Background:Endovascular thrombectomy (EVT) improves outcomes and reduces mortality in acute ischemic stroke. However, despite achieving successful recanalization in most patients, a subset still experiences poor functional outcomes at 3 months. This failure, despite complete vessel reopening, is termed futile recanalization (FR). We investigated clinical and radiological predictors of FR in a multicenter cohort in Türkiye. Methods:We retrospectively analyzed 497 consecutive patients with middle cerebral artery (M1 or M2) occlusion who underwent EVT and achieved modified Thrombolysis in Cerebral Infarction (mTICI) 3 recanalization within 6 h of symptom onset at 19 stroke centers. FR was defined as a modified Rankin Scale (mRS) score ≥4 at 3 months. Clinical and radiological parameters were recorded, and logistic regression was used to identify independent predictors of FR. Results:Among 497 patients, 133 (26.7%) experienced FR despite complete recanalization. Independent predictors included older age (adjusted odds ratio [aOR] 1.07; 95% CI 1.03-1.10; p < 0.001), longer puncture-to-recanalization time (aOR 1.03; 95% CI 1.02-1.05; p < 0.001), higher admission C-reactive protein (aOR 1.01; 95% CI 1.00-1.02; p = 0.03), intracranial hemorrhage on 24-h CT (aOR 0.46; 95% CI 0.23-0.95; p = 0.04), lower collateral score (aOR 42.98; 95% CI 6.15-30.62; p < 0.001), and higher 24-h NIHSS score (aOR 1.34; 95% CI 1.24-1.44; p < 0.001). Conclusion:Even with early and complete recanalization, elderly patients and those with poor collateral circulation remain at risk for futile recanalization. Identifying these predictors can guide patient selection, procedural planning, and post-procedural management to optimize functional outcomes.

INTRODUCTION: Stroke patients treated with disorders of consciousness in the neurointensive care unit (NICU) can be assessed by evaluating the severity of unconsciousness and get an idea of the prognosis.The aim of this study was to determine the characteristics of stroke patients followed up in the NICU and the predictive power of GCS (Glasgow Coma Scale), FOUR score and NIHSS (National Institutes of Health Stroke Scale) on prognosis.METHODS: A total of 59 patients admitted with a diagnosis of acute stroke and hospitalised in the NICU were included in the study.GCS and FOUR scores, and NIHSS scores on admission and at 72nd hours were calculated independently by two different neurology speciality students.Demographic information, presence of risk factors and neuroimaging results were recorded.Classification was made by dividing stroke into subtypes.Furthermore, the length of hospitalisation, discharge from the NICU, intubation during hospitalisation and within the first 30 days, and mortality were recorded for all patients, and the prognosis predictive power of GCS and FOUR score were compared using these parameters.RESULTS: The mean age of the patients was 68.6 ± 13.4 years.4 patients had haemorrhagic stroke and 55 patients had ischaemic stroke.The mean admission NIHSS was 13.1 and discharge NIHSS was 10.A statistically significant positive correlation (r=989) was found between the investigators in terms of GCS and FOUR score at arrival and 72nd hours.The GCS and FOUR score at 72nd hours of admission and hospitalisation, and the predictive power of mortality during hospitalisation and 30-day mortality were similar.DISCUSSION AND CONCLUSION: The prognostic value of the FOUR score and its consistency between different investigators were found to be significantly high.We believe that GCS and FOUR score together are effective in the prognostic evaluation of stroke patients during admission and follow-up in the NICUs.

Background: The prognostic value of the neutrophil-lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline (p = 0.018) and 24 h (p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

Objective: Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome (SARS)-like coronaviruses (SARS-CoV-2). Although the respiratory system is mainly affected, multiple organ systems like the central nervous system (CNS) might be complicated by COVID-19. Stroke is one of the most common complications of COVID-19. In the literature, the symptoms and effects of COVID-19 on stroke have been reported but potential reasons and results remain unclear. In this study, we aimed to determine whether COVID-19 plays a role in stroke and affects the prevalence of stroke and mortality by investigating blood parameters, day of stroke after COVID-19, death status, and infarct volume. Methods: In this cross-sectional clinical research, 74 individuals participated. Twenty-two patients were COVID-19 cases without stroke; thirty participants were patients with COVID-19 and stroke, while twenty-two were cases of non-COVID-19 and stroke. Data were collected from a single center, Basaksehir Cam and Sakura City Hospital and were presented as mean ± standard deviation (SD). Results: There was a statistically significant relationship among the age, D-dimer, INR, and lymphocyte values of the living group compared to those of the exitus group. The association between death and COVID-19 status was found to be statistically significant, indicating that the number of deaths in the COVID-19 and stroke group was higher than in the only stroke group (i.e., non-COVID-19 cases). No statistically significant relationship was observed between the alive and exitus groups in terms of the volume of infarction. Conclusions: This study comprehensively evaluated the relationship between COVID-19, stroke, and mortality. Given the relatively limited number of cases in this study, further investigation is needed to elucidate the connection among COVID-19, neurological complications of the disease, and mortality. In the meantime, the results of this study contribute to the understanding of the relationship between COVID-19, neurological complications, and mortality, providing additional valuable data to the existing literature.

INTRODUCTION:Recently, telemedicine has become a widely used method worldwide for the treatment of patients with acute ischemic stroke in hospitals where neurologists are unavailable. The purpose of this study was to determine the accuracy and reliability of treatment decisions made by remote neurologists via teleconference assisted by emergency physicians in acute stroke cases and to determine whether the use of teleconsultation would lead to any delays in assessment and treatment decisions.METHODS:This single-center and prospective study was performed with 104 patients who met the inclusion criteria. Patients were concurrently assessed by a teleneurologist (TN) experienced in stroke and an on-site neurologist (OS-N). The TN performed their assessment via teleconference and assisted by an emergency physician for test results and physical examination. NIHSS (The National Institutes of Health Stroke Scale) scores, assessment times, treatment decisions by the two neurologists, and patient outcomes were recorded separately. The TN was asked to rate the quality of communication.RESULTS:Of the 104 patients in the study, 59.6% (n = 62) were men and the median age was 66 (interquartile range = 56-78) years. The median duration of assessment by the OS-N was 30 (18-45) min and the median duration of assessment by the TN was 6 (5-8) min; the duration of assessment by the TN was significantly shorter (6.56 min vs. 33.35 min; Z = 8.669; p < 0.001). The median rating assigned by the TN to the quality of teleconsultation was 5.0 (4.25-5.0) (Table 1). The NIHSS scores assigned by both neurologists showed significant correlation (p < 0.001). Analysis of the agreement between the OS-N and TN in their treatment decisions yielded a Kappa value of 74.3% for interrater agreement.CONCLUSIONS:Teleconsultation was a successful and reliable strategy in assessing patients with ischemic stroke and making decisions for IV-tPA. Moreover, patient assessment via teleconsultation was less time consuming. The results of the study are promising for the use of teleconsultation in the future.

Moyamoya disease is a chronic, progressive hereditary disease characterized by narrowing of the vascular lumen because of hypertrophy of smooth muscles in the walls of the arteries that form the circle of Willis. Cerebral vessels may be encountered in bleeding and occlusion clinics. Although it is seen as predominant in Asian races, cases have been reported worldwide. Although its etiopathogenesis is not clear, genetics, some infectious agents, and autoimmune mechanisms are blamed. The gold standard in diagnosis is digital subtraction angiography. Surgical or endovascular interventions can be used in patients with recurrent progressive ischemic events and decreased cerebral perfusion. Here we present a 43-yearold Moyamoya patient who presented with posterior system findings and had a stent implantation with critical stenosis in the basilar artery.

Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neurointerventional therapy in Turkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0-2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 +/- 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 +/- 6; hospital stay, 24 +/- 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 +/- 13 years; NIHSS: 14.1 +/- 6.5; length of hospital stay, 33 +/- 31 days), 19% in those who received combined treatment (age: 66 +/- 14 years; NIHSS: 15.6 +/- 5.4; length of hospital stay, 26 +/- 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 +/- 13 years; NIHSS: 7.6 +/- 7.2; length of hospital stay, 21 +/- 28 days). The symptom-to-door time was 87 +/- 53 minutes in the IV treatment group and 200 +/- 26 minutes in the neurointerventional group. The average door-to-needle time was 66 +/- 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 +/- 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0-2 was 41%, while the rate of mRS 0-1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0-2 was 31% and mRS 0-1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 +/- 107 and 95 +/- 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Turkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the "Directive on Health Services to be Provided to Patients with Acute Stroke."

Mirror movements are involuntary movements caused by synchronized mimicry of one side's voluntary muscle movements by the opposite limb's homologous muscles. We present a case of mirror movement, which is shown also with functional magnetic resonance imaging.

What is known on this subject?In cases resistant to medical treatment, botulinum toxin application with ultrasound guidance to the salivary glands appears to be an effective and safe method. What this study adds?Since this method is known for increased saliva, more studies are needed for this subject.Our case will add expert experience to the literature.

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms.Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis.Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio >= 2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug.Conclusion: NoroTekTR revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF.

OBJECTIVE: We aimed at determining the effectiveness of mechanical thrombectomy (MT) in patients with major vessel occlusion and infected with COVID-19, evaluating its clinical outcome and comparing it with non-COVID patients. PATIENTS AND METHODS: During the pandemic, 729 patients who underwent MT in stroke centers due to Acute Ischemic Stroke (AIS) with large vessel occlusion were evaluated. This study included 40 patients with a confirmed COVID-19 diagnosis by a positive PCR test between March 11, 2020, and December 31, 2020. These patients were compared to 409 patients who underwent MT due to major vessel occlusion between March 11, 2019, and December 31, 2019. RESULTS: Of the patients with AIS who are infected with COVID-19, 62.5% were males, and all patients have a median age of 63.5 +/- 14.4 years. The median NIHSS score of the COVID-19 group was significantly higher than that of the non-COVID-19 groups. Dissection was significantly more in the COVID-19 group. The mortality rates at 3 months were higher in the COVID-19 groups compared to non-COVID-19 groups. CONCLUSIONS: This study revealed an increased frequency of dissection in patients with COVID-19. COVID-19-related ischemic strokes are associated with worse functional outcomes and higher mortality rates than non-COVID-19 ischemic strokes.

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NoroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69 +/- 14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (ss): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (ss): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (ss): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin's scale score 0-2) functional outcome [exp (ss): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (ss): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NoroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.

Background and purpose:In this study, we wanted to investigate the effect of antiplatelet and anticoagulant use on the success of mechanical thrombectomy in acute ischemic stroke cases.Methods:174 patients who were brought to the Stroke Center of Gaziantep University Şahinbey Research and Practice Hospital between January 2018 and February 2019 due to acute ischemic stroke and who underwent mechanical thrombectomy were retrospectively analyzed. The demographic characteristics, antiplatelet/anticoagulant use before the stroke and mTICI (modified-Throm-bolysis-In-Cerebral-Infarction) scores used for reperfusion in mechanical thrombectomy were evaluated. The findings were analyzed statistically (p<0.05).Results:The mean age was 63.3 ± 13.5 in 174 patients who underwent mechanical thrombectomy. 23/174 (13.2%) patients were using anticoagulant therapy (warfarin-OAC or new generation oral anticoagulant-NOAC) and 28/174 (16.1%) were using antiplatelet therapy. A history of atrial fibrillation (AF) was significantly higher in patients receiving anticoagulant therapy before acute ischemic stroke (p=0.001). Patients with a history of hyper tension (HT), diabetes mellitus (DM) and coronary artery disease (CAD) before acute ischemic stroke were receiving antiplatelet therapy in higher rates (respectively; p=0.003, p=0.037, p=0.005). Successful recanalization (mTICI ≥ 2b) was higher in patients with a history of anticoagulant use and who underwent mechanical thrombectomy (p=0.025).Conclusion:Our study showed that the use of anti-platelet or anticoagulants before mechanical thrombec-tomy may have an indirect positive effect on the success of the procedure.

Vertebral artery dissection (VAD) may occur after minor traumas in the head and neck region. A 29-year-old female patient, she had complaints of dizziness, nausea and vomiting that started after hair washing at the hairdresser. Bilateral VAD was detected on cranial imaging and angiography. Control angiography performed after 3 months of antiaggregant treatment was normal. Here, we aimed to present a rare case of VAD that occured after a minor neck injury and benefited from medical treatment.

Background: Some researches reveal that pharmacologic and phytotherapeutic agents have benefits on neurological disorders associated with the effects of reactive oxygen species. Aim: The purpose of this research was to evaluate the protective effects of curcumin and memantine in a cerebral ischemia/reperfusion model in rats. Materials and Methods: This experimental study was conducted at the Bagcilar Training and Research Hospital, Istanbul, Turkey. Rats were separated into five experimental groups (n=8) as follows: Curcumin (Group I), Memantine (Group II), Curcumin+Memantine (Group III), ischemia (Group IV), and sham (Group V). Cerebral ischemia was performed surgically with bilateral common carotid artery occlusion for 30 min, followed by reperfusion for 72 hr. Tissue and serum samples were collected and assessed for tumor necrosis factor-alpha, interleukin-6, lactate dehydrogenase, catalase, glutathione peroxidase, xanthine dehydrogenase, superoxide dismutase, and malondialdehyde levels. Further, in tissue samples, both neuronal loss and caspase-3 levels were determined. Results: Serum and tissue levels of interleukin-6, tumor necrosis factor-alpha, malondialdehyde, and lactate dehydrogenase were found significantly lower in the Group I, II, and III compared to Group IV (p < 0.001). Glutathione peroxidase, superoxide dismutase, and catalase levels in Group I, II, and III were significantly higher than those of Group IV (p < 0.001). Conclusion: Curcumin, Memantine, and Curcumin + Memantine treatment were found to be efficacious in decreasing oxidative damage in cerebral ischemia but failed to prevent tissue damage.

Background Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurological diseases that are difficult to diagnose. Aim We aimed to determine the common and distinct aspects of these two aetiologies of encephalitis as well as the characteristics of our patient group. Methods We respectively analysed the records of the patients including symptoms, demographic features, neurological examination, cranial-magnetic-resonance-imaging (MRI), electroencephalography (EEG) findings, cerebrospinal fluid results (CSF) findings. Autoimmune/paraneoplastic autoantibodies in blood and/or CSF were all documented. Results Forty-six patients fulfilled the diagnostic criteria. Thirty-eight of them were diagnosed with AIE, and 8 of them were diagnosed with PNS. The PNS group had higher nonconvulsive status epilepticus than the AIE (2/8 vs 0/38; p=0.027). PNS patients were diagnosed with a malignancy in their follow-ups more than those in the AIE group [4/38 vs 8/8] (p<0.001). When the symptoms of antibody-positive and negative patients were compared in the AIE group, the rates of consciousness/memory problems (13/15 vs 11/23; p=0.020) and speech impairment (8/15 vs 2/23; p=0.004) were significantly higher in patients without antibodies (n: 15) than in antibody-positive patients (n: 23). In antibody-negative groups, the rates of memory problems in neurological examination (13/15 vs 12/23 p=0.028) and temporal findings on electroencephalography were more prominent than antibody-positive groups (1/23 vs 5/15; p=0.027). The number of patients with cerebellar signs was higher in antibody-positive patients (6/23 vs 0/15; p=0.038). Conclusion Although the positivity of autoantibodies is critical in the diagnosis of AIE and PNS, even minor differences in clinical and laboratory findings of patients are helpful in the diagnosis, especially in the autoantibody-negative patients. Comparing the data with other population studies has shown that several inherited and environmental factors may contribute to the pathophysiology of AIE and PNS, as well as clinical and laboratory differences.

Background and Aims:We aimed to assess N-terminal pro brain-type natriuretic peptide (NT-proBNP) levels in acute ischemic stroke (AIS) patients according to clinical and radiological features and to investigate its relationship with short term clinical outcomes. Methods:In our study, 107 patients with AIS were evaluated prospectively. Of all, 56 patients had no evidence of atrial fibrillation (AF) (sinus rhythm [SR] group) (52.3%), 24 patients had paroxysmal AF (pAF group) (22.4%), and the other 27 patients had chronic AF (cAF group) (25.3%). Demographic datas, clinical characteristics, laboratory and radiological findings, CHA2DS2 -VASc scores, NIHSS (National Institute of Health Stroke Scale) and modified Rankin Scale (mRS) scores on admission and at the third month evaluations were recorded. Good functional outcome at 3 months was defined as modified Rankin score (mRS) 2 or less. According to the TOAST (Trial of Org 10172 in Acute StrokeTreatment) and OCSP (Oxfordshire Community Stroke Project) study, ischemic stroke subtyping was performed. Serum NT-proBNP levels were estimated in 107 stroke patients and 24 age- and sex-matched control subjects. Venous blood samples were obtained for serum NT-proBNP measurement within the first 48 hours of the patient group. Results:Mean age of the 107 AIS patients was 68 ± 15.22 years and 58.9% of them were women. Compared to controls, the SR, pAF and cAF groups had higher plasma NT-proBNP levels (P < 0.001) and also NT-proBNP values were significantly higher in the pAF and cAF group than SR groups (P < 0.001). NT-proBNP values were significantly higher in cardioembolic (CE) (n = 57) group than in large artery atherosclerosis (LAA) (n = 20) and small vessel disease (SVD) (n = 30) groups (P < 0.001). NT-proBNP levels of noncardioembolic SR (n = 49) (P = 0.080), LAA and SVD groups (P = 0.103) were higher than the control group but the difference was not statistically significant. There was a positive correlation between NT-proBNP level and third month mRS scores in CE group (r = 0.491). Conclusions:NT-proBNP will contribute to predict cardioembolic and pAF groups and estimate the prognosis.

We evaluated the predictive factors of symptomatic intracranial hemorrhage (SICH) in endovascular treatment of stroke. We included 975 ischemic stroke patients with anterior circulation occlusion. Patients that had hemorrhage and an increase of ≥4 points in their National Institutes of Health Stroke Scale (NIHSS) after the treatment were considered as SICH. The mean age of patients was 65.2±13.1 years and 469 (48.1%) were women. The median NIHSS was 16 (13-18) and Alberta Stroke Program Early CT 9 (8-10). In 420 patients (43.1%), modified Rankin Scale was favorable (0-2) and mortality was observed in 234 (24%) patients at the end of the third month. Patients with high diastolic blood pressure (P<.05) had significantly higher SICH. SICH was significantly higher in those with high NIHSS scores (P<.001), high blood glucose (P<.001), and leukocyte count at admission (P<.05). Diabetes mellitus (DM) (OR 1.90; P<.001), NIHSS (OR 1.07; P<.05), adjuvant intra-arterial thrombolytic therapy (IA-rtPA) (OR, 1.60; P<.05), and puncture-recanalization time (OR 1.01; P<.05) were independent factors of SICH. Higher baseline NIHSS score, longer procedure time, multiple thrombectomy maneuvers, administration of IA-rtPA, and the history of DM are independent predictors of SICH in anterior circulation occlusion.