The Time Is Brain Review
Stroke evidence. Critically reviewed.
GOLDEN BRIDGE II — Clinical Decision Support for Acute Ischaemic Stroke
GOLDEN BRIDGE II: a stroke CDSS improved care processes and reduced 3-month vascular events across 77 Chinese hospitals.
Short-term Risk of Recurrent Stroke in Symptomatic Carotid Near-Occlusion
Full-collapse near-occlusion marked higher 48-hour recurrence risk; pooled observational data do not prove revascularisation benefit.
Remote ischaemic conditioning in patients with supratentorial intracerebral haemorrhage (RICH-2): a multicentre, randomised, sham-controlled phase 3 trial in China
This sham-controlled phase 3 trial found no functional benefit from seven days of remote ischaemic conditioning in selected non-surgical supratentorial ICH, despite a radiographic haematoma-clearance signal.
Post-transfer reassessment for endovascular treatment: factors associated with changes in EVT eligibility
A single-network cohort links neurologic change and baseline imaging to interval recanalization or infarct progression after EVT transfer; prospective validation is needed before selective pathways are used.
Scalp acupuncture coupled with speech-language therapy modulates the ventral-dorsal structural brain network in patients with post-stroke anomia: a randomized clinical and DTI neuroimaging trial
A single-center randomized trial found greater immediate naming-score improvement when scalp acupuncture was added to speech-language therapy, but the small per-protocol analysis, lack of sham control and unblinded treatment limit causal interpretation.
Oedema reduction mediates thrombectomy benefit in large core stroke: secondary analysis of the TENSION trial
A selected CT-based secondary analysis of TENSION links EVT with less 24-hour net water uptake and estimates an oedema-mediated pathway to 90-day outcome, but the mediation is hypothesis-generating.
Anticoagulation Treatment Response Among Phenotypic ESUS Clusters: Evidence From CASPR
CASPR registry analysis found no significant overall anticoagulation advantage and no treatment-effect separation by phenotypic cluster.
Phenotypic determinants of atrial fibrillation in ischaemic stroke: a retrospective study
A retrospective stroke/TIA cohort links detected AF with stroke severity and cardiac-remodelling features; phenotypes remain hypothesis-generating.
The impact of levodopa on post-stroke depression: the ESTREL-depression-study
ESTREL-Depression found no reduction in three-month depressive symptoms with early levodopa; selection and imprecision limit the conclusion.
Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial
TRUST found no improvement in 90-day excellent functional outcome with one million units of intravenous urokinase versus guideline-based medical treatment for minor ischemic stroke within six hours; substantial crossover and sparse bleeding events limit stronger conclusions.
Influence of Support Surface Stability on Changes in Quadriceps Femoris Muscle Thickness During Progressive Squat Exercise in Patients with Stroke: A Randomized Controlled Trial — Thicker is not stronger
In a small stroke rehabilitation trial, unstable-surface squats increased rectus femoris and vastus medialis thickness more than stable-surface squats, without establishing strength or functional benefit.
Effects of blood flow restriction combined with visual feedback training on lower limb function and the serum levels of BDNF and VEGF in patients with stroke
A 40-patient trial found better four-week balance and lower-limb function when blood flow restriction was added to visual feedback training, but circulating biomarkers did not establish cerebral repair.
Neuronal autoantibodies associated with poorer neuropsychological and motor outcomes 6 months after stroke: results from the PHYS-STROKE trial
An exploratory PHYS-STROKE biomarker analysis links baseline neuronal autoantibodies to selected six-month outcomes, but only the NMDAR–subjective mobility association survives correction for multiple comparisons.
Edaravone dexborneol versus placebo on functional outcomes in patients with acute ischaemic stroke undergoing endovascular thrombectomy (TASTE-2): randomised controlled trial
In selected Chinese patients with anterior-circulation large-vessel occlusion treated by thrombectomy, edaravone dexborneol produced a borderline increase in 90-day functional independence without a detected increase in serious adverse events.
Transauricular Vagus Nerve Stimulation in Acute Ischaemic Stroke Requiring Mechanical Thrombectomy: Sham-Controlled, Randomised Device Trial — a neutral primary endpoint
In a 36-person sham-controlled thrombectomy pilot, auricular vagus stimulation was feasible and showed no serious device-related harm, but did not reduce 24-hour systolic blood-pressure variability.
Soft Robotic Glove Versus GRASP in Subacute Stroke: A Dose and Selection Question
In an under-enrolled, assessor-blinded trial, a soft robotic glove was not superior to supervised GRASP for upper-limb recovery after subacute stroke; a post-hoc distal-hand signal needs confirmation.
Tenecteplase in Minor Stroke: Does Vessel Occlusion Change the Answer? — TEMPO-2 Secondary Analysis
Baseline occlusion status did not identify a minor-stroke subgroup with improved 90-day recovery after tenecteplase versus non-thrombolytic care in TEMPO-2.
Speech Therapy Combined With Cerebrolysin in Enhancing Nonfluent Aphasia Recovery After Acute Ischemic Stroke: ESCAS Randomized Pilot Study
The ESCAS pilot found a 14.805-point greater mean 90-day Western Aphasia Battery–Aphasia Quotient gain with Cerebrolysin plus speech therapy, with uncertain generalizability and functional benefit.
DWI-Positive Lesions in Patients With Acute Intracerebral Hemorrhage — Associations With Cerebral Small Vessel Disease and Clinical Outcome
Remote DWI-positive lesions occurred in 21.6% of patients with acute intracerebral hemorrhage and independently marked greater small-vessel-disease burden and worse six-month functional outcome.
Action Observation Combined With Virtual Reality Promotes Motor Recovery After Stroke: A Randomized Controlled Trial
In this 48-participant randomized trial, adding action observation to virtual-reality rehabilitation produced a larger paretic-hand dexterity gain than virtual reality alone, exceeding the study's 7-block smallest-detectable-difference benchmark at treatment end and persisting at 6 months.
TREASURE — Allogeneic Stem Cell Therapy for Acute Ischemic Stroke
A multicenter double-blind phase 2/3 RCT in Japan found that allogeneic MultiStem cell therapy within 18–36 hours of acute ischemic stroke was safe but did not improve excellent-outcome rates at 90 days versus placebo, with exploratory subgroup signals in younger patients.
Defining the Therapeutic Ceiling of Endovascular Thrombectomy in Large-Core Stroke — Beyond the Limits of ASPECTS
Quantitative infarct volumetry — not NCCT-ASPECTS — sets the true ceiling for endovascular thrombectomy in large-core stroke: benefit holds up to a DWI core of roughly 110 mL, then collapses.
Immediate- vs Delayed-Intensive Statin in Acute Cerebral Ischemia: INSPIRES
In 6100 Chinese patients with mild ischemic stroke or high-risk TIA from presumed atherosclerosis, immediate-intensive atorvastatin (within 72 hours) did not reduce 90-day stroke recurrence versus a 3-day delayed start (8.1% vs 8.4%; HR 0.95; 95% CI 0.80-1.13; P = .58), with no excess bleeding — leaving functional outcome (OR 0.83) as hypothesis-generating.
Fibrinogenase for injection in the treatment of acute ischaemic stroke: a randomised clinical trial — the Chinese snake-venom fibrinolytic that beat placebo on mRS at 90 days
In a 235-patient Chinese RCT of fibrinogenase for injection within 72 hours of AIS onset, the ordinal mRS distribution at 90 days favoured fibrinogenase over placebo (OR 2.38, 95% CI 1.49–3.85; p<0.001), with no excess bleeding or mortality.
Impact of Ultra-Early Perioperative Antihypertensive Therapy in Acute Intracerebral Hemorrhage — INTERACT3 Secondary Analysis
In INTERACT3 surgical-evacuation patients, achieving systolic BP <140 mm Hg within 2 hours was associated with lower death or disability, better mRS shift, fewer serious adverse events, and no increase in mortality.