Pathobiology of ischaemic stroke: an integrated view
Abstract
Brain injury following transient or permanent focal cerebral ischaemia (stroke) develops from a complex series of pathophysiological events that evolve in time and space. In this article, the relevance of excitotoxicity, peri-infarct depolarizations, inflammation and apoptosis to delayed mechanisms of damage within the peri-infarct zone or ischaemic penumbra are discussed. While focusing on potentially new avenues of treatment, the issue of why many clinical stroke trials have so far proved disappointing is addressed. This article provides a framework that can be used to generate testable hypotheses and treatment strategies that are linked to the appearance of specific pathophysiological events within the ischaemic brain.
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Within minutes of blood flow interruption (15-20% below baseline), irreversible cell death ensues, resulting in the formation of an infarct core.
“Within minutes of blood flow interruption (15–20% below baseline), irreversible cell death ensues, resulting in the formation of an infarct core [85].”
From Microglia and monocytes in inflammatory CNS disease: integrating phenotype and function (2022) · cites this paper as [85]
Roots and leaves of Withania somnifera contain Withaferin-A, Withanone, Withastramonolide, 27-hydroxywithanone, Physagulin, and Withanolide-A.
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From Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomedicinal and toxicological aspects (2021) · cites this paper as [88]
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- Authors
- Dirnagl, U., Iadecola, C., & Moskowitz, M. A.
- Affiliations
- Stiftung Charité (DE)
- University of Minnesota (US)
- Harvard University (US)
- Venue
- Trends in Neurosciences
- Publisher
- Elsevier BV
- Published
- 1999-09
- Volume
- 22
- Issue
- 9
- Pages
- 391-397
- ISSN
- 0166-2236 (ISSN-L)
- OpenAlex
- W2169079203
- Cited by
- 3,943
- References
- 78
- Citations by year
- 2026: 123 · 2025: 84 · 2024: 102 · 2023: 96 · 2022: 119 · 2021: 155 · 2020: 152 · 2019: 135 · 2018: 163 · 2017: 155 · 2016: 177 · 2015: 163 · 2014: 205 · 2013: 199 · 2012: 203
- FWCI
- 22.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Trends in Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS-37853, R01NS035806, NS34179, NS-35806, R01NS037853)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Life Sciences › Neuroscience › Neurology › Neurological Disorders and Treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- ischemic stroke, cerebral ischemia, excitotoxicity, peri-infarct depolarization, neuroinflammation, apoptosis, ischemic penumbra, delayed neuronal death, stroke treatment strategies
- MeSH terms
- Acute-Phase Reaction, Brain, Brain Ischemia, Cerebrovascular Disorders, Humans, Inflammation, Isoenzymes, Membrane Proteins, Nerve Degeneration, Prostaglandin-Endoperoxide Synthases, Apoptosis, Receptors, Glutamate, Nitric Oxide Synthase, Cyclooxygenase 2, Nitric Oxide Synthase Type II
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