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Neurovascular Diseases: Clinical Advances and Challenges
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Neurovascular Diseases: Clinical Advances and Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 3418

Special Issue Editors

Dr. Roberto Colasanti

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Guest Editor
Department of Neuroscience, Division of Neurosurgery, AUSL Romagna, Maurizio Bufalini Hospital, Viale Ghirotti, 286, 47521 Cesena (FC), Italy
Interests: neurosurgery; neuro-oncology; skull base; cerebrovascular surgery; neuroanatomy; neurotrauma; spine surgery; neuro-imaging
Special Issues, Collections and Topics in MDPI journals
Dr. Silky Chotai

E-Mail Website
Guest Editor
Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
Interests: neuro-oncology; skull base surgery; neurosurgery; cerebrovascular surgery; neuro-imaging; neuroanatomy
Dr. Alessandro Di Rienzo

E-Mail Website
Guest Editor
Department of Neurosurgery, Università Politecnica delle Marche, 60121 Ancona, Italy
Interests: neurovascular surgery; spine oncology; neuro-oncology; skull base surgery; cerebrovascular surgery
Dr. Joham Choque-Velasquez

E-Mail Website
Guest Editor
School of Medicine, Universidad Andina del Cusco, Cusco, Peru
Interests: neurovascular diseases; neuro-oncology; skull base surgery; neurosurgery; neuro-imaging

Special Issue Information

Dear Colleagues,

Neurovascular diseases remain one of the leading causes of global morbidity and mortality, thus representing a major public health threat.

In recent decades, various advancements have progressively improved the diagnosis of neurovascular diseases, as well as their clinical and surgical management. In addition, advancements in artificial intelligence and related technologies could optimize early and precise detection methodologies, as well as enhance treatment algorithms. However, challenges still remain.

The aim of this Special Issue is to spotlight the current research and progress for every aspect of the management of neurovascular diseases (primary and secondary prevention, when possible, diagnostic imaging, acute inpatient care, endovascular and/or surgical treatment, complication management, rehabilitation and recovery, and progress in translational science).

Our goal is to provide a detailed overview of key discoveries, novel diagnostic and innovative treatment methods, and improved applications of established approaches, while shedding light on emerging research areas and future perspectives.

We eagerly anticipate contributions on ischemic and hemorrhagic stroke, as well as on aneurysms and vascular malformations.

In addition, we encourage interdisciplinary collaborations, inviting contributions from neurosurgeons, neuroradiologists, neurologists, neurorehabilitation specialists, and other allied healthcare professionals.

Dr. Roberto Colasanti
Dr. Silky Chotai
Dr. Alessandro Di Rienzo
Dr. Joham Choque-Velasquez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neurovascular diseases
  • ischemic stroke
  • hemorrhagic stroke
  • aneurysms
  • vascular malformations
  • diagnostic imaging
  • minimally invasive approaches
  • surgical techniques
  • endovascular interventions
  • treatment algorithms

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Published Papers (4 papers)

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13 pages, 1271 KiB  
Article
Blood Flow in the Internal Jugular Veins in the Lateral Decubitus Body Position in the Healthy People
by Agata Maria Kawalec-Rutkowska, Joanna Czaja, Marcin Skuła and Marian Simka
J. Clin. Med. 2025, 14(4), 1211; https://doi.org/10.3390/jcm14041211 - 12 Feb 2025
Viewed by 636
Abstract
Background: Some studies have suggested that the lateral decubitus position during sleep may protect the brain from neurodegenerative processes. Although the mechanisms of such possible protection are not known, an optimal venous outflow may be responsible. Venous outflow from the cranial cavity is [...] Read more.
Background: Some studies have suggested that the lateral decubitus position during sleep may protect the brain from neurodegenerative processes. Although the mechanisms of such possible protection are not known, an optimal venous outflow may be responsible. Venous outflow from the cranial cavity is dependent on the body’s position. However, to date, flow in the internal jugular veins (IJVs) in the lateral position has not been studied quantitatively. Methods: Using ultrasonography, we measured the cross-sectional areas and flow volumes in the IJVs in a group of 25 healthy individuals aged 20–52 ± 12.1 years. These measurements were performed in the supine, upright, and lateral decubitus positions. Results: In the lateral decubitus position, we revealed a collapse of the IJV located higher, dilatation of the opposite vein, and a shift in flow from one vein to the opposite. In the right lateral position, the mean cross-sectional area and flow in the right IJV were 88.6 ± 71.1 mm2 and 74.3 ± 97.5 mL/min, in the left IJV: 37.2 ± 33.4 mm2 and 48.8 ± 82.8 mL/min. In the left lateral position, the right IJV was 38.4 ± 30.7 mm2 and 56.7 ± 56.1 mL/min, and the left IJV was 75.9 ± 51.9 mm2 and 99.7 ± 123.9 mL/min. However, there was also a high heterogeneity of the cross-sectional area changes, and in many participants, this pattern was not observed. Regarding flow volumes in the lateral body positions, in comparison with the supine position, the total outflow through both internal jugular veins was not significantly different. Conclusions: In terms of venous outflow, the lateral decubitus position did not differ significantly from the supine position. The working hypothesis of a potentially protective effect of this body position during sleep against neurodegeneration through improved venous outflow has not been proven, at least in healthy individuals. Full article
(This article belongs to the Special Issue Neurovascular Diseases: Clinical Advances and Challenges)
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18 pages, 1062 KiB  
Article
Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
by Taghi Khaniyev, Efecan Cekic, Neslihan Nisa Gecici, Sinem Can, Naim Ata, Mustafa Mahir Ulgu, Suayip Birinci, Ahmet Ilkay Isikay, Abdurrahman Bakir, Anil Arat and Sahin Hanalioglu
J. Clin. Med. 2025, 14(4), 1144; https://doi.org/10.3390/jcm14041144 - 10 Feb 2025
Cited by 1 | Viewed by 816
Abstract
Background/Objective: Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates, necessitating prognostic algorithms to guide decisions. Our study evaluates the use of machine learning (ML) models for predicting 1-month and 1-year mortality among SAH patients using national electronic health records (EHR) [...] Read more.
Background/Objective: Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates, necessitating prognostic algorithms to guide decisions. Our study evaluates the use of machine learning (ML) models for predicting 1-month and 1-year mortality among SAH patients using national electronic health records (EHR) system. Methods: Retrospective cohort of 29,274 SAH patients, identified through national EHR system from January 2017 to December 2022, was analyzed, with mortality data obtained from central civil registration system in Türkiye. Variables included (n = 102) pre- (n = 65) and post-admission (n = 37) data, such as patient demographics, clinical presentation, comorbidities, laboratory results, and complications. We employed logistic regression (LR), decision trees (DTs), random forests (RFs), and artificial neural networks (ANN). Model performance was evaluated using area under the curve (AUC), average precision, and accuracy. Feature significance analysis was conducted using LR. Results: The average age was 56.23 ± 16.45 years (47.8% female). The overall mortality rate was 22.8% at 1 month and 33.3% at 1 year. One-month mortality increased from 20.9% to 24.57% (p < 0.001), and 1-year mortality rose from 30.85% to 35.55% (p < 0.001) in the post-COVID period compared to the pre-COVID period. For 1-month mortality prediction, the ANN, LR, RF, and DT models achieved AUCs of 0.946, 0.942, 0.931, and 0.916, with accuracies of 0.905, 0.901, 0.893, and 0.885, respectively. For 1-year mortality, the AUCs were 0.941, 0.927, 0.926, and 0.907, with accuracies of 0.884, 0.875, 0.861, and 0.851, respectively. Key predictors of mortality included age, cardiopulmonary arrest, abnormal laboratory results (such as abnormal glucose and lactate levels) at presentation, and pre-existing comorbidities. Incorporating post-admission features (n = 37) alongside pre-admission features (n = 65) improved model performance for both 1-month and 1-year mortality predictions, with average AUC improvements of 0.093 ± 0.011 and 0.089 ± 0.012, respectively. Conclusions: Our study demonstrates the effectiveness of ML models in predicting mortality in SAH patients using big data. LR models’ robustness, interpretability, and feature significance analysis validate its importance. Including post-admission data significantly improved all models’ performances. Our results demonstrate the utility of big data analytics in population-level health outcomes studies. Full article
(This article belongs to the Special Issue Neurovascular Diseases: Clinical Advances and Challenges)
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7 pages, 1179 KiB  
Case Report
Perioperative Stroke in MCA Aneurysm Surgery: The Hidden Risks of Amphetamine Use
by Firat Taskaya, Vanessa Magdalena Swiatek, Sifian Al-Hamid, Julius Reiser, Roland Schwab, Klaus-Peter Stein, Daniel Behme, Ali Rashidi, I. Erol Sandalcioglu and Belal Neyazi
J. Clin. Med. 2025, 14(9), 3246; https://doi.org/10.3390/jcm14093246 - 7 May 2025
Viewed by 173
Abstract
Background/Objectives: Perioperative strokes are a rare but recognized complication of cerebral aneurysm surgeries, often influenced by patient-specific factors. Amphetamine abuse, known for its vasospastic effects, is an underexplored risk factor in the neurosurgical setting. This report highlights the clinical and perioperative challenges associated [...] Read more.
Background/Objectives: Perioperative strokes are a rare but recognized complication of cerebral aneurysm surgeries, often influenced by patient-specific factors. Amphetamine abuse, known for its vasospastic effects, is an underexplored risk factor in the neurosurgical setting. This report highlights the clinical and perioperative challenges associated with acute undisclosed amphetamine abuse in a patient undergoing elective clipping of an unruptured middle cerebral artery (MCA) aneurysm. Methods: A 46-year-old male presented with a 3 mm broad-based unruptured aneurysm in the proximal M1 segment of the right MCA. The patient reported a history of illicit drug use, including intravenous consumption. Upon further questioning, he admitted to intermittent use of amphetamines, although he denied any recent use. Elective aneurysm clipping via a transsylvian approach was performed after multidisciplinary consensus. Postoperatively, the patient developed anisocoria, prompting an emergency CT with perfusion and angiography, showing significant findings. Further imaging revealed a bilateral superior cerebellar artery territory infarction. Given the patient’s medical history, a toxicology screening later confirmed recent amphetamine use. Conclusions: This case highlights the need for preoperative evaluation, including routine toxicology screening, in patients with a history of substance abuse. Amphetamine use may present perioperative challenges and increase the risk of complications like vasospasm and stroke. Full article
(This article belongs to the Special Issue Neurovascular Diseases: Clinical Advances and Challenges)
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16 pages, 2312 KiB  
Case Report
Single-Stage Microsurgical Clipping of Multiple Intracranial Aneurysms in a Patient with Cerebral Atherosclerosis: A Case Report and Review of Surgical Management
by Corneliu Toader, Matei Serban, Razvan-Adrian Covache-Busuioc, Mugurel Petrinel Radoi, Ghaith Saleh Radi Aljboor, Horia Petre Costin, Milena-Monica Ilie, Andrei Adrian Popa and Radu Mircea Gorgan
J. Clin. Med. 2025, 14(1), 269; https://doi.org/10.3390/jcm14010269 - 5 Jan 2025
Cited by 1 | Viewed by 1231
Abstract
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery [...] Read more.
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA), pericallosal artery, and M2 segment. The patient also had a history of systemic atherosclerosis and right-sided breast cancer, factors that increased the complexity of surgical intervention. The aim of this report is to demonstrate the efficacy of single-stage microsurgical clipping in managing multiple aneurysms with favorable outcomes in a complex patient profile. Methods: The patient underwent right-sided pterional craniotomy for microsurgical clipping of all three aneurysms during a single-stage procedure. Two aneurysms in the MCA were clipped using Yasargil clips, and a third aneurysm located at the bifurcation of the pericallosal artery was also secured with a clip. The procedure was performed under microscopic visualization, with meticulous dissection of the atherosclerotic vessels and careful intraoperative hemostasis. Postoperative care involved proactive perioperative management, including blood pressure control and vigilant neurological monitoring. Results: Postoperative imaging at three months confirmed proper clip placement with no evidence of residual aneurysm filling or ischemic complications. The patient exhibited a full neurological recovery, with no deficits or further complications, highlighting the effectiveness of the surgical approach in managing multiple aneurysms concurrently. Conclusions: This case supports the use of single-stage microsurgical clipping as an effective treatment for patients with multiple intracranial aneurysms, even in the presence of complicating factors such as atherosclerosis. A meticulous surgical technique and perioperative management are critical to achieving favorable outcomes and reducing the risk of delayed ischemia or other postoperative complications. Full article
(This article belongs to the Special Issue Neurovascular Diseases: Clinical Advances and Challenges)
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