Thrombolysis With the Nonimmunogenic Staphylokinase for Acute Ischemic Stroke in FORPI Registry: An Observational Study

FORPI登记研究：非免疫原性葡激酶溶栓治疗急性缺血性卒中——一项观察性研究

The nonimmunogenic staphylokinase is a recombinant staphylokinase with low immunogenicity, high thrombolytic activity, and fibrin selectivity approved in Russia for the acute ischemic stroke (AIS) thrombolytic therapy within 4.5 hours after symptom onset. We evaluated safety and efficacy outcomes of the nonimmunogenic staphylokinase usage in patients with AIS in the Fortelyzin Population Investigation registry. The presented data suggest that intravenous thrombolysis with the nonimmunogenic staphylokinase is safe and effective in routine clinical practice when used within 4.5 hours of AIS symptoms onset. These findings should encourage the wider usage of thrombolytic therapy with the nonimmunogenic staphylokinase for suitable patients.

非免疫原性葡激酶是一种重组葡激酶，具有低免疫原性、高溶栓活性和纤维蛋白选择性，已在俄罗斯获批用于症状发作后4.5小时内的急性缺血性脑卒中（AIS）溶栓治疗。我们在Fortelyzin人群调查登记处评估了非免疫原性葡激酶用于AIS患者的安全性和有效性结局。所呈现的数据表明，在AIS症状发作后4.5小时内使用非免疫原性葡激酶进行静脉溶栓治疗，在常规临床实践中是安全有效的。这些发现应促使非免疫原性葡激酶溶栓治疗在合适患者中得到更广泛的应用。

REF: Shamalov NA, Martynov MY, Yarovaya EB, et al. Thrombolysis With the Nonimmunogenic Staphylokinase for Acute Ischemic Stroke in FORPI Registry: An Observational Study. Stroke. Published online November 26, 2025. doi:10.1161/STROKEAHA.125.051115 PMID: 41293810

Incidence and Mortality of Chronic Subdural Hematomas: A Population-Based Study

慢性硬膜下血肿的发病率和死亡率：一项基于人群的研究

Despite a rising public health burden, there have been few population-based studies of chronic subdural hematomas (cSDH) in the United States. We provide the first estimates of cSDH incidence and mortality in a large, representative U.S. population. Our contemporary population-level data show that cSDH is common in the US and primarily afflicts patients with a high degree of functional impairment and frailty. While short-term mortality is low, longer-term mortality is high and often related to comorbid illnesses.

尽管公共卫生负担不断加重，但美国针对慢性硬膜下血肿（cSDH）开展的基于人群的研究却寥寥无几。我们首次对美国大量具有代表性人群中的cSDH发病率和死亡率进行了估算。我们当前的人群层面数据显示，cSDH在美国很常见，且主要影响存在高度功能障碍和身体虚弱的患者。虽然短期死亡率较低，但长期死亡率较高，且往往与合并症有关。

REF: Robinson D, Ding L, Stanton RJ, et al. Incidence and Mortality of Chronic Subdural Hematomas: A Population-Based Study. Stroke. Published online November 25, 2025. doi:10.1161/STROKEAHA.125.053396 PMID: 41287962

Association of Net Water Uptake With Catastrophic Functional Outcome After Thrombectomy in Patients With Large Infarcts

大面积梗死患者取栓术后净水分摄取与灾难性功能结局的关联

This study aimed to investigate whether net water uptake (NWU) is associated with 3-month catastrophic functional outcome (modified Rankin Scale score, 5-6) and to develop predictive models with preprocedural factors, including NWU, in patients with large infarcts who underwent endovascular thrombectomy. Elevated ASPECTS10-NWU is strongly associated with catastrophic functional outcome in patients with large infarcts treated with endovascular thrombectomy. Integrating the ASPECTS10-NWU with clinical variables may provide patient-specific prognostication that may assist clinicians in decision-making for endovascular thrombectomy in large infarcts.

本研究旨在探讨净水分摄取量（NWU）是否与 3 个月时灾难性功能结局（改良 Rankin 量表评分 5 - 6 分）相关，并针对接受血管内血栓切除术的大面积梗死患者，利用术前因素（包括 NWU）构建预测模型。在接受血管内血栓切除术治疗的大面积梗死患者中，ASPECTS10 - NWU 升高与灾难性功能结局密切相关。将 ASPECTS10 - NWU 与临床变量相结合，可为患者提供个体化的预后评估，有助于临床医生为大面积梗死患者进行血管内血栓切除术决策。

REF: Gwak DS, Choi W, Kim BJ, et al. Association of Net Water Uptake With Catastrophic Functional Outcome After Thrombectomy in Patients With Large Infarcts. Stroke. Published online November 21, 2025. doi:10.1161/STROKEAHA.125.053071 PMID: 41268658

Updated Priorities for Cerebroprotection Trials

脑保护试验的最新优先事项

A STAIR XIII workshop was held to discuss aspects of trials likely to have the greatest impact on detecting meaningful treatment effects of cerebroprotection in acute stroke. Intended goals for hyperacute protection should be focused on preserving penumbral tissue and delaying infarct core growth to augment the impact of reperfusion therapies. Infarct volume is a biologically and clinically meaningful surrogate imaging marker to assess the treatment effects of cerebroprotection. Lastly, clinical outcome measures for cerebroprotection should include domain-specific and patient-centered outcomes to detect clinically meaningful changes across multiple functional domains.

召开了STAIR XIII研讨会，以探讨那些可能对检测急性中风脑保护有意义的治疗效果产生最大影响的试验方面。超急性脑保护的预期目标应集中在保护半暗带组织和延缓梗死核心扩大，以增强再灌注治疗的效果。梗死体积是评估脑保护治疗效果的一个在生物学和临床上都有意义的替代影像学标志物。最后，脑保护的临床结局指标应包括特定领域和以患者为中心的结局，以检测多个功能领域的临床有意义的变化。

REF: Savitz SI, Samaniego EA, Liebeskind DS, Boltze J; STAIR XIII Participants. Updated Priorities for Cerebroprotection Trials. Stroke. Published online November 20, 2025. doi:10.1161/STROKEAHA.125.052147 PMID: 41263084

Prevalence, Predictors, and Prognosis of Depression After Transient Ischemic Attack: A Population-Based Study

短暂性脑缺血发作后抑郁症的患病率、预测因素及预后：一项基于人群的研究

Depression is common after stroke and is associated with increased mortality. However, there are few data on the prevalence, predictors, or prognosis of depression after transient ischemic attack (TIA). Although poststroke depression is often assumed to be due to the brain lesion or disability, patients with TIA may also be susceptible due to shared risk factors, lifestyle/medication changes, or worries about stroke. Depression is common early after TIA, independent of acute ischemia on brain imaging, and persistent depression is also strongly associated with adverse outcomes.

卒中后抑郁症很常见，且与死亡率升高有关。然而，关于短暂性脑缺血发作（TIA）后抑郁症的患病率、预测因素或预后的数据却很少。虽然卒中后抑郁症通常被认为是由脑部病变或残疾所致，但TIA患者也可能因共同的危险因素、生活方式/药物治疗的改变或对卒中的担忧而容易患上抑郁症。TIA后早期抑郁症很常见，且与脑部影像学上的急性缺血无关，持续性抑郁症也与不良预后密切相关。

REF: McColl AJ, Luengo-Fernandez R, Vaughan-Fowler ER, et al. Prevalence, Predictors, and Prognosis of Depression After Transient Ischemic Attack: A Population-Based Study. Stroke. Published online November 20, 2025. doi:10.1161/STROKEAHA.125.052251 PMID: 41263085

GLP-1 Receptor Agonists as Treatment of Nondiabetic Ischemic Stroke—A Systematic Review and Meta-Analysis

GLP - 1受体激动剂用于非糖尿病性缺血性脑卒中的治疗——一项系统评价和Meta分析

Reperfusion therapies for ischemic stroke are a cornerstone of acute treatment, though only available for a subset of patients due to a narrow time window. Other supplementary treatment is warranted, as only half of the patients reach functional independence. GLP-1 RA (glucagon-like peptide-1 receptor agonists) are associated with decreased cardiovascular disease, mainly driven by reduced stroke risk, and have gained interest as therapeutic agents for stroke recovery in experimental stroke models. This review aims to evaluate the current data on the effect and safety of GLP-1 RA in nondiabetic patients with ischemic stroke and in animal models of cerebral ischemia. We will describe its potential neuroprotective mechanisms. GLP-1 RA improves functional outcome and reduces infarct volume in preclinical animal stroke models without diabetes. Translating these promising preclinical findings into clinical benefits remains a key challenge and a critical opportunity for future research.

缺血性中风的再灌注治疗是急性治疗的基石，不过由于时间窗较窄，仅适用于部分患者。鉴于只有一半的患者能实现功能独立，因此有必要采取其他辅助治疗。胰高血糖素样肽 -1 受体激动剂（GLP - 1 RA）与心血管疾病风险降低相关，这主要是因为其降低了中风风险，并且在实验性中风模型中，它作为促进中风康复的治疗药物受到了关注。本综述旨在评估关于 GLP - 1 RA 对非糖尿病缺血性中风患者及脑缺血动物模型的疗效和安全性的现有数据。我们将阐述其潜在的神经保护机制。在无糖尿病的临床前动物中风模型中，GLP - 1 RA 可改善功能结局并减小梗死体积。将这些有前景的临床前研究成果转化为临床益处仍是一项关键挑战，也是未来研究的重要机遇。

REF: Michaelsen MK, Drasbek KR, Valentin JB, et al. GLP-1 Receptor Agonists as Treatment of Nondiabetic Ischemic Stroke-A Systematic Review and Meta-Analysis. Stroke. Published online November 20, 2025. doi:10.1161/STROKEAHA.125.053075 PMID: 41263069

Testing for Primary Aldosteronism Underutilized Following Stroke: A Multicenter Cohort Study

卒中后原发性醛固酮增多症检测未得到充分利用：一项多中心队列研究

Primary aldosteronism, the most common endocrine cause of hypertension, is associated with an increased risk of stroke compared with essential hypertension. Targeted treatment with mineralocorticoid receptor antagonists, or surgical resection of an aldosterone-producing adrenal adenoma, can effectively reduce blood pressure and mitigate cardiovascular risk. However, despite being a highly modifiable cardiovascular risk factor, primary aldosteronism is grossly underdiagnosed, even in high-risk populations. These findings highlight a missed opportunity to identify a treatable cause of hypertension in patients at high risk of recurrent cerebrovascular events. Routine testing for primary aldosteronism in stroke care pathways may improve long-term outcomes through targeted intervention.

原发性醛固酮增多症是高血压最常见的内分泌病因，与原发性高血压相比，其卒中风险更高。使用盐皮质激素受体拮抗剂进行靶向治疗，或手术切除分泌醛固酮的肾上腺腺瘤，可有效降低血压并减轻心血管风险。然而，尽管原发性醛固酮增多症是一种极易改善的心血管危险因素，但即使在高危人群中，其诊断率也严重不足。这些发现凸显了在复发性脑血管事件高危患者中错失了识别可治疗性高血压病因的机会。在卒中治疗路径中常规筛查原发性醛固酮增多症，可能通过靶向干预改善患者的长期预后。

REF: McCarthy J, Widjaja J, Gao FM, et al. Testing for Primary Aldosteronism Underutilized Following Stroke: A Multicenter Cohort Study. Stroke. Published online November 18, 2025. doi:10.1161/STROKEAHA.125.052691 PMID: 41250988

Statin Use Is Not Associated With Reduced Cardio- and Cerebrovascular Hospitalizations in Older Adults With Dementia

在患有痴呆症的老年人中，使用他汀类药物与减少心脑血管疾病住院率无关

Cardiovascular and cerebrovascular diseases are significant global health challenges and leading causes of death worldwide. Although there is substantial evidence supporting the positive effects of statins for both primary and secondary prevention of these diseases, evidence is lacking regarding the benefits in people with dementia. This study investigated the associations between statin use and cardiovascular and cerebrovascular hospitalizations in nursing home residents with and without dementia. In our study, statin use was associated with an increased risk of hospitalization due to cardiovascular or cerebrovascular events among people with dementia. These findings highlight the need for further research and cautious consideration of statin use in people with dementia.

心脑血管疾病是全球重大的健康挑战，也是全球范围内的主要死因。尽管有大量证据表明他汀类药物在这些疾病的一级和二级预防中具有积极作用，但对于痴呆患者使用他汀类药物的益处，目前仍缺乏相关证据。本研究探讨了养老院中有和无痴呆的居民使用他汀类药物与心脑血管疾病住院之间的关联。在我们的研究中，痴呆患者使用他汀类药物与因心脑血管事件住院的风险增加有关。这些研究结果强调了有必要进一步开展研究，并谨慎考虑痴呆患者使用他汀类药物的问题。

REF: Lech S, Kohl R, O'Sullivan JL, et al. Statin Use Is Not Associated With Reduced Cardio- and Cerebrovascular Hospitalizations in Older Adults With Dementia. Stroke. Published online November 17, 2025. doi:10.1161/STROKEAHA.125.051157 PMID: 41243816

Hybrid Brain/Neural Exoskeleton Enables Bimanual ADL Training in Routine Stroke Rehabilitation

混合脑/神经外骨骼助力常规卒中康复中的双手日常生活活动训练

Severe upper limb motor impairment is one of the most disabling consequences of stroke. Although brain-controlled rehabilitation technologies, such as brain/neural exoskeletons (B/NE), have been shown to be effective in promoting motor recovery, their clinical adoption remains limited because of insufficient integration of B/NE into existing clinical workflows. Here, we introduce and validate a fully portable B/NE system that overcomes this limitation by relying on brain (electroencephalography) and ocular (electrooculography) signals to restore bimanual activities of daily living within a novel therapeutic framework. These findings highlight the compatibility of the novel B/NE with existing clinical workflows and its feasibility to enable B/NE-supported stroke neurorehabilitation by facilitating seamless integration into clinical practice.

上肢严重运动障碍是中风最具致残性的后果之一。尽管脑控康复技术，如脑/神经外骨骼（B/NE）已被证明能有效促进运动恢复，但由于B/NE未能充分融入现有的临床工作流程，其临床应用仍然有限。在此，我们推出并验证了一种全便携式B/NE系统，该系统通过依赖大脑（脑电图）和眼部（眼电图）信号，在一种全新的治疗框架内恢复双手日常生活活动能力，从而克服了这一局限。这些研究结果凸显了这种新型B/NE与现有临床工作流程的兼容性，以及通过促进其无缝融入临床实践来实现B/NE支持的中风神经康复的可行性。

REF: Colucci A, Vermehren M, Angerhöfer C, et al. Hybrid Brain/Neural Exoskeleton Enables Bimanual ADL Training in Routine Stroke Rehabilitation. Stroke. Published online November 17, 2025. doi:10.1161/STROKEAHA.125.052008 PMID: 41243805