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
- •LMCs maintain perfusion during stroke
- •Upon recanalization, LMCs allow for a gradual reperfusion
- •In mice with poor LMCs, recanalization causes deleterious hyperperfusion
- •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.
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