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: Predicting mortality in patients with acute ischemic stroke who need endovascular treatment (EVT) has previously been shown to be related to inflammation. In this study, we aimed to examine the effects of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hypersensitive C-reactive protein-to-albumin ratio (CAR) values on mortality and hemorrhagic transformation. Methods: A total of 225 adult patients who underwent EVT between 2022 and 2024 were retrospectively analyzed. The presence of intracranial hemorrhage (ICH) after the procedure; good and poor clinical outcomes according to modified Rankin Scores; mortality status; and NLR, PLR, and CAR values were collected. Results: The average age of the patients was 66.95 ± 12.74 years, and 133 (59.1%) patients were male. Thirty-eight (30.4%) patients had symptomatic ICH. While 164 (72.9%) patients had a poor outcome, 80 (35.6%) patients died. There was a correlation between the NLR and PLR values and symptomatic ICH (p = 0.013, 0.009, respectively) in the univariate analysis, but this relationship was not found in the multivariate analyses (p: 0.212 and p: 0.459). No statistically significant relationship was observed between the CAR and symptomatic ICH and mortality (p = 0.784, 0.079, respectively). When the laboratory data were compared according to the mortality status, the NLR and PLR were observed to be statistically significantly higher in the patients with mortality (p < 0.001, 0.005, respectively) in univariate analyses. But, as a result, the NLR, PLR, and CAR were not associated with ICH and mortality according to the multivariable logistic regression analysis. Conclusions: Our findings highlight the need to better understand the post-stroke immune response. Our study demonstrated that the NLR, PLR, and CAR were not associated with ICH and mortality according to the multivariable logistic regression analysis.

Objectives: Recently, the need for early diagnosis of modifiable risk factors involved in the etiology of stroke has been highlighted in the literature. Nesfatin-1 is a peptide expressed in the central nervous system and peripheral tissues and has been used as a biomarker in recent years. This study aimed to determine the association of ischemic stroke with internal carotid artery stenosis according to nesfatin-1 level and whether it could be used as a biomarker. Methods: A total of 118 patients were included in the study. Three groups were defined: acute stroke patients with symptomatic internal carotid artery stenosis, acute stroke patients without internal carotid artery stenosis, and a control group. Nesfatin-1 levels were measured and compared. Results: The median value was 22 pg/mL in acute stroke patients with internal carotid artery stenosis, 24.3 pg/mL in acute stroke patients without internal carotid artery stenosis, and 46.4 pg/mL in the control group. There is a difference between the median values of nesfatin-1 according to the stroke groups with the control group (p < 0.001). When a cut-off value of ≤30.62 was taken for nesfatin-1, an AUC value of 0.773 indicated statistical significance (p < 0.001). Sensitivity was 77.03%, specificity 83.33%, PPV 90.48%, and NPV 63.83%. The main limitations of our study are the small sample size and the fact that the function of nesfatin-1 is not completely known. Conclusions: Although we found that nesfatin-1 levels were lower in ischemic stroke patients compared to controls, its diagnostic potential indicates a moderate discriminatory ability with an AUC value of 0.773. Therefore, whether it is suitable for clinical use will be demonstrated by studies in larger and multicenter cohorts.

Background: Trunk control is the basic component of postural control, and achieving trunk control is a complex process that can be achieved by dynamically building and maintaining neuromuscular function. Lateropulsion, which is also defined as the body falling to one side, is considered an important condition that is frequently encountered after stroke and affects trunk control. It is known that there are differences in the regulation of postural control and trunk control according to hemispheric localization. We had a very specific group of patients and tried to find out the outcomes prospectively in this study. Methods: The patients were divided into 2 groups those with right hemisphere lesions (Group 1) and those with left hemisphere lesions (Group 2). Comorbidity and cognitive function were evaluated using the Charlson Comorbidity Index (CMI) and Standardized Mini-Mental State Test (SMMSE). Activities of daily living were evaluated using the Turkish version of the Modified Barthel Index (MBI). The Stroke Rehabilitation Assessment of Movement Instrument (STREAM) test was used to assess trunk control and the Brunnstrom (BS) test was used to assess motor functions. Results: There was a significant difference between Groups 1 and 2 in terms of STREAM in lower extremity scores were higher in Group 2 ( P < .05). The number of patients in BS lower extremity Stages IV-VI was higher in Group 1 and Group 2 ( P < .05). It was determined that upper extremity, lower extremity and Total STREAM scores and BS Hand stage in Group 2 were significantly higher than Group 1 in patients with total middle cerebral artery (MCA) affected( P < .05). Conclusion: It was determined that trunk control was more affected in patients with right hemispheric lesions. Additionally, trunk control is significantly affected in patients with total MCA lesions.

Objective: The thalamus is a control point that is a gateway for all sensory impulses except smell and contributes to regulating the sleep-wake process. Therefore, infarcts of the thalamus cause a diversity of symptoms along with a diversity of vascular anatomy. The fact that thalamic infarcts are mostly considered lacunar infarcts seems to create inadequacy in understanding the etiology. This study aimed to compare the etiologic, diagnostic, and therapeutic parameters of thalamic infarction. Materials and Methods: This retrospective study analyzed 230 patients with thalamic infarction among 820 stroke patients admitted between January 2019 and April 2022. Patients with hemorrhagic stroke, malignancy, or infection were excluded. Demographic data, comorbidities, imaging results, and treatments administered were evaluated. All these results were analyzed in two subgroups: isolated thalamic and extrathalamic involvement. Results: Bilateral thalamic involvement was 8.386 times more common in patients with extrathalamic participation. Patients using dual antiaggregants had 2.207 times higher isolated thalamic involvement, while those on oral anticoagulants had 2.378 times higher extrathalamic involvement. Pathologies in the basilar and vertebral arteries increased the risk of extrathalamic involvement by 2.660 times (p<0.001). Conclusion: Thalamic infarcts cannot be considered exclusively lacunar. Extrathalamic involvement has been associated with worse functional scores and arterial pathologies. The protective effects of dual antiaggregants and oral anticoagulants vary depending on whether the thalamic infarct is extrathalamic or not, emphasizing the need for individualized therapies.