Background: Endothelial dysfunction plays a critical role in ischemic stroke. The Endothelial Activation and Stress Index (EASIX), calculated from creatinine, lactate dehydrogenase (LDH), and platelet levels, reflects endothelial injury. This study aimed to investigate the relationship between EASIX and 90-day mortality in patients with posterior circulation ischemic stroke (PCIS) treated with mechanical thrombectomy. Methods: Fifty-eight patients with acute ischemic stroke who underwent mechanical thrombectomy (MT) or MT combined with intravenous thrombolysis (intravenous tissue plasminogen activator (tPA)) for posterior circulation ischemic stroke (PCIS) were included. EASIX was calculated using 24 h laboratory values of creatinine, LDH, and platelets. Its association with 90-day mortality, length of hospital stay, intubation, and parenchymal hemorrhage was analyzed. Results: In patients receiving reperfusion therapy, the Endothelial Activation and Stress Index (EASIX) showed modest ability to predict 90-day mortality (AUC = 0.583, 95% CI 0.428–0.739, p = 0.295). Higher EASIX values were linked to a 6.58-fold increase in mortality risk. Patients with elevated EASIX were generally older, had more frequent hyperlipidemia, had higher 24 h National Institutes of Health Stroke Scale (NIHSS) scores, had greater need for intubation, and had higher in-hospital mortality. Conclusions: EASIX is a simple, inexpensive, and non-invasive marker that may reflect endothelial dysfunction and help predict mortality in PCIS patients undergoing reperfusion therapy. Higher EASIX values are associated with poorer prognosis. Early identification of high-risk patients may support secondary prevention strategies.

In-hospital acute ischemic stroke (AIS) is a distinct clinical entity that may differ from community-onset AIS in terms of patient characteristics, treatment processes, and outcomes. This study aimed to compare the clinical features, treatment pathways, and functional outcomes of patients with in-hospital versus community-onset AIS who received recanalization therapies. This retrospective analysis included adult patients with AIS treated with intravenous tissue plasminogen activator and/or mechanical thrombectomy (MT) at a single center between July 2020 and January 2025. The patients were stratified based on whether stroke occurred during hospitalization or in the community. Patient demographics, treatment strategies, procedural time intervals, recanalization success, and clinical outcomes were assessed. The in-hospital stroke group had a higher prevalence of cardiac disease and malignancy. The patients in this group underwent groin puncture sooner after symptom onset, and all those who underwent MT achieved successful recanalization. Nevertheless, the rates of favorable functional recovery at 3 months (modified rankin scale ≤ 2) and in-hospital mortality were similar between the in-hospital and community-onset stroke groups. In-hospital stroke was not identified as a significant predictor of 3-month functional outcome in the multivariate analysis. Among patients who received recanalization therapies, in-hospital AIS cases (despite a higher comorbidity burden) can achieve clinical outcomes similar to those of community-onset strokes through early recognition and treatment initiation. These findings highlight the importance of structured in-hospital stroke protocols and the role of MT in in-hospital stroke management.

Objectives: Diabetic neuropathy, significantly impacts patients' quality of life and may lead to severe morbidity in the long term. Early detection of diabetic neuropathy is crucial in preventing or delaying irreversible damage. In this study, we aimed to evaluate the role of medial plantar nerve conduction studies in the early diagnosis of diabetic polyneuropathy and to determine which of the examined nerve conduction studies demonstrates higher sensitivity. Methods: Sixty patients with suspected diabetic polyneuropathy and 30 healthy controls were included. Diabetic neuropathy symptoms were assessed using the Diabetic Neuropathy Symptom (DNS) score. Sensory and motor nerve conduction studies, including median, ulnar, posterior tibial, medial plantar, and sural nerves, were performed. Results: Sensory response amplitudes of both medial plantar and sural nerves were significantly lower in patients compared to controls. Abnormal sensory responses were detected in 23 (38.33%) patients for the sural nerve and 39 (65%) for the medial plantar nerve. Conclusions: Both nerve conduction studies are valuable in diagnosing diabetic polyneuropathy, but medial plantar nerve conduction studies demonstrated higher sensitivity. Including medial plantar nerve assessments in routine evaluations may improve diagnostic accuracy.

Decompressive craniectomy (DC) is a life-saving intervention for malignant cerebral edema following large territorial infarctions. While numerous studies demonstrate reduced mortality with DC, most data are derived from patients who did not receive reperfusion therapy. Outcomes in patients undergoing DC after reperfusion remain insufficiently characterized. This study presents our clinical experience in this population, focusing on demographics, clinical course, complications, and prognostic factors. We retrospectively analyzed 33 patients with acute ischemic stroke treated at Bursa City Hospital between July 2020 and January 2025. All underwent intravenous thrombolysis, endovascular therapy, or both, followed by DC during Neurology Intensive Care Unit stay. Functional outcomes were assessed at 90 days using the modified Rankin Scale (mRS). The mean age was 64.3 ± 14.4 years, and successful recanalization (≥ mTICI 2b) was achieved in 90.3% of cases. Hemorrhagic transformation occurred in 81%, with symptomatic intracerebral hemorrhage in 60.6%. DC was performed within 48 hours in 78.7% of patients. At 3-month follow-up, mortality was 48.4%, and all survivors had severe disability (mRS 4–5). Compared with historical data from patients who did not receive reperfusion therapy, the absence of favorable outcomes in our cohort may relate to the high rate of hemorrhagic transformation after reperfusion, potentially exerting a detrimental effect on neurological recovery. Larger randomized controlled trials are needed to determine which patients who underwent reperfusion therapy may derive meaningful benefit from DC.