Stroke Management - Diagnostic and Therapy

Dear Colleagues,

In the past two decades, diagnosis and therapy of stroke have been improved enormously. The recognition of a significant benefit with recanalization times as short as possible has led to standard operating procedures (SOPs) including fast lane imaging, subsequent thrombolysis, and stroke unit care. With the scientific proof of mechanical thrombectomy as the standard of care for patients with large vessel occlusions and symptom onset up to 24 hours, computed tomography (CT) angiography or magnetic resonance (MR) angiography were included in fast lane imaging SOPs.

As soon as ischemic damage has occurred, actual therapeutic options are limited to secondary prevention and rehabilitation measures. While diverse trials of neuroprotective agents have failed to prove efficacy on the way from bench to bedside, there is still the urgent need to find measures to prevent neurons from injury or degeneration, and ideally to keep neuronal and glial damage under the threshold of symptom manifestation. With a closer interaction between the laboratory and the clinic, some of the promising treatments currently tested may still prove efficacy. Further, in the current coronavirus pandemic, we face new challenges regarding the detection and management of cerebrovascular disease in the intensive care setting where “neuro-COVID” is often the key prognostic aspect.

Future perspectives include the restoration of damaged brain tissue. The dream of replacing scars by intact cells via stem cell has been nourished very recently through the publication of promising results using allogeneic modified bone marrow-derived mesenchymal stromal/stem cells in patients with chronic deficits after traumatic brain injury. Further promising approaches to neuroplasticity include transcranial magnetic stimulation, optogenetic approaches, vagal nerve stimulation, and brain–computer interface (BCI) research.

In this Special Issue of JCM, we aim to discuss the key options of state-of-the-art stroke diagnosis and treatment. We will further discuss the most promising and intriguing future treatment options with a focus on neuroprotective and neurorestorative strategies.Also, we strongly support the submission of manuscripts focusing on cerebrovascular disease in neuro-COVID including the most recently discussed cases after COVID vaccinations.

Prof. Dr. Hansjörg Bäzner
Prof.Dr. Hans Henkes
Guest Editors

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