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Diagnostics
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Cerebrovascular Lesions: Diagnosis and Management
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Cerebrovascular Lesions: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 4639

Special Issue Editors

Dr. Hung-Chieh Chen

E-Mail Website
Guest Editor
1. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
2. Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
Interests: diagnostic neuroradiology; interventional neuroradiology
Dr. Wei-Ju Lee

E-Mail Website
Guest Editor
1. Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
2. Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
Interests: dementia; neuroimaging; biomarkers

Special Issue Information

Dear Colleagues, 

Cerebrovascular diseases and stroke are the fifth leading cause of death worldwide. Survivors often suffer from significant morbidity or complications. Cerebrovascular disease can develop from a variety of causes, including atherosclerosis, thrombosis, embolic events or vascular lesions. Accurate diagnosis and proper management are important to achieve better outcomes and decrease complications.

The goal of this Special Issue, “Cerebrovascular Lesions: Diagnosis and Management”, is to collect studies focusing on the pathophysiology, diagnostic methods, potential pitfalls and treatment methods of cerebrovascular diseases. Thus, this Special Issue will provide insight into the latest medical progress in cerebrovascular diseases and could set up the foundation for advanced future studies. We welcome the submission of original research articles, focused reviews, and pictorial essays or case reports focusing on the pathophysiology, diagnosis, treatment and prognosis evaluation for cerebrovascular diseases.

Dr. Hung-Chieh Chen
Dr. Wei-Ju Lee
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. Diagnostics 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
  • aneurysm
  • vascular malformation
  • computed tomography (CT)
  • magnetic resonance imaging (MRI)

Published Papers (4 papers)

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Research

11 pages, 2945 KiB  
Article
Improved Visualization and Quantification of Net Water Uptake in Recent Small Subcortical Infarcts in the Thalamus Using Computed Tomography
by Felix Schön, Hannes Wahl, Arne Grey, Pawel Krukowski, Angela Müller, Volker Puetz, Jennifer Linn and Daniel P. O. Kaiser
Diagnostics 2023, 13(22), 3416; https://doi.org/10.3390/diagnostics13223416 - 9 Nov 2023
Viewed by 718
Abstract
Diagnosing recent small subcortical infarcts (RSSIs) via early computed tomography (CT) remains challenging. This study aimed to assess CT attenuation values (Hounsfield Units (HU)) and net water uptake (NWU) in RSSI and explore a postprocessing algorithm’s potential to enhance thalamic RSSI detection. We [...] Read more.
Diagnosing recent small subcortical infarcts (RSSIs) via early computed tomography (CT) remains challenging. This study aimed to assess CT attenuation values (Hounsfield Units (HU)) and net water uptake (NWU) in RSSI and explore a postprocessing algorithm’s potential to enhance thalamic RSSI detection. We examined non-contrast CT (NCCT) data from patients with confirmed thalamic RSSI on diffusion-weighted magnetic resonance imaging (DW-MRI) between January 2010 and October 2017. Co-registered DW-MRI and NCCT images enabled HU and NWU quantification in the infarct area compared to unaffected contralateral tissue. Results were categorized based on symptom onset to NCCT timing. Postprocessing using window optimization and frequency-selective non-linear blending (FSNLB) was applied, with interpretations by three blinded Neuroradiologists. The study included 34 patients (median age 70 years [IQR 63–76], 14 women). RSSI exhibited significantly reduced mean CT attenuation compared to unaffected thalamus (29.6 HU (±3.1) vs. 33.3 HU (±2.6); p < 0.01). Mean NWU in the infarct area increased from 6.4% (±7.2) at 0–6 h to 16.6% (±8.7) at 24–36 h post-symptom onset. Postprocessed NCCT using these HU values improved sensitivity for RSSI detection from 32% in unprocessed CT to 41% in FSNLB-optimized CT, with specificities ranging from 86% to 95%. In conclusion, CT attenuation values and NWU are discernible in thalamic RSSI up to 36 h post-symptom onset. Postprocessing techniques, particularly window optimization and FSNLB, moderately enhance RSSI detection. Full article
(This article belongs to the Special Issue Cerebrovascular Lesions: Diagnosis and Management)
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11 pages, 1422 KiB  
Article
Long-Term Outcomes of Endovascular Embolization in a Vein of Galen Aneurysmal Malformation: A Single-Center Experience
by Chingiz Nurimanov, Yerbol Makhambetov, Karashash Menlibayeva, Nurtay Nurakay, Nursultan Makhambetov, Elena Zholdybayeva and Serik Akshulakov
Diagnostics 2023, 13(16), 2704; https://doi.org/10.3390/diagnostics13162704 - 18 Aug 2023
Cited by 1 | Viewed by 867
Abstract
Background: A vein of Galen aneurysmal malformation (VGAM) is a rare congenital cerebral vascular condition with a high mortality rate if left untreated. This study describes the long-term outcomes of patients with VGAM, who were treated with endovascular embolization. Methods: This retrospective analysis [...] Read more.
Background: A vein of Galen aneurysmal malformation (VGAM) is a rare congenital cerebral vascular condition with a high mortality rate if left untreated. This study describes the long-term outcomes of patients with VGAM, who were treated with endovascular embolization. Methods: This retrospective analysis focused on VGAM patients who underwent one or more endovascular embolization sessions between January 2008 and December 2022. The study included newborns and children under 18 years. Data encompassed clinical and demographic characteristics, types of endovascular embolization, treatment complications, mortality rates, and long-term outcomes. Results: Out of 22 VGAM cases, the majority were boys (86.36%), and the average age of the participants was 38 months, ranging from 25 days to 17 years. Endovascular embolization using liquid embolizing agents was the most common intervention (50%), and around 73% of patients underwent multiple sessions. Some patients underwent ventriculoperitoneal shunting (VPS) due to persistent hydrocephalus. In long-term outcomes, four patients (18.2%) showed developmental delays, and 16 patients (72.7%) had a positive outcome. Conclusions: Combining endovascular therapy with a comprehensive management strategy significantly reduces mortality rates and improves the possibility of normal neurological development in patients. Full article
(This article belongs to the Special Issue Cerebrovascular Lesions: Diagnosis and Management)
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13 pages, 1103 KiB  
Article
Heart-Rate-to-Blood-Pressure Ratios Correlate with Malignant Brain Edema and One-Month Death in Large Hemispheric Infarction: A Cohort Study
by Xindi Song, Yanan Wang, Wen Guo, Meng Liu, Yilun Deng, Kaili Ye and Ming Liu
Diagnostics 2023, 13(15), 2506; https://doi.org/10.3390/diagnostics13152506 - 27 Jul 2023
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Abstract
Introduction: Large hemispheric infarction (LHI) can lead to fatal complications such as malignant brain edema (MBE). We aimed to investigate the correlation between heart-rate-to-blood-pressure ratios and MBE or one-month death after LHI. Methods: We prospectively included LHI patients from a registered cohort. Hourly [...] Read more.
Introduction: Large hemispheric infarction (LHI) can lead to fatal complications such as malignant brain edema (MBE). We aimed to investigate the correlation between heart-rate-to-blood-pressure ratios and MBE or one-month death after LHI. Methods: We prospectively included LHI patients from a registered cohort. Hourly heart-rate-to-blood-pressure ratios were recorded as a variation of the traditional shock index (SI), SIs and SId (systolic and diastolic pressures, respectively), and calculated for mean and variability (standard deviation) in 24 h and two 12 h epochs (1–12 h and 13–24 h) after onset of symptoms. MBE was defined as neurological deterioration symptoms with imaging evidence of brain swelling. We employed a generalized estimating equation to compare the trend in longitudinal collected SIs and SId between patients with and without MBE. We used multivariate logistic regression to investigate the correlation between SIs, SId and outcomes. Results: Of the included 162 LHI patients, 28.4% (46/162) developed MBE and 25.3% (40/158) died within one month. SIs and SId increased over baseline in all patients, with a similar ascending profile during the first 12 h epoch and a more intensive increase in the MBE group during the second 12 h epoch (p < 0.05). During the overall 24 h, patients with greater SId variability had a significantly increased MBE risk after adjustment (OR 3.72, 95%CI 1.38–10.04). Additionally, during the second 12 h epoch (13–24 h after symptom onset), patients developing MBE had a significantly higher SId level (OR 1.18, 95%CI 1.00–1.39) and greater SId variability (OR 3.16, 95%CI 1.35–7.40). Higher SId and greater SId variability within 24 h independently correlated with one-month death (all p < 0.05). Within the second 12 h epoch, higher SIs, higher SId and greater SId variability independently correlated with one-month death (all p < 0.05). No significant correlation was observed in the first 12 h epoch. Conclusions: Higher and more fluctuated heart-rate-to-blood-pressure ratios independently correlated with MBE development and one-month death in LHI patients, especially during the second 12 h (13–24 h) epoch after onset. Full article
(This article belongs to the Special Issue Cerebrovascular Lesions: Diagnosis and Management)
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13 pages, 881 KiB  
Article
Effect of Targeted Embolization on Seizure Outcomes in Patients with Brain Arteriovenous Malformations
by Chingiz Nurimanov, Aisha Babi, Karashash Menlibayeva, Yerbol Makhambetov, Assylbek Kaliyev, Elena Zholdybayeva and Serik Akshulakov
Diagnostics 2023, 13(1), 47; https://doi.org/10.3390/diagnostics13010047 - 23 Dec 2022
Cited by 1 | Viewed by 1320
Abstract
Background: Seizures are one of the most debilitating manifestations of brain arteriovenous malformations (AVMs). This study aimed to evaluate the effect of curative embolization on brain AVM patients presenting with seizures. Methods: The records of patients who underwent embolization for brain AVM from [...] Read more.
Background: Seizures are one of the most debilitating manifestations of brain arteriovenous malformations (AVMs). This study aimed to evaluate the effect of curative embolization on brain AVM patients presenting with seizures. Methods: The records of patients who underwent embolization for brain AVM from January 2012 to December 2020 were evaluated and patients presenting with seizures were interviewed. Patient responses were evaluated according to the International League Against Epilepsy (ILAE) and Engel classifications. Statistical analyses of factors associated with seizure outcomes and complications were performed using ANOVA and Fischer’s exact tests. Results: The mean age of the participants was 35.2 ± 10.7 years. More than 80% of the patients received no or suboptimal dosages of antiepileptic drugs (AEDs) prior to embolization. Positive seizure dynamics were observed in 50% of the patients post-procedure. A correlation was found between length of seizures in anamnesis and outcomes of both Engel and ILAE score, where shorter length was associated with better outcomes. Post-embolization hemorrhage was associated with initial presentation with hemorrhage. Conclusions: The embolization of brain AVMs had a positive effect on seizure presentation and a relatively low prevalence of complications. However, the results of the study are obscured by inadequate AED treatment received by the patients, which prompts prospective studies on the topic with careful patient selection. Full article
(This article belongs to the Special Issue Cerebrovascular Lesions: Diagnosis and Management)
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