Resting-state functional magnetic resonance imaging (R-fMRI) has been intensively used to assess alterations of inter-regional functional connectivity in patients with stroke, but the regional properties of brain activity in stroke have not yet been fully investigated. Additionally, no study has examined a frequency effect on such regional properties in stroke patients, although this effect has been shown to play important roles in both normal brain functioning and functional abnormalities. Here we utilized R-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo), two major methods for characterizing the regional properties of R-fMRI, in three different frequency bands (slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.73 Hz; and typical band: 0.01-0.1 Hz) in 19 stroke patients and 15 healthy controls. Both the ALFF and ReHo analyses revealed changes in brain activity in a number of brain regions, particularly the parietal cortex, in stroke patients compared with healthy controls. Remarkably, the regions with changed activity as detected by the slow-5 band data were more extensive, and this finding was true for both the ALFF and ReHo analyses. These results not only confirm previous studies showing abnormality in the parietal cortex in patients with stroke, but also suggest that R-fMRI studies of stroke should take frequency effects into account when measuring intrinsic brain activity.

Introduction We herein describe three patients who developed fatal intracranial hemorrhage (ICH) after carotid artery stenting (CAS). Case Presentation: We retrospectively reviewed 126 patients who underwent CAS from January 2016 to December 2018 and identified 3 patients (2.4%) (all male, mean age of 59 years) who developed ICH after CAS. Two of them developed left basal ganglia hemorrhage with extension into the ventricle and subarachnoid space, and the third patient developed primary ventricular bleeding. One hemorrhage occurred immediately after CAS, whereas the other two occurred 3 hours and 8 hours after the procedure, respectively. The mean stenosis of the treated carotid arteries was 91%. All three hemorrhages were fatal, and the mean time from hemorrhage to death was 50 hours. Conclusion ICH is a potentially fatal complication of CAS and often occurs several hours after the procedure. Headache, vomiting, and consciousness disorders are the most common symptoms of ICH. Careful screening to identify high-risk patients and strict management of perioperative blood pressure are important to prevent this complication.

Background Mechanical thrombectomy (MT) has been established as the first-line treatment for acute ischemic stroke (AIS) from large vessel occlusions. However, the benefits of MT to the patients over 80 years old is not yet clear, for the elderly with AIS were usually excluded from large randomized controlled stroke clinical trials for their poor prognosis. Methods This study enrolled 187 adult patients with acute ischemic stroke from large vessel occlusions, including 53 patients ≥ 80 years old. Propensity score matching was used to match the patients༜80 years old with those ≥ 80 years old in a ratio of 1:1. The elderly patients were divided into bridging therapy subgroup and direct MT subgroup. The baseline characteristics and outcome were compared between younger patients and older patients, and elderly patients in two subgroups by multivariate logistic regression analysis. Results The good functional status at 90 days occurred in 44 (32.8%) younger patients, 12 (22.6%) in older patients, but the difference was not statistically significant (adjusted OR, 1.244[95%CI,0.520–2.882], P = 0.644). A higher mortality rate was observed in older patients (43% vs 16%, OR,0.245[95%CI,0.104–0.578], P = 0.001). After propensity score matching, the similar results were found in the good functional prognosis and mortality in the two groups. Moreover, in elderly patients, no significant difference was found in the outcome between the two subgroups. Conclusions Elderly patients with AIS from large vessel occlusions who received MT had similar good functional status and successful reperfusion to patients༜80 years old. MT is effective and relatively safe for the elderly.