BACKGROUND: Endothelial progenitor cells (EPCs) contribute to vascular repair and may play a critical role in recovery following cerebrovascular disease. This study aimed to evaluate the association between circulating EPC levels and clinical outcomes in patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack. METHODS: We conducted a prospective observational study at Hospital Universitario de Gran Canaria Doctor Negrín (Spain) between September 2023 and June 2024. We evaluated the association between circulating EPC levels and clinical outcomes in 126 patients with cerebrovascular disease (mean age, 70.4±12.9 years; 58.7% male), recruited within 48 hours of symptom onset. EPCs were quantified at admission (<48 hours), day 7, and 12 weeks. The primary outcome was favorable functional status at 3 months (modified Rankin Scale score, 0–2). Secondary outcomes included stroke severity (National Institutes of Health Stroke Scale), hospital stay, and mortality. RESULTS: Higher EPC levels on day 7 were independently associated with favorable functional outcome at 3 months (odds ratio, 0.769 [95% CI, 0.605–0.977]; P =0.032). Significant negative correlations were found between EPCs at day 7 and stroke severity at admission (r=–0.205; P =0.034) and length of hospital stay (r=–0.253; P =0.008). EPCs at day 7 were significantly lower in patients who died during follow-up (mean rank, 44.40 versus 56.34; P =0.004). Subgroup analysis in patients with ischemic stroke confirmed that day-7 EPC levels remained an independent predictor of good outcome (odds ratio, 0.743 [95% CI, 0.570–0.968]; P =0.028), shorter hospitalization (r=–0.278; P =0.006), and survival (U=552.000; P =0.043). CONCLUSIONS: EPC levels at day 7 may serve as a prognostic biomarker for recovery and mortality in cerebrovascular disease. These findings suggest a potential therapeutic window targeting endothelial repair mechanisms.

Objective. This study aimed to evaluate differences associated with two teaching methodologies on academic performance and student evaluation of teaching quality in neuroanatomy, using physiology as a control group. Methodology. A quasi-experimental study compared two academic years (2023–2024 and 2024–2025). Neuroanatomy changed from a flipped classroom to a traditional lecture-based teaching format, while physiology remained traditional lecture-based teaching in both years. Academic performance was assessed using final grades (primary outcome), examination scores, and continuous assessment. Student evaluation of teaching quality was measured using institutional surveys and normalized to a 0–100 scale. Comparisons were performed using the Mann–Whitney U test. Difference-in-differences (DiD) analyses were conducted using linear regression models including academic year, subject, and their interaction. Results. A total of 87 neuroanatomy students and 86 physiology students were included. In neuroanatomy, final grades decreased from 4.44 ± 2.33 to 3.02 ± 2.21 (p = 0.006), with significant reductions in examination scores (p = 0.007) and continuous assessment (p < 0.001). Similar declines were observed in physiology (final grades: 6.20 ± 1.27 vs. 3.39 ± 2.98; p < 0.001). In the DiD analysis, the interaction term showed a non-significant effect (β = -1.387; 95% CI [-2.814, 0.039]; p = 0.057), suggesting that no statistically significant independent effect of teaching methodology on performance could be demonstrated after adjustment for cohort effects. In contrast, student satisfaction was higher in 2024–2025 after normalization, with DiD analyses indicating improved engagement (β = -7.17; p < 0.05) and a trend toward higher perceived clarity. Conclusions. No teaching methodology demonstrated statistically significant superiority in academic performance after adjustment for cohort effects. However, the methodology implemented in 2024–2025 was associated with higher student satisfaction, particularly in engagement. These findings suggest a dissociation between perceived and objective learning outcomes and highlight the importance of controlled designs in educational research.

Introduction. Aortic arch complex atheromatosis is a source of cerebral embolism. A percentage of lacunar infarct could be of embolic etiology, especially due to microemboli of the aortic arch. Case report. We present the case of a 63-year-old hypertensive man suffering from dysarthria-clumsy hand syndrome for a right hemispheric minor ischemic stroke. The patient developed sequential acute thromboembolism of the left lower and right upper limbs. Computed tomography angiography revealed an aortic arch thrombus. Vascular surgery was successfully performed. Conclusion. This case highlights the importance of considering embolic sources in lacunar syndromes, especially at the level of the aortic arch.