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• W2560669805 abstract "Stroke remains one of the leading causes of morbidity and mortality around the world and it is associated with an important long-term functional disability. Some neuroimaging resources and certain peripheral blood or cerebrospinal fluid proteins can give important information about etiology, therapeutic approach, follow-up and functional prognosis in acute ischemic stroke patients. However, among the scientific community, there is currently more interest in the stroke vital prognosis over the functional prognosis. Predicting the functional prognosis during acute phase would allow more objective rehabilitation programs and better management of the available resources. The aim of this work is to review the potential role of acute phase neuroimaging and blood biomarkers as functional recovery predictors after ischemic stroke.Review of the literature published between 2005 and 2015, in English, using the terms ischemic stroke, neuroimaging e blood biomarkers.We included nine studies, based on abstract reading.Computerized tomography, transcranial doppler ultrasound and diffuse magnetic resonance imaging show potential predictive value, based on the blood flow study and the evaluation of stroke's volume and localization, especially when combined with the National Institutes of Health Stroke Scale. Several biomarkers have been studied as diagnostic, risk stratification and prognostic tools, namely the S100 calcium binding protein B, C-reactive protein, matrix metalloproteinases and cerebral natriuretic peptide.Although some biomarkers and neuroimaging techniques have potential predictive value, none of the studies were able to support its use, alone or in association, as a clinically useful functionality predictor model. All the evaluated markers were considered insufficient to predict functional prognosis at three months, when applied in the first hours after stroke. Additional studies are necessary to identify reliable predictive markers for functional prognosis after ischemic stroke.Introdução: O acidente vascular cerebral é uma das principais causas de mortalidade e morbilidade em todo o mundo, associando-se a considerável incapacidade funcional. Atualmente sabe-se que tanto técnicas de neuroimagem como determinados biomarcadores fornecem informações úteis acerca da etiologia, decisão terapêutica, follow-up e prognóstico em doentes com acidente vascular cerebral isquémico. Assiste-se, porém, a um interesse particular na previsão do prognóstico vital em detrimento do prognóstico funcional. Antecipar o prognóstico funcional permitiria definir um programa de reabilitação adequado, objetivo e individualizado, com uma alocação de recursos mais eficiente. O presente trabalho tem como objetivo rever o conhecimento atual acerca do papel da neuroimagem e dos biomarcadores sanguíneos em fase aguda na previsão da recuperação funcional dos doentes que sobrevivem a um acidente vascular cerebral isquémico. Material e Métodos: Revisão da literatura publicada entre 2005 e 2015, em língua inglesa, utilizando os termos “ischemic stroke”, “neuroimaging” e “blood biomarkers”. Resultados: Foram selecionados nove artigos com base na leitura dos resumos. Discussão: Técnicas de neuroimagem como a tomografia computorizada, a ecografia doppler transcraniana, a angiografia cerebrale a imagem de difusão por ressonância magnética apresentam potencial preditivo do prognóstico funcional do acidente vascular cerebral, nomeadamente através da avaliação do fluxo sanguíneo e do volume e localização da lesão, sobretudo quando usados em associação com a National Institutes of Health Stroke Scale. Vários biomarcadores têm sido estudados como potenciais marcadores de diagnóstico, estratificação de risco e previsão de prognóstico no acidente vascular cerebral, em particular a S100 calcium binding protein B, a proteína C-reativa, as metaloproteinases de matriz e o peptídeo natriurético cerebral. Conclusão: Apesar de alguns biomarcadores e técnicas de neuroimagem revelarem capacidade preditiva, nenhum dos estudos com estas metodologias, isoladamente ou em associação, é capaz de sustentar a validação de um potencial modelo clínico preditivo de funcionalidade, revelando-se assim insuficientes na determinação precisa, nas primeiras horas após o acidente vascular cerebral, do prognóstico funcional aos três meses. Considera-se que são necessários mais estudos nesta área para o seu esclarecimento." @default.
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• W2560669805 date "2016-11-30" @default.
• W2560669805 modified "2023-10-17" @default.
• W2560669805 title "Neuroimagem e Biomarcadores no Prognóstico Funcional de Doentes com Acidente Vascular Cerebral" @default.
• W2560669805 doi "https://doi.org/10.20344/amp.7411" @default.
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