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2014 ; 34
(6
): 921-32
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Mechanisms of perinatal arterial ischemic stroke
#MMPMID24667913
Fernández-López D
; Natarajan N
; Ashwal S
; Vexler ZS
J Cereb Blood Flow Metab
2014[Jun]; 34
(6
): 921-32
PMID24667913
show ga
The incidence of perinatal stroke is high, similar to that in the elderly, and
produces a significant morbidity and severe long-term neurologic and cognitive
deficits, including cerebral palsy, epilepsy, neuropsychological impairments, and
behavioral disorders. Emerging clinical data and data from experimental models of
cerebral ischemia in neonatal rodents have shown that the pathophysiology of
perinatal brain damage is multifactorial. These studies have revealed that, far
from just being a smaller version of the adult brain, the neonatal brain is
unique with a very particular and age-dependent responsiveness to
hypoxia-ischemia and focal arterial stroke. In this review, we discuss
fundamental clinical aspects of perinatal stroke as well as some of the most
recent and relevant findings regarding the susceptibility of specific brain cell
populations to injury, the dynamics and the mechanisms of neuronal cell death in
injured neonates, the responses of neonatal blood-brain barrier to stroke in
relation to systemic and local inflammation, and the long-term effects of stroke
on angiogenesis and neurogenesis. Finally, we address translational strategies
currently being considered for neonatal stroke as well as treatments that might
effectively enhance repair later after injury.
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