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Neurology International
Special Issues
Treatment Strategy and Mechanism of Acute Ischemic Stroke
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Treatment Strategy and Mechanism of Acute Ischemic Stroke

A special issue of Neurology International (ISSN 2035-8377).

Deadline for manuscript submissions: 1 October 2024 | Viewed by 5021

Special Issue Editor

Dr. Sonu M. M. Bhaskar

E-Mail Website
Guest Editor
1. Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
2. Global Health Neurology Lab, Sydney, Australia
3. NSW Brain Clot Bank, Sydney, Australia
Interests: cerebrovascular disorders; stroke; biomarkers; social inequalities in health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of acute ischemic stroke has witnessed remarkable advancements in recent decades, particularly with the emergence of reperfusion therapy. This Special Issue, entitled "Treatment Strategy and Mechanism of Acute Ischemic Stroke", aims to offer a comprehensive and up-to-date overview of acute ischemic stroke management, covering the entire stroke continuum. This Special Issue intends to serve as a robust platform for stroke researchers, clinicians, and experts in this domain.

Encompassing a wide range of subjects, this Special Issue includes topics such as multimodal imaging techniques for precise diagnosis and prognosis, innovative interventions for optimizing patient outcomes, and mechanistic studies uncovering the intricate pathways that underlie acute ischemic stroke as well as inequities in stroke care. Discussions will encompass pertinent ongoing matters, including existing research gaps, health systems, and practical challenges in routine clinical practice. There is a pivotal focus on evidence-based studies that contribute to the advancement of diagnostic and treatment approaches.

By focusing on these aspects, this Special Issue seeks to bridge the gap between research and clinical practice in acute ischemic stroke management. In line with recent research trends, we encourage submissions that offer novel insights into personalized and precision medicine approaches, exploring the potential of tailored interventions based on clinical, imaging, and pathological phenotypes.

Dr. Sonu M. M. Bhaskar
Guest Editor

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. Neurology International 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 1600 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
  • reperfusion therapy
  • imaging
  • biomarkers
  • disease burden
  • meta-analysis
  • pathophysiology
  • evidence-based medicine

Published Papers (5 papers)

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Research

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10 pages, 892 KiB  
Article
Safety and Efficacy of Low-Dose Eptifibatide for Tandem Occlusions in Acute Ischemic Stroke
by Paweł Latacz, Tadeusz Popiela, Paweł Brzegowy, Bartłomiej Lasocha, Krzysztof Kwiecień and Marian Simka
Neurol. Int. 2024, 16(1), 253-262; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint16010017 - 09 Feb 2024
Viewed by 724
Abstract
Objectives: The optimal treatment strategy for ischemic stroke in patients presenting with tandem occlusions of the internal carotid artery remains controversial. Several studies have demonstrated better clinical outcomes after eptifibatide, which is a short half-life antiplatelet agent. This retrospective analysis focused on the [...] Read more.
Objectives: The optimal treatment strategy for ischemic stroke in patients presenting with tandem occlusions of the internal carotid artery remains controversial. Several studies have demonstrated better clinical outcomes after eptifibatide, which is a short half-life antiplatelet agent. This retrospective analysis focused on the safety and efficacy of low-dose eptifibatide administration in stroke patients with tandem lesions. Methods: We evaluated the results of endovascular treatment in 148 stroke patients with tandem lesions. Patients in whom balloon angioplasty alone resulted in satisfactory cerebral flow did not receive eptifibatide (33 patients); others received this drug together with stent implantation (115 patients). Eptifibatide was given as an intravenous bolus of 180 μg/kg and then in a modified low dose of 1 μg/kg/min for 24 hours. Results: There were no statistically significant differences between both groups regarding 30-day mortality, frequency of thrombotic events, or hemorrhagic complications. An analysis of clinical status at 30-day follow-up revealed that the administration of eptifibatide was associated with a statistically significant better outcome: a higher rate of either no neurological symptoms or only mild symptoms (4 NIHSS points maximally). Conclusions: The administration of eptifibatide in stroke patients presenting with tandem lesions is relatively safe. Moreover, treatment with this drug can improve clinical outcomes in these challenging patients. Full article
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
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10 pages, 472 KiB  
Article
Physical Rehabilitation and Post-Stroke Pneumonia: A Retrospective Observational Study Using the Japanese Diagnosis Procedure Combination Database
by Takehiro Nishimura, Ryutaro Matsugaki and Shinya Matsuda
Neurol. Int. 2023, 15(4), 1459-1468; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint15040094 - 04 Dec 2023
Viewed by 942
Abstract
In this study, the relationship between the duration of physical rehabilitation and occurrence of pneumonia after ischemic stroke was examined. We included 426,508 patients aged ≥75 years with acute ischemic stroke. A multilevel logistic regression analysis nested at the hospital level was [...] Read more.
In this study, the relationship between the duration of physical rehabilitation and occurrence of pneumonia after ischemic stroke was examined. We included 426,508 patients aged ≥75 years with acute ischemic stroke. A multilevel logistic regression analysis nested at the hospital level was conducted to examine the association between the duration of physical rehabilitation and occurrence of pneumonia. The duration of physical rehabilitation refers to the hours of physical rehabilitation performed daily until the 7th day of hospitalization. In the multivariable analysis, the intensity of rehabilitation for durations of 20–39 min/day (adjusted odds ratio [aOR]: 0.78, 95% Confidence Interval [CI]: 0.75–0.81, p < 0.001), 40–59 min/day (aOR: 0.68, 95% CI: 0.66–0.71, p < 0.001), 60–79 min/day (aOR:0.56, 95% CI: 0.53–0.58, p < 0.001), and ≥80 min/day (aOR: 0.46, 95% CI: 0.44–0.48, p < 0.001) were significantly associated with a reduced incidence of pneumonia. In addition, the trend identified for duration of rehabilitation was significant (p < 0.001). The results of this study suggest the usefulness of high-duration physical rehabilitation for preventing pneumonia in older patients with ischemic stroke. Full article
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
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Review

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13 pages, 1479 KiB  
Review
A Comprehensive Review on the Role of Resting-State Functional Magnetic Resonance Imaging in Predicting Post-Stroke Motor and Sensory Outcomes
by Foteini Christidi, Ilias Orgianelis, Ermis Merkouris, Christos Koutsokostas, Dimitrios Tsiptsios, Efstratios Karavasilis, Evlampia A. Psatha, Anna Tsiakiri, Aspasia Serdari, Nikolaos Aggelousis and Konstantinos Vadikolias
Neurol. Int. 2024, 16(1), 189-201; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint16010012 - 19 Jan 2024
Viewed by 923
Abstract
Stroke is a major leading cause of chronic disability, often affecting patients’ motor and sensory functions. Functional magnetic resonance imaging (fMRI) is the most commonly used method of functional neuroimaging, and it allows for the non-invasive study of brain activity. The time-dependent coactivation [...] Read more.
Stroke is a major leading cause of chronic disability, often affecting patients’ motor and sensory functions. Functional magnetic resonance imaging (fMRI) is the most commonly used method of functional neuroimaging, and it allows for the non-invasive study of brain activity. The time-dependent coactivation of different brain regions at rest is described as resting-state activation. As a non-invasive task-independent functional neuroimaging approach, resting-state fMRI (rs-fMRI) may provide therapeutically useful information on both the focal vascular lesion and the connectivity-based reorganization and subsequent functional recovery in stroke patients. Considering the role of a prompt and accurate prognosis in stroke survivors along with the potential of rs-fMRI in identifying patterns of neuroplasticity in different post-stroke phases, this review provides a comprehensive overview of the latest literature regarding the role of rs-fMRI in stroke prognosis in terms of motor and sensory outcomes. Our comprehensive review suggests that with the advancement of MRI acquisition and data analysis methods, rs-fMRI emerges as a promising tool to study the motor and sensory outcomes in stroke patients and evaluate the effects of different interventions. Full article
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
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16 pages, 2052 KiB  
Review
Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?
by Pietro Crispino
Neurol. Int. 2023, 15(4), 1443-1458; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint15040093 - 30 Nov 2023
Viewed by 933
Abstract
Coagulation and fibrinolytic system disorders are conditions in which the blood’s ability to clot is impaired, resulting in an increased risk of thrombosis or bleeding. Although these disorders are the expression of two opposing tendencies, they can often be associated with or be [...] Read more.
Coagulation and fibrinolytic system disorders are conditions in which the blood’s ability to clot is impaired, resulting in an increased risk of thrombosis or bleeding. Although these disorders are the expression of two opposing tendencies, they can often be associated with or be a consequence of each other, contributing to making the prognosis of acute cerebrovascular events more difficult. It is important to recognize those conditions that are characterized by dual alterations in the coagulation and fibrinolytic systems to reduce the prognostic impact of clinical conditions with difficult treatment and often unfortunate outcomes. Management of these individuals can be challenging, as clinicians must balance the need to prevent bleeding episodes with the potential risk of clot formation. Treatment decisions should be made on an individual basis, considering the specific bleeding disorder, its severity, and the patient’s general medical condition. This review aims to deal with all those forms in which coagulation and fibrinolysis represent two sides of the same media in the correct management of patients with acute neurological syndrome. Precision medicine, personalized treatment, advanced anticoagulant strategies, and innovations in bleeding control represent future directions in the management of these complex pathologies in which stroke can be the evolution of two different acute events or be the first manifestation of an occult or unknown underlying pathology. Full article
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
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Other

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23 pages, 858 KiB  
Systematic Review
Pulmonary Function Tests Post-Stroke. Correlation between Lung Function, Severity of Stroke, and Improvement after Respiratory Muscle Training
by Fotios Drakopanagiotakis, Konstantinos Bonelis, Paschalis Steiropoulos, Dimitrios Tsiptsios, Anastasia Sousanidou, Foteini Christidi, Aimilios Gkantzios, Aspasia Serdari, Styliani Voutidou, Chrysoula-Maria Takou, Christos Kokkotis, Nikolaos Aggelousis and Konstantinos Vadikolias
Neurol. Int. 2024, 16(1), 139-161; https://0-doi-org.brum.beds.ac.uk/10.3390/neurolint16010009 - 11 Jan 2024
Viewed by 1015
Abstract
Stroke is a significant cause of mortality and chronic morbidity caused by cardiovascular disease. Respiratory muscles can be affected in stroke survivors, leading to stroke complications, such as respiratory infections. Respiratory function can be assessed using pulmonary function tests (PFTs). Data regarding PFTs [...] Read more.
Stroke is a significant cause of mortality and chronic morbidity caused by cardiovascular disease. Respiratory muscles can be affected in stroke survivors, leading to stroke complications, such as respiratory infections. Respiratory function can be assessed using pulmonary function tests (PFTs). Data regarding PFTs in stroke survivors are limited. We reviewed the correlation between PFTs and stroke severity or degree of disability. Furthermore, we reviewed the PFT change in stroke patients undergoing a respiratory muscle training program. We searched PubMed until September 2023 using inclusion and exclusion criteria in order to identify studies reporting PFTs post-stroke and their change after a respiratory muscle training program. Outcomes included lung function parameters (FEV1, FVC, PEF, MIP and MEP) were measured in acute or chronic stroke survivors. We identified 22 studies of stroke patients, who had undergone PFTs and 24 randomised controlled trials in stroke patients having PFTs after respiratory muscle training. The number of patients included was limited and studies were characterised by great heterogeneity regarding the studied population and the applied intervention. In general, PFTs were significantly reduced compared to healthy controls and predicted normal values and associated with stroke severity. Furthermore, we found that respiratory muscle training was associated with significant improvement in various PFT parameters and functional stroke parameters. PFTs are associated with stroke severity and are improved after respiratory muscle training. Full article
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
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