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Abstract
Purpose of Review To explore factors associated with infarct progression in the early and late phase of acute ischemic stroke in patients undergoing endovascular therapy.
Recent Findings Following ischemic stroke, brain injury can progress at a variable rate, at the expense of “penumbral tissue,” which is the ischemic tissue at risk of infarction. Despite dramatic advances in endovascular stroke therapies with early revascularization in more than 80% of cases, nearly half of patients do not achieve functional independence despite successful recanalization. This is largely attributed to the irreversible damage that is already extensive at the time of revascularization.
Summary The underlying pathophysiology and determinants of the core infarct progression are complex and multifactorial, depending on a balance between brain energy consumption and collateral perfusion supply. It is crucial to develop creative and individualized theranostics to predict infarct progression and to “freeze” the tissue at risk prior to recanalization.
Glossary
- CBF=
- cerebral blood flow;
- CTA=
- CT angiography;
- ELVO=
- emergent large vessel occlusion;
- EVT=
- endovascular therapy;
- MCA=
- middle cerebral artery;
- SPGS=
- sphenopalatine ganglion stimulation
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- © 2021 American Academy of Neurology
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