Deans' stroke musings: Leptomeningeal collaterals regulate reperfusion in ischemic stroke and rescue the brain from futile recanalization

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, February 27, 2024

Leptomeningeal collaterals regulate reperfusion in ischemic stroke and rescue the brain from futile recanalization

So you found something useful to survivor recovery. WHAT THE FUCK ARE YOU DOING TO GET THIS INTERVENTION TO ALL PATIENTS? NOTHING? Then why the fuck are you stroke researchers if you don't help survivors?

Leptomeningeal collaterals regulate reperfusion in ischemic stroke and rescue the brain from futile recanalization

Open AccessPublished:February 26, 2024DOI:https://doi.org/10.1016/j.neuron.2024.01.031

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LMCs maintain perfusion during stroke
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Upon recanalization, LMCs allow for a gradual reperfusion
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In mice with poor LMCs, recanalization causes deleterious hyperperfusion
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Stroke patients with poor LMCs show fast reperfusion and futile recanalization

Summary

Recanalization is the mainstay of ischemic stroke treatment. However, even with timely clot removal, many stroke patients recover poorly. Leptomeningeal collaterals (LMCs) are pial anastomotic vessels with yet-unknown functions. We applied laser speckle imaging, ultrafast ultrasound, and two-photon microscopy in a thrombin-based mouse model of stroke and fibrinolytic treatment to show that LMCs maintain cerebral autoregulation and allow for gradual reperfusion, resulting in small infarcts. In mice with poor LMCs, distal arterial segments collapse, and deleterious hyperemia causes hemorrhage and mortality after recanalization. In silico analyses confirm the relevance of LMCs for preserving perfusion in the ischemic region. Accordingly, in stroke patients with poor collaterals undergoing thrombectomy, rapid reperfusion resulted in hemorrhagic transformation and unfavorable recovery. Thus, we identify LMCs as key components regulating reperfusion and preventing futile recanalization after stroke. Future therapeutic interventions(What specific person is going to do this research?) should aim to enhance collateral function, allowing for beneficial reperfusion after stroke.