Advances in Clinical Neurosonology: From Point-of-Care Ultrasound to Therapeutic Application

Dear Colleagues,

Over the last decade, clinical neurosonology has undergone a profound transformation. Point-of-care ultrasound has evolved from a focused adjunct technique into a clinically relevant extension of bedside assessment, while at the same time ultrasound technology has begun to cross the boundary between diagnosis and therapy. These two trajectories—the expansion of bedside diagnostic applications and the emergence of therapeutic ultrasound—together define the current frontier of the field.

In neurology, stroke medicine, and neurocritical care, the diagnostic evolution is especially significant. The Neuro-POCUS concept formally defined point-of-care ultrasound in neurology as a focused examination performed by the treating clinician to answer a specific clinical question in real time—an adjunct, not a replacement, to CT, MRI, and comprehensive ultrasound studies. More recently, the Stroke-POCUS framework has expanded this vision into an integrated multimodal model combining cervical and transcranial ultrasound with orbital, cardiac, venous, lung, abdominal, and interventional applications across prehospital, emergency, stroke unit, and neuro-ICU settings.

In parallel, focused ultrasound has opened entirely new therapeutic possibilities: from the non-invasive treatment of essential tremor and Parkinson’s disease to blood–brain barrier opening for drug delivery to experimental applications in neuro-oncology. Intraoperative ultrasound guidance in neurosurgery further illustrates how ultrasound has become an active instrument of intervention, not merely of observation.

This Special Issue aims to capture the full breadth of this evolution, presenting and disseminating the most recent clinical and scientific advances across the diagnostic-to-therapeutic spectrum of clinical neurosonology. We welcome original research articles and comprehensive review papers. Particular interest will be given to contributions addressing multimodal ultrasound integration, quality assurance, workflow implementation, tele-ultrasound, robotic applications, and artificial intelligence-assisted acquisition and interpretation. 

Topics of interest for publication include, but are not limited to, the following:

• Neuro-POCUS and Stroke-POCUS: concepts, validation, and clinical implementation;
• Bedside neurovascular ultrasound in acute ischemic stroke and intracerebral hemorrhage;
• Transcranial Doppler and transcranial color-coded duplex for recanalization monitoring, vasospasm, hyperperfusion, and microembolic signals;
• Orbital ultrasound and non-invasive assessment of intracranial pressure;
• Focused cardiac ultrasound in stroke etiological work-up;
• Lung, venous, and abdominal ultrasound in stroke-unit and neurocritical care patients;
• Ultrasound-guided bedside procedures in neurological and neurocritical care settings;
• Intraoperative ultrasound in neurosurgery;
• Focused ultrasound for the treatment of movement disorders, epilepsy, and brain tumors;
• Blood–brain barrier opening and ultrasound-mediated drug delivery;
• Artificial intelligence, robotic ultrasound, tele-ultrasound, and emerging technological developments.

Dr. Vincenzo Inchingolo
Dr. Giovanni Malferrari
Guest Editors

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