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The ischemic penumbra in stroke

William Pulsinelli
From: Science & Medicine: Volume 2 Number 1: Page 16 (February 1995)

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Abstract: Early lysis of occlusive clots to restore blood flow and equally prompt reversal of metabolic deterioration will maximize the attenuation of cerebral infarct volume after a stroke. This is so because, surrounding the severely ischemic core, there is a region of reduced perfusion and unstable electrophysiologic activity where cells remain viable for several hours after onset of focal ischemia. At the molecular level the pathogenesis of irreversible cell injury in the penumbral zone is neither simple nor fully understood. Disordered calcium homeostasis and depletion of high-energy phosphate stores are salient features, and increased free radical production may be an important factor.

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