Initial Assessment and Management of Acute Stroke

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Systems Neuroscience".

Deadline for manuscript submissions: 20 January 2025 | Viewed by 1042

Special Issue Editor


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Guest Editor
Department of Neurological Surgery, University of Virginia Health Sciences Center, 1215 Lee Street, Charlottesville, VA 22903, USA
Interests: neurosurgery; neuroinflammation; stroke

Special Issue Information

Dear Colleagues,

Acute stroke can be categorized as ischemic or hemorrhagic, with some overlap in risk factors and clinical presentations; however, their management approaches differ substantially. Ischemic strokes occur when blood vessels are obstructed, limiting the blood supply to the brain. Stroke, whether ischemic or hemorrhagic, is an emergency that warrants immediate medical attention. The specific treatment will depend on the type of stroke, the time elapsed since the onset of symptoms, and the underlying cause or presence of comorbidities.

The goal for the acute management of patients with stroke is to stabilize the patient and complete initial evaluation and assessment, including imaging and laboratory studies, within 60 minutes of patient arrival. The management of acute ischemic stroke is time-dependent. Accurate diagnosis, emergent management to stabilize the patient, and correct choice of imaging can make a lot of difference in the outcome of a patient. Every minute lost while performing incorrect imaging or analyzing laboratory test results in decrease in functional outcome and, ultimately, irreversible paralysis.

For this Special Issue, we would like to collect all research related to the assessment for stroke, as well as its management.

Dr. Jennifer D. Sokolowski
Guest Editor

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Keywords

  • stroke
  • assessment
  • treatment
  • critical care
  • neuroimaging

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Published Papers (1 paper)

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Research

10 pages, 1556 KiB  
Article
Involvement of Subinsular Territory Stroke as Predictor of Outcome after Successful Endovascular Recanalization of Left Middle Cerebral Artery Occlusion
by Yasuyuki Yoshida, Tatsushi Mutoh, Yasuko Tatewaki, Yasuyuki Taki, Junta Moroi and Tatsuya Ishikawa
Brain Sci. 2024, 14(9), 885; https://doi.org/10.3390/brainsci14090885 - 30 Aug 2024
Viewed by 803
Abstract
Subinsular stroke (subIS) can occur between the penetrating middle cerebral artery (MCA) branches, which clinical and radiological findings sometimes encounter in patients after the recanalization of left proximal MCA occlusion. However, no supportive data are available to clarify this relationship. This study investigated [...] Read more.
Subinsular stroke (subIS) can occur between the penetrating middle cerebral artery (MCA) branches, which clinical and radiological findings sometimes encounter in patients after the recanalization of left proximal MCA occlusion. However, no supportive data are available to clarify this relationship. This study investigated whether the involvement of subIS can impact outcomes after successful reperfusion therapy. Data from 152 consecutive patients who underwent endovascular thrombectomy between 2019 and 2023 were collected. A 3-month functional independence defined as a modified Rankin Scale 0–2 (primary outcome) and influencing factors were analyzed retrospectively. Recanalization was achieved in 35 patients, of whom 11 (31%) developed subIS. Patients with subIS were older in age (81 vs. 75; p < 0.05), had lower apparent diffusion coefficient (ADC) values on admission (0.52 vs. 0.62; p < 0.001), and higher modified Rankin Scale (mRS) scores (4 vs. 2; p < 0.001) than those without subIS. In a multivariate analysis, subIS was independently associated with a worse functional outcome (odds ratio: 10.5, p = 0.02). The cut-off value of the ADCs was 0.52 with a sensitivity and specificity of 70% and 64%, respectively. Subinsular ischemic lesions contribute to poor functional independence in patients after the successful recanalization of left MCA occlusion. The attenuation of the ADC value in these territories could be a valuable predictor of the outcome. Full article
(This article belongs to the Special Issue Initial Assessment and Management of Acute Stroke)
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