Vascular Neurology

Prof. Octávio Marques Pontes-Neto, Prof. Taiza Elaine Grespan dos Santos Pontelli, Prof. Marcelo Ribeiro, Prof. Millene Rodrigues Camilo

This line of clinical research has explored the frontier of knowledge in the etiological diagnosis, treatment, prognosis, and rehabilitation of patients with cerebrovascular disease, aiming to provide answers for the more effective performance of the neurologist. Simultaneously, studies with transcranial and transorbital ultrasonography have enabled the professional master’s students to use transcranial ultrasound as an armed propaedeutic tool. The master’s student also collaborates intensively with other multidisciplinary teams involved in the care of patients with stroke. Eleven dissertations have been defended in this line of research, with significant clinical national and international impact. We emphasize the research funding and the significant scientific and technical production of the group, which currently coordinates the National Stroke Research Network (RNPAVC) of the Ministry of Health (https://sites.usp.br/rnpavc/). The National Stroke Research Network is a network with Brazilian scientific, technological, and health institutions to improve stroke management, treatment, and innovation in Brazil. It was established by the Ordinance 195 of the Ministry of Health on January 31, 2014. Research networks expand communication between researchers and enable the creation of research centers. RNPAVC conducts clinical trials aiming to reduce the damage associated with stroke in Brazil.

Projects already completed:

● Accuracy of Transcranial Color Ultrasonography in the Diagnosis of Patent Foramen Oval

● Analysis of Collateral Blood Flow in Patients with Acute Ischemic Stroke Due to Proximal Occlusion of the Middle Cerebral Artery

● Assessment of the frequency and severity of the intracranial atherosclerotic disease in patients with stroke and TIA by transcranial color ultrasound and cranial angiotomography

● Predictive factors for falls in patients with stroke

● Transtemporal window quality defined by transcranial duplex.

● Evaluation of the relationship between thrombus density in unenhanced cranial tomography and clinical outcome in patients with proximal middle cerebral artery stroke.

Ongoing projects:

● Analysis of factors associated with better prognosis in patients with malignant middle cerebral artery infarction undergoing decompressive craniectomy

● Association between tomographic characteristics of the temporal bone and the quality of the transtemporal window by the transcranial duplex

● Clinical-radiological characterization of post-stroke apathy

● Impact of Emergency Care Units in the treatment of acute stroke

● Reperfusion therapy for acute ischemic stroke: analysis of the case series of a Brazilian university hospital in the interior of São Paulo

Intellectual Productions Associated with this line of research:

Between 2017 and 2020, the line of research in cerebrovascular diseases produced 61 scientific papers published in journals indexed in PubMed, highlighting three papers published in the New England Journal of Medicine (impact factor: 72,406) and one published in THE LANCET journal (impact factor: 60,392), results of important international research collaborations of the vascular neurology group at HCFMRP-USP with national funding from the CNPq (Processes: 402388/2013-5, 467322/2014-7, 443861/2018- 8) and FAPESP (process: 2016/15236-8). Importantly, ten of these papers were from students of the program.