{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:46:39Z","timestamp":1782938799721,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Intracranial hemorrhage (ICH) is a recognized complication of mechanical thrombectomy that may affect outcomes. Whether the occlusion site within the MCA M1 segment (proximal vs. distal) influences the risk and subtype distribution of post\u2010procedural ICH remains uncertain. We compared the frequency and subtypes of ICH between proximal and distal MCA M1 occlusions and evaluated their impact on 90\u2010day clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed consecutive patients from two stroke centers who underwent mechanical thrombectomy for isolated MCA M1 occlusion. Patients were classified as proximal or distal. Post\u2010procedural ICH was assessed on 24\u2010h non\u2010contrast CT (or earlier if NIHSS worsened by \u2265\u00a04 points) and categorized as hemorrhagic infarction (HI, Types 1\u20132) or parenchymal hematoma (PH, Types 1\u20132). Ninety\u2010day outcomes were evaluated using the modified Rankin scale (mRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 178 patients (107 proximal, 71 distal), successful reperfusion (mTICI 2b\u20133) was achieved in 89.1%. HI was more frequent in proximal than distal occlusions (27.1%\u00a0vs. 12.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.037), mainly due to HI1 (12.1%\u00a0vs. 1.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.009). PH and symptomatic ICH rates were similar between groups. In logistic regression analysis, occlusion site was not an independent determinant of post\u2010thrombectomy hemorrhage (OR 1.52, 95% CI 0.80\u20132.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.20). At 90 days, functional outcomes did not differ significantly between groups (mRS 0\u20132: 39.2% proximal vs. 47.9% distal,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.271).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hemorrhagic infarction is more frequently observed in proximal MCA M1 occlusions, likely due to involvement of lenticulostriate arteries. However, this does not translate into a worse functional outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71562","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:31:43Z","timestamp":1782401503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intracranial Hemorrhage After Mechanical Thrombectomy: Proximal Versus Distal MCA M1 Occlusions"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2924-8707","authenticated-orcid":false,"given":"Dogan","family":"Hasan","sequence":"first","affiliation":[{"name":"Interventional Neurology, Department of Neurology, Samsun City Hospital, Faculty of Medicine, Samsun University  Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8404-7049","authenticated-orcid":false,"given":"Aytac","family":"Emrah","sequence":"additional","affiliation":[{"name":"Interventional Neurology, Department of Neurology, Faculty of Medicine, F\u0131rat University Firat University  Elaz\u0131\u011f Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-921X","authenticated-orcid":false,"given":"Balgetir","family":"Ferhat","sequence":"additional","affiliation":[{"name":"Interventional Neurology, Department of Neurology, Faculty of Medicine, F\u0131rat University Firat University  Elaz\u0131\u011f Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-1048","authenticated-orcid":false,"given":"Akpinar Cetin","family":"Kursad","sequence":"additional","affiliation":[{"name":"Interventional Neurology, Department of Neurology, Samsun City Hospital, Faculty of Medicine, Samsun University  Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1591019920938223"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13767"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg\u20102014\u2010011212"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(16)30177\u20106"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1276"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000830"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000333606"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.11.2280"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002794"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00163\u2010X"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12383"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.17.2.179"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144452"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.522904"},{"issue":"1","key":"e_1_2_11_17_1","first-page":"52","article-title":"Blood\u2010Brain Barrier, Reperfusion Injury, and Hemorrhagic Transformation in Acute Ischemic Stroke","volume":"79","author":"Khatri R.","year":"2012","journal-title":"Neurology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2021.01.053"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000500947"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000027036"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032666"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/08941939.2015.1067738"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.551705"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/str.43.suppl_1.A139"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239\u2010022\u201002731\u20104"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000117012"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.5.598"},{"key":"e_1_2_11_29_1","first-page":"1534","article-title":"Use of the Alberta Stroke Program Early CT Score (ASPECTS) for Assessing CT Scans in Patients With Acute Stroke","volume":"22","author":"Pexman J. 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