NIHSS) score ( P<0.001), approximate length of BA ( P=0.007), BAL ( P=0.020), BL ( P=0.005) and the proportion of patients with BA dolichosis ( P=0.002) and bending ( P=0.008) in the poor outcome group were significantly higher than those in the good outcome group. Spearman correlation analysis showed that the approximate length of BA was significantly positively correlated with BL ( r=0.597, P<0001). Multivariate logistic regression analysis showed that BA dolichosis (odds ratio 5.441, 95% confidence interval 1.814-16.320; P=0.003) and the higher baseline NIHSS score (odds ratio 1.696, 95% confidence interval 1.291-2.228; P<0.001) were the independent risk factors for poor outcomes in patients with acute isolated pontine infarction. Conclusion:BA dolichosis is common in patients with acute isolated pontine infarction. BA dolichosis may be an independent risk factor for poor outcome in patients with acute isolated pontine infarction at 3 months after onset.

Objective To compare the effect and safety of stenting versus directional atherectomy (DA) in the treatment of TASCⅡ A and B superficial femoral artery lesions.Methods 100 patients with TASC Ⅱ A and B lesions were divided into percutaneous transluminal stenting(PTS) group (n =50) and DA group (n =50).Patients were compared in terms of technical success rate,treatment success rate,first operation cost,postoperative ankle brachial index (ABI),limb salvage rate,survival,and patency.Results The technical success rate in both PTS and DA group was 100％.The treatment success rate was 98％ vs.86％,P＞0.05.Postoperative ABI:0.82 ±0.19 vs.0.80 ±0.27,P＞0.05.First operation cost:(34 820 ± 1 051) yuan vs.(45 635 ± 1 358) yuan,P ＜0.001;All patients were followed-up for up to 2-year,the cumulative patency rate was 81.6％ vs.72.9％ (P＞0.05).Limb salvage rate was 97.9％ vs.93.8 ％,P ＞ 0.05.Conclusion There were no significant differences in the effect and safety of PTS versus DA in the treatment of TASCⅡ A and B superficial femoral artery lesions.

Susceptibility-weighted imaging (SWI) is a tool that uses the intrinsic nature of local magnetic fields to enhance image contrast in order to improve the visibility of various susceptibility sources. SWI has blood oxygen levels dependent effect and is sensitive to the change of the cerebral oxygen saturation. This imaging method is applied to various diseases with abnormal deoxyhemoglobin concentration, such as ischemic stroke and cerebral arteriovenous malformation. Patients with acute ischemic stroke have elevated levels of deoxygenated hemoglobin in the affected area, so the ischemic area can show abnormal venous imaging on SWI images. SWI could recognize penumbra and guide the management of patients with acute stroke. Besides, SWI also could evaluate the severity of symptoms, predict prognosis and future surviving state. This paper reviews the research progress of the prominent hypointense vessels sign and its application in acute ischemic stroke.

Vertebrobasilar dolichoectasia (VBD) is a rare posterior circulation vascular variant disease.Studies have shown that VBD has an effect on the outcome of ischemic stroke.This article reviews the relationship between VBD and ischemic stroke.