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Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke
Journal article   Open access   Peer reviewed

Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke

Xiaoming Hu, T Michael De Silva, Jun Chen and Frank M Faraci
Circulation research, Vol.120(3), pp.449-471
02/03/2017
DOI: 10.1161/CIRCRESAHA.116.308427
PMCID: PMC5313039
PMID: 28154097
url
https://doi.org/10.1161/CIRCRESAHA.116.308427View
Published (Version of record) Open Access

Abstract

The consequences of cerebrovascular disease are among the leading health issues worldwide. Large and small cerebral vessel disease can trigger stroke and contribute to the vascular component of other forms of neurological dysfunction and degeneration. Both forms of vascular disease are driven by diverse risk factors, with hypertension as the leading contributor. Despite the importance of neurovascular disease and subsequent injury after ischemic events, fundamental knowledge in these areas lag behind our current understanding of neuroprotection and vascular biology in general. The goal of this review is to address select key structural and functional changes in the vasculature that promote hypoperfusion and ischemia, while also affecting the extent of injury and effectiveness of therapy. In addition, as damage to the blood-brain barrier is one of the major consequences of ischemia, we discuss cellular and molecular mechanisms underlying ischemia-induced changes in blood-brain barrier integrity and function, including alterations in endothelial cells and the contribution of pericytes, immune cells, and matrix metalloproteinases. Identification of cell types, pathways, and molecules that control vascular changes before and after ischemia may result in novel approaches to slow the progression of cerebrovascular disease and lessen both the frequency and impact of ischemic events.
Cerebrovascular Disorders - physiopathology Humans Risk Factors Blood-Brain Barrier - physiopathology Endothelium, Vascular - physiopathology Brain Ischemia - metabolism Brain Ischemia - physiopathology Cerebrovascular Disorders - metabolism Stroke - physiopathology Blood-Brain Barrier - metabolism Stroke - metabolism Animals Endothelium, Vascular - metabolism

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