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Medicina
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Stroke: Diagnostic Approaches and Therapies
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Stroke: Diagnostic Approaches and Therapies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 9099

Special Issue Editors

Dr. Anna Podlasek

E-Mail Website
Guest Editor
Tayside Innovation MedTech Ecosystem (TIME), University of Dundee, Dundee DD1 4HN, UK
Interests: stroke
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Iris Quasar Grunwald

E-Mail Website
Guest Editor
Tayside Innovation MedTech Ecosystem (TIME), University of Dundee, Dundee DD1 4HN, UK
Interests: neuroscience; stroke; endarterectomy; neuroradiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am writing to invite you to submit a paper to this upcoming Special Issue of the journal Medicina, titled “Stroke: Diagnostic Approaches and Therapies". This Special Issue will focus on the latest advances in the diagnosis and treatment of stroke, including the following topics:

  • New imaging techniques for the early detection of stroke;
  • Novel biomarkers for the prediction of stroke risk;
  • Targeted therapies for the prevention and treatment of stroke;
  • Rehabilitation strategies for stroke survivors.

The aim of this Special Issue is to provide a comprehensive overview of the latest research in the field of stroke and to identify new directions for future research. We are soliciting papers that report original research, review articles, clinical practice guidelines, commentaries and letters.

I hope that you will consider submitting a paper to this Special Issue. The deadline for submission is 30 April 2024.

Thank you for your time and consideration.

Sincerely,

Dr. Anna Podlasek
Prof. Dr. Iris Quasar Grunwald
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. Medicina is an international peer-reviewed open access monthly 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 2200 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
  • thrombolysis
  • tenecteplase
  • mechanical thrombectomy
  • neuroprotection
  • neuroimaging

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Further information on MDPI's Special Issue polices can be found here.

Related Special Issue

Published Papers (5 papers)

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Research

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12 pages, 1000 KiB  
Article
Nationwide Big Data Analysis of Statin Use and Intracerebral Hemorrhage Risk in Acute Ischemic Stroke Patients in Taiwan
by William Winardi, Sin-Hua Moi, Thomas Winardi, Yu-Wen Cheng, Po-Yuan Chen and Cheng-Kai Lin
Medicina 2024, 60(6), 939; https://doi.org/10.3390/medicina60060939 - 4 Jun 2024
Viewed by 743
Abstract
Background and Objectives: Although statins are recommended for secondary prevention of acute ischemic stroke, some population-based studies and clinical evidence suggest that they might be used with an increased risk of intracranial hemorrhage. In this nested case–control study, we used Taiwan’s nationwide [...] Read more.
Background and Objectives: Although statins are recommended for secondary prevention of acute ischemic stroke, some population-based studies and clinical evidence suggest that they might be used with an increased risk of intracranial hemorrhage. In this nested case–control study, we used Taiwan’s nationwide universal health insurance database to investigate the possible association between statin therapy prescribed to acute ischemic stroke patients and their risk of subsequent intracerebral hemorrhage and all-cause mortality in Taiwan. Materials and Methods: All data were retrospectively obtained from Taiwan’s National Health Insurance Research Database. Acute ischemic stroke patients were divided into a cohort receiving statin pharmacotherapy and a control cohort not receiving statin pharmacotherapy. A 1:1 matching for age, gender, and index day, and propensity score matching was conducted, producing 39,366 cases and 39,366 controls. The primary outcomes were long-term subsequent intracerebral hemorrhage and all-cause mortality. The competing risk between subsequent intracerebral hemorrhage and all-cause mortality was estimated using the Fine and Gray regression hazards model. Results: Patients receiving statin pharmacotherapy after an acute ischemic stroke had a significantly lower risk of subsequent intracerebral hemorrhage (p < 0.0001) and lower all-cause mortality rates (p < 0.0001). Low, moderate, and high dosages of statin were associated with significantly decreased risks for subsequent intracerebral hemorrhage (adjusted sHRs 0.82, 0.74, 0.53) and all-cause mortality (adjusted sHRs 0.75, 0.74, 0.74), respectively. Conclusions: Statin pharmacotherapy was found to safely and effectively reduce the risk of subsequent intracerebral hemorrhage and all-cause mortality in acute ischemic stroke patients in Taiwan. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)
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13 pages, 330 KiB  
Article
Perceptions of Post-Stroke Fatigue among Health Care Practitioners: A Qualitative Interview Study
by Wafa Saeed Alahmari, Reem M. Basuodan, Kholood Matouq Shalabi, Ahmed Saad Alhowimel, Mazyad Alotaibi, Eirini Kontou, Pip Logan and Neil Coulson
Medicina 2023, 59(12), 2146; https://doi.org/10.3390/medicina59122146 - 11 Dec 2023
Viewed by 1518
Abstract
Background and Objectives: Post-Stroke Fatigue (PSF) is a complex, multidimensional, debilitating condition that affects almost half of all stroke survivors. This study explored the perceptions of physiatrists, physiotherapists, and occupational therapists about PSF and their experiences in managing patients with PSF in [...] Read more.
Background and Objectives: Post-Stroke Fatigue (PSF) is a complex, multidimensional, debilitating condition that affects almost half of all stroke survivors. This study explored the perceptions of physiatrists, physiotherapists, and occupational therapists about PSF and their experiences in managing patients with PSF in Saudi Arabia. Materials and Methods: Qualitative semi-structured interviews were conducted with participants from three different groups: eight physiotherapists (PTs), eight occupational therapists (OTs), and eight physiatrists (DRs). Using purposive sampling, participants with at least one year of experience in the field of PSF management were invited to take part. The data were analysed using inductive thematic analysis. Results: Twenty-four health care participants (eight PTs, eight OTs, eight DRs) were recruited. Five overarching themes encompassing various subthemes and sub-subthemes were generated: ‘knowledge about post-stroke fatigue’, ‘diagnosing post-stroke fatigue’, ‘treatment approach’, ‘lack of awareness about post-stroke fatigue’, and ‘domains to improve’. The data indicated that participants used various strategies to manage PSF, including dietary changes, sleep hygiene, exercise, and energy conservation. Conclusions: Participants acknowledged that they lacked PSF-related management skills, despite possessing adequate knowledge about the management of stroke. Their openness to participating in activities that would improve their ability to diagnose and manage PSF was particularly striking. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)

Review

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12 pages, 318 KiB  
Review
Updated Perspectives on Lifestyle Interventions as Secondary Stroke Prevention Measures: A Narrative Review
by Valbona Govori, Hrvoje Budinčević, Sandra Morović, Filip Đerke and Vida Demarin
Medicina 2024, 60(3), 504; https://doi.org/10.3390/medicina60030504 - 19 Mar 2024
Cited by 1 | Viewed by 3434
Abstract
Despite being highly preventable, stroke is the second-most common cause of death and disability in the world. Secondary prevention is critical as the stroke recurrence risk is 6- to 15-fold higher than the risk of stroke in the general population. Stroke recurrence is [...] Read more.
Despite being highly preventable, stroke is the second-most common cause of death and disability in the world. Secondary prevention is critical as the stroke recurrence risk is 6- to 15-fold higher than the risk of stroke in the general population. Stroke recurrence is associated with higher mortality rates and increased disability levels. Lifestyle modifications should address not single but multiple cardiovascular risk factors to effectively reduce the risk of stroke. Lifestyle modifications on a personal level should include adequate physical activity, a healthy diet, the cessation of smoking and alcohol consumption, and stress reduction. Physical activities should be performed in a healthy environment without air pollution. According to recent studies, up to 90% of strokes might be prevented by addressing and treating ten modifiable stroke risk factors, half of which are related to lifestyle modifications. These lifestyle modifications, which are behavioral interventions, could impact other modifiable risk factors such as arterial hypertension, hyperlipidemia, obesity, diabetes, and atrial fibrillation. The most common obstacles to effective secondary stroke prevention are motor impairment, post-stroke cognitive impairment, post-stroke depression, and stroke subtype. Long-term lifestyle modifications are difficult to sustain and require comprehensive, individualized interventions. This review underlines the benefits of adhering to lifestyle modifications as the most effective secondary stroke prevention measure. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)
11 pages, 473 KiB  
Review
What Is the Added Value of Carotid CEUS in the Characterization of Atherosclerotic Plaque?
by Andrejs Lioznovs, Maija Radzina, Laura Saule, Peteris Einars Grinbergs and Aigars Lacis
Medicina 2024, 60(3), 375; https://doi.org/10.3390/medicina60030375 - 23 Feb 2024
Cited by 1 | Viewed by 1361
Abstract
Background and Objectives: Unstable atherosclerotic plaque in the arteries is one of the main risk factors for cerebral ischemia. Duplex ultrasound is a frequently used diagnostic method, but it has some limitations for microvascularization and neovascularization evaluation. The aim of this review [...] Read more.
Background and Objectives: Unstable atherosclerotic plaque in the arteries is one of the main risk factors for cerebral ischemia. Duplex ultrasound is a frequently used diagnostic method, but it has some limitations for microvascularization and neovascularization evaluation. The aim of this review was to evaluate the role of the new multiparametric US method—contrast-enhanced ultrasound (CEUS)—in atherosclerotic plaque instability verification. Materials and Methods: Original studies, reviews, and meta-analyses were included in this article. A total of 53 studies were retrieved; 29 were included in this study. Results: Carotid artery CEUS as a part of the multiparametric ultrasound method shows promising results and provides additional characteristics of soft- and high-risk atherosclerotic plaques; it can be advised in clinical practice for patients with carotid artery soft- and high-risk plaques. However, there are some limitations, such as extensive calcinosis with important acoustic shadows in carotid atherosclerotic plaque neovascularization diagnostics by CEUS. The added value of CEUS in the characterization of atherosclerotic plaque is that it indicates regions with high neovascularization and visualizes ulcerations on plaque surfaces, suggestive of increased instability risk. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)

Other

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13 pages, 707 KiB  
Systematic Review
Circle of Willis Configuration and Thrombus Localization Impact on Ischemic Stroke Patient Outcomes: A Systematic Review
by Audrius Širvinskas, Givi Lengvenis, Giedrius Ledas, Valerija Mosenko and Saulius Lukoševičius
Medicina 2023, 59(12), 2115; https://doi.org/10.3390/medicina59122115 - 3 Dec 2023
Cited by 1 | Viewed by 1535
Abstract
Background and Objectives: The published literature highlights the fact that the integrity of the Circle of Willis has a direct impact on stroke outcome, especially in cases of distal internal carotid T occlusion. The aim of this study was to review the [...] Read more.
Background and Objectives: The published literature highlights the fact that the integrity of the Circle of Willis has a direct impact on stroke outcome, especially in cases of distal internal carotid T occlusion. The aim of this study was to review the available data on the Circle of Willis configuration and thrombus location impact on patient outcome in cases of ischemic stroke. Materials and Methods: A systematic search according to PRISMA guidelines was performed in PubMed, Cochrane, and EMBASE databases to identify studies investigating the influence of Circle of Willis variants on ischemic stroke outcomes published up to March 2023. The manuscripts were reviewed by three researchers separately and scored on the quality of the research using the MINORS criteria. Results: After screening 157 manuscripts, 11 studies (n = 4643) were included. Circle of Willis integrity plays a vital role in stroke outcome, especially when T-form occlusions are present. Despite this, in the event of M1 occlusion Circle of Willis configuration does not play an important role. In cases of distal internal carotid artery occlusion, the presence of a fully developed contralateral A1 segment and anterior communicating artery is essential for a favorable stroke outcome. Conclusions: The preserved integrity of the Circle of Willis has great significance for collateral flow in the event of ischemic stroke and helps patients to achieve more favorable outcomes, as it determines the affected brain territory. The clinical outcome of the ischemic stroke appears to be significantly better if only one artery territory is affected, compared to two or more. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies)
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