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Stroke research has traditionally focused on the cerebral processes following ischemic brain injury, where oxygen and glucose deprivation incite prolonged activation of excitatory neurotransmitter receptors, intracellular calcium accumulation, inflammation, reactive oxygen species proliferation, and ultimately neuronal death. A recent growing body of evidence, however, points to far-reaching pathophysiological consequences of acute ischemic stroke. Shortly after stroke onset, peripheral immunodepression in conjunction with hyperstimulation of autonomic and neuroendocrine pathways and motor pathway impairment result in dysfunction of the respiratory, urinary, cardiovascular, gastrointestinal, musculoskeletal, and endocrine systems. These end organ abnormalities play a major role in the morbidity and mortality of acute ischemic stroke. Using a pathophysiology-based approach, this current review discusses the pathophysiological mechanisms following ischemic brain insult that result in end organ dysfunction. By characterizing stroke as a systemic disease, future research must consider bidirectional interactions between the brain and peripheral organs to inform treatment paradigms and develop effective, comprehensive therapeutics for acute ischemic stroke.
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참고문헌 (115)
참고문헌 신청
Benjamin EJ / 2019 / Heart disease and stroke statistics—2019update : a report from the American Heart Association / Circulation 139:e56~e528
GBD 2016 Stroke Collaborators / 2019 / Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 / Lancet Neurol 18:439~458
Pierot L / 2018 / Standards of practice in acute ischemic stroke intervention : international recommendations / J Neurointerv Surg 10:1121~1126
Powers WJ / 2018 / 2018 Guidelines for the early management of patients with acute ischemic stroke : a guideline for healthcare professionals from the American Heart Association/American Stroke Association / Stroke 49:e46~e110
Platz T / 2019 / Evidence-based guidelines and clinical pathways in stroke rehabilitation : an international perspective / Front Neurol 10:200
GBD 2016 Stroke Collaborators / 2019 / Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 / Lancet Neurol 18:439~458
Pierot L / 2018 / Standards of practice in acute ischemic stroke intervention : international recommendations / J Neurointerv Surg 10:1121~1126
Powers WJ / 2018 / 2018 Guidelines for the early management of patients with acute ischemic stroke : a guideline for healthcare professionals from the American Heart Association/American Stroke Association / Stroke 49:e46~e110
Platz T / 2019 / Evidence-based guidelines and clinical pathways in stroke rehabilitation : an international perspective / Front Neurol 10:200
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