Stroke in back of brain
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Stroke in the Back of the Brain: Pathophysiology, Network Disruptions, and Recovery Mechanisms
Pathophysiology of Stroke in the Posterior Brain
Stroke in the back of the brain, often involving the occipital lobe, cerebellum, and brainstem, leads to complex pathophysiological events. These events include excitotoxicity, oxidative stress, inflammation, and apoptosis, which contribute to neuronal cell death and secondary brain injury5 6 10. The release of damage-associated molecular patterns (DAMPs) triggers localized inflammation, exacerbating blood-brain barrier damage, microvascular failure, and brain edema1. This inflammation is not confined to the injured region but can spread throughout the brain, influencing long-term neurological outcomes1.
Global Brain Inflammation and Network Disruptions
Recent studies highlight that stroke impacts not only the focal area but also the entire brain's network properties, making it a network disease3. Functional neuroimaging has shown that stroke disrupts physiological brain functions, leading to impairments in functional brain networks involved in voluntary movements2. These disruptions occur both locally and remotely, affecting white-matter tracts and neural interactions among widespread networks3. The reorganization of motor networks, particularly the restoration of interhemispheric functional coherence, is crucial for motor recovery2.
Mechanisms of Brain Repair and Plasticity
Stroke induces a period of enhanced plasticity in the brain, characterized by the sprouting of new axons, formation of new synapses, and remapping of sensory-motor functions4. This plastic state is driven by molecular systems underlying learning and memory, such as changes in cellular excitability4. The brain's intrinsic capacity to reorganize surviving networks is fundamental for recovery, with neuroimaging studies revealing the role of contralesional motor hemispheres in supporting recovered function9.
Emerging Therapies and Rehabilitation Approaches
Novel therapies aim to enhance brain plasticity and promote recovery. These include modern rehabilitation techniques, brain stimulation, cell therapy, brain-computer interfaces, and peripheral nervous transfer8. These approaches focus on improving brain remodeling and constructing neural bypasses to avoid brain injury8. Connectivity analyses provide insights into the pathophysiology underlying neurological deficits and help develop neurobiologically informed treatment strategies2.
Conclusion
Stroke in the back of the brain involves complex pathophysiological events and widespread network disruptions. Understanding these mechanisms and the brain's plasticity is crucial for developing effective therapies. Emerging treatments targeting brain plasticity and network reorganization hold promise for improving recovery and long-term outcomes for stroke patients.
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Most relevant research papers on this topic
Global brain inflammation in stroke
Global brain inflammation after stroke occurs and persists throughout the brain, potentially shaping the evolving pathology and affecting long-term neurological outcomes.
Highly CitedCerebral network disorders after stroke: evidence from imaging‐based connectivity analyses of active and resting brain states in humans
Stroke disrupts brain connectivity, leading to motor impairments and recovery, with reorganization of motor networks occurring across hemispheres and involving stronger interactions between primary motor areas.
Literature Review
Rigorous JournalHighly CitedBrain networks and their relevance for stroke rehabilitation
Stroke is a network disease, affecting the entire brain and its network properties, and individualized rehabilitation approaches targeting specific network patterns show promise for improving recovery outcomes.
Literature Review
Very Rigorous JournalHighly CitedEncouraging an excitable brain state: mechanisms of brain repair in stroke
Stroke recovery involves promoting neuronal allocation to damaged circuits, driven by changes in neuronal excitability, to promote functional recovery in the adult brain.
Highly CitedPathobiology of ischaemic stroke: an integrated view
This paper explores the complex pathobiology of ischaemic stroke, focusing on potential new treatment avenues and addressing the issue of why clinical stroke trials have been disappointing.
Highly CitedMechanisms of ischemic brain damage
The complex pathophysiology of stroke involves multiple pathways, and understanding these pathways could lead to new treatments for this devastating disease.
Highly CitedElectromagnetic Tomography for Detection, Differentiation, and Monitoring of Brain Stroke: A Virtual Data and Human Head Phantom Study.
Electromagnetic tomography (EMT) shows potential in detecting, differentiating, and monitoring brain strokes, potentially improving early treatment decisions and enhancing patient outcomes.
Highly CitedEnhancing Brain Plasticity to Promote Stroke Recovery
Novel therapies like brain stimulation, cell therapy, and peripheral nervous transfer can improve stroke recovery by enhancing brain plasticity and promoting brain remodeling and restoration.
Cortical Reorganization After Stroke
Neuroimaging techniques reveal that the brain's intrinsic capacity to compensate for structural damage and recover function after stroke depends on factors like time since stroke, lesion location, and anatomical region.
Literature ReviewHighly CitedPathogenic mechanisms following ischemic stroke
Ischemic stroke is caused by complex pathophysiological events, with potential therapeutic targets including excitotoxicity, oxidative stress, inflammation, and apoptosis.
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