PhD defense Kees van Hespen

On Tuesday 11 May 2021, Kees van Hespen will defend his thesis entitled: “The Brain at Risk: Detection and Quantification of Cerebrovascular Disease”.


Stroke is one of the most import causes of death worldwide. In stroke, arteries that supply the brain with oxygenated blood are blocked or ruptured, leading to acute and severe symptoms. Survivors of stroke are oftentimes confronted with (long-term) disability, and high chance of recurrent strokes. Similarly, patients with cardiovascular disease also have a higher chance of getting a stroke. In these groups, early detection of changes to the (brain) arteries are important, in order to take timely preventative measures against (recurrent) strokes. In this thesis, we focused on three areas involved in disease of the brain arteries: vessel walls, blood flow, and brain tissue. We observed that patients suffering from an elevated blood pressure had stiffer internal carotid arteries compared to patients with a normal blood pressure. We also showed that the resolution of clinically-used MRI images is insufficient to allow for accurate vessel wall thickness measurements of the brain arteries using conventional measurement methods. Our proposed artificial intelligence algorithm did allow for accurate vessel wall thickness measurements, potentially enabling the detection of early vessel wall thickening caused by disease. For the blood flow, we developed software to quantify the distensibility of the brain arteries, which is the change in artery diameter caused by a change in blood pressure over the cardiac cycle. We used distensibility as a surrogate measure for arterial stiffness. Lastly, we developed an artificial intelligence algorithm for the detection of brain tissue damage resulting from disease of the brain arteries.

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