Reinventing the Penumbra — the Emerging Clockwork of a Multi-modal Mechanistic Paradigm

Journal article

Ischemic stroke research has enabled significant advancements in diagnosis, treatment, and management of this debilitating disease, yet challenges remain standing in the way of better patient prognoses. In this narrative review, a fictional case illustrates challenges and uncertainties that medical professionals still face – penumbra identification, lack of neuroprotective agents, side-effects of tissue plasminogen activator, dearth of molecular biomarkers, incomplete microvascular reperfusion or no-reflow, post-recanalization hyperperfusion, blood pressure management and procedural anesthetic effects. The current state of the field is broadly reviewed per topic, with the aim to introduce a broad audience (scientist and clinician alike) to recent successes in translational stroke research and pending scientific queries that are tractable for preclinical assessment. Opportunities for co-operation between clinical and experimental stroke experts are highlighted to increase the size and frequency of strides the field makes to improve our understanding of this disease and ways of treating it.

Authors: Walther, J; Kirsch, EM; Hellwig, L; Schmerbeck, SS; Holloway, PM

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Translational Stroke Research
• Volume: 14
• Issue: 5
• Pages: 643-666
• Publication date: 2022-10-11
• DOI: 10.1007/s12975-022-01090-9
• EISSN: 1868-601X
• ISSN: 1868-4483
• Language: English
• Keywords: Stroke (engine); Medicine; Neuroprotection; Penumbra; Cardiology; Ischemia; Neurology; Internal medicine; Neuroscience; Biology