Cognitive impairment after stroke brings heavy burden to patients and their families. Early identification and intervention are helpful to delay the occurrence and development of cognitive impairment after stroke. This article introduces the conception, epidemiological and clinical characteristics of cognitive impairment after stroke, and expounds the application status, existing problems of cognitive function assessment tools in stroke patients at home and abroad. The purpose of this study is to provide a reference for doctors and nurses to choose appropriate assessment tools, and also the ideas for the development of stroke cognitive function assessment tools in line with the cultural background of our country.

The epidemiological characteristics of stroke in China from 2007 to 2017 were collected by consulting the global burden of disease research database and reviewing the literature, and descriptive epidemiological methods were used to analyze the characteristics of stroke in China. The results showed that, from 2007 to 2017, the prevalence trend of stroke in China mainly showed that the incidence and prevalence of ischemic stroke continued to increase, while the incidence and prevalence of hemorrhagic stroke showed a decreasing trend, and the overall mortality of stroke showed a decreasing trend. The epidemic characteristics of stroke in China are as follows: the younger-onset tendency; In terms of incidence, prevalence and mortality, more patients in males than that in females, more in rural areas than that in urban areas, and more in northern areas than in southern areas. In the most recent decade, the incidence and prevalence of ischemic stroke in China have increased significantly with lower average age at onset compared with those ten years ago, which were considered to be related to unhealthy lifestyle, such as dietary habits. The government should strongly advocate good lifestyle and dietary habits. In addition, the incidence, prevalence and mortality of stroke were significantly higher in rural areas than that in urban areas. Therefore, strengthening the prevention and control of stroke in rural areas should be the key of future work.

This article reviews mainly the advancement of artificial intelligence technology in stroke screening, and analyses the research directions of intelligent assessment algorithms based on the establishment of stroke screening by using neural networks and deep learning algorithms. Artificial intelligence application has been emerging in both regular population screening of stroke and screening and prevention of stroke for a high-risk population. At present, the main problems, however, are the small amount of accumulated screening data, the lack of standardized and AI-suitable datasets, and the discrepancy in predictive accuracy between AI-assisted screening and traditional analysis methods due to particular data and undefined risk factors. Therefore, we should establish standardized datasets and adopt deep learning algorithms suitable for structured feature data for intelligent screening research of stroke.

Intracerebral hemorrhage is characterized by high prevalence, mortality and disability rate, and unfortunately few proven treatments are available at present. Early hematoma expansion is significantly associated with worse outcome in patients with intracerebral hemorrhage. Therefore, it is of great importance to early identify the patients with high risk of hematoma expansion, and to provide them with active interventions to improve the prognosis. In the current study, we have reviewed the progress in definition, mechanism, predictive factors and treatments of hematoma expansion in patients with intracerebral hemorrhage.

To retrieve, evaluate and summarize the available evidence of identifying and preventing patients with post-stroke depression.

The researchers systematically retrieved BMJ Best Practice, UpToDate, National Guideline Clearinghouse, Joanna Briggs Institute Library, the Cochrane Library, and other databases to collect relevant evidence summaries, best practice recommendations, clinical practice guidelines, expert consensus, and systematic reviews. Available evidence was extracted and summarized based on the themes after the methodological quality assessments were completed.

A total of 12 articles were retrieved, including 5 evidence summaries, 3 guidelines, 1 expert consensus, and 3 systematic reviews. Twenty-six pieces of evidences were summarized into the following 4 categories: screening and assessment, management, non-pharmacological therapy, and pharmacotherapy.

This study summarized the best evidence of identifying and preventing patients with post-stroke depression, and generated recommendations，which can provide evidence for healthcare professionals.

With the in-depth study of the clinical, imaging, and pathophysiological mechanism of cerebral small vessel disease (CSVD) , it was found that the various imaging markers of CSVD were interrelated and interacted with each other, and they might have synergistic or superimposed effects on the clinical symptoms. Increasing evidence showed that CSVD was closely related to stroke recurrence, cognitive decline, dyskinesia, emotional abnormality, dysuria, and defecation disorder, which should therefore be treated as a whole brain disease. We reviewed the evaluation and clinical significance of CSVD imaging markers together with the research progress of CSVD total burden scoring methods, in order to provide some reference for further improvement of CSVD total burden score.

Cerebral amyloid angiopathy (CAA) is characterized by the pathological deposition of amyloid β-protein in the media and adventitia of small arteries in the cortex and leptomeninges, which often causes vascular dysfunction and brain parenchyma damage. CAA is common in the elderly. This article reviews the progress in the epidemiology, pathogenesis, pathological changes, clinical manifestations, clinical imaging manifestations, diagnostic criteria, and treatment of CAA, to improve the clinical recognition and rational therapy.

Cerebral small vessel disease (CSVD) is a disorder of cerebral small vessels caused by various reasons, resulting in a series of clinical, imaging and pathological changes. Neurovascular unit is composed by neurons-glial cells-cerebral blood vessels. In recent year, with the deeper understanding of CSVD pathogenesis, there has been an increasing interest in the role of the interaction among different components of neurovascular unit. Thus, this review comprehensively elucidates the role of the interaction among its components in the pathogenesis of CSVD, so as to provide theoretical basis for the prevention and treatment.

Intracerebral hemorrhage (ICH) is the type of stroke with the highest mortality and disability. There is still no effective treatment. The scarcity of animal models that strictly simulate the clinical characteristics of ICH may be the root cause for hindering the research of ICH. This article reviews the existing spontaneous ICH mouse models and found two hypertensive ICH models，one spontaneous deep ICH model and five cerebral amyloid angiopathy models. One of the hypertensive models was double transgenic mice，which overexpressed human renin and angiotensinogen，leading to hypertension in mice. However，the occurrence of this model of ICH required a combination of a high-salt diet and a nitric oxide synthase inhibitor. The other hypertensive model utilized slow subcutaneous release of angiotensin Ⅱ and inhibition of nitric oxide synthase to cause chronic hypertension，followed by acute injection of angiotensin Ⅱ to further increase blood pressure and cause dramatic fluctuations in blood pressure to induce ICH. The spontaneous deep ICH model may be the most ideal mouse model for studying ICH except for hypertension. In addition，the five cerebral amyloid angiopathy models were all established in transgenic mice with amyloid precursor protein mutations，but the research on the characteristics of ICH was relatively scarce. At present，spontaneous ICH still lacks widely recognized and used animal models. The ideal ICH model should be able to simulate the development characteristics of the disease to the greatest extent. Only by carrying out ICH basic research that meets clinical needs can it be expected to provide new and effective targets on ICH prevention and treatment.

The outcomes of cardiac arrest (CA) patients are still not optimistic. Severe brain damage after resuscitation is the main cause of death and neurological disability. Therefore, reducing brain injury is the key point of treatment in post CA syndrome. Target temperature management (TTM) is proved to be the only intervention that can effectively improve survival and neurological prognosis. However, a investigation published recently showed insufficient understanding and poor practice of TTM in CA patients in China. So it is of great significance to promote TTM awareness and translations of guidelines into standardized clinical practice in pre-hospital emergency medical systems, departments of emergency, intensive care units. We comprehensively interpreted the TTM part in 2020 expert consensus statement on neuroprotection after cardiac arrest in China and other international guidelines, mainly involved the neuroprotective mechanism, timing of initiation, target temperature, duration of the cooling phase, cooling methods and rewarming rate.

To investigate the clinical efficacy and safety of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia in the elderly.

The clinical data of elderly patients with trigeminal neuralgia treated with MVD (25 cases) or PBC (28 cases) from January 2019 to December 2019 were retrospectively analyzed. The chi-square test or Fisher exact probabilities was used to compare the surgical efficacy and complications between the two groups, and the t-test was used to compare the length of stay and hospitalization costs between the two groups.

There was no significant difference between PBC group and MVD group in surgical cure rate (67.9% vs 68.0%), and effective rate (85.7% vs 96.0%) (all P＞0.05). The operation time of PBC group was significantly shorter than that of MVD group [(56±17)min vs (141±29)min, t=6.277, P＜0.001]; the length of hospital stay was shorter than that of MVD group [(6±2)d vs (16±5)d, t=9.199, P＜0.001], and the hospitalization cost was lower than that of MVD group [(24110±5941)yuan vs (27648±5523)yuan, t=0.615, P=0.030]. The incidence of facial numbness, facial swelling and trigeminal nerve inhibition in the PBC group were higher than those in the MVD group [85.7%(24/28) vs 8.0%(2/25); 21.4%(6/28) vs 0; 21.4%(6/28) vs 0], while the incidence of postoperative febrile reaction was lower than that in the MVD group [0 vs 76.0%(19/25)], the differences were statistically significant (P<0.001; χ²=4.095, P=0.043; χ²=4.095, P=0.043; χ²=33.172, P＜0.001).

Both MVD and PBC surgery can effectively treat primary trigeminal neuralgia in elderly patients. Compared with MVD surgery, PBC surgery is simpler, safer and more effective in the treatment of primary trigeminal neuralgia.

With the development of magnetic resonance technology, more new vascular techniques are emerging and play an important role in vascular morphology and hemodynamics. The plaque in head and neck is the most common vascular pathology. Plaque rupture may lead to stroke which is a disease with high disability and mortality. We summarizes the new techniques including high resolution magnetic resonance of vessel wall imaging, 4D flow magnetic resonance imaging, silent magnetic resonance angiography and compressed sensing magnetic resonance angiography; and introduced the imaging principle and their applications in plaque.

Cerebral small vessel disease (CSVD) refers to a series of pathological syndromes resulted from the pathophysiological changes in small arteries, perforating arteries and venules. Neuropathological studies of patients with CSVD have shown that inflammation and endothelial dysfunction play a key role in it, and further research in related fields would become an important means of understanding CSVD. In recent years, with the continuous improvement of MRI scanning intensity and the clinical development of new sequences, such as arterial spin-labeled perfusion imaging and diffusion tensor imaging, clinicians are able to evaluate smaller brain structures and lesions than ever before, so that the pathological features of CSVD can be identified at an very early stage before symptoms appear.

Toll-like receptor 4 (TLR4), as a kind of pattern recognition receptor, is the key trigger of innate immune inflammatory response. Studies have confirmed that TLR4 signaling pathway-mediated immune inflammatory response plays a key role in stroke, Alzheimer's disease, Parkinson's disease, and other neurological diseases. This article mainly reviews the research progress of TLR4 signaling pathway in nervous system diseases, so as to inspire new ideas for TLR4-targeted therapy for nervous system diseases.

Intracerebral hemorrhage posts a serious threat to human health. Thalamic hemorrhage bears the worst outcome among supratentorial intracerebral hemorrhage with a high rate of mortality and disability. Obstructive hydrocephalus caused by thalamic hemorrhage breaking into the ventricles is an independent predictor of prognosis. The efficacy of surgical treatment for thalamic hemorrhage is still controversial. However, with the development of neuroendoscopy in recent years, more and more studies have confirmed the potential advantages of endoscopy in the treatment of thalamic hemorrhage breaking into the ventricles, and the clearance rate of hematoma can reach more than 90%. Combined with the relevant studies in recent years, we found that neuroendoscopic microinvasive surgery is safe and effective in the treatment of thalamic hemorrhage breaking into the ventricles. Optimizing surgical approach according to the type of hemorrhage and the size of hematoma could improve the hematoma clearance rate and reduce the incidence of shunt-dependent hydrocephalus and other complications.

Glioblastoma (GBM) is the most aggressive and common malignant tumor in the central nervous system. Current therapeutic regimens, including surgical resection combined with external radiation and chemotherapy, are insufficient to treat GBM. Three important factors account for the lack of efficacy. GBM can infiltrate into surrounding tissues and makes complete resection impossible. Besides, the blood-brain barrier usually prevents therapeutic agents and limits the chemotherapy efficacy. In addition, tumor cells can develop resistance to therapeutic agents. Convection-enhancement delivery (CED) is the technique that is expected to improve the efficacy of chemotherapy in GBM. The systematic overview of CED in the treatment of GBM is based on the researches from 2000 to 2020, involving in the technical basis of CED, animal models, chemotherapeutic agents, tracing, and clinical research. The results show that CED technology has advantages including overcoming the blood-brain barrier, inducing the immune reaction in the tumor, and reducing systemic toxicity. In the future, the mechanism on transportation and metabolism of drugs in the extracellular space and the development of chemotherapy-tracing multimodal nano-agents should be warranted.

Neurological prognostication has become a very important part of post-cardiac arrest (CA) care. Early and accurate prediction of neurological should allows optimizing identification of those individuals with no chance of a good recovery and avoid making inappropriate decisions on withdrawal of life support in patients with the potential for recovery which is a frequent cause of death. However, there are still many challenges to address CA as an important public health issue in China, such as insufficient awareness as well as poor and non-standard practice of neurological assessment. To promote standardized neurological assessment after CA, we interpreted the part of neurological assessment in 2020 expert consensus statement on neuroprotection after cardiac arrest in China, which mainly involved the methods and protocols of neurological assessment after cardiopulmonary resuscitation.