Reperfusion injury in acute ischemic stroke: Tackling the irony of revascularization

Clin Neurol Neurosurg. 2023 Feb:225:107574. doi: 10.1016/j.clineuro.2022.107574. Epub 2023 Jan 4.

Abstract

Reperfusion injury is an unfortunate consequence of restoring blood flow to tissue after a period of ischemia. This phenomenon can occur in any organ, although it has been best studied in cardiac cells. Based on cardiovascular studies, neuroprotective strategies have been developed. The molecular biology of reperfusion injury remains to be fully elucidated involving several mechanisms, however these mechanisms all converge on a similar final common pathway: blood brain barrier disruption. This results in an inflammatory cascade that ultimately leads to a loss of cerebral autoregulation and clinical worsening. In this article, the authors present an overview of these mechanisms and the current strategies being employed to minimize injury after restoration of blood flow to compromised cerebral territories.

Keywords: Ischemic stroke; Reperfusion injury; Revascularization; Thrombectomy.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / surgery
  • Humans
  • Ischemic Stroke*
  • Reperfusion
  • Reperfusion Injury*
  • Stroke* / surgery
  • Vascular Surgical Procedures