Advances in stroke management
Citation Manager Formats
Make Comment
See Comments
![Loading Loading](https://n.neurology.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif)
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Traditionally, leukocytes of normal function are considered a vital blood element without which the body's survival would be threatened. Leukocytes protect us from invading microorganisms. Without them, we would easily fall prey to the life-threatening attack of otherwise benign infections. In the past few years we have come to realize that as leukocytes react to a variety of tissue injuries, including ischemia, they may actually contribute to and accentuate tissue damage. When tissue injuries such as ischemia occur, signals arise in the endothelium of the microvasculature in the ischemic brain to attract leukocytes to the region of injury. Leukocytes in the circulating blood pass by the vasculature of ischemic brain. They are compelled to linger and attach to the endothelium, flatten, and penetrate the endothelium into the injured ischemic tissue. We now know that there are a variety of receptors on the leukocyte surface that have the ability to react to receptor sites on the endothelium. Among these receptors is the intercellular adhesion molecule-1 (ICAM-1) located on the endothelial cells. Leukocyte adhesion and migration require the interaction of ICAM-1 on the endothelium with CD11/CD18 leukocyte integrins on the surface of neutrophils. As leukocytes and monocytes adhere to the vessel wall, they can release damaging cytokines including IL-1, IL-2, and tissue necrosis factor alpha(TNF-α). These cytokines become proinflammatory and can promote thrombosis by binding circulating anticoagulants, such as protein S, and inhibiting tissue plasminogen activator release.
Some of the early basic observations that led to an understanding of this process grew out of the …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Jessica Ailani and Dr. Ailna Masters-Israilov
► Watch
Related Articles
- No related articles found.
Alert Me
Recommended articles
-
Views & Reviews
Intravenous thrombolysis for acute strokeP. D. Lyden, J. C. Grotta, S. R. Levine et al.Neurology, July 01, 1997 -
Training, Certification, & Practice Standards
Developing practice recommendations for endovascular revascularization for acute ischemic strokeMarc A. Lazzaro, Roberta L. Novakovic, Andrei V. Alexandrov et al.Neurology, September 24, 2012 -
Therapy
Retrievable stents, “stentrievers,” for endovascular acute ischemic stroke therapyRoberta L. Novakovic, Gabor Toth, Sandra Narayanan et al.Neurology, September 24, 2012 -
Therapy
The Penumbra system for mechanical thrombectomy in endovascular acute ischemic stroke therapySyed I. Hussain, Osama O. Zaidat, Brian-Fred M. Fitzsimmons et al.Neurology, September 24, 2012