Acute ischemic stroke (AIS) is one of the leading causes of morbidity worldwide, thus, early recognition is essential to accelerate treatment. The only definite way to diagnose AIS is radiological imaging, which is limited to hospitals. However, two serum neuromarkers, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1), have been proven as indicators of brain trauma and AIS. We aimed to investigate the potential utility of these markers in distinguishing between large vessel occlusion (LVO) and small vessel occlusion (SVO), considering differences in treatment. Sixty-nine AIS patients were included in our study and divided into LVO and SVO groups based on radiological imaging. Control group consisted of 22 participants without history of neurological disorders. Results showed differences in serum levels of both GFAP and UHC-L1 between all groups; control vs. SVO vs. LVO (GFAP: 30.19 pg/mL vs. 58.6 pg/mL vs. 321.3 pg/mL; UCH-L1: 117.7 pg/mL vs. 251.8 pg/mL vs. 573.1 pg/mL; p < 0.0001), with LVO having the highest values. Other prognostic factors of stroke severity were analyzed and did not correlate with serum biomarkers. In conclusion, a combination of GFAP and UCH-L1 could potentially be a valuable diagnostic tool for differentiating LVO and SVO in AIS patients.

Acute ischemic stroke (AIS) is the world’s second leading cause of mortality. An established method for treating stroke patients in acute settings is endovascular therapy (EVT). However, the correlation of the successful endovascular treatment of AIS with the presence of communicating arteries in the circle of Willis needs to be proven. Our study examined clinical and radiological data of 158 consecutive patients treated with mechanical thrombectomy (MT) at our comprehensive stroke center. We analyzed their CT angiograms and digital subtraction angiography (DSA) to assess anatomical variants of Willis’ circle and formed two groups—collateral-negative and collateral-positive group. The first group included patients with aplasia of both anterior (ACoA) and posterior communicating Artery (PCoA). The second group included patients that have at least one communicating artery (either anterior or posterior). We evaluated their reperfusion outcomes and functional recovery three months later. Our results showed that patients with communicating arteries had smaller areas of infarction on post-interventional CT and higher rates of functional recovery (Modified Rankin Score). The ACoA had a higher impact on early and late outcomes, confirmed by lower control CT scores and more favorable functional recovery. Therefore, anatomic variants of Willis’ circle should be considered as a significant prognostic factor in AIS.

Coronavirus disease 2019 (COVID-19) increases the risk for thromboembolic events, such as acute ischemic stroke (AIS). Mechanical thrombectomy (MT) is a therapy of choice in early diagnosed AIS; however, its success and outcomes in COVID-19 patients are contradictory. This study presented our experience with MT performed in COVID-19 patients compared to a control group. The retrospective analysis included patients with AIS who underwent MT from April 2021 to April 2022 at our institution. There were 13 COVID-19-related patients (with active or past COVID-19 infection) and 55 non-COVID-19 patients (negative COVID-19 status). We analyzed patients’ baseline clinical and laboratory data, modified Thrombolysis in Cerebral Infarction (mTICI) scale, used 24 h follow-up CT findings, and modified the Rankin scale. The COVID-19 group had higher values of leukocytes, neutrophils, neutrophil/leukocyte ratios, ASL, ALT, LDH and CRP, and lower values of lymphocytes compared to the control group. The AIS mostly occurred in posterior circulation in the COVID-19 group, while anterior circulation was more affected in the control group. Treatment approach and successful reperfusion did not differ between groups. In conclusion, although differences in some clinical and laboratory parameters between COVID-19 and non-COVID-19 groups were found, the outcomes of mechanical thrombectomy were equal.

The collateral system is a compensatory mechanism activated in the acute phase of an ischemic stroke. It increases brain perfusion to the hypoperfused area. Arteries of the Willis’ circle supply antegrade blood flow, while pial (leptomeningeal) arteries direct blood via retrograde flow. The aim of our retrospective study was to investigate the relationship between both collateral systems, computed tomography perfusion (CTP) values, and functional outcomes in acute stroke patients. Overall, 158 patients with anterior circulation stroke who underwent mechanical thrombectomy were included in the study. We analyzed the presence of communicating arteries and leptomeningeal arteries on computed tomography angiography. Patients were divided into three groups according to their collateral status. The main outcomes were the rate of functional independence 3 months after stroke (modified Rankin scale score, mRS) and mortality rate. Our study suggests that the collateral status, as indicated by the three groups (unfavorable, intermediate, and favorable), is linked to CT perfusion parameters, potential recuperation ratio, and stroke outcomes. Patients with favorable collateral status exhibited smaller core infarct and penumbra volumes, higher mismatch ratios, better potential for recuperation, and improved functional outcomes compared to patients with unfavorable or intermediate collateral status.

Background: Although SARS-CoV-2 infection is primarily a respiratory illness, complications such as arterial and venous thromboembolism have been reported during acute infection and in the period after its resolution.Methods: We report the case of a 33-year-old male, previously healthy patient with acute recurrent unilateral arterial thrombosis of the leg occurring one month after a mild Covid-19 infection.Results: The patient has recently been diagnosed with essential hypertension and did not have other known risk factors for arterial thrombosis. He presented to the Emergency Department with a pale left foot and absent dorsal pedal pulse and after confirmed arterial occlusion by Doppler ultrasound, he underwent urgent thromboembolectomy. The following day a computed tomography angiogram showed recurrent thrombosis of the superficial femoral artery which was then resolved in an Angio-suite by balloon dilatation. Three months later he experienced another occlusion of the left superficial femoral artery based on pronounced neointimal hyperplasia and again underwent endarterectomy with patch plastic.Conclusion: SARS-Cov-2 infection should be considered a risk factor in the development of both arterial and venous thrombo-sis during the acute phase and in the post-infective period

Objectives Depression is characterized by a lack of energy, social withdrawal, and fatigue, and it is also associated with increased inflammation in the brain. Some studies suggest that adropin may have anti-inflammatory effects and could reduce the inflammatory processes contributing to depression. Methods: We included 54 newly diagnosed patients experiencing their first episode of depression and 56 healthy volunteers in this study. The participants with depression were divided into three subgroups based on DSM-5 and BDI-II criteria. The focus of the study was to compare adropin levels between depressive patients and healthy volunteers, as well as to monitor changes in adropin levels after six months of treatment for depressive patients. Results: Initial measurements showed no significant differences in standard laboratory parameters or adropin levels between the depression and control groups. However, adropin and vitamin D levels increased in the group of depressive patients during the six-month follow-up. Conclusions: Our research indicates that adropin plays a significant role in the development of depression and may influence the effectiveness of depression treatments.