Neuroimaging in ischemic stroke, hemorrhagic stroke and cerebral amyloid angiopathy

The focus of research in ischemic stroke is to identify radiological parameters that have predictive value for clinical outcome after the ischemic insult, with the ultimate goal to select patients for recanalization therapies based on baseline imaging parameters, within and outside the currently used time windows.

The main research lines are the following:

1. Identification, development and quantification of brain MRI markers (at 3T and ultra-high field 7T MRI) in patients with hemorrhagic stroke and cerebral amyloid angiopathy with the aim to elucidate the underlying pathophysiological processes, monitor disease progression and relate imaging finding to clinical phenotypes and cognitive impairment.
2. identification of baseline imaging markers that can be used to select or exclude patients for recanalization therapies in the acute phase of an ischemic stroke in order to improve patient outcome and prevent futile recanalization.

This research line has a strong focus on one of the most common cerebral small vessel diseases worldwide, sporadic cerebral amyloid angiopathy (CAA), and within this research line we focus on the hereditary type of CAA that is highly prevalent in the vicinity of Leiden (Dutch type CAA, D-CAA). This patient population serves as a ‘pure’ model for sporadic CAA and provides the unique opportunity to study the natural history of the disease, including the presymptomatic phase, with identification and development of (early) structural and functional biomarkers using conventional and advanced MR techniques at 3T and 7T MRI that may be used as outcome parameters in future clinical trials.

Within the University NeuroVascular Center (UNVC) of the LUMC-HMC the largest number of ischemic stroke patients in the Netherlands are being treated. Using state-of-the art dynamic volumetric CT scanners, novel imaging parameters are developed - such as cortical venous filling - to enhance prediction of patient outcome based on baseline imaging assessment.

Team members

• Dr. MAA van Walderveen, radiologist
• Prof. Dr. van Buchem, radiologist
• Prof. Dr. Wermer, neurologist
• Prof. Dr. Terwindt, neurologist
• Prof. Dr. van Osch, MR physicist