{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:23:47Z","timestamp":1766157827023,"version":"3.48.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) often presents as acute ischemic stroke involving cerebral perforators. This study compared the clinical and imaging characteristics and stroke recurrence between patients with CADASIL and those with sporadic small vessel occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We retrospectively analyzed 70 patients with CADASIL and 70 age\u2010 and sex\u2010matched patients with sporadic small vessel occlusion, all of whom experienced acute ischemic stroke. Clinical characteristics and imaging findings were compared, and factors associated with stroke recurrence over a 10\u2010year follow\u2010up period were assessed using Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients with sporadic small vessel occlusion had more vascular risk factors, whereas patients with CADASIL had more extensive small vessel disease. Acute ischemic stroke lesions in CADASIL were more commonly located in the anterior circulation (78.6% versus 59.4%) and frequently involved the subcortex (28.6% versus 4.3%), centrum semiovale (25.7% versus 0%), and splenium (15.7% versus 0%). In contrast, lesions were less common in the basal ganglia (11.4% versus 32.9%) and brainstem (8.6% versus 24.3%). Multiple simultaneous lesions were more frequent in CADASIL (35.7% versus 7.1%). The 10\u2010year stroke recurrence rate in CADASIL was 50%, with a hazard ratio (HR) of 7.12 (95% CI, 2.99\u201316.94;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). In multivariable Cox regression, CADASIL was the strongest independent predictor of recurrence (adjusted HR, 15.692 [95% CI, 4.452\u201349.166];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), along with older age, hypertension, elevated initial diastolic blood pressure, periventricular white matter hyperintensities (grade 2), and multiple lesion involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with CADASIL patients with acute ischemic stroke have distinct imaging patterns and a significantly higher recurrence risk compared with those with sporadic small vessel occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045400","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T12:04:48Z","timestamp":1764763488000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and Long\u2010Term Outcome of Acute Ischemic Stroke in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Compared With Sporadic Small Vessel Occlusion"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2926-2368","authenticated-orcid":false,"given":"Sang Hee","family":"Ha","sequence":"first","affiliation":[{"name":"Gacheon University","place":["Incheon, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8641-3786","authenticated-orcid":false,"given":"Jae Young","family":"Park","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Hee","family":"Ahn","sequence":"additional","affiliation":[{"name":"Namseoul University","place":["Cheonan\u2010si, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-9258","authenticated-orcid":false,"given":"Jun Young","family":"Chang","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4737-0530","authenticated-orcid":false,"given":"Chong Hyun","family":"Suh","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0264-4531","authenticated-orcid":false,"given":"Hyunjin","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6157-2908","authenticated-orcid":false,"given":"Jae\u2010Sung","family":"Lim","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong\u2010Wha","family":"Kang","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-331X","authenticated-orcid":false,"given":"Sun U.","family":"Kwon","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-058X","authenticated-orcid":false,"given":"Satoshi","family":"Saito","sequence":"additional","affiliation":[{"name":"National Cerebrovascular and Cardiovascular Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-3252","authenticated-orcid":false,"given":"Bum Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, South 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