Neurovascular Disorders – From Stroke Management to Surgical Interventions

Neurovascular disorders represent a major cause of global morbidity and mortality, with stroke remaining one of the leading contributors to death and disability worldwide. This chapter provides a comprehensive overview of the epidemiology, risk factors, pathophysiology, and management of neurovascular diseases, with particular emphasis on ischemic and hemorrhagic stroke. The molecular cascade of ischemic injury—including ATP depletion, excitotoxicity, oxidative stress, blood–brain barrier disruption, and neuroinflammation—is examined alongside the clinical classification of stroke subtypes. Acute stroke management strategies are detailed, highlighting timely neuroimaging, thrombolysis, mechanical thrombectomy, and evidence-based secondary prevention with antiplatelet and anticoagulant therapies. Surgical and endovascular interventions—including carotid endarterectomy, carotid artery stenting, aneurysm clipping and coiling, arteriovenous malformation resection, and extracranial–intracranial bypass techniques—are analyzed with respect to indications, timing, benefits, and limitations. Emerging innovations such as advanced perfusion imaging, flow-diverting devices, artificial intelligence–assisted diagnostics, robotic catheter navigation, and precision-guided endovascular technologies are discussed as transformative tools reshaping neurovascular care. The chapter concludes by emphasizing the importance of interdisciplinary collaboration, translational research, imaging biomarkers, and global health equity in advancing the next generation of individualized neurovascular therapies.