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Is Reperfusion Injury a Largely Intra-Ischemic Injury?
Stroke
December 2024
Department of Neurology, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, GHU Paris Psychiatrie et Neurosciences, Université Paris Cité, France.
Reperfusion injury (RI) refers to an array of detrimental cellular and biochemical processes that are widely believed to be triggered by reperfusion following focal cerebral ischemia and to contribute to infarct extension and poor outcome despite complete recanalization. Accordingly, it is widely recommended that therapies targeting RI be administered after recanalization. The present topical review demonstrates, however, that the vast majority of, and possibly all, processes considered part of RI are not actually provoked by reperfusion but develop during the ischemic phase.
View Article and Find Full Text PDFMalignant Brain Edema and Associated Factors in Large Hemispheric Infarction Following Reperfusion Therapy.
Curr Neurovasc Res
December 2024
Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.
Objective: This study aimed to explore Malignant Brain Edema (MBE) and associated factors in patients with Large Hemispheric Infarction (LHI) following early reperfusion therapy.
Methods: We consecutively and retrospectively enrolled a cohort of 114 LHI patients who had received early reperfusion therapy, including Intravenous Thrombolysis (IVT) or Endovascular Therapy (EVT) at the hyperacute stage of stroke between January 2009 and December 2018. MBE was defined as a midline shift ≥5 mm, accompanied by signs of herniation.
Clinical state and future directions of stem cell therapy in stroke rehabilitation.
Exp Neurol
December 2024
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA; Stanford Stroke Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address:
Despite substantial advances in the acute management of stroke, it remains a leading cause of adult disability and mortality worldwide. Currently, the reperfusion modalities thrombolysis and thrombectomy benefit only a fraction of patients in the hyperacute phase of ischemic stroke. Thus, with the exception of vagal nerve stimulation combined with intensive physical therapy, there are no approved neuroprotective/neurorestorative therapies for stroke survivors.
View Article and Find Full Text PDFBlood pressure variability and functional outcome after decompressive hemicraniectomy in malignant middle cerebral artery infarction.
Eur J Neurol
January 2025
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background And Purpose: Malignant middle cerebral artery infarction (MMI) is a severe condition with a high mortality rate. While decompressive hemicraniectomy has been demonstrated to reduce mortality, there is limited knowledge regarding blood pressure (BP) management following the surgery. This study aimed to investigate whether early blood pressure variability after surgery is associated with functional outcomes.
View Article and Find Full Text PDFHemodynamic Insights Into the Asymmetrical Medullary Vein Sign on T2* Imaging in Hyperacute M1 Occlusion.
Cureus
December 2024
Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Narita, JPN.
Background In treating acute ischemic stroke (AIS), asymmetrical vein signs (AVS) on blood-oxygen-level-dependent imaging reflect increased deoxyhemoglobin levels due to increased oxygen extraction fraction. Meanwhile, although veins connecting pial and deep venous systems, such as transcerebral veins, are well studied, dynamic observation of these veins remains challenging. This study aimed to elucidate the venous flow of the deep white matter (DWM), focusing on medullary AVS in patients with hyperacute cardioembolic M1 occlusion.
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