Background: The prognostic value of the neutrophil–lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline (p = 0.018) and 24 h (p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

Background/Objectives: The C-reactive protein-to-lymphocyte ratio (CLR) has emerged as an inflammatory biomarker reflecting innate and adaptive immune responses. Its prognostic value in acute ischemic stroke patients undergoing mechanical thrombectomy remains unclear. This study investigated whether CLR predicts functional outcome, mortality, and symptomatic intracranial hemorrhage (sICH). Methods: In this multicenter retrospective study, 714 patients with anterior circulation large-vessel occlusion treated with mechanical thrombectomy between January 2024 and January 2025 were analyzed. Clinical, angiographic, and laboratory data, including CLR, were collected. CLR was calculated as CRP divided by lymphocyte count/1000. Outcomes were 90-day modified Rankin Scale (mRS; poor outcome = 3–6; mortality = 6) and sICH per ECASS II. Receiver operating characteristic (ROC) analyses identified optimal CLR cut-offs. Logistic regression analyses determined independent predictors of outcomes. Results: sICH occurred in 39 patients (5.5%). CLR correlated with higher baseline NIHSS and lower ASPECTS. ROC analyses showed that CLR predicted poor functional outcome and mortality with an identical cut-off (≥7.51; AUCs 0.634 and 0.664), and demonstrated strong discrimination for sICH (cut-off ≥ 10.64; AUC 0.855). In multivariable analyses, CLR remained an independent predictor across all outcomes (ORs 1.02, 1.02, and 1.03, all p < 0.001), in addition to established clinical factors. Conclusions: Admission CLR was independently associated with poor outcomes, mortality, and sICH after mechanical thrombectomy. As an easily obtainable marker from routine laboratory tests, CLR may provide additional prognostic information and complement established predictors, but prospective validation is required.

Introduction: Conventional nerve conduction studies (NCS) are used in the electrodiagnosis of diabetic neuropathy. The aim of our study was to investigate diabetic small fiber neuropathy in newly diagnosed type 2 diabetes mellitus (DM) patient group by using autonomic tests. Methods: Our study was conducted on 49 patients (24 female, 25 male) who were newly diagnosed with type 2 DM in the last 3 months and a control group of 25 volunteers. In addition to conventional NCS, sympathetic skin response (SSR) and RR interval variability (RRIV) tests were performed. Results: The mean upper limb SSR latency of the patient group was more prolonged than that of the control group, whereas the mean lower limb SSR amplitude of the patient group was lower than that of the control group (p=0.002, p<0.001; respectively). The mean resting (R) and deep inspiration (D) RRIV values of the patient group were lower than that of the control group (p=0.037, p<0.001; respectively). In the patient group, the mean R-RRIV and D-RRIV values were found to be positively correlated with the lower limb SSR amplitude (r=0.006, r=0.011; respectively). The mean R-RRIV and D-RRIV change rate of the patient group (D-R)/R was found to be lower than that of the control group (p=0.002). Conclusion: In our study, we showed that autonomic function tests were impaired in newly diagnosed type 2 DM patients who were found not to have diabetic polyneuropathy by standard electrophysiological study. These findings suggest that standard electrophysiological tests are not sufficient in the early stages of the disease.

Background: Endovascular thrombectomy (EVT) improves outcomes and reduces mortality in acute ischemic stroke. However, despite achieving successful recanalization in most patients, a subset still experiences poor functional outcomes at 3 months. This failure, despite complete vessel reopening, is termed futile recanalization (FR). We investigated clinical and radiological predictors of FR in a multicenter cohort in Türkiye. Methods: We retrospectively analyzed 497 consecutive patients with middle cerebral artery (M1 or M2) occlusion who underwent EVT and achieved modified Thrombolysis in Cerebral Infarction (mTICI) 3 recanalization within 6 h of symptom onset at 19 stroke centers. FR was defined as a modified Rankin Scale (mRS) score ≥4 at 3 months. Clinical and radiological parameters were recorded, and logistic regression was used to identify independent predictors of FR. Results: Among 497 patients, 133 (26.7%) experienced FR despite complete recanalization. Independent predictors included older age (adjusted odds ratio [aOR] 1.07; 95% CI 1.03–1.10; p < 0.001), longer puncture-to-recanalization time (aOR 1.03; 95% CI 1.02–1.05; p < 0.001), higher admission C-reactive protein (aOR 1.01; 95% CI 1.00–1.02; p = 0.03), intracranial hemorrhage on 24-h CT (aOR 0.46; 95% CI 0.23–0.95; p = 0.04), lower collateral score (aOR 42.98; 95% CI 6.15–30.62; p < 0.001), and higher 24-h NIHSS score (aOR 1.34; 95% CI 1.24–1.44; p < 0.001). Conclusion: Even with early and complete recanalization, elderly patients and those with poor collateral circulation remain at risk for futile recanalization. Identifying these predictors can guide patient selection, procedural planning, and post-procedural management to optimize functional outcomes.

Eagle Syndrome is a rare vascular condition characterized by the elongation of the styloid process and/or the calcification of the styloid ligament. This elongation or calcification can lead to compression or irritation of the surrounding nerves, blood vessels, and soft tissues, potentially causing compression or irritation of the extracranial part of the internal carotid artery (ICA) and resulting in symptoms such as throat pain, difficulty swallowing, ear pain, headache, and facial pain. Diagnosis of Eagle Syndrome typically involves clinical assessment and imaging studies, with treatment options varying from conservative approaches to surgical interventions based on symptom severity. Patients with dissection of the extracranial part of the ICA or the vertebral artery are generally recommended antithrombotic therapy, which may include antiplatelet or anticoagulation treatment. In this case, the diagnosis and treatment of Eagle Syndrome, which presented with an ischemic stroke caused by the elongated styloid process after a fall during a marathon, are discussed.