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Cerebrovascular Accident and Neurological Disease in Emergency Medicine
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Cerebrovascular Accident and Neurological Disease in Emergency Medicine

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

Deadline for manuscript submissions: closed (15 May 2023) | Viewed by 3648

Special Issue Editor

Prof. Dr. Hengli Tian

E-Mail Website
Guest Editor
Department of Neurosurgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
Interests: neuroscience; neuropharmacology; emergency medicine; traumatic brain injury; stroke; cerebrovascular accidents; neurocritical care; animal models; clinical study

Special Issue Information

Dear Colleagues,

A cerebrovascular accident (CVA), or stroke, is a syndrome characterized by the rapid onset (minutes to hours) of neurologic symptoms caused by the destruction of brain substance as a result of hemorrhagic and ischemic forms, such as spontaneous intracerebral hemorrhage, transient ischemic attack, cerebral thrombosis or cerebral infarction. CVA is a common neurological emergency and a major worldwide cause of mortality and disability affecting millions of patients annually in modern society. Notwithstanding an increasing clinical emphasis on CVA and advances in treatment and neurocritical care monitoring, the outcomes of the survivors are still not optimistic; many of them are even left with cognitive impairment and permanent disability. Therefore, novel therapeutic strategies and pharmacotherapies that can effectively improve neurological function after CVA need to be further explored.

Except for CVA, other neurological diseases such as spinal cord disease, infection or autoimmune diseases of the central nervous system, epilepsy and neuromuscular junction disorders are also common in emergency medicine, and each disease has its heterogeneity in etiology, pathophysiological process and clinical manifestations. To further improve the clinical management, more lab findings and transformation practice are essential and urgent. This research field covers a large area of neuroscience and neuropharmacology research, including a broad range of topics related to laboratory and clinical research.

This Special Issue welcomes all types of articles providing new insights from experimental models and clinical studies about CVA and neurological disease in emergency medicine, with a focus on targets for pharmacological intervention and novel approaches.

Prof. Dr. Hengli Tian
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. 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

  • cerebrovascular accident (CVA) mechanisms
  • cognitive impairment after CVA
  • neurological disease in emergency medicine
  • neuropharmacology in CVA
  • neurocritical care in CVA
  • CVA novel therapies
  • clinical study

Published Papers (2 papers)

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Research

14 pages, 739 KiB  
Article
Elevated Blood Alcohol Concentration Is Associated with Improved Clinical Outcomes of Intravenous Thrombolysis Treatment in Acute Ischemic Stroke Patients—A Retrospective Study
by Tamás Árokszállási, Eszter Balogh, Rita Orbán-Kálmándi, Máté Pásztor, Anita Árokszállási, Edit Boglárka Nagy, Ivett Belán, Zsolt May, Tünde Csépány, László Csiba, Zsuzsa Bagoly and László Oláh
J. Clin. Med. 2023, 12(6), 2238; https://doi.org/10.3390/jcm12062238 - 14 Mar 2023
Cited by 1 | Viewed by 1641
Abstract
Background: Intravenous thrombolysis (IVT) improves acute ischemic stroke (AIS) outcomes, but with limited success. In addition, ethanol potentiates the effect of r-tPA in ischemia models. Methods: The effect of acute alcohol consumption on IVT outcomes was investigated in a retrospective cohort study. AIS [...] Read more.
Background: Intravenous thrombolysis (IVT) improves acute ischemic stroke (AIS) outcomes, but with limited success. In addition, ethanol potentiates the effect of r-tPA in ischemia models. Methods: The effect of acute alcohol consumption on IVT outcomes was investigated in a retrospective cohort study. AIS patients with detectable blood alcohol concentration (BAC) during IVT were included (alcohol group; n = 60). For each case, 3 control subjects who underwent IVT but denied alcohol consumption were matched in terms of age, sex, affected brain area, and stroke severity. Outcomes were determined using the NIHSS at 7 days and the modified Rankin scale (mRS) at 90 days. Results: Patients were younger and had a less severe stroke than in a standard stroke study. Favorable long-term outcomes (mRS 0–2) occurred significantly more frequently in the alcohol group compared to controls (90% vs. 63%, p < 0.001). However, the rates of hemorrhagic transformation were similar. Multiple logistic regression models identified elevated BAC as a significant protective factor against unfavorable short-term (OR: 0.091, 95% CI: 0.036–0.227, p < 0.001) and long-term outcomes (OR: 0.187, 95% CI: 0.066–0.535, p = 0.002). In patients with BAC > 0.2%, significantly lower NIHSS was observed at 3 and 7 days after IVT vs. in those with 0.01–0.2% ethanol levels. Conclusion: Elevated BAC is associated with improved outcomes in IVT-treated AIS without affecting safety. Full article
(This article belongs to the Special Issue Cerebrovascular Accident and Neurological Disease in Emergency Medicine)
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17 pages, 343 KiB  
Article
Clinical and Imaging Phenotypes and Outcomes in a Costa Rican Cohort of Acute Ischemic Stroke Survivors: A Retrospective Study
by María Lorena Serrano-Castro, Mónica Garro-Zúñiga, Erik Simon, Arturo Tamayo and Timo Siepmann
J. Clin. Med. 2023, 12(3), 1080; https://doi.org/10.3390/jcm12031080 - 30 Jan 2023
Cited by 1 | Viewed by 1209
Abstract
Background: We characterized clinical and imaging phenotypes and their association with clinical outcomes in acute ischemic stroke (AIS) survivors in the understudied region of Costa Rica. Methods: We conducted a retrospective cohort study in AIS patients treated at a tertiary stroke center in [...] Read more.
Background: We characterized clinical and imaging phenotypes and their association with clinical outcomes in acute ischemic stroke (AIS) survivors in the understudied region of Costa Rica. Methods: We conducted a retrospective cohort study in AIS patients treated at a tertiary stroke center in Costa Rica from 2011–2015. Participants underwent detailed phenotyping for cardiovascular risk factors and stroke etiology. We assessed the association of ischemic brain lesion features and clinical outcomes using the Oxfordshire Community Stroke Project (OCSP) classification. Results: We included 684 AIS survivors (60.2% males, aged 68.1 ± 13.6 years, mean ± SD). While the cardiovascular risk profiles and mortality rates of our patients were similar to populations in European and North American countries, only 20.2% of patients with atrial fibrillation (AF) received anticoagulation. On multivariable analysis, patients with total anterior circulation infarct (TACI) displayed an increased risk of complications (OR: 4.2; 95% CI: 2.2–7.8; p < 0.001), higher mortality (OR: 6.9; 95% CI: 2.9–16.1; p < 0.001) and lower chance of functional independence at discharge (OR: 8.9; 95% CI: 4.1–19; p < 0.001) compared to non-TACI. The comorbidity of bronchopneumonia increased the probability of death by 14.5 times. Conclusions: Our observations in a Costa Rican cohort of AIS survivors might help improve local measures for preventing and managing AIS. Full article
(This article belongs to the Special Issue Cerebrovascular Accident and Neurological Disease in Emergency Medicine)
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