Cerebral Small Vessel Diseases (SVD) are a subtype of cerebrovascular disease with a broad range of clinical manifestations, from incidental finding in asymptomatic persons to depression, from cognitive impairment to dementia, from cerebral hemorrhage to ischemic stroke, from Transient Focal Neurological Episodes to epilepsy. In terms of neuroimaging, SVD is described by a complex neuroradiological semiology, CT and MR-based, and PET-based. SVDs also represent an etiopathogenetic category of cerebrovascular disease that intersects very closely with neurodegeneration in a conundrum that often poses a diagnostic and management challenge in clinical practice. Furthermore, the contribution of monogenic forms of disease is not negligible, even in clearly age-related forms.
The management pathways of SVD are only partially defined in neurovascular clinical practice and ideally require a dedicated approach by a multidisciplinary team with a specific expertise and background. From a therapeutic point of view, in the absence of specific pharmacological approaches, questions and challenges arise in the primary and secondary prevention of cerebrovascular damage and individual clinical manifestations. The prototype of this dilemma is the patient with possible/probable cerebral amyloid angiopathy, especially if there are comorbidities strongly conditioning the choice of treatment (e.g. atrial fibrillation). Comorbidities with atherothrombosis are another challenging issue; moreover, a well-known association in the literature is that between SVD and dilated large artery disease, particularly intracranial artery dilatative arteriopathy. SVDs represent a widespread and often underestimated condition, not only in the most advanced ages, and are an important source of morbidity and disability, the management of which requires specific skills that must be realized in neurovascular clinical pathways integrated with the main lines of translational research and clinic.
This Research Topic aims to address the impact of the several markers and manifestations of SVD on the pathways of care of patients. Areas of interest in this topic include, but are not limited to the following:
• Neuroimaging markers and their relation with clinical manifestations and outcome
• Interplay between neuroimaging, blood and CSF biomarkers, nuclear medicine findings
• Therapeutical issues in primary and secondary prevention
• The impact of comorbidities in determining the outcome
• Proposed diagnostic pathways
• Dedicated management pathways and their applicability in real life settings
Article types: Original Research Articles, Review and Minireview Articles, Methods Articles, expert Opinion and Case Reports
Dr Linn reports speaker's honoraria and royalties from Bayer Healthcare, and serves as advisory board member for Biogen GmbH and Mediaire GmbH. Dr Zedde reports consultant fees for Takeda, and serves as advisory board member for SANOFI-GENZYME, SHORE, and AMICUS.
Cerebral Small Vessel Diseases (SVD) are a subtype of cerebrovascular disease with a broad range of clinical manifestations, from incidental finding in asymptomatic persons to depression, from cognitive impairment to dementia, from cerebral hemorrhage to ischemic stroke, from Transient Focal Neurological Episodes to epilepsy. In terms of neuroimaging, SVD is described by a complex neuroradiological semiology, CT and MR-based, and PET-based. SVDs also represent an etiopathogenetic category of cerebrovascular disease that intersects very closely with neurodegeneration in a conundrum that often poses a diagnostic and management challenge in clinical practice. Furthermore, the contribution of monogenic forms of disease is not negligible, even in clearly age-related forms.
The management pathways of SVD are only partially defined in neurovascular clinical practice and ideally require a dedicated approach by a multidisciplinary team with a specific expertise and background. From a therapeutic point of view, in the absence of specific pharmacological approaches, questions and challenges arise in the primary and secondary prevention of cerebrovascular damage and individual clinical manifestations. The prototype of this dilemma is the patient with possible/probable cerebral amyloid angiopathy, especially if there are comorbidities strongly conditioning the choice of treatment (e.g. atrial fibrillation). Comorbidities with atherothrombosis are another challenging issue; moreover, a well-known association in the literature is that between SVD and dilated large artery disease, particularly intracranial artery dilatative arteriopathy. SVDs represent a widespread and often underestimated condition, not only in the most advanced ages, and are an important source of morbidity and disability, the management of which requires specific skills that must be realized in neurovascular clinical pathways integrated with the main lines of translational research and clinic.
This Research Topic aims to address the impact of the several markers and manifestations of SVD on the pathways of care of patients. Areas of interest in this topic include, but are not limited to the following:
• Neuroimaging markers and their relation with clinical manifestations and outcome
• Interplay between neuroimaging, blood and CSF biomarkers, nuclear medicine findings
• Therapeutical issues in primary and secondary prevention
• The impact of comorbidities in determining the outcome
• Proposed diagnostic pathways
• Dedicated management pathways and their applicability in real life settings
Article types: Original Research Articles, Review and Minireview Articles, Methods Articles, expert Opinion and Case Reports
Dr Linn reports speaker's honoraria and royalties from Bayer Healthcare, and serves as advisory board member for Biogen GmbH and Mediaire GmbH. Dr Zedde reports consultant fees for Takeda, and serves as advisory board member for SANOFI-GENZYME, SHORE, and AMICUS.