Emerging Biomarkers and Therapeutic Approaches in Neurovascular Diseases

Dear Colleagues,

Neurovascular disease encompasses a wide range of conditions, including stroke (both ischaemic and haemorrhagic), intracerebral haemorrhages, intracranial aneurysms, arteriovenous malformations, cavernous malformations and dural arteriovenous fistulae (DAVFs, e.g., those formed in the course of venous sinus thrombosis). These conditions can lead to potentially life-threatening bleeding and neurological complications.

Despite our growing knowledge base; the advances in treatment modalities, whether conservative, endovascular or surgical; and the increasing availability of state-of-the-art equipment in vascular laboratories and operating theatres, much remains to be clarified. For example, which intracranial aneurysms are most prone to rupture, and when, and what are the optimal treatment approaches? Should these aneurysms be treated surgically or endovascularly, and in which settings? Of those that do rupture, which patients will develop cerebral vasospasm and which will suffer delayed cerebral ischaemia (DCI)? Furthermore, which clinical, radiological, serum/plasma or CSF biomarkers can be used for the early detection of these complications, and how can this information be utilized for effective prevention?

Consider an intracerebral haemorrhage: when should it be managed conservatively and when is surgical intervention required? Should its treatment involve a decompressive craniectomy, the surgical evacuation of the bleed, or modern minimally invasive techniques such as the Artemis system? Are there biomarkers that can guide the selection of these different treatment strategies for patients, and which of these can help predict patient outcomes?

The exact pathogenesis of DAVFs remains elusive. What is the risk of bleeding from these fistulas, and what is the most effective treatment approach? Furthermore, how should patients be monitored after treatment to ensure long-term vigilance and detect potential recurrences or complications?

Many issues surrounding neurovascular disease have not been addressed here. In fact, there are numerous smaller entities and conditions that could not be included in this summary of the research topic. Even for the above questions, the answers remain incomplete, highlighting how much work remains to be done in this field. With this in mind, we encourage active participation in the development of a series of studies under the umbrella title “Emerging Biomarkers and Therapeutic Approaches in Neurovascular Diseases”. We invite the submission of original research articles and reviews that address these important questions.

Dr. Karol Wiśniewski
Dr. Bartosz Szmyd
Guest Editors

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• intracranial aneurysm
• giant aneurysm
• intracranial bypass
• aneurysmal subarachnoid haemorrhage
• delayed cerebral ischemia
• computational fluid dynamics
• neurovascular compression syndromes
• biomarkers