Dr. Marco Della Valle

Dr. Marco Della Valle is the consultant neurologist serving the Republic of San Marino, holding a dual appointment at the Ospedale di Stato della Repubblica di San Marino — the nation's state hospital — and the Ospedale M. Bufalini di Cesena, part of the Azienda USL Romagna network in nearby Italy. With over 18 years of experience in neurology, Dr. Della Valle specialises in epilepsy, stroke, dementia, and headache disorders, providing comprehensive neurological care for San Marino's approximately 34,000 residents in the context of the country's deep integration with Italy's Romagna healthcare region.

San Marino's demographic profile creates particular relevance for Dr. Della Valle's subspecialties: the Republic has one of the world's highest life expectancies and an ageing population structure in which dementia, cerebrovascular disease, and Parkinson's disease are leading causes of disability and healthcare utilisation. Managing these conditions effectively in a small-country setting requires both broad clinical competency and well-established cross-border referral pathways for cases requiring specialist neuroradiology, neurosurgery, or epilepsy surgery evaluation — all of which Dr. Della Valle coordinates through his joint appointment at the Ospedale di Cesena and its connections to the broader Romagna neurology network.

Dr. Della Valle trained at the Università degli Studi di Bologna and undertook his neurology residency at the Policlinico Sant'Orsola-Malpighi in Bologna before completing a subspecialty fellowship in dementia and cognitive disorders at the Ospedale Policlinico San Martino in Genoa. He returned to the Romagna region to establish his practice, which has grown to encompass the neurological care needs of both San Marino's resident population and Italian patients in the Cesena catchment area.

Dr. Della Valle runs the San Marino dementia clinic at the state hospital, providing systematic cognitive screening, diagnosis, and treatment for patients with Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, in collaboration with geriatric and psychiatric colleagues. He leads the stroke management pathway at the San Marino hospital and manages a comprehensive epilepsy outpatient service.

Dr. Della Valle completed his medical degree at the Università degli Studi di Bologna, one of the world's oldest and most distinguished universities and a major centre for Italian medical education. He undertook his neurology specialty residency at the Policlinico Sant'Orsola-Malpighi in Bologna, receiving comprehensive training in all aspects of clinical neurology including acute stroke, epilepsy, neuromuscular diseases, movement disorders, and cognitive neurology. He subsequently completed a subspecialty fellowship in dementia and cognitive disorders at the IRCCS Ospedale Policlinico San Martino in Genoa — one of Italy's leading neurological research centres — gaining advanced expertise in the diagnosis of neurodegenerative dementias using clinical, neuropsychological, neuroimaging, and CSF biomarker approaches. He holds board certification in neurology from the Società Italiana di Neurologia (SIN) and is a member of the European Academy of Neurology (EAN). He has completed advanced EEG training through the LICE (Italian League Against Epilepsy) and participates in the Alzheimer's Association and EAN educational programmes for dementia specialists.

Dr. Della Valle's neurological practice covers the full spectrum of neurological conditions presenting in a small-country setting, with particular depth in dementia, stroke, epilepsy, and headache disorders. In dementia, he provides systematic cognitive assessment using standardised neuropsychological batteries (MMSE, MoCA, expanded neuropsychological testing), coordinates brain MRI and FDG-PET neuroimaging, analyses CSF biomarkers (amyloid, tau, phospho-tau) for Alzheimer's disease diagnosis, and manages pharmacological treatment with acetylcholinesterase inhibitors and memantine for Alzheimer's disease. He also manages the behavioural and psychological symptoms of dementia (BPSD) and coordinates with geriatric and social care services for dementia patients requiring residential or domiciliary support.

For epilepsy, he provides diagnostic evaluation including routine EEG, ambulatory EEG, and sleep EEG, and manages anti-epileptic drug selection and optimisation across the full range of available agents. For drug-resistant epilepsy cases, he coordinates referral to the epilepsy surgery centre at the Policlinico Sant'Orsola-Malpighi in Bologna. In stroke, he manages acute ischaemic stroke including intravenous thrombolysis and coordination of thrombectomy transfers to the Ospedale M. Bufalini stroke unit and interventional neuroradiology team. For headache disorders, he runs a dedicated botulinum toxin clinic for chronic migraine and manages CGRP-antagonist therapies. He also provides Parkinson's disease and movement disorder assessments and manages peripheral neuropathy within his general neurology practice.

Dr. Della Valle has published over 30 peer-reviewed articles in journals including Neurology, the European Journal of Neurology, the Journal of Alzheimer's Disease, and Epilepsia. His primary research interests are stroke and dementia epidemiology in San Marino's elderly population, and the challenges of providing comprehensive neurological care in a microstate with deep Italian healthcare integration. He has collaborated with the Azienda USL Romagna neurological consortium on multicentre stroke registry analyses and has contributed San Marino data to pan-Italian AITA (Italian Stroke Register) and the EAN stroke research network. His dementia research includes an analysis of cognitive decline trajectories in San Marino's oldest-old residents, published in the Journal of Alzheimer's Disease, and a cross-border study of dementia diagnosis rates and time to treatment initiation comparing San Marino with adjacent Italian provinces. He has presented his research at SIN national congresses and EAN annual meetings and has been cited by the San Marino Health Authority in national dementia strategy documents.

Dr. Della Valle sees patients from San Marino, the Rimini and Cesena provinces of Italy, and occasionally from further afield. Italian citizens access neurological care through the bilateral Italian-San Marino health agreement at both the San Marino state hospital and the Ospedale di Cesena. EU citizens from other member states can access services under applicable cross-border healthcare directives. Non-EU international patients are accommodated as private patients. Consultations are conducted in Italian and English. For patients seeking specialist neurological second opinions — particularly for dementia diagnosis, epilepsy management, or stroke secondary prevention — Dr. Della Valle provides consultations with access to the full neurodiagnostic resources of both the San Marino state hospital and the Ospedale M. Bufalini. For complex cases requiring advanced neuroimaging, neurosurgery, or epilepsy surgery evaluation, he coordinates referrals to Bologna or other Italian university centres and manages the full follow-up pathway.

Dr. Della Valle has received the Società Sammarinese di Medicina (SSM) Award for his contributions to neurological care and research in the Republic of San Marino, with particular recognition for his development of the San Marino dementia clinic and his leadership of the stroke management pathway. He has been recognised by the Società Italiana di Neurologia (SIN) as a regular scientific presenter at national congresses, contributing important small-country epidemiological data to Italian neurology. He was recognised by the San Marino Health Authority with a Clinical Recognition Award for his cross-border neurology care coordination programme, which has significantly reduced the need for San Marino patients to travel to Italian university hospitals for routine neurological assessments. He participates actively in EAN educational activities and has contributed to EAN-SIN collaborative projects on dementia care standards in southern European countries.