Cerebrovascular diseases continue to represent a major global health challenge, with stroke among the leading causes of death and long-term disability. The complex and heterogeneous nature of stroke demands precise etiological classification to guide effective treatment. Recent developments in neuroimaging, clinical algorithms, and biomarker profiling have improved diagnostic accuracy, enabling more personalized therapeutic strategies. In ischemic stroke, the evolution from generalized antiplatelet regimens to the consideration of high-on-treatment platelet reactivity, pharmacogenomic testing, and dual antiplatelet therapy in select populations illustrates the growing emphasis on personalization. Meanwhile, the field of acute intervention has been transformed by the development of intravenous thrombolysis protocols and, more recently, endovascular thrombectomy—extending treatment windows, treating large core infarcts and improving outcomes in carefully selected patients. For hemorrhagic stroke, innovations in minimally invasive surgery and individualized medical management have emerged. These advancements signal a paradigm shift from uniform protocols to precision-based approaches, yet substantial challenges remain in translating these innovations into widespread, equitable care.

The goal of this Research Topic is to present the latest advancements in precision medicine within the field of cerebrovascular diseases, encompassing both basic and clinical science. Despite recent breakthroughs, many patients still receive generalized treatments that fail to account for individual variability in stroke etiology, genetics, and response to therapy. This special collection will highlight recent developments in the understanding, diagnosis, and personalized management of ischemic and hemorrhagic stroke, reflecting the rapid evolution of this field in recent years. By bringing together diverse specialties and perspectives, this collection aims to advance the transition from uniform protocols to personalized care in cerebrovascular disease management.

This Research Topic welcomes contributions from researchers and clinicians across disciplines to showcase innovations in diagnosis, pathophysiology, acute treatment and secondary prevention of both ischemic and hemorrhagic stroke. Authors are encouraged to highlight emerging issues within their sub-specialties, discuss barriers to clinical implementation, and propose forward-looking solutions. This collection aims to inspire collaboration, stimulate new research directions, and support the dissemination of knowledge that can ultimately improve individualized care for stroke patients.

This Research Topic welcomes any types of manuscripts supported by the journal, pertaining but not limited to the following themes:
• Advances in neuroimaging for acute stroke diagnosis
• Advances in stroke diagnosis and etiology
• Personalized antithrombotic therapy in stroke prevention
• Endovascular therapy (thrombolysis, thrombectomy)
• Advances in precision medicine techniques for intracerebral and subarachnoid hemorrhage
• Biomarkers and molecular profiling in stroke
• Use of Artificial Intelligence in stroke diagnostics and treatment
• Translational research based on human data. Please note that preclinical or animal studies are not within the scope of this Research Topic and will not be considered.

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Personalized Medicine in Cerebrovascular Disease: From Precision Diagnostics to Tailored Therapies