Integrating Diagnostics and Therapeutics in Cerebral Vasospasm and Delayed Ischemia Post-Subarachnoid Hemorrhage

Cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) remain prominent complications following subarachnoid hemorrhage (SAH), contributing significantly to poor neurological outcomes despite advances in acute neurocritical care. The pathophysiology of these secondary injuries continues to challenge clinicians, involving complex interactions between vascular constriction, microcirculatory failure, neuroinflammation, cortical spreading depolarizations, and autoregulatory disturbances. Diagnosing and managing CVS and DCI involve balancing early detection with avoidance of overtreatment, yet current diagnostic modalities including transcranial Doppler (TCD), CT perfusion, and angiography, have inherent limitations. Furthermore, while biomarkers, perfusion imaging, and multimodal neuromonitoring show emerging promise, accuracy and reproducibility remain variable. The ongoing debate concerning optimal treatment timing, individualized therapeutic selection, and integration of translational insights into bedside care underscores the persistent knowledge gap in evolving these diagnostic and management frameworks.This Research Topic aims to gather a multidisciplinary collection of studies that enhance understanding of the mechanisms, biomarkers, diagnostic innovations, and treatment strategies for CVS and DCI after SAH. By bringing together clinical, translational, and mechanistic research, it seeks to define the best practices for identifying patients at risk, optimizing therapeutic interventions, and improving short and long-term neurological outcomes. Contributions may span neuroimaging studies, biomarker validations, endovascular technique evaluations, and multimodal monitoring approaches, strengthening the continuum between data-driven discovery and pragmatic application in neurocritical care.To gather further insights into the detection and treatment of cerebral vasospasm and delayed ischemia after subarachnoid hemorrhage, we welcome submissions addressing, but not limited to, the following themes:• Diagnostic optimization: transcranial Doppler, CT perfusion, and angiographic techniques• Development and validation of blood or imaging biomarkers for vasospasm and DCI• Mechanistic insights into autoregulation, inflammation, and microcirculatory dysfunction after SAH• Pharmacologic and endovascular therapies: timing, selection, and effectiveness• Integration of multimodal neuromonitoring (EEG, PbtO₂, microdialysis, autoregulation indices)• Translational models and predictive algorithms for individualized care• Prognostic studies examining risk stratification and personalized treatment paradigms• Global and resource-variable approaches to DCI management in neurocritical care settings Topic editors: Michael L. James, Justin Granstein, Cappi Lay Source: https://www.frontiersin.org/research-topics/81515/integrating-diagnostics-and-therapeutics-in-cerebral-vasospasm-and-delayed-ischemia-post-subarachnoid-hemorrhage