title: [Neuroimaging and Blood Biomarkers in Functional Prognosis after Stroke].
abstract: BACKGROUND
  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.
  
  
  METHODS
  Review of the literature published between 2005 and 2015, in English, using the terms "ischemic stroke", "neuroimaging" e "blood biomarkers".
  
  
  RESULTS
  We included nine studies, based on abstract reading.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. Tocha. Portugal.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Branco
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Joana Santos
authors.initials: JS
authors.lastname: Costa
authors.affiliation: Serviço de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Sargento-Freitas
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Oliveira
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. Tocha. Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Mendes
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais. Tocha. Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Laíns
authors.affiliation: Serviço de Medicina Física e de Reabilitação. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Pinheiro
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002545:Brain Ischemia / Q000097:blood / Q000000981:diagnostic imaging*; D006801:Humans; D059906:Neuroimaging; D011237:Predictive Value of Tests; D011379:Prognosis; D020521:Stroke / Q000097:blood / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers
keywords: Acidente Vascular Cerebral; Biomarcadores/sangue; Neuroimagem; Prognóstico; Recuperação Funcional.