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Medicina
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Stroke: Diagnostic Approaches and Therapies: 2nd Edition
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Stroke: Diagnostic Approaches and Therapies: 2nd Edition

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

Deadline for manuscript submissions: closed (30 November 2025) | Viewed by 11135

Special Issue Editors

Dr. Anna Podlasek

E-Mail Website
Guest Editor
Image Guided Therapy and Research Facility (IGTRF), 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: 2nd Edition”. 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 solicit 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 15 February 2025.

Thank you for your time and consideration.

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 250 words) can be sent to the Editorial Office for assessment.

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 policies can be found here.

Related Special Issue

Published Papers (5 papers)

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12 pages, 641 KB  
Article
Prognostic Value of Inflammatory Hematological Indices for In-Hospital Mortality After Stroke
by Nazira Zharkinbekova, Gulnur Arykbayeva, Gulnara Mustapayeva, Ainur Yessetova, Murat Suleimenov, Gaukhar Tolebayeva, Aigul Turtayeva, Altynay Yelubayeva, Sandugash Rustemova, Dinara Tileuberdiyeva, Zaure Suleimenova and Aziza Mukasheva
Medicina 2026, 62(3), 441; https://doi.org/10.3390/medicina62030441 - 26 Feb 2026
Viewed by 671
Abstract
Background and Objectives: This study aimed to assess the prognostic value of several inflammation-based hematological indices in patients with ischemic and hemorrhagic stroke and to evaluate whether their prognostic significance differs between stroke types. The analyzed indices included the neutrophil-to-lymphocyte ratio (NLR), [...] Read more.
Background and Objectives: This study aimed to assess the prognostic value of several inflammation-based hematological indices in patients with ischemic and hemorrhagic stroke and to evaluate whether their prognostic significance differs between stroke types. The analyzed indices included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI). Materials and Methods: This retrospective cohort study analyzed the medical records of stroke patients admitted to two hospitals in Shymkent, Kazakhstan. Hematological parameters were calculated from routine complete blood counts obtained on the third day of hospitalization. Nonparametric tests, univariable and multivariable logistic regression, and receiver operating characteristic (ROC) analysis were used to evaluate associations between inflammatory indices and in-hospital mortality. Results: A total of 199 patients who met the inclusion criteria were classified into three groups according to in-hospital outcome at discharge: (1) patients discharged alive (favorable outcome), (2) patients who died during hospitalization due to ischemic stroke (unfavorable ischemic stroke), and (3) patients who died during hospitalization due to hemorrhagic stroke (unfavorable hemorrhagic stroke). NLR, SIRI, AISI, and SII values were significantly higher in both unfavorable outcome groups compared with the favorable outcome group (p < 0.001, effect size r > 0.6). No statistically significant differences were observed between unfavorable ischemic and hemorrhagic stroke outcomes. In logistic regression analysis, NLR (OR = 1.65) and SIRI (OR = 2.36) showed the strongest associations with in-hospital mortality. ROC analysis demonstrated good predictive performance, with AUC values of 0.885 for NLR and 0.867 for SIRI. Conclusions: The inflammatory indices evaluated in this study were associated with stroke outcomes regardless of stroke subtype. Among them, SIRI and NLR showed the highest prognostic value. These indices may serve as accessible markers of disease severity but should not be considered independent clinical decision-making tools. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies: 2nd Edition)
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11 pages, 335 KB  
Article
Predictor Role of VKORC1 rs9923231, CYP4F2 rs2108622, and GGCX rs11676382 Polymorphisms of 5 Years Mortality of Patients with Acute Ischemic Stroke
by Silvina Iluţ, Valer Donca, Antonia Eugenia Macarie, Ştefan Cristian Vesa, Raluca Maria Pop, Vitalie Văcăraş, Diana Şipoş-Lascu, Ioana Cristina Bârsan, Lăcrămioara Perju-Dumbravă, Ovidiu Sorin Chiroban, Camelia Alexandra Coadă and Anca Dana Buzoianu
Medicina 2025, 61(10), 1760; https://doi.org/10.3390/medicina61101760 - 28 Sep 2025
Viewed by 1145
Abstract
Background and Objectives: The aim of this study was to evaluate the potential predictive value of VKORC1, CYP4F2, and GGCX polymorphisms, as well as other clinical and demographic factors, for 5-year mortality in patients with acute ischemic stroke (AIS). Materials [...] Read more.
Background and Objectives: The aim of this study was to evaluate the potential predictive value of VKORC1, CYP4F2, and GGCX polymorphisms, as well as other clinical and demographic factors, for 5-year mortality in patients with acute ischemic stroke (AIS). Materials and Methods: The study enrolled 252 patients who were consecutively hospitalized for AIS. Demographic data, comorbidities, and laboratory tests were collected. Genotyping of the VKORC1 rs9923231 (-1639G > A; VKORC1*2), CYP4F2 rs2108622 (1347C > T), and GGCX rs11676382 (12970C > G) polymorphisms was performed. Mortality was noted if it occurred within five years following the 30 days after discharge, using the National Health Insurance House registry. Results: Death was recorded in 71 (28.1%) patients. In multivariate analysis the following variables were independent variables associated with 5-year mortality: age > 72 years (OR 2.83 (95%CI 1.32; 6.08), p = 0.007), a lesion volume > 12.6 mL (OR 4.05 (95%CI 2.05; 7.99), p < 0.001), and an NIHSS score > 7 (OR—2.64 (95%CI 1.31; 5.31), p = 0.006). VKORC1 (-1639G > A) SNP m/m variant was only marginally associated with mortality. Conclusions: In this study which included AIS patients, VKORC1, CYP4F2, and GGCX polymorphisms did not independently predict mortality. The VKORC1 variant was only marginally associated with mortality, but this was attenuated after correction for multiple testing. Advanced age, NIHSS score, and the lesion volume were independent predictors of long-term mortality in AIS patients. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies: 2nd Edition)
14 pages, 1289 KB  
Article
Clinical and Ultrasound Evaluation of Hemiplegic Shoulder Pain in Stroke Patients: A Longitudinal Observational Study Starting in the First Hours After Stroke
by Filippo Cotellessa, William Campanella, Luca Puce, Maria Cesarina May, Marta Ponzano, Riccardo Picasso, Matteo Mordeglia, Davide Subbrero, Ester Cecchella, Laura Mori, Davide Sassos, Massimo Del Sette, Matteo Formica and Carlo Trompetto
Medicina 2025, 61(3), 484; https://doi.org/10.3390/medicina61030484 - 11 Mar 2025
Cited by 5 | Viewed by 4301
Abstract
Background and Objectives: Hemiplegic shoulder pain (HSP) is a common and disabling complication in stroke patients, yet its pathogenesis remains unclear. This longitudinal study aimed to investigate the clinical and ultrasound characteristics of HSP emerging within the first 72 h (T0) post-stroke, [...] Read more.
Background and Objectives: Hemiplegic shoulder pain (HSP) is a common and disabling complication in stroke patients, yet its pathogenesis remains unclear. This longitudinal study aimed to investigate the clinical and ultrasound characteristics of HSP emerging within the first 72 h (T0) post-stroke, with follow-ups at one month (T1) and three months (T2). Materials and Methods: A total of 28 stroke patients with hemiparesis were assessed for HSP. Evaluations included pain severity during passive shoulder mobilization, passive and active range of motion, muscle strength, spasticity, and functional disability. Ultrasound examinations were conducted to assess tendon disorders, bursitis, effusion, glenohumeral subluxation, and adhesive capsulitis. Results: HSP prevalence increased over time, affecting 11% of patients at T0, 32% at T1, and 57% at T2. Higher baseline scores on the National Institutes of Health Stroke Scale (NIHSS), an established marker of stroke severity, were significantly associated with HSP (p < 0.05). At T2, patients with HSP exhibited greater impairment, including restricted passive and active range of movement, pronounced muscle weakness, and increased spasticity (p < 0.05). Ultrasound findings at T2 revealed that adhesive capsulitis and glenohumeral subluxation were significantly more frequent in HSP patients (p < 0.05). Adhesive capsulitis showed a significant increase from 0% at T0 to 21% at T2 (p = 0.031), while glenohumeral subluxation exhibited a non-significant rise from 4% to 21% (p = 0.063). Patients with these conditions experienced significantly greater pain progression (p < 0.001). Conclusions: These findings suggest that capsular pathology plays a key role in the development of HSP within the first three months after stroke. The results highlight the need for targeted interventions addressing glenohumeral subluxation and adhesive capsulitis to alleviate pain and improve rehabilitation outcomes. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies: 2nd Edition)
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22 pages, 2004 KB  
Systematic Review
Stroke Neurorehabilitation and the Role of Motor Imagery Training: Do ARAT and Barthel Index Improvements Support Its Clinical Use? A Systematic Review and Meta-Analysis
by Luis Polo-Ferrero, Javier Torres-Alonso, Juan Luis Sánchez-González, Sara Hernández-Rubia, María Agudo Juan, Rubén Pérez-Elvira and Javier Oltra-Cucarella
Medicina 2026, 62(1), 174; https://doi.org/10.3390/medicina62010174 - 15 Jan 2026
Cited by 1 | Viewed by 1282
Abstract
Background and Objectives: Although several meta-analyses have evaluated the effects of motor imagery (MI) on upper-limb recovery using the Fugl-Meyer Assessment for the Upper Extremity (FM-UE), evidence based on more specific (Action Research Arm Test, ARAT) and functional (Barthel Index, BI) outcomes [...] Read more.
Background and Objectives: Although several meta-analyses have evaluated the effects of motor imagery (MI) on upper-limb recovery using the Fugl-Meyer Assessment for the Upper Extremity (FM-UE), evidence based on more specific (Action Research Arm Test, ARAT) and functional (Barthel Index, BI) outcomes remains scarce. This study examined the effect of MI combined with conventional rehabilitation therapy (CRT), which translates into meaningful improvements in upper-limb performance and functional independence after stroke, accounting for methodological quality and publication bias. Materials and Methods: A systematic review and meta-analysis were carried out in accordance with PRISMA recommendations, with prior registration in PROSPERO (CRD420251120044). Comprehensive searches were conducted across six electronic databases up to July 2025. The methodological rigor of the included studies was evaluated using the PEDro scale, and risk of bias was appraised with the Cochrane RoB 2 instrument. Random-effects models estimated pooled effect sizes (ESs) for the ARAT and BI, alongside analyses of heterogeneity, publication bias, and moderators. Results: Eleven RCTs (n = 425) were included. A small pooled improvement in ARAT was observed (ES = 0.25; 95% CI: 0.13–0.37; p < 0.001); however, this effect was rendered non-significant after correction for publication bias (ES = 0.08; 95% CI: −0.14–0.31). No significant differences were found for the BI (ES = 0.41; 95% CI: −0.35–1.18; p = 0.268), with substantial heterogeneity (I2 = 96.6%). The mean PEDro score was 6.6, indicating moderate methodological quality. Conclusions: MI combined with CRT yields small and inconsistent effects on upper-limb recovery and no improvement in functional independence. Current evidence does not support its routine use in stroke rehabilitation. Well-designed, adequately powered randomized controlled trials employing standardized MI protocols are required to determine its true clinical relevance. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies: 2nd Edition)
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21 pages, 3850 KB  
Systematic Review
Thermography in Stroke—A Systematic Review
by Anna Podlasek, Ivo Petrov, Zoran Stankov, Kenneth Snyder, Carlos Alejandro Alvarez, Piotr Musialek and Iris Q. Grunwald
Medicina 2025, 61(5), 854; https://doi.org/10.3390/medicina61050854 - 6 May 2025
Cited by 5 | Viewed by 2671
Abstract
Background and Objectives: Thermography is a non-invasive diagnostic technique that measures skin surface temperatures to reflect normal or abnormal physiology. This review explores the clinical utility of thermography in diagnosing and monitoring stroke, with an emphasis on its clinical applications. Materials and [...] Read more.
Background and Objectives: Thermography is a non-invasive diagnostic technique that measures skin surface temperatures to reflect normal or abnormal physiology. This review explores the clinical utility of thermography in diagnosing and monitoring stroke, with an emphasis on its clinical applications. Materials and Methods: This systematic review followed PRISMA guidelines, with a protocol published prior to analysis. Three databases were screened up to end of 2024. Article selection was conducted in two stages: title and abstract screening using Rayyan®, followed by full-text eligibility assessment. Discrepancies were resolved through consensus. Risk of bias assessment was performed with ROBINS-I. Narrative synthesis was planned in addition to descriptive statistics. Results: A total of 20 studies were included after screening 277 records. Thermography emerged as a promising tool for stroke patients in both the acute and chronic phases. In the acute phase, it demonstrated potential in detecting early signs of carotid occlusive disease by identifying temperature differences in the forehead or neck regions. Additionally, thermography contributed to the differential diagnosis of Wallenberg syndrome. In the chronic phase, it exhibited clinical utility in monitoring rehabilitation progress. Conclusions: Thermography shows promise as a non-invasive tool for stroke assessment and monitoring. While preliminary studies suggest physiological relevance, its clinical utility remains investigational and requires further validation. Full article
(This article belongs to the Special Issue Stroke: Diagnostic Approaches and Therapies: 2nd Edition)
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