Incidence and prevalence of vascular cognitive impairment in China: a systematic review and meta-analysis

中国血管性认知障碍的发病率和患病率：系统评价与荟萃分析

Given China's rapid population ageing and substantial stroke burden, understanding the epidemiology of vascular cognitive impairment (VCI) is critical. This study aimed to systematically evaluate VCI prevalence and incidence in China from 1980 to 2023, and explore demographic and geographic disparities. VCI poses a growing burden in China, particularly among older and less-educated populations. This analysis provides the most comprehensive assessment of VCI in China to date, underscoring demographic and regional variations. These findings highlight the need for targeted public health strategies, improved diagnostics and lifestyle interventions to address the growing burden of VCI, particularly amidst China's ageing population. Future longitudinal research integrating clinical data, biomarkers and potentially neuroimaging is warranted to better understand VCI progression and refine intervention efficacy.

鉴于中国人口老龄化进程迅速且中风负担沉重，了解血管性认知障碍（VCI）的流行病学特征至关重要。本研究旨在系统评估1980年至2023年中国VCI的患病率和发病率，并探讨人口统计学和地理差异。VCI在中国造成的负担日益加重，尤其是在老年人和受教育程度较低的人群中。这项分析是迄今为止对中国VCI最全面的评估，凸显了人口统计学和地区差异。这些研究结果强调，有必要制定针对性的公共卫生策略、改善诊断方法并开展生活方式干预措施，以应对日益加重的VCI负担，特别是在中国人口老龄化的背景下。未来有必要开展整合临床数据、生物标志物以及可能的神经影像学检查的纵向研究，以便更好地了解VCI的进展情况并优化干预措施的效果。

REF: Liang SZ, Li S, Guan A, et al. Incidence and prevalence of vascular cognitive impairment in China: a systematic review and meta-analysis. Stroke Vasc Neurol. Published online August 31, 2025. doi:10.1136/svn-2025-004436 PMID: 40889799

Associations of new intracranial haemorrhage, ischaemic stroke and survival with dual antiplatelet therapy regimen or duration after endovascular treatment for ruptured cerebral aneurysm

破裂脑动脉瘤血管内治疗后双重抗血小板治疗方案或疗程与新发颅内出血、缺血性卒中及生存情况的关联

Dual antiplatelet therapy (DAPT) is often necessary following endovascular treatment for ruptured cerebral aneurysms; however, the optimal drug combination and treatment duration remain uncertain. Our real-world data analysis revealed no significant differences in ischaemic or haemorrhagic outcomes between the aspirin+clopidogrel and aspirin+ticagrelor regimens. However, the observed differences in survival suggest the need for more refined patient selection strategies. In addition, the appropriate duration of DAPT is still unknown, although our results suggest that a shorter DAPT duration may offer comparable safety and efficacy.

对于破裂脑动脉瘤进行血管内治疗后，双联抗血小板治疗（DAPT）通常是必要的；然而，最佳的药物组合和治疗持续时间仍不确定。我们对真实世界数据的分析显示，阿司匹林 + 氯吡格雷方案与阿司匹林 + 替格瑞洛方案在缺血性或出血性结局方面没有显著差异。然而，观察到的生存率差异表明需要更精细的患者选择策略。此外，DAPT 的合适持续时间仍不清楚，尽管我们的结果表明较短的 DAPT 持续时间可能具有相当的安全性和有效性。

REF: Perng PS, Chang Y, Chuang MT, et al. Associations of new intracranial haemorrhage, ischaemic stroke and survival with dual antiplatelet therapy regimen or duration after endovascular treatment for ruptured cerebral aneurysm. Stroke Vasc Neurol. Published online August 27, 2025. doi:10.1136/svn-2025-004362 PMID: 40866079

Differentiating central fever from infectious fever in intracerebral haemorrhage

脑出血患者中枢性发热与感染性发热的鉴别

In addition to infectious fever, stroke-related disturbances in thermoregulation, referred to as central fever, are frequently observed in patients with stroke, particularly in those with intracerebral haemorrhage (ICH). Rapid identification of the underlying cause of fever is crucial for treatment decisions. This study aims to identify clinical, laboratory and radiological parameters that differentiate central fever from infectious fever in patients with ICH. Early onset and hypothalamic involvement are the strongest indicators of central fever, which may help guide evidence-based treatment decisions for patients with fever following ICH.

除感染性发热外，与中风相关的体温调节紊乱（即中枢性发热）在中风患者中经常可见，尤其是脑出血（ICH）患者。快速确定发热的根本原因对于治疗决策至关重要。本研究旨在确定能够区分脑出血患者中枢性发热和感染性发热的临床、实验室及影像学参数。发病早和下丘脑受累是中枢性发热的最有力指标，这可能有助于为脑出血后发热患者制定循证治疗决策。

REF: Hess F, Baki E, McGinnis J, et al. Differentiating central fever from infectious fever in intracerebral haemorrhage. Stroke Vasc Neurol. Published online August 27, 2025. doi:10.1136/svn-2025-004441 PMID: 40866080

Secondary stroke evaluation in patients admitted for CRAO in a large national inpatient sample

大型全国住院患者样本中因视网膜中央动脉阻塞入院患者的二级卒中评估

Central retinal artery occlusion (CRAO) is an ophthalmic condition associated with cerebrovascular ischaemia. In patients with acute CRAO, the 2021 American Heart Association (AHA) scientific statement recommends a diagnostic evaluation for secondary stroke prevention, including cerebrovascular imaging, cardiac rhythm monitoring, echocardiogram and labs. This study aims to understand the national stroke evaluation rates for patients with CRAO before 2021. In this national cohort study, low percentages of patients with CRAO were evaluated for secondary stroke prevention before the 2021 AHA scientific statement on CRAO management. Notably, higher socioeconomic status patients underwent more comprehensive stroke evaluations.

视网膜中央动脉阻塞（CRAO）是一种与脑血管缺血相关的眼科疾病。对于急性CRAO患者，2021年美国心脏协会（AHA）科学声明建议进行诊断评估以预防继发性中风，包括脑血管成像、心律监测、超声心动图和实验室检查。本研究旨在了解2021年之前全国CRAO患者的中风评估率。在这项全国性队列研究中，在2021年AHA发布关于CRAO管理的科学声明之前，接受继发性中风预防评估的CRAO患者比例较低。值得注意的是，社会经济地位较高的患者接受了更全面的中风评估。

REF: Doshi S, Bisen JB, Bains HK, Keshwani A, Cherayil N, Mirza RG. Secondary stroke evaluation in patients admitted for CRAO in a large national inpatient sample. Stroke Vasc Neurol. Published online August 22, 2025. doi:10.1136/svn-2024-003971 PMID: 40846483

Smoking status and the efficacy of remote ischaemic conditioning: a secondary analysis of the RICAMIS trial

吸烟状况与远程缺血预适应的疗效：RICAMIS 试验的二次分析

Remote ischaemic conditioning (RIC) is a potential non-invasive neuroprotective strategy, but it remains unclear whether its efficacy is influenced by smoking status. This study explored the impact of smoking status on the therapeutic effect of RIC in patients with acute moderate ischaemic stroke through a post hoc subgroup analysis. In this analysis, RIC significantly improved the excellent functional prognosis of non-smoking stroke patients, but had no significant benefit for current smokers, suggesting that smoking may attenuate RIC efficacy.

远程缺血预处理（RIC）是一种潜在的非侵入性神经保护策略，但目前尚不清楚其疗效是否受吸烟状况的影响。本研究通过事后亚组分析，探讨了吸烟状况对急性中度缺血性脑卒中患者RIC治疗效果的影响。在该分析中，RIC显著改善了非吸烟脑卒中患者的良好功能预后，但对当前吸烟者无显著益处，这表明吸烟可能会削弱RIC的疗效。

REF: Zhang XW, Cui Y, Chen HS. Smoking status and the efficacy of remote ischaemic conditioning: a secondary analysis of the RICAMIS trial. Stroke Vasc Neurol. Published online August 19, 2025. doi:10.1136/svn-2025-004349 PMID: 40830061

Neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for the treatment of acute spontaneous deep intracerebral haemorrhage (NAS-TNK): rationale and design of a multicentre randomised trial

神经导航辅助下替奈普酶立体定向微创穿刺治疗急性自发性深部脑出血（NAS - TNK）：一项多中心随机试验的原理与设计

Minimally invasive puncture surgery followed by thrombolysis has been proven to be an effective approach for managing hypertensive intracerebral haemorrhage (ICH). Nevertheless, its impact on improving neurological outcomes remains controversial. The integration of neuronavigation-assisted stereotactic (NAS) technology will significantly help enhance the accuracy of catheter placement, while tenecteplase (TNK), a third-generation thrombolytic agent, offers stronger capabilities in breaking down platelet-rich clots and demonstrates increased fibrin selectivity, which could enhance the overall effectiveness of thrombolytic treatment. However, the efficacy and safety of combining NAS-assisted minimally invasive puncture with TNK (NAS-TNK) in reducing disability and mortality rates among patients with acute spontaneous deep ICH remain unknown. To describe the rationale and design of the NAS-TNK trial for the treatment of acute spontaneous deep ICH. The NAS-TNK study will help improve our understanding of the benefits of NAS-TNK in patients with acute spontaneous deep ICH.

微创穿刺术后溶栓已被证明是治疗高血压性脑出血（ICH）的一种有效方法。然而，其在改善神经功能预后方面的作用仍存在争议。引入神经导航辅助立体定向（NAS）技术将显著有助于提高置管的准确性，而第三代溶栓药物替奈普酶（TNK）在溶解富含血小板的血栓方面能力更强，且对纤维蛋白的选择性更高，这可能会提高溶栓治疗的整体效果。然而，将NAS辅助微创穿刺与TNK联合应用（NAS - TNK）在降低急性自发性深部脑出血患者残疾率和死亡率方面的有效性和安全性尚不清楚。本文旨在阐述NAS - TNK试验用于治疗急性自发性深部脑出血的原理和设计。NAS - TNK研究将有助于我们更好地了解NAS - TNK对急性自发性深部脑出血患者的益处。

REF: Wang M, Wu Z, Tang J, et al. Neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for the treatment of acute spontaneous deep intracerebral haemorrhage (NAS-TNK): rationale and design of a multicentre randomised trial. Stroke Vasc Neurol. Published online August 17, 2025. doi:10.1136/svn-2025-004234 PMID: 40819883

Treatment of acute intracerebral haemorrhage with a Chinese herbal formula (Shengdi Dahuang Decoction): a multicentre, double-blind, randomised, placebo-controlled trial

中药方剂（生地大黄汤）治疗急性脑出血的多中心、双盲、随机、安慰剂对照试验

Per preliminary studies, Shengdi Dahuang Decoction (SDD) is potentially effective for acute intracerebral haemorrhage (ICH); however, its effectiveness has not been rigorously assessed in extensive randomised clinical trials. To evaluate whether SDD can improve 90-day functional outcomes in patients with ICH. In patients with acute ICH, incorporating SDD as a supplementary intervention alongside guideline-directed treatments may help enhance 90-day functional outcomes; however, more clinical trials are required to further prove its efficacy.

根据初步研究，生地大黄汤（SDD）对急性脑出血（ICH）可能有效；然而，其有效性尚未在大规模随机临床试验中得到严格评估。评估生地大黄汤是否能改善脑出血患者90天的功能结局。对于急性脑出血患者，在遵循指南的治疗基础上，将生地大黄汤作为补充干预措施可能有助于改善90天的功能结局；不过，需要更多的临床试验来进一步证实其疗效。

REF: Sun Z, Zhou X, Xiang J, et al. Treatment of acute intracerebral haemorrhage with a Chinese herbal formula (Shengdi Dahuang Decoction): a multicentre, double-blind, randomised, placebo-controlled trial. Stroke Vasc Neurol. Published online August 2, 2025. doi:10.1136/svn-2024-003931 PMID: 40752894