Vascular Malformations and Stroke: Integrating Genetics, Hemodynamics, and Surgical Innovation for Personalized Care

Vishal K Chavda^1*Giuseppe Emmanuele Umana²Bipin Chaurasia^3*Stefano Maria Priola⁴Luis Rafael Moscote-Salazar⁵

• ¹Department of Medicine and Critical Care, Multispeciality, Trauma and ICCU Center, Sardar Hospital, Ahmedabad, Gujarat, India, Ahmedabad, India
• ²Department of Neurosurgery, KORE University of Enna, Enna, Italy, Enna, Italy
• ³Department of Neurosurgery, College of Medical Sciences, Birgunj, Nepal, Birgunj, Nepal
• ⁴Department of Neurosurgery, Northern Ontario School of Medicine University, Sudbury (ON), Canada, Sudbury, Canada
• ⁵University of Wisconsin-Madison, Madison, United States

The cerebral vasculature is a marvel of complexity and when disrupted by aneurysms, AVMs, or vascular malformations associated with connective tissue disorders, it becomes a critical substrate for ischemic and hemorrhagic stroke. This Research Topic in Frontiers in Neurology curates multidimensional contributions that unify genetics, computational modeling, clinical diagnostics, and procedural advances, collectively moving the field toward more individualized and proactive care models. Systemic inflammation and autoimmune disease have emerged as independent risk factors for aneurysm formation. (Shotar et al., 2024). Genetic investigations by Neyazi et al. found that CEACAM1 and IL-6 polymorphisms, along with sex-based immunologic differences, may underlie hemorrhagic risk in AVM carriers, suggesting that inflammation is both a symptom and a pathogenic driver (Neyazi et al., 2024). Finally, the issue turns a spotlight on connective tissue disorders where under-recognized risk meets preventable catastrophe. Kim, Brinjikji, and Kallmes reported aneurysm prevalence as high as 28% in patients with Ehlers-Danlos, Marfan, and Loeys-Dietz syndromes far exceeding the general population rate of 3% (Kim et al., 2016). These data argue for systematic screening in patients with heritable vasculopathies and call for collaboration between neurologists, geneticists, and vascular surgeons.In summary, this collection crystallizes three pillars of modern vascular neurology: inflammation and genetics as risk predictors, hemodynamic modeling as both diagnostic and therapeutic aid, and procedural refinement as a vehicle for safer, personalized interventions. Despite these gains, several gaps persist particularly in unifying risk scores, validating CFD parameters across platforms, and embedding genomic screening into standard practice. The future of stroke prevention in vascular malformations lies not in a single discipline but in cross-disciplinary synthesis, where predictive algorithms, surgical precision, and molecular insight converge at the bedside.