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Prognosis in Ischemic Stroke Patients and Related Prognostic Faktors
Kielbergerová, Lenka ; Rohan, Vladimír (advisor) ; Holečková, Irena (referee) ; Petrák, Ondřej (referee)
Stroke is a significant cause of morbidity and mortality in the developed world. In the theoretical part of the thesis, we try to summarize the overall knowledge of stroke, the definitions and the general approach to the diagnosis and treatment, with a focus on ischemic stroke. Furthermore, the issue of acute phase treatment and secondary preventive treatment of ischemic stroke is reviewed and the modalities of the subsequent neurological deficit evaluation, the occurrence of mood disorders and the assessment of the quality of life of individuals after stroke are discussed. Our research aimed to assess the perspective of ischemic stroke patients admitted to the hospital. The first part is focusing on the mortality of patients with ischemic stroke in the period 2003-2019 in the Westbohemian region and its relation to secondary prevention. The second part aims to identify the main clinical and psychosocial factors affecting the quality of life of chronic stable post-stroke patients after their first in-life episode of stroke. The relation of poor quality of life indicators, mortality and conventional cardiovascular risk factors is prospectively assessed. The mortality of patients after first-in-life ischemic stroke hospitalization the years 2003- 2019 is higher compared to worldwide trends. In the...
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The brain infarct core delineation using computed tomography angiography source images in acute stroke patients
Rohan, Vladimír ; Choc, Milan (advisor) ; Kalvach, Pavel (referee) ; Kalita, Zbyněk (referee) ; Smrčka, Martin (referee)
Background and Purpose: Ischemic stroke is the 3rd most common cause of death and most common cause of permanent disability in developed countries. Rapid diagnostic work-up with reliable assessment of infarcted brain tissue and potentionally salvageable brain tissue is critical for acute stroke management. The first aim of this study is to asses delineation of infarct core in acute stroke patients using whole brain perfused blood volume (PBV) maps. These maps are calculated by automatic processing from computed tomography angiography source images (CTA-SI) and non-contrast computed tomography (NCCT) data. The second aim is to determine optimal quantitative threshold of PBV for infarct core identification in acute stroke setting. Material and methods: PBV maps were constructed using prototype software from NCCT and CTA-SI data in 37 acute ischemic stroke patients with angiographically proved recanalization after intravenous thrombolytic treatment. These PBV maps were automatically compared with final infarct extension on follow-up NCCT. The anatomic pixel-by-pixel correlation was assessed using Matthew's correlation coefficient (MCC) for infarct core delineation using different critical values of PBV. The optimal threshold with the best correlation was used for infarct volume computation. Minimal PBV...
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The brain infarct core delineation using computed tomography angiography source images in acute stroke patients
Rohan, Vladimír ; Choc, Milan (advisor) ; Kalvach, Pavel (referee) ; Kalita, Zbyněk (referee) ; Smrčka, Martin (referee)
Background and Purpose: Ischemic stroke is the 3rd most common cause of death and most common cause of permanent disability in developed countries. Rapid diagnostic work-up with reliable assessment of infarcted brain tissue and potentionally salvageable brain tissue is critical for acute stroke management. The first aim of this study is to asses delineation of infarct core in acute stroke patients using whole brain perfused blood volume (PBV) maps. These maps are calculated by automatic processing from computed tomography angiography source images (CTA-SI) and non-contrast computed tomography (NCCT) data. The second aim is to determine optimal quantitative threshold of PBV for infarct core identification in acute stroke setting. Material and methods: PBV maps were constructed using prototype software from NCCT and CTA-SI data in 37 acute ischemic stroke patients with angiographically proved recanalization after intravenous thrombolytic treatment. These PBV maps were automatically compared with final infarct extension on follow-up NCCT. The anatomic pixel-by-pixel correlation was assessed using Matthew's correlation coefficient (MCC) for infarct core delineation using different critical values of PBV. The optimal threshold with the best correlation was used for infarct volume computation. Minimal PBV...
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