Cerebrovascular Disease: Update on Diagnosis and Treatment

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 857

Special Issue Editors


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Guest Editor
Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
Interests: cerebrovascular diseases; small vessel diseases; hemorrhagic stroke; cavernous angioma; cerebral amyloid angiopathy; CADASIL; FMD; gene
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
Interests: MRI; angiography; small vessel disease; cerebral amyloid angiopathy; hemorrhagic stroke; gene
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cerebrovascular disease (CVD) encompasses a range of disorders affecting the blood vessels in the brain, leading to significant morbidity and mortality worldwide. Conditions such as stroke, transient ischemic attack (TIA), and vascular dementia represent major public health challenges. Accurate diagnosis and timely intervention are critical to improving patient outcomes and minimizing long-term disability. As our understanding of the pathophysiology of cerebrovascular diseases evolves, so too do the diagnostic and therapeutic approaches. This Special Issue aims to provide a comprehensive update on the latest advancements in the diagnosis and treatment of cerebrovascular disease, addressing both established and emerging strategies.

The primary aim of this Special Issue is to gather and disseminate cutting-edge research and clinical insights into the diagnosis and management of cerebrovascular diseases. We seek to explore innovative diagnostic modalities, including advanced imaging techniques and biomarkers, as well as new therapeutic interventions, such as novel pharmacological agents and interdisciplinary management approaches. The scope 

of this issue includes, but is not limited to, studies on acute stroke management, secondary prevention strategies, rehabilitation techniques, and the integration of technology in patient care. By providing a platform for the latest research, we hope to enhance clinical practice and inform future directions in cerebrovascular disease management.

Historically, the field of cerebrovascular disease has undergone significant transformations. Advances in neuroimaging technologies and a better understanding of risk factors have revolutionized the diagnosis of CVD. The introduction of thrombolytic therapy and endovascular interventions has changed the landscape of acute stroke treatment, while ongoing research continues to refine management strategies for chronic cerebrovascular conditions. Despite these advancements, challenges remain in the early detection of CVD and effective treatment modalities, particularly in diverse populations. This Special Issue will trace the history of cerebrovascular disease management, highlighting key milestones and current gaps that require further exploration.

This Special Issue will feature cutting-edge research that highlights the latest breakthroughs in the diagnosis and treatment of cerebrovascular diseases. We aim to include studies that utilize novel imaging techniques, such as perfusion MRI and machine learning algorithms for stroke prediction, as well as research on emerging therapeutic agents that target the underlying mechanisms of cerebrovascular pathology. Additionally, we welcome investigations into multidisciplinary approaches that integrate medical, surgical, and rehabilitation strategies to optimize patient outcomes. By showcasing these advancements, we hope to foster collaboration and innovation in the field of cerebrovascular disease.

We invite original research articles, reviews, clinical guidelines, and case studies that contribute to the understanding and management of cerebrovascular disease. Specifically, we seek the following:

  • Original research articles that present novel findings related to diagnostic techniques or treatment interventions;
  • Comprehensive reviews that synthesize current knowledge and highlight gaps in the literature, offering insights into future research directions;
  • Clinical guidelines or consensus statements that provide evidence-based recommendations for the diagnosis and management of cerebrovascular disease;
  • Case studies that illustrate unique clinical presentations, innovative treatment approaches, or successful management strategies in cerebrovascular disease. Through this Special Issue, we aim to create a collaborative space for researchers, clinicians, and healthcare professionals to share knowledge and advance the field of cerebrovascular disease diagnosis and treatment.

You may choose choose our Joint Special Issue in Neurology International

Dr. Marialuisa Zedde
Dr. Rosario Pascarella
Guest Editors

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Keywords

  • ischemic stroke
  • SVD
  • vasculitides
  • fibromuscular dysplasia
  • thrombolysis
  • EVT
  • plaque imaging
  • intracranial stenosis

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Published Papers (2 papers)

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11 pages, 4892 KB  
Case Report
Dominant Orbitofrontal Pial Supply in Anterior Cranial Fossa Dural Arteriovenous Fistula: Angiographic Differentiation from Mixed Pial-Dural Arteriovenous Malformation and Anatomy-Based Treatment Selection
by Kosei Goto, Nobuo Kutsuna, Takuto Nishihara and Kotaro Makita
Brain Sci. 2026, 16(5), 534; https://doi.org/10.3390/brainsci16050534 - 19 May 2026
Viewed by 85
Abstract
Background: Anterior cranial fossa dural arteriovenous fistulas (ACF DAVFs) usually receive ethmoidal dural supply. Pial arterial supply has been described in intracranial DAVFs, including ACF DAVFs, but a dominant orbitofrontal pial feeder can create diagnostic overlap with mixed pial-dural arteriovenous malformation and make [...] Read more.
Background: Anterior cranial fossa dural arteriovenous fistulas (ACF DAVFs) usually receive ethmoidal dural supply. Pial arterial supply has been described in intracranial DAVFs, including ACF DAVFs, but a dominant orbitofrontal pial feeder can create diagnostic overlap with mixed pial-dural arteriovenous malformation and make endovascular treatment hazardous. Case Presentation: A 75-year-old man with atrial fibrillation presented with right middle cerebral artery occlusion and underwent intravenous thrombolysis followed by mechanical thrombectomy. During right internal carotid angiography, transient arterial-phase opacification of a contralateral frontal draining vein through the anterior communicating artery prompted post-recanalization angiography. A high-grade left ACF DAVF was diagnosed, with dominant supply from the left orbitofrontal artery, minor anterior ethmoidal supply, two venous drainage routes, cortical venous reflux, and a varix. Although the DAVF was incidental to the ischemic presentation, it was considered to require treatment because of high-risk angioarchitecture, including Borden type III/Cognard type IV drainage, cortical venous reflux, and venous ectasia. No intraparenchymal nidus or normal venous-phase use of the refluxing veins was identified. Because pial transarterial access and complete transvenous closure were considered unsafe or uncertain, microsurgical draining-vein disconnection was performed. Postoperative angiography confirmed complete obliteration. Conclusions: In this case, microsurgical disconnection achieved angiographic cure, and the patient was transferred for rehabilitation with a modified Rankin Scale score of 1. The central diagnostic and therapeutic issue in pial-feeder-dominant ACF DAVF is not rarity alone, but angiographic differentiation from mixed pial-dural arteriovenous malformation and assessment of whether the shunt can be closed without compromising normal pial arteries or venous outflow. The thrombectomy angiogram provided the route to diagnosis, whereas pial arterial dominance and divided venous drainage determined the curative strategy. Full article
(This article belongs to the Special Issue Cerebrovascular Disease: Update on Diagnosis and Treatment)
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19 pages, 987 KB  
Systematic Review
External Ventricular Drains and Infection Risk: Duration as the Dominant Predictor—A Systematic Review and Meta-Analysis
by Thamer H. Alsharif, Badr E. Hafiz, Lamair Albakri, Abdularhman D. Alofi, Ziad Alzahrani, Yazid Maghrabi and Moajeb Alzahrani
Brain Sci. 2026, 16(5), 528; https://doi.org/10.3390/brainsci16050528 - 15 May 2026
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Abstract
Background/Objectives: External ventricular drains (EVDs) are widely used in the management of intracranial hemorrhage and hydrocephalus; however, they carry a significant risk of device-related central nervous system infections, including ventriculitis and meningitis, which are associated with increased morbidity, mortality, and prolonged intensive care [...] Read more.
Background/Objectives: External ventricular drains (EVDs) are widely used in the management of intracranial hemorrhage and hydrocephalus; however, they carry a significant risk of device-related central nervous system infections, including ventriculitis and meningitis, which are associated with increased morbidity, mortality, and prolonged intensive care stays. We conducted a systematic review and meta-analysis to evaluate whether prolonged EVD duration (>10 days) is associated with an increased risk of ventriculostomy-related infection compared with shorter duration (≤10 days), and to explore the association with cerebrospinal fluid (CSF) leak where data were available. Methods: A comprehensive literature search of PubMed, Google Scholar, Web of Science, and Cochrane CENTRAL was performed from database inception through September 2025, including English-language clinical trials, cohort studies, and case–control studies reporting infection outcomes related to EVD management factors. Two reviewers independently screened studies and extracted data. A random-effects meta-analysis was conducted to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Results: Sixteen studies comprising approximately 5500 patients met the inclusion criteria. Shorter EVD duration (≤10 days) was associated with a significantly lower risk of infection (pooled OR 0.45, 95% CI 0.30–0.68; p = 0.0002), corresponding to a 55% reduction in the odds of ventriculostomy-related infection. Prolonged EVD duration was consistently associated with increased infection risk across studies. Conclusions:These findings suggest that minimizing EVD duration may reduce infection risk and support early removal when clinically feasible. However, given the observational nature of the included studies, the results should be interpreted with caution. Further research is warranted to evaluate additional modifiable risk factors, including CSF leakage and sampling practices. Full article
(This article belongs to the Special Issue Cerebrovascular Disease: Update on Diagnosis and Treatment)
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