Exosome-Based Liquid Biopsy for Real-Time Diagnosis and Assessment in Acute Stroke and Its Subtypes

Acute stroke remained a leading cause of death and disability worldwide, emphasizing the need for rapid and accurate diagnostic tools to enable timely intervention. Conventional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) provided structural insights but lacked real-time molecular-level information and were often time-consuming and resource-intensive. Despite advances in neuroimaging, rapid differentiation between the ischemic and hemorrhagic stroke in real time diagnosis remained a significant clinical challenge, mainly in resource-limited settings. Exosome-based liquid biopsy presented a minimally invasive alternative with the potential for rapid stroke subtype identification using molecular biomarkers. The present review explored the emerging role of exosome-based diagnostics in stroke differentiation, highlighting the modern technological advancements, clinical findings, key challenges, and future directions for integration into precision neurovascular care.