New Frontiers in the Clinical Management of Stroke

Dear Colleagues,

Unfortunately, stroke is a frequent condition, but not all the causes of cerebrovascular diseases are really frequent. Rare diseases are individually rare but collectively frequent, and among the several hundreds of causes of stroke, vascular neurologists frequently consider and look for rare diseases. The main topic of this Special Issue can be detailed considering a pragmatic approach to raising suspicion, distinguishing between subcategories of diseases, and performing the most appropriate diagnostic pathway in order to define the treatment, when available. Rare neurovascular disorders are often very good mimics of frequent conditions, both in clinical presentation and in neuroimaging pattern, but they exist, and many of them are probably largely undiagnosed because we rarely think of them. For example, monogenic causes of small vessel diseases have excellent phenocopies in frequent sporadic disorders (e.g., “hypertensive” small vessel disease, cerebral amyloid angiopathy or mixed small vessel diseases), and the main rare diseases can coexist with frequent diseases (e.g., atrial fibrillation, arterial hypertension, smoking habitus, diabetes). On the other side, non-atheromasic large vessel diseases range from vasculitides to dysplasic and/or dissecative arteriopathies. Another main issue is that “rare” does not mean “hereditary” or genetic, but this is a point frequently raised by patients and relatives, and it is not always easy to give a definite answer. Finally, rare diseases are often unique, so they represent a field where even single case may be relevant.

I hope many of you can contribute to this Special Issue by sharing your hypotheses and findings.

Dr. Maria Luisa Zedde
Dr. Rosario Pascarella
Guest Editors

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