Stroke is the third leading cause of death and the fourth leading cause of disability-adjusted life years worldwide, yet disease-modifying treatment remains largely confined to reperfusion of large-vessel ischemic occlusion within a narrow window. No neuroprotective or hemostatic agent has entered routine practice. Engineered nanoparticles have been proposed to improve delivery across the blood–brain barrier, concentrate drug within the ischemic or perihematomal microenvironment, and add imaging or sensing functions. The resulting literature is large but fragmented across platforms, models, and outcome measures, so it is not evident which platforms carry the strongest evidence or which are closest to clinical evaluation. This narrative review synthesizes preclinical and clinical evidence on nanoparticle-based diagnosis, treatment, rehabilitation, and monitoring in ischemic and hemorrhagic stroke. We searched PubMed, Scopus, and the Cochrane Library from inception to July 2025 using predefined Boolean strings and assigned each included study an evidence tier to separate extrapolated and cross-field evidence from stroke-specific data. Comparative tables summarize nanoparticle type, payload, model, route, dose, treatment window, particle size and surface charge, principal outcomes, safety assessment, and translational readiness. Therapeutic evidence is almost entirely preclinical: Efficacy has been shown in young, male, comorbidity-free rodents treated within minutes of reperfusion and followed for 24 h to 28 days, with group sizes typically between three and 15, and few studies reporting any bleeding or coagulation endpoint. Diagnostic applications are closer to patients because iron-oxide nanoparticles have already been given to humans, although not for imaging. We identified seven registered clinical studies of nanoparticle-related interventions in stroke; one perfluorocarbon nanodroplet emulsion completed a randomized dose-escalation trial in acute ischemic stroke, the EU Clinical Trials Register returned none, and none exists in hemorrhagic stroke. Nanoparticle platforms, therefore, remain investigational, and progress will depend less on new chemistry than on comorbid and large-animal models, realistic treatment windows, systematic reporting of bleeding risk and of interference with follow-up imaging, and reproducible manufacturing.
Objective To evaluate stroke awareness among high school students in Kezhou—a multiethnic region with limited healthcare resources—and to provide evidence for targeted stroke prevention and treatment education. Methods This cross‐sectional study utilized a self‐designed questionnaire to assess stroke‐related knowledge among high school students. Differences in stroke knowledge across demographic subgroups were analyzed, with a statistical significance set at p < 0.05. Result A total of 2525 questionnaires were collected. Full awareness rates for stroke emergency maps, the “stroke 1‐2‐0” rapid identification method, stroke classification, and intravenous thrombolytic therapy for ischemic stroke were 1.90%, 9.98%, 16.79%, and 20.00%, respectively. The lowest awareness rates for stroke risk factors were smoking (10.65%), unhealthy diet (12.75%), and obesity (22.34%), whereas the least recognized warning symptoms included personality changes (11.92%), dizziness/gait instability (17.23%), and blurred/double vision (22.30%). Correct response rates for stroke visit time, thrombolysis time window, and emergency management were 72.95%, 41.11%, and 21.50%, respectively. Students with stroke‐affected relatives, urban residents, and those exposed to stroke education demonstrated significantly higher knowledge levels ( p < 0.05). Kirgiz students showed poorer emergency response knowledge compared with other ethnic groups ( p < 0.05). Preferred educational channels included social media (66.61%), bulletin boards (57.50%), and medical professionals′ lectures (54.77%). Conclusion Kezhou high school students exhibited low stroke awareness, particularly regarding risk factors, the “stroke 1‐2‐0” identification method, emergency maps, and crisis management. It is recommended that stroke education be integrated into ethnic cultural activities, and that social media and posters on campuses and lectures by medical personnel be used to disseminate the “stroke 1‐2‐0” recognition method and improve regional stroke prevention and treatment capabilities.
Background:One of the most common nonneurological complications after stroke is stroke-associated pneumonia (SAP), which significantly increases morbidity and mortality. Early identification of factors associated with SAP is essential, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a practical and accessible systemic inflammatory biomarker for clinical screening. This study is aimed at determining the incidence of SAP and analyzing the biological and mechanical factors influencing its occurrence in patients with acute ischemic stroke. Method:This retrospective cohort study included consecutive patients with acute ischemic stroke whose data were extracted from medical record reviews, including admission NLR. Bivariate analyses were performed to identify factors associated with SAP, followed by multivariable logistic regression to determine independent predictors. The diagnostic performance of NLR was evaluated using receiver operating characteristic (ROC) curve analysis. Results:The incidence of SAP among 615 acute ischemic stroke patients was 19.7%. Multivariable logistic regression identified NLR > 5.21, dysphagia, NIHSS > 8, age > 60 years, and nutritional risk as independently associated with SAP. NLR > 5.21 had the largest adjusted odds ratio (aOR 11.43, 95% CI 5.74-18.93). In ROC analysis, NLR demonstrated good discrimination (AUC 0.78), although NIHSS showed higher discrimination (AUC 0.84). Conclusions:NLR > 5.21 was independently associated with SAP and demonstrated good discriminatory performance. However, NIHSS showed superior discrimination, indicating that NLR should be considered as a complementary biomarker rather than a standalone predictor.
Background:A hemorrhagic stroke is a life-threatening emergency that can lead to disability or death without prompt treatment. However, there is limited evidence on factors associated with mortality in hemorrhagic stroke, particularly in eastern Ethiopia. Therefore, this study is aimed at assessing the factors associated with mortality among adult hemorrhagic stroke patients in the Harari region, eastern Ethiopia. Methodology:A retrospective cohort study was conducted among 262 patients with hemorrhagic stroke at public hospitals in the Harari region of eastern Ethiopia, from September 1, 2019, to August 31, 2024. Factors associated with mortality were identified using the Gompertz hazards regression model. Results:Of the 262 patients included in the final analysis, 45 (17.18%; 95% CI: 13.05%-22.26%) died. The mortality rate for hemorrhagic stroke was 10.62 cases per 1000 person-months (95% CI: 7.93-14.23). Mortality was significantly associated with patients having kidney disease (AHR: 3.04; 95% CI: 1.44-6.44; p value: 0.004) and poor Glasgow Coma Scale (GCS) scores (AHR: 3.92; 95% CI: 1.58-9.71; p value: 0.003). Septic shock and aspiration pneumonia had exploratory associations with mortality. Conclusion:In-hospital mortality was observed in approximately one in six hemorrhagic stroke patients treated at public hospitals. Risk factors such as kidney disease, aspiration pneumonia, poor GCS, and septic shock increased mortality risk. Hence, special emphasis should be given to early screening for kidney disease and the management of stroke patients with poor a GCS score.
Cerebral ischemic stroke (CIS) is an acute cerebrovascular disease associated with high morbidity and disability rates. It is characterized by neurological damage caused by the interruption of cerebral blood flow, often accompanied by sequelae such as motor dysfunction and cognitive decline, which seriously affect the quality of life of patients. Despite continuous advancements in treatment methods, challenges persist, such as time window constraints, limited efficacy, and potential adverse reactions. Therefore, finding more proactive and effective treatment approaches has become an urgent problem to be solved. The mechanism of action of terpenoids is not a simple single-target inhibition. Essentially, it lies in the systematic remodeling of the postischemic neural microenvironment. The pathophysiological process of CIS involves complex cascades, including energy failure, excitotoxicity, oxidative stress, neuroinflammation, disruption of the blood-brain barrier, multiple cell death pathways, mitochondrial dysfunction, and impairment of nerve repair. Terpenoids can intervene in ischemic stroke through a dual-mechanism approach of direct neuroprotection and indirect microenvironment regulation by targeting key nodes within the abovementioned pathological network, ultimately achieving the protection and restoration of neural function. The aim of this review was to deepen the understanding of the therapeutic value of terpenoids in stroke; from an integrated perspective, it revealed the scientific essence of the multitarget synergistic effects of natural products, thereby providing a theoretical cornerstone and an innovative direction for the development of next-generation drugs for treating stroke.
