Abstract
A target for treatment of acute ischemic stroke is the penumbra, a territory of critically reduced blood flow between the core zone of an evolving infarction and the still sufficiently perfused brain. Unless there is early reperfusion of the ischemic area, neurons in the penumbra are destined to die in the ensuing hours to days, due to a cascade of biochemical events, the so-called ischemic cascade [1, 2]. Key steps in this cascade are uncontrolled depolarizations of neurons, build-up of extracellular glutamate, intracellular calcium overload, formation of nitric oxide and free radicals, and inflammation. Some forms of cell death in the ischemic penumbra also involve apoptosis [1, 2]. Studies in patients using positron emission tomography, combined perfusion and diffusion magnetic resonance imaging (MRI), and MR spectroscopy indicate that the penumbra in humans may remain viable for several (up to 48) hours after stroke onset [3-6].
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De Keyser, J., Ramsaransing, G., Zeinstra, E., Wilczak, N. (2004). Neuroprotection in Acute Ischemic Stroke: Lessons for Early Treatment in Multiple Sclerosis. In: Hommes, O.R., Comi, G. (eds) Early Indicators Early Treatments Neuroprotection in Multiple Sclerosis. Topics in Neuroscience. Springer, Milano. https://doi.org/10.1007/978-88-470-2117-4_10
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DOI: https://doi.org/10.1007/978-88-470-2117-4_10
Publisher Name: Springer, Milano
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