Search Results (414)

Background/Objectives: Within the last decade, there has been a 19% increase in stroke-related mortality among individuals aged 45–64. Understanding stroke characteristics is crucial, particularly in the younger age groups. This study describes the key demographics and clinical and anthropometric characteristics based on age categories in young adults admitted to the stroke unit in Abu Dhabi. Methods: This retrospective observational study had data between October 2024 and March 2025. Data were analyzed descriptively using SPSS, with a more detailed analysis conducted across two age-based groups. Results: A total of 51 patients were included, with the median age of 40 (IQR: 37–48) and 44 (86.3%) being males. The median hospital length of stay was 4 days (2–9 days). Most of the patients, 47 (92.2%), had ischemic stroke, with 24 (45.1%) presenting with right-side weakness, and bilateral weakness in 4 (7.8%). The median NIHSS score on admission was 4 (IQR 2–9). Prior to admission, 18 (35.3%) of the patients were known hypertensive, and 12 (23.5%) were diabetic. In terms of anthropometric measurements, the median waist-to-height ratio was 0.58 (0.5–0.69) and BMI was 25.7 (24.2–29.4), with 31 (60.8%) of the patients categorized as either obese or overweight. The statistical significance difference across the age groups was found in the gender distribution only (p = 0.034). Conclusions: In the UAE, more young men are experiencing Stroke due to lifestyle-related factors, many of which can be prevented. This growing trend calls for early screening, better prevention efforts, and tailored rehabilitation programs. Full article

Experiencing weakness or paralysis on one side of the body is a common consequence of stroke, with approximately 8 out of 10 patients experiencing some degree of Hemiparesis. Rehabilitation through physiotherapy and occupational therapy is one of the primary methods used to alleviate these conditions. However, physiotherapy, provided by a therapist, is not always readily available. Rehabilitation robots have been studied as alternatives and supplements to conventional therapy. These robots, based on their interaction with the user, can be categorized as end-effector and exoskeleton-based robots. This work aims to examine end-effector rehabilitation robots targeting hemiplegic arm’s proximal joints (shoulder and elbow) for post-stroke recovery. Additionally, we analyze their mechanical design, training modes, user interfaces, and clinical outcomes, highlighting trends and gaps in these systems. Furthermore, we suggest design considerations for home-based therapy and future integration with tele-rehabilitation, based on our findings. This review uniquely focuses on end-effector robots for proximal joints, synthesizing design trends and clinical evidence to guide future development. Full article

Background and Clinical Significance: Giant sphenoid wing meningiomas are generally viewed as skull base masses that compress frontal centers and their respective pathways gradually enough to cause a dysexecutive–apathetic syndrome, which can mimic primary neurodegenerative disease. The aim of this report is to illustrate how bedside phenotyping and multimodal imaging can disclose similar clinical presentations as surgically treatable network lesions. Case Presentation: An independent, right-handed older female developed an incremental, two-year decline of her ability to perform executive functions, extreme apathy, lack of instrumental functioning, and a frontal-based gait disturbance, culminating in a first generalized seizure and a newly acquired left-sided upper extremity pyramidal sign. Standardized neuropsychological evaluation revealed a predominant frontal-based dysexecutive profile with intact core language skills, similar to behavioral-variant frontotemporal dementia (bvFTD). MRI demonstrated a large, right fronto-temporo-basal extra-axial tumor attached to the sphenoid wing with homogeneous postcontrast enhancement, significant vasogenic edema within the frontal projection pathways, and a marked midline displacement of structures with an open venous pathway. With the use of a skull-base flattening pterional craniotomy with early devascularization followed by staged internal debulking, arachnoid preserving dissection, and conservative venous preservation, the surgeon accomplished a Simpson Grade I resection. Sequential improvements in the patient’s frontal “re-awakening” were demonstrated through postoperative improvements on standardized stroke, cognitive and functional assessment scales that correlated well with persistent decompression and symmetric ventricles on follow-up images. Conclusions: This case illustrates the possibility of a non-dominant sphenoid wing meningioma resulting in a pseudo-degenerative frontal syndrome and its potential for reversal if recognized as a network lesion and treated with tailored, venous-sparing skull-base surgery. Contrast-enhanced imaging and routine frontal testing in atypical “dementia” presentations may aid in identifying additional patients with potentially surgically remediable cases. Full article

Background: Chagas disease, caused by Trypanosoma cruzi, remains endemic throughout Latin America but is increasingly reported in urban areas due to migration and vector adaptation. The cardiac form is the most severe manifestation, associated with arrhythmia, mural thrombus formation, and a high risk of cardioembolic events. Stroke secondary to Chagas cardiomyopathy is uncommon and poses diagnostic and therapeutic challenges. Case Presentation: A 58-year-old woman with serologic evidence of T. cruzi infection presented with sudden-onset dyspnea, oppressive chest pain, and left-sided weakness. Neurological examination revealed left brachiocrural hemiparesis and mild dysarthria (NIHSS = 9). Non-contrast cranial CT showed an acute infarct in the right middle cerebral artery territory (ASPECTS = 7). Electrocardiography demonstrated typical atrial flutter with variable conduction, and transthoracic echocardiography revealed a markedly dilated left atrium containing a mural thrombus and a left ventricular ejection fraction of 45%. Intravenous thrombolysis with alteplase (0.9 mg/kg) was administered within 4.5 h of symptom onset. Pharmacologic rhythm control was achieved using intravenous and oral amiodarone, followed by oral anticoagulation with warfarin (target INR 2.0–3.0) after excluding hemorrhagic transformation. The patient showed rapid neurological improvement (NIHSS reduction from 9 to 2) and was discharged on day 10 with minimal residual deficit (mRS = 1), sinus rhythm, and stable hemodynamics. Conclusions: This case highlights the rare coexistence of Chagas cardiomyopathy, atrial flutter, and cardioembolic stroke due to left atrial thrombus. Early recognition, adherence to evidence-based guidelines, and multidisciplinary management were key to achieving a favorable outcome. Timely diagnosis and intervention remain crucial to preventing severe complications in patients with Chagas disease. Full article

The tailless flapping-wing micro aerial vehicle (FW-MAV) exhibits capabilities for hovering and agile six-degree-of-freedom flight, demonstrating potential for missions in complex environments such as forests and indoor spaces. However, limited payload and endurance restrict their practical application. This study presents a novel tailless FW-MAV named X-fly, incorporating a lightweight crank-rocker mechanism with high thrust-to-weight ratio. The optimized flapping-wing mechanism achieves a maximum single-side lift of 28.7 gf, with a lift-to-power ratio of 6.67 gf/W, outperforming conventional direct-drive propellers using the same motor. The X-fly employs servo-controlled stroke planes for tailless attitude stabilization and rapid disturbance recovery. It features a 36 cm wingspan and a net weight of 18.9 g (without battery). Using a commercially available 1100 mAh battery weighing 21.6 g, it demonstrates a peak lift-to-weight ratio of 1.42 at 3.8 V and achieves a maximum flight endurance of 33.2 min. When equipped with a 250 mAh battery weighing 5.5 g, it can carry an additional payload equal to its own net weight. The X-fly attains a maximum speed of 6 m/s and demonstrates high agility during forest flight. Furthermore, it successfully performs a simulated reconnaissance mission with an onboard camera, confirming its potential for practical applications. Full article

Background: In primary supratentorial intracerebral hemorrhage (PSICH), dexamethasone (Dexa) may be effective in reducing perihematoma edema (PHE). We compare the changes in the PHE, hematoma edema complex (HEC), and midline shift (MLS) in patients with PSICH in the Dexa and Non-Dexa groups. Methods: The CT-proven PSICHs were included, and their stroke risk factors, Glasgow Coma Scale (GCS) score, and National Institute of Health Stroke Scale (NIHSS) score were noted. Thirty-one patients received intravenous dexamethasone from day 4 to day 7 of stroke in a dose of 24 mg, 12 mg, and 8 mg daily for 3 days each. Thirty-three patients did not receive dexamethasone. The primary outcome was the change in PHE, HEC, and MLS at 15 days compared to the pre-Dexa CT scan, and the secondary outcomes were death and disability at 3 months and side effects. Results: The Dexa group had a higher volume of ICH, HEC, and PHE, and MLS compared to the Non-Dexa group, although their age, NIHSS and GCS scores were comparable at admission and just before intervention. The Dexa group had a larger reduction in HEC (p = 0.03) and MLS (p < 0.01) compared to the Non-Dexa group. The change in PHE volume was also insignificantly higher in the Dexa group (p = 0.36). At 3 months, the patients with medium (p < 0.001) and large-size hematomas (p < 0.001) in the Dexa group had a good outcome, but this benefit was not observed in small hematomas. Conclusions: In PSICH, dexamethasone after 3 days reduces the HEC and MLS and may have survival and disability benefits especially in medium and large hematomas. A multicentric–randomized–controlled trial may confirm these findings. Full article

It has long been known that inlet port geometry plays a crucial role in regulating in-cylinder flow processes, significantly affecting combustion efficiency and engine emissions. This paper elucidates the effects of an intake port geometry modification, specifically the implementation of a novel moving deflector to intensify tangential intake flow, on fluid flow patterns, combustion stage, and exhaust emissions in a spark-ignited internal combustion engine. The analysis was performed using multi-dimensional numerical modeling of reactive flow, where the numerical domain was extended to the complete intake system to explicitly encompass the modification. The numerical model was validated against experimental data, showing excellent agreement, with differences in peak in-cylinder pressure and peak rate of heat release (RHR) kept below 3% and the moment of peak pressure being nearly identical to the experimental results. During the induction stroke, the effects of implemented modification through intensification of intake jet were clearly legible, pursued by deflection of smaller side vortices in the vicinity of the bottom dead-center. During compression, the attenuation of the effects of the earlier established macro flow was encountered and some negative effects of the increased intake jet were elucidated. During combustion the existence of “flame dominated fluid flow” controlled primarily by turbulence diffusion was encountered. Negative effects on exhaust emissions were elucidated as well. As the combustion process in spark ignition internal combustion engines is primarily controlled by turbulent diffusion, proper identification of influential types of organized flows is a challenging but very important task. The advantages offered by the application of numerical modeling in these situations are clear. Full article

Background and Clinical Significance: Hemiplegia following a cerebrovascular accident (CVA) disrupts gait symmetry and efficiency, compromising functional independence. The integration of surface electromyography (sEMG) and inertial measurement units (IMU) enables quantitative assessment of muscle activation and segmental dynamics, providing objective data for therapeutic planning. Case presentation: A 57-year-old male with chronic right hemiplegia, eight years post-ischemic stroke of the left middle cerebral artery. The patient ambulated independently without assistive devices, exhibiting right lower-limb circumduction. Clinical assessment revealed the following scores: Barthel Index 85/100, Tinetti Performance-Oriented Mobility Assessment (POMA) 16/28, Timed Up and Go (TUG) test 13 s, and Modified Ashworth Scale (MAS) scores of 1 (upper limb) and 1+ (lower limb). Methods: Multichannel sEMG (Miotool 800^®, 8 channels) was recorded form the lumbar erectors, gluteus medius and maximus, vastus medialis, vastus intermedius, vastus lateralis, biceps femoris, tibialis anterior, medial gastrocnemius, and lateral gastrocnemius. Ag/AgCI electrodes were positioned according to SENIAM recommendations: sampling rate: 1000 Hz; band-pass filter: 20–500 Hz; notch filter: 60 Hz; normalization to %MVC. Simultaneously, IMU signals (Xsens DOT^®, 60 Hz) were collected from both ankles during slow, medium and fast walking (20 s each) and compared with a healthy control subject. Results: The patient exhibited reduced sEMG amplitude and increased peak irregularity on the affected side, particularly in the gluteus medius, tibialis anterior, and gastrocnemius, along with agonist desynchronication. IMU data revealed decreased range of motion and angular pattern irregularity, with inconsistent acceleration peaks in the right ankle compared to the control, confirming neuromuscular and kinematic asymmetry. Conclusions: The combined sEMG-IMU analysis identified deficits in selective motor control and propulsion on the affected hemibody, providing essential information to guide physiotherapeutic interventions targeting pelvic stability, dorsiflexion, and propulsive phase training, enabling objective follow-up beyond specialized laboratory settings. Full article

Background: This study aimed to assess the efficacy, optimal dosing, and timing of colchicine therapy in reducing major adverse cardiovascular events (MACE), its impact on inflammatory markers, and safety concerns in patients following acute coronary syndrome (ACS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted in accordance with PRISMA guidelines to identify RCTs comparing colchicine versus placebo or standard treatment in ACS patients. The primary outcome was MACE and secondary outcomes included all-cause and cardiovascular mortality, non-fatal MI, stroke, revascularization, heart failure, CRP/hs-CRP changes, and adverse effects. Fifteen RCTs involving 19,131 patients were analyzed. Results: The benefit of colchicine in reducing MACE risk was marginally significant (RR = 0.79, 95% CI: 0.63–0.99, p = 0.04, I² = 59%). No significant reduction was observed for all-cause mortality, cardiovascular mortality, other cardiovascular outcomes, early initiation of colchicine (≤3 days), or choice of dosage (≤0.5 mg/day vs. >0.5 mg/day). The findings pertaining to the delayed time-to-initiation (>3 days) and changes in CRP or hs-CRP levels were inconclusive. Gastrointestinal side effects, especially diarrhea (RR = 1.76, 95% CI: 1.16–2.66, p = 0.001), were most common. No increase in hematologic events or infections was observed. Conclusions: Colchicine potentially reduces MACE in ACS patients, without evidence of benefit in improving all-cause mortality or other cardiovascular outcomes. Gastrointestinal intolerance is the most common side effect. This result is consistent with current clinical guidelines: a Class IIb recommendation for colchicine use in ACS. There is a need for further high-quality trials to refine patient selection and optimize treatment regimens. Full article

Background/Objectives: This study aimed to develop and evaluate an automated fluid infusion management system for preventing hypotension during general anesthesia. Methods: This study was a single-blind, randomized, non-inferiority, clinical trial. Seventy-nine patients undergoing surgery under general anesthesia were randomly assigned to either an automatic group or a manual group. In the automatic group, the infusion rate was automatically adjusted based on stroke volume (SV) and effective arterial elastance (Ea), whereas in the manual group, the attending anesthesiologist manually adjusted the infusion rate according to the Enhanced Recovery After Surgery (ERAS) protocol. The primary endpoint was the proportion of time during anesthesia that mean arterial pressure (Pm) was maintained at ≥65 mmHg. Secondary endpoints included the proportion of time the estimated stroke volume index (esSVI) was below the threshold, total fluid volume administered, total phenylephrine dose, urine output, blood loss, and average estimated stroke volume variation (esSVV). Results: The results demonstrated non-inferiority of the automatic group to the manual group in maintaining Pm ≥ 65 mmHg (automatic group: 82.0 ± 12.7%, manual group: 79.9 ± 15.7%; difference [automatic group−manual group]: 2.0 percentage points; one-sided 97.5% CI lower limit: −4.7%; non-inferiority margin: −5%). There were no significant differences between the groups in total fluid volume, phenylephrine dose, urine output, or blood loss. No severe adverse events or device-related adverse events were observed. Conclusions: The automated system maintained intraoperative blood pressure safely and effectively. Full article

Background/Objectives: The growing population of stroke survivors living in rural communities, who require ongoing rehabilitation, highlights the need for effective, home-based rehabilitation methods. The aim of this study was to evaluate the potential benefits of Proprioceptive Neuromuscular Facilitation (PNF) on segmental and global motor function, gait performance, Activities of Daily Living (ADLs), and quality of life in a patient with chronic hemiplegia living at home. Methods: A 71-year-old woman, five years after an ischemic stroke of the left cerebral hemisphere, presented with severe right-sided hemiplegia and participated in a two-month home-based PNF rehabilitation programme consisting of 20 one-hour sessions delivered 2–3 times per week. To evaluate the effectiveness of the intervention, the following standardised outcome measures were used in given order: Fugl-Meyer Assessment of Lower Extremity (FMA-LE), Trunk Impairment Scale (TIS), Timed Up and Go Test (TUG), Rivermead Motor Assessment Scale (RMA), Barthel Scale (BS), and the Short Form Health Survey (SF-36). Results: Improvements were observed in lower limb motor function (FMA-LE), gait performance (TUG), and overall quality of life (SF-36). Conclusions: PNF-based physiotherapy delivered at home environment may provide meaningful benefits for patients living in rural areas, even years after stroke. Full article

Background: One of the main goals of rehabilitation after stroke is the restoration of motor function. Understanding movement patterns and compensatory strategies is essential to optimize therapy. This study analyzes upper limb kinematics during the Box and Block Test (BBT) to identify and quantify typical post-stroke compensation strategies. Methods: Thirty-one sub-acute stroke participants and thirty-one healthy controls were included. Kinematic data were collected using a 7-IMU system. Joint angles were analyzed with MATLAB R2023a, and 3D trajectories were reconstructed from calibrated quaternions and anthropometric data. Group differences were assessed with the Mann–Whitney test. Compensation strategies were quantified in percentage terms relative to healthy subjects. Results: Significant intergroup differences were observed in mean joint angles and ranges of motion. On the paretic side, participants overused the wrist and shoulder to compensate for reduced elbow and trunk activity. Similar overuse was also observed on the unaffected side. Quantification showed that 83.9% and 80.6% compensate, respectively, with wrist and trunk and 67.7% with the shoulder. Conclusions: Using IMUs during the BBT, this study identified specific compensation strategies that may hinder recovery. It also contributed to developing a quantification scale, supporting more personalized rehabilitation and improved quality of life. Full article

Stroke-induced motor impairment necessitates objective and quantitative assessment tools for rehabilitation planning. In this study, a gesture-specific framework based on high-density surface electromyography (HD-sEMG) was developed to characterize neuromuscular dysfunction using eight macroscopic features and two microscopic motor unit decomposition features. HD-sEMG recordings were collected from stroke patients (n = 11; affected and unaffected sides) and healthy controls (n = 8; dominant side) during seven standardized hand gestures. Feature-level comparisons revealed hierarchical abnormalities, with the affected side showing significantly reduced activation/coordination relative to healthy controls, while the unaffected side exhibited intermediate deviations. For each gesture, dedicated K-nearest neighbors (KNN) models were constructed for clinical validation. For Brunnstrom stage classification, wrist extension yielded the best performance, achieving 92.08% accuracy and effectively discriminating severe (Stage 4), moderate (Stage 5), and mild (Stage 6) impairment as well as healthy controls. For fine motor recovery prediction, the thumb–index–middle finger pinch provided the optimal regression performance, predicting Upper Extremity Fugl–Meyer Assessment (UE-FMA) scores with R = 0.86 and RMSE = 3.24. These results indicate that gesture selection should be aligned with the clinical endpoint: wrist extension is most informative for gross recovery staging, whereas pinch gestures better capture fine motor control. Overall, the proposed HD-sEMG framework provides an objective approach for monitoring post-stroke recovery and supporting personalized rehabilitation assessment. Full article

Background: This study explored the correlation between lateral ventricle volume asymmetry and cerebral blood flow (CBF). Methods: A retrospective review of 94 patients who underwent CT perfusion (CTP) and standard brain imaging was conducted. Lateral ventricle volumes and CBF across 13 vascular-based regions of interest (ROIs) were measured. Cerebral artery stenosis was identified using magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). Paired t-tests, Pearson’s correlation, logistic regression, and Cox models were used to assess the relationships between lateral ventricle asymmetry, CBF differences, and their associations with cerebral artery stenosis and the risk of stroke during follow-up. Results: 94 patients were included (mean age: 60.7 years). CBF was significantly lower on the side of the larger lateral ventricle in regions supplied by the anterior cerebral artery (ACA) (Mean relative value ± SD, % = 112.3 ± 32.5, p-value = 0.0016) and middle cerebral artery (MCA) (Mean relative value ± SD, % = 123.1 ± 57.8, p-value = 0.0004). A moderate correlation was observed between lateral ventricle volume asymmetry and CBF differences across the entire cohort. Significant associations were identified between CBF differences in specific ROIs and the presence of cerebral artery stenosis (MCA: aOR = 1.026, 95% CI: 1.004–1.048, p-value = 0.019). Conclusions: Lateral ventricle asymmetry is associated with reduced CBF in specific brain regions, particularly those supplied by the ACA. CBF differences in regions supplied by the PCA are linked to increased risk of subsequent stroke during follow-up. Full article

The brain in healthy adults shows language localization in the left hemisphere, and the evidence from the literature supports neural plasticity after traumatic injuries. What happens if an injury occurs early in brain development? How does early unilateral brain damage affect a child’s ability to acquire language? Evidence regarding language development after early unilateral brain damage is mixed. Therefore, this case report aims to present the language and cognitive status at the age of seven in a child who suffered a left-sided arterial presumed perinatal ischemic stroke (APPIS), with reference to her MRI findings. As part of her ongoing rehabilitation, she has received continuous speech therapy since age four and physiotherapy since six months of age. The current evaluation provides insights into long-term neurodevelopmental outcomes following early brain injury, highlighting the variability in clinical outcomes and considering the potential for functional restitution. Full article