Current Advances and Future Perspectives of Ischemic Stroke

Dear Colleagues,

This year, 2025, marks the thirtieth anniversary of the introduction of thrombolysis in treatments of acute ischemic stroke. For the first time ever, it became possible to “cure” ischemic stroke. In 1995, for the first time, a clinical NINDS trial successfully applied the penumbral concept, showing a positive outcome in acute stroke patients who underwent tPA intravenous infusion within 3 hours from the stroke onset.

This was followed by advanced research in brain imaging, thereby confirming the largely variable time course of the so called “penumbral battleground”. Endovascular treatments, which were introduced in clinical practice around 10 years ago, have added a complementary strong instrument to reverse the progression of the penumbral sufference (even after many more hours from stroke onset in carefully selected patients). Moreover, innovative technologies, including artificial intelligence, are reshaping and supporting stroke care.

Nevertheless, the entire spatiotemporal evolution of stroke pathology needs to be better understood—both before and after the ischemic event—when reperfusion and neuroprotection are key targets, as well as days, weeks, or months after the stroke happened, when repair and regeneration are relevant targets.

This Special Issue aims at attracting the interest of the entire stroke research community, highlighting both the challenges and the opportunities of recent advancements in preclinical and clinical knowledge of pathophysiology mechanisms of ischemic stroke.

We look forward to receiving your contributions.

Dr. Marzia Baldereschi
Guest Editor

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