Invited Speaker Prof. Evguenia Vassileva: “Small Vessel Disease: Recent Advances and Future Directions”

Abstract

Cerebral small vessel disease (CSVD) represents a heterogeneous group of pathological processes affecting the brain’s small arteries, arterioles, capillaries and venules, and is a leading cause of stroke, cognitive impairment, gait disturbances and vascular dementia. Over the past decade, significant advances in neuroimaging, molecular biology and vascular neuroscience have substantially improved our understanding of the underlying mechanisms of cerebral small vessel disease. Recent evidence highlights the central role of endothelial dysfunction, blood–brain barrier disruption, neuroinflammation, impaired cerebral autoregulation and glymphatic system dysfunction in disease initiation and progression. Advanced magnetic resonance imaging techniques, including diffusion tensor imaging, susceptibility-weighted imaging and ultra-high-field MRI, have enhanced the detection of both overt and subtle manifestations of CSVD, enabling earlier diagnosis and improved disease characterization. Recent research has also identified novel circulating and imaging biomarkers that may facilitate risk stratification, disease monitoring and therapeutic response assessment. Despite these advances, effective disease-modifying therapies remain limited, with current management focusing primarily on vascular risk factor control and secondary stroke prevention. Ongoing investigations are focused on endothelial-targeted therapies, anti-inflammatory strategies and neuroprotective agents.

Curriculum Vitae

Professor Evguenia Vassileva is a neurologist and Head of the Clinic for Intensive Treatment of Neurological Diseases at University Hospital “Tsaritsa Yoanna – ISUL” in Sofia, Bulgaria. She is also Head of the Department of Neurology at the Medical University of Sofia. She graduated in Medicine from the Medical University of Pleven in 1986 and joined the Clinic of Neurology at University Hospital “Tsaritsa Yoanna – ISUL” in 1990. She became Associate Professor in 2007 and Professor of Neurology in 2015.

Professor Vassileva obtained her PhD in 2000 with research on transcranial Doppler monitoring of microembolic signals in patients with internal carotid artery atherosclerosis. In 2014, she was awarded the degree of Doctor of Medical Sciences for her research on the application of neurosonology in carotid atherosclerosis and ischemic stroke. Her postgraduate training includes specializations in neurosonology at Geneva University Hospitals, in neurology at Pitié-Salpêtrière University Hospital in Paris, and in cerebrovascular diseases within the European Stroke Summer School in Helsinki. Her principal clinical and research interests include neurosonology, cerebrovascular disease, carotid atherosclerosis, ischemic stroke and intensive care in acute and life-threatening neurological conditions.

Professor Vassileva has published extensively in the fields of neurosonology, cerebrovascular disease and clinical neurology, with contributions to Bulgarian and international scientific literature. She is also the author of monographic works in her field.