Introduction: Encephalopathy and stroke in COVID-19 patients have been repeatedly reported. Previous reports indicate that SARS-CoV-2 infection is associated with a significantly escalated risk of ischemic stroke, especially with potentially cryptogenic stroke. Encephalopathy is also present in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Definitive diagnosis of CADASIL is based on sequencing the NOTCH3 gene. Primary pathology is the accumulation of abnormal transmembrane deposits on vascular smooth muscle cells in the brain and other organs.Material and methods: Genome of the patient was sequenced with the average depth of coverage 32,7x and mapped to the reference genome GRCh38. The whole genome sequencing (WGS) approach identified heterozygous missense variant NOTCH3 in the exon 8. Targeted Sanger sequencing was done to confirm the presence of the variant, and to examine the closest relatives. Beside the patient, all family members were unaffected, the variant appeared de novo.Results: Identified variant was not reported in the GnomAD v.3 and 1000 Genomes, nor in polymorphism database dbSNP. No clinical information was available in ClinVar. The only information regarding variants in the same amino acid position (Cs440Ser and Cys440Gly) from LOVD database were reported by Markus et al. They were found in 2 individuals affected with CADASIL and interpreted as pathogenic on the basis of symptoms and familial cosegregation. Beside the patient, all family members were unaffected, the variant appeared de novo.Conclusions: The simultaneous COVID-19 infection could probably provoke an exacerbation of a previously asymptomatic CADASIL patient and could lead to an acute ischemic multi-infarct encephalopathy.

Introduction and objective: The purpose of the present study was to assess stress and anxiety levels during hospitalisation due to COVID-19 and the relationship between them and personality traits, and coping strategies among women and men, and assessment of stress predictors. Materials and methods: The study was conducted in a reference single-name hospital in Warsaw. The Perceived Stress Scale-10 (PSS-10), the BRIEF-COPE Questionnaire, the State and Trait Anxiety Inventory (STAI), and the Ten Item Personality Inventory (TIPI-PL) were used. Results: The study involved 60 patients (30 women and 30 men) aged 24 to 82 years (M = 52.42, standard deviation, SD = 12.94). Elevated stress levels were found in half of the subjects studied; state anxiety levels were increased in 70% of the participants, and trait anxiety in 77% of them. Compared to men, women had significantly higher levels of state anxiety, and lower levels of openness to new experiences. It was shown that reducing stress levels during hospitalisation depends on the use of either an Active Coping strategy or an avoidance of the Helplessness strategy, with the level of state anxiety being the moderator in both models. Conclusions: Half of the patients hospitalised with COVID-19 did not experience elevated stress levels; women felt state anxiety more intensely as a condition during their hospital stay than men, and 40% of the subjects had an increased level of trait anxiety. For lower stress levels and/or state anxiety, adaptive coping strategies and personality traits were crucial: conscientiousness and agreeableness for women, and openness to experiences and agreeableness for men.

Patients hospitalized with neurological disorders may be at increased risk of adverse outcomes when infected with SARS-CoV-2. We evaluated whether early routine serum inflammatory and injury markers obtained at hospital admission are associated with in-hospital mortality in this subgroup. This single-center observational cohort included 460 consecutive adult inpatients admitted for neurological disorders with SARS-CoV-2 infection confirmed on admission or during hospitalization. Serum IL-6, LDH, ferritin, hs-troponin I, CRP, procalcitonin, and D-dimers measured within 6 h of hospital admission for neurological disorder were analyzed and compared between survivors and non-survivors. Non-survivors had higher IL-6, LDH, ferritin, and hs-troponin I (all p < 0.001). In multivariable analysis, LDH, ferritin, IL-6, and hs-troponin I were independently associated with mortality. We conclude that in neurological inpatients with confirmed SARS-CoV-2 infection, elevated early IL-6, LDH, ferritin, and hs-troponin I are associated with in-hospital mortality. These markers likely reflect systemic disease severity rather than CNS-specific neuroinflammation and may support early risk stratification in this population.

Background/Objectives: Endovascular thrombectomy (EVT) has transformed the treatment of acute ischaemic stroke due to large-vessel occlusion, yet peri-procedural haemodynamic instability may compromise penumbral perfusion and neurological recovery. We assessed the frequency, determinants and clinical consequences of post-procedural hypotension after EVT. Methods: We retrospectively reviewed 201 consecutive adults who underwent endovascular thrombectomy for anterior-circulation large-vessel occlusion at a single tertiary centre over a period of eight years, from 1 January 2017 to 31 January 2025. Post-procedural hypotension was defined as hypotension requiring initiation of a continuous noradrenaline infusion within 24 h of the procedure. Comorbidities, anaesthetic modality (general anaesthesia [GA] or conscious sedation [CS]), National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores, and in-hospital mortality were recorded. Logistic regression identified independent predictors of hypotension. Results: Fifty-five patients (27.4%) developed post-procedural hypotension. They presented with more severe strokes (NIHSS 16.0 ± 5.0 vs. 13.7 ± 5.0; p = 0.002), had higher NIHSS scores at day 2 (14.0 ± 6.9 vs. 9.4 ± 6.7; p < 0.001) and day 7 (p = 0.003), and displayed markedly higher in-hospital mortality (50.9% vs. 20.5%; p < 0.001). In an ordinal analysis of the day 7 modified Rankin Scale with death coded as 6, hypotension was associated with a shift towards greater disability (common OR 2.57, 95% CI 1.40–4.72; p = 0.002). In an exploratory model, each additional 10 min of door-to-groin time was independently associated with hypotension (adjusted OR 1.10, 95% CI 1.03–1.18; p = 0.003). Independent predictors of hypotension were baseline NIHSS (adjusted OR 1.11 per point, 95% CI 1.04–1.19; p = 0.003) and active malignancy (adjusted OR 2.90, 95% CI 1.04–8.09; p = 0.042). Hypotension occurred with similar frequency under GA and CS (28.6% vs. 24.6%; adjusted OR 1.12, 95% CI 0.54–2.34; p = 0.766). Conclusions: Post-EVT hypotension is common and associated with poorer early neurological recovery and a more than two-fold higher in-hospital mortality rate. Its independent predictors were baseline stroke severity and active malignancy. Patients with severe stroke or active cancer may warrant intensified haemodynamic surveillance after thrombectomy. Procedural delay emerged as the only modifiable predictor identified and warrants prospective evaluation.

The term ‘brain perfusion’ is applied in clinical practice to a family of neuroimaging techniques that measure, in reality, quite different physiological quantities in the brain circulation. CT perfusion (CTP) and DSC-MRI track a contrast bolus to derive semi-quantitative haemodynamic parameters. ASL-MRI estimates cerebral blood flow (CBF) without contrast, but the result is sensitive to arterial transit time, haematocrit, and the patient’s haemodynamic state on the day of the scan. DCE-MRI quantifies blood–brain barrier (BBB) permeability, a property of the neurovascular unit rather than a flow measurement. Perfusion SPECT provides a relative, normalisation-dependent CBF map that is distorted by cortical atrophy. [¹⁸F]FDG-PET reflects synaptic glucose metabolism, but not blood flow. Because these techniques answer different physiological questions, their results are not interchangeable, and applying a threshold or pattern derived from one modality to interpret another is methodologically unsound — yet this conflation occurs with regularity in clinical practice. This narrative review synthesises the clinical applications, diagnostic performance, and interpretive pitfalls of each technique in Alzheimer’s disease (AD)/mild cognitive impairment (MCI-AD), dementia with Lewy bodies (DLB)/Parkinson’s disease dementia (PDD), frontotemporal dementia (FTD)/primary progressive aphasia (PPA), and mixed dementia with vascular pathology. Recognised limitations include the narrative study design and the small number of head-to-head multi-modal studies in pathologically confirmed cohorts. A comparative table and practical minimum reporting elements are provided.