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Clinical Diagnostics and Management of Stroke

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Dr. Qiwen Deng

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Nanjing First Hospital, Nanjing Medical University, Nangjing, China
Interests: cerebrovascular disease research; mechanisms of stroke-associated infections; personalized management of intracranial atherosclerosis

Special Issue Information

Dear Colleagues,

Stroke remains a leading cause of disability and mortality globally. Timely and accurate clinical diagnostics and management are crucial for improving patient outcomes, making this a vital area of research. We are pleased to invite you to contribute to a Special Issue of the journal dedicated to the "Clinical Diagnostics and Management of Stroke." In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) the following:

Advanced Diagnostic Tools:Novel biomarkers (e.g., blood-based, imaging), applications of artificial intelligence in neuroimaging, and multimodal CT/MRI protocols.
Acute Treatment Strategies:Optimizing thrombolysis (e.g., extended time windows, tenecteplase), and technical advances in endovascular thrombectomy.
Post-Stroke Management and Rehabilitation:Early and late-phase rehabilitation techniques, cognitive and emotional recovery, and management of post-stroke complications.
Secondary Prevention and Long-term Care:Advances in the management of atrial fibrillation and novel antiplatelet/anticoagulant regimens. Lifestyle interventions and risk factor control.
Translational Research and Neuroprotection:Bridging experimental therapies from bench to bedside, including studies on neuroinflammation, neuroprotection, and brain recovery.

I look forward to receiving your contributions.

Sincerely,

Dr. Qiwen Deng
Guest Editor

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12 pages, 600 KB

Open AccessArticle

Bone Turnover Markers as Biomarkers of Cough Dysfunction and Respiratory Risk in Subacute Ischemic Stroke

by Ki-Hyeok Ku, Seung Don Yoo, Dong Hwan Kim, Seung Ah Lee, Sung Joon Chung, Jinkyeong Park, Sae Rom Kim and Eo Jin Park

Diagnostics 2026, 16(7), 1008; https://doi.org/10.3390/diagnostics16071008 - 27 Mar 2026

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Abstract

Background/Objectives: Peak cough flow (PCF) is an objective measure of cough effectiveness after stroke, but biomarkers reflecting physiological vulnerability related to reduced PCF are not well established. We investigated whether bone turnover markers (BTMs)—C-terminal telopeptide of type I collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP)—were associated with PCF in subacute ischemic stroke. Methods: In this retrospective study, 112 patients admitted within 21 days of stroke onset had fasting morning CTX and P1NP measured by electrochemiluminescence immunoassay, and PCF measured within 72 h of admission. Associations were assessed using Spearman correlation and multivariable linear regression with BTMs standardized (per 1 standard deviation increase), adjusting for age, sex, body mass index, onset-to-admission days, National Institutes of Health Stroke Scale score, Korean version of the Modified Barthel Index, estimated glomerular filtration rate, smoking status, and brainstem lesion. Results: CTX showed an inverse correlation with PCF (rho = −0.469; p < 0.001) and remained independently associated with lower PCF after multivariable adjustment (β = −42.32 L/min; 95% confidence interval, −56.12 to −28.52; p < 0.001), whereas P1NP showed weaker associations. In secondary outcome analyses, higher CTX was associated with low PCF (PCF < 160 L/min), aspiration pneumonia, and longer length of stay. Conclusions: Higher CTX levels were independently associated with lower peak cough flow and selected respiratory-related outcomes in this retrospective cohort. These findings are hypothesis-generating, do not imply prognostic validation, and warrant confirmation in prospective multicenter studies assessing incremental predictive value. Full article

(This article belongs to the Special Issue Clinical Diagnostics and Management of Stroke)

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13 pages, 240 KB

Open AccessArticle

Relationship of ASPECTS Lesion Topography with Clinical Outcomes in Acute Ischemic Stroke Treated with Endovascular Thrombectomy: A Single-Center Cohort Study

by Hilmiye Tokmak, Hamza Özer and Muhammed Nur Öğün

Diagnostics 2026, 16(6), 822; https://doi.org/10.3390/diagnostics16060822 - 10 Mar 2026

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Abstract

Objective: Although an Alberta Stroke Program Early CT Score (ASPECTS) < 7 is known to be associated with poor clinical outcomes in patients with acute ischemic stroke (AIS), the relationship between regional differences in infarct location within the ASPECTS territory and clinical outcome has not been fully clarified. The aim of this study is to evaluate the association between infarct area localization and clinical outcomes in AIS patients with large vessel occlusion and to investigate whether these regional patterns can be used to predict prognosis independently of the total ASPECTS. Methods: In this retrospective, single-center study, patients with acute ischemic stroke who had undergone non-contrast brain CT prior to endovascular thrombectomy between January 2020 and July 2023 and were found to have internal carotid artery (ICA) and/or middle cerebral artery (MCA) M1 segment occlusion were included. Patients with a premorbid modified Rankin Scale (mRS) score of 0–2 were eligible for inclusion. Patients with unavailable imaging or clinical follow-up data were excluded. Clinical outcomes were assessed using the modified Rankin Scale at 90 days. An mRS score of 0–2 was defined as a good clinical outcome, whereas an mRS score of 3–6 was defined as a poor clinical outcome. Results: A total of 283 patients were included (median age 73 years; 57.2% female), of whom 147 (51.9%) achieved a good clinical outcome. The poor outcome group had higher NIHSS scores and lower total ASPECTS values (both p < 0.001). In the regional analysis, involvement of the internal capsule (32.4% vs. 4.1%; p < 0.001) and ASPECTS M1 region (26.5% vs. 10.2%; p < 0.001) was associated with poor outcome. In multivariable analysis, internal capsule involvement (adjusted odds ratio [aOR] ≈ 12) and M1 region involvement (aOR ≈ 2.7) remained independent predictors. In the subgroup with successful recanalization, only internal capsule involvement remained an independent predictor (aOR ≈ 19). In hemisphere-stratified analyses, M1 involvement in the right hemisphere and internal capsule involvement in the left hemisphere were independently associated with poor outcome. Conclusions: The prognostic contribution of individual ASPECTS regions is not uniform in patients with acute ischemic stroke undergoing endovascular thrombectomy (EVT). In particular, involvement of the internal capsule and the M1 region shows a strong association with poor clinical outcome independent of the total ASPECTS. However, these findings suggest that regional localization alone is not sufficient for EVT patient selection. Further large-scale, multicenter studies are needed to clarify the role of regional ASPECTS assessment in clinical decision-making. Full article

(This article belongs to the Special Issue Clinical Diagnostics and Management of Stroke)

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