ISCHEMIC STROKE: PATHOPHYSIOLOGY OF THE ISCHEMIC CASCADE, ETIOLOGICAL CLASSIFICATION, REPERFUSION STRATEGIES, NEUROPROTECTION, AND SECONDARY PREVENTION IN CONTEMPORARY NEUROLOGY
DOI:
https://doi.org/10.55640/Keywords:
ischemic stroke, cerebral ischemia, TOAST classification, intravenous thrombolysis, alteplase, mechanical thrombectomy, penumbra, excitotoxicity, NIHSS score, dual antiplatelet therapy, atrial fibrillation, statin therapy, stroke rehabilitation, secondary preventionAbstract
Conclusion: Ischemic stroke management has been transformed by acute reperfusion strategies with proven efficacy, but the narrow therapeutic time window demands stroke system organization—comprehensive stroke centers, pre-hospital triage protocols, and 24/7 thrombectomy capability—that remains incompletely developed in many healthcare systems. Secondary prevention through dual antiplatelet therapy, high-intensity statins, anticoagulation for atrial fibrillation, and aggressive vascular risk factor control offers the most durable means of reducing recurrent stroke risk.
Downloads
References
1.Feigin, V. L., Norrving, B., & Mensah, G. A. (2017). Global burden of stroke. Circulation Research, 120(3), 439–448. https://doi.org/10.1161/CIRCRESAHA.116.308413
2.Johnson, W., Onuma, O., Owolabi, M., & Sachdev, S. (2016). Stroke: A global response is needed. Bulletin of the World Health Organization, 94(9), 634–634A. https://doi.org/10.2471/BLT.16.181636
3.Dirnagl, U., Iadecola, C., & Moskowitz, M. A. (1999). Pathobiology of ischaemic stroke: An integrated view. Trends in Neurosciences, 22(9), 391–397. https://doi.org/10.1016/S0166-2236(99)01401-0
4.The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. (1995). Tissue plasminogen activator for acute ischemic stroke. New England Journal of Medicine, 333(24), 1581–1587. https://doi.org/10.1056/NEJM199512143332401
5.Goyal, M., Menon, B. K., van Zwam, W. H., Dippel, D. W. J., Mitchell, P. J., Demchuk, A. M., ... & Jovin, T. G. (2016). Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet, 387(10029), 1723–1731. https://doi.org/10.1016/S0140-6736(16)00163-X
6.Johnston, S. C., Easton, J. D., Farrant, M., Barsan, W., Conwit, R. A., Elm, J. J., ... & Kim, A. S. (2018). Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. New England Journal of Medicine, 379(3), 215–225. https://doi.org/10.1056/NEJMoa1800410
7.Amarenco, P., Bogousslavsky, J., Callahan, A., III, Goldstein, L. B., Hennerici, M., Rudolph, A. E., ... & Welch, K. M. A. (2006). High-dose atorvastatin after stroke or transient ischemic attack. New England Journal of Medicine, 355(6), 549–559. https://doi.org/10.1056/NEJMoa061894
8.Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011). Stroke rehabilitation. Lancet, 377(9778), 1693–1702. https://doi.org/10.1016/S0140-6736(11)60325-5
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their manuscripts, and all Open Access articles are disseminated under the terms of the Creative Commons Attribution License 4.0 (CC-BY), which licenses unrestricted use, distribution, and reproduction in any medium, provided that the original work is appropriately cited. The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations.

Germany
United States of America
Italy
United Kingdom
France
Canada
Uzbekistan
Japan
Republic of Korea
Australia
Spain
Switzerland
Sweden
Netherlands
China
India