Clinical Diagnosis and Treatment of Cerebrovascular Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 15 August 2024 | Viewed by 1511

Special Issue Editor


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Guest Editor
Department of Neurosurgery, University Hospital Augsburg, 86156 Augsburg, Germany
Interests: brain imaging; cerebrovascular disease; neuro-oncology; ultrasound; epilepsy surgery

Special Issue Information

Dear Colleagues,

According to the WHO, 32% of all global deaths are caused by cerebrovascular diseases. Thus, a reduction in the social and economic burden of these diseases is one of the major goals of medicine, particularly for all disciplines that focus on the diagnosis and treatment of the underlying causes. Both the arterial side of the extra- and intracranial blood vessels and the venous system are coming more and more into focus for scientific research in this field.

This Special Issue is dedicated to current research and novel insights on pathologies of the cerebrovascular system ranging from atherosclerosis to thromboembolism, stenosis, arterio-venous malformations, cavernomas and cerebral aneurysms. Emphasis is placed on novel diagnostic tools and treatment approaches including prevention and management of secondary complications such as cerebral vasospasm, delayed cerebral ischemia, hyperperfusion syndrome or brain edema. Thus, the aim of this Special Issue is to provide the reader with current developments and new insights.

Dr. Björn Sommer
Guest Editor

Manuscript Submission Information

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Keywords

  • stroke
  • intracranial stenosis
  • aneurysm
  • malformation
  • occlusion
  • therapy
  • detection

Published Papers (1 paper)

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Research

12 pages, 1608 KiB  
Article
Agreement between CT-Angiography and Digital Subtraction Angiography in Predicting Angiographic Vasospasm in Patients with Subarachnoid Hemorrhage
by Miriam M. Moser, Leon Gramss, Wolfgang Marik, Michael Weber, Dorian Hirschmann, Wei-Te Wang, Philippe Dodier, Gregor Kasprian, Gerhard Bavinzski, Karl Rössler and Arthur Hosmann
J. Clin. Med. 2024, 13(13), 3743; https://doi.org/10.3390/jcm13133743 - 26 Jun 2024
Viewed by 1285
Abstract
Background/Objectives: Digital subtraction angiography (DSA) is the gold standard in the diagnosis of cerebral vasospasm, frequently observed after subarachnoid hemorrhage (SAH). However, less-invasive methods, such as computed tomography angiography (CTA), may be equally accurate. To further clarify comparability, this study evaluated the reliability [...] Read more.
Background/Objectives: Digital subtraction angiography (DSA) is the gold standard in the diagnosis of cerebral vasospasm, frequently observed after subarachnoid hemorrhage (SAH). However, less-invasive methods, such as computed tomography angiography (CTA), may be equally accurate. To further clarify comparability, this study evaluated the reliability of CTA in detecting cerebral vasospasm. Methods: This retrospective study included 51 patients with SAH who underwent both CTA and DSA within 24 h. The smallest diameter of the proximal cerebral arterial segments was measured in both modalities at admission and during the vasospasm period. The mean difference in diameter, the intraclass correlation coefficient (ICC) of CTA and DSA, the difference in grade of vasospasm and sensitivity, the specificity and the positive predictive value (PPV) for CTA were calculated. Results: A total of 872 arterial segments were investigated. At time of admission, arterial diameters were significantly smaller on CTA compared to DSA in all segments (−0.26 ± 0.12 mm; p < 0.05). At time of suspected vasospasm (day 9 ± 5), these differences remained significant only for the M1 segment (−0.18 ± 0.37 mm, p = 0.02), the P1 segment (−0.13 ± 0.24 mm, p = 0.04) and the basilar artery (−0.20 ± 0.37 mm, p = 0.0.04). The ICC between CTA and DSA was good (0.5–0.8). The sensitivity of CTA for predicting angiographic vasospasm was 99%, the specificity was 50% and the PPV was 92%. Conclusions: Arterial diameters measured on CTA may underestimate the arterial caliber observed in DSA; however, these absolute differences were minor. Importantly, vessel diameter alone does not fully reflect malperfusion, requiring additional imaging techniques such as CT perfusion. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Cerebrovascular Diseases)
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