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Clinical Aspects of Cerebral Ischemia
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Clinical Aspects of Cerebral Ischemia

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

Deadline for manuscript submissions: closed (1 September 2023) | Viewed by 10284

Special Issue Editors

Dr. Mario Zanaty

E-Mail Website
Guest Editor
Department of Neurosurgery, University of Iowa Hospital and Clinics, Iowa City, IA, USA
Interests: cerebrovascular disease; cognition; delayed cerebral ischemia; revascularization; stroke
Special Issues, Collections and Topics in MDPI journals
Dr. Panagiotis Mastorakos

E-Mail Website
Guest Editor
Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, USA
Interests: cerebrovascular disease; neuroimmunology; stroke; subarachnoid hemorrhage; traumatic brain injury
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Stroke is the second leading cause of both disability and death worldwide, with about 17 million strokes per year globally. Despite the notable increase in the population of patients eligible for acute stroke intervention, access to acute stroke care and utilization of mechanical thrombectomy is lagging in these patients. Spreading awareness to increase the proportion of thrombectomies for eligible patients is needed. In addition, we are currently witnessing a rapid evolution in stroke medical devices, neuroimaging, and neuroprotection.

This Special Issue “Clinical Aspects of Cerebral Ischemia” aims to underline the latest advances in the stroke field, welcoming submissions that focus on prevention, improved detection, access to care, management, and therapeutic interventions.

Dr. Mario Zanaty
Dr. Panagiotis Mastorakos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stroke
  • cerebrovascular disease
  • cerebral Ischemia
  • revascularization
  • traumatic brain injury

Published Papers (3 papers)

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Review

19 pages, 3746 KiB  
Review
Endovascular Embolization for Epistaxis: A Single Center Experience and Meta-Analysis
by Kareem El Naamani, Charles Morse, Marc Ghanem, Julie Barbera, Abdelaziz Amllay, Grace Severance, Ramon Ruiz, Ahmad Sweid, Michael R. Gooch, Nabeel A. Herial, Pascal Jabbour, Robert H. Rosenwasser, Gurston G. Nyquist and Stavropoula Tjoumakaris
J. Clin. Med. 2023, 12(22), 6958; https://doi.org/10.3390/jcm12226958 - 7 Nov 2023
Cited by 1 | Viewed by 1442
Abstract
The optimal treatment for intractable epistaxis is still controversial. Various studies have demonstrated high success rates and low complication rates for endovascular embolization. Herein, the authors report an institutional experience and meta-analysis in terms of efficacy and safety of endovascular embolization of intractable [...] Read more.
The optimal treatment for intractable epistaxis is still controversial. Various studies have demonstrated high success rates and low complication rates for endovascular embolization. Herein, the authors report an institutional experience and meta-analysis in terms of efficacy and safety of endovascular embolization of intractable epistaxis. This was a retrospective observational study of 35 patients with epistaxis who underwent 40 embolization procedures between 2010 and 2023. The primary outcome was immediate success defined by immediate cessation of epistaxis at the end of the procedure. Immediate success was achieved in most of the procedures (39, 97.5%). During follow-up, three (7.5%) patients experienced a rebleed. Forty-one studies from 3595 articles were identified for inclusion in the meta-analysis and comprised 1632 patients. The mean pooled age was 57.5 years (95% CI: 57.2–57.8) and most patients were males (mean: 70.4, 95% CI: 69.8–71.0). Immediate success was achieved at a pooled mean of 90.9% (95% CI: 90.4–91.4) and rebleeding was observed at a pooled mean of 17% (95% CI: 16.5–17.5). In conclusion, endovascular embolization proved to be both safe and effective in treating intractable epistaxis carrying a low risk of post-operative stroke. Full article
(This article belongs to the Special Issue Clinical Aspects of Cerebral Ischemia)
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34 pages, 649 KiB  
Review
Advances in Therapies to Treat Neonatal Hypoxic-Ischemic Encephalopathy
by Amaresh K. Ranjan and Anil Gulati
J. Clin. Med. 2023, 12(20), 6653; https://doi.org/10.3390/jcm12206653 - 20 Oct 2023
Cited by 7 | Viewed by 4884
Abstract
Neonatal hypoxic-ischemic encephalopathy (HIE) is a condition that results in brain damage in newborns due to insufficient blood and oxygen supply during or after birth. HIE is a major cause of neurological disability and mortality in newborns, with over one million neonatal deaths [...] Read more.
Neonatal hypoxic-ischemic encephalopathy (HIE) is a condition that results in brain damage in newborns due to insufficient blood and oxygen supply during or after birth. HIE is a major cause of neurological disability and mortality in newborns, with over one million neonatal deaths occurring annually worldwide. The severity of brain injury and the outcome of HIE depend on several factors, including the cause of oxygen deprivation, brain maturity, regional blood flow, and maternal health conditions. HIE is classified into mild, moderate, and severe categories based on the extent of brain damage and resulting neurological issues. The pathophysiology of HIE involves different phases, including the primary phase, latent phase, secondary phase, and tertiary phase. The primary and secondary phases are characterized by episodes of energy and cell metabolism failures, increased cytotoxicity and apoptosis, and activated microglia and inflammation in the brain. A tertiary phase occurs if the brain injury persists, characterized by reduced neural plasticity and neuronal loss. Understanding the cellular and molecular aspects of the different phases of HIE is crucial for developing new interventions and therapeutics. This review aims to discuss the pathophysiology of HIE, therapeutic hypothermia (TH), the only approved therapy for HIE, ongoing developments of adjuvants for TH, and potential future drugs for HIE. Full article
(This article belongs to the Special Issue Clinical Aspects of Cerebral Ischemia)
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27 pages, 1324 KiB  
Review
Artificial Intelligence and Machine Learning in the Diagnosis and Management of Stroke: A Narrative Review of United States Food and Drug Administration-Approved Technologies
by Anirudha S. Chandrabhatla, Elyse A. Kuo, Jennifer D. Sokolowski, Ryan T. Kellogg, Min Park and Panagiotis Mastorakos
J. Clin. Med. 2023, 12(11), 3755; https://doi.org/10.3390/jcm12113755 - 30 May 2023
Cited by 10 | Viewed by 3624
Abstract
Stroke is an emergency in which delays in treatment can lead to significant loss of neurological function and be fatal. Technologies that increase the speed and accuracy of stroke diagnosis or assist in post-stroke rehabilitation can improve patient outcomes. No resource exists that [...] Read more.
Stroke is an emergency in which delays in treatment can lead to significant loss of neurological function and be fatal. Technologies that increase the speed and accuracy of stroke diagnosis or assist in post-stroke rehabilitation can improve patient outcomes. No resource exists that comprehensively assesses artificial intelligence/machine learning (AI/ML)-enabled technologies indicated for the management of ischemic and hemorrhagic stroke. We queried a United States Food and Drug Administration (FDA) database, along with PubMed and private company websites, to identify the recent literature assessing the clinical performance of FDA-approved AI/ML-enabled technologies. The FDA has approved 22 AI/ML-enabled technologies that triage brain imaging for more immediate diagnosis or promote post-stroke neurological/functional recovery. Technologies that assist with diagnosis predominantly use convolutional neural networks to identify abnormal brain images (e.g., CT perfusion). These technologies perform comparably to neuroradiologists, improve clinical workflows (e.g., time from scan acquisition to reading), and improve patient outcomes (e.g., days spent in the neurological ICU). Two devices are indicated for post-stroke rehabilitation by leveraging neuromodulation techniques. Multiple FDA-approved technologies exist that can help clinicians better diagnose and manage stroke. This review summarizes the most up-to-date literature regarding the functionality, performance, and utility of these technologies so clinicians can make informed decisions when using them in practice. Full article
(This article belongs to the Special Issue Clinical Aspects of Cerebral Ischemia)
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